Hematologic MalignancyPhase 2NCT04395222
Tocilizumab for the Prevention of Graft Failure and GVHD in Haplo-Cord Transplantation
A Phase 2 study testing Tocilizumab, Fludarabine and Melphalan in people with Hematologic Malignancy and Bone Marrow Transplant, run by Weill Medical College of Cornell University at 1 site in United States.
Trial summary
The purpose of this study is to evaluate the safety of reducing and ultimately eliminating anti-thymocyte globulin (ATG) from the haplo-cord transplant conditioning regimen and replacing it with tocilizumab, an IL-6 receptor monoclonal antibody, to improve immune reconstitution and reduce relapse while preserving low… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hematologic Malignancy, Bone Marrow Transplant
- What is being tested?
- Tocilizumab, Fludarabine and Melphalan
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 21 participants
- Where
- 1 siteUnited States
- Study dates
- 7 Oct 2020to Jun 2027
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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
- Subject must have a confirmed diagnosis of one of the following:
- Relapsed or refractory acute leukemia (myeloid or lymphoid)
- Acute leukemia in first remission at high-risk for recurrence
- Chronic myelogenous leukemia in chronic, accelerated phase or blast-crisis
- Myelodysplastic syndromes
- Chronic myeloproliferative disease
Show all 21Show fewer
- Recurrent, refractory or high-risk malignant lymphoma
- Chronic lymphocytic leukemia, relapsed or with poor prognostic features
- Multiple myeloma
- Other hematological disorder in need of allogeneic transplant (e.g. blastoid dendritic cell neoplasm)
- Age ≥ 18 years.
- Likely to benefit from allogeneic transplant in the opinion of the transplant physician.
- An HLA-identical related or unrelated donor cannot be identified within an appropriate time frame.
- Karnofsky Performance Status (KPS) of ≥ 70%.
- Acceptable organ function as defined below:
- Serum bilirubin: <2.0 mg/dL
- ALT (SGPT) <3x upper limit of normal (ULN)
- Creatinine Clearance: >50 mL/min/1.73m2 (eGFR as estimated by the modified MDRD equation)
- Left ventricular ejection fraction >40%
- Pulmonary diffusion capacity >40% predicted
- Ability to understand and the willingness to sign a written informed consent document.
Who cannot join
- Life expectancy is severely limited by concomitant illness or uncontrolled infection.
- Evidence of chronic active hepatitis or cirrhosis
- Uncontrolled HIV disease.
- Pregnancy or lactation.
- History of complicated diverticulitis, including fistulae, abscess formation or gastrointestinal perforation
- History of allergic reactions attributed to compounds of similar chemical or biological composition as tocilizumab, including known allergies to Chinese hamster ovary cell products or other recombinant human or humanized antibodies.
Trial locations and contacts
1 site in 1 country.
United States1 site
Weill Cornell Medical College
New York, New York, 10065
About this study
Official title: A Prospective Study of Tocilizumab for the Prevention of Graft Failure and Graft-versus-Host Disease in Haplo-Cord Transplantation
The purpose of this study is to evaluate the safety of reducing and ultimately eliminating anti-thymocyte globulin (ATG) from the haplo-cord transplant conditioning regimen and replacing it with tocilizumab, an IL-6 receptor monoclonal antibody, to improve immune reconstitution and reduce relapse while preserving low rates of graft failure and graft versus host disease (GVHD).
Read the detailed description
This study is a prospective phase II non-inferiority study investigating tocilizumab as a potential alternative to anti-thymocyte globulin (ATG) in haplo-cord transplantation. It is a single-center study based at Weill Cornell Medicine/NewYork Presbyterian Hospital.
The hypothesis is that tocilizumab is a safe and effective alternative to ATG in haplo-cord transplantation, facilitating transient engraftment of the haplo-identical stem cell graft without prolonged neutropenia or second nadir prior to durable cord engraftment while also preventing graft versus host disease (GVHD).
This study plans to enroll patients with hematologic malignancies in need of alternate donor transplant. All subjects will be conditioned with fludarabine, melphalan and total body irradiation (TBI), followed by a single dose of tocilizumab 8 mg/kg on Day -1. Patients will be enrolled into 4 successive cohorts, initially administering the current standard 3 doses of ATG 1.5 mg/kg (total 4.5 mg/kg). In the absence of safety signals, we will drop one dose of ATG in successive cohorts until the drug ultimately has been eliminated.
