A Phase II Trial of Prophylactic Rituximab Therapy for Prevention of Chronic Graft-vs.-Host Disease After Allogeneic Stem Cell Transplantation
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 65
- 试验地点
- 2
- 主要终点
- Incidence of Clinician-diagnosed Chronic GVHD at One and Two Years
研究概览
简要总结
The purpose of this trial is to determine if administration of rituximab after allogeneic stem cell transplantation can reduce the incidence of chronic GVHD. Chronic GVHD is a medical condition that can occur after bone marrow or stem cells are transplanted form one individual to another. After the transplant, the donor immune system may recognize the recipient body as foreign and may attempt to "reject" the body. Rituximab is a drug that interferes with the immune system function by specifically targeting B cells and killing them.
详细描述
Study Design: The study is designed as a Phase II, open label trial of Rituximab as chronic GVHD prophylaxis after HLA-matched, related or unrelated peripheral blood stem cell transplantation after ablative or non-ablative conditioning.
Primary Objective: To determine the incidence of clinically extensive chronic GVHD at one and two years after allogeneic stem cell transplantation after a single dose of Rituximab administered at 100 days, 6 months, 9 months and 1 year from transplantation as chronic GVHD prophylaxis.
Secondary Objectives: To determine the incidence of adverse hematological events, the incidence of infectious complications, the rate of malignant relapse, and the effects on donor hematopoietic chimerism after Rituximab administration.
Eligibility Criteria: Eligible patients will be 18 years of age or greater and will have undergone a non-myeloablative or fully ablative transplantation from an HLA-matched (6/6 loci) or single antigen/allele mismatched (5/6) donor approximately 100 days ago. Adequate performance status and organ function will be confirmed prior to enrollment. No ongoing infection or acute GVHD will be present at the time of enrollment. Evidence of sustained donor chimerism will be confirmed prior to study entry.
Treatment Description: Chronic GVHD prophylaxis will consist of Rituximab 375 mg/m2 administered 100 days, 6, 9 and 12 months after transplantation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who have undergone either ablative or non-myeloablative allogeneic stem cell transplantation
- •Peripheral blood stem cells must have been used as the stem cell source
- •Patients must have received transplantation from donors who are identical at 6 HLA loci, or mismatched at no more than 1 locus.
- •Patients who have undergone a non-myeloablative stem cell transplant must have > 80% donor hematopoiesis within 30 days of study enrollment
- •18 years of age or older
- •Performance Status 0-2
- •Life expectancy of > 100 days
- •Subjects with CLL are eligible, if there is no more than 20% residual leukemia in the bone marrow at the time of study entry
排除标准
- •Evidence of relapsed or residual malignancy within 30 days of trial entry
- •Highly aggressive B cell malignancy, such as Burkitt's lymphoma or Burkitt's-like lymphoma
- •Allogeneic stem cell transplantation using a single or multiple umbilical cord blood units or using bone marrow
- •Evidence of any active uncontrolled infection, or evidence of natural exposure to Hepatitis B, Hepatitis C or HIV
- •Evidence of ongoing gastrointestinal or hepatic acute GVHD, or evidence of greater than ongoing Stage I cutaneous acute GVHD
- •GVHD with chronic features diagnosed prior to day +100 or prior to enrollment
- •Participation in a clinical trial evaluating another preventative strategy for chronic GVHD, or ongoing participation in a clinical trial for therapy of acute GVHD
- •No Donor Lymphocyte Infusion (DLI) prior to day 100 and not plans for a DLI in the upcoming 30 days
- •Heart failure uncontrolled by medications
- •Pregnancy or lactation
结局指标
主要结局
Incidence of Clinician-diagnosed Chronic GVHD at One and Two Years
时间窗: by 1 and 2 years after peripheral blood stem cell (PBSC) infusion
次要结局
- Incidence of Grade 3 or Higher Infectious Complications(by 1 and 2 years after peripheral blood stem cell (PBSC) infusion)
- Incidence of Relapse or Progression of Disease(by 4 years after peripheral blood stem cell (PBSC) infusion)
- Incidence of Adverse Hematological Events(by 18 months after peripheral blood stem (PBSC) infusion)
研究者
Corey S. Cutler, MD, MPH
Principal Investigator
Dana-Farber Cancer Institute
