Allogeneic Hematopoietic Cell Transplantation Clinical Trial
Official title:
Precision Dosing of Alemtuzumab for Allogeneic Hematopoietic Cell Transplantation in Non-Malignant Diseases
The purpose of this study is to conduct a pilot trial of a Precision Dosing approach to alemtuzumab dosing for allogeneic hematopoietic cell transplantation of patients with non-malignant diseases. The investigators will measure the ability to use a population PK model of alemtuzumab to target patient Day 0 alemtuzumab levels to 0.15-0.6ug/mL in a pilot study of 20 patients.
The hypothesis is that the model-informed dosing regimen will prospectively allow the
precision dosing of alemtuzumab to target Day 0 levels to fall between 0.15-0.6ug/mL in
greater than 80% of patients. The investigators have chosen a conservative pilot study
approach, and the aim is to achieve Day 0 alemtuzumab levels between 0.15-0.6ug/mL in greater
than 60% of 20 patients enrolled in this pilot study based on a Simon two-stage design as
detailed below.
A Simon two-stage design (Simon, 1989) is being used. The null hypothesis that 30% of
patients will achieve a Day 0 alemtuzumab level between 0.15-0.6ug/mL will be tested against
a one-sided alternative that the alemtuzumab dose modification will result in 60% of patients
achieving a Day 0 alemtuzumab level between 0.15-0.6ug/mL. In the first stage, 7 patients
will be accrued. If there are 2 or fewer patients that achieve Day 0 alemtuzumab levels
within the range of 0.15-0.6ug/mL, the study will be stopped. Otherwise, 13 additional
patients will be accrued for a total of 20. The null hypothesis will be rejected if 11 or
more patients achieve a Day 0 level of 0.15-0.6ug/mL within the total 20 patients. This
design yields a type I error rate of 0.04 and power of 0.82 when the true response rate is
0.60. The investigators will enroll up to 30 patients in order allow for subject withdrawal,
but will stop enrollment once 20 patients reach Day 0.
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