Acute Graft Versus Host Disease Clinical Trial
Official title:
Intra-Arterial Steroid Administration of De Novo Acute Graft-vs-Host Disease of the Gastrointestinal Tract: A Phase II Study
This phase II trial studies how well methylprednisolone sodium succinate works in treating patients with graft-versus-host disease (GVHD) of the gastrointestinal tract that has begun within 100 days of transplant (acute GVHD). Corticosteroids are a type of drug that reduces inflammation. Giving corticosteroid drugs, such as methylprednisolone sodium succinate, directly into the arteries of the gastrointestinal tract may help treat inflammation caused by GVHD. Giving methylprednisolone sodium succinate in addition to standard treatments may be more effective in treating GVHD.
PRIMARY OBJECTIVES:
I. To assess the efficacy of intra-arterial steroid administration (IASA) with
methylprednisolone sodium succinate (MePDSL) in this dose-schedule for treatment of de novo
acute moderate-to-severe GvHD of the gastrointestinal tract (GIT).
SECONDARY OBJECTIVES:
I. To assess the safety of IASA MePDSL in this dose-schedule for treatment of de novo acute
moderate-to-severe acute GvHD of the GIT.
II. To assess the feasibility of IASA MePDSL in this dose-schedule for treatment of de novo
acute moderate-to-severe acute GvHD of the GIT.
OUTLINE:
STUDY AGENT: Patients receive methylprednisolone sodium succinate intra-arterially (IA) once
daily (QD) on days 1-3.
CONVENTIONAL THERAPY: Patients also receive conventional therapy comprising
methylprednisolone sodium succinate intravenously (IV) every 12 hours on for 7-14 days
beginning on day 1 and budesonide PO on days 1-56. Patients with response by day 7-14 may
begin taper and receive methylprednisolone orally (PO) on days 28-56. Treatment continues in
the absence of disease progression or unacceptable toxicity.
IMMUNOSUPPRESSIVE THERAPY (IST): Patients receive conventional IST or continue their previous
prophylactic regimen beginning on day 1 to 56 (or beyond) at the discretion of the treating
physician.
After completion of study treatment, patients are followed up for 360 days.
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