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GM-CSF With Post-Transplant Cyclophosphamide

Primary Purpose

Transplant-Related Hematologic Malignancy

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Sargramostim
Control Arm
Sponsored by
Northside Hospital, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Transplant-Related Hematologic Malignancy

Eligibility Criteria

18 Years - 78 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Availability of 5/10 to 8/10 matched related donor
  • KPS >/= 70%
  • CML, AML, MDS, ALL, CLL, HD, NHL, MPS/CMML, MM, any other hematologic condition deemed an eligible indication for allogeneic transplant by the treating center

Exclusion Criteria:

  • Poor cardiac, pulmonary, liver, and renal function
  • HIV-positive
  • Patients who have a debilitating medical or psychiatric illness that would preclude them from giving informed consent
  • History of severe or serious allergic reaction to human GM-CSF or yeast-derived products

Sites / Locations

  • Northside HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

GM-CSF post-transplant

Arm Description

Sargramostim (GM-CSF) will start on Day +5 and continue until ANC >1000 x3 days or >1500 x1 day. GM-CSF will be administered not less than 24 hours after the last dose of cyclophosphamide and will be given at a dose of 250mcg/m2/day as an infusion over 2 hours.

Outcomes

Primary Outcome Measures

The number of patients who achieved neutrophil engraftment at 20 days after the initiation of treatment.
The aim of the study is to establish equivalent effectiveness of Sargramostim to a matched control cohort of G-CSF treated patients in time to achieve neutrophil (ANC >500 x3 days) post infusion of HLA-mismatched peripheral blood haploidentical stem cells with post-transplant cyclophosphamide. Patients will be followed for 3 months following the initiation of treatment to see engraftment numbers at 20 days after initial treatment.

Secondary Outcome Measures

How many patients are still alive measured by overall survival at 12 months following the initiation of treatment.
To estimate overall survival
How many patients have not relapsed measured by relapse rates at 12 months following the initiation of treatment.
To estimate relapse rates
How many patients develop graft-versus-host-disease (GVHD) measured by the incidence of GVHD at 12 months following initiation of treatment
To estimate incidence of GVHD
How many patients have not relapsed measured by progression-free survival at 12 months following the initiation of treatment
To estimate non-relapse mortality
How many patients died due to infections measured by the incidence and type of infections at 12 months following initiation of treatment
To estimate infection-related mortality
How many patients died due to a treatment-related adverse events grade 2 or greater as assessed by CTCAE v.4.0
To estimate event-free survival
Number of patients to achieve full donor chimerisms at Days 30, 50, 100, and 6 months post-transplant as measured by donor chimerism data
To estimate graft failure
Number of patients that acquired an infection in the first 100-days post-transplant as measured by the incidence of infections
To estimate the rate of infections
Number of patients achieving platelet engraftment as measured by platelets reaching 20,000 without transfusion for 7 days
To assess time to platelet engraftment

Full Information

First Posted
January 17, 2020
Last Updated
October 19, 2022
Sponsor
Northside Hospital, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04237623
Brief Title
GM-CSF With Post-Transplant Cyclophosphamide
Official Title
Phase II Trial Evaluating the Efficacy and Safety of Sargramostim Post-Infusion of T-Replete HLA Mismatched Peripheral Blood Haploidentical Hematopoietic Stem Cells and With Post Transplant Cyclophosphamide
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 18, 2020 (Actual)
Primary Completion Date
May 18, 2024 (Anticipated)
Study Completion Date
May 18, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Northside Hospital, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Given the increased number of HLA-mismatched haploidentical transplantation with post-transplant cyclophosphamide performed each year and the high risk of infectious complications associated with this type of transplant, the investigators suggest that GM-CSF administration post-infusion of T-replete haploidentical stem cells and post-transplant cyclophosphamide can yield similar count recovery rates to G-CSF with a potential of lowering risk of infectious complications.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Transplant-Related Hematologic Malignancy

