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GVHD, AcutePhase 22017-00355NCT04118556

Decidua Stroma Cells for Steroid Resistent Acute Graft-versus-host Disease After Allo-HSCT

A Phase 2 study testing Decidua Stroma Cells (DSC) and Best available Treatment (BAT) in people with GVHD, Acute, run by Mats Remberger at 4 sites in 3 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

A randomized (1:1) phase II open label study of DSC compared to Investigator choice Best Available Therapy (BAT) in allogeneic hematopoietic stem cell transplant recipients with Grades II-IV steroid refractory acute graft vs. host disease in the second part of the study. Patients will receive 2 doses of DSC. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
GVHD, Acute
What is being tested?
Decidua Stroma Cells (DSC) and Best available Treatment (BAT)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
4 sitesin 3 countries
Study dates
1 Dec 2021to 29 Apr 2026
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adult patients (age ≥ 18 years) with steroid refractory acute GvHD grades II-IV after allo-HSCT.
  • Signed written study informed consent once SR-aGvHD is confirmed.

Who cannot join

  • Presence of an active uncontrolled infection including significant bacterial, fungal, viral or parasitic infection requiring treatment.
  • Has received systemic treatment for aGvHD apart from steroids.
  • Clinical presentation resembling de novo chronic GvHD or GvHD overlap syndrome.
  • Pregnant or lactating women.
  • Significant respiratory disease.
  • Presence of severely impaired renal function
Show all 16Show fewer
  • Any corticosteroid therapy for indications other than aGvHD
  • Previous participation in a study of any investigational treatment agent within 30 days
  • Known human immunodeficiency virus infection (HIV).
  • Patients suffering on active tuberculosis or viral hepatitis
  • Significant respiratory disease
  • Presence of severely impaired renal or liver function
  • History of progressive multifocal leuko-encephalopathy
  • Patients with coagulopathy
  • History of severe chronic history of heart disease
  • Any condition that would, in the Investigator's judgment, interfere with full participation in the study.

Trial locations and contacts

4 sites in 3 countries.

4 sites in 3 countries

Sweden2 sites
  • Lund University Hospital

    Lund, SE-221 85

  • Uppsala University Hospital

    Uppsala, SE-75185

Other trials in Sweden

Denmark1 site
  • Copenhagen Univerity Hospital

    Copenhagen, 2300

Other trials in Denmark

Norway1 site
  • Oslo University Hospital

    Oslo, NO-0424

Other trials in Norway

About this study

Official title: A Multicenter, Open-label, Randomized, Phase I/II Clinical Trial Comparing Safety and Durable Overall Response Day 56 in Patients With Steroid Resistent Acute GvHD After Allogeneic Hematopoietic Stem Cell Transplant Treated With DSC or BAT

A randomized (1:1) phase II open label study of DSC compared to Investigator choice Best Available Therapy (BAT) in allogeneic hematopoietic stem cell transplant recipients with Grades II-IV steroid refractory acute graft vs. host disease in the second part of the study. Patients will receive 2 doses of DSC. Additional doses (up to 4 doses) may be given depending on response.

No cross-over are planned in the second stage of the study.

Read the detailed description

Main inclusion criteria:

Adult patients (age ≥ 18 years) with steroid refractory (SR) acute GvHD (aGVHD) grades II-IV after allo-HSCT.

Signed written study informed consent once SR-aGvHD is confirmed.

Main exclusion criteria:

Presence of an active uncontrolled infection requiring treatment. Has received systemic treatment for aGvHD apart from steroids. Clinical presentation resembling de novo chronic GvHD or GvHD overlap syndrome. Known human immunodeficiency virus infection (HIV). Patients suffering on active tuberculosis or viral hepatitis. Significant respiratory disease Presence of severely impaired renal function Patients with coagulopathy Pregnant or nursing (lactating) women Malignancy that has required treatment in the previous two years Any condition that would, in the Investigator's judgment, interfere with full participation in the study.

Design:

The trial is a Phase II, randomized (1:1), open label study investigating the efficacy and safety of DSC vs. BAT added to the patient's immunosuppressive regimen in adults with SR-aGvHD.

