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Rapamycin for Prevention of Chronic Graft-Versus-Host Disease

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Yale University

Status and phase

Terminated
Phase 2
Phase 1

Conditions

Graft Versus Host Disease

Treatments

Drug: Tacrolimus
Drug: Rapamycin

Study type

Interventional

Funder types

Other

Identifiers

NCT00623012
0702002350

Details and patient eligibility

About

The objective of this study is to evaluate feasibility, toxicity and efficacy of using Rapamycin to prevent chronic graft-versus-host-disease (GVHD) during and after the tacrolimus taper in recipients of allogeneic stem cell transplant.

Our hypothesis is that the T cells that can cause chronic GVHD are suppressed but not eliminated by calcineurin inhibitors. Therefore, when the calcineurin inhibitors are discontinued, the T cells may get activated and result in GVHD. Rapamycin on the other hand will allow anergy formation and thus when discontinued, T cells should not get activated. The schedule is designed to have therapeutic rapamycin levels as the tacrolimus is discontinued. Rapamycin will be continued as a single agent for additional 4 weeks and be tapered off in two weeks.

Enrollment

2 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age ≥18 years
  • Received an allogeneic MSD or MUD PBSCT
  • 24 weeks post SCT
  • Currently on Tacrolimus for GVHD prophylaxis
  • Deemed eligible for tapering off of Tacrolimus by primary BMT physician

Exclusion criteria

  • Relapsed Disease
  • Ongoing GVHD
  • Patients whose immunosuppression is being stopped early to treat or prevent relapse
  • Patients with pure red cell aplasia due to ABO mismatched donor
  • Ongoing thrombotic microangiopathy
  • Allergy to rapamycin
  • Women of childbearing potential must have a negative serum pregnancy test performed prior to the start of treatment

Trial design

Primary purpose

Treatment

Allocation

N/A

Interventional model

Single Group Assignment

Masking

None (Open label)

2 participants in 1 patient group

1
Experimental group
Treatment:
Drug: Rapamycin
Drug: Tacrolimus

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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