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Poor Graft FunctionPhase 3NCT05907499

Decitabine for Poor Graft Function Post Allo-HSCT

A Phase 3 study testing Decitabine, Granulocyte Colony-Stimulating Factor and Thrombopoietin Receptor Agonist in people with Poor Graft Function, run by The First Affiliated Hospital of Soochow University at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized trial aims at validating the efficacy and safety of low-dose decitabine for PGF post allo-HSCT. Read more about this study

Who is it for?
Ages 16 to 70 years
Conditions the study is for
Poor Graft Function
What is being tested?
Decitabine, Granulocyte Colony-Stimulating Factor and Thrombopoietin Receptor Agonist
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
1 siteChina
Study dates
1 Jul 2023to 1 Jan 2026
Phase
Phase 3
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 16 to 70 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosed as PGF at day 28 post-HSCT or later. PGF was defined as two or three cytopenias, absolute neutrophil count ≤ 1.5 × 109/L, platelet count ≤ 30 × 109/L, hemoglobin ≤ 85g/L, lasting for more than 2 consecutive weeks;
  • Full donor chimerism;
  • Primary disease in remission;
  • No severe GVHD and relapse;
  • ECOG: 0-2;
  • Expected survival longer than 1 month

Who cannot join

  • Allergic to decitabine;
  • Active infections;
  • Uncontrolled GVHD;
  • Severe organ dysfunction;
  • Relapse of underlying malignancies;
  • Graft failure;
  • Received decitabine or participated in other clinical trials within one month before screening.

Trial locations and contacts

1 site in 1 country.

China1 site
  • The First Affiliated Hospital of Soochow University

    Suzhou, Jiangsu, 215000

Other trials in China

About this study

Official title: Low Dose Decitabine for Poor Graft Function Post Allogenic Hematopoietic Stem Cell Transplantation

This randomized trial aims at validating the efficacy and safety of low-dose decitabine for PGF post allo-HSCT.

Read the detailed description

Poor graft function (PGF), defined by the presence of multilineage cytopenias in the presence of 100% donor chimerism, is a serious complication of allogeneic stem cell transplant (allo-HSCT). Emerging evidence demonstrates that the inadequate stem cells infusion, bone marrow microenvironment and immune dysregulation play a crucial role in maintaining and regulating hematopoiesis. Current therapies remain debatable, including selected CD34+ cells infusion, mesenchymal stromal cells infusion, prophylactic N-acetyl cysteine administration, etc. Thereafter, the investigators conduct a randomized trial aiming at validating the efficacy and safety of low-dose decitabine in PGF post allo-HSCT patients.

Being tested
Decitabine, Granulocyte Colony-Stimulating Factor, Thrombopoietin Receptor Agonist, Recombinant human erythropoietin
Keywords
poor graft function, hematopoietic stem cell transplantation

What participants receive

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

  • DecitabineDrug

    Also called Dec

    Decitabine 6 mg/m2 daily subcutaneously for consecutive 3 days (day 1 to day 3)

  • Granulocyte Colony-Stimulating FactorDrug

    Also called G-CSF

    5ug/kg/d when absolute neutrophil count ≤ 1.5 × 109/L

  • Thrombopoietin Receptor AgonistDrug

    Also called Eltrombopag / Avatrombopag

    Eltrombopag initial dose: 25 mg orally once a day, may increase to up to 75 mg/day, when platelet count ≤ 30 × 109/L; Avatrombopag initial dose: 20 mg orally once a day, may increase to up to 60 mg/day, when platelet count ≤ 30 × 109/L.

