Improving Outcomes Assessment in Chronic GVHD
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| ClinicalTrials.gov Identifier: NCT00637689 |
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Recruitment Status :
Active, not recruiting
First Posted : March 18, 2008
Last Update Posted : March 30, 2023
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| Condition or disease |
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| Chronic Graft Versus Host Disease |
Chronic graft-versus-host disease (GVHD) is one of the most devastating long-term complications after infusion of allogeneic hematopoietic stem cells, and it remains one of the major barriers to successful transplantation. Relatively little progress has been made in understanding and improving treatments for chronic GVHD over the last 20 years, and the survival rate after diagnosis of chronic GVHD has barely improved despite advances in supportive care. The National Institutes of Health convened a Consensus Conference on this topic in June 2004 and recently published its recommendations on improving research methods in a series of six papers.
In our study, we will establish a multi-center, observational, longitudinal cohort in order to improve outcomes assessment in chronic GVHD with the specific aims of (1) validating prognostic factors for risk stratification; and (2) defining significant variables for a chronic GVHD activity index that predicts short-term (provider perception of change, patient perception of change, and changes in immunosuppressive medications) and longer-term outcomes (overall survival, time to discontinuation of systemic immunosuppressive therapy, and functional impairments). This goal will be accomplished by assembling a large modern cohort of people with chronic GVHD at four large core transplant centers. Approximately 700 people (half prevalent cases, half incident cases) with chronic GVHD will be enrolled. Every 3-6 months we will collect both objective and subjective measures reflecting disease activity, response to therapy, detailed physician assessments about organ involvement, and patient self-assessments about symptoms, functional status, and quality of life. Data will be used to test published hypotheses and the new recommendations emanating from the NIH Consensus conference. We will also be able to provide the detailed data needed to understand modern trends in chronic GVHD incidence, manifestations, and response to treatment. These studies are needed to operationalize the recommendations of the NIH Consensus conference, advance our understanding of chronic GVHD, and enhance our ability to conduct clinical trials.
| Study Type : | Observational |
| Actual Enrollment : | 601 participants |
| Observational Model: | Cohort |
| Time Perspective: | Prospective |
| Official Title: | Improving Outcomes Assessment in Chronic GVHD |
| Actual Study Start Date : | September 2007 |
| Actual Primary Completion Date : | May 2017 |
| Estimated Study Completion Date : | February 2025 |
- Overall survival [ Time Frame: 3 years ]
- Time to discontinuation of immunosuppression [ Time Frame: 3 years ]
- Functional impairments [ Time Frame: 3 years ]
- Provider perception of change [ Time Frame: 6 months ]
- Patient perception of change [ Time Frame: 6 months ]
- Changes in immunosuppressive medications [ Time Frame: 6 months ]
Biospecimen Retention: Samples With DNA
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| Ages Eligible for Study: | 2 Years and older (Child, Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Age greater than or equal to 2 years
- Prior allogeneic stem cell transplant, with any graft source, donor type, and GVHD prophylaxis allowed
- Clinical or histologic diagnosis of chronic GVHD (overlap syndrome with acute GVHD is allowed
- Need for systemic treatment, defined as any medication or intervention delivered systemically, including extracorporeal photopheresis. If a patient only received topical or local therapy at diagnosis, but subsequently requires systemic treatment, they may be enrolled upon initiation of systemic therapy. (Note, these patients will be classified as incident or prevalent cases depending on time from chronic GVHD diagnosis, not start of systemic therapy)
- If a prevalent case (defined as enrollment three or more months after chronic GVHD diagnosis), then subject must be within 2 years of stem cell infusion
- If an incident case (enrollment less than 3 months after chronic GVHD diagnosis) then no limitation on time from transplantation
- No evidence of primary disease relapseProgression-free for their malignancy at enrollment (no evidence of primary disease progression since transplant, although residual disease may still be present)
- Evaluation at the transplant center at the time of study enrollment
- Signed, informed consent and if applicable, child assent
Exclusion Criteria:
- Inability to comply with study procedures
- Anticipated survival less than 6 months due to co-morbid disease
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00637689
| United States, California | |
| Stanford University | |
| Stanford, California, United States, 94305 | |
| United States, Florida | |
| H. Lee Moffitt Cancer Center | |
| Tampa, Florida, United States, 33612 | |
| United States, Massachusetts | |
| Dana-Farber Cancer Institute | |
| Boston, Massachusetts, United States, 02115 | |
| United States, Minnesota | |
| University of Minnesota | |
| Minneapolis, Minnesota, United States, 55455 | |
| United States, Missouri | |
| Washington University School of Medicine | |
| Saint Louis, Missouri, United States, 63110 | |
| United States, New York | |
| Memorial Sloan Kettering | |
| New York, New York, United States, 10065 | |
| United States, Tennessee | |
| Vanderbilt University | |
| Nashville, Tennessee, United States, 37232 | |
| United States, Washington | |
| Fred Hutchinson Cancer Research Center | |
| Seattle, Washington, United States, 98109 | |
| United States, Wisconsin | |
| Medical College of Wisconsin | |
| Milwaukee, Wisconsin, United States, 53226 | |
| Principal Investigator: | Stephanie J Lee, MD MPH | Fred Hutchinson Cancer Center |
| Responsible Party: | Fred Hutchinson Cancer Center |
| ClinicalTrials.gov Identifier: | NCT00637689 |
| Other Study ID Numbers: |
FHCRC-2192.00 U01CA118953-01A1 ( U.S. NIH Grant/Contract ) IR-6531 ( Other Identifier: FHCRC ) RG1000709 ( Other Identifier: Fred Hutch/University of Washington Cancer Consortium ) |
| First Posted: | March 18, 2008 Key Record Dates |
| Last Update Posted: | March 30, 2023 |
| Last Verified: | March 2023 |
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Chronic graft versus host disease Allogeneic hematopoietic cell transplantation Biomarkers |
Response criteria Surrogate endpoints Natural history |
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Bronchiolitis Obliterans Syndrome Graft vs Host Disease Immune System Diseases Organizing Pneumonia Bronchiolitis Obliterans Bronchiolitis |
Bronchitis Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive Lung Diseases |