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Safety and Efficacy Study of Photopheresis with UVADEX to Prevent Graft-versus-Host Disease



Safety and Efficacy Study of Photopheresis with UVADEX to Prevent Graft-versus-Host Disease

For Condition: Graft-Versus-Host Disease
Status: Recruiting
Sponsor(s): Therakos ,
Synopsis: The purpose of this study is to determine whether Extracorporeal Photopheresis with UVADEX (ECP) prior to bone marrow or peripheral blood stem cell transplantation is effective in the prevention of Graft-versus-Host Disease (GvHD).
Details: Approximately 30% of HLA-identical related bone marrow graft recipients and up to 90% of patients receiving bone marrow from unrelated donors develop significant acute GvHD despite the use of prophylactic therapies such as cyclosporine and methotrexate. About half of these patients respond to initial treatment with steroids and require no further treatment. The remainder of these patients are either unresponsive to initial therapy or become steroid-resistant over time. The prognosis in these cases is poor and mortality for patients with steroid-resistant GvHD may be as high as 50%. ECP is a technique in which peripheral white blood cells are exposed to a photoactivatable compound (UVADEX) administered extracorporeally and ultraviolet A light. After cells are reinfused into the patient, their function is altered, thereby activating mechanisms that allow for further regulation of specific lymphocyte populations. ECP has shown activity in several inflammatory and autoimmune diseases, including scleroderma, rheumatoid arthritis, transplantation rejection, acute and chronic GvHD. In a previous single-center, open label, single-arm study of 56 patients receiving ECP treatment on two consecutive days and reduced-intensity bone-marrow conditioning prior to bone marrow transplantation from matched or partially matched human donors, the incidence of grade II-IV acute GvHD was less than 10%. This is in contrast to an expected incidence of approximately 40%. The purpose of this study is to determine the role of ECP, administered pre-transplant, in preventing GvHD when used in conjunction with a standard myeloablative conditioning regimen.
Eligibility:
Study Type:
  Interventional, Prevention, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Minimum Age/Maximum Age: 18 Years/60 Years
Genders: Both
Protocol Entry Criteria: Inclusion Criteria: - Patients with a diagnosis of a malignancy of the blood (e.g. leukemia) for which allogeneic bone marrow or peripheral blood stem cell transplantation is a treatment option. - Patients who are candidates for a standard allogenic bone marrow transplant or PBSC transplant. - Patients must have adequate renal, hepatic, pulmonary and cardiac function to enable the patient to tolerate shifts in the volumes of body fluids associated with extracorporeal photopheresis, as determined by the physician's clinical judgement. - Patients must weigh at least 40 kg (88 lbs) Exclusion Criteria: - Patients who have received a prior bone marrow transplant or peripheral blood stem cell transplant.
Total Enrollment: 60

Location and Contact Information:

Careggi Hospital *Not yet recruiting*
Florence,  ,  1-50134
Italy
Not yet recruiting  

St. Vincent's Hospital *Not yet recruiting*
Sydney,  ,  2010
Australia
Not yet recruiting  

Royal Melbourne Hospital *Not yet recruiting*
Parkville,  ,  3050
Australia
Not yet recruiting  

Royal Brisbane Hospital *Not yet recruiting*
Brisbane,  ,  4006
Australia
Not yet recruiting  

Hammersmith Hospital *Not yet recruiting*
London,  ,  W12 0NN
United Kingdom
Not yet recruiting Jane  Apperley 011-44-208-383-3237

Instituto Portugues de Oncologia de Francisco Gentil *Not yet recruiting*
Lisbon,  ,  1099-023
Portugal
Not yet recruiting Alexandra  Machado 351-21-722-9864

Hospital Azevedo Carvalho *Not yet recruiting*
Jau,  , 
Brazil
Not yet recruiting  

Ankara University Medical School *Not yet recruiting*
Ankara,  ,  6100
Turkey
Not yet recruiting  

Kansas City Cancer Center *Recruiting*
Kansas City,  Missouri,  64111
United States
Recruiting Sunil  Abhyankar 816-531-1417

San Martino Hospital *Not yet recruiting*
Genova,  ,  16132
Italy
Not yet recruiting Stefania  Bregante 390105553405

National Cancer Institute *Not yet recruiting*
Rio de Janeiro,  , 
Brazil
Not yet recruiting  

University of Florida *Recruiting*
Gainesville,  Florida, 
United States
Recruiting  

Hemocentro *Not yet recruiting*
Sao Paulo,  , 
Brazil
Not yet recruiting  

Alfred Hospital *Not yet recruiting*
Melbourne,  , 
Australia
Not yet recruiting  

Texas Transplant *Recruiting*
San Antonio,  Texas,  78229
United States
Recruiting Paul  Shaughnessy 210-575-8500

University of Chicago *Not yet recruiting*
Chicago,  Illinois,  60637
United States
Not yet recruiting  

Peter MacCallum Cancer Institute *Not yet recruiting*
East Melbourne,  ,  8006
Australia
Not yet recruiting  

National Cancer Institute *Not yet recruiting*
Bratislava,  , 
Slovakia
Not yet recruiting  

Cleveland Clinic Foundation *Recruiting*
Cleveland,  Ohio,  44195
United States
Recruiting Julie  Curtis 216-444-9384

Ludwig-Maximiliano Universitaet Muenchen *Not yet recruiting*
Munchen,  ,  D-81377
Germany
Not yet recruiting  

Tufts New England Medical Center *Not yet recruiting*
Boston,  Massachusetts,  02111
United States
Not yet recruiting Tracy  Bell 617-636-5558


Additional Information:
Study ID Numbers:
  GvHD Prevention; 
Study Start Date: June 2002
Record last reviewed: February 2003
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00054600

Other Graft-Versus-Host Disease Studies:
1. Safety and Efficacy Study of Photopheresis Plus Standard Therapy to Treat Chronic Graft-versus-Host Disease

2. Safety and Efficacy Study of Photopheresis with UVADEX to Prevent Graft-versus-Host Disease

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