The primary endpoint of the study is successful haplo-derived neutrophil engraftment. Treatment will only be of interest if there is evidence that this rate is greater than 60%. If there are 4 or fewer successes, that dose group will be deemed unacceptable and the next higher ATG dose for which there were 5 or more success will be expanded.
- Conditions
- Hematologic Malignancy, Bone Marrow Transplant
- Being tested
- Tocilizumab, Fludarabine, Melphalan, Anti-thymocyte globulin (rabbit), Total Body Irradiation
- Keywords
- Tocilizumab, Haplo-Cord Transplant, Allogeneic Transplant, Hematologic Malignancies
- Medical subject headings
- Hematologic Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TocilizumabDrug
Also called Actemra
Tocilizumab 8 mg/kg intravenously administered as a single dose on Day -1 of transplant conditioning regimen
FludarabineDrug
Also called Fludara
Fludarabine 30 mg/m2 intravenously administered on Day -7, Day -6, Day -5, Day -4, Day -3 of transplant conditioning regimen if under the age of 60. If over the age of 60, Fludarabine 30 mg/m2 intravenously administered on Day -5, Day -4 and Day -3 of transplant conditioning regimen.
MelphalanDrug
Also called Alkeran
Melphalan 140 mg/m2 intravenously administered on Day -2 of transplant conditioning regimen.
Anti-thymocyte globulin (rabbit)Drug
Also called Thymoglobulin
Anti-thymocyte globulin (ATG) 1.5 mg/kg
Total Body IrradiationRadiation
Total Body Irradiation (TBI) 2 Gray, administered on Day -4 and Day -3 of transplant conditioning regimen
| Study group | Role | What they receive |
|---|---|---|
| ATG Group I | Experimental | Anti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5, Day -3 and Day -1 of the transplant conditioning regimen.
* Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old)
* Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen.
* Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen.
* Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. Receives: Drug: Tocilizumab; Drug: Fludarabine; Drug: Melphalan; Drug: Anti-thymocyte globulin (rabbit); Radiation: Total Body Irradiation |
| ATG Group II | Experimental | Anti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5, and Day -3 of the transplant conditioning regimen.
* Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old)
* Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen.
* Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen.
* Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. Receives: Drug: Tocilizumab; Drug: Fludarabine; Drug: Melphalan; Drug: Anti-thymocyte globulin (rabbit); Radiation: Total Body Irradiation |
| ATG Group III | Experimental | Anti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5 of the transplant conditioning regimen.
* Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old)
* Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen.
* Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen.
* Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. Receives: Drug: Tocilizumab; Drug: Fludarabine; Drug: Melphalan; Drug: Anti-thymocyte globulin (rabbit); Radiation: Total Body Irradiation |
| ATG Group IV | Experimental | * Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old)
* Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen.
* Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen.
* Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. Receives: Drug: Tocilizumab; Drug: Fludarabine; Drug: Melphalan; Radiation: Total Body Irradiation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Subjects With Successful Haplo-derived Neutrophil Engraftment
This is defined as:
- Achieve an absolute neutrophil count (ANC) of 500 cells/microL for three consecutive days with the first on or prior to Day +21 post-transplant, AND
- Absence of a second nadir - a drop in the ANC to <300 cells/microL for five consecutive days - after initial neutrophil recovery.
Measured: 21 days post-transplant
Secondary outcomes (7)
Progression-Free Survival
Time elapsed between Day 0 and progression of the underlying malignancy for which the transplant was performed, assessed up to 5 years post-transplant.
Measured: 5 years post-transplant
Overall Survival
Time elapsed between Day 0 and death from any cause, assessed up to 5 years post-transplant.
Measured: 5 years post-transplant
Transplant-Related Mortality
Proportion of deaths which cannot be explained by persistence, relapse or progression of the underlying malignancy once the preparative regimen starts, assessed up to 5 years post-transplant.
Measured: 5 years post-transplant
Proportion of Platelet Engraftment Success
Proportion of patients who successfully achieve platelet engraftment, defined as a platelet count of >20k/microL for three consecutive days without transfusion support for seven consecutive days.