  • Recombinant human erythropoietinDrug

    Also called EPO

    10000 U/day when hemoglobin ≤ 85 g/L

Study groups in NCT05907499
Study groupRoleWhat they receive
DecitabineExperimentalDecitabine 6 mg/m2 daily subcutaneously for consecutive 3 days (day 1 to day 3)
Receives: Drug: Decitabine; Drug: Granulocyte Colony-Stimulating Factor; Drug: Thrombopoietin Receptor Agonist; Drug: Recombinant human erythropoietin
Conventional treatmentActive comparatorThe hematologic growth factors (granulocyte-colony stimulating factor, thrombopoietin receptor agonists, recombinant human erythropoietin)
Receives: Drug: Granulocyte Colony-Stimulating Factor; Drug: Thrombopoietin Receptor Agonist; Drug: Recombinant human erythropoietin

What is being measured

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

  1. Number of Participants Achieving Treatment Response (Hematological Response + Hematological Improvement)

    Hematological response (HR) was defined as recovery in all cell lineages (neutrophils ≥ 1.5 x 109/L, platelets ≥ 30 x 109/L and hemoglobin ≥ 85 g/L) without the need for transfusion or growth factor support for consecutive 7 days. Hematological improvement (HI) was defined as recovery of at least 1 lineage. No response (NR) refers to those who failed to reach HR or HI.

    Measured: day +28

  2. Overall Survival Rate

    Overall survival was calculated from time of random assignment to death from any cause

    Measured: 1 year

Secondary outcomes (4)
  1. Number of Participants With Bone Marrow Recovery

    Bone marrow recovery was assessed using quantitative morphometric analysis to determine marrow cellularity, the myeloid-to-erythroid ratio, and megakaryocyte counts.

    Measured: day +28

  2. Number of Participants With Relapse

    Relapse was defined according to the European LeukemiaNet (ELN) guidelines

    Measured: 3-month

  3. Event Free Survival Rate

    EFS referred to time from random assignment to disease progression /relapse, severe bleeding events, severe infections or death from any cause.

    Measured: 1 year

  4. Number of Participants With GVHD

    Diagnosis and grading of GVHD was performed according to NCCN Clinical Practice Guidelines, 2020

    Measured: 3-month

Timeline

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

  1. First posted18 Jun 2023
  2. Study start1 Jul 2023
  3. Primary completion1 Jan 2026
  4. Study completion1 Jan 2026

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05907499
Sponsor's protocol ID
SOOCHOW-HY-2023-06-06
Status last verified
Apr 2026
First submitted
8 Jun 2023
Last updated
23 Oct 2026
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: A lot of work

Publications

  • Alchalby H, Yunus DR, Zabelina T, Ayuk F, Kroger N. Incidence and risk factors of poor graft function after allogeneic stem cell transplantation for myelofibrosis. Bone Marrow Transplant. 2016 Sep;51(9):1223-7. doi: 10.1038/bmt.2016.98. Epub 2016 Apr 18.

    PubMed 27088376
  • Larocca A, Piaggio G, Podesta M, Pitto A, Bruno B, Di Grazia C, Gualandi F, Occhini D, Raiola AM, Dominietto A, Bregante S, Lamparelli T, Tedone E, Oneto R, Frassoni F, Van Lint MT, Pogliani E, Bacigalupo A. Boost of CD34+-selected peripheral blood cells without further conditioning in patients with poor graft function following allogeneic stem cell transplantation. Haematologica. 2006 Jul;91(7):935-40.

    PubMed 16818281
  • Prabahran A, Koldej R, Chee L, Ritchie D. Clinical features, pathophysiology, and therapy of poor graft function post-allogeneic stem cell transplantation. Blood Adv. 2022 Mar 22;6(6):1947-1959. doi: 10.1182/bloodadvances.2021004537.

    PubMed 34492685
  • Ghobadi A, Fiala MA, Ramsingh G, Gao F, Abboud CN, Stockerl-Goldstein K, Uy GL, Grossman BJ, Westervelt P, DiPersio JF. Fresh or Cryopreserved CD34+-Selected Mobilized Peripheral Blood Stem and Progenitor Cells for the Treatment of Poor Graft Function after Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant. 2017 Jul;23(7):1072-1077. doi: 10.1016/j.bbmt.2017.03.019. Epub 2017 Mar 18.

