The aim of the current study is to evaluate the efficacy of combined regimen of GVHD prophylaxis with thymoglobulin in conditioning regimen and PTCY with ruxolitinib used after HSCT in patients with inborn errors of immunity (IEI)
Hematopoietic stem cell transplantation (HSCT) is widely used in inborn errors of immunity (IEI), and risks of graft-versus-host disease (GVHD) remain high. Use of post-transplant cyclophosphamide (PTCY) for GVHD prophylaxis revolutionized the outcomes of HSCT from mismatched related donor (MMRD). Use of ruxolitinib for GVHD prophylaxis demonstrates promising results in adult patients. Another well-known option for GVHD prevention is antithymocyte globulin. To evaluate the efficacy of combination of thymoglobulin with PTCY and ruxolitinib for GVHD prophylaxis, conditioning regimen containing treosulfan 30-42 g/m2, fludarabine 150 mg/mg, and thiotepa 10 mg/kg or melphalan 140 mg/m2 and GVHD prophylaxis regimen containing cyclophosphamide 50 mg/kg for MMRD, 25 mg/kg for matched unrelated and related donors at days +3, 4 post-HSCT and ruxolitinib at dose 7 mg/m2 from day +5 after HSCT will be used in patients with IEI.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Cyclophosphamide 25mg/kg (days +3, +4) after HSCT from MUD and MRD Cyclophosphamide 50mg/kg (days +3, +4) after HSCT from MMRD
Ruxolitinib 7 mg/m2 from day +5 after HSCT
HSCT department
Moscow, Russia
RECRUITINGEvent-free survival
Events: graft failure, death
Time frame: 1 year after HSCT
Overall survival
Time frame: 1 year after HSCT
Cumulative incidence of acute graft versus host disease
Time frame: 1 year after HSCT
Cumulative incidence of chronic graft versus host disease
Time frame: 1 year after HSCT
Cumulative incidence of engraftment
Time frame: 100 days
Cumulative incidence of graft failure
Time frame: 1 year after HSCT
Incidence of early organ toxicity
Time frame: 100 days
Cumulative incidence of transplant related mortality
Time frame: 1 year after HSCT
Cumulative incidence of viral infections
Time frame: 1 year after HSCT
Investigation of the concentration of ruxolitinib in the blood To investigate the pharmacokinetics of ruxolitinib
The features of pharmacokinetics in children of different ages
Time frame: 1 month after HSCT
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