Antithymocyte Globulin and Cyclosporine in Treating Low Risk Patients With Myelodysplastic Syndrome

NCT ID: NCT00488436

Last Updated: 2008-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-05-31

Study Completion Date

2007-12-31

Brief Summary

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The different mechanisms of action between Antithymocyte globulin and cyclosporine can improve the effectivity when both are used in combination in patients with myelodysplastic syndrome.

Detailed Description

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Patients are treated with:

Antithymocyte globulin (Timoglobulin SangStat)

* 2,5 mg/kg/day IV over 8 hours on days 1-4
* Total dose: 10 mg/kg
* Calculated dose adjusted to ideal weight
* Especial considerations:

Paracetamol 1 gr (oral or IV) Dexclorfeniramine 5 mg IV Methylprednisolone 1 mg/kg IV 30 minutes before Timoglobulin and repeat if necessary at 4 hours - Platelet transfusion if platelet count is \< 50 x 109/L

Cyclosporine (Sandimmun Neoral)

-2,5 mg/kg/12 h over 3 months

Conditions

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Myelodysplastic Syndrome

Keywords

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Myelodysplastic Syndrome Antithymocyte Globulin Cyclosporine

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Antithymocyte globulin

Intervention Type DRUG

Cyclosporine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of low or intermediate risk myelodysplastic syndrome (MDS) (or high risk patient not eligible to intensive chemotherapy or for bone marrow transplantation), excluding chronic myelomonocytic leukemia
* At less one of two following conditions:
* Transfusion dependence: 1)Packed red blood cell transfusions greater than 2 times; 2)Untransfused hemoglobin level no greater than 10 g/dL; 3)Platelet transfusions greater than 1 time
* Infection grade III or IV secondary to neutropenia
* ECOG \< or = 2

Exclusion Criteria

* Chronic myelomonocytic leukemia
* Creatinine greater than 2 mg/dl
* Bilirubin greater than 2.5 mg/dl
* History of heart failure
* History of allergy to rabbit proteins
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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PETHEMA Foundation

OTHER

Sponsor Role lead

Responsible Party

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pethema

Principal Investigators

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Sanz Guillermo, Dr

Role: STUDY_DIRECTOR

Hospital La Fe de Valencia

Julia Antonio, Dr

Role: STUDY_DIRECTOR

Hospital Vall d'Hebron Barcelona

Locations

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Hospital de Cabueñes

Asturias, , Spain

Site Status

Hospital germans Trias i Pujol

Badalona, , Spain

Site Status

Hospital de Basurto

Bilbao, , Spain

Site Status

Hospital Ntra Sra del Rossell

Cartagena, , Spain

Site Status

Hospital Materno Infantil de Las Palmas

Las Palmas de Gran Canaria, , Spain

Site Status

Hospital Virgen de la Victoria

Málaga, , Spain

Site Status

Hospital Morales Messeguer

Murcia, , Spain

Site Status

Hospital de Navarra

Pamplona, , Spain

Site Status

Hospital Arnau de Vilanova

Valencia, , Spain

Site Status

Hospital Dr Pesset

Valencia, , Spain

Site Status

Hospital Clinico Universitario

Zaragoza, , Spain

Site Status

Countries

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Spain

References

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Sugawara T, Endo K, Shishido T, Sato A, Kameoka J, Fukuhara O, Yoshinaga K, Miura A. T cell-mediated inhibition of erythropoiesis in myelodysplastic syndromes. Am J Hematol. 1992 Dec;41(4):304-5. doi: 10.1002/ajh.2830410425. No abstract available.

Reference Type BACKGROUND
PMID: 1288301 (View on PubMed)

Molldrem JJ, Jiang YZ, Stetler-Stevenson M, Mavroudis D, Hensel N, Barrett AJ. Haematological response of patients with myelodysplastic syndrome to antithymocyte globulin is associated with a loss of lymphocyte-mediated inhibition of CFU-GM and alterations in T-cell receptor Vbeta profiles. Br J Haematol. 1998 Sep;102(5):1314-22. doi: 10.1046/j.1365-2141.1998.00920.x.

