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Acute Lymphoblastic LeukemiaPhase 1NCT02443831

CARPALL: Immunotherapy With CD19+CD22 CAR T-cells for CD19+ and CD22+ Acute Lymphoblastic Leukaemia

A Phase 1 study testing Leukapheresis, Total Body Irradiation (TBI) and Lymphodepletion with Fludarabine in people with Acute Lymphoblastic Leukemia, run by University College, London at 3 sites in United Kingdom.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This study aims to evaluate the safety, efficacy and duration of response of CD19+CD22 Chimeric Antigen Receptor (CAR) redirected autologous T-cells in children with high risk, relapsed CD19+ and CD22+ acute lymphoblastic leukaemia Read more about this study

Who is it for?
Ages Up to 24 years
Conditions the study is for
Acute Lymphoblastic Leukemia
What is being tested?
Leukapheresis, Total Body Irradiation (TBI) and Lymphodepletion with Fludarabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
3 sitesUnited Kingdom
Study dates
Apr 2016to 31 Dec 2041
Phase
Phase 1
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 24 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Children and young adults (age 24 years or younger) with high risk/relapsed CD19+ and CD22+ acute lymphoblastic leukaemia with:
  • Resistant disease (>5% blasts) at end of ALLTogether-1 protocol or equivalent induction
  • ALL with persisting high level MRD at 2nd time point of frontline national protocol (currently MRD >10-4 at week 9 ALLTogether-1 Protocol or equivalent).
  • High risk infant ALL (age < 6 months at diagnosis with MLL gene rearrangement and either presenting white cell count > 300 x 10^9/L or poor steroid early response (i.e. circulating blast count >1x10^9/L following 7 day steroid pre-phase of induction as per national guidelines or equivalent)
  • Any patient with t(17,19) TCF3-HLF rearrangement
  • High risk 1st relapse (defined as very early (relapse within 18 months of diagnosis) and early relapses (any patient relapsing on therapy or within 6 months of completing treatment) and any relapse with high risk genetics, namely (KMT2A (MLL) rearrangements, low hypodiploidy/near haploidy, t(17;19)(q22;p13)/TCF3-HLF, iAMP21 and t(1;19)(q21;p13)/TCF3- PBX1, t(9;22)(34.1 q11.2)/BCR-ABL1
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  • Any on therapy relapse in patients age 16-24
  • Any relapse of infant ALL
  • ALL post ≥ 2nd relapse
  • Any refractory relapse of ALL (defined as > 1% blasts by flow cytometry after a at least 1 cycle of standard chemotherapy)
  • ALL with MRD >10-4 prior to planned stem cell transplant
  • Any relapse of ALL eligible for stem cell transplant but no available HLA matched donor or other contraindication to transplant
  • Any relapse of ALL after stem cell transplant as long as planned time of CD19+CD22CAR T cell infusion is > 4 months post-transplant
  • Early (defined as < 6 months post-infusion) loss of B cell aplasia or any CD19+CD22+ relapse following CD19CAR T cell therapy with Tisagenlecleucel
  • Note patients with isolated CNS relapse meeting one or more of the criteria above are eligible for the study
  • Agreement to have a pregnancy test, use adequate contraception (if applicable)
  • Written informed consent

Who cannot join

  • Active Hepatitis B, C or HIV infection
  • Oxygen saturation ≤ 90% on air
  • Bilirubin > 3 x upper limit of normal
  • Creatinine > 3 x upper limit of normal
  • Women who are pregnant or breastfeeding
  • Stem Cell Transplant patients only: active significant (overall Grade ≥ II, Seattle criteria) acute GVHD or moderate/ severe chronic GVHD (NIH consensus criteria) requiring systemic steroids.
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  • Inability to tolerate leucapheresis
  • Karnofsky (age ≥ 10 years) or Lansky (age < 10) score ≤ 50%
  • Pre-existing significant neurological disorder (other than CNS involvement of underlying haematological malignancy)
  • CD19 negative or CD22 negative disease
  • Severe intercurrent infection at the time of scheduled CD19+CD22 CAR T-cell infusion
  • Requirement for supplementary oxygen or active pulmonary infiltrates at the time of scheduled CD19+CD22 CAR T-cell infusion
  • Allogeneic transplant recipients with active significant acute GVHD overall grade ≥II or moderate/severe chronic GVHD requiring systemic steroids at the time of scheduled CD19+CD22 CAR T-cell infusion. Note: Such patients will be excluded until the patient is GVHD free and off steroids

