Chronic Myeloproliferative Disorders, Graft Versus Host Disease, Infection, Leukemia, Lymphoma, Multiple Myeloma and Plasma Cell Neoplasm, Myelodysplastic/Myeloproliferative Neoplasms, Myelodysplastic Syndromes, Precancerous Condition, Secondary Myelofibrosis, Small Intestine Cancer
Conditions
Keywords
graft versus host disease, infection, adult favorable prognosis Hodgkin lymphoma, adult unfavorable prognosis Hodgkin lymphoma, childhood favorable prognosis Hodgkin lymphoma, childhood unfavorable prognosis Hodgkin lymphoma, cutaneous B-cell non-Hodgkin lymphoma, recurrent adult Hodgkin lymphoma, recurrent cutaneous T-cell non-Hodgkin lymphoma, recurrent/refractory childhood Hodgkin lymphoma, stage I adult Hodgkin lymphoma, stage I childhood Hodgkin lymphoma, stage I cutaneous T-cell non-Hodgkin lymphoma, stage II adult Hodgkin lymphoma, stage II childhood Hodgkin lymphoma, stage II cutaneous T-cell non-Hodgkin lymphoma, stage III adult Hodgkin lymphoma, stage III childhood Hodgkin lymphoma, stage III cutaneous T-cell non-Hodgkin lymphoma, stage IV adult Hodgkin lymphoma, stage IV childhood Hodgkin lymphoma, stage IV cutaneous T-cell non-Hodgkin lymphoma, anaplastic large cell lymphoma, angioimmunoblastic T-cell lymphoma, Burkitt lymphoma, contiguous stage II adult Burkitt lymphoma, contiguous stage II adult diffuse large cell lymphoma, contiguous stage II adult diffuse mixed cell lymphoma, contiguous stage II adult diffuse small cleaved cell lymphoma, contiguous stage II adult immunoblastic large cell lymphoma, contiguous stage II adult lymphoblastic lymphoma, contiguous stage II grade 1 follicular lymphoma, contiguous stage II grade 2 follicular lymphoma, contiguous stage II grade 3 follicular lymphoma, contiguous stage II mantle cell lymphoma, contiguous stage II marginal zone lymphoma, contiguous stage II small lymphocytic lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, noncontiguous stage II adult Burkitt lymphoma, noncontiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse mixed cell lymphoma, noncontiguous stage II adult diffuse small cleaved cell lymphoma, noncontiguous stage II adult immunoblastic large cell lymphoma, noncontiguous stage II adult lymphoblastic lymphoma, noncontiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, noncontiguous stage II mantle cell lymphoma, noncontiguous stage II marginal zone lymphoma, noncontiguous stage II small lymphocytic lymphoma, recurrent adult Burkitt lymphoma, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult grade III lymphomatoid granulomatosis, recurrent adult immunoblastic large cell lymphoma, recurrent adult lymphoblastic lymphoma, recurrent adult T-cell leukemia/lymphoma, recurrent childhood anaplastic large cell lymphoma, recurrent childhood grade III lymphomatoid granulomatosis, recurrent childhood lymphoblastic lymphoma, recurrent childhood small noncleaved cell lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent grade I lymphomatoid granulomatosis, recurrent grade II lymphomatoid granulomatosis, recurrent mantle cell lymphoma, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, small intestine lymphoma, splenic marginal zone lymphoma, stage I adult Burkitt lymphoma, stage I adult diffuse large cell lymphoma, stage I adult diffuse mixed cell lymphoma, stage I adult diffuse small cleaved cell lymphoma, stage I adult immunoblastic large cell lymphoma, stage I adult lymphoblastic lymphoma, stage I adult T-cell leukemia/lymphoma, stage III adult Burkitt lymphoma, stage III adult diffuse large cell lymphoma, stage III adult diffuse mixed cell lymphoma, stage III adult diffuse small cleaved cell lymphoma, stage III adult immunoblastic large cell lymphoma, stage III adult lymphoblastic lymphoma, stage III adult T-cell leukemia/lymphoma, stage III childhood anaplastic large cell lymphoma, stage III childhood lymphoblastic lymphoma, stage III childhood small noncleaved cell lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III grade 3 follicular lymphoma, stage III mantle cell lymphoma, stage III marginal zone lymphoma, stage III small lymphocytic lymphoma, stage