Azacitidine in Haploidentical Donor Hematopoietic Cell Transplantation
2020年10月16日 更新者：Washington University School of Medicine
A Phase I/II Study of Azacitidine in Haploidentical Donor Hematopoietic Cell Transplantation
Allogeneic hematopoietic cell transplantation (allo-HCT) is a potentially curative therapy for patients with hematologic malignancies including acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and acute lymphoblastic leukemia (ALL); however, human leukocyte antigen (HLA)-matched donor availability continues to be a major hurdle.
Historically, HLA haploidentical donor hematopoietic cell transplantation (haplo-HCT) was associated with high incidences of graft rejection and excessive non-relapse mortality (NRM), but recent advances utilizing post-transplant cyclophosphamide (PT-Cy) have revolutionized haplo-HCT and the outcomes are now comparable to allo-HCT using more traditional HLA matched related and unrelated donors.
However, graft-versus-host disease (GvHD) continues to be a problem and is associated with significant morbidity and mortality in allo-HCT patients including those who receive haplo-HCT on PT-Cy platform.
The aim of this early phase study is to investigate the safety and overall efficacy of azacitidine in reducing the incidence and severity of GvHD when added to PT-Cy based haplo-HCT platform for patients with AML, ALL, or advanced MDS.
研究概览
地位
终止
研究类型
介入性
注册 (实际的)
5
阶段
- 阶段1
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
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Missouri
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Saint Louis、Missouri、美国、63110
- Washington University School of Medicine
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 及以上 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Diagnosis of acute leukemia (AML/ALL) or advanced MDS (INT-2 or high risk) in complete remission (CR/CRc/CRi) documented by bone marrow biopsy done within 30 days prior to the initiation of conditioning regimen.
Available HLA-haploidentical donor that meets the following criteria:
- Immediate family member (sibling, offspring, or parent)
- At least 18 years of age
- HLA-haploidentical donor/recipient match by class I serologic typing at the A&B locus.
- In the treating physician's opinion, is in general good health, and medically able to tolerate leukapheresis required for harvesting HSC
- No active hepatitis (B, C), HTLV, and HIV infections
- Not pregnant
- Karnofsky performance status ≥ 70 %
Adequate organ function as defined below:
- Total bilirubin ≤ 2.5 mg/dl (unless the patient has a history of Gilbert's syndrome)
- AST(SGOT) and ALT(SGPT) ≤ 3.0 x IULN
- Creatinine ≤ 2.0 x IULN OR estimated creatinine clearance ≥ 30 mL/min/1.73 m^2 by Cockcroft-Gault Formula
- Oxygen saturation ≥ 90% on room air
- LVEF ≥ 40%
- FEV1 and FVC ≥ 50% predicted, corrected DLCO ≥ 40% predicted
- At least 18 years of age at the time of study registration
- Able to understand and willing to sign an IRB approved written informed consent document (or that of legally authorized representative, if applicable)
Exclusion Criteria:
- Recipients with donor sensitive antibodies (DSA), defined by 2000 or higher MFI against one or more class I or II antigens
- Known HIV or active Hepatitis B or C infection
- Underwent a previous related or unrelated allogeneic transplant
- Known hypersensitivity to one or more of the study agents
- Currently receiving or has received any investigational drugs within the 14 days prior to the first dose of the conditioning regimen.
- Pregnant and/or breastfeeding
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, or unstable cardiac arrhythmias.
- Presence of a readily available 6/6 matched sibling donor who is a candidate for donation
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：不适用
- 介入模型：单组作业
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：Arm 1: Azacitidine
|
其他名称：
其他名称：
其他名称：
其他名称：
其他名称：
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 |
措施说明 |
大体时间 |
|---|---|---|
|
Safety of azacitidine (Phase I only) as measured by frequency and grade of adverse events
大体时间：Up to Day 35
|
The descriptions and grading scales found in the revised NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 will be utilized for all toxicity reporting.
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Up to Day 35
|
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Maximum tolerated dose of azacitidine (Phase I only)
大体时间：Estimated to be 3-4 months (completion of all Phase I patients through Day 35)
|
Estimated to be 3-4 months (completion of all Phase I patients through Day 35)
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|
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Grade II-IV acute GvHD rate of azacitidine (Phase II only)
大体时间：Up to Day 100
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Up to Day 100
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Event-free survival (EFS)
大体时间：Up to 48 months
|
EFS is defined as the time from date of first dose of the preparative regimen until failure to engraft, treatment failure, disease progression/relapse, or death from any cause (whichever occurs first).
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Up to 48 months
|
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Overall survival (OS)
大体时间：Up to 48 months
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OS is defined as the time from the date of Day 0 until death from any cause.
|
Up to 48 months
|
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Disease-free survival (DFS)
大体时间：Up to 48 months
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Up to 48 months
|
|
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Non-relapse mortality (NRM)
大体时间：Up to Day 100
|
NRM is defined as death that results from a transplant procedure-related complication (e.g.
infection, organ failure, hemorrhage, GvHD) rather than from relapse of the underlying disease prior to Day +100 visit.
|
Up to Day 100
|
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Time to neutrophil engraftment
大体时间：Up to 12 months
|
Time to neutrophil engraftment is measured by determining the first of 3 consecutive measurements of neutrophil count ≥ 500/ul following conditioning regimen-induced nadir.
|
Up to 12 months
|
|
Time to platelet engraftment
大体时间：Up to 12 months
|
Time to platelet engraftment is measured by determining the first of 3 consecutive measurements of platelet count ≥ 20,000/ul without platelet transfusion support for 7 days.
|
Up to 12 months
|
|
Rate of acute GvHD
大体时间：Up to Day 100
|
Incidence and severity of acute GvHD will be assessed based on the modified Glucksberg criteria and Seattle criteria.
Attempts should be made to confirm the diagnosis pathologically by biopsy of target organ(s).
|
Up to Day 100
|
|
Rate of chronic GvHD
大体时间：Day 100 through Day 365
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Incidence and severity of chronic GvHD will be assessed based on the NIH consensus criteria and global severity scoring system.
Attempts should be made to confirm the diagnosis pathologically by biopsy of target organ(s).
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Day 100 through Day 365
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2016年6月27日
初级完成 (实际的)
2017年5月24日
研究完成 (实际的)
2020年10月14日
研究注册日期
首次提交
2016年4月18日
首先提交符合 QC 标准的
2016年4月20日
首次发布 (估计)
2016年4月25日
研究记录更新
最后更新发布 (实际的)
2020年10月20日
上次提交的符合 QC 标准的更新
2020年10月16日
最后验证
2020年10月1日
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- 201604081
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研究美国 FDA 监管的药品
是的
研究美国 FDA 监管的设备产品
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在美国制造并从美国出口的产品
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