Clinical Study on CD20 Monoclonal Antibody for Preventing Early EB Virus Activation After Allogeneic Hematopoietic Stem Cell Transplantation
Efficacy and Safety of B-cell Clearance in Preventing Early Epstein-Barr Virus Activation After Allogeneic Hematopoietic Stem Cell Transplantation: A Multicenter, Prospective, Randomized Controlled Clinical Study
The main purpose of this study is to evaluate the preventive effect and safety of CD20 monoclonal antibody clearing B cells on EBV activation 180 days after allogeneic hematopoietic stem cell transplantation. The study will also observe the effects of this strategy on EBV-PTLD, CMV reactivation, hematopoietic reconstruction, acute and chronic graft-versus-host disease (GVHD), non recurrent death, recurrence, survival, and post transplant immune reconstruction.
In this study, CD20 monoclonal antibody was used for the prevention of EBV activation after transplantation, which is an investigational prophylactic drug/beyond the indications stated in the instructions. The research doctor will explain the relevant basis, potential benefits, and potential risks to you during the informed consent process.
The research subjects were patients who received their first allogeneic hematopoietic stem cell transplantation in each enrolled transplantation center. After evaluating the inclusion and exclusion criteria and signing the informed consent form, they were randomly divided into an experimental group and a control group at a 1:1 ratio. The experimental group received prophylactic CD20 monoclonal antibody treatment (dose of 375mg/m2, intravenous application, once) 5 days after transplantation; If medication cannot be administered on time due to special clinical circumstances, it can be completed within 5 to 30 days after transplantation. The control group did not receive prophylactic CD20 monoclonal antibody within 30 days after transplantation, and EBV-DNA, CMV-DNA, and transplant related complications were monitored according to the routine procedures of the center. All subjects were followed up according to the protocol until 2 years after transplantation or death/loss to follow-up/withdrawal of informed consent. Primary endpoint evaluation will be conducted 180 days after transplantation, and continuous collection of PTLD, CMV reactivation, hematopoietic reconstruction, etc. will be conducted GVHD、 Data on recurrence, survival, safety, and immune reconstitution. Among them, allogeneic hematopoietic stem cell transplantation, routine blood routine/liver and kidney function tests, EBV-DNA/CMV-DNA monitoring, infection and GVHD management are procedures that need to be performed for diagnosis and treatment; Randomized grouping, prophylactic CD20 monoclonal antibody administration in the experimental group, data collection, and protocol specified follow-up are the relevant procedures of this study.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
研究の種類
研究の種類
入学 (推定)
入学
段階
段階
- フェーズ2
- フェーズ 3
連絡先と場所
研究連絡先
研究連絡先
- 名前:JIA CHEN
- 電話番号:+86 051267976801
- メール:drchenjia@163.com
研究場所
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Beijing、中国、100000
- まだ募集していません
- Peking University People's Hospita
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Chongqing、中国、400000
- まだ募集していません
- The Second Affiliated Hospital of the Third Military Medical University
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Shanghai、中国、200000
- まだ募集していません
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
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Suzhou、中国、215000
- 募集
- The first Affiliated Hospital of Soochow University
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コンタクト:
- Jia Chen
- 電話番号:86+052167976801
- メール:drchenjia@163.com
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Anhui
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Hefei、Anhui、中国、230000
- まだ募集していません
- Anhui Provincial Hospital
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Henan
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Zhengzhou、Henan、中国、450000
- まだ募集していません
- The First Affiliated Hospital of Zhengzhou University School of Medicine
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Jiangsu
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Huai'an、Jiangsu、中国、223200
- まだ募集していません
- Huai'an Second People's Hospital
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Nanjing、Jiangsu、中国、210000
- まだ募集していません
- Jiangsu Provincial People's Hospital
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Xuzhou、Jiangsu、中国、221000
- まだ募集していません
- Xuzhou Medical University Affiliated Hospital
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Zhejiang
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Hangzhou、Zhejiang、中国、310000
- まだ募集していません
- The First Affiliated Hospital of Zhejiang University School of Medicine
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参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- 1) Age range of 14-70 years old (including threshold), gender not limited; 2) Receiving allogeneic hematopoietic stem cell transplantation for the first time; 3) Accept allogeneic hematopoietic stem cell transplantation with pre-treatment regimen containing ATG (total dose ≥ 4.5mg/kg), or determine by the researcher to be a high-risk transplant population for EBV reactivation; 4) At the time of enrollment, there were no uncontrolled severe infections, shock, severe organ failure, or other intolerance to the study treatment; 5) Expected to complete at least 180 days of follow-up for the primary endpoint, and the researcher's assessment of compliance is good; 6) The subject voluntarily signs the informed consent form; Individuals under the age of 18 are required to have their legal guardian sign an informed consent form and obtain their informed consent/consent expression if their understanding ability allows.
