Acute GVH Disease
Conditions
Keywords
acute GVHD, MTX, Corticosteroid
Brief summary
The aim of the study is to identify the efficacy and safety of methotrexate (MTX) combined corticosteroid as first-line therapy for acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (alloHSCT).
Detailed description
Allo-HSCT is an effective treatment of malignant hematopoietic diseases. However, aGVHD remains a major complication after allo-HSCT and the destruction of recipient tissues by alloantigen-activated T cells is a key event in the development of aGVHD. Corticosteroid is the standard first-line therapy for aGVHD due to their roles in suppressing T cell responses. However, the response rate of corticosteroid was approximate 50%, and the clinical outcomes of patients with corticosteroid refractory GVHD were poor. Thus far, no combination therapy had been prove to be superior to corticosteroid alone as initial therapy for aGVHD. The study hypothesis: MTX combined corticosteroid treatment could help to further ameliorate the activity of T cells and control aGVHD.
Interventions
DRUGMTX
MTX (5-10 mg/day,Dmax 10mg/day) was given on days 1, 3, and 8, and repeated weekly until aGVHD was CR
DRUGCorticosteroid
corticosteroid Methylprednisolone 1 mg/kg/day was given for 10 days and then the dosage was gradually reduced according to patient's response
Sponsors
Peking University People's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Patients who are fully informed and sign informed consent by themselves or their guardians; 2. Patients receiving allogeneic hematopoietic stem cell transplantation; 3. Patients with acute graft-versus-host disease of grade II-IV were diagnosed after transplantation; 4. Patients with stable implantation of granulocytes and platelets. 5. ECOG score ≤3
Exclusion criteria
1. Patients with severe brain, heart, kidney or liver dysfunction unrelated to graft-versus host disease; 2. Patients with uncontrollable active infection; 3. Patients with recurrence of primary malignant hematopathy; 4. Expected survival is less than 3 months 5. Patients who have histories of severe allergic reactions 6. Pregnant or lactating women 7. The researcher judges that there are other factors that are not suitable for participating
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall response rate (ORR) for aGVHD treatment after treatment | 10 days | Overall response rate is defined as the proportion of patients demonstrating a complete response or partial response without requirement for additional systemic therapies for an earlier progression, mixed response or non-response |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall response rate (ORR) for aGVHD treatment at 42 days after treatment | 42 days | Overall response rate is defined as the proportion of patients demonstrating a complete response or partial response without requirement for additional systemic therapies for an earlier progression, mixed response or non-response |
| Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | 42 days | Data collection including questionnaires at individual and group visits and physician interviews at individual visits will be used to assess participants for treatment-related adverse events. |
| cGVHD | 1 years | The cumulative incidence of chronic GVHD |
| Infection and poor graft function | 1 year | The cumulative incidence of severe infection and poor graft function |
| Overall response rate (ORR) for aGVHD treatment at 28 days after treatment | 28 days | Overall response rate is defined as the proportion of patients demonstrating a complete response or partial response without requirement for additional systemic therapies for an earlier progression, mixed response or non-response |
| Non-relapse mortality | 1 year | The cumulative incidence of non-relapse mortality |
| Overall survival | 1 year | The cumulative incidence of overall survival |
| Disease free survival | 1 year | The cumulative incidence of disease free survival |
| Relapse | 1 year | The cumulative incidence of relapse |
Countries
China
Outcome results
None listed