a Clinical Trial of Efficacy and Safety of the Holistic Treatment of Young High-risk Multiple Myeloma Patients

NCT ID: NCT04008888

Last Updated: 2019-07-05

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-05

Study Completion Date

2020-08-01

Brief Summary

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The clinical trial was conducted in a cohort of young, high-risk myeloma patients who were designed to receive a combination of high-dose chemotherapy with allogeneic or autologous hematopoietic stem cell transplantation. The objective was to assess the progression free survival (PFS), overall survival (OS),and overall response rate (ORR) of the overall treatment.

Detailed Description

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50 cases of HR-NDMM patients were divided into two groups nonrandomizedly. TE group received hematopoietic stem cell transplantation after induction therapy. Allo-sct for the young patients with suitable donors, Asct for the others. TNE group received consolidation therapy after induction therapy. All patients received PI-based maintenance therapy.

Conditions

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Multiple Myeloma Plasma Cell Leukemia Extramedullary Plasmacytoma Loss of Chromosome 17p t(14;16) t(4;14) T(14;20) 1Q21 Amplification Complex Karyotype

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A:Allogeneic Stem Cell Transplant Group

Fludarabine+Melphalan followed by Allogeneic SCT.

Group Type EXPERIMENTAL

Allogeneic Hematopoietic Stem Cell Transplantation

Intervention Type PROCEDURE

Allogeneic Stem Cell Transplant: Day 0 Infusion of allogeneic peripheral blood stem cells. For the allogeneic matched-related donors peripheral blood stem cells will be harvested with GCSF mobilization and infused fresh to the recipients.

Melphalan Given IV

Intervention Type DRUG

conditioning regimen: autologous ARM: Day -2 Melphalan 200 mg/m\^2/day IV over 30 minutes. allogeneic ARM: Day -4, Day -3 Melphalan 70 mg/m\^2/day IV over 30 minutes

Fludarabine Injection

Intervention Type DRUG

conditioning regimen:Days -6,-5,-4,-3 Fludarabine 30 mg/m\^2/day IV

PI and dexamethasone as maintenance therapy

Intervention Type DRUG

Bortezomib and dexamethasone(VD),Ixazomib and dexamethasone(ID)

B:Autologous Stem Cell Transplant

Melphalan followed by Autologous SCT.

Group Type EXPERIMENTAL

Autologous Hematopoietic Stem Cell Transplantation x 1 or x 2

Intervention Type PROCEDURE

Autologous hematopoietic stem cell transplantation :Stem cell mobilization with granulocyte colony-stimulating factor (GCSF) at a dose of 10 μg/kg/day followed collecting CD34+ peripheral blood stem cells . Day 0 Infusion of autologous stem cells. Patients during 3-6 months after the 1st SCT will undergo a 2nd SCT. Patients who had not enough PBSC will undergo a 1st SCT.

Melphalan Given IV

Intervention Type DRUG

conditioning regimen: autologous ARM: Day -2 Melphalan 200 mg/m\^2/day IV over 30 minutes. allogeneic ARM: Day -4, Day -3 Melphalan 70 mg/m\^2/day IV over 30 minutes

PI and dexamethasone as maintenance therapy

Intervention Type DRUG

Bortezomib and dexamethasone(VD),Ixazomib and dexamethasone(ID)

C:Non-Transplant

Consolidated Chemotherapy for Patients Unable to Receive Transplantation

Group Type EXPERIMENTAL

PI and dexamethasone as maintenance therapy

Intervention Type DRUG

Bortezomib and dexamethasone(VD),Ixazomib and dexamethasone(ID)

PI+IMids+Dexamethasone as Consolidated Chemotherapy

Intervention Type DRUG

Oral lenalidomide at the starting dose of 25mg on days 1-21 every 28 days or days 1-14 every 21 days. Dexamethasone at 20mg twice weekly on days 1,2,4,5,8,9,11\&12 of each 21-day.

Interventions

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Allogeneic Hematopoietic Stem Cell Transplantation

Allogeneic Stem Cell Transplant: Day 0 Infusion of allogeneic peripheral blood stem cells. For the allogeneic matched-related donors peripheral blood stem cells will be harvested with GCSF mobilization and infused fresh to the recipients.

