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    Clinical Trial Results:
    Clinical phase II trial to describe the safety and efficacy of Treosulfan-based conditioning therapy prior to allogeneic haematopoietic stem cell transplantation in paediatric patients with haematological malignancies

    Summary
    EudraCT number
    2013-003604-39
    Trial protocol
    DE   PL   AT   CZ   GB   IT  
    Global end of trial date
    30 Sep 2019

    Results information
    Results version number
    v2(current)
    This version publication date
    16 May 2020
    First version publication date
    02 May 2018
    Other versions
    v1
    Version creation reason
    • New data added to full data set
    Study results were analyzed for the primary endpoint 12 month after the last trial subject completed the 12 months follow up visit and posted in May 2018. Meanwhile the long term 3-year follow up period of the trial was completed in Sep 2019 and therefore results will updated or added.

    Trial information

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    Trial identification
    Sponsor protocol code
    MC-FludT.17/M
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02333058
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    medac Gesellschaft für klinische Spezialpräparate mbH
    Sponsor organisation address
    Theaterstraße 6, Wedel, Germany, 22880
    Public contact
    Clinical Trial Disclosure Desk, medac GmbH, 0049 410380060, eudract@medac.de
    Scientific contact
    Medical Expert, medac GmbH, 0049 410380060, med-wiss@medac.de
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000883-PIP01-10
    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
    02 Dec 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Sep 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To describe the safety and efficacy of i.v. Treosulfan administered as part of a standardised Fludarabine-containing conditioning and to contribute to a pharmacokinetic (PK) model which permits - in conjunction with data comparing Treosulfan and Busulfan in adults with malignant diseases - to extend the use of Treosulfan in the paediatric population by extrapolating efficacy.
    Protection of trial subjects
    The DMC reviewed all available safety and efficacy data frequently at least every 6 months. PK blood sampling was performed only in a subset of trial subjects. A sparse sampling concept was used. Subjects’s data were transferred pseudonymously.
    Background therapy
    This trial protocol allowed administration of two different background conditioning regimens with Treosulfan : 1. Standard regimen A: Fludarabine i.v. (30 mg/m²/day) 2. Intensified regimen B: Fludarabine i.v. (30 mg/m²/day) plus ThioTEPA i.v. (2 x 5 mg/kg/day) The investigator decided for each individual patient whether to treat the patient with regimen A or with regimen B.
    Evidence for comparator
    NA
    Actual start date of recruitment
    01 Jul 2014
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy, Regulatory reason
    Long term follow-up duration
    2 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 37
    Country: Number of subjects enrolled
    United Kingdom: 10
    Country: Number of subjects enrolled
    Germany: 20
    Country: Number of subjects enrolled
    Italy: 2
    Country: Number of subjects enrolled
    Czech Republic: 1
    Worldwide total number of subjects
    70
    EEA total number of subjects
    70
    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)
    9
    Children (2-11 years)
    28
    Adolescents (12-17 years)
    33
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects fulfilled the criteria to be involved in the trial. According to GCP and the national regulations written informed consent was obtained from parent(s), legal guardian(s) or - if required by national law - by the subject. Informed assent was obtained from subjects.

    Pre-assignment
    Screening details
    No study specific screening phase was planned in this trial. All paediatric patients were routinely checked for their general eligibility for an allo-HSCT procedure. All examinations are part of routine care and are not considered study specific procedures.

    Period 1
    Period 1 title
    Baseline up to 12 month
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Treosulfan
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Treosulfan
    Investigational medicinal product code
    NA
    Other name
    Ovastat 1000, Treosulfan for injection, L-Threitol 1,4-bis(methanesulfonate)
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Patients were treated with BSA adapted Treosulfan doses. The treatment consists of 10 g/m² Treosulfan for patients with a BSA ≤ 0.5 m², 12 g/m² Treosulfan for a BSA > 0.5 to 1.0 m² or 14 g/m² Treosulfan for a BSA > 1.0 m² administered on three consecutive days (Days - 6, -5, -4).

