Status:

NOT_YET_RECRUITING

Steroids Versus ECP and Steroids as First-line Treatment of Grade II Acute GVHD

Lead Sponsor:

Central Hospital, Nancy, France

Conditions:

Graft Vs Host Disease

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

The goal of this clinical trial is to compare as a first line of grade II skin acute GVHD sconventional treatment with steroids alone to a combination of steroids and extracoporeal photopheresis (ECP)...

Detailed Description

A multi-center randomized phase II study comparing corticosteroids alone (standard of care) versus corticosteroids and extracorporeal photopheresis as first-line treatment of Grade II acute graft-vers...

Eligibility Criteria

Inclusion

  • Age \> 18 years,
  • allogeneic hematopoietic stem cell transplantation received (from any type of graft and donor) after malignant or non malignant disease
  • patient suffering from Grade II acute GVHD with skin +/- high GI involvement (stage 2-3 skin + upper gastrointestinal tract or skin stage 3) in the 3 months following stem cell transplantation
  • patient requiring first line treatment for acute GVHD
  • patient able to start PCE therapy in the 3 days after randomization
  • validation of the presence of a peripheral or central venous access (its type should be conform to the recommendations described in the Therakos Cellex operator manual), allowing to perform PCE sessions weekly during 3 months. In the absence of appropriate preexisting central line at inclusion, peripheral access will be preferred.
  • leukocytes \> 1.5 G/l, platelets \> 30 G/l, hematocrit \> 27% (blood transfusion are permitted), based on the last available blood testing results,
  • patient with French Health Insurance,
  • patient informed about the clinical trial content and organization,
  • informed consent form signed.

Exclusion

  • \- Grade 1 acute GVHD,
  • acute GVH grade \> II or acute GVH with lower gastrointestinal tract or with liver involvement,
  • relapse of the hematologic disease at time of acute GVHD,
  • uncontrolled ongoing infection at time of inclusion: bacterial or fungal infections, CMV reactivation with increasing CMV viral load,
  • HIV positivity or replicative HBV or HCV infection (based on pre-transplant assessment),
  • patient with allergy or contraindications to UVADEX, extracorporeal photopheresis, steroids, or posaconazole (see details in the study protocol),
  • woman of childbearing age without efficient contraceptive method, pregnancy or breast feeding woman,
  • patient with history of profound venous thrombosis in the last 5 years,
  • patient included in another acute GVHD prospective clinical trial.

Key Trial Info

Start Date :

January 1 2024

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

January 1 2026

Estimated Enrollment :

42 Patients enrolled

Trial Details

Trial ID

NCT06133192

Start Date

January 1 2024

End Date

January 1 2026

Last Update

November 15 2023

Active Locations (1)

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1

CHRU de Nancy

Vandœuvre-lès-Nancy, France, 54511