CD19-CAR T Cell Therapy After Transplant for Pediatric Leukemia and Lymphoma

This study is for children and young adults (up to 21 years old) with high-risk CD19-positive B-cell leukemia (ALL) or lymphoma that has come back or is hard to treat. It's looking at a new approach after a special type of stem cell transplant from a partially matched family member. The study will give a chemotherapy regimen including Anti-Thymocyte Globulin, Cyclophosphamide, Fludarabine, and Thiotepa, followed by a transplant. Then, patients will receive CD19-CAR T cells (a type of immunotherapy where a patient's own immune cells are modified to fight cancer). The main goals are to see if this combined treatment is safe and practical within the first 100 days after transplant.

Study design
This is a Phase I study, meaning it's an early-stage study to test safety. It plans to enroll 70 participants.
What's involved
Participants will receive a conditioning chemotherapy regimen, followed by a stem cell transplant, and then an infusion of CD19-CAR T cells. They will be monitored for safety and effectiveness.
Compensation
Not stated in the trial record.
Follow-up
Safety and feasibility will be assessed within 100 days post-transplant, with some assessments within the first 60 days. Longer-term survival and other outcomes will be estimated at 1 year.

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NCT07257419

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

Recruiting
PHASE1Up to 21InterventionalTreatment
St. Jude Children's Research Hospital
~70 participants
Updated 2026-07-17 on ClinicalTrials.gov
What's tested:Anti-Thymocyte Globulin (Rabbit)CyclophosphamideFludarabineThiotepaMesnaMelphalan

At a glance

Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
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.
Measured over This will be assessed 100 days post-HCT
+1 more outcome measured
Relapsed Pediatric ALL
Hematopoietic Cell Transplantation
Hematologic Malignancy
1 sites across 1 states
Tennessee1
  • Swati Naik, MBBS · PRINCIPAL_INVESTIGATOR · St. Jude Children's Research Hospital

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Eligibility criteria

Inclusion

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
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
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

Exclusion

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
Breast feeding
Any severe current uncontrolled bacterial, fungal or viral infection
Pregnant, negative test must be confirmed by serum or urine pregnancy test within 14 days prior to enrollment if female
If female, breast feeding
  • 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.This will be assessed 100 days post-HCT

    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.

  • 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 assessed in the first 60 days post-HCT

    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