Graft Vs Host DiseasePhase 1/2NCT05152160
Umbilical Cord Mesenchymal Stem Cells in the Treatment of Moderate/Severe Chronic Graft-versus-host Disease
A Phase 1/2 study testing Umbilical Cord Mesenchymal Stem Cell Therapy in people with Graft Vs Host Disease, run by Shenzhen University General Hospital at 1 site in China.
Trial summary
cGVHD is a systemic disease with multi-system damage similar to autoimmune and other immune diseases. It can affect multiple organs such as skin, liver, kidney, and peripheral nerves, causing a serious decline in the quality of life of patients, and death in the late stage of transplantation. Read more about this study
- Who is it for?
- Ages 14 to 70 years
- Conditions the study is for
- Graft Vs Host Disease
- What is being tested?
- Umbilical Cord Mesenchymal Stem Cell Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteChina
- Study dates
- 1 Aug 2021to Aug 2024
- Phase
- Phase 1/2
- 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 14 to 70 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Age 14-70 (≥14, ≤70) one year old, no gender limit;
- The subject voluntarily participates in the study, and he or his legal guardian signs the "Informed Consent";
- CGVHD occurred after transplantation of allogeneic hematopoietic stem cells (umbilical cord blood, bone marrow or mobilized peripheral blood) with the primary disease of hematological malignancy, and was diagnosed as moderate/severe cGVHD according to the "Chinese Expert Consensus on the Diagnosis and Treatment of cGVHD (2021 Edition)";
- Those who are tolerant to the first-line standard treatment regimen (glucocorticoid with or without calcineurin inhibitor):
- 1) The organ damage that has been involved in the past is aggravated; 2) People with new organ involvement; 3) No improvement in symptoms and signs after 1 month of regular medication (such as glucocorticoid therapy alone, progress in the initial 2 weeks, no improvement in 6-8 weeks, consider glucocorticoid resistance); 4) At 2 months, prednisone cannot be reduced to less than 1.0mg/kg/d; 5. EOCG score ≤ 3 points.
Who cannot join
- -
- Patients with any of the following cannot be included in this study:
- Serum virological examination showed that hepatitis C virus (HCV) antibody, Treponema pallidum (TP) antibody or human immunodeficiency virus (HIV) antibody test results were positive;
- People with severe hepatic vein occlusive disease or sinus vein occlusive syndrome;
- According to the evaluation of the investigator, patients with cytomegalovirus (CMV) enteritis, transplantation-related thrombotic microangiopathy (TA-TMA), and gastrointestinal infections caused by diarrhea cannot be ruled out clinically; the pathological diagnosis criteria of CMV enteritis are: intestinal mucosa. Large cells of basic inclusion bodies, immunohistochemical CMV early/late antigen positive, intestinal mucosal homogenate CMV nucleic acid PCR positive;
- Patient renal function: creatinine clearance rate <30mL/min; creatinine clearance rate is calculated by Cockcroft-Gault formula: Ccr(ml/min)=[(140-age)×weight (kg)]/(72×serum creatinine( mg/dL), for women, according to the calculation result × 0.85), the unit of creatinine should be paid attention to during the calculation of creatinine clearance;
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- Within 6 months before enrollment, there is evidence that the patient has other diseases or their physiological conditions may interfere with the evaluation results of this test, or the complications are severely life-threatening, including but not limited to uncontrolled infections, pulmonary hypertension, severe Cardiac insufficiency (NYHA class III and IV), unstable angina or acute myocardial infarction, refractory hypertension (defined as the simultaneous use of 3 different types of antihypertensive drugs [one of which is a diuretic] Higher than 180/110mmHg) (subject to the diagnosis of hospitalized medical records), etc.;
- Patients with active malignant solid tumors within the first 5 years of the study, except for radically cured cervical cancer, in situ localized prostate cancer and non-melanoma skin cancer;
- Patients with myelofibrosis;
- People who suffer from mental or neurological diseases and cannot express their wishes correctly;
- Those who have a history of severe allergies to blood components or blood products, or those who have a history of allergies to heterologous proteins;
- Breastfeeding women, or female patients who have pregnancy plans or egg donation plans from the start of the study to the follow-up period, and male patients (or their partners) have birth plans or sperm donation plans from the start of the study to the follow-up period, and are unwilling to take contraceptive measures ；
- Those determined by the investigator to be unsuitable to participate in this clinical trial;
- Those who have participated in other clinical trials within the previous month.
