Early Chimerism Following Allogeneic Stem-Cell Transplant

NCT ID: NCT03689907

Last Updated: 2025-04-04

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

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-19

Study Completion Date

2024-12-30

Brief Summary

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Allogeneic stem cell transplant (allo-SCT) is a common treatment for variety of blood cancers. To determine how many cells are from the donor after transplant, doctors complete a "chimerism analysis" or a test of participant cells to look at the DNA. Chimerism testing helps doctors predict graft rejection or recurrence of disease. Doctors at NCCC do chimerism testing routinely and it is usually done between 30 and 100 days after transplantation. The researchers believe that analyzing chimerism sooner than 30 days after transplant may help identify problems earlier, get patients treatment sooner, and increase the chances of a successful transplant.

The purpose of this study is to find out if doing chimerism testing earlier than the traditional approach is better for patient outcomes (about 14 days after transplantation rather than 30+ days). Information gained from this study can be used to help prevent some post-transplant complications such as graft loss, graft-versus-host disease, or even relapse for future patients.

Also, the researchers hope to learn more about chimerism testing of cells of patients with haploidentical donors (donors who are only a "half-match" - such as a parent or child of the recipient), because there have not been many chimerism analysis studies done in this population.

Detailed Description

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Conditions

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Allogeneic Stem-Cell Transplant

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Allogeneic Stem-Cell Transplant Recipients

1. At day +14/15-post transplant - lineage-specific chimerism analysis will be performed on a peripheral blood sample drawn from the patient.
2. At day +30-post transplant, most participants will be in the outpatient setting and would undergo chimerism evaluation as part of the standard of care for transplant patients.

Chimerism Evaluation

Intervention Type OTHER

Blood collection for chimerism evaluation will be performed on days +14/15-post transplant and +30-post transplant for each study participant.

Interventions

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Chimerism Evaluation

Blood collection for chimerism evaluation will be performed on days +14/15-post transplant and +30-post transplant for each study participant.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients will have been cleared by a Transplant Attending to undergo allogeneic stem cell transplant

Exclusion Criteria

* Patients undergoing a second allogeneic stem cell transplant or beyond
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dartmouth-Hitchcock Medical Center

OTHER

Sponsor Role lead

Responsible Party

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John M. Hill, Jr., MD

Director, Allogeneic Bone Marrow Transplant Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John M. Hill, MD

Role: PRINCIPAL_INVESTIGATOR

Dartmouth-Hitchcock Medical Center

Locations

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Dartmouth Hitchcock Medical Center, Norris Cotton Cancer Center

Lebanon, New Hampshire, United States

Site Status

Countries

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United States

References

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Farhan S, Bazydlo M, Neme K, Mikulandric N, Peres E, Janakiraman N. Chimerism in Myeloid Malignancies following Stem Cell Transplantation Using FluBu4 with and without Busulfan Pharmacokinetics versus BuCy. Adv Hematol. 2017;2017:8690416. doi: 10.1155/2017/8690416. Epub 2017 Nov 8.

Reference Type BACKGROUND
PMID: 29250116 (View on PubMed)

Passweg JR, Baldomero H, Bader P, Bonini C, Duarte RF, Dufour C, Gennery A, Kroger N, Kuball J, Lanza F, Montoto S, Nagler A, Snowden JA, Styczynski J, Mohty M. Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report. Bone Marrow Transplant. 2017 Jun;52(6):811-817. doi: 10.1038/bmt.2017.34. Epub 2017 Mar 13.

Reference Type BACKGROUND
PMID: 28287639 (View on PubMed)

Parmesar K, Raj K. Haploidentical Stem Cell Transplantation in Adult Haematological Malignancies. Adv Hematol. 2016;2016:3905907. doi: 10.1155/2016/3905907. Epub 2016 May 30.

Reference Type BACKGROUND
PMID: 27313619 (View on PubMed)

Fabricius WA, Ramanathan M. Review on Haploidentical Hematopoietic Cell Transplantation in Patients with Hematologic Malignancies. Adv Hematol. 2016;2016:5726132. doi: 10.1155/2016/5726132. Epub 2016 Feb 29.

Reference Type BACKGROUND
PMID: 27034676 (View on PubMed)

Bashey A, Solomon SR. T-cell replete haploidentical donor transplantation using post-transplant CY: an emerging standard-of-care option for patients who lack an HLA-identical sibling donor. Bone Marrow Transplant. 2014 Aug;49(8):999-1008. doi: 10.1038/bmt.2014.62. Epub 2014 May 19.

Reference Type BACKGROUND
PMID: 24842530 (View on PubMed)

Koreth J, Kim HT, Nikiforow S, Milford EL, Armand P, Cutler C, Glotzbecker B, Ho VT, Antin JH, Soiffer RJ, Ritz J, Alyea EP 3rd. Donor chimerism early after reduced-intensity conditioning hematopoietic stem cell transplantation predicts relapse and survival. Biol Blood Marrow Transplant. 2014 Oct;20(10):1516-21. doi: 10.1016/j.bbmt.2014.05.025. Epub 2014 Jun 4.

