Lymphocyte Reconstitution After Administration of Pegfilgrastim Versus Filgrastim After Peripheral Stem Cell Transplantation

NCT ID: NCT01541072

Last Updated: 2016-11-01

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

TERMINATED

Clinical Phase

NA

Total Enrollment

34 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2014-09-30

Brief Summary

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The purpose of this study is to describe the kinetics of lymphocyte subsets reconstitution after growth factor administration, Pegfilgrastim versus Filgrastim in patients with B-cell malignant non-Hodgkin lymphoma treated with high-dose chemotherapy and autologous peripheral stem cell transplantation.

Detailed Description

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High dose chemotherapy with autologous peripheral stem cell transplantation is a standard consolidation treatment used in patients with non-Hodgkin lymphoma, in first or second line of treatment. This procedure is associated with prolonged neutropenia and considerable morbidity. Different guidelines have recommended the use of growth factor after peripheral stem cell transplantation.Pegfilgrastim is a granulocyte colony-stimulating factor (G-CSF) resulting from the modification of Filgrastim by chemical addition of a polyethylene glycol(PEG) moiety which increases its half-life by decreasing its renal clearance. Then, a single injection substitutes several Filgrastim injections. The trial "PALM" realized by our team has shown, between these 2 molecules, an equivalent efficacy on the duration of chemotherapy-induced febrile neutropenia in patients treated for lymphoma or myeloma. This trial has also shown that Pegfilgrastim is a cost-effectiveness dominant strategy.

Some studies have shown that a rapid lymphocyte reconstitution after stem cell transplantation is associated with better overall survival and progression-free survival.

In the present PALM2 study, the investigators want to describe the kinetics of different lymphocyte subsets reconstitution within 3 and 6 months after transplantation, in patients with B-cell malignant non-Hodgkin lymphoma, in first or second-line chemotherapy and first autologous transplantation. The investigators will assess the kinetics of reconstitution for T-lymphocytes (Naïve T-lymphocytes, regulatory T-cells and memory T-cells), B-lymphocytes (transitional B cells), cytotoxic T-cells and natural killer T-cells, dendritic cells. A preliminary phase to this assessment will consist in estimate intra-center variability of lymphocyte phenotyping.

Conditions

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Non Hodgkin Lymphoma

Keywords

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Lymphoma, B-cell Lymphocyte reconstitution Lymphocyte subsets Peripheral stem cell transplantation Induction chemotherapy growth factor Granulocyte Colony-stimulating factor Pegfilgrastim Filgrastim

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Pegfilgrastim

Group Type EXPERIMENTAL

Pegfilgrastim

Intervention Type DRUG

Pegfilgrastim (Neulasta®, AMGEN Laboratories): single subcutaneous administration of Pegfilgrastim, 6 mg at day 5 (D5) after autologous stem cell transplantation

Filgrastim

Group Type ACTIVE_COMPARATOR

Filgrastim

Intervention Type DRUG

Filgrastim (Neupogen®, AMGEN Laboratories): daily subcutaneous administration, 5µg/kg/day from day 5 (D5) after autologous stem cell transplantation until recovery from aplasia (Neutrophils \>= 0.5 G/L)

Interventions

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Pegfilgrastim

Pegfilgrastim (Neulasta®, AMGEN Laboratories): single subcutaneous administration of Pegfilgrastim, 6 mg at day 5 (D5) after autologous stem cell transplantation

Intervention Type DRUG

Filgrastim

Filgrastim (Neupogen®, AMGEN Laboratories): daily subcutaneous administration, 5µg/kg/day from day 5 (D5) after autologous stem cell transplantation until recovery from aplasia (Neutrophils \>= 0.5 G/L)

Intervention Type DRUG

Other Intervention Names

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Neulasta, AMGEN Laboratories Neupogen, AMGEN Laboratories

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 18 years.
* Patients with B-cell NHL, except Burkitt Lymphoma and primary brain lymphoma, as first-line or second-line therapy, with planed BICNU, etoposide, aracytine and melphalan (BEAM) chemotherapy after pre-inclusion.
* Minimum one mobilization with G-CSF, G-CSF and endoxan or mozobil
* Minimum one cytapheresis with CD34\>2 millions CD34/kg for stem cell transplantation
* Patients hospitalized in the investigational center throughout the procedure and until recovery from aplasia (neutrophils\> 0.5 G/L)
* Mandatory affiliation with a health insurance system
* Subjects must provide written informed consent prior to performance of study-specific assessments

Exclusion Criteria

* Patients already treated with intensive chemotherapy and autologous stem cell transplantation
* Total irradiation exposure (patients with partial irradiation exposure can be included in the study)
* Intolerance to one of the two studied growth factors, or hypersensitivity to one of their components
* Patients with neutropenia (neutrophils \<1.2 G/L) or thrombopenia (platelets \< 100 G/L) before intensive chemotherapy
* Acquired immune deficiency syndrome, seropositivity
* Pregnant or lactating women (pregnancy test, for women of childbearing potential, should be negative, in blood or urine, at inclusion time)
* Impossibility to comply with protocol constraints because of geographical, psychiatric, social or family reasons
* Deprived of liberty (court judgement or administrative decision)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role collaborator

Centre Leon Berard

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Catherine SEBBAN, MD

Role: PRINCIPAL_INVESTIGATOR

Centre Leon Berard, Lyon, France

Locations

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CHU Clermont-Ferrand, Hôpital d'Estaing

Clermont-Ferrand, , France

Site Status

Centre Leon Berard

Lyon, , France

Site Status

Countries

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France

References

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Other Identifiers

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2011-A00662-39

Identifier Type: REGISTRY

Identifier Source: secondary_id

ET2011-010

Identifier Type: -

Identifier Source: org_study_id