Allo-HSCT Vs. Auto-HSCT for PTCL Patients With PR After First-line Systemic Therapy : A Prospective, Multicenter, Cohort Study-(T-START-PR)

NCT ID: NCT07253129

Last Updated: 2025-12-23

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

RECRUITING

Total Enrollment

88 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-12-31

Study Completion Date

2029-09-30

Brief Summary

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This study is a multicenter, two-arm, prospective clinical trial, comprising two groups: the allogeneic hematopoietic stem cell transplantation group (Allo-HSCT) and the autologous hematopoietic stem cell transplantation group (Auto-HSCT). It aims to evaluate the efficacy and safety of Auto-HSCT and Allo-HSCT in the treatment of peripheral T-cell lymphoma that has achieved partial response (PR) after first-line therapy. During the screening/baseline period, informed consent will be obtained, and inclusion/exclusion criteria will be verified. Group assignment (Allo-HSCT vs. Auto-HSCT) will be determined taking into account the availability of a matched donor and the patient's preference. The study plans to enroll 44 patients in the allogeneic hematopoietic stem cell transplantation group, while all concurrent patients undergoing autologous stem cell transplantation will be included in the other group for inverse probability weighting analysis. Data on demographics and medical history will be collected, and assessments including vital signs, physical examination, PET-CT, bone marrow aspiration smear, flow cytometry, and bone marrow pathology will be performed.

Detailed Description

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Conditions

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Peripheral T Cell Lymphoma

Keywords

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peripheral T cell lymphoma allogeneic hematopoietic stem cell transplantation autologous hematopoietic stem cell transplantation partial response

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Allo-HSCT

Allo-HSCT involves the infusion of stem cells collected from a donor (genetically similar, but not identical)

Allogenic stem cell transplant (ASCT)

Intervention Type PROCEDURE

ASCT involves the infusion of stem cells collected from a donor (genetically similar, but not identical).

Auto-HSCT

Auto-HSCT involves the infusion of the patient's own previously collected stem cells.

Autologous Hematopoietic Stem Cell Transplantation

Intervention Type PROCEDURE

Auto-HSCT involves the infusion of the patient's own previously collected stem cells.

Interventions

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Autologous Hematopoietic Stem Cell Transplantation

Auto-HSCT involves the infusion of the patient's own previously collected stem cells.

Intervention Type PROCEDURE

Allogenic stem cell transplant (ASCT)

ASCT involves the infusion of stem cells collected from a donor (genetically similar, but not identical).

Intervention Type PROCEDURE

Other Intervention Names

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Auto-HSCT ASCT Allo-HSCT

Eligibility Criteria

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Inclusion Criteria

1. Age \& Sex:

Males or females aged 18 to 70 years (inclusive).
2. ECOG performance status score of 0 to 1, with no deterioration within the last two weeks.
3. Expected survival period greater than 12 weeks.
4. Patients must have a histopathological confirmation of PTCL according to the 2016 revised WHO classification of lymphoid neoplasms (Swerdlow SH et al. 2016). Eligible histological subtypes are limited to the following:

* Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS)
* Anaplastic large cell lymphoma, ALK-negative (ALK-ALCL)
* Follicular helper T-cell lymphoma or PTCL with TFH phenotype (FTCL or PTCL-TFH)

Patients undergoing allogeneic hematopoietic stem cell transplantation must have a suitable stem cell donor:

(i) Related donors must be at least 5/10 matched for HLA-A, -B, -C, -DQB1, and -DRB1.

(ii) Unrelated donors must be at least 8/10 matched for HLA-A, -B, -C, -DQB1, and -DRB1.
5. Patients must have achieved a partial response (PR) as per the Lugano 2014 response criteria for lymphoma after six cycles of CHOP, BV-CHP or CHOP-like chemotherapy.
6. Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) score ≤ 2.
7. Adequate hepatic, renal, cardiac, and pulmonary function, defined as follows:

1. Hepatic function: Serum total bilirubin ≤ 2 × upper limit of normal (ULN) (≤ 3.0 × ULN in cases of Gilbert's syndrome or baseline hepatic involvement); alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5 × ULN (≤ 5.0 × ULN in cases of hepatic involvement).
2. Renal function: Serum creatinine ≤ 1.5 × ULN, or creatinine clearance ≥ 50 mL/min as calculated or measured by the Cockcroft-Gault method.
3. Cardiac function: Left ventricular ejection fraction (LVEF) ≥ 50% as measured by multigated acquisition (MUGA) scan or echocardiography (ECHO).
4. Baseline oxygen saturation \> 92%.
5. Pulmonary function: Diffusing capacity of the lung for carbon monoxide (DLCO) (hemoglobin-corrected) ≥ 40% and forced expiratory volume in 1 second (FEV1) ≥ 50%.

