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    Clinical Trial Results:
    Phase 2/3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Assess the Safety and Efficacy of Posoleucel (ALVR105, Viralym-M) Compared to Placebo for the Prevention of AdV, BKV, CMV, EBV, HHV-6, and JCV Infection and/or Disease, in High-Risk Patients After Allogeneic Hematopoietic Cell Transplant

    Summary
    EudraCT number
    2021-005105-27
    Trial protocol
    IT   FR   ES   BE  
    Global end of trial date
    30 Jan 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    05 May 2024
    First version publication date
    05 May 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    P-105-202
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05305040
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AlloVir, Inc
    Sponsor organisation address
    1100 Winter Street, Waltham, United States, MA 02451
    Public contact
    Clinical Trials Information Line, AlloVir, Inc., +1 833 409-2281, clinicaltrials@allovir.com
    Scientific contact
    Clinical Trials Information Line, AlloVir, Inc., +1 833 409-2281, clinicaltrials@allovir.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-002908-PIP01-20
    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?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    30 Jan 2024
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    30 Jan 2024
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To compare the efficacy of posoleucel (ALVR105) to placebo by the number of clinically significant infections or episodes of end-organ disease per patient due to Adenovirus (AdV), BK virus (BKV), Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Human herpes virus 6 (HHV-6), or JC virus (JCV) as determined by an independent, blinded Clinical Adjudication Committee (CAC) through Week 14.
    Protection of trial subjects
    This study was performed in accordance with Good Clinical Practice, including the archiving of essential documents.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    24 Mar 2022
    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
    Spain: 17
    Country: Number of subjects enrolled
    Belgium: 23
    Country: Number of subjects enrolled
    France: 44
    Country: Number of subjects enrolled
    Italy: 27
    Country: Number of subjects enrolled
    Australia: 6
    Country: Number of subjects enrolled
    Korea, Democratic People's Republic of: 34
    Country: Number of subjects enrolled
    Türkiye: 47
    Country: Number of subjects enrolled
    United States: 233
    Country: Number of subjects enrolled
    United Kingdom: 11
    Country: Number of subjects enrolled
    Canada: 9
    Worldwide total number of subjects
    451
    EEA total number of subjects
    111
    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)
    4
    Children (2-11 years)
    45
    Adolescents (12-17 years)
    22
    Adults (18-64 years)
    271
    From 65 to 84 years
    109
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants at high risk for viral infection after allogeneic Hematopoietic Cell Transplant were enrolled in the Phase 3 portion of study P-105-202 between Mar 2022 and Jan 2024. The Phase 3 study was discontinued in Dec 2023 after futility analysis of the Primary Outcome Measure. No safety concerns were identified.

    Pre-assignment
    Screening details
    A total of 451 participants were enrolled in this Phase 3 study. Due to the early termination of this study, 74 were not dosed. The 377 randomized participants that were dosed comprise the Safety Population and are presented in the participant flow.

    Pre-assignment period milestones
    Number of subjects started
    451
    Number of subjects completed
    377

    Pre-assignment subject non-completion reasons
    Reason: Number of subjects
    Randomized but not dosed: 74
    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Data analyst

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Posoleucel (ALVR105)
    Arm description
    Participants received posoleucel administered as 2-4 mL intravenous (IV) infusion once every 14 days for 7 doses.
    Arm type
    Experimental

    Investigational medicinal product name
    Posoleucel
    Investigational medicinal product code
    ALVR105
    Other name
    Viralym-M
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    2×10^7 cells or 4 × 10^7cells administered as a 2-4 mL IV infusion once every 14 days for 7 doses.

    Arm title
    Placebo
    Arm description
    Participants received placebo administered as 2-4 mL IV infusion once every 14 days for 7 doses.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Placebo was administered as a 2-4 mL IV infusion once every 14 days for 7 doses.