Exclusion Criteria:
- 1) Previously used CD20 monoclonal antibody or known to have allergic reactions to its excipients; 2) Secondary transplantation; 3) Previous history of EB virus infection related hemophilic cell syndrome, lymphoma, and other diseases; 4) EBV activation that meets the protocol definition has occurred within the 6 months prior to joining the group; 5) Patients who have received B-cell targeted therapy for any reason within the first 6 months of enrollment, including anti B-cell antibodies, B-cell antibody conjugates, BTK inhibitors, and B-cell targeted CAR-T cell therapy such as CD19; 6) There are uncontrolled infections; 7) Severe liver and kidney dysfunction, heart and lung dysfunction; 8) Those who cannot understand or comply with the research protocol or cannot sign the informed consent form; 9) The researchers believe that the patient has other circumstances that are not suitable for participating in this study.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:防止
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
アーム数
武器と介入
参加者グループ / アーム参加者グループ / アーム |
介入・治療介入・治療 |
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実験的:実験グループ
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The experimental group will receive prophylactic CD20 monoclonal antibody treatment (dose of 375mg/m2, intravenous application, once) 5 days after transplantation; If medication cannot be administered on time due to special clinical circumstances, it can be completed within 5 to 30 days after transplantation. |
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介入なし:Control group
The control group won't receive prophylactic CD20 monoclonal antibody within 30 days after transplantation, and EBV-DNA, CMV-DNA, and transplant related complications will be monitored according to the routine procedures of the center. |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
時間枠 |
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EBV activation rate
時間枠:180 days after transplantation
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180 days after transplantation
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協力者と研究者
出版物と役立つリンク
一般刊行物
- Zhang S, Ji Q, Wang Q, Hu S. Prophylactic rituximab administered on day -1 during conditioning significantly reduces early ebv reactivation in pediatric allogeneic hsct: Real-world evidence from a propensity-matched cohort of 834 patients. Blood. 2025;146:5988-5988
- Dominietto A, Tedone E, Soracco M, Bruno B, Raiola AM, Van Lint MT, Geroldi S, Lamparelli T, Galano B, Gualandi F, Frassoni F, Bacigalupo A. In vivo B-cell depletion with rituximab for alternative donor hemopoietic SCT. Bone Marrow Transplant. 2012 Jan;47(1):101-6. doi: 10.1038/bmt.2011.28. Epub 2011 Apr 4.
- Burns DM, Rana S, Martin E, Nagra S, Ward J, Osman H, Bell AI, Moss P, Russell NH, Craddock CF, Fox CP, Chaganti S. Greatly reduced risk of EBV reactivation in rituximab-experienced recipients of alemtuzumab-conditioned allogeneic HSCT. Bone Marrow Transplant. 2016 Jun;51(6):825-32. doi: 10.1038/bmt.2016.19. Epub 2016 Feb 22.
- Launspach M, Temel D, Ohlendorf E, Zirngibl F, Materne B, Oevermann L, Deubzer HE, Henssen AG, Kunkele A, Hundsdorfer P, Bernuth HV, Pruss A, Eggert A, Stackelberg AV, Lang P, Schulte JH. Rituximab therapy after pediatric hematopoietic stem cell transplantation can cause prolonged B-cell impairment and increases the risk for infections - a retrospective matched cohort study. Haematologica. 2023 Jan 1;108(1):267-272. doi: 10.3324/haematol.2022.281134. No abstract available.
- Stocker N, Labopin M, Boussen I, Paccoud O, Bonnin A, Malard F, Amiel C, Gozlan J, Battipaglia G, Dulery R, Giannotti F, Ruggeri A, Gaugler B, Mohty M, Brissot E. Pre-emptive rituximab treatment for Epstein-Barr virus reactivation after allogeneic hematopoietic stem cell transplantation is a worthwhile strategy in high-risk recipients: a comparative study for immune recovery and clinical outcomes. Bone Marrow Transplant. 2020 Mar;55(3):586-594. doi: 10.1038/s41409-019-0699-6. Epub 2019 Sep 27.
