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Relapsed Pediatric ALLPhase 1NCT07257419

CD45RA-depleted CD19-CAR T Cell Consolidation After TCRαβ+/CD19 B Cell-depleted Haploidentical Hematopoietic Cell Transplantation for Relapsed/Refractory CD19+ ALL and Lymphoma

A Phase 1 study testing Anti-Thymocyte Globulin (Rabbit), Cyclophosphamide and Fludarabine in people with Relapsed Pediatric ALL and Hematopoietic Cell Transplantation, run by St. Jude Children's Research Hospital at 1 site in United States.

Recruiting

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

Sites and contacts
Official record
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Trial summary

The purpose of this study is to learn more about newer methods of transplanting blood cells donated by a partially matched family member to children with high-risk CD19 positive leukemia ALL. Read more about this study

Who is it for?
Ages Up to 21 years
What is being tested?
Anti-Thymocyte Globulin (Rabbit), Cyclophosphamide and Fludarabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
1 siteUnited States
Study dates
3 Oct 2026to Dec 2035
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 21 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Recipient
  • Age less than or equal to 21 years
  • High risk hematologic malignancy where allogeneic transplantation is the current standard of care. This includes (but is not limited to):
  • High risk CD19+ B cell ALL in CR1 or CR2
  • Any CD19+ B-cell ALL in CR3 or subsequent
  • If prior CNS leukemia, it must be treated and in CNS CR
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  • Left ventricular ejection fraction > 40%, or shortening fraction ≥ 25%
  • Creatinine clearance (CrCl) or glomerular filtration rate (GFR) ≥ 50 ml/min/1.73m2
  • Forced vital capacity (FVC) ≥ 50% of predicted value; or pulse oximetry ≥ 92% on room air if patient is unable to perform pulmonary function testing
  • Karnofsky or Lansky (age dependent) performance score ≥ 50 (See APPENDIX A)
  • Bilirubin ≤ 3 times the upper limit of normal for age
  • Alanine aminotransferase (ALT) or Aspartate aminotransferase (AST) ≤ 5 times the upper limit of normal for age
  • Donor
  • At least single haplotype matched (≥ 4 of 8) family member
  • At least 18 years of age
  • HIV negative
  • If sexually active, agreement to use birth control until 2 weeks after completion of the mobilization and apheresis procedure
  • Regarding donation eligibility, is identified as either:
  • Completed the process of donor eligibility determination as outlined in 21 CFR 1271 and agency guidance; OR
  • Does not meet 21 CFR 1271 eligibility requirements, but has a declaration of urgent medical need completed by the principal investigator or physician sub-investigator per 21 CFR 1271

Who cannot join

  • Recipient
  • Has a suitable HLA-identical sibling or suitable 12/12 (HLA-A, B, C, DRB1, DQB1, and DPB1) HLA-matched unrelated donor available in an appropriate time frame
  • Any other active malignancy other than the one for which this HCT is indicated
  • Received a prior allogeneic HCT at any time
  • Pregnant, if female is of childbearing potential, negative test must be confirmed by serum or urine pregnancy test within 14 days prior to enrollment
  • If sexually active, agreement to use birth control until 6 months after T cell infusion
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  • Breast feeding
  • Any severe current uncontrolled bacterial, fungal or viral infection
  • Donor
  • Pregnant, negative test must be confirmed by serum or urine pregnancy test within 14 days prior to enrollment if female
  • If female, breast feeding

Trial locations and contacts

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

Swati Naik, MBBS contact

888-226-4343

referralinfo@stjude.org

United States1 site, 1 recruiting
  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

    Swati Naik, MBBS, 888-226-4343, referralinfo@stjude.org

    Swati Naik, MBBS

    Recruiting

Other trials in United States

About this study

The purpose of this study is to learn more about newer methods of transplanting blood cells donated by a partially matched family member to children with high-risk CD19 positive leukemia ALL.

Primary Objective:

  • To assess the safety and feasibility of combining CD19-CAR(Mem) T cells after TCRαβ+/CD19 depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies.

Secondary Objectives:

  • To estimate 1-year post-transplant overall survival, event-free survival, and GVHD-free relapse-free survival (GRFS).
  • To estimate cumulative incidence of engraftment, acute and chronic GVHD, and immune-related adverse events, including CRS and ICANS.
Read the detailed description

This is a Phase I study evaluating the addback of CD19-CAR(Mem) T cells after TCRαβ+/CD19 B cell depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies.

Donors that meet eligibility criteria will be consented to undergo two separate collections: 1) G-CSF mobilized stem cell graft via apheresis for progenitor cell infusion and 2) Non-mobilized peripheral blood mononuclear cells (PBMC) via apheresis for subsequent CAR T-cell manufacturing and DLI if needed.

Patients that meet eligibility criteria to receive therapy will be consented to proceed on study. Treatment will include a conditioning chemotherapy preparative regimen followed by infusion of TCRαβ/CD19 B cell depleted progenitor cell infusion on day 0. Then as early as day + 14 patients will receive the previously manufactured CD19-CAR(Mem) T cell product. Patients will then be monitored for safety and efficacy of the infused CAR T-cell product, as well as collection of correlative samples.

Being tested
Anti-Thymocyte Globulin (Rabbit), Cyclophosphamide, Fludarabine, Thiotepa, Mesna
Keywords
Relapsed/Refractory ALL
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Hematologic Neoplasms, Recurrence

What participants receive

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

  • Anti-Thymocyte Globulin (Rabbit)Drug

    Days -10, -11, -12.

  • CyclophosphamideDrug

    60 mg/kg intravenous once daily on day -9.

