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Maraviroc as GVHD Prophylaxis in Transplant Recipients

Phase 1
Terminated
Conditions
Diagnoses That Require Stem Cell Transplant
Graft Versus Host Disease (GVHD)
Interventions
Registration Number
NCT02167451
Lead Sponsor
Children's Hospital Medical Center, Cincinnati
Brief Summary

The purpose is to determine if the addition of Maraviroc to a standard transplant regimen will reduce the incidence of graft versus host disease in children and young adults after a stem cell transplant.

Detailed Description

In the first stage, drug levels will be obtained to establish appropriate dosing. In the second stage of the study the investigators will study the effects of using Maraviroc in these patients.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
31
Inclusion Criteria
  • Ages 5 years and </= 40 years
  • All diagnoses
  • Peripheral blood stem cells, marrow or cord blood
  • All conditioning regimens
  • Patient must be planned to receive a calcineurin inhibitor (cyclosporine or tacrolimus) together with steroid, methotrexate or mycophenolate mofetil as GVHD prophylaxis.
Exclusion Criteria
  • Documented anaphylaxis to Maraviroc
  • Ex vivo T-cell (type of white blood cell) depleted grafts
  • Abnormal Alanine Aminotransferase (ALT) (>/=10X ULN) on day -3. (Assessed at study enrollment and confirmed again prior to the first dose of maraviroc.)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
MaravirocMaravirocMaraviroc administration will start on day -3 and will end on day +30 after stell cell transplant, making the total number of days of drug administration 34 days. Maraviroc will be administered twice daily orally or via enteral tube. Dosing of Maraviroc will be based on body surface area (starting with 100mg twice a day for BSA of 0.2 and up to 300mg twice a day for BSA greater than 1.73).
Primary Outcome Measures
NameTimeMethod
Area Under The Concentration-Time Curve (AUC) of MaravirocDay 10

pK target \>100ng/ml at day 10 at the following time points : before the dose and 1, 2, 4, 6, 8, and 12 hours after maraviroc administration

Incidence of Visceral GVHDday+100

determine the number of patients who develop visceral GVHD by day+100

Feasibility of MaravirocUp to day +100

The ability to administer twice daily oral maraviroc in children and adults undergoing stem cell transplant in addition to routine standard graft versus host disease prophylaxis.

GVHD IncidenceBy day +100

Incidence of GVHD by day+100

Secondary Outcome Measures
NameTimeMethod
Overall SurvivalBy day +100

Overall survival for patients who were enrolled and received maraviroc

Graft FailureBy day +100

Failure to engraft and loss of graft.

Primary Disease RelapseBy day +100
ToxicitiesUp to day +100

Incidence of toxicities due to drug

Infectious ComplicationsUp to day +100

Infections complications which include asymptomatic viremias for EBV, Adenovirus, CMV, and/or viral disease, bacterial and fungal infections as documented by blood cultures.

Time to NeutrophilUp to day +100

Neutrophil engraftment is defined as the first of three consecutive measurements of ANC\>500mcL over 3 or more days.

Time to Platelet Engraftmentdays

Time to achieve platelets count of 20,000 without transfusions

Trial Locations

Locations (1)

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

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