    Number of subjects in period 1
    Treosulfan
    Started
    70
    Completed
    63
    Not completed
    7
         Death
    7
    Period 2
    Period 2 title
    Longer-term follow-up period
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    Treosulfan
    Arm description
    -
    Arm type
    Experimental

    Investigational medicinal product name
    Treosulfan
    Investigational medicinal product code
    NA
    Other name
    Ovastat 1000, Treosulfan for injection, L-Threitol 1,4-bis(methanesulfonate)
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Patients were treated with BSA adapted Treosulfan doses. The treatment consists of 10 g/m² Treosulfan for patients with a BSA ≤ 0.5 m², 12 g/m² Treosulfan for a BSA > 0.5 to 1.0 m² or 14 g/m² Treosulfan for a BSA > 1.0 m² administered on three consecutive days (Days - 6, -5, -4).

    Number of subjects in period 2
    Treosulfan
    Started
    63
    Completed
    56
    Not completed
    7
         Consent withdrawn by subject
    1
         Death
    5
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Treosulfan
    Reporting group description
    -

    Reporting group values
    Treosulfan Total
    Number of subjects
    70 70
    Age categorical
    Units: Subjects
        Infants and toddlers (28 days-23 months)
    9 9
        Children (2-11 years)
    28 28
        Adolescents (12-17 years)
    33 33
    Age continuous
    Units: years
        median (full range (min-max))
    9.5 (0 to 17) -
    Gender categorical
    Units: Subjects
        Female
    26 26
        Male
    44 44
    Disease
    Units: Subjects
        ALL - acute lymphoblastic leukaemia
    27 27
        AML - acute myeloid leukaemia
    29 29
        MDS - myelodysplastic syndrome
    10 10
        JMML - juvenile myelomonocytic leukaemia
    4 4
    Number of HSCT
    Units: Subjects
        First
    65 65
        Second
    5 5
    Donor type
    Units: Subjects
        MSD - matched sibling donor
    13 13
        MFD - matched family donor
    1 1
        MUD - matched unrelated donor
    56 56
    BSA - Body surface area
    Units: m²
        median (full range (min-max))
    1.10 (0.32 to 2.00) -

    End points

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    End points reporting groups
    Reporting group title
    Treosulfan
    Reporting group description
    -
    Reporting group title
    Treosulfan
    Reporting group description
    -

    Subject analysis set title
    Full Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The Full Analysis Set is equal to the Safety Analysis Set.

    Subject analysis set title
    Safety Analysis Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Analysis Set includes all subjects enrolled in the trial who have received at least one dose of Treosulfan.

    Primary: Freedom from Transplant (Treatment)-related Mortality - number

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    End point title
    Freedom from Transplant (Treatment)-related Mortality - number [1]
    End point description
    Freedom from Transplant (Treatment)-related Mortality until day +100 after HSCT - number of subjects with and without event The primary endpoint, freedom from transplant (treatment)-related mortality, was defined as death from any transplant-related cause from the day of first administration of trial medication (ie visit Day -6) until 100 days after HSCT.
    End point type
    Primary
    End point timeframe
    Until day +100 after HSCT
    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: No statistical analysis for comparison has been performed because this trial consists only of one treatment arm.
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: Subjects with event
        Without event
    69
        With event
    1
    No statistical analyses for this end point

    Primary: Freedom from Transplant (Treatment)-related Mortality - rate

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    End point title
    Freedom from Transplant (Treatment)-related Mortality - rate [2]
    End point description
    Freedom from Transplant (Treatment)-related Mortality until day +100 after HSCT - percentage of subjects without transplant (treatment) - related death. The primary endpoint, freedom from transplant (treatment)-related mortality, was defined as death from any transplant-related cause from the day of first administration of trial medication (ie visit Day -6) until 100 days after HSCT.
    End point type
    Primary
    End point timeframe
    Until day +100 after HSCT
    Notes
    [2] - 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: No statistical analysis for comparison has been performed because this trial consists only of one treatment arm.
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
        number (confidence interval 90%)
    98.6 (93.4 to 99.9)
    No statistical analyses for this end point