IV adult Burkitt lymphoma, stage IV adult diffuse large cell lymphoma, stage IV adult diffuse mixed cell lymphoma, stage IV adult diffuse small cleaved cell lymphoma, stage IV adult immunoblastic large cell lymphoma, stage IV adult lymphoblastic lymphoma, stage IV adult T-cell leukemia/lymphoma, stage IV childhood anaplastic large cell lymphoma, stage IV childhood lymphoblastic lymphoma, stage IV childhood small noncleaved cell lymphoma, stage IV grade 1 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV grade 3 follicular lymphoma, stage IV mantle cell lymphoma, stage IV marginal zone lymphoma, stage IV small lymphocytic lymphoma, adult acute myeloid leukemia in remission, adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), childhood acute myeloid leukemia in remission, recurrent adult acute myeloid leukemia, recurrent childhood acute myeloid leukemia, secondary acute myeloid leukemia, adult acute lymphoblastic leukemia in remission, childhood acute lymphoblastic leukemia in remission, recurrent adult acute lymphoblastic leukemia, recurrent childhood acute lymphoblastic leukemia, accelerated phase chronic myelogenous leukemia, chronic phase chronic myelogenous leukemia, refractory chronic lymphocytic leukemia, relapsing chronic myelogenous leukemia, stage I chronic lymphocytic leukemia, stage II chronic lymphocytic leukemia, stage III chronic lymphocytic leukemia, stage IV chronic lymphocytic leukemia, stage I multiple myeloma, stage II multiple myeloma, stage III multiple myeloma, childhood myelodysplastic syndromes, de novo myelodysplastic syndromes, myelodysplastic/myeloproliferative neoplasm, unclassifiable, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes, atypical chronic myeloid leukemia, BCR-ABL negative, chronic myelomonocytic leukemia, juvenile myelomonocytic leukemia, primary myelofibrosis, secondary myelofibrosis
Brief summary
RATIONALE: Giving chemotherapy and total-body irradiation before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving tacrolimus, sirolimus, antithymocyte globulin, and methotrexate before and after transplant may stop this from happening. PURPOSE: This phase II trial is studying how well sirolimus, tacrolimus, and antithymocyte globulin work in preventing graft-versus-host disease in patients undergoing a donor stem cell transplant for hematological cancer .
Detailed description
OBJECTIVES: Primary * To determine the incidence and severity of acute- and chronic-graft-versus-host disease (GVHD) after HLA-matched or -mismatched unrelated donor hematopoietic peripheral blood transplantation in patients with hematologic malignancies scheduled to receive immunosuppressive combination of sirolimus, tacrolimus, and anti-thymocyte globulin as GVHD prophylaxis. * To determine the safety of this combination in the first six months post-transplant. Secondary * To determine the time-to-engraftment, non-relapse mortality rate, overall and disease-free survival, incidence of disease relapse, and incidence of opportunistic infections with this GVHD prophylaxis. OUTLINE: Patients are stratified according to conditioning regimen (fludarabine phosphate and melphalan vs fractionated total-body irradiation \[FTBI\] and etoposide vs FTBI and cyclophosphamide) and degree of donor/recipient HLA mismatch (high-risk vs low-risk). * Conditioning regimen: Patients receive 1 of 3 standard conditioning regimens beginning on day -9 or -8 and continuing to day -1 or 0. * Peripheral blood stem cell transplantation: Patients receive HLA-matched or mismatched unrelated donor peripheral blood stem cells on day 0. * Graft-versus-host disease prophylaxis: Patients receive tacrolimus IV continuously beginning on day -3 and then orally when tolerated, oral sirolimus on days -3 and -2, anti-thymocyte globulin IV over 4-8 hours on days -3 to 0, and methotrexate\* IV on days 1, 3, and 6. Tacrolimus and sirolimus continue for 3-6 months (with taper). NOTE: \*Only patients with high-risk HLA mismatch receive treatment with methotrexate. After completion of study therapy, patients are followed periodically for up to 2 years.
