Not yet recruiting NCT07602751
FMT for Pediatric SR-aGVHD
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Fecal Microbial Transplantation.
- Who it may be relevant to
- Registry conditions: Acute Graft Versus Host Disease in Intestine. Basic parameters: 3 months — 25 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Italy
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Fecal Microbiota Transplantation for the Treatment of Steroid-refractory Graft-versus-host Disease.
Overview
This is a pilot, prospective, non-profit, multicenter, uncontrolled, open-label study to evaluate the safety and feasibility of FMT in patients aged between 3 months and 25 years suffering from acute intestinal GVHD resistant to conventional steroid therapy. Eligible patients will receive 1-3 FMT via naso-jejunal tube or endoscopy.
Interventions
- Biological Fecal Microbial Transplantation
The administration of the fecal preparation (from a related donor or a third party donor) will be carried out via esophagogastroduodenoscopy, with the release of the fecal preparation into the duodenum; or via a nasoduodenal tube, with the release of the fecal preparation into the duodenum at a 'dose' of 7-12 ml/kg, up to a maximum of 250 ml/administration; or via colonoscopy. In the latter case, mucosal biopsies will not be performed to reduce the risk of bacterial translocation. In some subjec
Primary outcome measures
- Safety (AE and treatment-related AE, according to CTCAE v5.0) [Time frame: 28 days]
Secondary outcome measures (5)
- Efficacy: Overall Response Rate (ORR) [Time frame: 28 days]
- Microbiota modification [Time frame: 56 days]
- Cumulative incidence of infections [Time frame: 28 days]
- Efficacy on other GVHD target organs [Time frame: 56 days]
- Immune reconstitution [Time frame: 90 days]
Eligibility criteria
Inclusion criteria
- Diagnosis of hematological disease, malignant or non-malignant;
- Patients undergoing allogeneic stem cell transplantation from a familial or unrelated donor;
- Presence of acute GVHD with intestinal involvement (grade II-IV), steroid-resistant (i.e., with progression after 3 days of high-dose steroid therapy (methylprednisolone > 2 mg/kg), no response after 7 days, progression during steroid tapering, or failure to achieve remission on day 28 from the start of steroid therapy), for those who have no indication for other second- or third-line therapies;
- Signed informed consent.
Exclusion criteria
- Presence of concurrent bacterial infections requiring systemic antibiotic therapy;
- Positivity for anti-HIV or anti-HCV antibodies, or for HbsAg with HBV-DNA positive by PCR;
- Presence of severe mucositis;
- History of chronic inflammatory bowel disease.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Single group
- Masking
- Open label
- Primary purpose
- Treatment
Study locations
Italy · 3 centers
- Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna — Bologna
- UOC Clinica di Oncoematologia Pediatrica, Azienda Ospedale-Università Padova — Padova
- Department of Hematology/Oncology, Cell and Gene Therapy, IRCCS Bambino Gesù Children's Ho — Roma
Publications
- van Lier YF, Davids M, Haverkate NJE, de Groot PF, Donker ML, Meijer E, Heubel-Moenen FCJI, Nur E, Zeerleder SS, Nieuwdorp M, Blom B, Hazenberg MD. Donor fecal microbiota transplantation ameliorates intestinal graft-versus-host disease in allogeneic hematopoietic cell transplant recipients. Sci Transl Med. 2020 Aug 12;12(556):eaaz8926. doi: 10.1126/scitranslmed.aaz8926. PMID 32801142
- Kakihana K, Fujioka Y, Suda W, Najima Y, Kuwata G, Sasajima S, Mimura I, Morita H, Sugiyama D, Nishikawa H, Hattori M, Hino Y, Ikegawa S, Yamamoto K, Toya T, Doki N, Koizumi K, Honda K, Ohashi K. Fecal microbiota transplantation for patients with steroid-resistant acute graft-versus-host disease of the gut. Blood. 2016 Oct 20;128(16):2083-2088. doi: 10.1182/blood-2016-05-717652. Epub 2016 Jul 26. PMID 27461930
Identifiers
NCT: NCT07602751 · 3444_OPBG_2024