The primary objectives will be safety and to compare durable overall response (DOR) at 56 days after randomization between patients receiving DSC with patients receiving BAT as treatment for SR acute GvHD grades II-IV. Target enrollment is 50 patients, 25 in the DSC treatment-arm and 25 in the BAT arm. Patients will be given the optimal dose of DSC from the Phase I, dose escalating part of the study, as mentioned above. At least 2 doses of DSC will be given one week apart. Additional doses of DSC (maximum 4 doses) may be given depending on response. Additional doses (beyond the first 2 doses) may be given one week apart until response, or whenever needed if aGVHD flare occur within 6 months after randomization (EOT).

BAT: Investigator's choice Best Available Therapy (BAT) will vary depending upon Investigator's choice identified prior to randomization. Dose and frequency will depend on label (where approved) and institutional guidelines for various BAT.

Primary objective

  • Assess the Safety of DSC.
  • Durable Overall Response (DOR) at Day 56.

Secondary objectives

  • To assess Overall Response Rate (ORR) at day 28
  • To assess 1-year Overall Survival (OS)
  • To assess 1-year Non-Relapse Mortality (NRM)
  • To assess incidence of infections

Exploratory objectives

  • To assess the cumulative steroid dose until Day 56 and Day 90
  • To assess Event-Free Survival (EFS)
  • To assess incidence of Malignancy Relapse/Progression
  • To measure the incidence of chronic GvHD
  • To measure immune reconstitution
  • To evaluate changes in Patient Reported Outcomes
Conditions
GVHD, Acute
Being tested
Decidua Stroma Cells (DSC), Best available Treatment (BAT)
Keywords
DSC, BAT, GVHD, HSCT
Medical subject headings
Graft vs Host Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Decidua Stroma Cells (DSC)Biological

    Placenta-derived Decidua Stroma Cells. The product consists of a viable allogeneic DSCs frozen in 5% of human serum albumin (HSA) in sodium chloride (NaCl) 0.9% and 10% dimethylsulfoxide (DMSO), that is thawed and immediately diluted in 40 mL sodium chloride (NaCl) 0.9% prior to infusion. That will give a final concentration of 2.2% HSA and 2% DMSO.

    DSC will be infused when steroid-refractory acute GVHD after allogenic stem-cell transplantation has been diagnosed. Two doses, one week apart, will be given to all patients. Additional doses will be used depending on response.

  • Best available Treatment (BAT)Drug

    Also called ECP, Everolimus, Sirolimus, Etanercept, Vedolizumab, Ruxolitinib, Infliximab.

    The BAT in this study will freely be identified by the Investigator prior to patient randomization and may include treatments such as: extracorporeal photopheresis (ECP), low-dose methotrexate (MTX), mycophenolate mofetil (MMF), mTOR inhibitors (everolimus or sirolimus), etanercept, vedolizumab, ruxolitinib or infliximab. Dose and frequency will depend on label (where approved) and institutional guidelines for various BAT.

Study groups in NCT04118556
Study groupRoleWhat they receive
Decidua Stroma Cells (DSC)ExperimentalPlacenta derived decidua stroma cells (DSC). In the first phase I part, two different dose levels will be used, 1x10^6/kg and 3x10^6/kg. Two doses, one week apart, will be given. The decision to proceed to the next dose level will depend on results observed at the previous dose level. The dose in the randomized part will be based on the findings in the phase I part. In the Phase II study all patients will receive 2 doses, one week apart. Depending on response, up to 6 doses in total may be given. Additional doses (beyond the first 2 doses) may be given one week apart until response.
Receives: Biological: Decidua Stroma Cells (DSC)
Best Available Treatment (BAT)Active comparatorThe BAT in this study will freely be identified by the Investigator prior to patient randomization and may include treatments such as: anti-thymocyte globulin (ATG), extracorporeal photopheresis (ECP), low-dose methotrexate (MTX), mycophenolate mofetil (MMF), mTOR inhibitors (everolimus or sirolimus), etanercept, vedolizumab, ruxolitinib or infliximab. Dose and frequency will depend on label (where approved) and institutional guidelines for various BAT.
Receives: Drug: Best available Treatment (BAT)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety and tolerability evaluation including Severe Adverse Events (SAE).