    Secondary: Engraftment of neutrophils - number

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    End point title
    Engraftment of neutrophils - number
    End point description
    Engraftment of neutrophils - number of subjects with and without Event. Time to engraftment was defined as the time span between end of HSCT and neutrophil engraftment. The date of reaching engraftment was the documented “date of engraftment”. Death from any cause, relapse/progression or use of rescue therapies until the date of primary graft failure or documentation of engraftment status (whatever occurred first) were competing events. The maximum conditional cumulative incidence is reported here.
    End point type
    Secondary
    End point timeframe
    Until day +100 after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        With event
    69
        Without event
    1
    No statistical analyses for this end point

    Secondary: Engraftment of neutrophils - conditional cumulative incidence

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    End point title
    Engraftment of neutrophils - conditional cumulative incidence
    End point description
    Engraftment of neutrophils - conditional cumulative incidence. Time to engraftment was defined as the time span between end of HSCT and neutrophil engraftment. The date of reaching engraftment was the documented “date of engraftment”. Death from any cause, relapse/progression or use of rescue therapies until the date of primary graft failure or documentation of engraftment status (whatever occurred first) were competing events. The maximum conditional cumulative incidence is reported here.
    End point type
    Secondary
    End point timeframe
    Until day +100 after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
        number (confidence interval 90%)
    100.00 (97.7 to 100.0)
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism at visit Day 28 - number

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    End point title
    Incidence of complete donor type chimerism at visit Day 28 - number
    End point description
    Incidence of complete donor type chimerism at visit Day +28. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Day +28
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: subjects
        With complete chimerism
    65
        Without complete chimerism
    3
        Without information
    1
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism visit Day +28 - rate

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    End point title
    Incidence of complete donor type chimerism visit Day +28 - rate
    End point description
    Incidence of complete donor type chimerism at visit Day +28. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Day +28
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: percent
        number (confidence interval 90%)
    94.2 (87.2 to 98.0)
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism visit Day +100 - number

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    End point title
    Incidence of complete donor type chimerism visit Day +100 - number
    End point description
    Incidence of complete donor type chimerism at visit Day +100. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Day +100
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: subjects
        With complete chimerism
    63
        Without complete chimerism
    6
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism at visit Day +100 - rate

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    End point title
    Incidence of complete donor type chimerism at visit Day +100 - rate
    End point description
    Incidence of complete donor type chimerism at visit Day +100. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Day +100
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: percent
        number (confidence interval 90%)
    91.3 (83.6 to 96.1)
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism at visit Month 12 - number

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    End point title
    Incidence of complete donor type chimerism at visit Month 12 - number
    End point description
    Incidence of complete donor type chimerism at visit Month 12. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Month 12
    End point values
    Full Analysis Set
    Number of subjects analysed
    57
    Units: subjects
        With complete chimerism
    52
        Without complete chimerism
    3
        Without information
    2
    No statistical analyses for this end point

    Secondary: Incidence of complete donor type chimerism at visit Month 12 - rate

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    End point title
    Incidence of complete donor type chimerism at visit Month 12 - rate
    End point description
    Incidence of complete donor type chimerism at visit Month 12. Based on the examinations (documented on the CRF), complete donor-type chimerism was defined if a value of >= 95% is detected. The incidences of complete donor-type chimerism were estimated as the number of subjects with complete chimerism divided by the total number of subjects at risk.
    End point type
    Secondary
    End point timeframe
    Visit Month 12
    End point values
    Full Analysis Set
    Number of subjects analysed
    57
    Units: percent
        number (confidence interval 90%)
    91.2 (82.4 to 96.5)
    No statistical analyses for this end point

    Secondary: Non-relapse mortality - number (cumulative)

