Hematologic Malignancies Clinical Trial
Official title:
A Randomized Trial of Thymoglobulin to Prevent Chronic Graft Versus Host Disease in Patients Undergoing Hematopoietic Progenitor Cell Transplantation (HPCT) From Unrelated Donors
This is a randomized trial for patients undergoing hematopoietic progenitor cell transplantation (HPCT) from an unrelated donor. Approximately 50% of the patients enrolled will receive Thymoglobulin® as part of the preparative regimen prior to HPCT. The other 50% of the patients enrolled will receive a standard preparative regimen. Thymoglobulin is known to suppress the types of cells that can cause a transplant complication known as "chronic graft versus host disease (cGVHD)". The goal of this trial is to find out if adding Thymoglobulin to the preparative regimen will result in a decrease in cGVHD.
This study is a non-blinded, randomized, multicentre trial testing the effect of
Thymoglobulin® vs. placebo on the primary outcome of cGVHD. Subjects will be children and
adults having unrelated donor transplants.
Intervention: Infusion of Thymoglobulin® on three days prior to the transplant.
Hypothesis: The hypothesis is that the use of Thymoglobulin® in the experimental group will
result in an absolute 20% increase in the number of patients free of cGVHD at 12 months, the
time of peak incidence, from 20% in the control group to 40% in the experimental group.
Outcome Measures: The Primary Outcome Measure is freedom from cGVHD at 12 months from
transplantation, defined as withdrawal of all systemic immunosuppressive agents and without
resumption up to 12 months (a binary end-point, yes/no). Secondary outcome measures: Quality
of Life, overall incidence of cGVHD (including untreated cases and resolved cases), the
incidence of "extensive" cGVHD, time to non-relapse mortality, time to all-cause mortality,
time to relapse of leukemia, graft rejection or failure (Yes vs. No), serious infection (Yes
vs. No), CMV activation (Yes vs. No), organ-specific grading of chronic graft versus host
disease, resumption of immunosuppressive agents after 12 months (Yes vs. No), doses of
immunosuppressive drugs still required at 12 months, and incidence of acute graft versus
host disease.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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