    Number of subjects in period 1 [1]
    Posoleucel (ALVR105) Placebo
    Started
    188
    189
    Completed
    100
    101
    Not completed
    88
    88
         Adverse event, serious fatal
    14
    13
         Consent withdrawn by subject
    15
    10
         Investigator's Decision
    1
    1
         Study Closure
    34
    46
         Adverse event, non-fatal
    3
    3
         Not Specified
    13
    10
         Graft versus host disease
    2
    -
         Lost to follow-up
    2
    1
         Primary Malignancy Relapse
    3
    4
         COVID-19 Reasons
    1
    -
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Of the participants that were randomized, 74 were not dosed and are not included in the baseline population. The baseline period represents the safety population which included all participants who received at least one dose of posoleucel or placebo.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Posoleucel (ALVR105)
    Reporting group description
    Participants received posoleucel administered as 2-4 mL intravenous (IV) infusion once every 14 days for 7 doses.

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo administered as 2-4 mL IV infusion once every 14 days for 7 doses.

    Reporting group values
    Posoleucel (ALVR105) Placebo Total
    Number of subjects
    188 189 377
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    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)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (full range (min-max))
    55.0 (1 to 77) 53.0 (0 to 75) -
    Gender categorical
    Units: Subjects
        Female
    78 66 144
        Male
    110 123 233
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    13 24 37
        Not Hispanic or Latino
    143 144 287
        Unknown or Not Reported
    32 21 53
    Race
    Units: Subjects
        American Indian or Alaskan Native
    1 1 2
        Asian
    25 21 46
        Black or African American
    7 5 12
        Native Hawaiian or Other Pacific Islander
    1 1 2
        White
    118 131 249
        Other
    9 8 17
        Unknown
    27 22 49

    End points

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    End points reporting groups
    Reporting group title
    Posoleucel (ALVR105)
    Reporting group description
    Participants received posoleucel administered as 2-4 mL intravenous (IV) infusion once every 14 days for 7 doses.

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo administered as 2-4 mL IV infusion once every 14 days for 7 doses.

    Primary: Average Number of Clinically Significant Infections or Episodes of End-Organ Disease Through Week 14

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    End point title
    Average Number of Clinically Significant Infections or Episodes of End-Organ Disease Through Week 14
    End point description
    The number of clinically significant infections or episodes of end-organ disease per participant due to AdV, BKV, CMV, EBV, HHV-6, or JCV. Analysis Population Description: Includes modified Intent-to-Treat (mITT) Population comprised of all randomized participants who received study drug and completed through Week 14 visit.
    End point type
    Primary
    End point timeframe
    Through Week 14
    End point values
    Posoleucel (ALVR105) Placebo
    Number of subjects analysed
    159
    155
    Units: Infections/Episodes per participant
        arithmetic mean (standard deviation)
    0.2 ( 0.44 )
    0.2 ( 0.42 )
    Statistical analysis title
    ANCOVA Analysis
    Comparison groups
    Placebo v Posoleucel (ALVR105)
    Number of subjects included in analysis
    314
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.5603 [1]
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    0.01
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.09
         upper limit
    0.1
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.049
    Notes
    [1] - 1-sided p-value

    Secondary: Average Number of Clinically Significant Infections or Episodes of End-Organ Disease Through Week 26

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    End point title
    Average Number of Clinically Significant Infections or Episodes of End-Organ Disease Through Week 26
    End point description
    The number of clinically significant infections or episodes of end-organ disease per participant due to AdV, BKV, CMV, EBV, HHV-6, or JCV.
    End point type
    Secondary
    End point timeframe
    Through Week 26
    End point values
    Posoleucel (ALVR105) Placebo
    Number of subjects analysed
    0 [2]
    0 [3]
    Units: Infections/Episodes per participant
        arithmetic mean (standard deviation)
    ( )
    ( )
    Notes
    [2] - Data not collected due to early termination of the study.
    [3] - Data not collected due to early termination of the study.
    No statistical analyses for this end point

    Secondary: Number of Participants With Clinically Significant Infections or Episodes of End-Organ Disease Due to Each Virus

