Randomized, Placebo-Controlled, Phase II Trial Examining Ustekinumab for Prevention of Graft vs. Host Disease after Allogeneic Hematopoietic Cell Transplantation
Summary
This phase II trial studies how well ustekinumab works in preventing acute graft versus host disease after unrelated donor hematopoietic cell transplant. Sometimes the transplanted cells from a donor can attack the body's normal tissues (called graft-versus-host disease). Giving ustekinumab after the transplant may help prevent acute graft versus host disease by controlling the body's immune response.
Objective
The primary objective of this trial is to determine the grade II-IV acute GVHD-free survival at 6 months post-HCT when ustekinumab is combined with standard of care pharmacologic GVHD prophylaxis.
Secondary:
1. Estimate the cumulative incidence of grade II-IV and grade III-IV acute GVHD for both ustekinumab- and placebo-treated subjects.
2. Compare acute GVHD organ involvement and severity between ustekinumab- and placebo-treated subjects.
3. Examine the cumulative incidence of NIH-defined overall chronic GVHD, and NIH moderate-severe chronic GVHD for ustekinumab- and placebo-treated subjects.
4. Estimate post-HCT relapse, non-relapse mortality, relapse-free survival, and overall survival for ustekinumab- and placebo-treated subjects.
Hematologic malignancy or disorder requiring allogeneic hematopoietic cell transplantation
Left ventricular ejection fraction (LVEF) >= 50%
Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and diffusion capacity of the lung for carbon monoxide (DLCO) >= 50% of predicted values on pulmonary function tests
HCT donor is at least 8/8 (matched at human leukocyte antigen [HLA]-A, -B, -C, -DRB1) matched with the recipient
PBSC (peripheral blood mobilized stem cells) as graft source
Fully myeloablative, reduced-toxicity ablative, or reduced-intensity conditioning regimens. If melphalan is part of the condition regimen, dose must be at least 75mg/m2.
Active infection not controlled with appropriate antimicrobial therapy
Human immunodeficiency virus (HIV), hepatitis B, or hepatitis C infection
Anti-thymocyte globulin (ATG) as part of the conditioning regimen or GVHD prophylaxis
Pregnant or nursing women
Patients of childbearing age unwilling to use an effective birth control method or refrain from sexual intercourse until 15 weeks after last dose of study drug
Non-myeloablative conditioning regimens or conditioning regimens that use less than 75mg/m2 of melphalan
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