Interventions
BIOLOGICALanti-thymocyte globulin
0.5 mg/kg on day -3, 1.5 mg/kg on day -2 and 2.5 mg/kg on day -1 or day 0 from stem cell transplant
DRUGcyclophosphamide
60mg/kg on days -5 and -4 from stem cell transplant
DRUGetoposide
60mg/kg on day -4 from stem cell transplant
DRUGfludarabine phosphate
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant
DRUGmelphalan
Melphalan 140 mg/m2 on day -4 from stem cell transplant
DRUGmethotrexate
For high risk HLA-mismatch transplant only: 5 mg/m2 on days +1, +3 and +6 from stem cell transplant
DRUGsirolimus
Adults: 12 mg loading dose on day -3 from stem cell transplant followed by 4 mg orally single morning daily dose. Pediatric Patients \<40kg: 3 mg/m2 orally on day -3 from stem cell transplant followed by 1 mg/m2 orally single morning daily dose
DRUGtacrolimus
0.02 mg/kd/d CIV beginning on day -3 from stem cell transplant
PROCEDUREallogeneic hematopoietic stem cell transplantation
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
PROCEDUREhematopoietic stem cell transplantation
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
PROCEDUREnonmyeloablative allogeneic hematopoietic stem cell transplantation
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant, Melphalan 140 mg/m2 on day -4 from stem cell transplant
PROCEDUREperipheral blood stem cell transplantation
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
RADIATIONtotal-body irradiation
1320 cGy in 11 fractions from day -8 to day -5 or day -9 to day -6 prior to stem cell transplant
Sponsors
National Cancer Institute (NCI)
City of Hope Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to No maximum
Healthy volunteers
No
Inclusion criteria
DISEASE CHARACTERISTICS: * Diagnosis of hematological malignancy including any of the following: * Non-Hodgkin lymphoma (NHL) in any complete remission (CR) or partial response (PR) * Hodgkin lymphoma in any CR or PR * Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) in any CR * Bone marrow blasts \< 20% within 4 weeks of transplant and peripheral blood absolute blast count \< 500/µL on the day of initiation of conditioning for patients with non-CR AML or ALL * Myelodysplastic syndromes (MDS) treated or untreated * Chronic myelogenous leukemia (CML) in chronic or accelerated phase * Multiple myeloma in any CR or PR * Chronic lymphocytic leukemia in CR or PR 2 or greater * Myelofibrosis and other myeloproliferative disorders * Bone marrow blasts \< 20% within 4 weeks of transplant and peripheral blood absolute blast count \< 500/µL on the day of initiation * High-risk disease defined as AML or ALL \> CR1, accelerated phase CML, recurrent aggressive lymphoma, or active lymphoproliferative disease at transplant * Low-risk disease defined as AML or ALL in CR1, chronic phase CML, or low-grade lymphoproliferative disorder with controlled disease at transplant * Must be planning to receive 1 of the following conditioning regimens at City of Hope: * Fludarabine phosphate and melphalan for patients with hematological malignancies and contraindications for conventional myeloablative regimens due to age, co-morbidity, or previous transplant * Fractionated total-body irradiation (FTBI) and etoposide for patients with AML and ALL or CML in accelerated phase * FTBI and cyclophosphamide for patients with NHL, AML, CML, and MDS * Suitable unrelated donor available * HLA-matched or mismatched * Peripheral blood stem cells available * No bone marrow or ex vivo-engineered or processed graft (e.g., CD34-positive, T-cell depletion) * No uncontrolled CNS disease PATIENT CHARACTERISTICS: * Karnofsky performance status (PS) 70-100% or ECOG PS 0-2 * Creatinine \< 1.3 mg/dL or creatinine clearance ≥ 70 mL/min * Ejection fraction \> 45% * Direct bilirubin \< 3 times upper limit of normal (ULN) * ALT and AST \< 3 times ULN * Forced vital capacity, FEV1, and DLCO \> 45% of predicted * Able to cooperate with oral medication intake * No active donor or recipient serology positive for HIV * No known contraindication to administration of sirolimus, tacrolimus, or anti-thymocyte globulin * No active hepatitis B or C * Negative pregnancy test PRIOR CONCURRENT THERAPY: * See Disease Characteristics * Concurrent participation in other clinical trials for prevention or treatment of viral, bacterial, or fungal disease allowed provided agents do not interact with agents used in the current study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cumulative Incidence of Grade II-IV Acute Graft-Versus-Host Disease (GVHD) at Day 100 | 100 Days Post Hematopoietic Stem Cell Transplant (HSCT) | Patients were evaluated for the development of acute GVHD within the first 100 days post HSCT. The cumulative incidence of grade II-IV acute GVHD was determined using competing risk analysis. Competing risks for acute GVHD were death and nonengraftment. |
