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
Condition(s) studied
Investigational drug(s) / intervention(s)
Grafalon: 10 mg/Kg/day IV for 3 consecutive days (day-3 to -1 before transplantation)
Thymoglobulin: 2.5 mg/Kg/day IV for 2 consecutive days (day-3 and -2 before transplantation)
Study 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 allo-HSCT are above 50 years of age and are transplanted with a reduced intensity conditioning (RIC) regimen. The optimal RIC and Graft Versus Host Disease (GVHD) prophylaxis regimen allowing a good control of the disease while preventing GVHD remains to be determined for elderly patients. A phase III trial comparing the conventional RIC fludarabine-busulfan 2 days to fludarabine-treosulfan demonstrated an advantage for the flu-treosulfan arm in terms of event free survival (EFS), that should therefore be considered as the new standard of RIC regimen for AML and MDS. GVHD prevention has a crucial role in post-transplant outcomes by potentially interfering with the graft-versus-leukemia (GVL) effect and immune reconstitution. Anti-thymocyte globulins (ATG) are recommended to reduce the risk of acute and chronic GVHD in transplants performed with matched unrelated donors. However, the optimal type of ATG between the 2 approved brands (ATG-thymoglobulin and ATLG-grafalon) displaying distinct characteristics and the optimal dose of ATG are still unknown. In a retrospective study of patients transplanted mainly with RIC with matched related and unrelated donors for haematological malignancies, Anti-T lymphocyte globulin (ATLG) was associated with a reduction of grade II-IV acute GVHD in comparison to ATG without increasing the incidence of relapse.
This phase III randomised study propose to compare GVHD prevention with ATG versus ATLG in AML and MDS patients above 50 years of age transplanted with a matched unrelated donor following a fludarabine-treosulfan RIC, with the hypothesis that ATLG would better control GVHD in this population of patients thus limiting the risk of morbidity and mortality of the procedure.
Eligibility
Primary outcome measure(s)
- Incidence of grade II-IV acute Graft Versus Host Disease (GVHD) according to the Mount Sinai Acute GVHD International Consortium (MAGIC) classification — At day 100 post-transplantation
Acute GVHD MAGIC classification permit to diagnose and score the severity of acute GVHD. MAGIC score varies from Grade 0 to Grade 4. The higher the score the more severe the damage.
Trial sites (28)
| Facility | City | Region | Status |
|---|---|---|---|
| CHU Amiens | Amiens | France | Recruiting |
| CHU Angers | Angers | France | Recruiting |
| CHU Besançon | Besançon | France | Recruiting |
| CHU Bordeaux | Bordeaux | France | Recruiting |
| CHU Brest | Brest | France | Recruiting |
| CHU Caen | Caen | France | Recruiting |
| CHU Clermont-Ferrand | Clermont-Ferrand | France | Recruiting |
| Hôpital Henri Mondor AP-HP | Créteil | France | Not Yet Recruiting |
| CHU Grenoble | Grenoble | France | Recruiting |
| CHU Lille | Lille | France | Recruiting |
| CHU Limoges | Limoges | France | Recruiting |
| CHU Lyon Sud | Lyon | France | Recruiting |
| IPC Marseille | Marseille | France | Recruiting |
| CHU Montpellier | Montpellier | France | Recruiting |
| CHRU Nancy | Nancy | France | Recruiting |
| CHU Nantes | Nantes | France | Recruiting |
| CHU Nice | Nice | France | Recruiting |
| Hôpital La Pitié Salpêtrière AP-HP | Paris | France | Recruiting |
| Hôpital Necker AP-HP | Paris | France | Recruiting |
| Hôpital Saint Louis AP-HP | Paris | France | Recruiting |
| Hôpital Saint-Antoine AP-HP | Paris | France | Recruiting |
| CHU Poitiers | Poitiers | France | Recruiting |
| CHU Rennes | Rennes | France | Recruiting |
| CHU Saint Etienne | Saint-Etienne | France | Recruiting |
| CHRU Strasbourg | Strasbourg | France | Recruiting |
| Oncopole Toulouse | Toulouse | France | Recruiting |
| CHRU Tours | Tours | France | Not Yet Recruiting |
| Institut Gustave Roussy | Villejuif | France | Recruiting |
More Assistance Publique - Hôpitaux de Paris trials in France
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
View NCT06083129 on ClinicalTrials.gov ↗ ← All trials in France