Ruxolitinib for Newly Diagnosed Bronchiolitis Obliterans Syndrome After Allogeneic Hematopoietic Stem Cell Transplantation

  • STATUS
    Recruiting
  • End date
    Jan 1, 2025
  • participants needed
    50
  • sponsor
    First Affiliated Hospital of Zhejiang University
Updated on 21 October 2022
graft versus host disease
cell transplantation

Summary

Lung is one of the target organs in chronic graft versus host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Bronchiolitis obliterans syndrome (BOS) after allo-HSCT was a clinical syndrome characterized by persistent airflow restriction which is the result of lung cGVHD. BOS is one of the main causes of late mortality after allo-HSCT, severely restricting the daily activities and respiratory function of patients. It limits the quality of life and increased the non-relapse mortality (NRM) after allo-HSCT. Currently, the first-line treatment for BOS is FAM ( oral fluticasone, azithromycin and montelukast). However, more than 50% of patients develop as steroids resistant (SR)-BOS, and SR-BOS has a poor prognosis and irreversible impaired lung function. Ruxolitinib is an effective drug in the treatment of SR-cGVHD. This is a phase Ⅱ prospective clinical study to explore the efficacy and safety of ruxolitinib as a first-line treatment for newly diagnosed BOS after allo-HSCT.

Description

The incidence of chronic graft versus host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) was 30%-70%, Which extremely limited the quality of life and the survival of patients after allo-HSCT. Lung is one of the target organs in cGVHD after allo-HSCT. Bronchiolitis obliterans syndrome (BOS) after allo-HSCT was a clinical syndrome characterized by persistent airflow restriction which is the result of lung cGVHD. BOS is one of the main causes of late mortality after allo-HSCT, severely restricting the daily activities and respiratory function of patients. It limits the quality of life and increased the non-relapse mortality (NRM) after allo-HSCT. Currently, the first-line treatment for BOS is FAM ( oral fluticasone, azithromycin and montelukast). However, more than 50% of patients develop as steroids resistant (SR)-BOS, and SR-BOS has a poor prognosis and irreversible impaired lung function. Ruxolitinib is an effective drug in the treatment of SR-cGVHD. This is a phase Ⅱ prospective clinical study to explore the efficacy and safety of ruxolitinib as a first-line treatment for newly diagnosed BOS after allo-HSCT.

Details
Condition Bronchiolitis Obliterans Syndrome, Hematologic Malignancy
Treatment Ruxolitinib
Clinical Study IdentifierNCT05413356
SponsorFirst Affiliated Hospital of Zhejiang University
Last Modified on21 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Male or female; 18-65 years old
Diagnosis of BOS after allo-HCT defined as the 2014 NIH criteria
Life expectancy > 6 months at the time of enrollment
At least 4 weeks since initiation of the most recent systemic therapy for cGVHD or BOS
The ability to understand and willingness to sign a written consent document

Exclusion Criteria

Recurrent malignancy or disease progression requiring anticancer therapy
Currently receiving or have previously received ruxolitinib for chronic GVHD therapy
Known history of allergy to ruxolitinib or its excipients
Hepatic dysfunction: transaminases (ALT, AST) > 5X ULN and/or total bilirubin > 3X ULN
Hematologic dysfunction: absolute neutrophil count <1000/μL, platelet cout <3010E9/L, and/or Hgb < 8 g/dL
Renal dysfunction: calculated creatinine clearance < 30 mL/min (Cockcroft-Gault formula)
previously received second-line treatment or any drugs in clinical trials for cGVHD
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