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    End point title
    Number of Participants With Clinically Significant Infections or Episodes of End-Organ Disease Due to Each Virus
    End point description
    The number of participants with clinically significant infections or episodes of end-organ disease due to each of the following viruses: AdV, BKV, CMV, EBV, HHV-6, or JCV. Analysis Population Description: Includes mITT Population comprised of all randomized participants who received study drug and completed through Week 14 visit.
    End point type
    Secondary
    End point timeframe
    Through Week 14
    End point values
    Posoleucel (ALVR105) Placebo
    Number of subjects analysed
    159
    155
    Units: participants
        AdV
    3
    2
        BKV
    2
    2
        CMV
    16
    19
        EBV
    10
    6
        HHV-6
    0
    0
        JCV
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Day 1 through Week 26
    Adverse event reporting additional description
    Adverse events are reported for the Safety Population which included all participants who received at least one dose of posoleucel or placebo. Non-serious AEs can be calculated by subtracting the number of events from the serious AE table from the corresponding events in the combined table.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    Posoleucel (ALVR105)
    Reporting group description
    Participants received posoleucel (2×10^7 cells [if <40 kg body weight at screening] or 4 × 10^7cells [if ≥40 kg body weight at screening]), administered as a 2-4 mL intravenous (IV) infusion once every 14 days for 7 doses.

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo administered as a 2-4 mL IV infusion once every 14 days for 7 doses.

