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Phase 1 N=55 Treatment

Study of Itacitinib for the Prophylaxis of Graft-Versus-Host Disease and Cytokine Release Syndrome After T-cell Replete Haploidentical Peripheral Blood Hematopoietic Cell Transplantation

Acute Myelogenous Leukemia · Acute Lymphocytic Leukemia · Myelodysplastic Syndromes · Non-Hodgkin Lymphoma · Hodgkin Disease

Enrolled (actual)
55
Serious AEs
82.6%
Results posted
Apr 2025
Primary outcome: Primary: Number of Participants With Graft Failure (Pilot Study Only) — 0 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 1
Interventions
Stem cell transplantation (Procedure); Itacitinib (Drug); Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) (Other); Human Activity Profile (Other)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Washington University School of Medicine
Primary completion
Apr 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants With Graft Failure (Pilot Study Only)
PRIMARY
Number of Participants With Grades III-IV Acute GVHD
0; 0
SECONDARY
Number of Participants Who Experience Cytokine Release Syndrome (CRS)
18; 15; 5; 1
SECONDARY
Number of Participants With Treatment Related Mortality
0; 0
SECONDARY
Cumulative Incidence of Grades II-IV Acute GVHD (Expansion Phase)
20

Summary

In this trial, the investigators will begin to explore the possibility that, as in mice, janus kinase inhibitor 1 (JAK1) inhibition with haploidentical-hematopoietic cell transplantation (HCT) may mitigate graft-versus-host-disease (GVHD) and cytokine release syndrome (CRS) while retaining Graft-versus-Leukemia (GVL) and improving engraftment. The purpose of this pilot study is to determine the safety of itacitinib with haplo-hematopoietic cell transplantation (HCT) measured by the effect on engraftment and grade III-IV GVHD.

Eligibility Criteria

Inclusion Criteria

Patients must meet the following criteria within 30 days prior to Day 0 unless otherwise noted.

  • Diagnosis of a hematological malignancy listed below:
  • Acute myelogenous leukemia (AML) in complete morphological remission (based on International Working Group (IWG) Criteria)
  • Acute lymphocytic leukemia (ALL) in complete morphological remission (MRD negative, based on IWG Criteria)
  • Myelodysplastic syndrome with ≤ 5% blasts in bone marrow.
  • Non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD) in 2nd or greater complete or partial remission.
  • Planned treatment is myeloablative or reduced intensity conditioning followed by T Cell-replete peripheral blood haploidentical donor transplantation
  • Available human leukocyte antigen (HLA)-haploidentical donor who meets the following criteria:
  • Blood-related family member, including (but not limited to) sibling, offspring, cousin, nephew, or parent. Younger donors should be prioritized.
  • At least 18 years of age
  • HLA-haploidentical donor/recipient match by at least low-resolution typing per institutional standards.
  • In the investigator's opinion, is in general good health, and medically able to tolerate leukapheresis required for harvesting hematopoietic stem cells (HSC).
  • No active hepatitis.
  • Negative for human T-cell lymphotrophic virus (HTLV) and human immunodeficiency virus (HIV).
  • Not pregnant.
  • Safety Lead-In Phase: For the first three patients, the donor must consent to a second product collection should it prove necessary.
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Adequate organ function as defined below:
  • Total bilirubin must be within normal range at baseline
  • Aspartate aminotransferase (AST)(SGOT) and alanine aminotransferase (ALT) (SGPT) ≤ 3.0 x institutional upper limit of normal (IULN).
  • Creatinine ≤ 1.5 x IULN OR creatinine clearance ≥ 45 mL/min/1.73 m^2 by Cockcroft-Gault Formula.
  • Oxygen saturation ≥ 90% on room air.
  • Left ventricular ejection fraction (LVEF) ≥ 40%.
  • Forced expiratory volume (FEV1) and forced vital capacity (FVC) ≥ 40% predicted, diffusing capacity of the lung for carbon monoxide (DLCOc) ≥ 40% predicted. If DLCO is 35 days after transplant.
  • Must not receive antithymocyte globulin as part of pre-transplant conditioning regimens.
  • Currently receiving or has received any investigational drugs within the 14 days prior to the first dose of study drug (Day -3).
  • Pregnant and/or breastfeeding.
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, autoimmune disease, symptomatic congestive heart failure, unstable angina pectoris, unstable cardiac arrhythmias, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Immunosuppressive doses of steroids. Subjects with steroids for adrenal insufficiency will not be excluded.

Additional Inclusion Criteria Under Amendment 5

  • Five subjects with myelofibrosis will be enrolled in the expansion phase.
  • Three patients whose donors fail to collect the target number of CD34+ cells and the treating physician choses to move forward with the haplo-HCT will be enrolled in the expansion phase.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03755414). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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