This study aimed to investigate the efficacy and safety of Pegaspargase together with liposomal doxorubicin, etoposide and high dose methylprednisolone (L-DEP) as an initial treatment for Epstein Barr virus-induced hemophagocytic lymphohistiocytosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
120
2000U/m2 day5
25 mg/m2 day 1
100 mg/m2 was administered once on the first day of every week
Beijing Friendship Hospital, Capital Medical University
Beijing, Beijing Municipality, China
RECRUITINGOverall response(complete response+ partial response) rate of Participants
A complete response was defined as normalization of all of the quantifiable symptoms and laboratory markers of HLH, including levels of sCD25(pg/ml), ferritin(μg/L), and triglyceride(mmol/L); hemoglobin(g/L); neutrophil counts(×109/L); platelet counts(×109/L); and alanine aminotransferase (ALT(U/L)). A partial response was defined as at least a 25% improvement in 2 or more quantifiable symptoms and laboratory markers as follows: sCD25(pg/ml) response was\>1.5-fold decreased; ferritin (μg/L)and triglyceride(mmol/L) decreased at least 25%; for patients with an initial neutrophil count of\<0.5 ×109/L, a response was defined as an increase by at least 100% to\>0.5× 109/L; for patients with a neutrophil count of 0.5 to 2.0 × 109/L, an increase by at least 100% to \>2.0 × 109/L was considered a response; and for patients with ALT \>400 U/L, response was defined as an ALT (U/L)decrease of at least 50%.
Time frame: Change from before and 2,4,6 and 8 weeks after initiating L-DEP or HLH-94 therapy
Compare survival between two arms
Time frame: from the time patients received L-DEP or HLH-94 therapy up to 12 months or September 2019
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Adverse events including pancreatitis, liver function damage, myelosuppression, infection, bleeding and so on.
Time frame: through study completion, an average of 1 years
Change of Epstein-Barr virus(EBV)-DNA before and after therapy
Time frame: Change from before and 2, 4, 6 and 8 weeks after initiating L-DEP or HLH-94 therapy
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15 mg/kg days 1 to 3, 0.75 mg/kg days 4 to 7
150 mg/m2 twice weekly for 2 weeks and then weekly
initially 10 mg/m2 for 2 weeks followed by 5 mg/m2 for 2 weeks, 2.5 mg/m2 for 2 weeks, 1.25 mg/m2 for one week, and one week of tapering