ATLG Levels in Autologous HSCT for Multiple Sclerosis (ATLG-MS)

June 4, 2026 updated by: Ciceri Fabio

ATLG Levels and Immune Reconstitution Kinetics in Autologous HSCT for Multiple Sclerosis

This is a prospective, observational, biological, multicenter study to investigate IR profile, ATLG dynamics, main HSCT and disease outcomes in MS. This study will provide a preliminary descriptive evaluation of key study parameters, including ATLG pharmacokinetics and immune reconstitution trends, as well as an initial assessment of variability (e.g., dispersion of immunological biomarkers), to support the interpretation of results and the design of future studies. Since this is an observational study, no clinical decision will be made, and the interim analysis will not have an impact of the study conduction, and it will not be a stopping rule.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

20

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

Study Locations

  • Italy
    • Italy
      • Milan, Italy, Italy, 20132
        • Recruiting
        • IRCCS Ospedale San Raffaele
        • 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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study will involve 20 MS patients, treated with autologous HSCT as standard-of-care according to guidelines and consensus recommendations. Autologous HSCT is considered a standard-of-care intervention in the following selected MS patients: RRMS who have failed to respond to one or more high-efficacy DMTs or progressive MS with superimposed inflammatory activity, or aggressive forms of MS where rapid neurological decline occurs early in the disease course.

Patients will receive standard conditioning regimen (BEAM or cyclophosphamide) and ATLG (total dose 30 mg/kg over 3 days: 10 mg/kg on days -3, -2 and -1).

Description

Inclusion Criteria:

  • Participant is willing and able to give informed consent for participation in the study.
  • Adult patients (age >/= 18y)
  • Diagnosis of MS
  • Confirmed program of autologous HSCT according to standard EBMT indications (any conditioning regimen considered standard, BEAM or Cyclophosphamide)
  • ATLG (total dose 30 mg/kg over 3 days: 10 mg/kg on days -3, -2 and -1) in the conditioning regimen.

Exclusion Criteria:

  • Subjects that did not accept to sign the informed consent.
  • Use of ATG.
  • Contraindications to HSCT procedures (including pregnancy and breast feeding, uncontrolled active infections)

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Multiple Sclerosis patients treated with autologous HSCT as standard of care
The study will involve 20 Multiple Sclerosis (MS) patients, treated with autologous HSCT as standard-of-care according to guidelines and consensus recommendations. Autologous Hematopoietic stem cell transplantation (HSCT) is considered a standard-of-care intervention in the following selected MS patients: RRMS who have failed to respond to one or more high-efficacy Disease modifying therapies (DMTs) or progressive MS with superimposed inflammatory activity, or aggressive forms of MS where rapid neurological decline occurs early in the disease course.
Drug: ATLG administration
Patients will receive standard conditioning regimen (BEAM or cyclophosphamide) and ATLG (total dose 30 mg/kg over 3 days: 10 mg/kg on days -3, -2 and -1).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Investigate immune status in correlation with ATLG
Time Frame: before mobilization, before conditioning, +1/3/6/12 months after HSCT.
Longitudinal IR monitoring (T/B/NK lymphocyte subpopulations including naïve- memory- stem/memory- regulatory subsets, cytokine profile, NFL/Macrophages) on PB
before mobilization, before conditioning, +1/3/6/12 months after HSCT.
Investigate immune status in correlation with ATLG
Time Frame: before and 30' after the end of ATLG dose, day0, day1, weekly for 4 weeks.
Assessment of ATLG levels & kinetics
before and 30' after the end of ATLG dose, day0, day1, weekly for 4 weeks.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assess clinically relevant viral infections in correlation with viral specific IR
Time Frame: before mobilization, +1 month after HSCT within the first year after HSCT.
Assessment of pathogen-specific responses (CMV specific T cells by ELISpot) and occurrence of clinically relevant viral infections (CMV, EBV; ECIL 10 guidelines).
before mobilization, +1 month after HSCT within the first year after HSCT.
To assess HSCT and neurological outcomes
Time Frame: at 100 days and 1-year
Transplant-related mortality (TRM)
at 100 days and 1-year
Assessment of Progression Free Survival (PFS)
Time Frame: at 1-year
Assessment of general HSCT outcomes (PFS)
at 1-year
Assessment of Overall survival (OS)
Time Frame: At 1 year
Assessment of general HSCT outcomes - OS
At 1 year
neurological status- Expanded Disability Status Scale (EDSS)
Time Frame: at 100 days, 6 months and 1-year
Expanded Disability Status Scale (EDSS)
at 100 days, 6 months and 1-year
neurological status - neurological progression
Time Frame: at 1 year
neurological status - neurological progression
at 1 year
neurological status -No Evidence of Disease Activity
Time Frame: At 1 year
No Evidence of Disease Activity (NEDA)
At 1 year

Collaborators and Investigators

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

Sponsor

Ciceri Fabio

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 (Actual)

May 4, 2026

Primary Completion (Estimated)

May 4, 2028

Study Completion (Estimated)

May 4, 2029

Study Registration Dates

First Submitted

June 4, 2026

First Submitted That Met QC Criteria

June 4, 2026

First Posted (Actual)

June 9, 2026

Study Record Updates

Last Update Posted (Actual)

June 9, 2026

Last Update Submitted That Met QC Criteria

June 4, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ATLG-MS
  • 4332 (Other Identifier: Registro studi osservazionali)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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