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Effects of Antithymocyte Globulin in Adults With Myelodysplastic Syndrome
This study is currently recruiting participants.
Verified by Office of Rare Diseases (ORD), September 2008
Sponsors and Collaborators: Office of Rare Diseases (ORD)
Rare Diseases Clinical Research Network
Information provided by: Office of Rare Diseases (ORD)
ClinicalTrials.gov Identifier: NCT00466843
  Purpose

Myelodysplastic syndrome (MDS) is a rare, potentially serious bone marrow disease. Currently available treatments for MDS have been only somewhat beneficial. The purpose of this study is to determine the effects of the medication antithymocyte globulin (ATG) in adults with MDS and to determine which individuals with MDS are most likely to benefit from treatment with ATG.


Condition Intervention Phase
Myelodysplastic Syndrome
Drug: Antithymocyte globulin (ATG)
Drug: Prednisone
Phase II

Drug Information available for: Prednisone
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Mechanism and Response of Thymoglobulin in Patients With Myelodysplastic Syndrome (MDS)

Further study details as provided by Office of Rare Diseases (ORD):

Primary Outcome Measures:
  • Bone marrow response and hematologic improvement [ Time Frame: Measured at Week 16 or 24 ] [ Designated as safety issue: No ]
  • Bone marrow cytogenetic response [ Time Frame: Measured at Week 16 or 24 ] [ Designated as safety issue: No ]

Estimated Enrollment: 54
Study Start Date: April 2007
Estimated Study Completion Date: February 2010
Estimated Primary Completion Date: February 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Participants will be treated with ATG
Drug: Antithymocyte globulin (ATG)
ATG 2.5 mg/kg/day via IV will be given for 4 doses. Each participant will receive only one cycle of therapy. The daily infusion will be administered over at least 6 hours and slowed as necessary to minimize infusion-related symptoms.
Drug: Prednisone
All participants will be pre-treated with prednisone (1 mg/kg/day by mouth) 2 days prior to the first ATG does and continuing for 14 days after the final dose to prevent serum sickness

Detailed Description:

In people with MDS, the bone marrow stops making healthy blood cells and instead produces poorly functioning, malformed, and immature blood cells. This can lead to anemia resulting from too few healthy red blood cells, infection resulting from too few healthy white blood cells, and bleeding resulting from too few healthy platelets. The exact cause of MDS remains unknown, but it may be caused by abnormal autoimmune activity in which activated T cells, a type of white blood cell, prevent normal bone marrow production. ATG, a medication that inhibits immune function, can restore normal blood production in some people with MDS, but it is not known how this happens and why it does not happen in all MDS patients. The purpose of this study is to examine the effects of ATG in adults with MDS and to determine which individuals with MDS are most likely to benefit from treatment with ATG.

Based on disease severity and likely disease progression, participants will be separated into either a high-risk group or a low-risk group. Participants will be hospitalized for a 4-day period during which they will receive daily infusions of ATG. Oral prednisone will be given 2 days before hospitalization, throughout hospitalization, and then for 14 days after hospitalization to limit the side effects of ATG. Antihistamines and acetaminophen will also be given during hospitalization to reduce the chances of an allergic reaction to ATG. After discharge, all participants will attend monthly study visits that will include blood collection, review of disease symptoms, and evaluation of medication response. At Week 16, participants in the high-risk group will undergo additional blood collection, a bone marrow biopsy, and a thorough evaluation of disease progression and the effects of MDS on daily living abilities. Participants in the low-risk group will undergo these same procedures at Week 24. Follow-up for all participants may last up to 2 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of MDS that meets International Prognostic Scoring System (IPSS) criteria for low risk, intermediate-1 risk, or intermediate-2 risk. More information about this criterion can be found in the protocol.
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2
  • Willing and able to attend study visits
  • Willing to use acceptable forms of contraception prior to study entry and for the duration of the study

Exclusion Criteria:

  • Any serious medical illness that might limit survival to less than 2 years
  • Any other uncontrolled condition or illness. More information about this criterion can be found in the protocol.
  • Prior anti-lymphocyte serotherapy (received serum from an immunized animal)
  • Proliferative chronic myelomonocytic leukemia
  • MDS that is caused by radiotherapy, chemotherapy, and/or immunotherapy for cancerous or autoimmune diseases
  • Previous or current cancer. More information about this criterion can be found in the protocol.
  • Receiving any other investigational agents
  • Certain abnormal lab values. More information about this criterion can be found in the protocol.
  • History of a grade 2 National Cancer Institute common toxic criteria allergic reaction to rabbit proteins
  • Psychiatric illness that might interfere with study participation
  • HIV-1 infection
  • Pregnancy or breastfeeding
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00466843

Locations
United States, California
UCLA Oncology Center Not yet recruiting
Los Angeles, California, United States, 90095
Contact: Troy Overfield         toverfield@mednet.ucla.edu    
Principal Investigator: Ronald Paquette, MD            
United States, Florida
H. Lee Moffitt Cancer Center Recruiting
Tampa, Florida, United States, 33612
Contact: Tera Uliano, RN     813-745-1706        
Principal Investigator: Alan List, MD            
United States, Ohio
Cleveland Clinic Foundation - Case Western University Recruiting
Cleveland, Ohio, United States, 44195
Contact: Robin Heggeland, RN         heggelr@ccf.org    
Principal Investigator: Jaroslaw P. Maciejewski, MD, PhD            
United States, Pennsylvania
Penn State University Recruiting
Hershey, Pennsylvania, United States, 17033
Contact: Lynn Ruiz         lruiz@psu.edu    
Principal Investigator: Thomas P. Loughran, Jr., MD            
Sponsors and Collaborators
Rare Diseases Clinical Research Network
Investigators
Principal Investigator: Alan List, MD H. Lee Moffitt Cancer Center
  More Information

Publications:
Responsible Party: H. Lee Moffitt Cancer Center ( Alan List, MD )
Study ID Numbers: RDCRN 5406
Study First Received: April 25, 2007
Last Updated: September 2, 2008
ClinicalTrials.gov Identifier: NCT00466843  
Health Authority: United States: Federal Government

Keywords provided by Office of Rare Diseases (ORD):
Abnormal hematopoiesis
Leukemia
Autoimmune Disease

Study placed in the following topic categories:
Antilymphocyte Serum
Myelodysplastic syndromes
Prednisone
Leukemia
Preleukemia
Autoimmune Diseases
Precancerous Conditions
Hematologic Diseases
Myelodysplasia
Myelodysplastic Syndromes
Bone Marrow Diseases

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Disease
Immunologic Factors
Antineoplastic Agents, Hormonal
Antineoplastic Agents
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Immunosuppressive Agents
Glucocorticoids
Hormones
Pharmacologic Actions
Neoplasms
Pathologic Processes
Therapeutic Uses
Syndrome

ClinicalTrials.gov processed this record on January 15, 2009