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United Kingdom3 sites, 3 recruiting
  • Great Ormond Street Hospital

    London

    Prof. Persis Amrolia

    Recruiting
  • University College Hospital

    London

    Dr Rachael Hough

    Recruiting
  • Manchester Royal Children's Hospital

    Manchester

    Dr Denise Bonney

    Recruiting

Other trials in United Kingdom

About this study

Official title: Immunotherapy With CD19+CD22 CAR Redirected T-cells for High Risk/Relapsed Paediatric CD19+ and CD22+ Acute Lymphoblastic Leukaemia

This study aims to evaluate the safety, efficacy and duration of response of CD19+CD22 Chimeric Antigen Receptor (CAR) redirected autologous T-cells in children with high risk, relapsed CD19+ and CD22+ acute lymphoblastic leukaemia

Read the detailed description

This is a multi-centre, non-randomised, open label Phase I clinical trial of an Advanced Therapy Investigational Medicinal Product named CD19+CD22 Chimeric Antigen Receptor (CAR) T-cells (CD19+CD22 CAR T-cells) in children and young adults (age <24 years) with high risk, relapsed CD19+ and CD22+ acute lymphoblastic leukaemia. Following informed consent and registration to the trial, patients will undergo an unstimulated leukapheresis for the generation of the CD19+CD22 CAR T-cells. Patients will receive the CD19+CD22CAR T-cells following lymphodepleting chemotherapy and total body irradiation. The study will evaluate the safety, efficacy and duration of response of the CD19+CD22 CAR T-cells in children with high risk relapsed CD19+ and CD22+ acute lymphoblastic leukaemia.

Being tested
Leukapheresis, Total Body Irradiation (TBI), Lymphodepletion with Fludarabine, Lymphodepletion with Cyclophosphamide, CD19+CD22 CAR T-cells
Keywords
high risk relapsed CD19+ and CD22+ acute lymphoblastic leukaemia
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • LeukapheresisProcedure or surgery

    Patients will undergo an unstimulated leukapheresis to isolate the required immune cells to produce the CD19+CD22 CAR T-cells

  • Total Body Irradiation (TBI)Radiation

    Participants will receive low-dose total body irradiation delivered as a single fraction on day -7 prior to CD19+CD22CAR T-cell infusion.

  • Lymphodepletion with FludarabineDrug

    Patients will receive lymphodepleting chemotherapy with iv fludarabine on days -6 to -3 prior to CD19+CD22CAR T-cell infusion.

  • Lymphodepletion with CyclophosphamideDrug

    Patients will receive lymphodepleting chemotherapy with iv cyclophosphamide on days -6 to -5 prior to CD19+CD22CAR T-cell infusion.

  • CD19+CD22 CAR T-cellsBiological

    1 dose of CD19+CD22 CAR T-cells given as an intravenous injection through a Hickman line or PICC line (peripherally inserted central catheter) on day 0.

Study groups in NCT02443831
Study groupRoleWhat they receive
CD19+CD22 CAR T-cellsExperimentalPatients meeting the eligibility criteria will have leukapheresis to isolate the blood immune cells used to manufacture the CD19+CD22CAR T-cells. Patients will receive lymphodepletion with low dose total body irradiation, fludarabine and cyclophosphamide prior to infusion of the CD19+CD22CAR T-cells.
Receives: Procedure: Leukapheresis; Radiation: Total Body Irradiation (TBI); Drug: Lymphodepletion with Fludarabine; Drug: Lymphodepletion with Cyclophosphamide; Biological: CD19+CD22 CAR T-cells

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Incidence of unacceptable toxicity following CD19+CD22 CAR T-cell infusion

    The incidence of unacceptable toxicity occurring within 28 days of CD19+CD22CAR T-cell infusion.

    Measured: 28 days

  2. Molecular remission

    Efficacy will be assessed by determining Minimal Residual Disease in the bone marrow aspirate using immunoglobulin heavy chain (IgH) quantitative polymerase chain reaction (qPCR) and/or Next Generation Sequencing in all patients. The proportion of patients achieving molecular remission at 28 days post CD19+CD22CAR T-cell infusion will be determined.

    Measured: 28 days

Secondary outcomes (10)
  1. Feasibility of Generation of CD19+CD22 CAR T-cells

    Evaluated by the number of therapeutic products generated.

    Measured: Day 28

  2. Molecular Remission

    Efficacy will be assessed by determining Minimal Residual Disease in the bone marrow aspirate using immunoglobulin heavy chain (IgH) quantitative polymerase chain reaction (qPCR) and/or Next Generation Sequencing in all patients. The proportion of patients achieving molecular remission at 3 months post CD19+CD22CAR T-cell infusion will be determined.