    Serious adverse events
    Posoleucel (ALVR105) Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    88 / 188 (46.81%)
    86 / 189 (45.50%)
         number of deaths (all causes)
    18
    19
         number of deaths resulting from adverse events
    18
    19
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Acute lymphocytic leukaemia recurrent
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myeloid leukaemia
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Acute myeloid leukaemia recurrent
         subjects affected / exposed
    1 / 188 (0.53%)
    6 / 189 (3.17%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 6
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Chronic lymphocytic leukaemia recurrent
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Leukaemia recurrent
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Myelodysplastic syndrome
         subjects affected / exposed
    2 / 188 (1.06%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Myelofibrosis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-Hodgkin's lymphoma
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Post transplant lymphoproliferative disorder
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Precursor T-lymphoblastic lymphoma/leukaemia recurrent
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Hypertensive crisis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypovolaemic shock
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    3 / 188 (1.60%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 1
    Fatigue
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fever and rigors
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Influenza like illness
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Positive cultures from indwelling CVAD
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    4 / 188 (2.13%)
    12 / 189 (6.35%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Systemic inflammatory response syndrome
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Acute graft versus host disease
         subjects affected / exposed
    1 / 188 (0.53%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Acute graft versus host disease in intestine
         subjects affected / exposed
    1 / 188 (0.53%)
    3 / 189 (1.59%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute graft versus host disease in liver
         subjects affected / exposed
    2 / 188 (1.06%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute graft versus host disease in skin
         subjects affected / exposed
    4 / 188 (2.13%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune disorder
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic graft versus host disease
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic graft versus host disease in liver
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic graft versus host disease in skin
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytokine release syndrome
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease
         subjects affected / exposed
    1 / 188 (0.53%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Graft versus host disease in gastrointestinal tract
         subjects affected / exposed
    7 / 188 (3.72%)
    7 / 189 (3.70%)
         occurrences causally related to treatment / all
    1 / 7
    1 / 7
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Graft versus host disease in liver
         subjects affected / exposed
    2 / 188 (1.06%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Graft versus host disease in skin
         subjects affected / exposed
    1 / 188 (0.53%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemophagocytic lymphohistiocytosis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    0 / 188 (0.00%)
    3 / 189 (1.59%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    4 / 188 (2.13%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Enterobacter test positive
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus antigen positive
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus test positive
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes simplex test positive
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Human rhinovirus test positive
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza A virus test positive
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver function test abnormal
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver function test increased
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory syncytial virus test positive
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Humerus fracture
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lumbar vertebral fracture
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haemorrhage
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transplant failure
         subjects affected / exposed
    3 / 188 (1.60%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Aplasia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac arrest
         subjects affected / exposed
    0 / 188 (0.00%)
    3 / 189 (1.59%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Cardiac failure
         subjects affected / exposed
    2 / 188 (1.06%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardio-respiratory arrest with sepsis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pericardial effusion
         subjects affected / exposed
    2 / 188 (1.06%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pericarditis
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Central nervous system lesion
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebellar haematoma
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Headache
         subjects affected / exposed
    3 / 188 (1.60%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Status epilepticus
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient aphasia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytopenia
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    4 / 188 (2.13%)
    6 / 189 (3.17%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Leukocytosis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombotic microangiopathy
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Warm autoimmune haemolytic anaemia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Papilloedema
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Strabismus
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Barrett's oesophagus
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    6 / 188 (3.19%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    1 / 6
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hospitalization for nausea and vomiting
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 188 (0.00%)
    3 / 189 (1.59%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct stone
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic necrosis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Hypertransaminasaemia
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    4 / 188 (2.13%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cystitis haemorrhagic
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Chondrocalcinosis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Adenoviral haemorrhagic cystitis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adenovirus infection
         subjects affected / exposed