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    End point title
    Non-relapse mortality - number (cumulative)
    End point description
    Non-relapse mortality (NRM) was defined as the probability of dying in the absence of persisting disease or previous occurrence of relapse/progression or graft failure. The associated time span was defined as the interval from end of HSCT to death from all causes without previous graft failure or relapse/progression of the underlying disease. Relapse/progression and graft failure were considered competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Subjects with event - month 12
    1
        Subjects with event - month 24
    2
        Subjects with event - month 36
    2
    No statistical analyses for this end point

    Secondary: Non-relapse mortality - cumulative incidence

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    End point title
    Non-relapse mortality - cumulative incidence
    End point description
    Non-relapse mortality (NRM) was defined as the probability of dying in the absence of persisting disease or previous occurrence of relapse/progression or graft failure. The associated time span was defined as the interval from end of HSCT to death from all causes without previous graft failure or relapse/progression of the underlying disease. Relapse/progression and graft failure were considered competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    1.4 (0.0 to 3.8)
        Month 24
    2.9 (0.0 to 6.1)
        Month 36
    2.9 (0.0 to 6.1)
    No statistical analyses for this end point

    Secondary: Primary graft failure - number

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    End point title
    Primary graft failure - number
    End point description
    The rate of primary graft failure was estimated as the number of subjects with primary graft failure divided by the total number of subjects receiving HSCT within the 12-months trial period. In the case that graft failure was ticked as “unknown” on the CRF and a relapse / progression was documented, the appropriate subject was not considered a graft failure but a disease relapse / progression.
    End point type
    Secondary
    End point timeframe
    Until 12 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: event
        Yes
    0
        No
    70
    No statistical analyses for this end point

    Secondary: Primary graft failure - rate

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    End point title
    Primary graft failure - rate
    End point description
    The rate of primary graft failure was estimated as the number of subjects with primary graft failure divided by the total number of subjects receiving HSCT within the 12-months trial period. In the case that graft failure was ticked as “unknown” on the CRF and a relapse / progression was documented, the appropriate subject was not considered a graft failure but a disease relapse / progression.
    End point type
    Secondary
    End point timeframe
    Until 12 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
        number (confidence interval 90%)
    0.0 (0.0 to 4.2)
    No statistical analyses for this end point

    Secondary: Secondary graft failure - number

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    End point title
    Secondary graft failure - number
    End point description
    The rate of secondary graft failure was estimated as the number of subjects with secondary graft failure divided by the total number of subjects who have engrafted after stem cell transplantation (ie alive without documented primary graft failure) within the 12-months trial period. In the case that graft failure was ticked as “unknown” on the CRF and a relapse / progression was documented, the appropriate subject was not considered a graft failure but a disease relapse / progression.
    End point type
    Secondary
    End point timeframe
    Until 12 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: events
        Yes
    1
        No
    68
    No statistical analyses for this end point

    Secondary: Secondary graft failure - rate

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    End point title
    Secondary graft failure - rate
    End point description
    The rate of secondary graft failure was estimated as the number of subjects with secondary graft failure divided by the total number of subjects who have engrafted after stem cell transplantation (ie alive without documented primary graft failure) within the 12-months trial period. In the case that graft failure was ticked as “unknown” on the CRF and a relapse / progression was documented, the appropriate subject was not considered a graft failure but a disease relapse / progression.
    End point type
    Secondary
    End point timeframe
    Until 12 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    69
    Units: percent
        number (confidence interval 90%)
    1.4 (0.1 to 6.7)
    No statistical analyses for this end point

    Secondary: Incidence of relapse/progression - number (cumulative)

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    End point title
    Incidence of relapse/progression - number (cumulative)
    End point description
    The incidence of relapse/progression (RI) was defined as the probability of having a relapse/progression of the underlying disease. Deaths without relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Subjects with event - month 12
    11
        Subjects with event - month 24
    16
        Subjects with event - month 36
    16
    No statistical analyses for this end point

    Secondary: Incidence of relapse/progression - cumulative incidence

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    End point title
    Incidence of relapse/progression - cumulative incidence
    End point description
    The incidence of relapse/progression (RI) was defined as the probability of having a relapse/progression of the underlying disease. Deaths without relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    15.7 (8.6 to 22.9)
        Month 24
    23.0 (14.7 to 31.3)
        Month 36
    23.0 (14.7 to 31.3)
    No statistical analyses for this end point

