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- Ensayo clínico NCT01997918
Secondary Haplo HSCT for Relapse After Initial Allogeneic HSCT
2 de mayo de 2018 actualizado por: University Hospital Tuebingen
Haploidentical Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) in the Treatment of Relapse After a First Allogeneic HSCT: a Retrospective Cohort Study by the German Cooperative Transplant Study Group
Relapse of underlying hematologic malignancies after allogeneic hematopoietic stem cell transplantation (HSCT) is frequently treated by a second allogeneic HSCT (HSCT2).
Choosing an alternative donor is often advocated to maximize chances of a graft versus tumour (GVT) effect.
We and others published that success of this strategy when using an alternative human leukocyte antigen (HLA) identical donor is limited, at least when acute leukemia is the underlying disease.
The aggressivity of the rapidly proliferating leukemia seems to prevail over GVT effects.
A more potent alloimmune response is observed following haploidentical HSCT, especially early after haploidentical HSCT.
This might be related to a fast and large expansion of natural killer (NK)-cells.
Their alloreactive effect might translate into higher rates of tumor control.
On the other hand, non-relapse complications (treatment related mortality, TRM) might be high in advanced relapsed tumour patients with heavy pretreatment and due to delayed immune reconstitution after haploidentical HSCT.
The use of a haploidentical donor for HSCT2 following a first allogeneic HSCT from an HLA identical donor has been so far only systematically evaluated in small retrospective single center reports.
Thus, in this multicenter study we aim to collect data on the extent to which participating centers employ haploidentical transplantation in the situation of relapse after HSCT2.
Descripción general del estudio
Estado
Terminado
Condiciones
Descripción detallada
Relapse of underlying hematologic malignancies after allogeneic hematopoietic stem cell transplantation (HSCT) is frequently treated by a second allogeneic HSCT (HSCT2).
Choosing an alternative donor is often advocated to maximize chances of a graft versus tumour (GVT) effect.
We and others published that success of this strategy when using an alternative HLA identical donor is limited, at least when acute leukemia is the underlying disease.
The aggressivity of the rapidly proliferating leukemia seems to prevail over GVT effects.
A more potent alloimmune response is observed following haploidentical HSCT, especially early after haploidentical HSCT.
This might be related to a fast and large expansion of NK-cells.
Their alloreactive effect might translate into higher rates of tumor control.
On the other hand, non-relapse complications (treatment related mortality, TRM) might be high in advanced relapsed tumour patients with heavy pretreatment and due to delayed immune reconstitution after haploidentical HSCT.
The use of a haploidentical donor for HSCT2 following a first allogeneic HSCT from an HLA identical donor has been so far only systematically evaluated in small retrospective single center reports.
Thus, in this multicenter study we aim to collect data on the extent to which participating centers employ haploidentical transplantation in the situation of relapse after HSCT2.
We will describe and quantify the specific patient, donor, treatment, graft and outcomes characteristics associated with the course of treatment.
To assess and control for the bias that is associated with the retrospective nature of this study, we will emphasize to collect clearly stated reasons for the decision to use a haploidentical transplant, e.g. as opposed to drug therapy or a second transplant from the original or an alternative HLA identical donor.
This is a retrospective observational cohort study.
German centers performing allogeneic HSCT are asked to contribute.
Data will be validated and missing information will be further retrieved by the four principal investigators through phone.
Final follow up will be performed in April 2014, 2014.
To be able to supply durable data on the primary endpoints, only patients receiving a haploidentical HSCT2 between 01.07.2003 and 30.06.2013 will be included.
Tipo de estudio
De observación
Inscripción (Actual)
60
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años y mayores (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Método de muestreo
Muestra no probabilística
Población de estudio
Patients receiving salvage secondary haploidentical allogeneic HSCT after failure of primary allogeneic HSCT
Descripción
Inclusion Criteria:
- Age >18 years at time of HSCT2
- Malignant hematologic disease
- Informed consent signed by the patients on the use of data in registry analyses
- 1st allogeneic HSCT performed from any donor, including haploidentical HSCT1
- Hematological or extramedullary relapse after HSCT1
- Haploidentical 2nd allogeneic HSCT (i.e. >= 2 Antigen mismatch family donor) between 01.07.2003 and 30.06.2013
Third or higher allogeneic HSCT does not preclude analysis as long as HSCT2 was haploidentical.
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
---|---|---|
Treatment related mortality (TRM) of haploidentical HSCT2
Periodo de tiempo: up to day 365
|
up to day 365
|
|
Toxicity of haploidentical HSCT2
Periodo de tiempo: up to day 365
|
NCI Common Terminology Criteria for Adverse Events (CTCAE) v.4
|
up to day 365
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
complete remission (CR) rate after haploidentical HSCT2
Periodo de tiempo: day 100
|
day 100
|
Overall survival (OS) at 2 years after haploidentical HSCT2
Periodo de tiempo: 2 years
|
2 years
|
Graft versus host disease (GVHD) after haploidentical HSCT2
Periodo de tiempo: 2 years
|
2 years
|
Incidence of rejection after haploidentical HSCT2
Periodo de tiempo: 1 year
|
1 year
|
Disease free survival (DFS) at 2 years after haploidentical HSCT2
Periodo de tiempo: 2 years
|
2 years
|
Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Investigadores
- Investigador principal: Wolfgang A Bethge, MD, University Hospital Tuebingen
- Investigador principal: Christoph Schmid, MD, University Hospital Augsburg
- Investigador principal: Johanna Tischer, MD, Ludwig-Maximilians University Hospital Munich
- Investigador principal: Maximilian Christopeit, MD, University Hospital of Halle
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de octubre de 2013
Finalización primaria (Actual)
30 de diciembre de 2017
Finalización del estudio (Actual)
30 de diciembre de 2017
Fechas de registro del estudio
Enviado por primera vez
29 de octubre de 2013
Primero enviado que cumplió con los criterios de control de calidad
27 de noviembre de 2013
Publicado por primera vez (Estimar)
28 de noviembre de 2013
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
3 de mayo de 2018
Última actualización enviada que cumplió con los criterios de control de calidad
2 de mayo de 2018
Última verificación
1 de mayo de 2018
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- KTS 2. Haplo HSCT
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .