Letermovir Prophylaxis Duration Guided by CMV-Specific T-cell Monitoring After Allo-HSCT.
A Multicenter, Randomized, Controlled, Open-label Clinical Study to Evaluate the Efficacy and Safety of Letermovir Prophylaxis Duration Guided by Dynamic Monitoring of Specific T-cells for Preventing Cytomegalovirus Infection in Adult Recipients of Allogeneic Hematopoietic Stem Cell Transplantation in China.
The purpose of this study is to evaluate the efficacy and safety of a personalized strategy for discontinuing Letermovir (a drug used to prevent Cytomegalovirus [CMV] infection) based on the recovery of the patient's own immune system.
Cytomegalovirus (CMV) is a common and serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Currently, Letermovir is typically given as a standard prevention for about 100 days post-transplant. However, some patients may recover their CMV-specific immunity earlier, while others may need longer protection.
In this study, researchers will use a dynamic monitoring technology (QuantiFERON-CMV) to detect the level of CMV-specific T-cells in patients. Participants will be randomly assigned to either the experimental group or the control group:
Experimental Group: Letermovir discontinuation will be guided by T-cell recovery. If the test shows that the patient's CMV-specific T-cells have recovered, Letermovir may be stopped earlier than the standard 100 days.
Control Group: Patients will receive the standard Letermovir prophylaxis for approximately 100 days, regardless of T-cell status.
The study aims to determine if this immune-guided strategy can effectively prevent CMV infection while potentially reducing the duration of medication and associated costs, without increasing the risk of CMV disease.
研究概览
地位
研究类型
注册 (估计的)
阶段
- 第四阶段
联系人和位置
学习联系方式
- 姓名:wei MD, PhD
- 电话号码:+86 027-85726003
- 邮箱:shiwei076@hust.edu.cn
学习地点
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Beijing Municipality
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Beijing、Beijing Municipality、中国、100853
- 尚未招聘
- Chinese PLA General Hospital
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接触:
- Fei Li
- 电话号码:+86 18611406860
- 邮箱:847982123@qq.com
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Hebei
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Shijiazhuang、Hebei、中国、050000
- 尚未招聘
- The Second Hospital of Hebei Medical University
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接触:
- Fuxu Wang
- 电话号码:+86 13931100360
- 邮箱:827064030@qq.com
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Henan
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Zhengzhou、Henan、中国、450008
- 尚未招聘
- Henan Cancer Hospital
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接触:
- Jian Zhou
- 电话号码:+86 13623822347
- 邮箱:zhoujiandoctor@163.com
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Zhengzhou、Henan、中国、450052
- 尚未招聘
- The First Affiliated Hospital of Zhengzhou University
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接触:
- Weijie Cao
- 电话号码:+86 15093360671
- 邮箱:caoweijie2003@126.com
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Hubei
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Jingzhou、Hubei、中国、434020
- 尚未招聘
- Jingzhou Central Hospital
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接触:
- Yuanyan Tang
- 电话号码:+86 18107168243
- 邮箱:343665915@qq.com
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Jingzhou、Hubei、中国、434000
- 尚未招聘
- Jingzhou First People's Hospital
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接触:
- Jie Tan
- 电话号码:+86 18163137226
- 邮箱:Tanjie@yangtzeu.edu.cn
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Wuhan、Hubei、中国、430071
- 尚未招聘
- Zhongnan Hospital of Wuhan University
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接触:
- Fei Chen
- 电话号码:+86 13545297071
- 邮箱:chenfeiwhu@whu.edu.cn
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Wuhan、Hubei、中国、430030
- 尚未招聘
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
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接触:
- Yang Cao
- 电话号码:+86 13986142606
- 邮箱:caoyangemma@163.com
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Wuhan、Hubei、中国、430022
- 招聘中
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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接触:
- Wei Shi, M.D.
- 电话号码:+86 027-85726003
- 邮箱:shiwei076@hust.edu.cn
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Inner Mongolia
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Hohhot、Inner Mongolia、中国、010050
- 尚未招聘
- The Affiliated Hospital of Inner Mongolia Medical University
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接触:
- Da Gao
- 电话号码:+86 13947130473
- 邮箱:gaoda72@163.com
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Jiangxi
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Nanchang、Jiangxi、中国、330006
- 尚未招聘
- The First Affiliated Hospital of Nanchang University
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接触:
- Xianbao Huang
- 电话号码:+86 18679119505
- 邮箱:huangxianbao2017@163.com
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Zhejiang
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Wenzhou、Zhejiang、中国、325000
- 尚未招聘
- The First Affiliated Hospital of Wenzhou Medical University
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接触:
- Lan Sun Sun
- 电话号码:+86 13587685726
- 邮箱:sunlan91@126.com
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT).
- CMV serostatus of the recipient is positive (R+).
- Aged 18 years or older.
- Expected survival > 6 months.
- Provision of signed informed consent.
Exclusion Criteria:
1.Active CMV infection or CMV disease at the time of screening.
2.Known hypersensitivity to Letermovir or its excipients.
3.Severe hepatic or renal impairment.
4.Pregnant or breastfeeding women.
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 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:Experimental (T-cell Guided Group)
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Patients receive Letermovir prophylaxis (480 mg/day orally or IV) according to the standard protocol until approximately 100 days post-transplantation, regardless of T-cell recovery status.
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有源比较器:Active Comparator (Standard Prophylaxis Group)
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Patients receive Letermovir prophylaxis (480 mg/day orally or IV) according to the standard protocol until approximately 100 days post-transplantation, regardless of T-cell recovery status.
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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 |
|---|---|---|
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Incidence of Clinically Significant CMV Infection (CS-CMVi)
大体时间:Through 200 days post-transplantation
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The percentage of participants who develop clinically significant CMV infection, defined as CMV DNAemia requiring preemptive antiviral therapy (PET) according to institutional guidelines (e.g., two consecutive positive results or a single viral load ≥ 500 copies/mL) or the occurrence of CMV disease (e.g., CMV pneumonia, enteritis, or retinitis).
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Through 200 days post-transplantation
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Duration of Letermovir Prophylaxis
大体时间:Through 200 days post-transplantation
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The total number of days each participant received Letermovir prophylaxis from the start of treatment (between Day 0 and Day 28 post-HSCT) until the end of the intervention (up to 200 days).
This measure will compare the median duration of medication between the experimental arm (T-cell guided) and the control arm (standard 200-day prophylaxis) to evaluate the reduction in drug exposure.
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Through 200 days post-transplantation
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合作者和调查者
赞助
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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