    Secondary: Relapse/progression-free survival - number (cumulative)

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    End point title
    Relapse/progression-free survival - number (cumulative)
    End point description
    Relapse-free/progression-free survival was defined as the time length between end of HSCT and the date of relapse/progression of the underlying disease or death due to any cause.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Events - month 12
    12
        Events - month 24
    19
        Events - month 36
    19
    No statistical analyses for this end point

    Secondary: Relapse/progression-free survival - rate

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    End point title
    Relapse/progression-free survival - rate
    End point description
    Relapse-free/progression-free survival was defined as the time length between end of HSCT and the date of relapse/progression of the underlying disease or death due to any cause.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    82.9 (73.9 to 89.0)
        Month 24
    72.7 (62.7 to 80.4)
        Month 36
    72.7 (62.7 to 80.4)
    No statistical analyses for this end point

    Secondary: Overall survival - number (cumulative)

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    End point title
    Overall survival - number (cumulative)
    End point description
    Overall survival (OS) after HSCT was defined as the probability of surviving. Survival time was defined as the time period between end of HSCT and the date of death due to any cause.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Death - month 12
    6
        Death - month 24
    10
        Death - month 36
    11
    No statistical analyses for this end point

    Secondary: Overall survival - rate

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    End point title
    Overall survival - rate
    End point description
    Overall survival (OS) after HSCT was defined as the probability of surviving. Survival time was defined as the time period between end of HSCT and the date of death due to any cause.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    91.4 (83.9 to 95.5)
        Month 24
    85.7 (77.1 to 91.2)
        Month 36
    84.3 (75.5 to 90.1)
    No statistical analyses for this end point

    Secondary: Acute GvHD grade I-IV - number

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    End point title
    Acute GvHD grade I-IV - number
    End point description
    Acute graft versus host disease of grades I to IV - number of subjects with and without Event Time to acute GvHD (aGvHD) was defined as the time between end of HSCT and the date of first occurrence of acute GvHD. Death, relapse/progression and graft failure within 100 days after end of HSCT were competing events.
    End point type
    Secondary
    End point timeframe
    Until 100 days after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        With event
    30
        Without event
    40
    No statistical analyses for this end point

    Secondary: Acute GvHD grade I-IV - cumulative incidence

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    End point title
    Acute GvHD grade I-IV - cumulative incidence
    End point description
    Acute graft versus host disease of grades I to IV - cumulative incidence Time to acute GvHD (aGvHD) was defined as the time between end of HSCT and the date of first occurrence of acute GvHD. Death, relapse/progression and graft failure within 100 days after end of HSCT were competing events.
    End point type
    Secondary
    End point timeframe
    Until 100 days after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
        number (confidence interval 90%)
    43.5 (33.7 to 53.3)
    No statistical analyses for this end point

    Secondary: Acute GvHD grade III-IV - number

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    End point title
    Acute GvHD grade III-IV - number
    End point description
    Acute graft versus host disease of grades III to IV - number of subjects with and without Event. Time to acute GvHD (aGvHD) was defined as the time between end of HSCT and the date of first occurrence of acute GvHD. Death, relapse/progression and graft failure within 100 days after end of HSCT were competing events.
    End point type
    Secondary
    End point timeframe
    Until 100 days after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        With event
    6
        Without event
    64
    No statistical analyses for this end point

    Secondary: Acute GvHD grade III-IV - cumulative incidence

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    End point title
    Acute GvHD grade III-IV - cumulative incidence
    End point description
    Acute graft versus host disease of grades III to IV - cumulative incidence. Time to acute GvHD (aGvHD) was defined as the time between end of HSCT and the date of first occurrence of acute GvHD. Death, relapse/progression and graft failure within 100 days after end of HSCT were competing events.
    End point type
    Secondary
    End point timeframe
    Until 100 days after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
        number (confidence interval 90%)
    8.7 (3.1 to 14.3)
    No statistical analyses for this end point

