Maraviroc-Based GVHD Prophylaxis in HLA-Unrelated and HLA-Mismatched Related Transplantation
Safety and Efficacy of Maraviroc-Based Graft-Versus-Host-Disease Prophylaxis in HLA-Unrelated and HLA-Mismatched Related Donor Transplantation
HLA-mismatched unrelated donor (MMUD) and HLA-haploidentical donor (Haplo Donor) hematopoietic stem cell transplantation (HSCT) is associated with increased graft-versus-host-disease (GVHD) and impaired survival.
The chemokine receptor 5 (CCR5) antagonist maraviroc has immunomodulatory properties potentially beneficial for GVHD control as it can blockade lymphocyte chemotaxis without impairing T-cell function.
The aim of this study is to evaluate the safety and efficacy of maraviroc combined with standard graft-versus-host-disease prophylaxis in patients with hematologic malignancies after allogeneic stem cell transplantation from HLA-Unrelated or HLA-Mismatched Related donors.
Based on the results of our previously small sample study with maraviroc combined with cyclosporine/tacrolimus and methotrexate for prophylaxis of GVHD, the investigators plan to perform the clinical trail.
研究概览
地位
未知
研究类型
介入性
注册 (预期的)
40
阶段
- 阶段2
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
-
-
Beijing
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Beijing、Beijing、中国、100071
- 招聘中
- Department of Hematopoietic Stem Cell Transplantation
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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
12年 至 65年 (孩子、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:
- Age 12-65 years (patient is older than 12.0 and less than 66.0 years old)
- Patients with acute leukemia, myelodysplastic syndrome or lymphoma who scheduled to undergo allogeneic stem-cell transplantation from HLA-Unrelated or HLA-Mismatched Related donors
- Renal function: estimated creatinine clearance greater than 40 mL/minute (using the Cockcroft-Gault formula and actual body weight)
- Hepatic function: Baseline direct bilirubin, alanine aminotransferase (ALT) lower than three times the upper limit of normal
- Pulmonary disease: forced vital capacity (FVC) or forced expiratory volume at one second (FEV1) > 40% predicted
- Cardiac ejection fraction > 40%
- Signed informed consent
Exclusion Criteria:
- Patients not expected to be available for follow-up in our institution for at least 100 days after the transplant
- Prior allogeneic transplant
- Karnofsky Performance Score < 70%
- Patients who are not undergoing standard GVHD prophylaxis with cyclosporine/tacrolimus and methotrexate
- Patients with uncontrolled bacterial, viral or fungal infections
- Patients receiving other investigational drugs for GVHD
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：预防
- 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：Maraviroc + standard GVHD prophylaxis
Maraviroc administration (in addition to the standard prophylaxis therapy of cyclosporine/tacrolimus and methotrexate) will start on day -2 and will end on day +30 after stem cell transplant, making the total number of days of drug administration 33 days.
Maraviroc will be administered 300mg twice daily orally.
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Maraviroc will be administered 300mg twice daily and start on day -2 end on day +30 after stem cell transplant for 33 days.
其他名称：
Cyclosporine will be given intravenously at a dose of 2-3 mg/kg starting Day -1.
Subsequent dosing will be based on blood levels.
Patients were advanced to oral cyclosporine once they could tolerate.
The dose should be adjusted accordingly to maintain a suggested target serum level of 150-250 ng/mL.
In the absence of aGVHD, the oral cyclosporine dose was reduced by approximately 5% weekly, beginning on or near day 100, and therapy was usually discontinued by Day 180 after transplantation or relapse.
其他名称：
Tacrolimus will be given orally at a dose of 0.05 mg/kg twince a day or intravenously at a dose of 0.03 mg/kg starting Day -3.
Subsequent dosing should be adjusted accordingly to maintain a suggested target serum level of 5-10 ng/mL.
Tacrolimus taper can be initiated at a minimum of 100 days post HSCT if there is no evidence of active GVHD.
The rate of tapering will be done according institutional practices but patients should be off tacrolimus by Day 180 post HSCT if there is no evidence of active GVHD.
其他名称：
Methotrexate will be administered intravenously at a dose of 15 mg/m^2 on day +1, and 10 mg/m^2 on day +3, +6 and +11 after HSC transplantation.at the doses of 15 mg/m^2 IV bolus on Day +1, and 10 mg/m^2 IV bolus on Days +3, +6 and +11 after hematopoietic stem cell infusion.
The Day +11 dose of methotrexate will be not given to those patients who fail to reach white blood cell count (WBC) of more than 1.0×10^9/L.
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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Incidence of Acute GVHD Grades II-IV
大体时间：1 Year
|
1 Year
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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总生存期
大体时间：1年
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1年
|
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Incidence of Acute GVHD Grades III-IV
大体时间：By day +100 post-HSCT
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By day +100 post-HSCT
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Incidence of Chronic GVHD
大体时间：1 Year
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1 Year
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Hematologic Recovery (Neutrophils and Platelets)
大体时间：Up to day +100 post-HSCT
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Up to day +100 post-HSCT
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Disease Relapse or Progression
大体时间：1 Year
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1 Year
|
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Incidence of Transplant-Related Mortality
大体时间：By day +100 post-HSCT
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By day +100 post-HSCT
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Frequency of Grade 3 or Greater Toxicities
大体时间：Up to day +100 post-HSCT
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Up to day +100 post-HSCT
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Incidence of Grade 2 and 3 Infections
大体时间：1 Year
|
1 Year
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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。
调查人员
- 首席研究员：Hu Chen, M.D., Ph.D.、Affiliated Hospital to Academy of Military Medical Sciences
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
2014年4月1日
初级完成 (预期的)
2016年12月1日
研究完成 (预期的)
2017年4月1日
研究注册日期
首次提交
2016年6月3日
首先提交符合 QC 标准的
2016年6月9日
首次发布 (估计)
2016年6月15日
研究记录更新
最后更新发布 (估计)
2016年6月15日
上次提交的符合 QC 标准的更新
2016年6月9日
最后验证
2016年6月1日
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.