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    Clinical Trial Results:
    Prevention of severe GVHD after allogeneic hematopoietic stem cell transplantation, applied as consolidation immunotherapy in patients with hematological malignancies. A prospective randomized phase III trial.

    Summary
    EudraCT number
    2008-003540-11
    Trial protocol
    NL   BE  
    Global end of trial date
    07 Jan 2021

    Results information
    Results version number
    v1(current)
    This version publication date
    25 Dec 2022
    First version publication date
    25 Dec 2022
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    HO96GVHD
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    HOVON
    Sponsor organisation address
    De Boelelaan 1117, Amsterdam, Netherlands,
    Public contact
    HOVON Data Center, HOVON, hdc@erasmusmc.nl
    Scientific contact
    HOVON Data Center, HOVON, hdc@erasmusmc.nl
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Jul 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 Jul 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    07 Jan 2021
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Objectives: - to increase the proportion of patients with non severe GVHD within 180 days post-allo-SCT, - to reduce the progression rate and - to improve the progression free survival using a time restricted immunosuppressive regimen or a short-course post-transplant GVHD prophylaxis consisting of high-dose cyclophosphamide as compared to a prolonged, standard immunosuppressive regimen.
    Protection of trial subjects
    Monitoring and Insurance
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    14 Apr 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 491
    Country: Number of subjects enrolled
    Belgium: 3
    Worldwide total number of subjects
    494
    EEA total number of subjects
    494
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    418
    From 65 to 84 years
    76
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    All subjects gave written informed consent and were screened according to the inclusion- and exclusion criteria.

    Period 1
    Period 1 title
    Overall period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A
    Arm description
    Standard immunosuppression with Cyclosporin A and Myfortic.
    Arm type
    Standard treatment

    Investigational medicinal product name
    Cyclosporine A
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule, soft, Powder for infusion
    Routes of administration
    Infusion , Oral use
    Dosage and administration details
    Cyclosporine A (CyA) immunosuppression: 9 mg/kg p.o. (in 2 doses) OR 3 mg/kg i.v. (in 2 doses) from day -5/-3 (depending on local procedures) till day 180.

    Investigational medicinal product name
    Myfortic
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Myfortic immunosuppression: (2x 16 mg/kg p.o.) from day 0 till day 84. Myfortic will be given with a maximum of 2160 mg/day.

    Arm title
    Arm B
    Arm description
    Time-restricted immunosuppression with Cyclosporin A and Myfortic.
    Arm type
    Experimental

    Investigational medicinal product name
    Cyclosporine A
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule, soft, Powder for infusion
    Routes of administration
    Infusion , Oral use
    Dosage and administration details
    Cyclosporine A time-restricted immunosuppression: 9 mg/kg p.o. (in 2 doses) OR 3 mg/kg i.v. (in 2 doses) from day -5/-3 (depending on local procedures) till day 84.

    Investigational medicinal product name
    Myfortic
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Myfortic time-restricted immunosuppression:(2x 16 mg/kg p.o.) from day 0 till day 28. Myfortic will be given with a maximum of 2160 mg/day.

    Arm title
    Arm C
    Arm description
    Post-transplant cyclophosphamide
    Arm type
    Experimental

    Investigational medicinal product name
    Cyclophosphamide
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Cyclophosphamide during conditioning: 14.5 mg/kg i.v. (day -6 and -5). Cyclophosphamide during post-transplant immunosuppression: 50 mg/kg i.v. (day +3 and +4)

    Investigational medicinal product name
    Fludarabine
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Fludarabine during conditioning: 30 mg/m^2 i.v. (day -6 to -2) 5 days.

    Investigational medicinal product name
    Cyclosporine A
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule, soft, Powder for infusion
    Routes of administration
    Infusion , Oral use
    Dosage and administration details
    Cyclosporine A during post-transplant immunosuppression: 9 mg/kg p.o. (in 2 doses) OR 3 mg/kg i.v. (in 2 doses) during day +5 till +70.