| Severity of Acute GVHD | 100 Days Post HSCT | All patients were considered for the evaluation of the severity of acute GVHD. |
| Cumulative Incidence of Chronic GVHD | 2 year point estimate was provided. | Patients were evaluated for the development of chronic GVHD from 101 days post HSCT to last contact or documented evidence of the disease. The cumulative incidence of chronic GVHD was determined using competing risk analysis. Competing risks for GVHD were death and nonengraftment. |
| Severity of Chronic GVHD | Patients were evaluated until they developed chronic GVHD, a median of 130 days post HSCT | All Patients were considered for the evaluation of chronic GVHD severity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Occurence of Sinusoidal Obstructive Syndrome (SOS) | Median Follow Up: 28 Months (Range: 1-49 Months) | Participants were monitored throughout the trial (median of 28 months) for various infections/complications. This is the number of participants who developed SOS. |
| Non-relapse Mortality at 100 Days Post HSCT | 100 day point estimate was provided | Patients were evaluated for non-relapse mortality (NRM) throughout the study. Non-relapse mortality was considered any death not attributable to relapse or disease progression. The cumulative incidence of NRM was determined using competing risk analysis. Competing risks for NRM were death due to disease progression, relapse and nonengraftment. |
| Non-relapse Mortality at Two Years Post HSCT | 2 year point estimate was provided. | Patients were evaluated for non-relapse mortality (NRM) throughout the study. Non-relapse mortality was considered any death not attributable to relapse or disease progression. The cumulative incidence of NRM was determined using competing risk analysis. Competing risks for NRM were death due to disease progression, relapse and nonengraftment. |
| Time to Absolute Neutrophil Count Recovery (Engraftment) | Patients were evaluated until neutrophil recovery, a median of 15 days post HSCT | Absolute neutrophil count (ANC) recovery is defined as an ANC of ≥ 0.5 x 10\^9/L (500/mm3) for three consecutive laboratory values obtained on different days |
| Event Free Survival at Two Years Post HSCT | 2 year point estimate was provided. | Patients were evaluated for event free survival (EFS) throughout the study. Events were defined as death, relapse, progression, or nonengraftment. Kaplan Meier estimates were calculated as time from HSCT to event. |
| Incidence of Disease Relapse/Progression at 2 Years Post HSCT | 2 year point estimate was provided. | Patients were evaluated for relapse/progression post transplant throughout the study. The cumulative incidence of relapse/progression was determined using competing risk analysis. Competing risks for relapse were non-relapse mortality and nonengraftment. |
| Overall Survival at Two Years Post HSCT | 2 year point estimate was provided. | Patients were evaluated for survival (OS) throughout the study. Kaplan Meier estiamtes were calculated for overall survival using time from HSCT to death of any cause or for surviving patients last contact date. |
| Time to Platelet Count Recovery (Engraftment) | Patients were evaluated until platelet recovery, a median of 14 days | Platelet recovery is defined as the first date of three consecutive laboratory values ≥ 25 x 10\^9 L obtained on different days. |
| Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation | Median Follow Up: 28 months (Range: 1-49 months) | Participants were monitored throughout the trial (median of 28 months) for various infections/complications. |
| Occurrence of Thrombotic Microangiopathy | Median Follow Up: 28 Months (Range: 1-49 months) | Participants were monitored throughout the trial (median of 28 months) for various infections/complications. This is the number of participants who developed TMA. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| All Patients All patients were analyzed as a single population. Stratification by conditioning regimen was not done. | 32 |
| Total | 32 |
Baseline characteristics
| Characteristic | All Patients |
|---|---|
| Age, Continuous | 59.5 years |
| Conditioning Regimen Fludarabine/Melphalan | 23 participants |
