Actively Recruiting
Phase II Study of Donor Stem Cell Transplant to Treat VEXAS Syndrome Using Reduced Intensity Conditioning and GVHD Prevention
Led by National Cancer Institute (NCI) · Updated on 2026-07-10
54
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are studying whether allogeneic hematopoietic stem cell transplantation HSCT can be successfully performed in adults aged 18 to 75 with VEXAS Syndrome, a condition involving severe inflammatory and blood-related problems that are often resistant to standard treatments. This disease causes systemic inflammation and bone marrow failure, leading to serious health issues and increased mortality. The study aims to see if HSCT can reverse the disease symptoms and achieve sustained donor cell engraftment. Participants receive different reduced intensity conditioning regimens depending on their donor match status before undergoing HSCT. Those with an 88 HLA matched donor receive fludarabine and busulfan, while those with a 78 matched or haploidentical donor receive fludarabine, cyclophosphamide, total body irradiation, and busulfan. After transplant, all participants receive drugs to prevent graft-versus-host disease GVHD, including cyclophosphamide, mycophenolate mofetil, and tacrolimus. These treatments are given according to a detailed schedule around the transplant day. Participants undergo extensive screening including physical exams, blood and urine tests, imaging scans, and specialist evaluations. After transplant, they stay in or near the hospital for at least 100 days with weekly visits, followed by study visits at 30, 60, 100, 180, 210, 240, 300, and 360 days post-transplant, then yearly visits for two years and annual phone contacts thereafter. Researchers monitor disease reversal, donor cell engraftment, safety, GVHD incidence, survival, and other outcomes over several years.
CONDITIONS
Brief Title
A Phase II Study of Allogeneic Hematopoietic Stem Cell Transplant for Subjects With VEXAS (Vacuoles, E1 Enzyme, X-linked, Autoinflammatory, Somatic) Syndrome
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Age between 18 and 75 years
- Availability of an 8/8 or 7/8 HLA-matched related or unrelated donor, or a haploidentical related donor
- Karnofsky performance status of at least 40%
- Adequate heart function with left ventricular ejection fraction over 35%
- Adequate kidney function with creatinine at or below 2.0 mg/dl and creatinine clearance at least 30 ml/min
- Liver function with conjugated bilirubin below 3.0 mg/dl and ALT and AST no more than 5 times the upper normal limit
- Pulmonary function with FEV1 and DLCO above 30%
- Ability and willingness to provide informed consent
- Agreement to use effective contraception if of childbearing potential or male partner, from study entry through one year post-transplant
- Willingness to remain near the hospital for at least 100 days after transplant with caregiver support if outpatient
- Somatic mutation in UBA1 or clinical history characteristic of VEXAS syndrome with at least two key disease manifestations
- Presence of cytopenia or myeloid neoplasm or intolerance or refractoriness to standard steroid treatments
You will not qualify if you...
- Hematopoietic Cell Transplantation Comorbidity Index of 5 or higher
- Diagnosis of multiple myeloma (low risk smoldering forms and monoclonal gammopathy are allowed)
- Use of other investigational agents within 30 days before treatment
- HIV infection
- Allergic reactions to study drugs including steroids, cyclophosphamide, busulfan, tacrolimus, mycophenolate mofetil, or filgrastim
- Pregnancy or breastfeeding
- Uncontrolled illnesses or social issues limiting study compliance
- Active uncontrolled infections deemed unsafe for transplant
- Active psychiatric disorders compromising protocol compliance
Research Team
B
Bhavisha A Patel, M.D.
Not the Right Trial for You?
Explore thousands of other clinical trials that might be a better match.
Sign up to get personalized trial recommendations delivered to your inbox.
Already have an account? Log in here