Clinical Registration Study of Haplo-HSCT for Elderly Patients With Acute Leukemia/ Myelodysplastic Syndrome

Sponsor
Peking University People's Hospital (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05902416
Collaborator
(none)
120
1
18
6.7

Study Details

Study Description

Brief Summary

This study is an open, prospective, single-center, single-arm study expanded based on the study of NCT03412409.The primary objective of this study is to evaluate the transplantation efficacy of the RIC conditioning regimen in elderly patients receiving the transplantation of haploidentical hematopoietic stem cells. Elderly patients are defined as ≥55 years of age; High comorbidity is defined as an HCT-CI score ≥3.Primary endpoint is 1-year LFS. Secondary endpoints are 1-year OS and 1-year TRM, Other indicators to be assessed in this study include acute GVHD, chronic GVHD, CMV activation, EBV activation, engraftment.

Condition or Disease Intervention/Treatment Phase

    Detailed Description

    Currently, the transplantation of allogeneic hematopoietic stem cells (allo-SCT) remains the main and often the only cure for neoplastic hematologic disorder or hematological malignancy. Although HLA-matched siblings are the preferred donor, not all patients have one; or it needs to wait so long to obtain it that the optimal time for transplantation is past. Haploidentical transplants as secondary donors are more readily available and may be considered in combination with the conditions of the donor and the patient and the experience of the transplant facility when a matched donor is unavailable. Currently, haploidentical transplantation has been commonly applied to young patients. On the other hand, TRM rate will be higher in elderly patients and patients with high comorbidity due to tolerability, thus reducing the ultimate benefits of patients.

    The choice of conditioning regimen is influenced by multiple factors such as disease type, disease status, physical condition, and source of transplant donor. For patients over 55 years of age or with a comorbidity index ≥3, the RIC regimen may be considered to improve patient tolerability. RIC regimen can improve the tolerability of patients receive transplants, while regimens such as immune suppressants are also needed to control and improve the overall transplant efficiency. An in-depth study of RIC regimen will help improve the effects of transplantation and increase patient benefits.

    This study is aim to evaluate the efficacy of RIC conditioning regimen for transplantation in elderly patients or patients with high comorbidity receiving the transplantation of haploidentical hematopoietic stem cells.

    Drugs and dosage of conditioning regimen:

    Ara-C(2g/m2/day,-10 days to -9 days),Bu(9.6mg/kg,-8 days to -6 days),Flu(30mg/m2/day,-6 days to -2 days),Cy(1,000mg/m2/day,-5 days to -4 days),semustine(250mg/m2,-3 days),ATG(10 mg/kg,-5 to -2 days).

    Supportive care:

    CsA: To prevent GVHD, CsA therapy starts 9 days before transplantation at 2.5 mg/kg intravenously until gut function returns to normal after transplantation; CsA is then orally administered. MMF: To prevent GVHD, 0.5g of MMF is orally administered every 12 hours 9 days before transplantation until hematopoietic function is restored after transplantation. MTX: To prevent GVHD, MTX is intravenously administered at 15 mg/m2 on day 1 after transplantation. On days 3, 6 and 11 after transplantation, MTX is intravenously administered at 10 mg/m2. Ganciclovir: To prevent post-transplantation CMV infection, it is administered 2 days before transplantation, and to prevent post-transplantation CMV infection, it is orally administered at 400 mg twice a day until the end of all immunosuppressive medications.

    Primary endpoint is 1-year LFS. Secondary endpoints are 1-year OS and 1-year TRM, Other indicators to be assessed in this study include acute GVHD, chronic GVHD, CMV activation, EBV activation, engraftment.

    CMV and EBV Tests are performed twice weekly for monitor based on PCR means.

    The follow-up period designed for this study is 1 year, with the day of hematopoietic stem cell transplantation as Day 1 and the visit dates of Day 0, 1st month, 2nd month, 3rd month, 6th month and 12th month. The end of the study is defined as the date of the last visit of the last patient (LPLV).

    Study Design

    Study Type:
    Observational
    Anticipated Enrollment :
    120 participants
    Observational Model:
    Cohort
    Time Perspective:
    Prospective
    Official Title:
    Clinical Registration Study of Haploidentical Stem Cell Transplantation for Elderly Patients With Acute Leukemia or Myelodysplastic Syndrome
    Anticipated Study Start Date :
    Jun 1, 2023
    Anticipated Primary Completion Date :
    Jun 1, 2024
    Anticipated Study Completion Date :
    Dec 1, 2024

    Arms and Interventions

    Arm Intervention/Treatment
    RIC regimen,Elderly,Haplo-HSCT,PFS,OS,TRM

    Outcome Measures

    Primary Outcome Measures

    1. 1-year LFS [Participants will be followed for an expected average of 1 years]

      defined as disease relapse, disease progression or death (whichever occurs first) within 1 year from the day the patient receives transplantation.

    Secondary Outcome Measures

    1. 1-year OS [Participants will be followed for an expected average of 1 years]

      defined as survival rate within 1 year from the day the patient receives transplantation, calculated based on death from any cause.

    2. 1-year TRM [Participants will be followed for an expected average of 1 years]

      defined as death from any cause other than disease relapse within 1 year from the day the patient receives transplantation.

    Other Outcome Measures

    1. Adverse event [Participants will be followed for an expected average of 1 years]

      The incidence rate of acute GVHD, chronic GVHD, CMV activation, EBV activation after transplantation

    2. Engraftment rate [Participants will be followed for an expected average of 1 years]

      The success rate of engraftment after transplantation

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    55 Years to 70 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Patients ≥55 years of age and <70 years of age, with acute leukemia or MDS (with or without HCT-CI≥3);

    • Patients eligible for the transplantation of allogeneic hematopoietic stem cells;

    • Patients unavailable with HLA matched donors but available with haploidentical donors;

    • Voluntary participation in this study and signing the informed consent form.

    Exclusion Criteria:
    • Patients with the severe infections;

    • Pregnant or lactating women or female and male subjects of childbearing age and their spouses who are unable to secure effective contraception during the dosing period and within 90 days after the end of the dosing period.

    • Patients who are not eligible for hematopoietic stem cell transplantation;

    • Patients who are enrolled in other clinical trials within 1 month;

    • Patients who may not be able to complete the study for other reasons, or may be considered by the investigator not suitable to participate in the study;

    • Patients unable to properly understand or refusing to accept the informed consent form.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Peking University People's Hospital Beijing Beijing China 100044

    Sponsors and Collaborators

    • Peking University People's Hospital

    Investigators

    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Xiao-Jun Huang, Principal Investigator, Peking University People's Hospital
    ClinicalTrials.gov Identifier:
    NCT05902416
    Other Study ID Numbers:
    • 2022PHB352-001
    First Posted:
    Jun 15, 2023
    Last Update Posted:
    Jun 15, 2023
    Last Verified:
    Jun 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Xiao-Jun Huang, Principal Investigator, Peking University People's Hospital
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Jun 15, 2023