  • FludarabineDrug

    30 mg/m2 intravenous once daily for >10 kg, 1 mg/kg intravenous once daily for ≤10 kg on days -4, -5, -6, -7, -8.

  • ThiotepaDrug

    5 mg/kg intravenous twice daily on day -3.

  • MesnaDrug

    Mesna is planned to be administered at 15 mg/kg/dose prior to cyclophosphamide and at approximately 3, 6, and 9 hours after the cyclophosphamide infusion, to give a 1:1 ratio of mesna:cyclophosphamide.

  • MelphalanDrug

    70 mg/m2 intravenous once daily for >10 kg, 2.3 mg/kg intravenous once daily for ≤10 kg on days -1, and -2.

  • FilgrastimDrug

    Also called G-CSF

    G-CSF* 10 mcg/kg/day SC days 0, -1, -2, -3, -4, -5.

  • CliniMACS SystemDevice

    The mechanism of action of the CliniMACS Cell Selection System is based on magnetic-activated cell sorting (MACS). The CliniMACS device is a powerful tool for the isolation of many cell types from heterogeneous cell mixtures, (e.g. apheresis products). These can then be separated in a magnetic field using an immunomagnetic label specific for the cell type of interest.

Study groups in NCT07257419
Study groupRoleWhat they receive
HAPALL TreatmentExperimentalPatients receive a conditioning regimen that will comprise of ATG, Fludarabine, Cyclophosphamide. Melphalan and Thiotepa. Following the conditioning regimen, patients receive infusion of TCRαβ+/CD19 B cell depleted progenitor cell infusion on day 0. Then as early as day + 14 patients will receive the previously manufactured CD19-CAR(Mem) T cell product. Patients will then be monitored for safety and efficacy of the infused CAR T-cell product, Cells for infusion are prepared using the CliniMACS system.
Receives: Drug: Anti-Thymocyte Globulin (Rabbit); Drug: Cyclophosphamide; Drug: Fludarabine; Drug: Thiotepa; Drug: Mesna; Drug: Melphalan; Drug: Filgrastim; Device: CliniMACS System

What is being measured

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

  1. To assess the safety of combining CD19-CAR(Mem) T cells after TCRαβ+/CD19 depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies.

    The primary analysis will compute the sample proportions and corresponding binomial exact 95% confidence intervals among evaluable patients for the following toxicities (separately for each toxicity) within 100 days post-HCT: 1) Severe aGVHD defined as Grade 3-4 aGVHD 2) Severe CRS defined as Grade 4 CRS that does not resolve to grade 3 or lower within 72 hours of onset 3) Severe ICANS defined as Grade 4 ICANS that does not resolve to grade 3 or lower within 72 hours of onset 4) TRM defined as death without prior relapse or disease progression within 100 days post-HCT 5) Other toxicity data will also be reported for a complete safety assessment of the study regimen.

    Measured: This will be assessed 100 days post-HCT

  2. To assess the feasibility of combining CD19-CAR(Mem) T cells after TCRαβ+/CD19 depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies.

    this will be measured by the failure to receive CD19-CAR(Mem) T cells among patients who received HCT. The number of patients who fail to receive addback will be reported as the proportion who were unable to receive addback within 60 days post-HCT

    Measured: This will be assessed in the first 60 days post-HCT

Secondary outcomes (6)
  1. To assess the feasibility of combining CD19-CAR(Mem) T cells after TCRαβ+/CD19 depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies.

    This will be measured by the failure to receive CD19-CAR(Mem) T cells among patients who received HCT. The number of patients who fail to receive addback will be reported as the proportion who were unable to receive addback within 60 days post-HCT

    Measured: This will be assessed in the first 60 days post-HCT

  2. Estimate 1-year post-transplant relapse free survival

    This this will be estimated by the Kaplan-Meier method

    Measured: This will be assessed in the first 3 years post-HCT

  3. Estimate cumulative incidence of neutrophil engraftment

    This will be summarized by cumulative incidence functions estimated by the Kalbfleisch-Prentice method.

    Measured: This will be assessed in the first 30 days post-HCT

  4. Estimate cumulative incidence of platelet engraftment

    This will be summarized by cumulative incidence functions estimated by the Kalbfleisch-Prentice method.

    Measured: This will be assessed in the first 100 days post-HCT

  5. Estimate cumulative incidence of acute and chronic GVHD

    This will be summarized by cumulative incidence functions estimated by the Kalbfleisch-Prentice method.

    Measured: This will be assessed in the first 3 years post-HCT

  6. Estimate cumulative incidence of immune-related adverse events

    This will be summarized by cumulative incidence functions estimated by the Kalbfleisch-Prentice method.

    Measured: This will be assessed in the first 1 years post-HCT

Timeline

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

  1. First posted2 Dec 2025
  2. Study start3 Oct 2026 (estimated)
  3. Primary completionDec 2031 (estimated)
  4. Study completionDec 2035 (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
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07257419
Sponsor's protocol ID
HAPALL
Other IDs
NCI-2025-08364
Status last verified
Aug 2026
First submitted
20 Nov 2025
Last updated
28 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Anti-Thymocyte Globulin (Rabbit), Cyclophosphamide and Fludarabine in people with Relapsed Pediatric ALL and Hematopoietic Cell Transplantation, run by St. Jude Children's Research Hospital at 1 site in United States.

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 20 inclusion and 11 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 28 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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 Swati Naik, MBBS (888-226-4343, referralinfo@stjude.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

To assess the safety of combining CD19-CAR(Mem) T cells after TCRαβ+/CD19 depleted haploidentical donor transplantation for pediatric patients with relapsed/refractory CD19+ B-cell malignancies. (time frame: This will be assessed 100 days post-HCT). 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?
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 28 Aug 2026.

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