Chronic Graft Versus Host Disease
Conditions
Keywords
cGVHD
Brief summary
The primary purpose of the study is to evaluate the safety and efficacy of mesenchymal stem cells (MSC) for the treatment of patients who have developed an extensive chronic graft versus host disease (with skin and/or liver damage) after HSCs transplantation and do not respond to first-line therapy. The secondary purpose of the study is to evaluate the effect of mesenchymal stem cells (MSC) on one-year survival rate, long-term survival rate, life quality and recurrence of patients who have developed an extensive chronic graft versus host disease (with skin and/or liver damage) after HSCs transplantation and do not respond to hormone treatment.
Detailed description
Chronic Graft-versus-host disease (GVHD)， with the incidence of 30%-60%, is a serious late complication of allogeneic hematopoietic stem cell transplantation (HSCT) and is the major cause of death in the late stage of transplantation. According to targeted organs, cGVHD is divided into two types, limited cGVHD and extensive cGVHD. Extensive cGVHD needs systemic immunosuppressant treatment. However, currently standard first-line regimen including cyclophosphamide and prednisolone is only effective for some patients. Novel treatment is urgently needed. Our previous study has shown that mesenchymal stem cells (MSCs) are effective for cGVHD patients with multiple skin damage. To further explore the therapeutic effect of MSCs for extensive cGVHD, we plan to conduct a multi-center clinical trial. Patients who developed an extensive cGVHD (with skin and/or liver damage) after HSCs transplantation and do not respond to first-line therapy are enrolled. They will be randomly divided into two groups which will receive MSCs and routine second-line drugs respectively. We will evaluate the efficacy and safety of MSCs for extensive cGVHD by comparison of symptom improvement, survival rate, recurrence as well as side effects in the two groups.
Interventions
BIOLOGICALBiological: mesenchymal stem cell
Mesenchymal stem cells, 1-2×107, bone marrow injection, once a week for the first four weeks; whether to continue after four weeks depends on patients' symptoms.
DRUGCyclosporine and Glucocorticoid
Calmodulin inhibitors such as cyclosporine, combined with Glucocorticoid 0.5-1mg/kg/d ,to the end of the study.
Sponsors
Zhejiang University
Chinese PLA General Hospital
307 Hospital of PLA
Peking Union Medical College
Chinese Academy of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
2 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Extensive cGVHD with skin and/or liver damage developed after allogeneic hematopoietic stem cell transplantation * cGVHD that do not response to conventional immunosuppressant treatment for two months * KPS\>= 30 * informed consent from the patient
Exclusion criteria
* Extensive cGVHD without skin or liver damage * With other acute severe complications * In pregnancy or lactation * Disease relapses * With non-hematological malignancy * Have a history of mental disorder, drug or alcohol abuse over the past five years * Allergic * Participate in other clinical trial within three months before the start of this trial * With bone marrow fibrosis * Have undergone hematopoietic stem cell transplantation to treat solid tumor
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The total Response rate defined as patients with complete and partial response | 1 year after MSCs administration. |
Secondary
| Measure | Time frame |
|---|---|
| one-year survival rate | 1 year after MSCs administration |
| disease relapse | 2 years after MSCs administration |
| quality of life | 2 years after MSCs administration |
Countries
China
Contacts
Primary ContactHe Huang, MD
Outcome results
None listed