| Conditioning Regimen Fractionated Total Body Irradiation/Cytoxan | 4 participants |
| Conditioning Regimen Fractionated Total Body Irradiation/Etoposide | 5 participants |
| Diagnosis Acute Lymphoblastic Leukemia | 3 participants |
| Diagnosis Acute Myeloid Leukemia | 14 participants |
| Diagnosis Chronic Lymphocytic Leukemia | 1 participants |
| Diagnosis Chronic Myeloid Leukemia | 3 participants |
| Diagnosis Myelodysplastic Syndrome | 6 participants |
| Diagnosis Myeloproliferative Disorder | 2 participants |
| Diagnosis Non-Hodgkin Lymphoma | 3 participants |
| Disease Status (American Society for Blood and Marrow Transplantation Guidelines) High/Intermediate Risk | 18 participants |
| Disease Status (American Society for Blood and Marrow Transplantation Guidelines) Standard Risk | 14 participants |
| Human Leukocyte Antigen (HLA) Match Type 10/10 Matched | 18 participants |
| Human Leukocyte Antigen (HLA) Match Type 1 Mismatch | 12 participants |
| Human Leukocyte Antigen (HLA) Match Type 2 Mismatches | 1 participants |
| Human Leukocyte Antigen (HLA) Match Type 3 Mismatches | 1 participants |
| Patient/Donor Cytomegalovirus (CMV) infection status Negative/Negative | 3 participants |
| Patient/Donor Cytomegalovirus (CMV) infection status Negative/Positive | 5 participants |
| Patient/Donor Cytomegalovirus (CMV) infection status Positive/Negative | 12 participants |
| Patient/Donor Cytomegalovirus (CMV) infection status Positive/Positive | 12 participants |
| Patient/donor sex match Male patient/Female donor | 3 participants |
| Patient/donor sex match Others | 29 participants |
| Region of Enrollment United States | 32 participants |
| Sex: Female, Male Female | 19 Participants |
| Sex: Female, Male Male | 13 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 31 / 31 |
| serious Total, serious adverse events | 9 / 31 |
Outcome results
Primary
Cumulative Incidence of Chronic GVHD
Patients were evaluated for the development of chronic GVHD from 101 days post HSCT to last contact or documented evidence of the disease. The cumulative incidence of chronic GVHD was determined using competing risk analysis. Competing risks for GVHD were death and nonengraftment.
Time frame: 2 year point estimate was provided.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Cumulative Incidence of Chronic GVHD | 62.5 Percentage of patients developing cGVHD |
Primary
Cumulative Incidence of Grade II-IV Acute Graft-Versus-Host Disease (GVHD) at Day 100
Patients were evaluated for the development of acute GVHD within the first 100 days post HSCT. The cumulative incidence of grade II-IV acute GVHD was determined using competing risk analysis. Competing risks for acute GVHD were death and nonengraftment.
Time frame: 100 Days Post Hematopoietic Stem Cell Transplant (HSCT)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Cumulative Incidence of Grade II-IV Acute Graft-Versus-Host Disease (GVHD) at Day 100 | 37.3 Percentage of patients developing aGVHD |
Primary
Severity of Acute GVHD
All patients were considered for the evaluation of the severity of acute GVHD.
Time frame: 100 Days Post HSCT
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| All Patients | Severity of Acute GVHD | No Acute GVHD | 9 participants |
| All Patients | Severity of Acute GVHD | Yes- Grade II | 9 participants |
| All Patients | Severity of Acute GVHD | Yes- Grade III | 1 participants |
| All Patients | Severity of Acute GVHD | Yes - Grade IV | 0 participants |
| All Patients | Severity of Acute GVHD | No- Inevaluable (graft failures) | 4 participants |
| All Patients | Severity of Acute GVHD | Yes - Grade I | 9 participants |
Primary
Severity of Chronic GVHD
All Patients were considered for the evaluation of chronic GVHD severity.
Time frame: Patients were evaluated until they developed chronic GVHD, a median of 130 days post HSCT
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| All Patients | Severity of Chronic GVHD | No Chronic GVHD | 4 participants |
| All Patients | Severity of Chronic GVHD | Yes- Limited | 4 participants |
| All Patients | Severity of Chronic GVHD | Yes - Extensive | 17 participants |
| All Patients | Severity of Chronic GVHD | No- Inevaluable (graft failure/died <day 100) | 7 participants |
Secondary
Event Free Survival at Two Years Post HSCT
Patients were evaluated for event free survival (EFS) throughout the study. Events were defined as death, relapse, progression, or nonengraftment. Kaplan Meier estimates were calculated as time from HSCT to event.
