Trial Outcomes & Findings for Combined Haploidentical-Cord Blood Transplantation for Adults and Children (NCT NCT00943800)

NCT ID: NCT00943800

Last Updated: 2021-01-27

Results Overview

Cumulative incidence of graft failure (neutrophil) by day 28 was reported. Patients who did not have neutrophil engraftment before death was considered as a competing risk. Failure to engraft was defined as lack of evidence of hematopoietic recovery (ANC \<500/mm3 and platelet count \< 20,000/mm3) by day +35, confirmed by a biopsy revealing a marrow cellularity \< 5%. Graft failure was also defined as initial myeloid engraftment by day +35, documented to be of donor origin, followed by a drop in the ANC to \< 500/mm3 for more than three days, independent of any myelosuppressive drugs, severe GVHD, CMV, or other infection.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

87 participants

Primary outcome timeframe

Transplant (Day 0) through Day +28

Results posted on

2021-01-27

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment Group
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Overall Study
STARTED
87
Overall Study
COMPLETED
87
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Combined Haploidentical-Cord Blood Transplantation for Adults and Children

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment Group
n=87 Participants
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Age, Continuous
45.5 years
n=5 Participants
Sex: Female, Male
Female
36 Participants
n=5 Participants
Sex: Female, Male
Male
51 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
21 Participants
n=5 Participants
Race (NIH/OMB)
White
53 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
9 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Transplant (Day 0) through Day +28

Cumulative incidence of graft failure (neutrophil) by day 28 was reported. Patients who did not have neutrophil engraftment before death was considered as a competing risk. Failure to engraft was defined as lack of evidence of hematopoietic recovery (ANC \<500/mm3 and platelet count \< 20,000/mm3) by day +35, confirmed by a biopsy revealing a marrow cellularity \< 5%. Graft failure was also defined as initial myeloid engraftment by day +35, documented to be of donor origin, followed by a drop in the ANC to \< 500/mm3 for more than three days, independent of any myelosuppressive drugs, severe GVHD, CMV, or other infection.

Outcome measures

Outcome measures
Measure
Treatment Group
n=87 Participants
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Percentage of Participants With Neutrophil Engraftment
85.1 percentage of patients
Interval 75.4 to 91.1

SECONDARY outcome

Timeframe: Up to 2 years

Acute GVHD is defined by the Przepiorka criteria, which stages the degree of organ involvement in the skin, liver, and gastrointestinal (GI) tract, based on severity, with Stage 1+ being least severe and stage 4+ being the most severe. Grading of acute GVHD is as follows: Grade II (skin involvement stages 1+ to 3+, liver 1+, GI tract 1+), Grade III (skin involvement stages 2+ to 3+, liver 1+, GI tract 2+ to 4+), Grade IV (skin involvement stages 4+, Liver 4+). Chronic GVHD is assessed by NIH consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant. 2005; 11:945-56., for grading criteria. (See Citation: Filipovich AH et al) The incidence of patients with acute GVHD (Grade II-IV) was determined at 180 days. The incidence of Chronic GVHD by 2 years was reported

Outcome measures

Outcome measures
Measure
Treatment Group
n=87 Participants
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Percentage of Participants With Incidence of Acute (Grade II-IV) and Chronic Graft-vs-host Disease(GVHD)
Acute GVHD (grade II-IV)
16.1 percentage of patients
Interval 9.3 to 24.6
Percentage of Participants With Incidence of Acute (Grade II-IV) and Chronic Graft-vs-host Disease(GVHD)
Chronic GVHD
3.4 percentage of patients
Interval 0.9 to 9.0

SECONDARY outcome

Timeframe: up to 5 years

We reported overall survival at 2 years and 5 years after transplant

Outcome measures

Outcome measures
Measure
Treatment Group
n=87 Participants
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Overall Survival- Percentage of Participants Who Survived at 2 Years and 5 Years
Two-year overall survival
43.7 percentage of patients
Interval 34.4 to 55.4
Overall Survival- Percentage of Participants Who Survived at 2 Years and 5 Years
Five-year overall survival
32.9 percentage of patients
Interval 24.3 to 44.5

Adverse Events

Treatment Group

Serious events: 24 serious events
Other events: 0 other events
Deaths: 18 deaths

Serious adverse events

Serious adverse events
Measure
Treatment Group
n=87 participants at risk
Although the protocol initially had different disease intensities, ultimately, moved to one regimen for all patients. Subjects received 30mg/m\^2 of Fludarabine from Day-7 until Day-3, 140mg/m\^2 of Melphalan on Day-2, and 1.5mg/kg of Rabbit antithymocyte globulin at Day-7,-5,-3 and -1."
Infections and infestations
Abdominal infection
2.3%
2/87 • 100 days
Blood and lymphatic system disorders
Anemia
1.1%
1/87 • 100 days
Immune system disorders
Cytokine release syndrome
1.1%
1/87 • 100 days
Gastrointestinal disorders
Diarrhea
1.1%
1/87 • 100 days
Infections and infestations
Epstein-barr virus infection
3.4%
3/87 • 100 days
Infections and infestations
Esophageal infection
1.1%
1/87 • 100 days
Blood and lymphatic system disorders
Febrile neutropenia
1.1%
1/87 • 100 days
Gastrointestinal disorders
Fever
1.1%
1/87 • 100 days
General disorders
Gait disturbance
1.1%
1/87 • 100 days
Cardiac disorders
Heart failure
1.1%
1/87 • 100 days
Metabolism and nutrition disorders
Hypernatremia
1.1%
1/87 • 100 days
Respiratory, thoracic and mediastinal disorders
Hypoxia
3.4%
3/87 • 100 days
Infections and infestations
Lung infection
2.3%
2/87 • 100 days
Investigations
Neutrophil count decreased
1.1%
1/87 • 100 days
Cardiac disorders
Pericardial tamponade
1.1%
1/87 • 100 days
Respiratory, thoracic and mediastinal disorders
Respiratory failure
4.6%
4/87 • 100 days
Infections and infestations
Sepsis
12.6%
11/87 • 100 days
Infections and infestations
Skin infection
1.1%
1/87 • 100 days
Investigations
White blood cell decreased
1.1%
1/87 • 100 days

Other adverse events

Adverse event data not reported

Additional Information

Hongtao Liu

University of Chicago

Phone: 773-834-8980

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place