Chronic Graft-Versus-Host Disease
Conditions
Keywords
Chronic Graft-Versus-Host Disease, Mesenchymal Stromal Cells
Brief summary
Chronic Graft-versus-Host Disease (cGvHD) is a potentially lethal disorder. A variety of second line immunosuppressive agents have been investigated but no optimal treatment has emerged. There is therefore a need for novel treatment strategies. Mesenchymal stromal cells (MSC) exhibit immunomodulatory properties and a recent pilot study suggests a response rate of 70% in steroid- refractory patients. In the present randomized study the efficacy and safety of MSC treatment will be further studied in patients with cGvHD.
Interventions
Mesenchymal stem cell(MSC). Patients with newly diagnosed cGvHD: prednisone 1mg/kg + cyclosporine or tacrolimus and MSC 2×1,000,000 MSC/kg, IV twice a week for the first two weeks and weekly for the following two weeks(6 doses totally).
Sponsors
Study design
Eligibility
Inclusion criteria
* Newly diagnosed cGvHD * Informed consent obtained from patient and donor. * Any patient who has undergone allogeneic stem cell transplantation with c GvHD. * Have not received additional agent for cGVHD within 3 months. * Expected life is more than 90 days. * Adequate pulmonary function with no evidence of chronic obstructive or severe restrictive pulmonary disease. * Adequate cardiac function with no evidence of uncontrolled high blood pressure,congestive heart failure, angina pectoris, acute myocardial infarction within 6 months prior to the process.
Exclusion criteria
* Invasive fungal disease. * Active cytomegalovirus (CMV)/Epstein-Barr virus(EBV)/varicella disease). * Patient is with a history of hypersensitivity to bovine products. * Relapsed malignancy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients responding to treatment of cGvHD with MSC | 90 days |
Secondary
| Measure | Time frame |
|---|---|
| Overall survival | 2 year |
| Progression-free survival | 2 year |
| Time without systemic immunosuppression | 2 year |
| Cumulative incidents of non-relapse mortality | 2 year |
| Adverse events | 2 year |
Other
| Measure | Time frame |
|---|---|
| Quality of life | 2 year |
| Immune reconstitution including monitoring of absolute T-cell subsets, B-cells, NK-cells as well as biomarkers of cGvHD | 2 year |
Countries
China