Exclusion Criteria

1. Ann Arbor clinical stage I disease.
2. History of malignancy within the past 5 years, except for locally curable malignancies that have been treated with curative intent (e.g., basal or squamous cell skin cancer, superficial bladder cancer, or carcinoma in situ of the prostate, cervix, or breast).
3. Active infection, including:

1. Known active or latent tuberculosis, evidenced by a positive tuberculin (PPD) skin test (induration \>10 mm or per local criteria for a positive result) or radiographic findings suggestive of active/latent TB on chest X-ray/CT.
2. Known history of infection with Human Immunodeficiency Virus (HIV) and/or AIDS.
3. Chronic active hepatitis B or hepatitis C infection:

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1. Patients positive for hepatitis B virus (HBV) DNA are excluded; however, those with undetectable HBV DNA levels are eligible. The upper limit of normal (ULN) for HBV DNA shall be based on the reference values of each participating center.
2. Patients positive for hepatitis C virus (HCV) RNA are excluded; however, those with undetectable HCV RNA are eligible. The ULN for HCV RNA shall be based on the reference values of each participating center.

(d) Active viral infections other than hepatitis B or hepatitis C (e.g., herpes zoster, cytomegalovirus).

(e) Infection requiring intravenous antimicrobial therapy, associated with hemodynamic instability, worsening or new onset of infectious signs/symptoms, or new infectious foci on imaging; or persistent fever without localizing signs that cannot rule out infection.

(f) Positive serum DNA test for Epstein-Barr virus (EBV).
4. Poorly controlled cardiac symptoms or disease, such as:

i. Heart failure greater than New York Heart Association (NYHA) class II. ii. Unstable angina. iii. Myocardial infarction within the past year. iv. Clinically significant supraventricular or ventricular arrhythmia requiring treatment or intervention.
5. Pregnant or lactating women, and subjects of childbearing potential unwilling to use effective contraception.
6. Psychiatric illness or individuals unable to provide informed consent.
7. PTCL patients with central nervous system involvement.
8. PTCL patients who have previously received PD-1 inhibitor therapy.
9. Any other condition that, in the judgment of the investigator, would make the subject unsuitable for participation in this study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Xianmin Song, MD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Shanghai General Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Countries

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China

Central Contacts

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xianmin song, MD

Role: CONTACT

Phone: +862163240090

Email: [email protected]

Facility Contacts

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xianmin Song, MD

Role: primary

References

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Schmitz N, Truemper L, Bouabdallah K, Ziepert M, Leclerc M, Cartron G, Jaccard A, Reimer P, Wagner E, Wilhelm M, Sanhes L, Lamy T, de Leval L, Rosenwald A, Roussel M, Kroschinsky F, Lindemann W, Dreger P, Viardot A, Milpied N, Gisselbrecht C, Wulf G, Gyan E, Gaulard P, Bay JO, Glass B, Poeschel V, Damaj G, Sibon D, Delmer A, Bilger K, Banos A, Haenel M, Dreyling M, Metzner B, Keller U, Braulke F, Friedrichs B, Nickelsen M, Altmann B, Tournilhac O. A randomized phase 3 trial of autologous vs allogeneic transplantation as part of first-line therapy in poor-risk peripheral T-NHL. Blood. 2021 May 13;137(19):2646-2656. doi: 10.1182/blood.2020008825.

Reference Type BACKGROUND
PMID: 33512419 (View on PubMed)

Tournilhac O, Altmann B, Friedrichs B, Bouabdallah K, Leclerc M, Cartron G, Turlure P, Reimer P, Wagner-Drouet E, Sanhes L, Houot R, Roussel M, Kroschinsky F, Dreger P, Viardot A, de Leval L, Rosenwald A, Gaulard P, Wulf G, Villate A, Latiere C, Elmaagacli A, Glass B, Poeschel V, Damaj G, Sibon D, Durot E, Bilger K, Banos A, Haenel M, Dreyling M, Keller U, Tiab M, Drenou B, Cornillon J, Nguyen S, Robin M, Nickelsen M, Trumper L, Lenz G, Ziepert M, Schmitz N; French Lymphoma Study Association (LYSA), the Societe Francophone de greffe de moelle et Therapie Cellulaire (SFGM-TC), and the German Lymphoma Alliance (GLA). Long-Term Follow-Up of the Prospective Randomized AATT Study (Autologous or Allogeneic Transplantation in Patients With Peripheral T-Cell Lymphoma). J Clin Oncol. 2024 Nov 10;42(32):3788-3794. doi: 10.1200/JCO.24.00554. Epub 2024 Sep 13.

Reference Type BACKGROUND
PMID: 39270145 (View on PubMed)

Other Identifiers

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T-START-PR

Identifier Type: -

Identifier Source: org_study_id