    Secondary: Overall chronic GvHD - number (cumulative)

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    End point title
    Overall chronic GvHD - number (cumulative)
    End point description
    Chronic graft versus host disease - number. Subjects are at risk (evaluable) for chronic GvHD (cGvHD) if they have survived 100 days after end of HSCT relapse/progression-free and graft-failure-free. In addition, subjects with premature trial termination at Day +100 visit are excluded from the risk set. Time to cGvHD was defined as the time between 100 days after end of HSCT and the first episode of cGvHD. Death, relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Events - month 12
    16
        Events - month 24
    17
        Events - month 36
    17
    No statistical analyses for this end point

    Secondary: Overall chronic GvHD - cumulative incidence

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    End point title
    Overall chronic GvHD - cumulative incidence
    End point description
    Chronic graft versus host disease - cumulative incidence Subjects are at risk (evaluable) for chronic GvHD (cGvHD) if they have survived 100 days after end of HSCT relapse/progression-free and graft-failure-free. In addition, subjects with premature trial termination at Day +100 visit are excluded from the risk set. Time to cGvHD was defined as the time between 100 days after end of HSCT and the first episode of cGvHD. Death, relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    23.9 (15.3 to 32.4)
        Month 24
    25.4 (16.6 to 34.1)
        Month 36
    25.4 (16.6 to 34.1)
    No statistical analyses for this end point

    Secondary: Moderate/severe chronic GvHD - number (cumulative)

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    End point title
    Moderate/severe chronic GvHD - number (cumulative)
    End point description
    Moderate or severe chronic graft versus host disease - number of patients with and without Event. Subjects are at risk (evaluable) for chronic GvHD (cGvHD) if they have survived 100 days after end of HSCT relapse/progression-free and graft-failure-free. In addition, subjects with premature trial termination at Day +100 visit are excluded from the risk set. Time to cGvHD was defined as the time between 100 days after end of HSCT and the first episode of cGvHD. Death, relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: subjects
        Events - month 12
    12
        Events - month 24
    13
        Events - month 36
    13
    No statistical analyses for this end point

    Secondary: Moderate/severe chronic GvHD - cumulative incidence

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    End point title
    Moderate/severe chronic GvHD - cumulative incidence
    End point description
    Moderate or severe chronic graft versus host disease - cumulative incidence. Subjects are at risk (evaluable) for chronic GvHD (cGvHD) if they have survived 100 days after end of HSCT relapse/progression-free and graft-failure-free. In addition, subjects with premature trial termination at Day +100 visit are excluded from the risk set. Time to cGvHD was defined as the time between 100 days after end of HSCT and the first episode of cGvHD. Death, relapse/progression and graft failure are competing events.
    End point type
    Secondary
    End point timeframe
    12, 24 and 36 months after HSCT
    End point values
    Full Analysis Set
    Number of subjects analysed
    70
    Units: percent
    number (confidence interval 90%)
        Month 12
    17.9 (10.2 to 25.6)
        Month 24
    19.4 (11.5 to 27.4)
        Month 36
    19.4 (11.5 to 27.4)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Until 100 days after HSCT
    Adverse event reporting additional description
    Adverse event reporting was based on the Safety Analysis Set. This includes all subjects enrolled in the trial who have received at least one dose of Treosulfan.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    CTCAE
    Dictionary version
    4.03
    Reporting groups
    Reporting group title
    Treosulfan
    Reporting group description
    -

    Serious adverse events
    Treosulfan
    Total subjects affected by serious adverse events
         subjects affected / exposed
    23 / 70 (32.86%)
         number of deaths (all causes)
    7
         number of deaths resulting from adverse events
    1
    Nervous system disorders
    Encephalopathy
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tremor
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Fever
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Allergic reaction
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Enterocolitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mucositis oral
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper gastrointestinal hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Laryngeal hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Pulmonary edema
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Infections and infestations - Other, specify
         subjects affected / exposed
    6 / 70 (8.57%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Upper respiratory infection
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Catheter related infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Encephalitis infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatitis viral
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sinusitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    Treosulfan
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    68 / 70 (97.14%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    21 / 70 (30.00%)
         occurrences all number
    33
    Hematoma
         subjects affected / exposed
    7 / 70 (10.00%)
         occurrences all number
    8
    Hypotension
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Capillary leak syndrome
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Peripheral ischemia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Thromboembolic event
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Vascular disorders - Other, specify
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    General disorders and administration site conditions
    Fever
         subjects affected / exposed
    51 / 70 (72.86%)
         occurrences all number
    96
    Fatigue
         subjects affected / exposed
    6 / 70 (8.57%)
         occurrences all number
    6
    Edema face
         subjects affected / exposed
    5 / 70 (7.14%)
         occurrences all number
    6
    Infusion related reaction
         subjects affected / exposed
    5 / 70 (7.14%)
         occurrences all number
    6
    Chills
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    5
    Edema limbs
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Pain
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Localized edema
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Edema trunk
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Flu like symptoms
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Infusion site extravasation
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Injection site reaction
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Immune system disorders
    Allergic reaction
         subjects affected / exposed
    12 / 70 (17.14%)
         occurrences all number
    17
    Cytokine release syndrome
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Reproductive system and breast disorders
    Breast pain
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Menorrhagia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Testicular pain
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Uterine hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Vaginal hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    13 / 70 (18.57%)
         occurrences all number
    21
    Nasal congestion
         subjects affected / exposed
    7 / 70 (10.00%)
         occurrences all number
    9
    Dyspnea
         subjects affected / exposed
    5 / 70 (7.14%)
         occurrences all number
    5
    Pneumonitis
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Sore throat
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    6
    Epistaxis
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Pulmonary edema
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Respiratory, thoracic and mediastinal disorders - Other, specify
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Sneezing
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Hiccups
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Hypoxia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Laryngopharyngeal dysesthesia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Pharyngolaryngeal pain
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Wheezing
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Delirium
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Depression
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Insomnia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Psychiatric disorders - Other, specify
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    12
    Blood bilirubin increased
         subjects affected / exposed
    9 / 70 (12.86%)
         occurrences all number
    11
    Alanine aminotransferase increased
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    8
    Investigations - Other, specify
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    5
    Creatinine increased
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    5
    GGT increased
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    INR increased
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Alkaline phosphatase increased
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Fibrinogen decreased
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Weight loss
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Bruising
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Fall
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Burn
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Postoperative hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Vascular access complication
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Cardiac disorders
    Sinus tachycardia
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    9
    Sinus bradycardia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Heart failure
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    19 / 70 (27.14%)
         occurrences all number
    28
    Lethargy
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Tremor
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    7
    Dysesthesia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Paresthesia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Peripheral motor neuropathy
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Peripheral sensory neuropathy
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Blood and lymphatic system disorders
    Blood and lympatic disorders - Other, specify
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Febrile neutropenia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Hemolysis
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Thrombotic thrombocytopenic purpura
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Eye disorders
    Blurred vision
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Eye pain
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    5
    Conjunctivitis
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Eye disorders - Other, specify
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Dry eye
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Optic nerve disorder
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Vitreous hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Gastrointestinal disorders