    1 / 188 (0.53%)
    3 / 189 (1.59%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adenovirus reactivation
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anorectal infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspergillus infection
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    2 / 188 (1.06%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Bacterial sepsis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopulmonary aspergillosis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    5 / 188 (2.66%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Catheter site infection
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridial sepsis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cystitis viral
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytomegalovirus infection
         subjects affected / exposed
    3 / 188 (1.60%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cytomegalovirus infection reactivation
         subjects affected / exposed
    1 / 188 (0.53%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cytomegalovirus viraemia
         subjects affected / exposed
    2 / 188 (1.06%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related bacteraemia
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterobacter bacteraemia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis bacterial
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr viraemia
         subjects affected / exposed
    2 / 188 (1.06%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus infection
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epstein-Barr virus infection reactivation
         subjects affected / exposed
    2 / 188 (1.06%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fungal infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    2 / 188 (1.06%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes simplex
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Human bocavirus infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Human herpesvirus 6 infection reactivation
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella bacteraemia
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella sepsis
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Meningitis aseptic
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Norovirus infection
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Parainfluenzae virus infection
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Paronychia
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumococcal sepsis
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    4 / 188 (2.13%)
    4 / 189 (2.12%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Respiratory tract infection viral
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rotavirus infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    5 / 188 (2.66%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Sepsis with fever and rigor
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis with multiple organ failure
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Sinusitis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Systemic candida
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Toxoplasmosis
         subjects affected / exposed
    0 / 188 (0.00%)
    2 / 189 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tracheobronchitis
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular device infection
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral haemorrhagic cystitis
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 188 (0.53%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperglycaemic hyperosmolar nonketotic syndrome
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 188 (0.53%)
    0 / 189 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    0 / 188 (0.00%)
    1 / 189 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Posoleucel (ALVR105) Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    180 / 188 (95.74%)
    184 / 189 (97.35%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    16 / 188 (8.51%)
    7 / 189 (3.70%)
         occurrences all number
    16
    7
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    11 / 188 (5.85%)
    8 / 189 (4.23%)
         occurrences all number
    11
    8
    Fatigue
         subjects affected / exposed
    22 / 188 (11.70%)
    17 / 189 (8.99%)
         occurrences all number
    22
    17
    Oedema peripheral
         subjects affected / exposed
    17 / 188 (9.04%)
    20 / 189 (10.58%)
         occurrences all number
    17
    20
    Pyrexia
         subjects affected / exposed
    33 / 188 (17.55%)
    36 / 189 (19.05%)
         occurrences all number
    33
    36
    Immune system disorders
    Acute graft versus host disease
         subjects affected / exposed
    11 / 188 (5.85%)
    7 / 189 (3.70%)
         occurrences all number
    11
    7
    Acute graft versus host disease in skin
         subjects affected / exposed
    36 / 188 (19.15%)
    27 / 189 (14.29%)
         occurrences all number
    36
    27
    Graft versus host disease in gastrointestinal tract
         subjects affected / exposed
    24 / 188 (12.77%)
    16 / 189 (8.47%)
         occurrences all number
    24
    16
    Graft versus host disease in skin
         subjects affected / exposed
    15 / 188 (7.98%)
    15 / 189 (7.94%)
         occurrences all number
    15
    15
    Hypogammaglobulinaemia
         subjects affected / exposed
    6 / 188 (3.19%)
    12 / 189 (6.35%)
         occurrences all number
    6
    12
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    30 / 188 (15.96%)
    20 / 189 (10.58%)
         occurrences all number
    30
    20
    Dyspnoea
         subjects affected / exposed
    14 / 188 (7.45%)
    22 / 189 (11.64%)
         occurrences all number
    14
    22
    Oropharyngeal pain
         subjects affected / exposed
    9 / 188 (4.79%)
    14 / 189 (7.41%)
         occurrences all number
    9
    14
    Rhinorrhoea
         subjects affected / exposed
    10 / 188 (5.32%)
    5 / 189 (2.65%)
         occurrences all number
    10
    5
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    11 / 188 (5.85%)
    7 / 189 (3.70%)
         occurrences all number
    11
    7
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    14 / 188 (7.45%)
    16 / 189 (8.47%)
         occurrences all number
    14
    16
    Aspartate aminotransferase increased
         subjects affected / exposed
    9 / 188 (4.79%)
    11 / 189 (5.82%)
         occurrences all number
    9
    11
    Blood creatinine increased
         subjects affected / exposed
    30 / 188 (15.96%)
    22 / 189 (11.64%)
         occurrences all number
    30
    22
    Neutrophil count decreased
         subjects affected / exposed
    10 / 188 (5.32%)
    8 / 189 (4.23%)
         occurrences all number
    10
    8
    Platelet count decreased
         subjects affected / exposed
    22 / 188 (11.70%)
    15 / 189 (7.94%)
         occurrences all number
    22
    15
    White blood cell count decreased
         subjects affected / exposed
    12 / 188 (6.38%)
    8 / 189 (4.23%)
         occurrences all number
    12
    8
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    8 / 188 (4.26%)
    10 / 189 (5.29%)
         occurrences all number
    8
    10
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    10 / 188 (5.32%)
    12 / 189 (6.35%)
