Xiaochaihu Granules for Depression After Allogeneic Hematopoietic Stem Cell Transplantation

A Single-Center, Prospective, Randomized, Parallel-Assignment, Phase II Study Evaluating Two Dose Levels of Xiaochaihu Granules for Depression After Allogeneic Hematopoietic Stem Cell Transplantation

This is a single-center, prospective, randomized, dose-escalation Phase II clinical study. A total of 46 patients with newly diagnosed depression following allogeneic hematopoietic stem cell transplantation (allo-HSCT) will be enrolled.

Participants will be randomly assigned to receive different doses of Xiaochaihu Granules in addition to standard post-transplant care for 100 days. The primary objective is to evaluate the efficacy of Xiaochaihu Granules in improving depressive symptoms. Secondary objectives include assessment of safety and clinical outcomes such as event-free survival (EFS), graft-versus-host disease (GVHD), infections, and other transplantation-related complications.

Study Overview

• Status: Not yet recruiting
• Conditions: Hematopoietic Stem Cell Transplantation; Depressive Disorder, Secondary
• Intervention / Treatment: Drug: Xiaochaihu Granules (Low Dose); Drug: Xiaochaihu Granules (High Dose)

Detailed Description

This is a single-center, prospective, randomized, dose-escalation Phase II clinical trial designed to evaluate the efficacy and safety of Xiaochaihu Granules in patients with depression following allogeneic hematopoietic stem cell transplantation (allo-HSCT).

A total of 46 eligible patients with newly diagnosed depression after allo-HSCT will be enrolled. Participants will be randomly assigned to receive either a low-dose or high-dose regimen of Xiaochaihu Granules, administered orally twice daily for 100 days, in addition to standard post-transplant care.

The primary endpoints include changes in depression severity as assessed by validated scales (e.g., HADS and HAMD) and changes in symptom burden. Secondary endpoints include event-free survival (EFS), incidence of graft-versus-host disease (GVHD), infections, viral reactivation, engraftment outcomes, and overall safety.

• Study Type: Interventional
• Enrollment (Estimated): 46
• Phase: Phase 2

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Participants must meet all of the following criteria:

  1. Able to understand the study procedures and voluntarily provide written informed consent (or consent from a legal guardian where applicable);
  2. Age ≥14 years, male or female;
  3. Patients who have undergone allogeneic hematopoietic stem cell transplantation (allo-HSCT);
  4. Newly diagnosed depression after allo-HSCT, assessed by standardized scales (e.g., HADS and/or HAMD);
  5. Evidence of successful neutrophil engraftment prior to enrollment;
  6. Willing and able to comply with study procedures and follow-up assessments.

Exclusion Criteria:

1. Refusal to participate in the study;
2. Presence of severe psychiatric disorders or severe somatic symptom disorders;
3. Known allergy to Xiaochaihu Granules or any of its components;
4. Current use of other antidepressant medications;

5. Severe organ dysfunction or unstable clinical condition, including but not limited to:

   Uncontrolled bloodstream infection; Expected survival <3 months;

6. History of splenectomy;
7. Renal insufficiency with serum creatinine ≥2.0 mg/dL;
8. Cholestatic liver disease or unresolved hepatic veno-occlusive disease (VOD);

9. Significant cardiovascular conditions, including:

   Unstable angina; Acute myocardial infarction within 6 months prior to enrollment; NYHA class III-IV heart failure; Circulatory failure requiring vasoactive or inotropic support; Clinically significant arrhythmia requiring treatment;

10. Severe respiratory disease requiring mechanical ventilation or ≥50% oxygen support;
11. Patients whose primary disease is in complete remission after transplantation (per protocol definition);
12. Participation in another interventional clinical trial within 21 days prior to enrollment (or within 5 half-lives of the investigational product, whichever is longer);
13. Any other condition deemed by the investigator to make the patient unsuitable for participation.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Low-dose group; On the basis of conventional standard treatment, apply the Shaoyang harmonizing method--low-dose group: Xiao Chai Hu Granules 10g, twice daily;	Drug: Xiaochaihu Granules (Low Dose); Xiaochaihu Granules 10 g, orally administered twice daily (BID) for 100 days, in addition to standard post-transplant care.
Active Comparator: High-dose group; Xiao Chai Hu Granules 20g, twice daily, dissolved in water,	Drug: Xiaochaihu Granules (High Dose); Xiaochaihu Granules 20 g, orally administered twice daily (BID) for 100 days, in addition to standard post-transplant care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Hospital Anxiety and Depression Scale (HADS) score	Change in HADS total score from baseline to Day 100. The HADS is a validated self-reported scale ranging from 0 to 42, with higher scores indicating more severe anxiety and depression symptoms.	Baseline to Day 100
Change in Hamilton Depression Rating Scale (HAMD) score	Change in HAMD score from baseline to Day 100. The HAMD is a clinician-administered scale assessing depression severity, with higher scores indicating more severe depressive symptoms.	Baseline to Day 100
Change in Traditional Chinese Medicine (TCM) syndrome score	Change in TCM syndrome score based on a standardized scoring system evaluating symptoms such as appetite, mood, sleep, and somatic complaints. Higher scores indicate more severe syndrome manifestations.	Baseline to Day 100

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Event-Free Survival (EFS)	Time from treatment initiation to the occurrence of any predefined event, including disease progression, relapse, or death from any cause.	Up to Day 100
Incidence of Graft-versus-Host Disease (GVHD)	Incidence of acute or chronic GVHD diagnosed according to standard clinical criteria.	Up to Day 100
Incidence of infections	Occurrence of clinically or microbiologically confirmed infections during the study period.	Up to Day 100
Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation	Incidence of CMV or EBV reactivation detected by laboratory testing (e.g., PCR).	Up to Day 100
Number of participants with hepatic veno-occlusive disease (VOD) diagnosed according to EBMT criteria	The number of participants who develop hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) after allo-HSCT, diagnosed according to the European Society for Blood and Marrow Transplantation (EBMT) clinical criteria, including bilirubin elevation, weight gain, hepatomegaly, ascites, or related clinical findings.	Up to Day 100 after transplantation
Time to neutrophil and platelet engraftment after allo-HSCT	Neutrophil engraftment is defined as the first of 3 consecutive days with an absolute neutrophil count (ANC) ≥ 0.5 × 10^9/L without growth factor support. Platelet engraftment is defined as the first of 7 consecutive days with platelet count ≥ 20 × 10^9/L without platelet transfusion support. Time to engraftment will be calculated from transplantation to the date of engraftment.	Up to Day 100 after transplantation

Collaborators and Investigators

• Sponsor: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

Study record dates

Study Major Dates

• Study Start (Estimated): May 16, 2026
• Primary Completion (Estimated): August 26, 2026
• Study Completion (Estimated): September 30, 2029

Study Registration Dates

• First Submitted: May 3, 2026
• First Submitted That Met QC Criteria: May 25, 2026
• First Posted (Actual): May 27, 2026

Study Record Updates

• Last Update Posted (Actual): May 27, 2026
• Last Update Submitted That Met QC Criteria: May 25, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Neoplasms; Neoplastic Processes; Mood Disorders; Pathological Conditions, Signs and Symptoms; Depressive Disorder; Neoplasm Metastasis
• Other Study ID Numbers: OMD-HSCT-20250902

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