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GM-CSF post-transplant
Arm Type
Experimental
Arm Description
Sargramostim (GM-CSF) will start on Day +5 and continue until ANC >1000 x3 days or >1500 x1 day. GM-CSF will be administered not less than 24 hours after the last dose of cyclophosphamide and will be given at a dose of 250mcg/m2/day as an infusion over 2 hours.
Intervention Type
Drug
Intervention Name(s)
Sargramostim
Other Intervention Name(s)
GM-CSF
Intervention Description
250mcg/m2/day IV starting Day +5
Intervention Type
Other
Intervention Name(s)
Control Arm
Other Intervention Name(s)
G-CSF
Intervention Description
Standard G-CSF given to those who decline to receive GM-CSF
Primary Outcome Measure Information:
Title
The number of patients who achieved neutrophil engraftment at 20 days after the initiation of treatment.
Description
The aim of the study is to establish equivalent effectiveness of Sargramostim to a matched control cohort of G-CSF treated patients in time to achieve neutrophil (ANC >500 x3 days) post infusion of HLA-mismatched peripheral blood haploidentical stem cells with post-transplant cyclophosphamide. Patients will be followed for 3 months following the initiation of treatment to see engraftment numbers at 20 days after initial treatment.
Time Frame
3 months after initial treatment
Secondary Outcome Measure Information:
Title
How many patients are still alive measured by overall survival at 12 months following the initiation of treatment.
Description
To estimate overall survival
Time Frame
12 months following initiation of treatment
Title
How many patients have not relapsed measured by relapse rates at 12 months following the initiation of treatment.
Description
To estimate relapse rates
Time Frame
12 months following initiation of treatment
Title
How many patients develop graft-versus-host-disease (GVHD) measured by the incidence of GVHD at 12 months following initiation of treatment
Description
To estimate incidence of GVHD
Time Frame
12 months following initiation of treatment
Title
How many patients have not relapsed measured by progression-free survival at 12 months following the initiation of treatment
Description
To estimate non-relapse mortality
Time Frame
12 months following initiation of treatment
Title
How many patients died due to infections measured by the incidence and type of infections at 12 months following initiation of treatment
Description
To estimate infection-related mortality
Time Frame
12 months following initiation of treatment
Title
How many patients died due to a treatment-related adverse events grade 2 or greater as assessed by CTCAE v.4.0
Description
To estimate event-free survival
Time Frame
12 months following initiation of treatment
Title
Number of patients to achieve full donor chimerisms at Days 30, 50, 100, and 6 months post-transplant as measured by donor chimerism data
Description
To estimate graft failure
Time Frame
12 months following initiation of treatment
Title
Number of patients that acquired an infection in the first 100-days post-transplant as measured by the incidence of infections
Description
To estimate the rate of infections
Time Frame
12 months following initiation of treatment
Title
Number of patients achieving platelet engraftment as measured by platelets reaching 20,000 without transfusion for 7 days
Description
To assess time to platelet engraftment
Time Frame
12 months following initiation of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
78 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Availability of 5/10 to 8/10 matched related donor KPS >/= 70% CML, AML, MDS, ALL, CLL, HD, NHL, MPS/CMML, MM, any other hematologic condition deemed an eligible indication for allogeneic transplant by the treating center Exclusion Criteria: Poor cardiac, pulmonary, liver, and renal function HIV-positive Patients who have a debilitating medical or psychiatric illness that would preclude them from giving informed consent History of severe or serious allergic reaction to human GM-CSF or yeast-derived products
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Stacey Brown, BA
Phone
404-780-7965
Email
stacey.brown@northside.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Melhem Solh, MD
Organizational Affiliation
Northside Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Northside Hospital
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Stacey Brown, BA
Phone
404-780-7965
Email
stacey.brown@northside.com
First Name & Middle Initial & Last Name & Degree
Caitlin Guzowski, MBA, MHA
Phone
404-851-8523
Email
caitlin.guzowski@northside.com
First Name & Middle Initial & Last Name & Degree
H. Kent Holland, MD
First Name & Middle Initial & Last Name & Degree
Asad Bashey, MD
First Name & Middle Initial & Last Name & Degree
Lawrence E Morris, MD
First Name & Middle Initial & Last Name & Degree
Scott Solomon, MD
First Name & Middle Initial & Last Name & Degree
Melhem Solh, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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GM-CSF With Post-Transplant Cyclophosphamide

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