Reference Type BACKGROUND
PMID: 9753062 (View on PubMed)

Smith MA, Smith JG. The occurrence subtype and significance of haemopoietic inhibitory T cells (HIT cells) in myelodysplasia: an in vitro study. Leuk Res. 1991;15(7):597-601. doi: 10.1016/0145-2126(91)90028-r.

Reference Type BACKGROUND
PMID: 1830630 (View on PubMed)

Young NS. The problem of clonality in aplastic anemia: Dr Dameshek's riddle, restated. Blood. 1992 Mar 15;79(6):1385-92. No abstract available.

Reference Type BACKGROUND
PMID: 1547338 (View on PubMed)

Jonasova A, Neuwirtova R, Cermak J, Vozobulova V, Mocikova K, Siskova M, Hochova I. Cyclosporin A therapy in hypoplastic MDS patients and certain refractory anaemias without hypoplastic bone marrow. Br J Haematol. 1998 Feb;100(2):304-9. doi: 10.1046/j.1365-2141.1998.00551.x.

Reference Type BACKGROUND
PMID: 9488617 (View on PubMed)

Epperson DE, Nakamura R, Saunthararajah Y, Melenhorst J, Barrett AJ. Oligoclonal T cell expansion in myelodysplastic syndrome: evidence for an autoimmune process. Leuk Res. 2001 Dec;25(12):1075-83. doi: 10.1016/s0145-2126(01)00083-2.

Reference Type BACKGROUND
PMID: 11684279 (View on PubMed)

Maciejewski JP, Follmann D, Nakamura R, Saunthararajah Y, Rivera CE, Simonis T, Brown KE, Barrett JA, Young NS. Increased frequency of HLA-DR2 in patients with paroxysmal nocturnal hemoglobinuria and the PNH/aplastic anemia syndrome. Blood. 2001 Dec 15;98(13):3513-9. doi: 10.1182/blood.v98.13.3513.

Reference Type BACKGROUND
PMID: 11739151 (View on PubMed)

Molldrem JJ, Caples M, Mavroudis D, Plante M, Young NS, Barrett AJ. Antithymocyte globulin for patients with myelodysplastic syndrome. Br J Haematol. 1997 Dec;99(3):699-705. doi: 10.1046/j.1365-2141.1997.4423249.x.

Reference Type BACKGROUND
PMID: 9401087 (View on PubMed)

Greenberg P, Cox C, LeBeau MM, Fenaux P, Morel P, Sanz G, Sanz M, Vallespi T, Hamblin T, Oscier D, Ohyashiki K, Toyama K, Aul C, Mufti G, Bennett J. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997 Mar 15;89(6):2079-88.

Reference Type BACKGROUND
PMID: 9058730 (View on PubMed)

Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C. Proposals for the classification of the myelodysplastic syndromes. Br J Haematol. 1982 Jun;51(2):189-99.

Reference Type BACKGROUND
PMID: 6952920 (View on PubMed)

Cheson BD, Bennett JM, Kantarjian H, Pinto A, Schiffer CA, Nimer SD, Lowenberg B, Beran M, de Witte TM, Stone RM, Mittelman M, Sanz GF, Wijermans PW, Gore S, Greenberg PL; World Health Organization(WHO) international working group. Report of an international working group to standardize response criteria for myelodysplastic syndromes. Blood. 2000 Dec 1;96(12):3671-4.

Reference Type BACKGROUND
PMID: 11090046 (View on PubMed)

Cheson BD, Bennett JM, Kantarjian H, Schiffer CA, Nimer SD, Lowenberg B, Stone RM, Mittelman M, Sanz GF, Wijermans PW, Greenberg PL. Myelodysplastic syndromes standardized response criteria: further definition. Blood. 2001 Sep 15;98(6):1985. doi: 10.1182/blood.v98.6.1985. No abstract available.

Reference Type BACKGROUND
PMID: 11535540 (View on PubMed)

Related Links

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http://www.aehh.org

Spanish association of Haematology

Other Identifiers

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SMD/ATG-CSA/2002

Identifier Type: -

Identifier Source: org_study_id