Status:

NOT_YET_RECRUITING

Phase III Study Comparing GVHD Prophylaxis With ATG-thymoglobulin to ATLG-grafalon in Elderly Patients With Acute Myeloid Leukemia or Myelodysplasic Syndrome and Receiving an Allogeneic Hematopoietic Stem Cell Transplantation With a 10/10 HLA Matched Unrelated Donor

Lead Sponsor:

Assistance Publique - Hôpitaux de Paris

Conditions:

GVHD

Eligibility:

All Genders

50-70 years

Phase:

PHASE3

Brief Summary

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only curative therapy in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Most of the patients requiring an a...

Eligibility Criteria

Inclusion

  • Age ≥ 50 and ≤ 70 years
  • Patient between 50 and 55 years should be unfit for a myeloblative conditioning (SORROR score ≥2)
  • AML requiring allogeneic stem cell transplantation (intermediate or high-risk AML) in complete cytologic response (CR1 or above) or MDS requiring allogeneic stem cell transplantation (IPSS≥ 1.5 or IPSS-R \> 4.5 or IPSS-R \> 3-4.5 with risk features \[rapide blast increase, life-threatening neutropenia (\<0.3 G/L) or thrombopenia (\<30G/L) or high transfusion needs (\>2/month for 6 months)\]
  • Without an HLA matched related donor
  • Having an identified matched HLA 10/10 unrelated donor
  • With usual criteria for HSCT:
  • ECOG performans status ≤ 2
  • No severe and uncontrolled infection
  • Cardiac left ventricular ejection fraction ≥50%
  • Lung DLCO \> 40%
  • Adequate organ function: ASAT and ALAT ≤ 3N, total bilirubin ≤ 2N, creatinine clearance ≥ 50 mL/min (except if those abnormalities are linked to the hematological disease)
  • With health insurance coverage
  • Having signed a written informed consent
  • Contraception methods must be prescribed during all the duration of the research
  • NB: The authorized contraceptive methods are:
  • For women of childbearing age and in absence of permanent sterilization: oral, intravaginal or transdermal combined hormonal contraception, oral, injectable or transdermal progestogen-only hormonal contraception, intrauterine hormonal releasing system (IUS), sexual abstinence (only if this the preferred and usual lifestyle of the participants).
  • For man in absence of permanent sterilization: sexual abstinence, condoms

Exclusion

  • Cancer in the last 5 years (except basal cell carcinoma of the skin or "in situ" carcinoma of the cervix)
  • Uncontrolled infection
  • Seropositivity for HIV or HTLV-1 or active hepatitis B or C
  • Yellow fever vaccine and all others live virus vaccines within 2 months before transplantation
  • Heart failure according to NYHA (II or more) or Left ventricular ejection fraction \< 50%.
  • Lung DLCO ≤ 40%
  • Preexisting acute hemorrhagic cystitis
  • Renal failure with creatinine clearance \< 50ml / min
  • Pregnancy (β-HCG positive) or breast-feeding
  • Patients with any debilitating medical or psychiatric illness, which would preclude the realization of the SCT or the understanding of the protocol
  • Patient under state medical aid
  • Patient under legal protection (protection of the court, or in curatorship or guardianship).
  • For Grafalon: Hypersensitivity to the active substance or to any of the excipients
  • For Thymoglobulin: Hypersensitivity to rabbit proteins or to any of the excipients
  • Participation in other interventional clinical trials
  • Any contraindication mentioned in the SmPC of all auxiliary medicinal products planned to be used in the trial: cyclosporine, mycophenolate mofetil, fludarabine, treosulfan

Key Trial Info

Start Date :

November 1 2023

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

November 1 2028

Estimated Enrollment :

324 Patients enrolled

Trial Details

Trial ID

NCT06083129

Start Date

November 1 2023

End Date

November 1 2028

Last Update

October 13 2023

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