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
Li Yu
Shenzhen, Guangdong, 518000
Li Yu, +8675521839178, liyu_gcp@163.com
About this study
Official title: Clinical Trial of Umbilical Cord Mesenchymal Stem Cells in the Treatment of Moderate/Severe Chronic Graft-versus-host Disease
cGVHD is a systemic disease with multi-system damage similar to autoimmune and other immune diseases. It can affect multiple organs such as skin, liver, kidney, and peripheral nerves, causing a serious decline in the quality of life of patients, and death in the late stage of transplantation. According to the cGVHD prognostic risk scoring system (revised Risk Group) revised by the European Society for Blood and Bone Marrow Transplantation (EBMT) in 2017, the 3-year survival rate of patients with rRG1 (0-3 points) is about 93.3 ± 6.4%, and rRG2 (4-6 points) about 84.9 ± 3.4%, rRG3 (7-9 points) about 70.9 ± 4.4%, rRG4 (≥10 points) about 32.0 ± 1.1%, it can be seen that moderate to severe cGVHD directly affects the survival of allo-HSCT patients.
Once moderate or severe cGVHD is diagnosed, glucocorticoids with or without calcineurin inhibitor (CNI) are first-line drugs, but the effective rate is less than 50%, and the prognosis of hormone-resistant severe cGVHD is extremely poor even if second-line treatment is added. Second-line treatments include monoclonal antibodies, immunosuppressants, chemotherapy drugs, phototherapy or others. Most of them cannot improve the long-term survival rate. The main reason is that these treatments suppress immunity for a long time, which increases the risk of infection and reduces the survival rate. In this context, the treatment of mesenchymal stromal stem cells (MSCs) provides a new path for clinical treatment of cGVHD.
Read the detailed description
Chronic graft-versus-host disease (cGVHD) refers to the clinicopathological synthesis of lymphocytes from the donor attacking the recipient's organs during the process of rebuilding the donor's immunity after allogeneic hematopoietic stem cell transplantation (allo-HSCT) Signs (including classic cGVHD and overlap syndrome) are one of the main complications after transplantation, with an incidence of 30% to 70%. cGVHD is a systemic disease with multi-system damage similar to autoimmune and other immune diseases. It can affect multiple organs such as skin, liver, kidney, and peripheral nerves, causing a serious decline in the quality of life of patients, and death in the late stage of transplantation. main reason. According to the cGVHD prognostic risk scoring system (revised Risk Group) revised by the European Society for Blood and Bone Marrow Transplantation (EBMT) in 2017, the 3-year survival rate of patients with rRG1 (0-3 points) is about 93.3 ± 6.4%, and rRG2 (4-6 points) About 84.9 ± 3.4%, rRG3 (7-9 points) about 70.9 ± 4.4%, rRG4 (≥10 points) about 32.0 ± 1.1%, it can be seen that moderate to severe cGVHD directly affects the survival of allo-HSCT patients.
Once moderate or severe cGVHD is diagnosed, glucocorticoids with or without calcineurin inhibitor (CNI) are first-line drugs, but the effective rate is less than 50%, and the prognosis of hormone-resistant severe cGVHD is extremely poor even if second-line treatment is added. Second-line treatments include monoclonal antibodies, immunosuppressants, chemotherapy drugs, phototherapy or others. Most of them cannot improve the long-term survival rate. The main reason is that these treatments suppress immunity for a long time, which increases the risk of infection and reduces the survival rate. In this context, the treatment of mesenchymal stromal stem cells (MSCs) provides a new path for clinical treatment of cGVHD.
In 2002, Frassoni reported for the first time that MSCs expanded in vitro were used to evaluate the efficacy of allo-HSCT. Allo-HSCT transplanted patients with hematological malignancies were enrolled. MSCs were derived from the donor's bone marrow. After expanded in vitro, participants were combined with the donor's hematopoietic stem cells for reinfusion. As a result, the incidence of aGVHD in the MSCs expansion group and cGVHD within 6 months was significantly lower in the control group, the 6-month OS was significantly higher than that in the control group, and there was no significant difference in the recurrence rate. Subsequently, in 2004, Le Blanc and others successfully used third-party MSCs to successfully treat a refractory grade IV intestinal combined with liver aGVHD for the first time. Subsequently, MSCs were increasingly used in clinical studies for the treatment of GVHD. More clinical trials have shown that umbilical cord-derived MSCs cultured in vitro can not only promote the implantation of hematopoietic stem cells (HSC), but also reduce the incidence of severe GVHD in patients, showing a good therapeutic effect.
- Conditions
- Graft Vs Host Disease
- Being tested
- Umbilical Cord Mesenchymal Stem Cell Therapy
- 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.