    PubMed 28323004
  • Lubbert M, Suciu S, Baila L, Ruter BH, Platzbecker U, Giagounidis A, Selleslag D, Labar B, Germing U, Salih HR, Beeldens F, Muus P, Pfluger KH, Coens C, Hagemeijer A, Eckart Schaefer H, Ganser A, Aul C, de Witte T, Wijermans PW. Low-dose decitabine versus best supportive care in elderly patients with intermediate- or high-risk myelodysplastic syndrome (MDS) ineligible for intensive chemotherapy: final results of the randomized phase III study of the European Organisation for Research and Treatment of Cancer Leukemia Group and the German MDS Study Group. J Clin Oncol. 2011 May 20;29(15):1987-96. doi: 10.1200/JCO.2010.30.9245. Epub 2011 Apr 11.

    PubMed 21483003
  • Han P, Yu T, Hou Y, Zhao Y, Liu Y, Sun Y, Wang H, Xu P, Li G, Sun T, Hu X, Liu X, Li L, Peng J, Zhou H, Hou M. Low-Dose Decitabine Inhibits Cytotoxic T Lymphocytes-Mediated Platelet Destruction via Modulating PD-1 Methylation in Immune Thrombocytopenia. Front Immunol. 2021 Feb 17;12:630693. doi: 10.3389/fimmu.2021.630693. eCollection 2021.

    PubMed 33679776
  • Han P, Hou Y, Zhao Y, Liu Y, Yu T, Sun Y, Wang H, Xu P, Li G, Sun T, Hu X, Liu X, Li L, Peng J, Zhou H, Hou M. Low-dose decitabine modulates T-cell homeostasis and restores immune tolerance in immune thrombocytopenia. Blood. 2021 Aug 26;138(8):674-688. doi: 10.1182/blood.2020008477.

    PubMed 33876188
  • Zambuzi FA, Cardoso-Silva PM, Castro RC, Fontanari C, Emery FDS, Frantz FG. Decitabine Promotes Modulation in Phenotype and Function of Monocytes and Macrophages That Drive Immune Response Regulation. Cells. 2021 Apr 12;10(4):868. doi: 10.3390/cells10040868.

    PubMed 33921194
  • Kopp LM, Ray A, Denman CJ, Senyukov VS, Somanchi SS, Zhu S, Lee DA. Decitabine has a biphasic effect on natural killer cell viability, phenotype, and function under proliferative conditions. Mol Immunol. 2013 Jul;54(3-4):296-301. doi: 10.1016/j.molimm.2012.12.012. Epub 2013 Jan 16.

    PubMed 23328088
  • Tang Y, Chen J, Liu Q, Chu T, Pan T, Liang J, He XF, Chen F, Yang T, Ma X, Wu X, Hu S, Cao X, Hu X, Hu J, Liu Y, Qi J, Shen Y, Ruan C, Han Y, Wu D. Low-dose decitabine for refractory prolonged isolated thrombocytopenia after HCT: a randomized multicenter trial. Blood Adv. 2021 Mar 9;5(5):1250-1258. doi: 10.1182/bloodadvances.2020002790.

    PubMed 33646303
  • Han Y, Tang Y, Chen J, Liang J, Ye C, Ruan C, Wu D. Low-Dose Decitabine for Patients With Thrombocytopenia Following Allogeneic Hematopoietic Stem Cell Transplantation: A Pilot Therapeutic Study. JAMA Oncol. 2015 May;1(2):249-51. doi: 10.1001/jamaoncol.2014.316. No abstract available.

    PubMed 26181032
  • DeSimone J, Koshy M, Dorn L, Lavelle D, Bressler L, Molokie R, Talischy N. Maintenance of elevated fetal hemoglobin levels by decitabine during dose interval treatment of sickle cell anemia. Blood. 2002 Jun 1;99(11):3905-8. doi: 10.1182/blood.v99.11.3905.

    PubMed 12010787

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Decitabine, Granulocyte Colony-Stimulating Factor and Thrombopoietin Receptor Agonist in people with Poor Graft Function, run by The First Affiliated Hospital of Soochow University 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 6 inclusion and 7 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: finished, as of the sponsor's last update on 23 Oct 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 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 phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 2026). 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?

Number of Participants Achieving Treatment Response (Hematological Response + Hematological Improvement) (time frame: day +28). 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 NCT05907499, which also lists 12 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 23 Oct 2026.

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