    Adverse events will be assessed and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

    Measured: 5 years

  2. Durable Response to treatment

    Durable Overall Response (DOR) day 56.

    Measured: 56 days

Secondary outcomes (8)
  1. Number of patients with overall response (CR+PR) at day 28

    Overall Response Rate (ORR) at day 28.

    Measured: 28 days

  2. Rate of Survival

    Death within 1 year after inclusion in study.

    Measured: 1 year

  3. Incidence of Non-Relapse Mortality (NRM)

    Death of any cause with enduring complete remission.

    Measured: 1 year

  4. Incidence of infections

    Serious infections occurring after inclusion in study.

    Measured: 1 year

  5. Change of Quality of Life

    Change of self-experienced well-being (Quality of Life)(FACT-BMT version 4) at four time-points after inclusion. Scoring procedures consist of summing the items with reversed scoring (0-4p where 0=best and 4=worst) for several items which produces individual subscale scores (0-24/28p) and an overall score (0-200p).

    The FACT-BMT (Functional Assessment of Cancer Therapy-Bone Marrow Transplant) has a total of 50 questions. This is a questionnaire of general questions divided into four primary quality of life domains: physical well-being (PWB; 7-items), social/family well-being (SWB; 7-items), emotional well-being (EWB; 6-items); and functional well-being (FWB; 7-items), 18 items address the BMT related side effects, specifically designed to assess the BMT patients' quality of life. Five other questions from different QoL questionnaire were added as they were considered relevant to FACT-BMT.

    Measured: 1 year

  6. Incidence of Relapse

    Recurrence of the disease the patient were transplanted for.

    Measured: 5 year

  7. Incidence of secondary malignancies

    Occurrence of other malignancies than the patient were transplanted for.

    Measured: 5 year

  8. Incidence of chronic GVHD

    Occurrence of chronic GVHD.

    Measured: 5 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Oct 2019
  2. Study start1 Dec 2021
  3. Primary completion29 Apr 2026
  4. Study completion29 Apr 2026

Why it stopped: Too slow recruitment

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A randomized (1:1) phase II open label study of DSC compared to Investigator choice Best Available Therapy (BAT) in allogeneic hematopoietic stem cell transplant recipients with Grades II-IV steroid refractory acute graft vs. host disease. Patients will receive 2 doses of DSC. Additional doses (up to 4 doses) may be given depending on response. No cross-over are planned in the second stage of the study.
Masking
None (open label)
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04118556
Sponsor's protocol ID
DSC-BROMS-1
Other IDs
2019-002186-36, 2019
Acronym
2017-00355
Status last verified
Apr 2026
First submitted
27 Sep 2019
Last updated
6 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Ringden O, Baygan A, Remberger M, Gustafsson B, Winiarski J, Khoein B, Moll G, Klingspor L, Westgren M, Sadeghi B. Placenta-Derived Decidua Stromal Cells for Treatment of Severe Acute Graft-Versus-Host Disease. Stem Cells Transl Med. 2018 Apr;7(4):325-331. doi: 10.1002/sctm.17-0167. Epub 2018 Mar 13.

    PubMed 29533533
  • Sadeghi B, Remberger M, Gustafsson B, Winiarski J, Moretti G, Khoein B, Klingspor L, Westgren M, Mattsson J, Ringden O. Long-Term Follow-Up of a Pilot Study Using Placenta-Derived Decidua Stromal Cells for Severe Acute Graft-versus-Host Disease. Biol Blood Marrow Transplant. 2019 Oct;25(10):1965-1969. doi: 10.1016/j.bbmt.2019.05.034. Epub 2019 Jun 4.

    PubMed 31173898

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Decidua Stroma Cells (DSC) and Best available Treatment (BAT) in people with GVHD, Acute, run by Mats Remberger at 4 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 6 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Sweden, Denmark, Norway. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Too slow recruitment). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety and tolerability evaluation including Severe Adverse Events (SAE). (time frame: 5 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04118556, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 May 2026.

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