Intervention Type PROCEDURE

Autologous Hematopoietic Stem Cell Transplantation x 1 or x 2

Autologous hematopoietic stem cell transplantation :Stem cell mobilization with granulocyte colony-stimulating factor (GCSF) at a dose of 10 μg/kg/day followed collecting CD34+ peripheral blood stem cells . Day 0 Infusion of autologous stem cells. Patients during 3-6 months after the 1st SCT will undergo a 2nd SCT. Patients who had not enough PBSC will undergo a 1st SCT.

Intervention Type PROCEDURE

Melphalan Given IV

conditioning regimen: autologous ARM: Day -2 Melphalan 200 mg/m\^2/day IV over 30 minutes. allogeneic ARM: Day -4, Day -3 Melphalan 70 mg/m\^2/day IV over 30 minutes

Intervention Type DRUG

Fludarabine Injection

conditioning regimen:Days -6,-5,-4,-3 Fludarabine 30 mg/m\^2/day IV

Intervention Type DRUG

PI and dexamethasone as maintenance therapy

Bortezomib and dexamethasone(VD),Ixazomib and dexamethasone(ID)

Intervention Type DRUG

PI+IMids+Dexamethasone as Consolidated Chemotherapy

Oral lenalidomide at the starting dose of 25mg on days 1-21 every 28 days or days 1-14 every 21 days. Dexamethasone at 20mg twice weekly on days 1,2,4,5,8,9,11\&12 of each 21-day.

Intervention Type DRUG

Other Intervention Names

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Allogeneic Hematopoietic Cell Transplantation Allogeneic Stem Cell Transplantation HCT SCT autologous stem cell transplantation Alkeran Fludara VD ID VRD IRD VDPACE VDECP

Eligibility Criteria

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Inclusion Criteria

1. Clinical diagnosis of high-risk multiple myeloma

In addition, patients must meet at least one of the following criteria I-IX (I-VIII at time of diagnosis or pre-autograft):

I.Complex karyotype

II.Fluorescent in situ hybridization (FISH) translocation 4:14 or 14:16,

III.FISH translocation 1q21,

IV.FISH deletion 17p,

V.R-ISS III stage,

VI.Two or more high-risk cytogenetic abnormalities exist

VII.Plasma cell leukemia

VIII.Extramedullary plasmacytoma

IX.Recurrent or non-responsive (less than partial remission \[PR\]) MM after at least 4 cycles of PI/IMids-based chemotherapy
2. candidate for high-dose chemotherapy with stem cell transplantation
3. ECOG performance status score of 0,1,or2 -

Exclusion Criteria

1. The current diagnosis of smoldering multiple myeloma, monoclonal gammopathy of undetermined significance of disease, Waldenstr o m macroglobulinemia.
2. during the first 5 years of the study, there were no other malignancies, including basal cell carcinoma or in situ cervical cancer.
3. according to the National Cancer Institute general toxicity criteria (NCI CTC), subjects had peripheral neuropathy of grade 2 or above:
4. were enrolled within 6 months before had a myocardial infarction, or New York Heart Association (NYHA) III or IV heart failure ,uncontrolled angina, uncontrolled severe ventricular arrhythmias or ECG evidence of acute ischemia or conduction system abnormalities and activity the clinical significance of pericardial disease, or cardiac amyloidosis -
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institute of Hematology & Blood Diseases Hospital, China

OTHER

Sponsor Role lead

Responsible Party

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Qiu Lugui

Chief physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lu G Qiu, Dr.

Role: PRINCIPAL_INVESTIGATOR

Institute of Hematology & Blood Diseases Hospital, China

Locations

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Institute of Hematology and Blood Diseases Hospital Chinese Academy of Medical Sciences

Tianjin, Tianjin Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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WEI W SUI, Dr.

Role: CONTACT

86-022-23909171

GANG AN, Dr.

Role: CONTACT

86-022-23909171

Facility Contacts

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WEI W SUI, Master

Role: primary

86-022-23909171

Other Identifiers

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IHBDH-IIT2016011

Identifier Type: -

Identifier Source: org_study_id

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