Umbilical Cord Mesenchymal Stem Cell TherapyBiological
Umbilical Cord Mesenchymal Stem Cell Therapy
| Study group | Role | What they receive |
|---|---|---|
| Treatment group | Experimental | Umbilical Cord Mesenchymal Stem Cell Therapy Receives: Biological: Umbilical Cord Mesenchymal Stem Cell Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Disease-related clinical reactions
Complete remission, partial remission, disease progression
Measured: Change frome baseline clinical manifestationc of cGVHD at 8 weeks
Secondary outcomes (1)
PFS
Progression-Free-Survival
Measured: From admission to the end of follow up, up to 2 years.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Dec 2021
- Study start1 Aug 2021
- Primary completionAug 2024 (estimated)
- Study completionAug 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Graft Vs Host DiseaseStudies of the same condition, open and under way.
- 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 1/2
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 10 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Shenzhen University General Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, YuLi, Shenzhen University General Hospital
- Investigators
- Li Yu, Dr, Principal investigator, Shenzhen University General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05152160
- Sponsor's protocol ID
- HEM-ONCO-014
- Status last verified
- Aug 2021
- First submitted
- 22 Nov 2021
- Last updated
- 9 Dec 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Dec 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Clinical Trial of Umbilical Cord Mesenchymal Stem Cells in the Treatment of Moderate/Severe Chronic Graft-versus-host Disease
- ClinicalTrials.gov ID
- NCT05152160
- Acronym / sponsor ID
- HEM-ONCO-014
- Conditions
- Graft Vs Host Disease
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 10 participants (estimated)
- Lead sponsor
- Shenzhen University General HospitalUniversity, hospital or other
- Study start
- 1 Aug 2021 (actual)
- Primary completion
- Aug 2024 (estimated)
- Study completion
- Aug 2024 (estimated)
- First posted
- 9 Dec 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
cGVHD is a systemic disease with multi-system damage similar to autoimmune and other immune diseases. It can affect multiple organs such as skin, liver, kidney, and peripheral nerves, causing a serious decline in the quality of life of patients, and death in the late stage of transplantation. According to the cGVHD prognostic risk scoring system (revised Risk Group) revised by the European Society for Blood and Bone Marrow Transplantation (EBMT) in 2017, the 3-year survival rate of patients with rRG1 (0-3 points) is about 93.3 ± 6.4%, and rRG2 (4-6 points) about 84.9 ± 3.4%, rRG3 (7-9 points) about 70.9 ± 4.4%, rRG4 (≥10 points) about 32.0 ± 1.1%, it can be seen that moderate to severe cGVHD directly affects the survival of allo-HSCT patients.
Once moderate or severe cGVHD is diagnosed, glucocorticoids with or without calcineurin inhibitor (CNI) are first-line drugs, but the effective rate is less than 50%, and the prognosis of hormone-resistant severe cGVHD is extremely poor even if second-line treatment is added. Second-line treatments include monoclonal antibodies, immunosuppressants, chemotherapy drugs, phototherapy or others. Most of them cannot improve the long-term survival rate. The main reason is that these treatments suppress immunity for a long time, which increases the risk of infection and reduces the survival rate. In this context, the treatment of mesenchymal stromal stem cells (MSCs) provides a new path for clinical treatment of cGVHD.
Detailed description
Chronic graft-versus-host disease (cGVHD) refers to the clinicopathological synthesis of lymphocytes from the donor attacking the recipient's organs during the process of rebuilding the donor's immunity after allogeneic hematopoietic stem cell transplantation (allo-HSCT) Signs (including classic cGVHD and overlap syndrome) are one of the main complications after transplantation, with an incidence of 30% to 70%. cGVHD is a systemic disease with multi-system damage similar to autoimmune and other immune diseases. It can affect multiple organs such as skin, liver, kidney, and peripheral nerves, causing a serious decline in the quality of life of patients, and death in the late stage of transplantation. main reason. According to the cGVHD prognostic risk scoring system (revised Risk Group) revised by the European Society for Blood and Bone Marrow Transplantation (EBMT) in 2017, the 3-year survival rate of patients with rRG1 (0-3 points) is about 93.3 ± 6.4%, and rRG2 (4-6 points) About 84.9 ± 3.4%, rRG3 (7-9 points) about 70.9 ± 4.4%, rRG4 (≥10 points) about 32.0 ± 1.1%, it can be seen that moderate to severe cGVHD directly affects the survival of allo-HSCT patients.
Once moderate or severe cGVHD is diagnosed, glucocorticoids with or without calcineurin inhibitor (CNI) are first-line drugs, but the effective rate is less than 50%, and the prognosis of hormone-resistant severe cGVHD is extremely poor even if second-line treatment is added. Second-line treatments include monoclonal antibodies, immunosuppressants, chemotherapy drugs, phototherapy or others. Most of them cannot improve the long-term survival rate. The main reason is that these treatments suppress immunity for a long time, which increases the risk of infection and reduces the survival rate. In this context, the treatment of mesenchymal stromal stem cells (MSCs) provides a new path for clinical treatment of cGVHD.