    Number of subjects in period 1
    Arm A Arm B Arm C
    Started
    195
    194
    105
    Completed
    35
    38
    40
    Not completed
    160
    156
    65
         Adverse Reaction
    82
    84
    39
         Other
    21
    15
    7
         At patients request
    1
    -
    -
         Lack of efficacy
    56
    57
    19

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall period
    Reporting group description
    -

    Reporting group values
    Overall period Total
    Number of subjects
    494 494
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    418 418
        From 65-84 years
    76 76
        85 years and over
    0 0
    Age continuous
    Units: years
        median (full range (min-max))
    56 (18 to 71) -
    Gender categorical
    Units: Subjects
        Female
    201 201
        Male
    293 293

    End points

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    End points reporting groups
    Reporting group title
    Arm A
    Reporting group description
    Standard immunosuppression with Cyclosporin A and Myfortic.

    Reporting group title
    Arm B
    Reporting group description
    Time-restricted immunosuppression with Cyclosporin A and Myfortic.

    Reporting group title
    Arm C
    Reporting group description
    Post-transplant cyclophosphamide

    Primary: Primary endpoint

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    End point title
    Primary endpoint [1]
    End point description
    End point type
    Primary
    End point timeframe
    See publication
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistical analysis has been uploaded in the chart section.
    End point values
    Arm A Arm B Arm C
    Number of subjects analysed
    184
    185
    99
    Units: Whole
    184
    185
    99
    Attachments
    Statistical data section from publication
    List of reported non-SAE's
    List of reported SAE's
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All AEs CTCAE grade >= 2 have to be reported (with the exception of progression). However, GVHD of all grades has to be reported on the GVHD forms.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    3.0
    Reporting groups
    Reporting group title
    Control group (standard immunosuppression)
    Reporting group description
    -

    Reporting group title
    Time-restricted immunosuppression
    Reporting group description
    -

    Reporting group title
    Post-transplant cyclophosphamide
    Reporting group description
    -

