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CompletedNCT03234335IRMYGUpdated May 6, 2023

High Dose Therapy Followed by Autologous Transplantation for Myeloma Patients With Severe Renal Impairment

An observational study in Multiple Myeloma and Renal Failure, sponsored by Centre Hospitalier Universitaire de Saint Etienne. Completed at 33 sites in 4 countries. Open to participants aged 66 Years and older. Per ClinicalTrials.gov, last updated 2023-05-06.

Sponsored by Centre Hospitalier Universitaire de Saint Etienne · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
50
Ages
66 Years and older
Sex
All
01

Study summary

Multiple myeloma (MM) is a malignant plasma cell disorder, characterized by the presence of more than 10 % of clonal plasma cells in the bone marrow. Therapeutic intervention is recommended when at least one of the myeloma defining events occurs (CRAB features). Renal impairment (RI) is one of the most common complications of MM, accounting for 20-30 % of MM patients at diagnosis and 40-50% of patients during the course of their disease. To date, there is no defined consensus for the management of myeloma patients with renal failure. It is then of clinical importance to better considering available therapeutic options to improve responses and survival of these patients.

Read the detailed description

RI is associated with poor prognosis and short median survival (32 months vs 55 months for MM patients with normal renal function). Thus, RI remains a major challenge for hematologists, including decisions on optimal anti-myeloma therapy, potential dialysis, supportive care and quality of life. The combination of a proteasome inhibitor and an immunomodulator is the preferred induction treatment for newly diagnosed transplant-eligible MM patients. After induction, high-dose therapy with Autologous Stem Cell Transplant (ASCT) is the standard of care for these patients. However, concerns related to management of comorbidities and treatment side effects question about therapeutic options for patients with severe renal damage. Of interest, recent studies argued that high-dose therapy followed by ASCT could be a feasible and safe method for renal failure MM patients. Yet, these observations on small sample size patients groups need to be confirmed with standardized conditions. This study proposes to evaluate the efficacy and the safety of this therapeutic strategy in MM patients with severe renal impairment.

02

Conditions studied

  • Multiple Myeloma
  • Renal Failure

Keywords

  • Multiple Myeloma
  • Renal Failure
  • Autologous Hematopoietic Stem Cell Transplantation (ASCT)
  • Melphalan
03

Who can participate

Ages eligible
66 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Myeloma patients with severe renal impairment suseptible of undergoing autologous transplantation.

Inclusion criteria

  • Age ≤ 66 years-old
  • Patients with symptomatic, measurable and newly diagnosed multiple myeloma associated:
  • Severe renal failure at the time of transplantation (creatinine clearance \< 40 ml/min/1.73m², CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration)
  • Partial response after induction treatment
  • For patients who undergo autologous transplantation, absence of known contraindication for transplantation
  • Absence of amylose
  • Patient affiliated to a social security regimen or beneficiary of the same
  • Signed written informed consent form

Exclusion criteria

Exclusion Criteria:

  • Patient without at least a partial hematological response following the induction stage
  • Medical history of previous malignancy
  • Patient under guardianship or deprived of his liberty or any condition that may affect the patient's ability to understand and sign the informed consent (art. L.1121-6, L.112-7, L.1211-8, L.1211-9)
  • Pregnant or breastfeeding woman
  • Declining participation
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
50 participants (actual)
Target follow-up
2 Years
Patient registry
Yes

Groups and cohorts

  • Myeloma patients with severe renal impairment

    Myeloma patients with severe renal impairment. Data collection will concern myeloma patients with severe renal impairment who are susceptible to undergo autologous transplantation.

    Other: Data collection

Interventions

  • OtherData collection

    Myeloma patients with severe renal impairment who are susceptible to undergo autologous transplantation will be followed in this study, and data related to the pathology, treatments and transplantation will be reported.

05

What researchers measure

Primary outcomes

  1. Non Relapse Mortality post-transplantation

    Non-relapse mortality at Day +100 post-transplantation will be reported.

    Time frame: 100 days post-transplantation

Secondary outcomes

  1. Overall survival

    Overall survival at 2 years post-transplantation will be reported.

    Time frame: 2 years post-transplantation

  2. progression-free survival

    progression-free survival at 2 years post-transplantation will be reported.

    Time frame: 2 years post-transplantation

  3. Number of toxicities

    Number of hematological and extra-hematological toxicities linked to autologous stem cell transplantation will be reported during 2 years.

    Time frame: 2 years post-transplantation

  4. presence of hematological response

    The presence of hematological response at Day+100 and at 6 months post-transplantation will be reported.

    Time frame: 6 months

  5. Level of renal response

    Level of renal response at 3 months, 6 months and one year post-transplantation will be quantified and reported.

    Time frame: 3 months, 6 months and one year

06

Study locations

33 sites
  • Centre Pierre et Marie Curie
    Alger, Algeria
  • EHU Oran
    Oran, Algeria
  • CHU Sart Tilman
    Liège, Belgium
  • Centre Hospitalier Universitaire d'Amiens
    Amiens, France
  • Centre Hospitalier Universitaire d'Angers
    Angers, 49933, France
  • Centre Hospitalier d'Argenteuil
    Argenteuil, 95100, France
  • Centre Hospitalier de la Côte Basque
    Bayonne, France
  • Centre Hospitalier Universitaire de Besançon
    Besançon, France
  • Centre Hospitalier de Boulogne
    Boulogne, France
  • CHU de Brest
    Brest, France
  • Centre Hospitalier Universitaire de Caen
    Caen, 14 000, France
  • Centre Hospitalier de Cholet
    Cholet, France
  • Centre Hospitalier Universitaire de Clermont Ferrand
    Clermont-Ferrand, France
  • Centre Hospitalier Universitaire de Dijon
    Dijon, 21 079, France
  • Centre Hospitalier Universitaire de Grenoble
    Grenoble, 38 043, France
  • CHU de Limoges
    Limoges, France
  • Centre Léon Bérard
    Lyon, 69 373, France
  • Hôpital Saint-Eloi
    Montpellier, 34 295, France
  • Centre Hospitalier Universitaire de Nancy
    Nancy, 54 500, France
  • Hôpital Archet
    Nice, France
  • Institut Curie
    Paris, 75 005, France
  • Groupe Hospitalier Pitié-Salpétrière
    Paris, 75 013, France
  • Hôpital Saint-Antoine
    Paris, 75 020, France
  • Hôpital Tenon
    Paris, 75 020, France
  • Hôpital Cochin
    Paris, France
  • Centre Hospitalier Lyon Sud
    Pierre-Bénite, 69 495, France
  • Hôpital Saint-Bernard
    Poitiers, 86 021, France
  • CHU de Rennes
    Rennes, France
  • Hôpital Victor Provo (Roubaix)
    Roubaix, France
  • CHU de Saint-Etienne
    Saint-Priest-en-Jarez, 42 270, France
  • Centre Hospitalier de Saint Quentin
    Saint-Quentin, France
  • Hôpitaux Universitaires de Strasbourg
    Strasbourg, France
  • American University of Beirut
    Beyrouth, Lebanon
07

Registry details

Key details

Study ID
NCT03234335
Lead sponsor
Centre Hospitalier Universitaire de Saint Etienne
Collaborators
Institut de Cancérologie de la Loire
Responsible party
Sponsor
First posted
Jul 31, 2017
Start date
Apr 10, 2018
Primary completion
Sep 29, 2020
Completion
Sep 27, 2022
Last update
May 6, 2023

Study contacts

Jérôme Cornillon, MD
principal investigator · CHU de Saint-Etienne

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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