Reference Type BACKGROUND
PMID: 24907627 (View on PubMed)

Reshef R, Hexner EO, Loren AW, Frey NV, Stadtmauer EA, Luger SM, Mangan JK, Gill SI, Vassilev P, Lafferty KA, Smith J, Van Deerlin VM, Mick R, Porter DL. Early donor chimerism levels predict relapse and survival after allogeneic stem cell transplantation with reduced-intensity conditioning. Biol Blood Marrow Transplant. 2014 Nov;20(11):1758-66. doi: 10.1016/j.bbmt.2014.07.003. Epub 2014 Jul 10.

Reference Type BACKGROUND
PMID: 25016197 (View on PubMed)

Mathur, A and Malhotra, H. Haploidentical Stem Cell Transplantation: A Mini Review. J Stem Cell Res Ther 2017; 2(2): 00056.

Reference Type BACKGROUND

Mattsson J, Ringden O, Storb R. Graft failure after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2008 Jan;14(1 Suppl 1):165-70. doi: 10.1016/j.bbmt.2007.10.025.

Reference Type BACKGROUND
PMID: 18162238 (View on PubMed)

Legrand, F et al. Chimerism Analysis after Haploidentical Stem Cell Transplantation: Is It Necessary for All Patients? Blood 2016; 128: 3417.

Reference Type BACKGROUND

Hussain, A et al. Lineage-Specific Chimerism and Incidence of Graft Failure Following T-Cell Replete Haploidentical Transplantation Using Post-Transplant Cyclophosphamide in Eighty-Nine Consecutive Patients From a Single Center. Blood 2012; 120: 3030.

Reference Type BACKGROUND

Moscardo F, Sanz J, Senent L, Cantero S, de la Rubia J, Montesinos P, Planelles D, Lorenzo I, Cervera J, Palau J, Sanz MA, Sanz GF. Impact of hematopoietic chimerism at day +14 on engraftment after unrelated donor umbilical cord blood transplantation for hematologic malignancies. Haematologica. 2009 Jun;94(6):827-32. doi: 10.3324/haematol.2008.000935.

Reference Type BACKGROUND
PMID: 19483157 (View on PubMed)

Miura Y, Tanaka J, Toubai T, Tsutsumi Y, Kato N, Hirate D, Kaji M, Sugita J, Shigematsu A, Iwao N, Ota S, Masauzi N, Fukuhara T, Kasai M, Asaka M, Imamura M. Analysis of donor-type chimerism in lineage-specific cell populations after allogeneic myeloablative and non-myeloablative stem cell transplantation. Bone Marrow Transplant. 2006 May;37(9):837-43. doi: 10.1038/sj.bmt.1705352.

Reference Type BACKGROUND
PMID: 16547484 (View on PubMed)

Breuer S, Preuner S, Fritsch G, Daxberger H, Koenig M, Poetschger U, Lawitschka A, Peters C, Mann G, Lion T, Matthes-Martin S. Early recipient chimerism testing in the T- and NK-cell lineages for risk assessment of graft rejection in pediatric patients undergoing allogeneic stem cell transplantation. Leukemia. 2012 Mar;26(3):509-19. doi: 10.1038/leu.2011.244. Epub 2011 Sep 16.

Reference Type BACKGROUND
PMID: 21926962 (View on PubMed)

Choi, YB et al. Does Day 14 Peripheral Blood Chimerism after Allogeneic Hematopoietic Stem Cell Transplantation Predict Treatment Failure in Children with Non-Malignant Disease? BBMT 2016; 22: S310.

Reference Type BACKGROUND

Antin JH, Childs R, Filipovich AH, Giralt S, Mackinnon S, Spitzer T, Weisdorf D. Establishment of complete and mixed donor chimerism after allogeneic lymphohematopoietic transplantation: recommendations from a workshop at the 2001 Tandem Meetings of the International Bone Marrow Transplant Registry and the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2001;7(9):473-85. doi: 10.1053/bbmt.2001.v7.pm11669214.

Reference Type BACKGROUND
PMID: 11669214 (View on PubMed)

Huisman C, de Weger RA, de Vries L, Tilanus MG, Verdonck LF. Chimerism analysis within 6 months of allogeneic stem cell transplantation predicts relapse in acute myeloid leukemia. Bone Marrow Transplant. 2007 Mar;39(5):285-91. doi: 10.1038/sj.bmt.1705582. Epub 2007 Jan 29.

Reference Type BACKGROUND
PMID: 17262061 (View on PubMed)

Other Identifiers

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NCI-2020-03008

Identifier Type: OTHER

Identifier Source: secondary_id

D18125

Identifier Type: -

Identifier Source: org_study_id

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