Measured: 6 months post-transplant
Proportion of Failure of the Haplo-Graft
Proportion of patients with a failed haplo-graft, defined as the absence of neutrophil engraftment by Day +21 or a drop in the absolute neutrophil count to <0.3 cells/microL for five consecutive days occurring after initial neutrophil engraftment within the first 3 weeks post-transplantation (second nadir)
Measured: 21 days post-transplant
Proportion of Acute Graft-versus-Host Disease
Proportion of patients who develop acute graft-versus-host disease
Measured: 1 year post-transplant
Percentage of Chronic Graft-versus-Host Disease
Percentage of patients who develop chronic graft-versus-host disease
Measured: 5 years post-transplant
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 May 2020
- Study start7 Oct 2020
- Primary completion28 Sep 2022
- Study completionJun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Hematologic MalignancyStudies of the same condition, open and under way.
- More trials run by Weill Medical College of Cornell UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 21 participants (actual)
Sponsor and investigators
- Lead sponsor
- Weill Medical College of Cornell University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Alexandra Gomez Arteaga, MD, Principal investigator, Weill Medical College of Cornell University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04395222
- Sponsor's protocol ID
- 19-08020738
- Status last verified
- Dec 2025
- First submitted
- 15 May 2020
- Last updated
- 6 Jan 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective Study of Tocilizumab for the Prevention of Graft Failure and Graft-versus-Host Disease in Haplo-Cord Transplantation
- ClinicalTrials.gov ID
- NCT04395222
- Acronym / sponsor ID
- 19-08020738
- Conditions
- Hematologic Malignancy, Bone Marrow Transplant
- Keywords
- Tocilizumab, Haplo-Cord Transplant, Allogeneic Transplant, Hematologic Malignancies
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 21 participants (actual)
- Lead sponsor
- Weill Medical College of Cornell UniversityUniversity, hospital or other
- Study start
- 7 Oct 2020 (actual)
- Primary completion
- 28 Sep 2022 (actual)
- Study completion
- Jun 2027 (estimated)
- First posted
- 20 May 2020 (actual)
- Results
- Posted 23 Oct 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the safety of reducing and ultimately eliminating anti-thymocyte globulin (ATG) from the haplo-cord transplant conditioning regimen and replacing it with tocilizumab, an IL-6 receptor monoclonal antibody, to improve immune reconstitution and reduce relapse while preserving low rates of graft failure and graft versus host disease (GVHD).
Detailed description
This study is a prospective phase II non-inferiority study investigating tocilizumab as a potential alternative to anti-thymocyte globulin (ATG) in haplo-cord transplantation. It is a single-center study based at Weill Cornell Medicine/NewYork Presbyterian Hospital.
The hypothesis is that tocilizumab is a safe and effective alternative to ATG in haplo-cord transplantation, facilitating transient engraftment of the haplo-identical stem cell graft without prolonged neutropenia or second nadir prior to durable cord engraftment while also preventing graft versus host disease (GVHD).
This study plans to enroll patients with hematologic malignancies in need of alternate donor transplant. All subjects will be conditioned with fludarabine, melphalan and total body irradiation (TBI), followed by a single dose of tocilizumab 8 mg/kg on Day -1. Patients will be enrolled into 4 successive cohorts, initially administering the current standard 3 doses of ATG 1.5 mg/kg (total 4.5 mg/kg). In the absence of safety signals, we will drop one dose of ATG in successive cohorts until the drug ultimately has been eliminated.
The primary endpoint of the study is successful haplo-derived neutrophil engraftment. Treatment will only be of interest if there is evidence that this rate is greater than 60%. If there are 4 or fewer successes, that dose group will be deemed unacceptable and the next higher ATG dose for which there were 5 or more success will be expanded.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| ATG Group I | Experimental | Drug: Tocilizumab, Drug: Fludarabine, Drug: Melphalan, Drug: Anti-thymocyte globulin (rabbit), Radiation: Total Body IrradiationAnti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5, Day -3 and Day -1 of the transplant conditioning regimen. * Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old) * Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen. * Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen. * Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. |
| ATG Group II | Experimental | Drug: Tocilizumab, Drug: Fludarabine, Drug: Melphalan, Drug: Anti-thymocyte globulin (rabbit), Radiation: Total Body IrradiationAnti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5, and Day -3 of the transplant conditioning regimen. * Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old) * Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen. * Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen. * Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. |
| ATG Group III | Experimental | Drug: Tocilizumab, Drug: Fludarabine, Drug: Melphalan, Drug: Anti-thymocyte globulin (rabbit), Radiation: Total Body IrradiationAnti-thymocyte Globulin (ATG) 1.5 mg/kg administered on Day -5 of the transplant conditioning regimen. * Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old) * Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen. * Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen. * Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. |
| ATG Group IV | Experimental | Drug: Tocilizumab, Drug: Fludarabine, Drug: Melphalan, Radiation: Total Body Irradiation* Fludarabine 30mg/m2 administered on Day -7 through Day -3 of transplant conditioning regimen (if under 60 years old), or on Day -5 through Day -3 of transplant conditioning regimen (if over 60 years old) * Melphalan 140 mg/m2 administered on Day -2 of transplant conditioning regimen. * Total Body Irradiation 2 Gray administered on Day -4, Day -3 of transplant conditioning regimen. * Tocilizumab 8 mg/kg administered on Day -1 of transplant conditioning regimen. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (21 listed)
- Subject must have a confirmed diagnosis of one of the following:
- Age ≥ 18 years.