In 2002, Frassoni reported for the first time that MSCs expanded in vitro were used to evaluate the efficacy of allo-HSCT. Allo-HSCT transplanted patients with hematological malignancies were enrolled. MSCs were derived from the donor's bone marrow. After expanded in vitro, participants were combined with the donor's hematopoietic stem cells for reinfusion. As a result, the incidence of aGVHD in the MSCs expansion group and cGVHD within 6 months was significantly lower in the control group, the 6-month OS was significantly higher than that in the control group, and there was no significant difference in the recurrence rate. Subsequently, in 2004, Le Blanc and others successfully used third-party MSCs to successfully treat a refractory grade IV intestinal combined with liver aGVHD for the first time. Subsequently, MSCs were increasingly used in clinical studies for the treatment of GVHD. More clinical trials have shown that umbilical cord-derived MSCs cultured in vitro can not only promote the implantation of hematopoietic stem cells (HSC), but also reduce the incidence of severe GVHD in patients, showing a good therapeutic effect.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Treatment group | Experimental | Biological: Umbilical Cord Mesenchymal Stem Cell TherapyUmbilical Cord Mesenchymal Stem Cell Therapy |
Who may qualify
- Ages
- 14 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Age 14-70 (≥14, ≤70) one year old, no gender limit;
- The subject voluntarily participates in the study, and he or his legal guardian signs the "Informed Consent";
- CGVHD occurred after transplantation of allogeneic hematopoietic stem cells (umbilical cord blood, bone marrow or mobilized peripheral blood) with the primary disease of hematological malignancy, and was diagnosed as moderate/severe cGVHD according to the "Chinese Expert Consensus on the Diagnosis and Treatment of cGVHD (2021 Edition)";
- Those who are tolerant to the first-line standard treatment regimen (glucocorticoid with or without calcineurin inhibitor):
- 1) The organ damage that has been involved in the past is aggravated; 2) People with new organ involvement; 3) No improvement in symptoms and signs after 1 month of regular medication (such as glucocorticoid therapy alone, progress in the initial 2 weeks, no improvement in 6-8 weeks, consider glucocorticoid resistance); 4) At 2 months, prednisone cannot be reduced to less than 1.0mg/kg/d; 5. EOCG score ≤ 3 points.
Key exclusion criteria (14 listed)
- -
- Serum virological examination showed that hepatitis C virus (HCV) antibody, Treponema pallidum (TP) antibody or human immunodeficiency virus (HIV) antibody test results were positive;
- People with severe hepatic vein occlusive disease or sinus vein occlusive syndrome;
- According to the evaluation of the investigator, patients with cytomegalovirus (CMV) enteritis, transplantation-related thrombotic microangiopathy (TA-TMA), and gastrointestinal infections caused by diarrhea cannot be ruled out clinically; the pathological diagnosis criteria of CMV enteritis are: intestinal mucosa. Large cells of basic inclusion bodies, immunohistochemical CMV early/late antigen positive, intestinal mucosal homogenate CMV nucleic acid PCR positive;
- Patient renal function: creatinine clearance rate <30mL/min; creatinine clearance rate is calculated by Cockcroft-Gault formula: Ccr(ml/min)=[(140-age)×weight (kg)]/(72×serum creatinine( mg/dL), for women, according to the calculation result × 0.85), the unit of creatinine should be paid attention to during the calculation of creatinine clearance;
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 |
|---|---|---|
| Umbilical Cord Mesenchymal Stem Cell TherapyUmbilical Cord Mesenchymal Stem Cell Therapy | Biological | Treatment group |
Primary outcome
Disease-related clinical reactions
Time frame: Change frome baseline clinical manifestationc of cGVHD at 8 weeks
Complete remission, partial remission, disease progression
1 secondary outcome
PFS
Time frame: From admission to the end of follow up, up to 2 years.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Dec 2021.
- Individual participant dataSharing planned: No
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Graft vs Host Disease
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.
Li Yu, Dr principal investigator
Shenzhen University General Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing Umbilical Cord Mesenchymal Stem Cell Therapy in people with Graft Vs Host Disease, run by Shenzhen University General Hospital at 1 site in China.
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 5 inclusion and 14 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: status not confirmed, as of the sponsor's last update on 9 Dec 2021. 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 China. 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 combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
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?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Li Yu (+8675521839178, liyu@vip.163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Disease-related clinical reactions (time frame: Change frome baseline clinical manifestationc of cGVHD at 8 weeks). 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 9 Dec 2021.