QUILT-3.018: Neukoplast™ (NK-92) for the Treatment of Refractory or Relapsed Acute Myeloid Leukemia

NK cells from patients with malignant diseases are often functionally impaired. Their function cannot be fully restored through ex vivo expansion and cytokine activation. In addition, the in vivo administration of cytokines not only expands NK cells but expands polyclonal T cells with no tumor specificity and no known effects.

The utilization of Neukoplast™, as a form of adoptive immunotherapy, offers several advantages. Neukoplast™ represents a uniform cell population with a well-characterized immunophenotype, confirmed strong anti-tumor activity and are easy to grow and expand in culture, so that they can be made available in large numbers for therapeutic delivery.


Eligibility Criteria:
Inclusion Criteria:

* Patients with refractory/relapse acute myeloid leukemia. Patients must not have received radiotherapy, chemotherapy (with the exception of hydroxyurea which must be discontinued 72 hours prior to therapy) or biological therapy within the preceding 2 weeks of the planned first Neukoplast™ cell infusion and must have recovered from any adverse events due to prior administered agents
* Assessable disease as measured by laboratory and bone marrow examinations
* Age: Eighteen years or older
* Performance status: ECOG ≤ 2 (Appendix A)
* Serum creatinine \< 2 X upper limit of normal
* Aspartate aminotransferase (AST) \< 5 X upper limit of normal
* Alanine aminotransferase (ALT) \< 5 X upper limit of normal
* Total bilirubin \< 3X upper limit of normal
* Activated partial thromboplastin time (PTT) \< 2.5 X upper limit of normal
* Patients must have left ventricular ejection fraction (LVEF) ≥45 %
* Females of child-bearing potential must have a negative pregnancy test and all subjects must agree to use an effective method of contraception for up to two weeks after the last infusion of Neukoplast™
* Ability to give informed consent
* Life expectancy of greater than 3 months

Note: as many of eligible patients will be pancytopenic secondary to their disease or prior therapies hematologic abnormalities will not be used as a criteria for entry or exclusion.

Exclusion Criteria:

* Patients with acute promyelocytic leukemia
* Symptomatic central nervous system (CNS) involvement
* History of congestive heart failure
* Evidence of severe or uncontrolled systemic diseases (e.g., unstable or uncompensated respiratory, hepatic, renal, or cardiac disease).
* Uncontrolled, life-threatening infection that is not responding to antimicrobial therapy
* ECOG performance status \>2 (Appendix A)
* Hepatitis B or C or HIV positive serology
* History of psychiatric disorder which may compromise compliance with the protocol or which does not allow for appropriate informed consent
* Patient may not be receiving any other investigational agents
* Patient is receiving systemic anticoagulation (e.g., warfarin, intravenous heparin. Low dose prophylactic anticoagulation is allowed )
* Patient undergone autologous or allogeneic stem cell transplantation
* Concurrent malignancy of solid tumors. Exception: Subjects who have been disease-free for 5 years, or subjects with a history of completely resected non-melanoma skin cancer or successfully treated in situ carcinoma are eligible. Subjects with second malignancies that are indolent or definitively treated may be enrolled.
* Pregnant or lactating female.