         occurrences all number
    10
    12
    Headache
         subjects affected / exposed
    22 / 188 (11.70%)
    22 / 189 (11.64%)
         occurrences all number
    22
    22
    Tremor
         subjects affected / exposed
    14 / 188 (7.45%)
    11 / 189 (5.82%)
         occurrences all number
    14
    11
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    26 / 188 (13.83%)
    24 / 189 (12.70%)
         occurrences all number
    26
    24
    Febrile neutropenia
         subjects affected / exposed
    10 / 188 (5.32%)
    9 / 189 (4.76%)
         occurrences all number
    10
    9
    Neutropenia
         subjects affected / exposed
    12 / 188 (6.38%)
    7 / 189 (3.70%)
         occurrences all number
    12
    7
    Thrombocytopenia
         subjects affected / exposed
    6 / 188 (3.19%)
    14 / 189 (7.41%)
         occurrences all number
    6
    14
    Eye disorders
    Dry eye
         subjects affected / exposed
    5 / 188 (2.66%)
    13 / 189 (6.88%)
         occurrences all number
    5
    13
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    25 / 188 (13.30%)
    16 / 189 (8.47%)
         occurrences all number
    25
    16
    Constipation
         subjects affected / exposed
    12 / 188 (6.38%)
    10 / 189 (5.29%)
         occurrences all number
    12
    10
    Diarrhoea
         subjects affected / exposed
    46 / 188 (24.47%)
    37 / 189 (19.58%)
         occurrences all number
    46
    37
    Nausea
         subjects affected / exposed
    36 / 188 (19.15%)
    22 / 189 (11.64%)
         occurrences all number
    36
    22
    Vomiting
         subjects affected / exposed
    29 / 188 (15.43%)
    21 / 189 (11.11%)
         occurrences all number
    29
    21
    Skin and subcutaneous tissue disorders
    Dry skin
         subjects affected / exposed
    10 / 188 (5.32%)
    9 / 189 (4.76%)
         occurrences all number
    10
    9
    Erythema
         subjects affected / exposed
    11 / 188 (5.85%)
    9 / 189 (4.76%)
         occurrences all number
    11
    9
    Pruritus
         subjects affected / exposed
    17 / 188 (9.04%)
    14 / 189 (7.41%)
         occurrences all number
    17
    14
    Rash
         subjects affected / exposed
    16 / 188 (8.51%)
    14 / 189 (7.41%)
         occurrences all number
    16
    14
    Rash maculo-papular
         subjects affected / exposed
    17 / 188 (9.04%)
    12 / 189 (6.35%)
         occurrences all number
    17
    12
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    14 / 188 (7.45%)
    6 / 189 (3.17%)
         occurrences all number
    14
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    8 / 188 (4.26%)
    11 / 189 (5.82%)
         occurrences all number
    8
    11
    Infections and infestations
    COVID-19
         subjects affected / exposed
    13 / 188 (6.91%)
    11 / 189 (5.82%)
         occurrences all number
    13
    11
    Cytomegalovirus infection
         subjects affected / exposed
    13 / 188 (6.91%)
    18 / 189 (9.52%)
         occurrences all number
    13
    18
    Cytomegalovirus infection reactivation
         subjects affected / exposed
    10 / 188 (5.32%)
    11 / 189 (5.82%)
         occurrences all number
    10
    11
    Pneumonia
         subjects affected / exposed
    11 / 188 (5.85%)
    14 / 189 (7.41%)
         occurrences all number
    11
    14
    Sepsis
         subjects affected / exposed
    10 / 188 (5.32%)
    3 / 189 (1.59%)
         occurrences all number
    10
    3
    Upper respiratory tract infection
         subjects affected / exposed
    5 / 188 (2.66%)
    14 / 189 (7.41%)
         occurrences all number
    5
    14
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    18 / 188 (9.57%)
    22 / 189 (11.64%)
         occurrences all number
    18
    22
    Hyperglycaemia
         subjects affected / exposed
    18 / 188 (9.57%)
    11 / 189 (5.82%)
         occurrences all number
    18
    11
    Hypokalaemia
         subjects affected / exposed
    23 / 188 (12.23%)
    12 / 189 (6.35%)
         occurrences all number
    23
    12
    Hypomagnesaemia
         subjects affected / exposed
    19 / 188 (10.11%)
    13 / 189 (6.88%)
         occurrences all number
    19
    13
    Hyponatraemia
         subjects affected / exposed
    10 / 188 (5.32%)
    7 / 189 (3.70%)
         occurrences all number
    10
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    27 Oct 2020
    Major revisions include: • Clarification on cell line change language • Clarification on retreatment option • Update to blood volume table • Update to Open Label Cohort Inclusion criteria • Clarification to unblinding section direction
    07 Apr 2021
    Major revisions include: • Extended the window for dosing post-HCT • Increased cap on percentage of patients receiving letermovir prophylaxis • Changes to inclusion/exclusion criteria • Assessment of viremia prior to randomization • Reduction in plasma samples collected in pediatric patients < 12 years of age • Updates to Schedule of Activities • Updated language regarding adverse events assessments • Treatment of Overdose • Updated Concomitant Therapy and Excluded Medications Sections • Definitions of clinical viremia, disease, and resolution • Infection Assessments • Updated Statistical Analysis Section • Updated Laboratory Tests • Updated Cytokine Release Syndrome Information • Changed references to the study drug from Viralym-M to posoleucel to conform to other company protocols.
    28 Jul 2021
    Major revisions include: • Randomized patients are now in one cohort, the Phase 3 study cohort. The open label cohort remains the same. Cohorts A and B were removed. • The study schema was updated to identify the Phase 3 study cohort and to be clearer on the timing of the Open Label cohort. Cohorts A and B were removed. • The inclusion criterion indicates that patients should have no known or suspected clinically significant disease from any of the 6 viruses. Inclusion criteria for viremia levels for Cohorts A and B were removed. • Exclusion criterion #2 regarding having evidence for more than 3 viruses was removed. • Removed optional pre-screening period to assess viral load because it is no longer necessary since patients are not assigned to cohort based on viral load. • A targeted percentage of patients not receiving letermovir is described.
    19 Oct 2021
    Major revisions include: • to add stratification factors • revise power and sample size • revise endpoints • remove visits and laboratories at odd numbered weeks for patients <12 years of age to reduce patient burden.
    11 Jan 2023
    Major revisions include: ● ALVR105 was changed to posoleucel throughout ● Clarifications made to language throughout protocol
    01 May 2023
    Major revisions include: • changes made to inclusion/exclusion criteria to capture the highest risk patients without compromising safety • removed requirement for engraftment for randomization. • engraftment now required prior to dosing with no change to criterion for confirming engraftment.

    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.
    The Phase 3 study was discontinued in Dec 2023 after futility analysis of the Primary Outcome Measure. No safety concerns were identified. The Phase 2 portion of study P-105-202 was not carried out within the EU.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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