Anti-thymocyte Globulin and Melphalan in Treating Patients With Relapsed Multiple Myeloma

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: NCT00635024
Recruitment Status : Terminated (Due to competing trials, this study is permanenlty closed to patient acrrual.)
First Posted : March 13, 2008
Results First Posted : October 18, 2010
Last Update Posted : February 10, 2017
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Mayo Clinic

March 12, 2008
March 13, 2008
August 27, 2010
October 18, 2010
February 10, 2017
May 2008
July 2008   (Final data collection date for primary outcome measure)
Hematological Response Rate Defined as the Number of Participants Who Achieve a Confirmed Response [ Time Frame: 4 months ]

Response that was confirmed on 2 consecutive evaluations during the first 4 months of treatment.

Complete Response(CR): Disappearance of M-protein from serum and urine, normalization of Free Light Chain (FLC) ratio and <5% plasma cells in bone marrow.

Very Good Partial Response(VGPR): >=90% reduction in serum M-component; Urine M-Component <100mg per 24hours.

Partial Response(PR): >=50% reduction in serum M-component and/or Urine M-Component >=90% reduction or <200mg per 24hours; or >=50% decrease in difference between involved and uninvolved FLC levels.

The proportion of confirmed response (complete response, partial response, or very good partial response) during first 4 months of treatment
Complete list of historical versions of study NCT00635024 on Archive Site
  • Overall Survival (OS) [ Time Frame: up to 2 years ]
    OS was defined as the time from registration to death of any cause.
  • Progression-free Survival (PFS) [ Time Frame: up to 2 years ]

    PFS was defined as the time from registration to progression or death due to any cause.

    Progression was defined as any one or more of the following:

    An increase of 25% from lowest confirmed response in:

    • Serum M-component (absolute increase >= 0.5g/dl)
    • Urine M-component (absolute increase >= 200mg/24hour
    • Difference between involved and uninvolved Free Light Chain levels (absolute increase >= 10mg/dl)
    • Bone marrow plasma cell percentage (absolute increase of >=10%)
    • Definite development of new bone lesion or soft tissue plasmacytomas
  • Duration of Response (DOR) [ Time Frame: up to 2 years ]
    DOR was calculated from the documentation of response (CR, VGPR or PR) until the date of progression in the subset of patients who responded.
  • Number of Participants With Severe Non-hematological Adverse Events [ Time Frame: every month during treatment, up to 12 months ]
    Severe non-hematologic adverse events were defined as adverse events grade 3 or higher, regardless of attribution to study drug. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI CTCAE version 3.0)
  • Overall survival
  • Progression-free survival
  • Duration of response
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Anti-thymocyte Globulin and Melphalan in Treating Patients With Relapsed Multiple Myeloma
A Phase II Trial of Thymoglobulin and Melphalan in Patients With Relapsed Multiple Myeloma

RATIONALE: Biological therapies, such as anti-thymocyte globulin, may stimulate the immune system in different ways and stop cancer cells from growing. Drugs used in chemotherapy, such as melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Anti-thymocyte globulin may also make cancer cells more sensitive to melphalan. Giving anti-thymocyte globulin together with melphalan may kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving anti-thymocyte globulin together with melphalan works in treating patients with relapsed multiple myeloma.



* To evaluate the hematological response rate of anti-thymocyte globulin given in combination with melphalan in patients with relapsed multiple myeloma.


  • To assess the toxicity and tolerability of this combination in these patients.
  • To assess time to disease progression in patients treated with these drugs.
  • To assess survival of patients treated with these drugs. OUTLINE: Patients receive anti-thymocyte globulin IV over 6 hours and melphalan IV on day 1. Treatment repeats every 28 days for 6 courses. Patients then receive melphalan alone as above for another 6 courses. Treatment continues in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3 months until disease progression and then every 6 months for up to 2 years.

Phase 2
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Multiple Myeloma and Plasma Cell Neoplasm
  • Biological: anti-thymocyte globulin
    2.5 mg/kg
  • Drug: melphalan
    16 mg/m^2
Experimental: Anti-thymocyte Globulin/Melphalan
Anti-thymocyte Globulin (2.5 mg/Kg)and Melphalan (16 mg/m^2)
  • Biological: anti-thymocyte globulin
  • Drug: melphalan
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
November 2010
July 2008   (Final data collection date for primary outcome measure)


  • Diagnosis of multiple myeloma

    - Relapsed disease

  • Must not be a candidate for stem cell transplantation, has refused transplantation, or has had stem cells collected previously
  • Measurable disease, defined by ≥ 1 of the following:

    • Serum monoclonal protein ≥ 1.0 g by protein electrophoresis
    • More than 200 mg of monoclonal protein in the urine on 24 hour electrophoresis
    • Serum immunoglobulin free light chain ≥ 10 mg/dL AND abnormal serum immunoglobulin kappa to lambda free light chain ratio
    • Monoclonal bone marrow plasmacytosis ≥ 30% (evaluable disease)


  • Eastern Cooperative Oncology Group (ECOG) performance status 0-3
  • Absolute neutrophil count ≥ 1,000/μL
  • Platelet count ≥ 75,000/μL
  • Hemoglobin ≥ 8.0 g/dL
  • CD4 > 100/μL
  • Creatinine ≤ 3 mg/dL
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No active malignancy with the exception of nonmelanoma skin cancer or in situ cervical or breast cancer
  • No uncontrolled infection
  • No other co-morbidity that would interfere with patient's ability to participate in trial


  • No limit to prior therapy
  • At least 4 weeks since prior melphalan or other myelosuppressive agents
  • At least 2 weeks since prior non-myelosuppressive agents (e.g., thalidomide or high-dose corticosteroids)
  • No concurrent high-dose corticosteroids

    • Concurrent chronic steroids (maximum dose 20 mg/day prednisone equivalent) allowed if they are being given for disorders other than amyloid (e.g., adrenal insufficiency or rheumatoid arthritis)
    • Concurrent continuation of low level/stable steroid doses for replacement or inhalation therapy allowed
  • Concurrent bisphosphonates allowed
  • No concurrent immunosuppressive medications such as cyclosporine
  • No other concurrent investigational treatment
  • No concurrent cytotoxic chemotherapy or external-beam radiotherapy>
  • No other concurrent systemic anti-neoplastic therapy including, but not limited to, immunotherapy, hormonal therapy, or monoclonal antibody therapy
  • No concurrent prophylactic hematopoietic growth factors (unless for treatment of an established cytopenia)
Sexes Eligible for Study: All
18 Years to 120 Years   (Adult, Senior)
Contact information is only displayed when the study is recruiting subjects
United States
P30CA015083 ( U.S. NIH Grant/Contract )
MC0687 ( Other Identifier: Mayo Clinic Cancer Center )
06-005792 ( Other Identifier: Mayo Clinic IRB )
Not Provided
Not Provided
Not Provided
Mayo Clinic
Mayo Clinic
National Cancer Institute (NCI)
Study Chair: Shaji K. Kumar, MD Mayo Clinic
Mayo Clinic
August 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP