Palifermin After Haploidentical PBSCT (KGF Haplo Allo)
Randomised Placebo-Controlled Double-Blind Phase II Study Applying Palifermin to Improve T-cell Immune Reconstitution After Haploidentical Allogeneic Peripheral Blood Progenitor Cell (PBPC) Transplantation
This is a double blind, placebo controlled clinical trial, where patients with an advanced form of blood cancer are treated with haploidentical allogeneic peripheral blood progenitor cell (PBPC) transplant after which they are randomised to receive either placebo or a keratinocyte growth factor (Palifermin or Kepivance®).
The function of Kepivance® is to stimulate the growth of epithelial cells. This drug has also been suggested to have an ability to help improve the reconstitution, or development, of the immune system after the transplantation.
The hypothesis is that the patients T-cell dependent humoral immune response to recall antigen (PrevenarTM) will be higher in in palifermin treated patients than in the placebo control group
研究概览
地位
干预/治疗
研究类型
阶段
- 阶段2
联系人和位置
学习地点
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Würzburg、德国、97080
- Dr Ruth Seggewiss
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
Recipient:
- Chemosensitive low/high grade B-NHL or T-NHL, Multiple Myeloma (MM) in partial or complete remission
- ALL and AML, secondary AML and biphenotypic acute leukemia in complete remission (CR1 or CR2) or PR (only if ≤20% blasts in BM), Myelodysplastic syndrome (MDS)
- CML in chronic or accelerated phase
- Osteomyelofibrosis (OMF)
- Hodgkin lymphoma (HD) in partial or complete remission
- Age ≥18 years, ≤ 65 years
- ECOG status ≤2
- Prior treatment with 3 or less different chemotherapy regimens (not cycles); prior local radiotherapy is allowed except radiation involving the thymus
- Adequate pulmonary function
- Left ventricular ejection fraction (LVEF) >30%
- Haploidentical related donor
- Failure to find matched related or matched unrelated donor and urgently requiring transplantation
- Planned conditioning regimen per Aversa or Würzburg protocol
- Women must be post-menopausal, sterile or use effective contraception and have a negative pregnancy test at study entry (β-HCG neg)
- Signed informed consent
Donor:
- Healthy family member
- Selection based on typing of HLA-A, B, C, DR loci. Donor must be at least genotypically HLA-A, B, C, DR haploidentical to the patient, but must differ for 2-3 HLA allele(s) on the unshared haplotype
- Donors must be capable of undergoing leukapheresis, have adequate venous access, and be willing to undergo insertion of a central venous catheter should leukapheresis via peripheral vein be inadequate.
- Donors must agree to a 2nd donation of PBPCs in case of insufficient CD34+ cell collection or should patient fail to demonstrate sustained engraftment
- Signed informed consent
Exclusion Criteria:
Recipient:
- History of or concurrent cancer (< 5 years ago) other than those named in inclusion criteria
- Primary chemorefractory disease
- CML in blast crisis
- MM with no or minor response to previous treatment
- Prior treatment with palifermin, or other keratinocyte growth factors
- Documented hypersensitivity to palifermin, E. coli-derived proteins, or any component of the product
- Documented hypersensitivity to Prevenar vaccine or its components
- Prior allogeneic or tandem PBPC transplantation (no more than 1 previous autologous transplantation
- Prior total body irradiation
- Post thymectomy
- Major anticipated illness or organ failure incompatible with survival from PBPC transplantation
- Active chronic skin disease requiring therapy
- Active inflammatory bowel disease requiring therapy
- Active uncontrolled infection
- Sero-positive HIV
- Pregnancy or breast-feeding
- Active invasive fungal tissue infection (EORTC criteria)
- 30 days or less since receiving an investigational product or device in another clinical trial
- Concurrent enrolment in another trial is not permitted unless the purpose is for long-term follow-up/survival data only, or observational only
- Chronic pancreatitis or history of acute pancreatitis within 1 year prior to transplant
- Psychiatric disorder associated with incompliance
- Myocardial infarction less than 3 months pre enrolment or EF <30% as measured in echocardiography/laevoventriculography
- Infusion of retrovirally or other transduced cells are not permitted.
- Planned intravenous application of immunoglobulins is contraindicated throughout the study period.
- Donor lymphocyte infusions are not allowed.
Donor:
- A positive HIV or HTLV-1 test or evidence of active/persistent viral hepatitis infection.
- Evidence of any other active infection
- Any medical condition (i.e. insulin-dependent diabetes, cardiovascular disorders, chronic inflammatory diseases) posing a health risk for peripheral blood stem cell harvest
- Hematopoietic or marrow function related disease interfering with the collection of sufficient numbers of normal progenitor cells
- Pregnancy or breast-feeding
- Any malignancy besides basal cell epithelioma or cured malignancy < 5 years ago
- Psychiatric disorder associated with incompliance
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:三倍
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Arm A
Palifermin once daily at a dose of 60 mg/kg/day for 3 days before the start of the conditioning regimen and then for 3 consecutive days starting on the day of transplantation (days 0 to day +2 inclusively).
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60 mg/kg/day
其他名称:
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安慰剂比较:Arm B
Placebo at a dose of 1.2 mL (saline 0,9%) once daily for 3 days before the start of the conditioning regimen and then for 3 consecutive days starting on the day of transplantation (days 0 to day +2 inclusively).
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1,2 mL once daily
其他名称:
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研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
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To test palifermin's effect on the T-cell dependent humoral immune response to recall antigen (Prevenar™)
大体时间:at study day +270 (20 days after the third Prevenar injection)
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at study day +270 (20 days after the third Prevenar injection)
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次要结果测量
结果测量 |
大体时间 |
---|---|
To assess if Palifermin improves T-cell reconstitution after haploidentical allogeneic transplantation
大体时间:at study days: +240
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at study days: +240
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To assess if Palifermin improves T-cell reconstitution after haploidentical allogeneic transplantation
大体时间:Study days +210, +240, +270
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Study days +210, +240, +270
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To assess disease free survival (DFS) and overall survival (OS), incidence and duration of GvHD, incidence and severity of OM, and incidence and severity of infections
大体时间:at 2 years
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at 2 years
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To assess drug related safety
大体时间:at 2 years
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at 2 years
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合作者和调查者
合作者
调查人员
- 学习椅:Ruth Seggewiss, MD、University Hospital of Würzburg
研究记录日期
研究主要日期
学习开始
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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