Graft-Versus-Host Disease
Conditions
Keywords
Acute Graft Versus Host Disease, Affect, Anti-inflammatory, Anti-inflammatory Agents, Antigen-Presenting Cells, Alloantigen, Allogeneic, Allograft rejection, Allograft Tolerance, Antigens, Autoimmunity, Biomarkers, Biospecimen Repository, BMT, Bone Marrow Transplantation, Cell Transplantation, Cells, Clonal Expansion, Complex, Cytokine, Data, Development, Environment, Failure (biologic function), Genomics, Graft-vs-Host Disease, Graft-vs-Leukemia, GVHD, GVL, Hematopoietic, Hematopoietic Stem Cell Transplantation, HCT, HSCT, IL-33 Receptor, Immune Reconstitution, Immune Response, Inflammatory, Modeling, Novel, Novel therapeutics, Outcome, Pathway interactions, Peptides, Prevent, Process, Production, Proteomics, Regulatory T-Lymphocyte, Response, Role, Signal, ST2, Transduction, T-cell response, T-cell Activation, T-Lymphocytes, Tissues
Brief summary
This study is designed to collect longitudinal biological samples from patients after hematopoietic cell transplantation (HCT) cared for at multiple bone marrow transplant centers to validate biomarkers of both acute and chronic GVHD as well as for use in future unspecified research. The centers include Dana-Farber Cancer Institute and Boston's Children's Hospital, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Fred Hutchinson Cancer Research Center, Texas Children's Hospital, Children's National Medical Center, and Indiana University Simon Cancer Center.
Detailed description
After informed consent is signed, this study will involve 1) collection of basic HCT data and clinical data available in the medical record and 2) providing blood (and saliva in occasional cases) samples for processing, storage, DNA extraction, and analysis (including a seven biomarker protein panel as well as future unspecified research purposes). Pediatric and adult patients will be included (all adult patients will be from the Fred Hutchinson Cancer Research Center, the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, and the Indiana University Simon Cancer Center). Primary Objective: 1\. To confirm that ST2 alone or the seven-biomarker panel measured at initiation of GVHD therapy predict a) D180 post-therapy non-relapse mortality; b) D28 post-therapy non-response, and c) GVHD grade 1-4 onset D180 post-therapy non-relapse mortality. Secondary Objective: 1. To demonstrate that ST2 alone or the seven-biomarker panel measured at day 14 or day 21 post-HCT (or a combination of these time points) predicts D180 post-HCT non-relapse mortality. 2. To demonstrate that ST2 alone or the seven-biomarker panel measured at initiation of GVHD symptoms/therapy diagnose acute GVHD as compared to other complications presenting with similar symptoms (drug rash, CMV, Clostridium enteritis). 3. To demonstrate that ST2 alone or the seven-biomarker panel measured at initiation of GVHD symptoms/therapy diagnose the severity of acute GVHD at onset and maximum. 4. To develop a repository of biospecimens linked to clinical data for future unspecified research.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
- All patients receiving an allogeneic hematopoietic stem cell transplant, cord blood transplant, bone marrow transplant, T cell depleted marrow, donor lymphocyte infusion (DLI), or donor cellular infusion (DCI) can be included.
Exclusion criteria
- patients not receiving an allogeneic hematopoietic stem cell transplant, cord blood transplant, bone marrow transplant, T cell depleted marrow, donor lymphocyte infusion (DLI), or donor cellular infusion (DCI) will be excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT | 1 year | To measure stimulation-2 (ST2) pre-HCT by number of participants at 12 months post-HCT for non-relapse mortality according to ST2 values and age less than or equal to 10 and greater than 10 using landmark analyses. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Hematopoietic Stem Cell Transplant 4 plasma biomarkers were assessed pre-HCT and at days +7, +14 and +21 post-HCT. | 415 |
| Total | 415 |
Baseline characteristics
| Characteristic | Hematopoietic Stem Cell Transplant |
|---|---|
| Age, Customized Age <10 | 170 Participants |
| Age, Customized Age >10 | 245 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 55 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 351 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 9 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 5 Participants |
| Race (NIH/OMB) Asian | 15 Participants |
| Race (NIH/OMB) Black or African American | 51 Participants |
| Race (NIH/OMB) More than one race | 40 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 11 Participants |
| Race (NIH/OMB) White | 293 Participants |
| Region of Enrollment United States | 415 participants |
| Sex: Female, Male Female | 187 Participants |
| Sex: Female, Male Male | 228 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 415 |
| other Total, other adverse events | 0 / 415 |
| serious Total, serious adverse events | 0 / 415 |
Outcome results
Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT
To measure stimulation-2 (ST2) pre-HCT by number of participants at 12 months post-HCT for non-relapse mortality according to ST2 values and age less than or equal to 10 and greater than 10 using landmark analyses.
Time frame: 1 year
Population: Participants who had all four biomarkers and four timepoints.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Hematopoietic Stem Cell Transplant | Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT | Age <10 high Pre-HCT ST2 >26 | 55 participants |
| Hematopoietic Stem Cell Transplant | Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT | Age <10 low pre-HCT ST2 <26 | 115 participants |
| Hematopoietic Stem Cell Transplant | Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT | Age >10 high Pre-HCT ST2 >26 | 125 participants |
| Hematopoietic Stem Cell Transplant | Number of Participants With Non Relapse Mortality (NRM) by Age and ST2 at 12 Months Post-HCT | Age >10 low Pre-HCT ST2 <26 | 120 participants |