Tacrolimus and Thymoglobulin, as GvHD Prophylaxis in Patients Undergoing Related Donor HCT
16 maj 2018 uppdaterad av: Zaid Al-Kadhimi, Barbara Ann Karmanos Cancer Institute
A Phase II Study of Tacrolimus and Thymoglobulin, as Graft-versus-Host-Disease Prophylaxis in Patients Undergoing Related Donor Hematopoietic Cell Transplantation
The primary goal of the study is to determine the incidence and severity of acute Graft versus Host Disease (GVHD) following human leukocyte antigen (HLA) matched related donor Hematopoetic Stem Cell(HSC) transplant in patients with blood related cancers who receive the combination of tacrolimus and Thymoglobulin as GVHD prophylaxis. The investigators also will determine the safety of this combination in the first six months post transplant.
Secondary goals include determining the time to recovery of white blood cells and platelets (engraftment), determining the occurrence of opportunistic infections, defined as infection that occurs in people with weakened immune systems and caused by organisms that do not normally cause disease (fungal infections, pneumocystis carinii pneumonia (PCP), and viral infections), estimating the incidence of chronic GVHD at two years and the overall and disease free survival at two years.
Immune response will be assessed by means of immuno-correlative studies both prior to and at various points after transplant.
Studieöversikt
Status
Avslutad
Betingelser
Intervention / Behandling
Studietyp
Interventionell
Inskrivning (Faktisk)
21
Fas
- Fas 2
Kontakter och platser
Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.
Studieorter
-
-
Michigan
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Detroit, Michigan, Förenta staterna, 48201
- Barbara Ann Karmanos Cancer Institute
-
-
Deltagandekriterier
Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.
Urvalskriterier
Åldrar som är berättigade till studier
18 år till 70 år (Vuxen, Äldre vuxen)
Tar emot friska volontärer
Nej
Kön som är behöriga för studier
Allt
Beskrivning
Inclusion Criteria:
- Suitable related donor as determined by the treating physician
- High resolution molecular HLA typing is mandatory for HLA Class I and II
- Diagnosis of hematological malignancy
- Patients with one of the following hematologic malignancies, and felt to be transplant candidates by their treating physician are eligible to enroll on this protocol:
- Non-Hodgkin lymphoma, any complete remission (CR)/partial remission (PR)
- Hodgkin disease, any CR/PR/stable disease (SD)
- Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) any CR; for non-CR AML or ALL, bone marrow blast < 20% within 4 weeks of transplant and peripheral blood (PB) absolute blast count < 500/μl on the day of initiation of conditioning
- Myelodysplastic syndrome (MDS), treated or untreated
- Chronic myelogenous leukemia (CML) in chronic phase or accelerated phase
- Chronic myelomonocytic leukemia (CMML)
- Multiple myeloma, any CR/PR/SD
- Chronic lymphocytic leukemia (CLL) any CR/PR
- Myelofibrosis and other myeloproliferative disorders; bone marrow blasts less than 20 percent within four weeks of transplant and peripheral blood absolute blast counts less than 500 per microliter on the day of initiation of conditioning
- Age >= 18 and able to cooperate with oral medication intake
- Filgrastim (G-CSF) mobilized Peripheral blood stem cells
- Agrees to participate, and informed consent signed
- Karnofsky performance status (KPS) >= 60, Eastern Cooperative Oncology Group (ECOG) performance status =< 2
- Creatinine clearance > 60 mL/min
- Ejection fraction > 50%
- Serum bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST) less than 3 X upper limit of normal
- Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) or diffusion capacity of carbon monoxide (DLCO) > 50% predicted
Exclusion Criteria:
- Bone marrow or Ex vivo engineered or processed graft (cluster of differentiation [CD]34+ enrichment, T-cell depletion, etc)
- Patients with documented uncontrolled central nervous system (CNS) disease
- Active donor or recipient serology positive for human immunodeficiency virus (HIV)
- Known contraindication to administration of Tacrolimus or Thymoglobulin
- Active Hepatitis B or C
- Patients with coronary heart disease (recent myocardial infarctions, angina, cardiac stent, or bypass surgery in the last 6 months) need to be cleared with a stress echocardiogram or nuclear myocardial perfusion stress test, and cardiology consult; all other cardiac history will be at the discretion of the Principal Investigator
- Oxygen usage at the time of enrollment
- Patients with clinical ascites
- Women who are pregnant or nursing
Studieplan
Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: N/A
- Interventionsmodell: Enskild gruppuppgift
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Tacrolimus and Thymoglobulin
Tacrolimus and Thymoglobulin, as Graft-versus-Host-Disease Prophylaxis
|
Intravenous Tacrolimus 0.03 mg/kg/d, beginning day -3, where day 0 is the day of stem cell infusion or "transplant."
Intravenous tacrolimus will be discontinued once the participant starts eating, and the drug will then be given orally at a dose of approximately 4 times the intravenous dose.
Tacrolimus will be discontinued starting 100 days after transplant unless signs of acute and chronic GVHD develop or if severe toxicity occurs.
Thymoglobulin will be given 0.5 mg/kg day-3, Thymoglobulin 1.5 mg/kg day -2, Thymoglobulin 2.5 mg/kg day -1.
Thymoglobulin will be given intravenously over 6 hours.
Andra namn:
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Incidence of Acute GVHD
Tidsram: Assessed first 6 months post transplant
|
Cumulative Incidence of grade II-V acute GVHD with relapse or NRM as competing risks
|
Assessed first 6 months post transplant
|
|
Safety Defined by Serious Adverse Events
Tidsram: Assessed first 6 months post transplant
|
Counted the number of participants that experienced any type of grade 3 or higher toxicity.
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Assessed first 6 months post transplant
|
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Severity of Acute GVHD
Tidsram: Assessed first 6 months post transplant
|
Cumulative Incidence of grade III-V acute GVHD with relapse or NRM as competing risks
|
Assessed first 6 months post transplant
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Determine Incidence of Opportunistic Infections
Tidsram: Followed for up to two years post transplant
|
Followed for up to two years post transplant
|
|
|
Estimate Incidence of Chronic GVHD at Two Years
Tidsram: Followed for up to two years post transplant
|
Cumulative Incidence of chronic GVHD with relapse or NRM as competing risks
|
Followed for up to two years post transplant
|
|
Overall Survival at Two Year,
Tidsram: Followed for up to two years post transplant
|
Followed for up to two years post transplant
|
|
|
Determine Time to Engraftment ("G500")
Tidsram: Followed for up to two years post transplant
|
The number of days until engraftment ("G500")
|
Followed for up to two years post transplant
|
|
Determine Time to Engraftment ("PLT20")
Tidsram: Followed for up to two years post transplant
|
The number of days until engraftment ("PLT20")
|
Followed for up to two years post transplant
|
Samarbetspartners och utredare
Det är här du hittar personer och organisationer som är involverade i denna studie.
Studieavstämningsdatum
Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.
Studera stora datum
Studiestart
1 november 2010
Primärt slutförande (Faktisk)
1 oktober 2013
Avslutad studie (Faktisk)
1 oktober 2013
Studieregistreringsdatum
Först inskickad
21 november 2010
Först inskickad som uppfyllde QC-kriterierna
22 november 2010
Första postat (Uppskatta)
23 november 2010
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
18 juni 2018
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
16 maj 2018
Senast verifierad
1 maj 2018
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- WSU 2009-095
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