Efficacy of Low-dose PT-Cy for Prevention of GVHD in Ambulatory Allogeneic HSCT

NCT07319000 — Phase 2, Completed, 35 participants, Hospital Universitario Dr. Jose E. Gonzalez

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Efficacy of Low-dose Post-transplant Cyclophosphamide for Prevention of Graft-versus-host Disease in Ambulatory Allogeneic Hematopoietic Stem Cell Transplantation

RegistryNCT07319000
StatusCompleted
PhasePhase 2
Study typeInterventional; na, single group, masking: none, treatment
Enrollment35 (Actual)
SponsorHospital Universitario Dr. Jose E. Gonzalez (Other)
ConditionsGraft Versus Host Disease
InterventionsCyclophosphamide (Drug)
Datesstart 2023-01-01, primary completion 2023-12-31, completion 2023-12-31, first posted 2026-01-06, last updated 2026-01-06
Locations1 site in Mexico

Related Papers Related Patents Related Grants Related Experts
All trials for Graft Versus Host Disease All trials of Cyclophosphamide

-Summary

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.

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+Detailed description

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.

+Arms and interventions

ArmTypeInterventionsDescription
Low-dose post-transplant cyclophosphamideExperimentalDrug: CyclophosphamideLow 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.
  • Cyclophosphamide (Drug): low-dose post-transplant cyclophosphamide

+Outcome measures

Primary outcomes

  • Efficacy of Low-dose PT-Cy [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.

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* 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.

Exclusion Criteria:

* 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.

+Locations (1)

FacilityCityCountryStatus
Hospital Universitario de MonterreyMonterreyMexico

+Publications

  • Results publication: Sugita J, Kamimura T, Ishikawa T, Ota S, Eto T, Kuroha T, Miyazaki Y, Kumagai H, Matsuo K, Akashi K, Taniguchi S, Harada M, Teshima T. Reduced dose of posttransplant cyclophosphamide in HLA-haploidentical peripheral blood stem cell transplantation. Bone Marrow Transplant. 2021 Mar;56(3):596-604. doi: 10.1038/s41409-020-01065-0. Epub 2020 Sep 24. PMID 32973350