    Measured: 3 months

  3. Long-Term Molecular Remission

    Number of patients in molecular remission without further therapy at 1 and 2 years

    Measured: 2 years

  4. Duration of Response

    Duration of response is measured from the time of achieving molecular remission or flow MRD negativity until the disease relapse or death, whichever occurs first.

    Measured: 15 years

  5. Safety and Tolerability of the CAR T-cells

    Incidence of adverse events and reactions (toxicity) to the CAR T-cells.

    Measured: 15 years

  6. Incidence of B Aplasia

    Incidence of B aplasia

    Measured: 2 years

  7. Incidence of Hypogammaglobulinaemia

    Incidence of hypogammaglobulinaemia

    Measured: 2 years

  8. Frequency of Circulating CD19+CD22 CAR T-cells

    Persistence and frequency of circulating CD19+CD22CAR T-cells in the peripheral blood by flow cytometry and qPCR analyses.

    Measured: 2 years

  9. Relapse rate

    Relapse rate

    Measured: 2 years

  10. Overall Survival (OS)

    Overall Survival (OS) at 1 and 2 years

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 May 2015 (estimated)
  2. Study startApr 2016
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2041 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02443831
Sponsor's protocol ID
UCL 14/0529
Status last verified
Feb 2026
First submitted
29 Apr 2015
Last updated
22 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ghorashian S, Lucchini G, Richardson R, Nguyen K, Terris C, Guvenel A, Oporto-Espuelas M, Yeung J, Pinner D, Chu J, Williams L, Ko KY, Walding C, Watts K, Inglott S, Thomas R, Connor C, Adams S, Gravett E, Gilmour K, Lal A, Kunaseelan S, Popova B, Lopes A, Ngai Y, Hackshaw A, Kokalaki E, Carulla MB, Mullanfiroze K, Lazareva A, Pavasovic V, Rao A, Bartram J, Vora A, Chiesa R, Silva J, Rao K, Bonney D, Wynn R, Pule M, Hough R, Amrolia PJ. CD19/CD22 targeting with cotransduced CAR T cells to prevent antigen-negative relapse after CAR T-cell therapy for B-cell ALL. Blood. 2024 Jan 11;143(2):118-123. doi: 10.1182/blood.2023020621.

    PubMed 37647647
  • Kokalaki E, Ma B, Ferrari M, Grothier T, Hazelton W, Manzoor S, Costu E, Taylor J, Bulek A, Srivastava S, Gannon I, Jha R, Gealy R, Stanczuk L, Rizou T, Robson M, El-Kholy M, Baldan V, Righi M, Sillibourne J, Thomas S, Onuoha S, Cordoba S, Pule M. Dual targeting of CD19 and CD22 against B-ALL using a novel high-sensitivity aCD22 CAR. Mol Ther. 2023 Jul 5;31(7):2089-2104. doi: 10.1016/j.ymthe.2023.03.020. Epub 2023 Mar 21.

    PubMed 36945773
  • Ghorashian S, Kramer AM, Onuoha S, Wright G, Bartram J, Richardson R, Albon SJ, Casanovas-Company J, Castro F, Popova B, Villanueva K, Yeung J, Vetharoy W, Guvenel A, Wawrzyniecka PA, Mekkaoui L, Cheung GW, Pinner D, Chu J, Lucchini G, Silva J, Ciocarlie O, Lazareva A, Inglott S, Gilmour KC, Ahsan G, Ferrari M, Manzoor S, Champion K, Brooks T, Lopes A, Hackshaw A, Farzaneh F, Chiesa R, Rao K, Bonney D, Samarasinghe S, Goulden N, Vora A, Veys P, Hough R, Wynn R, Pule MA, Amrolia PJ. Enhanced CAR T cell expansion and prolonged persistence in pediatric patients with ALL treated with a low-affinity CD19 CAR. Nat Med. 2019 Sep;25(9):1408-1414. doi: 10.1038/s41591-019-0549-5. Epub 2019 Sep 2.

    PubMed 31477906

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Leukapheresis, Total Body Irradiation (TBI) and Lymphodepletion with Fludarabine in people with Acute Lymphoblastic Leukemia, run by University College, London at 3 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 22 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Aniqa Tasnim (0203 108 4753, ctc.carpall@ucl.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Incidence of unacceptable toxicity following CD19+CD22 CAR T-cell infusion (time frame: 28 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02443831, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2026.

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