Acute Graft-Versus-Host Disease (aGvHD) Prophylaxis With ATG-Fresenius in Matched Unrelated Donor-Stem Cell Transplantation (MUD-SCT)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00655343
Recruitment Status : Completed
First Posted : April 9, 2008
Last Update Posted : December 12, 2011
University Medical Center Freiburg
Information provided by (Responsible Party):
Neovii Biotech

Brief Summary:
The study aim is to evaluate the influence of the anti-T-lymphocyte globulin ATG-Fresenius S given pre-transplant in addition to standard GvHD prophylaxis with cyclosporine A and a short course of methotrexate with respect to efficacy and safety.

Condition or disease Intervention/treatment Phase
Graft vs Host Disease Drug: ATG-Fresenius S Phase 3

Detailed Description:

To assess the efficacy of ATG-FRESENIUS S in addition to standard therapy (cyclosporine A / methotrexate) with respect to early treatment failure defined by the occurrence of severe acute GvHD grade III-IV or early mortality within 100 days post transplantation compared to standard therapy alone.

All patients receive myeloablative therapy. Recommended regimens: For patients with ALL: fractionated TBI (8-12 Gy) plus cyclophosphamide (1-2 x 60 mg/kg) [etoposide/melfalan are also allowed]. For all other indications: either TBI (8-12 Gy) or busulfan (per os 14-16 mg/kg b.w. or equivalent for IV administration) plus cyclophosphamide (1-2 x 60 mg/kg) or thiotepa ≥ 15 mg/kg or BCNU ≥ 300 mg/m2.

Conditioning regimens may differ from centre to centre; each centre decides for constant (disease specific) regimen(s) throughout the whole study period.

Standard GvHD prophylaxis consists of cyclosporine A (target trough level ≥ 200 ng/ml starting from day -1 until day +100) and short course methotrexate (15 mg/m2 at day +1, 10 mg/m2 at days +3, +6 and +11).

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 202 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: GvHD Prophylaxis With ATG-Fresenius S in Allogeneic Stem Cell Transplantation From Matched Unrelated Donors: A Randomized Phase III Multicenter Trial Comparing a Standard GvHD Prophylaxis With Cyclosporine A and Methotrexate With Additional Pretransplant ATG-Fresenius S
Study Start Date : February 2003
Actual Primary Completion Date : March 2007
Actual Study Completion Date : March 2009

Arm Intervention/treatment
Experimental: ATG-F

ATG-Fresenius S (20 mg/kg body weight at days -3 to -1 (total dose: 60 mg/kg)

cyclosporine A (target trough level > 200ng/ml (day -1 until day +100)

methotrexate: 15mg/m2 at day +1, 10mg/m2 at days +3, +6, and +11

Drug: ATG-Fresenius S

20 mg rabbit immunoglobulin (IgG) in 1 ml of sterile solution

20 mg/kg body weight per day diluted in 500 ml physiological saline, slow intravenous infusion at days -3, -2, -1 prior to transplantation

Other Names:
  • ATG-Fresenius
  • Anti-T-Lymphocyte globulin
No Intervention: non-ATG-F

cyclosporine A (target trough level > 200ng/ml (day -1 until day +100)

methotrexate: 15mg/m2 at day +1, 10mg/m2 at days +3, +6, and +11

Primary Outcome Measures :
  1. Primary: Early treatment failure defined by the occurrence of severe acute GvHD (°III-°IV) or early mortality within 100 days post transplantation. [ Time Frame: 100 days ]

Secondary Outcome Measures :
  1. Time to onset of acute GvHD, incidence and severity of infections until day +100, time to engraftment, incidence of cGvHD, disease free survival, relapse, death without relapse, overall survival, safety, tolerability. [ Time Frame: 24 months ]

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Participation of patients in simultaneous diagnostic and comprehensive therapeutical trials for certain entities is allowed.

  • Patients 18-60 years of age;
  • Patients suffering from one of the following diseases:

    • AML: 1st complete remission (CR1) or beyond 1st remission (CR2, CR3), in relapse, not in remission (primary refractory, induction failure);
    • ALL: 1st complete remission (CR1) or beyond 1st remission (CR2, CR3), in relapse, not in remission (primary refractory, induction failure);
    • MDS, if transplantation is medically indicated: RA (with poor risk factors as classified by the International Prognostic Scoring System of MDS), RARS, RAEB, RAEB-t, CMML;
    • CML: beyond 1st chronic phase (CP1): accelerated phase, blast crisis, chronic phase (CP2, CP3);
    • OMF, if transplantation is medically indicated: Osteomyelofibrosis;
  • Patients designated to undergo allogeneic bone marrow transplantation or allogeneic peripheral blood stem cell transplantation;
  • Patients with a HLA-A, -B (DNA-based, 2 digits), HLA-DRB1, -DQB1 (DNA-based 4 digits) matched (8 out of 8 alleles) unrelated donor; serological typing is not required
  • Patients with a Karnofsky Performance Score (KPS): > 60%;
  • Patients who underwent all obligatory screening examinations (special examinations within the last 4 weeks);
  • Patients who have given their written informed consent to participate in the study.

Exclusion Criteria:

  • Patients with significant cardiac (e.g. ejection fraction <50%), pulmonary (e.g. FEV1 <50%), renal (e.g. creatinine > 1.5 mg/dl), metabolic (e.g. bilirubin > 2.0 mg/dl) and/or CNS disease, currently uncontrolled by treatment, which may interfere with the completion of the study;
  • Patients with any bacterial, viral, or fungal infections not under adequate antimicrobial control;
  • Patients who are known to have serum hepatitis or who are carriers of the Hepatitis B surface antigen (HBs-Ag), or Hepatitis C antibody, or who are known to have a positive result to the test of HIV antibodies;
  • Patients with any additional concurrent or previous malignant disease;
  • Patients with known hypersensitivity to rabbit immunoglobulin antibodies in past patient history or with known allergy to any substance chemically related to the study medication;
  • Pregnant (β-HCG test) or lactating women;
  • Patients who formerly underwent transplantation including previous autologous transplants;
  • Patients who cannot communicate reliably with the investigator or who are not likely to cope with the requirements of the study.

Information from the National Library of Medicine

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 identifier (NCT number): NCT00655343

Universität Freiburg, Medizinische Klinik, Abteilung Innere Medizin I, Hämatologie/Onkologie
Freiburg, Baden-Württemberg, Germany, 79110
Sponsors and Collaborators
Neovii Biotech
University Medical Center Freiburg
Principal Investigator: Juergen Finke, Prof. Dr. Albert-Ludwigs-University Freiburg

Publications of Results:
Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Neovii Biotech Identifier: NCT00655343     History of Changes
Other Study ID Numbers: AP-AS-21-DE
First Posted: April 9, 2008    Key Record Dates
Last Update Posted: December 12, 2011
Last Verified: December 2011

Keywords provided by Neovii Biotech:
aGvHD prophylaxis
Matched unrelated donor
polyclonal antibody
GvHD prophylaxis for patients with ALL, AML, CML, MDS, OMF
Patients with allogeneic BM or PBSC transplantation
Patients with a matched unrelated donor

Additional relevant MeSH terms:
Graft vs Host Disease
Immune System Diseases
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Physiological Effects of Drugs
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Dermatologic Agents
Enzyme Inhibitors
Folic Acid Antagonists
Immunosuppressive Agents
Immunologic Factors
Antirheumatic Agents
Nucleic Acid Synthesis Inhibitors
Antifungal Agents
Anti-Infective Agents
Calcineurin Inhibitors