Transplant-Related Disorder
Conditions
Brief summary
To evaluate the efficacy and safety of ruxolitinib for prophylactic therapy of adult patients who are predicted to have a high risk for developing severe acute graftversus-host disease (aGVHD) by the dynamic aGVHD Onset Anticipation Tianjin (daGOAT) model.
Detailed description
This study aims to prospectively evaluate the use of the daGOAT model in real-world clinical settings at the Institute of Hematology, Chinese Academy of Medical Sciences (IHCAMS).
Interventions
DRUGRuxolitinib
Model-predicted high-risk patients: ruxolitinib 5mg bid po until at least day 60 post-transplant and terminated after day 100. If severe hematological signs occur such as when there is severe neutropenia (\<0.1×10\^9/L), ruxolitinib can be used at half dose or discontinued as appropriate, and can continue to be used after hematology recovery. Model-predicted moderate-risk patients: ruxolitinib 2.5mg bid p po until at least day 60 post-transplant and terminated after day 100. If severe hematological signs occur such as when there is severe neutropenia (\<0.1×10\^9/L), ruxolitinib can be used at half dose or discontinued as appropriate, and can continue to be used after hematology recovery. Model-predicted low risk: regular aGVHD prophylactic regimens.
Sponsors
Institute of Hematology & Blood Diseases Hospital, China
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients must be \> 16 years of age; 2. Patients receiving human leukocyte antigen mismatched and non-cord blood allogeneic hematopoietic stem cell transplantation; 3. Patients who can take oral medication; 4. Patients have to sign an informed consent form before the start of the research procedure.
Exclusion criteria
1. Tandem transplantation or multiple transplantations; 2. Patients who are allergic to or cannot tolerate ruxolitinib ; 3. Mental or other medical conditions that make the patients unable to comply with the research treatment and monitoring requirements ; 4. Patients who are pregnant or cannot take appropriate contraceptive measures during treatment; 5. Patients who are ineligible for the study due to other factors, or will bear great risk if participating in the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Severe aGVHD during 100 days after transplantation according to the MAGIC criteria | 100 days after transplantation | Incidence of severe aGVHD after transplantation within 100 days. The medical records for each case wil be reviewed by two or three physicians to confirm the aGVHD diagnosis and grading (according to the MAGIC criteria) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival during 1.5 year after transplantation | Days 14, 28, 42, 60, 90, 180, 270, 360 and 540 after transplantation | Patients will be followed up at days 14, 28, 42, 60, 90, 180, 270, 360 and 540 after transplantation; data on survival will be collected. |
| Relapse-free survival rate and relapse rate during 1.5 year after transplantation | Days 14, 28, 42, 60, 90, 180, 270, 360 and 540 after transplantation | Patients will be followed up at days 14, 28, 42, 60, 90, 180, 270, 360 and 540 after transplantation; data on relapse will be collected. |
| aGVHD in various target organs during 100 days after transplantation according to the MAGIC criteria | 100 days after transplantation | Incidence of aGVHD (any grade) in various target organs. The medical records for each case wil be reviewed by two or three physicians to confirm the aGVHD diagnosis and grading (according to the MAGIC criteria) |
| Safety of treatment during 100 days after transplantation according to the Common Terminology Criteria for Adverse Events version 5.0 | 100 days after transplantation | Data on adverse events of treatment will be collected. |
| Total cost of treatment during 1.5 year after transplantation | 1.5 year after transplantation | Data on total cost of treatment will be collected from the medical records. |
| Incidence of infections during 1.5 year after transplantation | 1.5 year after transplantation | Infection was defined as meeting one of the following criteria: culture-confirmed presence of bacteria or fungi in a sample collected from a sterile site; polymerase chain reaction-confirmed viremia at ≥ 5000 copies/ml for the cytomegalovirus or ≥ 10000 copies/ml for the Epstein-Barr virus; or body temperature ≥ 38 ℃ with culture-confirmed presence of pathogens from a non-sterile site. |
Countries
China
Outcome results
None listed