RecruitingPhase 2NCT04888741

Methods of T Cell Depletion Trial (MoTD)

A Multi-centre Phase II Trial of GVHD Prophylaxis Following Unrelated Donor Stem Cell Transplantation Comparing Thymoglobulin vs. Calcineurin Inhibitor or Sirolimus-based Post-transplant Cyclophosphamide


Sponsor

University of Birmingham

Enrollment

400 participants

Start Date

Feb 22, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

A multi-centre phase II trial of GvHD prophylaxis following unrelated donor stem cell transplantation comparing Thymoglobulin vs. Calcineurin inhibitor or Sirolimus-based post-transplant cyclophosphamide.


Eligibility

Min Age: 16 YearsMax Age: 70 Years

Inclusion Criteria20

  • Availability of suitably matched unrelated donor (9/10 or 10/10)
  • Planned to receive one of the following RIC protocols:
  • Fludarabine-Melphalan (Fludarabine 120-180mg/m2 IV; melphalan ≤ 150mg/m2 IV)
  • BEAM or LEAM (carmustine 300mg/m2 IV or lomustine 200mg/m2 IV with: etoposide 800 mg/m2 IV; cytarabine 1600mg/m2 IV; melphalan 140mg/m2 IV)
  • Fludarabine-Busulphan (Fludarabine 120-180mg/m2 IV; Busulphan ≤ 8mg/kg PO or 6.4mg/kg IV)
  • Fludarabine- Treosulfan (Fludarabine 150mg/m2 IV; Treosulfan 30g/m2 IV)
  • Planned use of PBSCs for transplantation
  • Planned allo-SCT for one of the following haematological malignancies:
  • AML in CR (patients enrolled onto the COSI trial are not eligible for this study)
  • ALL in CR (patients enrolled onto the ALL-RIC trial are not eligible for this study)
  • CMML <10% blasts
  • MDS <10% blasts (patients enrolled onto the COSI trial are not eligible for this study)
  • NHL in CR/PR
  • HL in CR/PR
  • MM in CR/PR
  • CLL in CR/PR
  • CML in 1st or 2nd chronic phase
  • Myelofibrosis
  • Age 16-70 years
  • Females of and male patients of reproductive potential (i.e., not post-menopausal or surgically sterilised) must agree to use appropriate, highly effective, contraception from the point of commencing therapy until 12 months after transplant

Exclusion Criteria15

  • Use of any method of graft manipulation (excluding storage of future DLI)
  • Use of alemtuzumab or any method of T cell depletion except those that are protocol-defined
  • Known hypersensitivity to study drugs or history of hypersensitivity to rabbits
  • Pregnant or lactating women
  • Adults of reproductive potential not willing to use appropriate, highly effective, contraception during the specified period
  • Life expectancy <8 weeks
  • Active HBV or HCV infection
  • Organ dysfunction defined as:
  • LVEF <45%
  • GFR <50ml/min
  • Bilirubin >50µmol/l
  • AST/ALT>3 x ULN
  • Participation in COSI or ALL-RIC trials
  • Contraindication to treatment with the study drugs (Thymoglobulin, cyclophosphamide, sirolimus, ciclosporin and mycophenolate mofetil) as detailed in each study drug SPC.
  • Patient has any other systemic dysfunction (e.g., gastrointestinal, renal, respiratory, cardiovascular) or significant disorder which, in the opinion of the investigator would jeopardise the safety of the patient by taking part in the trial.

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Interventions

DRUGThymoglobulin

GVHD prophylaxis

DRUGCyclophosphamide

Post transplant cyclophosphamide strategy for GVHD prophylaxis

DRUGCyclosporine

immunosuppressant

DRUGSirolimus

immunosuppressant

DRUGMycophenolate Mofetil

immunosuppressant


Locations(17)

University Hospital of Wales

Cardiff, Wales, United Kingdom

Queen Elizabeth Hospital

Birmingham, United Kingdom

Bristol Haematology and Oncology Centre

Bristol, United Kingdom

Addenbrookes Hospital

Cambridge, United Kingdom

Queen Elizabeth Hospital Glasgow

Glasgow, United Kingdom

St Jame's University Hospital

Leeds, United Kingdom

University College London Hospital

London, United Kingdom

King's College Hospital

London, United Kingdom

Hammersmith Hospital

London, United Kingdom

Manchester Royal Infirmary

Manchester, United Kingdom

The Christie

Manchester, United Kingdom

Freeman Hospital

Newcastle upon Tyne, United Kingdom

Nottingham City Hospital

Nottingham, United Kingdom

Churchill Hospital

Oxford, United Kingdom

Derriford Hospital

Plymouth, United Kingdom

Royal Hallamshire Hospital

Sheffield, United Kingdom

The Royal Marsden Hospital

Sutton, United Kingdom

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NCT04888741


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