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ATG Plus Low-dose PT-Cy for GVHD Prevention

Phase 3
Recruiting
Conditions
Hematologic Malignancy
Interventions
Registration Number
NCT06108739
Lead Sponsor
Peking University People's Hospital
Brief Summary

During the past decades, the wider application of easily available haploidentical donor hematopoietic cell transplant (haplo-HCT) has been made possible through the T cell-replete (TCR) regimens including T cell regulation with anti-thymocyte globulin (ATG)/granulocyte colony-stimulating factor (GCSF) and post-transplant cyclophosphamide (PTCy). To achieve decreased non-relapse mortality (NRM) and improved long-term outcomes in haploidentical transplant, the joint use of ATG and PTCy might effectively reduce graft versus host disease (GVHD) and mortality associated with severe forms of GVHD. Recently, investigators established a regimen using low-dose PTCy in conjunction with standard-dose ATG in order to lower the risk of GVHD without compromising engraftment and disease relapse.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
196
Inclusion Criteria
  1. Patients with acute leukemia and/or myelodysplastic syndrome undergoing their first allogeneic hematopoietic stem cell transplantation;
  2. Male or female , aged 12-55 years;
  3. Haploidentical donor transplantation;
  4. ECOG score ≤3; The basic organ function tests met the following standards;
  1. Cardiac ejection index >55% 2) Creatinine ≤1.5 times the highest normal value (ULN)
Exclusion Criteria
  1. Severe brain, heart, kidney or liver dysfunction;
  2. Refractory malignant state;
  3. Patients with other malignant tumors requiring treatment;
  4. Clinically uncontrolled severe active infection;
  5. The expected survival time was less than 3 months.
  6. A history of severe anaphylaxis.
  7. Pregnant or lactating women;
  8. Any condition considered by the investigators to be unsuitable for enrollment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ATG-PTCy cohortCyclophosphamidThe conditioning regimen is ATG/G-CSF based protocol (the so-called Beijing protocol). The rabbit ATG (Sangstat-Genzyme) 2.5mg/kg/day i.v., on days from - 5 to - 2 were administered.Two doses of 14.5 mg/kg Cy were given on days 3 and 4 post-HCT in ATG-PTCy cohort.
ATG-PTCy cohortATGThe conditioning regimen is ATG/G-CSF based protocol (the so-called Beijing protocol). The rabbit ATG (Sangstat-Genzyme) 2.5mg/kg/day i.v., on days from - 5 to - 2 were administered.Two doses of 14.5 mg/kg Cy were given on days 3 and 4 post-HCT in ATG-PTCy cohort.
ATG cohortATGThe conditioning regimen is ATG/G-CSF based protocol (the so-called Beijing protocol). The rabbit ATG (Sangstat-Genzyme) 2.5mg/kg/day i.v., on days from - 5 to - 2 were administered.
Primary Outcome Measures
NameTimeMethod
The incidence of acute graft versus host disease.100 days post HSCT.

The incidence of acute graft versus host disease. The severity of acute GVHD was evaluated according to standard international criteria.

Secondary Outcome Measures
NameTimeMethod
Engraftment30 days post HSCT.

Myeloid engraftment was defined as the first of three consecutive days with an ANC X0.5≥10\^9/L.

The incidence of chronic GvHD1 year post HSCT.

The incidence of chronic GvHD.

The incidence of non-relapse mortality1 year post HSCT.

The incidence of non-relapse mortality

The incidence of infection1 year post HSCT.

The incidence of infection

Overall survival1 year post HSCT.

Overall survival

The incidence of relapse1 year post HSCT.

The incidence of relapse

Immune reconstitution1 year post HSCT.

Immune reconstitution was evaluated at 1, 2, 3, 6, 9 and 12 months by analysis of peripheral blood MNCs detecting CD3, CD4, CD19 and immunoglobulin (Ig) A, G and M levels.

Disease free survival1 year post HSCT.

Disease free survival

GvHD relapse free survival1 year post HSCT.

GvHD relapse free survival

Trial Locations

Locations (1)

Peking University People's Hospital

🇨🇳

Beijing, China

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