    Mucositis oral
         subjects affected / exposed
    54 / 70 (77.14%)
         occurrences all number
    57
    Vomiting
         subjects affected / exposed
    48 / 70 (68.57%)
         occurrences all number
    95
    Diarrhea
         subjects affected / exposed
    46 / 70 (65.71%)
         occurrences all number
    69
    Nausea
         subjects affected / exposed
    32 / 70 (45.71%)
         occurrences all number
    53
    Abdominal pain
         subjects affected / exposed
    22 / 70 (31.43%)
         occurrences all number
    49
    Constipation
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    10
    Oral pain
         subjects affected / exposed
    5 / 70 (7.14%)
         occurrences all number
    7
    Dyspepsia
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Anal pain
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Dysphagia
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Stomach pain
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Abdominal distension
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Anal mucositis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Enterocolitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Esophageal pain
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Esophagitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Gastritis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Oral hemorrhage
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Pancreatitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Rectal mucositis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Rectal pain
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Toothache
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Typhlitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Hepatobiliary disorders
    Hepatobiliary disorders - Other, specify
         subjects affected / exposed
    25 / 70 (35.71%)
         occurrences all number
    29
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    20 / 70 (28.57%)
         occurrences all number
    29
    Pruritus
         subjects affected / exposed
    13 / 70 (18.57%)
         occurrences all number
    17
    Skin and subcutaneous tissue disorders - Other, specify
         subjects affected / exposed
    11 / 70 (15.71%)
         occurrences all number
    22
    Erythema multiforme
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    9
    Pain of skin
         subjects affected / exposed
    8 / 70 (11.43%)
         occurrences all number
    8
    Dry skin
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    4
    Erythroderma
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Skin hyperpigmentation
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Periorbital edema
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Rash acneiform
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Skin ulceration
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Urticaria
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    3
    Alopecia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Bullous dermatitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Palmar-plantar erythrodysesthesia syndrome
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Renal and urinary disorders
    Hematuria
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    5
    Urinary tract pain
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    4
    Acute kidney injury
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Bladder spasm
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Cystitis noninfective
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Renal and urinary disorders - Other, specify
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Endocrine disorders
    Hypothyroidism
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    13 / 70 (18.57%)
         occurrences all number
    19
    Bone pain
         subjects affected / exposed
    7 / 70 (10.00%)
         occurrences all number
    7
    Back pain
         subjects affected / exposed
    6 / 70 (8.57%)
         occurrences all number
    6
    Myalgia
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Arthralgia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Arthritis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Chest wall pain
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Infections and infestations
    Infections and infestations - Other, specify
         subjects affected / exposed
    43 / 70 (61.43%)
         occurrences all number
    113
    Catheter related infection
         subjects affected / exposed
    6 / 70 (8.57%)
         occurrences all number
    6
    Urinary tract infection
         subjects affected / exposed
    6 / 70 (8.57%)
         occurrences all number
    6
    Bladder infection
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Bronchial infection
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Enterocolitis infectious
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Mucosal infection
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Sepsis
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Skin infection
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    4
    Upper respiratory infection
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Conjunctivitis infective
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Laryngitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Nail infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Papulopustular rash
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    2
    Penile infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Rhinitis infective
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Sinusitis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Soft tissue infection
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Hypokalemia
         subjects affected / exposed
    11 / 70 (15.71%)
         occurrences all number
    11
    Hypomagnesemia
         subjects affected / exposed
    4 / 70 (5.71%)
         occurrences all number
    6
    Iron overload
         subjects affected / exposed
    3 / 70 (4.29%)
         occurrences all number
    3
    Glucose intolerance
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Hyperglycemia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Hyperkalemia
         subjects affected / exposed
    2 / 70 (2.86%)
         occurrences all number
    2
    Alkalosis
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Anorexia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1
    Hypercalcemia
         subjects affected / exposed
    1 / 70 (1.43%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    24 Jun 2014
    Relevant changes were: • Modification of treatment Regimen B • The schedule of assessments was revised • The reference for the grading of GvHD and cGvHD was adapted.
    28 Jul 2015
    Relevant changes were: • Specification inclusion and exclusion criteria • Specification on SAE/SAR reporting and time frame of reporting pregnancies • Specification on conditioning treatment • Specifications for secondary endpoints and PK sampling • Specification on documentation of concomitant medication • Specification on statistical data analysis
    25 Apr 2016
    Relevant changes were: • Specification on reference safety information • Specification on PK sampling • Revision of patient information documents
    20 Feb 2017
    • CRO change was implemented • Clarification on a secondary endpoint • Deletion on country-specific information

    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
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