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临床试验/NCT00031824
NCT00031824已完成3 期

Phase III Trial of Hydroxychloroquine + Standard Therapy for Chronic Graft-Versus-Host Disease

Children's Oncology Group104 个研究点 分布在 2 个国家目标入组 82 人开始时间: 2002年4月1日最近更新:
适应症
相关药物

试验速览

阶段
3 期
状态
已完成
入组人数
82
试验地点
104
主要终点
Progression Free Survival

研究概览

简要总结

RATIONALE: Hydroxychloroquine may decrease the immune response and be effective in treating chronic graft-versus-host disease. It is not yet known if standard therapy for graft-versus-host disease is more effective with or without hydroxychloroquine.

PURPOSE: Randomized phase III trial to compare the effectiveness of standard therapy alone with that of standard therapy plus hydroxychloroquine in treating patients who have newly diagnosed chronic graft-versus-host disease.

详细描述

OBJECTIVES:

Primary

  • Compare the efficacy of prednisone and cyclosporine with vs without hydroxychloroquine in patients with newly diagnosed extensive chronic graft-versus-host disease (GVHD).

Secondary

  • Compare the event-free and overall survival in patients treated with these regimens.
  • Compare the health-related quality of life, including longitudinal change in and magnitude of persistent disability, in patients treated with these regimens.
  • Correlate cytokine levels and T-helper cell subtypes with chronic GVHD activity and response in patients treated with these regimens.
  • Correlate whole blood hydroxychloroquine levels with response and toxicity in patients treated with these regimens.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Single Group
主要目的
Supportive Care
盲法
Double

入排标准

年龄范围
1 Year 至 29 Years(Child, Adult)
性别
All
接受健康志愿者
否

入选标准

  • •DISEASE CHARACTERISTICS:
  • •Histologically confirmed* newly diagnosed extensive chronic graft-versus-host disease (GVHD) of ≥ 1 organ system (e.g., lip, skin, or liver) documented by all of the following:
  • •Clinicopathologic features of GVHD, including involvement of any of the following organ systems:
  • •Skin changes
  • •Oral changes
  • •Hepatic involvement
  • •Gastrointestinal involvement
  • •Sicca syndrome
  • •Pulmonary involvement
  • •Myofascial
  • •Other inflammatory conditions (e.g., myositis, arthritis, polyserositis, or unexplained pericardial, pleural, or peritoneal effusions)
  • •Autoantibodies
  • •Extent of disease, defined according to the following classification:
  • •Limited chronic GVHD, defined by 1 of the following:
  • •Localized skin involvement and/or liver dysfunction
  • •Involvement of only 1 target organ
  • •Extensive chronic GVHD, defined by 1 of the following:
  • •Generalized skin involvement of ≥ 50% of body surface area
  • •Localized skin involvement and/or liver dysfunction AND ≥ 1 of the following:
  • •Liver histology showing chronic aggressive hepatitis, bridging necrosis, or cirrhosis
  • •Eye involvement (Schirmer's test with < 5 mm wetting)
  • •Involvement of minor salivary glands or oral mucosa on lip biopsy
  • •Involvement of any other target organs
  • •Involvement of ≥ 2 target organs
  • •Timing of onset, including onset of any of the following types:
  • •Progressive onset defined as, evolving directly from acute GVHD, commonly with the development of typical manifestations such as oral or skin lichenoid changes or sclerodermatous skin changes
  • •Quiescent onset, defined as developing after the resolution of acute GVHD
  • •De novo onset, defined as developing with no prior history of acute GVHD
  • •Must have ≥ 1 typical clinical manifestation of chronic GVHD that differs from that of acute GVHD (e.g., rash, anorexia, nausea, emesis, diarrhea, abdominal pain, or cholestasis)
  • •Symptoms of acute GVHD allowed at the time of diagnosis of chronic GVHD
  • •Prior allogeneic bone marrow, peripheral blood stem cell, or cord blood transplantation from a family member or unrelated donor for malignancy required NOTE: *Histologic confirmation may be "consistent with GVHD"
  • •PATIENT CHARACTERISTICS:
  • •Performance status:
  • •Lansky 50-100% OR
  • •Karnofsky 50-100%
  • •Life expectancy:
  • •At least 2 months
  • •Hematopoietic:
  • •Absolute neutrophil count ≥ 1,000/mm^3, unless due to chronic GVHD (i.e., autoimmune neutropenia or bone marrow suppression)
  • •See Disease Characteristics
  • •Creatinine < 1.5 times upper limit of normal OR
  • •Creatinine clearance ≥ 60 mL/min
  • •Not pregnant
  • •Negative pregnancy test
  • •Fertile patients must use effective contraception during and for 3 months after study participation
  • •No lysosomal storage disorder
  • •No uncontrolled infection (e.g., persistent bacterial, fungal, or viral infection despite appropriate antimicrobial therapy)
  • •No G6PD deficiency
  • •No history of psoriasis or porphyria
  • •No hypersensitivity to 4-aminoquinolines
  • 另有 31 项未显示

排除标准

  • 未提供

结局指标

主要结局

Progression Free Survival

时间窗: Length of study

次要结局

  • Compare the efficacy of a two-drug regimen(Length of study)
  • Compare conventional outcomes measures(Length of study)
  • To determine if cytokine levels and T helper cell subtypes (Th1 and Th2) correlate with chronic GVHD activity and response(Length of study)
  • Determine if whole blood hydroxychloroquine levels correlate with response and toxicity.

研究者

申办方类型
Network
责任方
Sponsor

研究点 (104)

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