Letermovir Prophylaxis Duration Guided by CMV-Specific T-cell Monitoring After Allo-HSCT.
A Multicenter, Randomized, Controlled, Open-label Clinical Study to Evaluate the Efficacy and Safety of Letermovir Prophylaxis Duration Guided by Dynamic Monitoring of Specific T-cells for Preventing Cytomegalovirus Infection in Adult Recipients of Allogeneic Hematopoietic Stem Cell Transplantation in China.
The purpose of this study is to evaluate the efficacy and safety of a personalized strategy for discontinuing Letermovir (a drug used to prevent Cytomegalovirus [CMV] infection) based on the recovery of the patient's own immune system.
Cytomegalovirus (CMV) is a common and serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Currently, Letermovir is typically given as a standard prevention for about 100 days post-transplant. However, some patients may recover their CMV-specific immunity earlier, while others may need longer protection.
In this study, researchers will use a dynamic monitoring technology (QuantiFERON-CMV) to detect the level of CMV-specific T-cells in patients. Participants will be randomly assigned to either the experimental group or the control group:
Experimental Group: Letermovir discontinuation will be guided by T-cell recovery. If the test shows that the patient's CMV-specific T-cells have recovered, Letermovir may be stopped earlier than the standard 100 days.
Control Group: Patients will receive the standard Letermovir prophylaxis for approximately 100 days, regardless of T-cell status.
The study aims to determine if this immune-guided strategy can effectively prevent CMV infection while potentially reducing the duration of medication and associated costs, without increasing the risk of CMV disease.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: wei MD, PhD
- Phone Number: +86 027-85726003
- Email: shiwei076@hust.edu.cn
Study Locations
-
-
Beijing Municipality
-
Beijing, Beijing Municipality, China, 100853
- Not yet recruiting
- Chinese PLA General Hospital
-
Contact:
- Fei Li
- Phone Number: +86 18611406860
- Email: 847982123@qq.com
-
-
Hebei
-
Shijiazhuang, Hebei, China, 050000
- Not yet recruiting
- The Second Hospital of Hebei Medical University
-
Contact:
- Fuxu Wang
- Phone Number: +86 13931100360
- Email: 827064030@qq.com
-
-
Henan
-
Zhengzhou, Henan, China, 450008
- Not yet recruiting
- Henan Cancer Hospital
-
Contact:
- Jian Zhou
- Phone Number: +86 13623822347
- Email: zhoujiandoctor@163.com
-
Zhengzhou, Henan, China, 450052
- Not yet recruiting
- The First Affiliated Hospital of Zhengzhou University
-
Contact:
- Weijie Cao
- Phone Number: +86 15093360671
- Email: caoweijie2003@126.com
-
-
Hubei
-
Jingzhou, Hubei, China, 434020
- Not yet recruiting
- Jingzhou Central Hospital
-
Contact:
- Yuanyan Tang
- Phone Number: +86 18107168243
- Email: 343665915@qq.com
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Jingzhou, Hubei, China, 434000
- Not yet recruiting
- Jingzhou First People's Hospital
-
Contact:
- Jie Tan
- Phone Number: +86 18163137226
- Email: Tanjie@yangtzeu.edu.cn
-
Wuhan, Hubei, China, 430071
- Not yet recruiting
- Zhongnan Hospital of Wuhan University
-
Contact:
- Fei Chen
- Phone Number: +86 13545297071
- Email: chenfeiwhu@whu.edu.cn
-
Wuhan, Hubei, China, 430030
- Not yet recruiting
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
-
Contact:
- Yang Cao
- Phone Number: +86 13986142606
- Email: caoyangemma@163.com
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Wuhan, Hubei, China, 430022
- Recruiting
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
-
Contact:
- Wei Shi, M.D.
- Phone Number: +86 027-85726003
- Email: shiwei076@hust.edu.cn
-
-
Inner Mongolia
-
Hohhot, Inner Mongolia, China, 010050
- Not yet recruiting
- The Affiliated Hospital of Inner Mongolia Medical University
-
Contact:
- Da Gao
- Phone Number: +86 13947130473
- Email: gaoda72@163.com
-
-
Jiangxi
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Nanchang, Jiangxi, China, 330006
- Not yet recruiting
- The First Affiliated Hospital of Nanchang University
-
Contact:
- Xianbao Huang
- Phone Number: +86 18679119505
- Email: huangxianbao2017@163.com
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-
Zhejiang
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Wenzhou, Zhejiang, China, 325000
- Not yet recruiting
- The first Affiliated hospital of Wenzhou medical University
-
Contact:
- Lan Sun Sun
- Phone Number: +86 13587685726
- Email: sunlan91@126.com
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- CMV serostatus of the recipient is positive (R+).
- Aged 18 years or older.
- Expected survival > 6 months.
- Provision of signed informed consent.
Exclusion Criteria:
1.Active CMV infection or CMV disease at the time of screening.
2.Known hypersensitivity to Letermovir or its excipients.
3.Severe hepatic or renal impairment.
4.Pregnant or breastfeeding women.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Experimental (T-cell Guided Group)
|
Patients receive Letermovir prophylaxis (480 mg/day orally or IV) according to the standard protocol until approximately 100 days post-transplantation, regardless of T-cell recovery status.
|
|
Active Comparator: Active Comparator (Standard Prophylaxis Group)
|
Patients receive Letermovir prophylaxis (480 mg/day orally or IV) according to the standard protocol until approximately 100 days post-transplantation, regardless of T-cell recovery status.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Clinically Significant CMV Infection (CS-CMVi)
Time Frame: Through 200 days post-transplantation
|
The percentage of participants who develop clinically significant CMV infection, defined as CMV DNAemia requiring preemptive antiviral therapy (PET) according to institutional guidelines (e.g., two consecutive positive results or a single viral load ≥ 500 copies/mL) or the occurrence of CMV disease (e.g., CMV pneumonia, enteritis, or retinitis).
|
Through 200 days post-transplantation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Duration of Letermovir Prophylaxis
Time Frame: Through 200 days post-transplantation
|
The total number of days each participant received Letermovir prophylaxis from the start of treatment (between Day 0 and Day 28 post-HSCT) until the end of the intervention (up to 200 days).
This measure will compare the median duration of medication between the experimental arm (T-cell guided) and the control arm (standard 200-day prophylaxis) to evaluate the reduction in drug exposure.
|
Through 200 days post-transplantation
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- [2025]num(0974)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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