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A prospective randomized study comparing rapamune and tacrolimus vs. cyclosporine and methotrexate as immune prophylaxis in allogeneic hematopoietic stem cell transplantation, using HLA-A, -B, DRß1 identical related or unrelated donors. A Nordic multicenter study

Conditions
Patients treated with allogeneic haematopoietic stem cell transplantation
Registration Number
EUCTR2006-006577-25-FI
Lead Sponsor
ordic Bone Marrow Transplant Group (NBMT)
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
200
Inclusion Criteria

Chronic myeloid leukemia (CML) in 1st or 2nd chronic phase, acute myeloid leukemia (AML) in complete remission, acute lymphoblastic leukemia (ALL) in complete remission, myelodysplastic syndrome, chronic lymphocytic leukemia, lymphoma, non-malignant disorders, severe aplastic anemia, hemoglobinopathies and metabolic disorders. More or less all diagnoses where there is an indication for hematopoietic stem cell transplantation with a related or unrelated HLA-identical donor may be included in the study. The inclusion of various cohorts of patients is at the discretion of each participating center – i.e., some centers may only want to include unrelated donors, other may want to include related and unrelated donors, and other centers may be more specific with regard to the various diagnoses. Since acute GVHD is the primary endpoint, all these different diagnoses may add to the statistical power of the analysis. Patients with leukemia will be analyzed separately to look at the incidence of relapse. If important factors are unevenly distributed, multivariate analysis will be performed to evaluate significant factors.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

•Recipients of major HLA-mismatched grafts.
•Patients who are addicted to drugs or alcohol.
•Patients who receive other stem cell source than bone marrow or peripheral stem cells, for instance cord blood transplants.
•Patients with relapse or blast crisis of their malignant disease.
•Prior allogeneic transplant using any hematopoietic stem cell source
•Seropositive for the human immunodeficiency virus (HIV)
•Uncontrolled bacterial, viral, or fungal infection (progression of clinical symptoms)
•Pregnant (positive serum human chorionic gonadotropin [ß-HCG] test) or breastfeeding within 4 weeks of study entry
•Kidney function: serum creatinine outside the normal range for age, or measured creatinine clearance less than 40 mL/min/1.72m² within 4 weeks of study entry and proteinuria >0.3 g/day
•Liver function: most recent direct bilirubin, ALT, or AST greater than two times the upper limit of normal within 4 weeks of study entry
•Lung disease: in adults, FVC or FEV1 less than 60% of predicted value (corrected for hemoglobin); in children, overt hypoxemia, as measured by an oxygen saturation of less than 92% within 4 weeks of study entry
•Cardiac ejection fraction of less than 45% in adults and children, or less than 26% shortening fraction in children within 4 weeks of study entry
•Cholesterol level greater than 300 mg/dL or triglyceride level greater than 300 mg/dL while being treated, or not on appropriate lipid-lowering therapy within 4 weeks of study entry
•Karnofsky score <70%
•Prior history of allergy to sirolimus
•Requires voriconazole at time of study entry
•Currently receiving another investigational drug unless cleared by the principal investigator and sponsor

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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