Recruiting
Phase 1
Phase 2

Transplantation

Sponsor:

Paul Szabolcs

Code:

NCT03500731

Conditions

Idiopathic Pulmonary Fibrosis

Emphysema or COPD

Eligibility Criteria

Sex: All

Age: 18 - 60

Healthy Volunteers: Not accepted

Interventions

CD3/CD19 negative hematopoietic stem cells

Rituximab

Alemtuzumab

Fludarabine

Thiotepa

Study Details

Brief summary:

The purpose of this study is to determine whether a lung transplantation prior to bone marrow transplantation (BMT) would allow for restoration of pulmonary function prior to BMT, allowing to proceed to BMT, to restore hematologic function.

Conditions

Idiopathic Pulmonary Fibrosis

Emphysema or COPD

Study ID

NCT03500731

Start date

Apr 19, 2018

Status verified date

Jan, 2026

Completion date

Dec, 2028

Anticipated

Primary completion date

Dec, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 60

Healthy Volunteers: Not accepted

Inclusion Criteria:

Individuals must meet all of the following criteria in order to be eligible for this study.

1. Subject must be able to understand and provide informed consent.
2. Male or female, 18 through 60 years old, inclusive, at the time of informed consent.
3. Meet criteria for UNOS listing for lung transplantation.
4. Patients must have evidence of end stage lung disease. Examples of such diseases include but are not limited to:

  • Pulmonary Fibrosis
  • COPD/Emphysema
5. Patients must have evidence of bone marrow failure with abnormal low cell count in at least one hematopoietic line, making the patient a poor candidate for long-term immunosuppressive therapy. Eligible patients must meet at least one of the following criteria:

  • Unexplained, non-drug induced neutropenia with absolute neutrophils counts of <1500/µL the previous year, confirmed by repeat testing
  • Unexplained, non-drug induced thrombocytopenia with mean platelets counts of <100,000/µL the previous year, confirmed by repeat testing
  • Unexplained, non-hemolytic anemia, with a hemoglobin level of < 12 g/dL the previous year, confirmed by repeat testing
6. GFR ≥45 mL/min/1.73 m2.
7. AST, ALT ≤4x upper limit of normal, total bilirubin ≤ 2.5 mg/dL, normal INR, albumin >3.0 g/dL
8. Cardiac ejection fraction ≥ 40% or shortening fraction ≥26%.
9. Negative pregnancy test for females, unless surgically sterilized.
10. All females of childbearing potential and sexually active males must agree to use a FDA approved method of birth control for up to 24 months after BMT or for as long as they are taking any medication that may harm a pregnancy, an unborn child or may cause birth defect.
11. Subject will also be counseled regarding the potential risks of infertility following BMT and advised to discuss sperm banking or oocyte harvesting.

Exclusion Criteria:

Individuals who meet any of these criteria are not eligible for this study.

1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol.
2. Patients who have underlying malignant conditions.
3. Patients who have non-malignant conditions not requiring BMT.
4. HIV positive by serology or PCR, HTLV positive by serology. If HTLV serology is positive, it will be confirmed by nucleic acid testing (NAT). If HTLV NAT is negative, subject will remain eligible regardless of HTLV serology result.
5. Females who are pregnant or who are lactating.
6. Allergy to DMSO or any other ingredient used in the manufacturing of the stem cell product.
7. Uncontrolled pulmonary infection, as determined by radiographic findings and/or significant clinical deterioration. NOTE: Pulmonary colonization with multiple organisms is common and will not be considered an exclusion criterion.
8. Uncontrolled infection, as determined by the appropriate imaging and/or confirmatory testing e.g. blood cultures, PCR testing, etc.
9. Recent recipient of any licensed or investigational live attenuated vaccine(s) within 4 weeks of transplant.
10. Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.

Study Design

Enrollment

8 participants

Anticipated

Intervention Model

Single group

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Lung and Bone Marrow Transplantation

All patients will undergo a cadaveric, partially HLA-matched lung transplantation followed by a CD3+/CD19+ depleted BMT from the same donor. In this study, the investigators will use a ≥1/6 HLA-matched T cell depleted bone marrow transplantation from a cadaveric organ donor with an identical ABO blood type as the recipient. Prior to transplantation, the marrow will be negatively selected for CD3/CD19 using a CliniMACS® depletion device.

Subjects will undergo lung transplantation utilizing standard induction regimens selected by the CO-PIs based on the subject's underlying comorbidities and allosensitization. Rituximab may be initiated prior to the lung transplantation with tacrolimus as the ongoing maintenance immunosuppression.

Subjects will undergo BMT utilizing CD3+/CD19+-depleted bone marrow with bone marrow conditioning beginning no less than 8 weeks after lung transplantation. Bone marrow will be recovered alongside solid organs and will be processed and cryopreserved.

Interventions

CD3/CD19 negative hematopoietic stem cells

Negative selection for CD3/CD19 will be performed on CliniMACS® depletion device and given at time no less than 8 weeks post lung transplantation

Rituximab

Transplantation Conditioning

Alemtuzumab

Transplantation Conditioning

Fludarabine

Transplantation Conditioning

Thiotepa

Transplantation Conditioning

G-CSF

Transplantation conditioning

Hydroxyurea

Transplantation Conditioning

Primary outcome measure

  • Death [ Time Frame: Up to 2 years post stem cell transplant ]
  • Engraftment failure [ Time Frame: Up to 2 years post stem cell transplant ]
  • Non-hematologic events [ Time Frame: Up to 2 years post stem cell transplant ]
  • Hematological events [ Time Frame: after 30 days post stem cell transplant ]
  • BOS Score [ Time Frame: at 1 year post lung transplant ]
  • T-cell Chimerism [ Time Frame: at 12 months post stem cell transplant ]
  • Myeloid chimerism [ Time Frame: at 12 months post stem cell transplant ]
  • Restoration of blood cell count (in absence of growth factors) [ Time Frame: at 12 months post stem cell transplant ]

Central Contacts and Locations

Central contacts

Locations

UPMC Presbyterian

Recruiting

Pittsburgh, Pennsylvania, United States, 15214

Contacts

Children's Hospital of Pittsburgh of UPMC

Recruiting

Pittsburgh, Pennsylvania, United States, 15224

Contacts

Principal Investigator:

Paul Szabolcs, MD

More Information

Sponsor

Paul Szabolcs

Last update posted

Jan 13, 2026

Last verified

Jan, 2026

Keywords

  • Lung Transplantation
  • Stem Cell Transplantation
  • Idiopathic Pulmonary Fibrosis
  • Emphysema or COPD
  • Bone marrow transplantation
  • Cadaveric donor
  • Unrelated donor
  • HLA-Mismatch
  • BMT
  • HSCT
  • IPF
  • Pulmonary fibrosis

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Paul Szabolcs on 2026-01-13.