    Serious adverse events
    Control group (standard immunosuppression) Time-restricted immunosuppression Post-transplant cyclophosphamide
    Total subjects affected by serious adverse events
         subjects affected / exposed
    58 / 184 (31.52%)
    70 / 185 (37.84%)
    26 / 99 (26.26%)
         number of deaths (all causes)
    92
    97
    43
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Neoplasms benign, malignant and unspecified
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 184 (0.54%)
    2 / 185 (1.08%)
    0 / 99 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    Vascular disorders
    Vascular disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 184 (1.09%)
    3 / 185 (1.62%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
    General disorders and administration site conditions
    General disorders and administration site conditions
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    6 / 184 (3.26%)
    6 / 185 (3.24%)
    4 / 99 (4.04%)
         occurrences causally related to treatment / all
    2 / 6
    1 / 6
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    Immune system disorders
    Immune system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    13 / 184 (7.07%)
    14 / 185 (7.57%)
    6 / 99 (6.06%)
         occurrences causally related to treatment / all
    3 / 15
    3 / 14
    0 / 6
         deaths causally related to treatment / all
    1 / 3
    0 / 2
    0 / 1
    Respiratory, thoracic and mediastinal disorders
    Respiratory, thoracic and mediastinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 184 (1.09%)
    2 / 185 (1.08%)
    4 / 99 (4.04%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    1 / 1
    0 / 3
    Psychiatric disorders
    Psychiatric disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 184 (0.00%)
    0 / 185 (0.00%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Investigations
    Investigations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    10 / 184 (5.43%)
    8 / 185 (4.32%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    12 / 12
    7 / 8
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Injury, poisoning and procedural complications
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 184 (1.09%)
    1 / 185 (0.54%)
    0 / 99 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Cardiac disorders
    Cardiac disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    1 / 185 (0.54%)
    3 / 99 (3.03%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    2 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Nervous system disorders
    Nervous system disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    10 / 185 (5.41%)
    0 / 99 (0.00%)
         occurrences causally related to treatment / all
    3 / 4
    8 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Blood and lymphatic system disorders
    Blood and lymphatic disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    9 / 185 (4.86%)
    3 / 99 (3.03%)
         occurrences causally related to treatment / all
    4 / 6
    5 / 9
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    Gastrointestinal disorders
    Gastrointestinal disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    17 / 184 (9.24%)
    15 / 185 (8.11%)
    3 / 99 (3.03%)
         occurrences causally related to treatment / all
    14 / 20
    10 / 16
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatobiliary disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 184 (1.09%)
    2 / 185 (1.08%)
    0 / 99 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin and subcutaneous tissue disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 184 (0.54%)
    0 / 185 (0.00%)
    0 / 99 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal and urinary disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 184 (0.54%)
    2 / 185 (1.08%)
    2 / 99 (2.02%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Infections and infestations
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    11 / 184 (5.98%)
    12 / 185 (6.49%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    1 / 12
    2 / 14
    0 / 1
         deaths causally related to treatment / all
    0 / 2
    2 / 3
    0 / 0
    Metabolism and nutrition disorders
    Metabolism and nutrition disorders
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    5 / 184 (2.72%)
    3 / 185 (1.62%)
    1 / 99 (1.01%)
         occurrences causally related to treatment / all
    2 / 5
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Control group (standard immunosuppression) Time-restricted immunosuppression Post-transplant cyclophosphamide
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    149 / 184 (80.98%)
    165 / 185 (89.19%)
    89 / 99 (89.90%)
    Vascular disorders
    Vascular
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    9 / 184 (4.89%)
    7 / 185 (3.78%)
    4 / 99 (4.04%)
         occurrences all number
    12
    8
    4
    Surgical and medical procedures
    Surgery/intra-operative injury
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    1 / 184 (0.54%)
    0 / 185 (0.00%)
    0 / 99 (0.00%)
         occurrences all number
    1
    0
    0
    General disorders and administration site conditions
    Constitutional symptoms
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    27 / 184 (14.67%)
    33 / 185 (17.84%)
    6 / 99 (6.06%)
         occurrences all number
    35
    37
    7
    Pain
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    14 / 184 (7.61%)
    19 / 185 (10.27%)
    10 / 99 (10.10%)
         occurrences all number
    14
    20
    11
    Death
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 184 (0.00%)
    1 / 185 (0.54%)
    0 / 99 (0.00%)
         occurrences all number
    0
    1
    0
    Secondary malignancy
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 184 (0.00%)
    1 / 185 (0.54%)
    0 / 99 (0.00%)
         occurrences all number
    0
    1
    0
    Syndromes
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 184 (0.00%)
    2 / 185 (1.08%)
    1 / 99 (1.01%)
         occurrences all number
    0
    3
    1
    Immune system disorders
    Allergy/immunology
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    2 / 184 (1.09%)
    0 / 185 (0.00%)
    3 / 99 (3.03%)
         occurrences all number
    2
    0
    5
    Reproductive system and breast disorders
    Sexual/reproductive function
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    0 / 184 (0.00%)
    1 / 185 (0.54%)
    1 / 99 (1.01%)
         occurrences all number
    0
    1
    1
    Respiratory, thoracic and mediastinal disorders
    Pulmonary/upper respiratory
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    8 / 184 (4.35%)
    12 / 185 (6.49%)
    8 / 99 (8.08%)
         occurrences all number
    9
    15
    11
    Cardiac disorders
    Cardiac arrythmia
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    4 / 185 (2.16%)
    3 / 99 (3.03%)
         occurrences all number
    4
    4
    3
    Cardiac general
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    42 / 184 (22.83%)
    43 / 185 (23.24%)
    24 / 99 (24.24%)
         occurrences all number
    45
    46
    24
    Nervous system disorders
    Neurology
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    26 / 184 (14.13%)
    22 / 185 (11.89%)
    11 / 99 (11.11%)
         occurrences all number
    31
    28
    13
    Blood and lymphatic system disorders
    Blood/bone marrow
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    51 / 184 (27.72%)
    42 / 185 (22.70%)
    9 / 99 (9.09%)
         occurrences all number
    90
    92
    15
    Coagulation
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    3 / 184 (1.63%)
    2 / 185 (1.08%)
    1 / 99 (1.01%)
         occurrences all number
    3
    3
    1
    Hemorrhage/bleeding
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    4 / 185 (2.16%)
    1 / 99 (1.01%)
         occurrences all number
    5
    4
    1
    Lymphatics
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    8 / 185 (4.32%)
    2 / 99 (2.02%)
         occurrences all number
    4
    8
    2
    Ear and labyrinth disorders
    Auditory/ear
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    3 / 184 (1.63%)
    1 / 185 (0.54%)
    1 / 99 (1.01%)
         occurrences all number
    3
    1
    1
    Eye disorders
    Ocular/visual
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    6 / 184 (3.26%)
    6 / 185 (3.24%)
    6 / 99 (6.06%)
         occurrences all number
    7
    6
    6
    Gastrointestinal disorders
    Gastrointestinal
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    53 / 184 (28.80%)
    50 / 185 (27.03%)
    27 / 99 (27.27%)
         occurrences all number
    65
    70
    29
    Hepatobiliary disorders
    Hepatobiliary/pancreas
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    4 / 184 (2.17%)
    1 / 185 (0.54%)
    0 / 99 (0.00%)
         occurrences all number
    4
    2
    0
    Skin and subcutaneous tissue disorders
    Dermatology/skin
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    10 / 184 (5.43%)
    21 / 185 (11.35%)
    10 / 99 (10.10%)
         occurrences all number
    10
    25
    12
    Renal and urinary disorders
    Renal/genitourinary
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    11 / 184 (5.98%)
    11 / 185 (5.95%)
    4 / 99 (4.04%)
         occurrences all number
    12
    11
    6
    Endocrine disorders
    Endocrine
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    3 / 184 (1.63%)
    7 / 185 (3.78%)
    2 / 99 (2.02%)
         occurrences all number
    3
    7
    2
    Musculoskeletal and connective tissue disorders
    Musculoskeletal/soft tissue
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    6 / 184 (3.26%)
    6 / 185 (3.24%)
    7 / 99 (7.07%)
         occurrences all number
    7
    6
    7
    Infections and infestations
    Infection
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    87 / 184 (47.28%)
    104 / 185 (56.22%)
    71 / 99 (71.72%)
         occurrences all number
    202
    226
    154
    Metabolism and nutrition disorders
    Metabolic/laboratory
    Additional description: All combined, see SAE chart for details
         subjects affected / exposed
    74 / 184 (40.22%)
    72 / 185 (38.92%)
    40 / 99 (40.40%)
         occurrences all number
    185
    156
    75

