Decitabine for Poor Graft Function Post Allo-HSCT

Low Dose Decitabine for Poor Graft Function Post Allogenic Hematopoietic Stem Cell Transplantation

This randomized trial aims at validating the efficacy and safety of low-dose decitabine for PGF post allo-HSCT.

Study Overview

Detailed Description

Poor graft function (PGF), defined by the presence of multilineage cytopenias in the presence of 100% donor chimerism, is a serious complication of allogeneic stem cell transplant (allo-HSCT). Emerging evidence demonstrates that the inadequate stem cells infusion, bone marrow microenvironment and immune dysregulation play a crucial role in maintaining and regulating hematopoiesis. Current therapies remain debatable, including selected CD34+ cells infusion, mesenchymal stromal cells infusion, prophylactic N-acetyl cysteine administration, etc. Thereafter, the investigators conduct a randomized trial aiming at validating the efficacy and safety of low-dose decitabine in PGF post allo-HSCT patients.

Study Type

Interventional

Enrollment (Estimated)

76

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Diagnosed as PGF at day 28 post-HSCT or later. PGF was defined as two or three cytopenias, absolute neutrophil count ≤ 1.5 × 109/L, platelet count ≤ 30 × 109/L, hemoglobin ≤ 85g/L, lasting for more than 2 consecutive weeks;
  2. Full donor chimerism;
  3. Primary disease in remission;
  4. No severe GVHD and relapse;
  5. ECOG: 0-2;
  6. Expected survival longer than 1 month

Exclusion Criteria:

  1. Allergic to decitabine;
  2. Active infections;
  3. Uncontrolled GVHD;
  4. Severe organ dysfunction;
  5. Relapse of underlying malignancies;
  6. Graft failure;
  7. Received decitabine or participated in other clinical trials within one month before screening.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Arm A
Decitabine 6 mg/m2 daily subcutaneously for consecutive 3 days (day 1 to day 3)
Decitabine 6 mg/m2 daily subcutaneously for consecutive 3 days (day 1 to day 3)
Other Names:
  • Dec
5ug/kg/d when absolute neutrophil count ≤ 1.5 × 109/L
Other Names:
  • G-CSF
Eltrombopag initial dose: 25 mg orally once a day, may increase to up to 75 mg/day, when platelet count ≤ 30 × 109/L; Avatrombopag initial dose: 20 mg orally once a day, may increase to up to 60 mg/day, when platelet count ≤ 30 × 109/L.
Other Names:
  • Eltrombopag / Avatrombopag
10000 U/day when hemoglobin ≤ 85 g/L
Other Names:
  • EPO
Active Comparator: Arm B
The hematologic growth factors (granulocyte-colony stimulating factor, thrombopoietin receptor agonists, recombinant human erythropoietin)
5ug/kg/d when absolute neutrophil count ≤ 1.5 × 109/L
Other Names:
  • G-CSF
Eltrombopag initial dose: 25 mg orally once a day, may increase to up to 75 mg/day, when platelet count ≤ 30 × 109/L; Avatrombopag initial dose: 20 mg orally once a day, may increase to up to 60 mg/day, when platelet count ≤ 30 × 109/L.
Other Names:
  • Eltrombopag / Avatrombopag
10000 U/day when hemoglobin ≤ 85 g/L
Other Names:
  • EPO

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Survival
Time Frame: 1 year
The rate of overall survival
1 year
The treatment response
Time Frame: day +28
The rate of hematological response of after HSCT
day +28

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bone marrow recovery
Time Frame: day +28
Number of participants with granulopoiesis, erythropoiesis and megakaryopoiesis recovery of bone marrow after HSCT
day +28
Relapse and GVHD
Time Frame: 3-month
The rate of relapse and GVHD after HSCT
3-month
Event free survival
Time Frame: 1 year
The rate of event free survival after HSCT
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Yue Han, Professor, The First Affiliated Hospital of Soochow University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2023

Primary Completion (Estimated)

July 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

June 8, 2023

First Submitted That Met QC Criteria

June 8, 2023

First Posted (Estimated)

June 16, 2023

Study Record Updates

Last Update Posted (Estimated)

June 16, 2023

Last Update Submitted That Met QC Criteria

June 8, 2023

Last Verified

June 1, 2023

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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