Status:

TERMINATED

Efficacy and Safety of Low-dose Decitabine in Refractory Aplastic Anemia

Lead Sponsor:

Institute of Hematology & Blood Diseases Hospital, China

Conditions:

Refractory Aplastic Anemia

Eligibility:

All Genders

12+ years

Phase:

PHASE2

Brief Summary

This is a phase 2, single-center, single-arm, open-label trial. Simon's two-stage design is performed to evaluate the efficacy of low-dose Decitabine in refractory aplastic anemia.

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Subjects eligible for enrollment in the study should meet all of following criteria:
  • Diagnosis of acquired aplastic confirmed by peripheral blood and bone-marrow examinations.
  • Refractory to standard first-line immunosuppressive therapy for at least 6 months, including the combination of rabbit anti-thymocyte globulin (rATG) or porcine anti-lymphocyte globulin (pALG) and cyclosporine (CsA); or ineligible for rATG/ pALG and refractory to CsA alone.
  • Persistent decrease of blood cell count, including platelet \<30×10\^9/L, and/or hemoglobin \<90g/L, and/or absolute neutrophil count \<0.5×10\^9/L.
  • Age ≥12 years old.
  • An Eastern Cooperative Oncology Group performance status score of 0 to 2 at screening.
  • Patients or their legally authorized representatives who have provided written informed consent of their free will to participate in this study.
  • Exclusion criteria:
  • Subjects must be excluded from participating in this study if they meet any of the following criteria:
  • Diagnosis of inherited bone marrow failure disorders.
  • Bone marrow reticulin grade of ≥2.
  • Having a plan to take thrombopoietin (TPO) receptor agonists.
  • Having a plan to undergo hematopoietic stem cell transplantation within 1 year.
  • Subjects with hemolytic paroxysmal nocturnal hemoglobinuria clone.
  • Having abnormalities of cytogenetic abnormalities related to myelodysplastic syndrome except for +8 or 20q- or -Y.
  • Previous or concurrent active malignancies with chemoradiotherapy, except localized tumors diagnosed more than one year previously and treated surgically with curative intent.
  • Cytopenias secondary to any other non-hematological disorders (e.g., liver cirrhosis, active connective tissue disease, or chronic persistent infectious diseases).
  • Active infection not adequately responding to appropriate therapy.
  • Positive for anti-human immunodeficiency virus antibodies, or current infection of hepatitis B virus or hepatitis C virus at screening.
  • Concurrent condition of acute hemorrhage in gastrointestinal tract or respiratory tract, or central nervous system.
  • Dysfunction of liver: Alanine aminotransferase or aspartate aminotransferase or total bilirubin is more than 2.0 times the upper limit of laboratory normal range.
  • Dysfunction of renal: creatinine clear rate is less than 30ml/min.
  • Clinically significant dysfunction of heart: class Ⅲ or Ⅳ of the New York Heart Association classification.
  • Uncontrolled diabetes mellitus.
  • History of congestive heart failure, unstable angina pectoris, myocardial infarction, arterial or venous thrombosis within one year before enrollment.
  • Lactating or pregnant women or patients who have no intention of using oral contraceptives or birth control.
  • Subjects with psychiatric history or severe cerebrovascular disease with cognitive disorder.
  • Participating in other clinical trials within 4 weeks before enrollment.
  • Hypersensitivity to decitabine or its components.
  • A history of decitabine, azacitidine, or other demethylation agents.
  • Receiving TPO-receptor agonists within 1 month before enrollment (other than patients who are treated with TPO-receptor agonists and have no response after at least 4 months treatment).
  • Patients who are considered to be ineligible for the study by the investigator for reasons other than above.

Exclusion

    Key Trial Info

    Start Date :

    April 22 2021

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    August 9 2022

    Estimated Enrollment :

    3 Patients enrolled

    Trial Details

    Trial ID

    NCT04854889

    Start Date

    April 22 2021

    End Date

    August 9 2022

    Last Update

    August 30 2022

    Active Locations (1)

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    Regenerative Medicine Center

    Tianjin, Tianjin Municipality, China