Sirolimus With Tacrolimus for Graft-vs-Host Disease Prophylaxis After Related Stem Cell Transplantation
Primary Purpose
Hematologic Malignancies, Myelogenous Leukemia, Acute Lymphoblastic Leukemia
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Sirolimus
Tacrolimus
Sponsored by
About this trial
This is an interventional prevention trial for Hematologic Malignancies focused on measuring Graft versus host disease, GVHD, Stem cell transplantation, sirolimus, tacrolimus
Eligibility Criteria
Inclusion Criteria: Patients with hematologic malignancies who will undergo allogeneic HSCT from matched family-members. Age greater than 18 ECOG performance status 0-2 Total bilirubin < 2.0 mg/dl AST < 90 IU Serum creatinine < 2.0 mg/dl Exclusion Criteria: Active, uncontrolled infection Ejection fraction < 45% by echocardiogram or MUGA scan Forced vital capacity < 60% Uncontrolled hypertension Second transplantation Evidence of HIV infection Cholesterol > 300 mg/dl Relapsed aggressive Burkitt's or Burkitt's-like lymphoma
Sites / Locations
- Dana-Farber Cancer Institute
Outcomes
Primary Outcome Measures
To determine the feasibility of using sirolimus and tacrolimus without methotrexate for GVHD prophylaxis after stem cell transplantation.
Secondary Outcome Measures
To compare the rates of grade II-IV and III-IV acute GVHD with historical controls
to determine the incidence of 100 day mortality after stem cell transplant using this regimen
to determine the overall survival at 1 year after transplantation in this patient population.
Full Information
NCT ID
NCT00144703
First Posted
September 1, 2005
Last Updated
January 24, 2012
Sponsor
Dana-Farber Cancer Institute
Collaborators
Brigham and Women's Hospital
1. Study Identification
Unique Protocol Identification Number
NCT00144703
Brief Title
Sirolimus With Tacrolimus for Graft-vs-Host Disease Prophylaxis After Related Stem Cell Transplantation
Official Title
Open Label Phase II Trial of Sirolimus in Combination With Tacrolimus for Graft-vs-Host Disease Prophylaxis After Matched, Related Allogeneic Hematopoietic Stem Cell Transplantation
Study Type
Interventional
2. Study Status
Record Verification Date
January 2009
Overall Recruitment Status
Completed
Study Start Date
July 2002 (undefined)
Primary Completion Date
November 2006 (Actual)
Study Completion Date
November 2006 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dana-Farber Cancer Institute
Collaborators
Brigham and Women's Hospital
4. Oversight
5. Study Description
Brief Summary
The purpose of this study is to evaluate the ability of sirolimus to prevent graft versus host disease (GVHD) in patients following stem cell transplant from a related donor.
Detailed Description
Therapy to prevent GVHD will consist of an infusion of tacrolimus intravenously and sirolimus orally once per day starting 3 days before stem cell infusion. This will take place in the hospital where the patient will remain for the duration of the transplant.
Sirolimus will continue for 9 weeks at at stable dose, then will be tapered by 1/3 on week 9 and 1/3 on week 17. It will be stopped on week 26 if there is no significant evidence of GVHD. These dose modifications will occur at home and patients will be seen weekly for the first 2 months after discharge.
If GVHD is present, the tapering schedule wil be slower and based upon the patient's clinical condition.
Tacrolimus will be given orally once the patient is discharged from the hospital and will be tapered at the same schedule as sirolimus. Blood levels of both tacrolimus and sirolimus will be monitored and the dose adjusted accordingly.
During the year following stem cell transplant, blood work will be performed to evaluate the immune system and GVHD.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hematologic Malignancies, Myelogenous Leukemia, Acute Lymphoblastic Leukemia, Myelodysplastic Syndrome, Non-Hodgkin's Lymphoma, Hodgkin's Disease
Keywords
Graft versus host disease, GVHD, Stem cell transplantation, sirolimus, tacrolimus
7. Study Design
Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
55 (false)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
Sirolimus
Intervention Type
Drug
Intervention Name(s)
Tacrolimus
Primary Outcome Measure Information:
Title
To determine the feasibility of using sirolimus and tacrolimus without methotrexate for GVHD prophylaxis after stem cell transplantation.
Secondary Outcome Measure Information:
Title
To compare the rates of grade II-IV and III-IV acute GVHD with historical controls
Title
to determine the incidence of 100 day mortality after stem cell transplant using this regimen
Title
to determine the overall survival at 1 year after transplantation in this patient population.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with hematologic malignancies who will undergo allogeneic HSCT from matched family-members.
Age greater than 18
ECOG performance status 0-2
Total bilirubin < 2.0 mg/dl
AST < 90 IU
Serum creatinine < 2.0 mg/dl
Exclusion Criteria:
Active, uncontrolled infection
Ejection fraction < 45% by echocardiogram or MUGA scan
Forced vital capacity < 60%
Uncontrolled hypertension
Second transplantation
Evidence of HIV infection
Cholesterol > 300 mg/dl
Relapsed aggressive Burkitt's or Burkitt's-like lymphoma
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Corey Cutler, MD, MPH
Organizational Affiliation
Dana-Farber Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dana-Farber Cancer Institute
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Sirolimus With Tacrolimus for Graft-vs-Host Disease Prophylaxis After Related Stem Cell Transplantation
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