Time frame: 2 year point estimate was provided.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Event Free Survival at Two Years Post HSCT | 61.3 Percentage of patients with an event |
Secondary
Incidence of Disease Relapse/Progression at 2 Years Post HSCT
Patients were evaluated for relapse/progression post transplant throughout the study. The cumulative incidence of relapse/progression was determined using competing risk analysis. Competing risks for relapse were non-relapse mortality and nonengraftment.
Time frame: 2 year point estimate was provided.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Incidence of Disease Relapse/Progression at 2 Years Post HSCT | 12.5 Percentage of patients who relapsed |
Secondary
Non-relapse Mortality at 100 Days Post HSCT
Patients were evaluated for non-relapse mortality (NRM) throughout the study. Non-relapse mortality was considered any death not attributable to relapse or disease progression. The cumulative incidence of NRM was determined using competing risk analysis. Competing risks for NRM were death due to disease progression, relapse and nonengraftment.
Time frame: 100 day point estimate was provided
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Non-relapse Mortality at 100 Days Post HSCT | 9.4 Percentage of patients with a NRM |
Secondary
Non-relapse Mortality at Two Years Post HSCT
Patients were evaluated for non-relapse mortality (NRM) throughout the study. Non-relapse mortality was considered any death not attributable to relapse or disease progression. The cumulative incidence of NRM was determined using competing risk analysis. Competing risks for NRM were death due to disease progression, relapse and nonengraftment.
Time frame: 2 year point estimate was provided.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Non-relapse Mortality at Two Years Post HSCT | 15.6 Percentage of patients with a NRM |
Secondary
Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation
Participants were monitored throughout the trial (median of 28 months) for various infections/complications.
Time frame: Median Follow Up: 28 months (Range: 1-49 months)
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| All Patients | Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation | Neither CMV or EBV | 16 participants |
| All Patients | Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation | CMV reactivation only | 9 participants |
| All Patients | Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation | EBV only | 3 participants |
| All Patients | Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation | Both CMV and EBV | 4 participants |
Secondary
Occurence of Sinusoidal Obstructive Syndrome (SOS)
Participants were monitored throughout the trial (median of 28 months) for various infections/complications. This is the number of participants who developed SOS.
Time frame: Median Follow Up: 28 Months (Range: 1-49 Months)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Occurence of Sinusoidal Obstructive Syndrome (SOS) | 1 participants |
Secondary
Occurrence of Thrombotic Microangiopathy
Participants were monitored throughout the trial (median of 28 months) for various infections/complications. This is the number of participants who developed TMA.
Time frame: Median Follow Up: 28 Months (Range: 1-49 months)
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Occurrence of Thrombotic Microangiopathy | 7 participants |
Secondary
Overall Survival at Two Years Post HSCT
Patients were evaluated for survival (OS) throughout the study. Kaplan Meier estiamtes were calculated for overall survival using time from HSCT to death of any cause or for surviving patients last contact date.
Time frame: 2 year point estimate was provided.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| All Patients | Overall Survival at Two Years Post HSCT | 65.6 Percentage of patients who died |
Secondary
Time to Absolute Neutrophil Count Recovery (Engraftment)
Absolute neutrophil count (ANC) recovery is defined as an ANC of ≥ 0.5 x 10\^9/L (500/mm3) for three consecutive laboratory values obtained on different days
Time frame: Patients were evaluated until neutrophil recovery, a median of 15 days post HSCT
Population: 28 of the 32 patients had absolute neutrophil count recovery.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Patients | Time to Absolute Neutrophil Count Recovery (Engraftment) | 14.5 Days |
Secondary
Time to Platelet Count Recovery (Engraftment)
Platelet recovery is defined as the first date of three consecutive laboratory values ≥ 25 x 10\^9 L obtained on different days.
Time frame: Patients were evaluated until platelet recovery, a median of 14 days
Population: 27 of the 32 patients had platelet recovery.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| All Patients | Time to Platelet Count Recovery (Engraftment) | 14 Days |