Hemophagocytic Lymphohistiocytosis
Conditions
Brief summary
This study aimed to investigate the efficacy and safety of ruxolitinib together with liposomal doxorubicin, etoposide and methylprednisolone (DEP-Ru) as a salvage therapy for refractory/relapsed hemophagocytic lymphohistiocytosis.
Interventions
* Drug: ruxolitinib * Drug: doxorubicin * Drug: etoposide * Drug: methylprednisolone
Sponsors
Study design
Eligibility
Inclusion criteria
1. meet HLH-04 diagnostic criteria; 2. treated with HLH-94 no less than 2 weeks before enrollment and did not achieve at least PR; or relapsed patients after remission; 3. Life expectancy exceeds 1 month; 4. Age≥1 year old and ≤70 years old, gender is not limited; 5. Before the start of the study, total bilirubin ≤ 10 times the upper limit of normal; serum creatinine ≤ 1.5 times normal; 6. Serum HIV antigen or antibody negative; 7. HCV antibody is negative, or HCV antibody is positive, but HCV RNA is negative; 8. Both HBV surface antigen and HBV core antibody were negative. If any of the above is positive, peripheral blood hepatitis B virus DNA titer should be detected, and less than 1×103 copies/ml can enter the group; 9. Echocardiographic examination of LVEF ≥ 50%; 10. Informed consent.
Exclusion criteria
1. Heart function above grade II (NYHA); 2. Accumulated dose of doxorubicin above 300mg/m2 or epirubicin above 450mg/m2; 3. Pregnancy or lactating Women; 4. Allergic to Pegaspargase, doxorubicin or etoposide; 5. Active bleeding of the internal organs; 6. uncontrollable infection; 7. Serious mental illness; 8. Non-melanoma skin cancer history; 9. Patients unable to comply during the trial and/or follow-up phase; 10. Participate in other clinical research at the same time.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of treatment response | Change from before and 2,4,6 and 8 weeks after initiating DEP-Ru salvage therapy | A complete response was defined as normalization of all of the quantifiable symptoms and laboratory markers of HLH, including levels of sCD25, ferritin, and triglyceride; hemoglobin; neutrophil counts; platelet counts; and alanine aminotransferase (ALT). A partial response was defined as at least a 25% improvement in 2 or more quantifiable symptoms and laboratory markers as follows: sCD25 response was\>1.5-fold decreased; ferritin and triglyceride decreased at least 25%; for patients with an initial neutrophil count of\<0.5 ×109/L, a response was defined as an increase by at least 100% to\>0.5× 109/L; for patients with a neutrophil count of 0.5 to 2.0 × 109/L, an increase by at least 100% to \>2.0 × 109/L was considered a response; and for patients with ALT \>400 U/L, response was defined as an ALT decrease of at least 50%. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Survival | from the time patients received DEP-Ru salvage therapy up to 24 months or June 2021 | survival |
| Adverse events that are related to treatment | through study completion, an average of 2 years | Adverse events including myelosuppression, infection, bleeding and so on. |
Countries
China