Efficacy of Low-dose Post-transplant Cyclophosphamide for Prevention of Graft-versus-host Disease in Ambulatory Allogeneic Hematopoietic Stem Cell Transplantation
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 发起方
- 入组人数
- 35
- 试验地点
- 1
- 主要终点
- Efficacy of Low-dose PT-Cy
研究概览
简要总结
Low-dose post-transplant cyclophosphamide have demonstrated therapeutic efficacy in allogeneic stem cell transplants which is comparable with the standard dose and also facilitates early hematological recovery.
详细描述
Graft-versus-host disease (GVHD) is the most important complication that occurs in hematopoietic stem cell transplantation (HSCT). GVHD prophylaxis based on the use of post-transplant cyclophosphamide (PT-Cy) has proven to be a practical, easily and accessible agent that allows both identical and haploidentical transplants to be performed with lower incidences of this disease.
Low-dose cyclophosphamide have already demonstrated therapeutic efficacy in these types of transplants which is comparable with the standard dose and also facilitates early hematological recovery that can in turn reduce risks of infection, hospital stay and total costs for the patient.
The investigators will conduct a phase 2, non-randomized, single center, non-comparative clinical trial to demonstrate the effectiveness of of low-dose PT-Cy which is accessible to a population with limited resources while maintaining acceptable efficacy and safety to prevent GVHD.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 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
- •Age >18 years.
- •Both genders.
- •Diagnosis of any blood disease in need of an allogeneic bone marrow transplant (aplastic anemia, acute myeloid leukemia, chronic granulocytic leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome, chronic myelomonocytic leukemia, Hodgkin lymphoma, and Non-Hodgkin lymphoma).
- •Patients who have compatible related donors to perform an identical or haploidentical allogeneic transplant.
- •Patients with functional status 0 to 2 using the ECOG scale.
排除标准
- •Poor functional status (ECOG>2).
- •Organic dysfunction (Marshall score ≥2).
- •Pregnancy
- •Heart failure (NYHA III or IV).
- •Renal failure (GFR <30 ml/min/1.72m2).
- •History of ventricular arrhythmias or uncontrolled arrhythmias.
- •Acute myocardial infarction, unstable angina, or stable angina in the last six months.
- •Uncontrolled active infection.
- •Liver disease (Child-Pugh C).
- •Patients not approved by the local transplant committee for any other reason.
研究组 & 干预措施
Low-dose post-transplant cyclophosphamide
Low dose post-transplant cyclophosphamide therapy will be administered as follows:
Allogeneic stem cell transplant:
Cyclophosphamide 30/mg/kg/day for 2 continuous days.
Haploidentical stem cell transplant:
Cyclophosphamide 40/mg/kg/day for 2 continuous days.
干预措施: Cyclophosphamide (Drug)
结局指标
主要结局
Efficacy of Low-dose PT-Cy
时间窗: 6 months
Low-dose PT-Cy (30 and 40 mg/kg/day/2 days) is effective in achieving an incidence of grade III/IV (Glucksberg grade) acute GVHD and moderate to severe chronic GVHD equal to or below historical controls of 20 and 30%, respectively.
次要结局
未报告次要终点
研究者
Cesar Homero Gutierrez-Aguirre
Professor of Hematology Service
Hospital Universitario Dr. Jose E. Gonzalez