- Heslop HE. How I treat EBV lymphoproliferation. Blood. 2009 Nov 5;114(19):4002-8. doi: 10.1182/blood-2009-07-143545. Epub 2009 Sep 1.
- Papalexandri A, Gavriilaki E, Vardi A, Kotsiou N, Demosthenous C, Constantinou N, Touloumenidou T, Zerva P, Kika F, Iskas M, Batsis I, Mallouri D, Yannaki E, Anagnostopoulos A, Sakellari I. Pre-Emptive Use of Rituximab in Epstein-Barr Virus Reactivation: Incidence, Predictive Factors, Monitoring, and Outcomes. Int J Mol Sci. 2023 Nov 7;24(22):16029. doi: 10.3390/ijms242216029.
- Styczynski J, van der Velden W, Fox CP, Engelhard D, de la Camara R, Cordonnier C, Ljungman P; Sixth European Conference on Infections in Leukemia, a joint venture of the Infectious Diseases Working Party of the European Society of Blood and Marrow Transplantation (EBMT-IDWP), the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer (EORTC-IDG), the International Immunocompromised Host Society (ICHS) and the European Leukemia Net (ELN). Management of Epstein-Barr Virus infections and post-transplant lymphoproliferative disorders in patients after allogeneic hematopoietic stem cell transplantation: Sixth European Conference on Infections in Leukemia (ECIL-6) guidelines. Haematologica. 2016 Jul;101(7):803-11. doi: 10.3324/haematol.2016.144428.
- Huang J, Pan Z, Wang L, Zhang Z, Huang J, Jiang C, Cai G, Yin T. Early T-cell reconstitution predicts risk of EBV reactivation after allogeneic hematopoietic stem cell transplantation. Clin Exp Med. 2024 Jan 27;24(1):22. doi: 10.1007/s10238-023-01270-3.
- Styczynski J, Gil L, Tridello G, Ljungman P, Donnelly JP, van der Velden W, Omar H, Martino R, Halkes C, Faraci M, Theunissen K, Kalwak K, Hubacek P, Sica S, Nozzoli C, Fagioli F, Matthes S, Diaz MA, Migliavacca M, Balduzzi A, Tomaszewska A, Camara Rde L, van Biezen A, Hoek J, Iacobelli S, Einsele H, Cesaro S; Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Response to rituximab-based therapy and risk factor analysis in Epstein Barr Virus-related lymphoproliferative disorder after hematopoietic stem cell transplant in children and adults: a study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Clin Infect Dis. 2013 Sep;57(6):794-802. doi: 10.1093/cid/cit391. Epub 2013 Jun 13.
- Zhen S, Liu L, Zhang X, Wang J, Sun J, Liang C, Cao W, Wei J, Zhai W, Chen X, Ma Q, Zhang R, Yang D, He Y, Pang A, Han M, Jiang E, Feng S. Increased Epstein-Barr virus reactivation but similar incidence of post-transplant lymphoproliferative disorders due to pre-emptive rituximab therapy following allogeneic hematopoietic stem cell transplantation in the letermovir era for cytomegalovirus prophylaxis. Bone Marrow Transplant. 2025 May;60(5):721-724. doi: 10.1038/s41409-025-02542-0. Epub 2025 Mar 3. No abstract available.
- Kimura H, Ito Y, Suzuki R, Nishiyama Y. Measuring Epstein-Barr virus (EBV) load: the significance and application for each EBV-associated disease. Rev Med Virol. 2008 Sep-Oct;18(5):305-19. doi: 10.1002/rmv.582.
- Walker I, Panzarella T, Couban S, Couture F, Devins G, Elemary M, Gallagher G, Kerr H, Kuruvilla J, Lee SJ, Moore J, Nevill T, Popradi G, Roy J, Schultz KR, Szwajcer D, Toze C, Foley R; Canadian Blood and Marrow Transplant Group. Pretreatment with anti-thymocyte globulin versus no anti-thymocyte globulin in patients with haematological malignancies undergoing haemopoietic cell transplantation from unrelated donors: a randomised, controlled, open-label, phase 3, multicentre trial. Lancet Oncol. 2016 Feb;17(2):164-173. doi: 10.1016/S1470-2045(15)00462-3. Epub 2015 Dec 24.
研究記録日
主要日程の研究
研究開始 (推定)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
その他の研究ID番号
- CD20antiEBV
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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