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No patients eligible for inclusion
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Given the role of B cells in the pathophysiology of chronic graft versus host disease (GvHD), the association between elevated BAFF levels post-transplant in abnormal B-cell homeostasis and chronic GvHD, and the efficacy of belimumab in the inhibition of soluble human B lymphocyte stimulator protein (BAFF) signaling, these proof-of-principle findings support the rational for use of belimumab as treatment of chronic GvHD.The investigators propose a pilot and feasibility study to assess the safety and tolerability, as well as preliminary efficacy, of belimumab a treatment of cGvHD following allogeneic hematopoietic cell transplantation (alloHCT). The investigators' central hypothesis is that belimumab will be well tolerated and have a favorable effect on chronic GvHD,and we explored therapeutic dosage of belimumab.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low-dose group of Belimumab | Experimental | Belimumab 1mg/kg com combined with conventional therapy |
|
| High-dose group of Belimumab | Experimental | Belimumab 4mg/kg com combined with conventional therapy |
|
| Control group | No Intervention | conventional therapy |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Belimumab (Benlysta) | Drug | Belimumab will be administered intravenously every 2 weeks for 3 cycles and then every 4 weeks for a total of 5 cycles |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall response rate of chronic GvHD after belimumab treatment | cGVHD grade according NIH | approximately 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Duration of response rate of chronic GvHD after belimumab treatment | Duration of ORR chronic GvHD after belimumab treatment | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability of belimumab as treatment of chronic GvHD | Adverse events will be graded according to CTCAE v4.03. | approximately 12 months |
| Overall survival | Overall survival will be determined from date of belimumab initiation, with death from any cause as the event of interest, and censoring at last follow up date for those with incomplete observations. Overall survival will be determined from date of belimumab initiation, with death from any cause as the event of interest, and censoring at last follow up date for those with incomplete observations. Overall survival will be determined from date of belimumab initiation, with death from any cause as the event of interest, and censoring at last follow up date for those with incomplete observations. |
Inclusion Criteria:
1.18 to 65years old 2.Newly diagnosed, moderate or severe chronic GvHD according to the 2014 NIH Consensus Criteria, requiring systemic immunosuppression 3.Karnofsky performance status greater than or equal to 60% 4.History of prior alloHSCT; any donors, conditioning regimens and graft sources are allowed 5.Newly diagnosed moderate or severe chronic Graft versus Host Disease (GvHD) (according to the 2014 NIH Consensus Criteria, requiring systemic immunosuppression 6.History of prior allogeneic Hematopoietic Stem Cell Transplant (HSCT) (any donors, conditioning regimens and graft sources are allowed).
7.Stable doses of other immunosuppressive medications (e.g., calcineurin inhibitors, mycophenolate mofetil, rapamune, etc.) with no dose increase in the 2 weeks prior to study treatment initiation. Doses may be adjusted for trough levels.
8.Patients tested positive for autoantibodies (ANA titer ≥1:80) and high BAFF levels (plasma concentration ≥15ng/ml).
9.Laboratory parameters as defined below: Serum creatinine less than or equal to 2.0 x ULN AST and ALT less than or equal to 3 x ULN (less than or equal to 5 x ULN if unequivocal liver GvHD) Total bilirubin less than or equal to 3 x ULN 10.Ability to understand and willingness to sign a written informed consent fo
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Hematology, Nanfang Hospital, Southern Medical University, | Guanzhou | 510515 | China |
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| ID | Term |
|---|---|
| C511911 | belimumab |
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| 24 months |