- Likely to benefit from allogeneic transplant in the opinion of the transplant physician.
- An HLA-identical related or unrelated donor cannot be identified within an appropriate time frame.
- Karnofsky Performance Status (KPS) of ≥ 70%.
Key exclusion criteria (6 listed)
- Life expectancy is severely limited by concomitant illness or uncontrolled infection.
- Evidence of chronic active hepatitis or cirrhosis
- Uncontrolled HIV disease.
- Pregnancy or lactation.
- History of complicated diverticulitis, including fistulae, abscess formation or gastrointestinal perforation
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TocilizumabAlso: ActemraTocilizumab 8 mg/kg intravenously administered as a single dose on Day -1 of transplant conditioning regimen | Drug | ATG Group I, ATG Group II, ATG Group III, ATG Group IV |
| FludarabineAlso: FludaraFludarabine 30 mg/m2 intravenously administered on Day -7, Day -6, Day -5, Day -4, Day -3 of transplant conditioning regimen if under the age of 60. If over the age of 60, Fludarabine 30 mg/m2 intravenously administered on Day -5, Day -4 and Day -3 of transplant conditioning regimen. | Drug | ATG Group I, ATG Group II, ATG Group III, ATG Group IV |
| MelphalanAlso: AlkeranMelphalan 140 mg/m2 intravenously administered on Day -2 of transplant conditioning regimen. | Drug | ATG Group I, ATG Group II, ATG Group III, ATG Group IV |
| Anti-thymocyte globulin (rabbit)Also: ThymoglobulinAnti-thymocyte globulin (ATG) 1.5 mg/kg | Drug | ATG Group I, ATG Group II, ATG Group III |
| Total Body IrradiationTotal Body Irradiation (TBI) 2 Gray, administered on Day -4 and Day -3 of transplant conditioning regimen | Radiation | ATG Group I, ATG Group II, ATG Group III, ATG Group IV |
Primary outcome
Percentage of Subjects With Successful Haplo-derived Neutrophil Engraftment
Time frame: 21 days post-transplant
This is defined as: 1. Achieve an absolute neutrophil count (ANC) of 500 cells/microL for three consecutive days with the first on or prior to Day +21 post-transplant, AND 2. Absence of a second nadir - a drop in the ANC to <300 cells/microL for five consecutive days - after initial neutrophil recovery.
7 secondary outcomes
Progression-Free Survival
Time frame: 5 years post-transplant
Overall Survival
Time frame: 5 years post-transplant
Transplant-Related Mortality
Time frame: 5 years post-transplant
Proportion of Platelet Engraftment Success
Time frame: 6 months post-transplant
Proportion of Failure of the Haplo-Graft
Time frame: 21 days post-transplant
Proportion of Acute Graft-versus-Host Disease
Time frame: 1 year post-transplant
Percentage of Chronic Graft-versus-Host Disease
Time frame: 5 years post-transplant
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Jan 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Alexandra Gomez Arteaga, MD principal investigator
Weill Medical College of Cornell University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Tocilizumab, Fludarabine and Melphalan in people with Hematologic Malignancy and Bone Marrow Transplant, run by Weill Medical College of Cornell University at 1 site in United States.
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 21 inclusion and 6 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: under way, not looking for participants, as of the sponsor's last update on 6 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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?
Yes. Results are posted in the registry (first posted 23 Oct 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
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?
Percentage of Subjects With Successful Haplo-derived Neutrophil Engraftment (time frame: 21 days post-transplant). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 Jan 2026.