Transplantation of ex vivo expanded cord blood cells using the copper chelator tetraethylenepentamine: a phase I/II clinical trial

M De Lima, J McMannis, A Gee, K Komanduri… - Bone marrow …, 2008 - nature.com
M De Lima, J McMannis, A Gee, K Komanduri, D Couriel, BS Andersson, C Hosing, I Khouri…
Bone marrow transplantation, 2008nature.com
The copper chelator tetraethylenepentamine (TEPA; StemEx) was shown to attenuate the
differentiation of ex vivo cultured hematopoietic cells resulting in preferential expansion of
early progenitors. A phase I/II trial was performed to test the feasibility and safety of
transplantation of CD133+ cord blood (CB) hematopoietic progenitors cultured in media
containing stem cell factor, FLT-3 ligand, interleukin-6, thrombopoietin and TEPA. Ten
patients with advanced hematological malignancies were transplanted with a CB unit …
Abstract
The copper chelator tetraethylenepentamine (TEPA; StemEx) was shown to attenuate the differentiation of ex vivo cultured hematopoietic cells resulting in preferential expansion of early progenitors. A phase I/II trial was performed to test the feasibility and safety of transplantation of CD133+ cord blood (CB) hematopoietic progenitors cultured in media containing stem cell factor, FLT-3 ligand, interleukin-6, thrombopoietin and TEPA. Ten patients with advanced hematological malignancies were transplanted with a CB unit originally frozen in two fractions. The smaller fraction was cultured ex vivo for 21 days and transplanted 24 h after infusion of the larger unmanipulated fraction. All but two units contained< 2× 10 7 total nucleated cells (TNCs) per kilogram pre-expansion. All donor–recipient pairs were mismatched for one or two HLA loci. Nine patients were beyond first remission; median age and weight were 21 years and 68.5 kg. The average TNCs fold expansion was 219 (range, 2–620). Mean increase of CD34+ cell count was 6 (over the CD34+ cell content in the entire unit). Despite the low TNCs per kilogram infused (median= 1.8× 10 7/kg), nine patients engrafted. Median time to neutrophil and platelet engraftment was 30 (range, 16–46) and 48 (range, 35–105) days. There were no cases of grades 3–4 acute graft-versus-host disease (GVHD) and 100-day survival was 90%. This strategy is feasible.
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