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    13 Oct 2010
    The study objective and statistical analysis of quality of life assessment are changed; Reporting of pregnancies is added; The grading of acute GvHD is corrected.
    17 May 2011
    Change of principal investigator; The registration of patients receiving a T-cell depleted allogenic SCT was added; An extra inclusion criterion for the second randomization was added; dose adjustment of cyclosporin A was added; deletion of a off protocol reason (infusion of donor lymphocytes);
    13 Mar 2012
    Change of principal investigator; Deletion of the section 'severe GvHD; The registration of patients receiving a T-cell depleted allogeneic SCT and that will be treated with immunosuppression according to local hospital policy is deleted form protocol. It was added in version 3, but has not been implemented; correction with regards to reporting of GvHD; Information requested at registering patient is corrected from “patient’s initials or code” into “local patient code (optional)”.
    17 Jul 2013
    Addition of an additional treatment arm with a short-course post-transplant GVHD prophylaxis consisting of high-dose cyclophosphamide. (introduction, objectives, study design, treatment, statistical considerations); Changed inclusion criterion regarding age; Changes in reason for going off protocol treatment with regards to development of GVHD; Added is the use of a Summary of Product Characteristics (SPC) for an authorized medicinal product in the definition of SUSAR.
    22 Apr 2014
    • Arm 3 Post transplant cyclophosphamide: Cyclosporine A treatment is extended to +70 days • Arm 3: Added option of cyclosporine A p.o. dose. • Arm 1 and 2: Date start cyclosporine A is changed to day -5 –day -3 (depending on local procedures). • Period of reporting adverse events is corrected (in accordance to earlier amendment • Exemptions of SAE reporting are clarified • Exemption of SAE reporting of chronic GvHD is limited to chronic GvHD not requiring systemic treatment. • Added is a monitoring of overall mortality to detect possible differences in relapse rate between arm 1 and arm 3.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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