ClinicalTrials.gg
RecruitingNCT04314219PTCy-PMATUpdated Mar 13, 2025

Comparing Post-Transplant Cyclophosphamide As GVHD Prophylaxis to Standard of Care for Acute Leukemia Patients

A Phase 3 interventional study of Cyclophosphamide 50mg and Methotrexate in Acute Lymphoblastic Leukemia (ALL) in Complete Remission and Acute Myeloid Leukemia (AML) in Remission, sponsored by King Faisal Specialist Hospital & Research Center. Recruiting at 1 site in Saudi Arabia. Open to participants aged 14 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-03-13.

Sponsored by King Faisal Specialist Hospital & Research Center · Phase 3, Interventional, and Prevention

From the registry’s dates

  • Primary completion was expected by Dec 2025, 11 months ago, but the record still lists the study as recruiting.
  • Started Aug 2021; still recruiting 5 years 2 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
264
Allocation
Randomized
Ages
14 Years to 65 Years
Sex
All
01

Study summary

This randomized clinical trial will evaluate two approaches of GvHD prophylaxis; the standard of care GVHD prophylaxis regimen (methotrexate/calcineurin inhibitors) and post-transplant cyclophosphamide with calcineurin inhibitors for their efficacy as a new GVHD prophylaxis strategy.

Read the detailed description

An open-label randomized clinical trial will be performed. Eligible patients are females and males, between 14 and 65 years undergoing allo-HCT for treatment of Acute Leukemia (AML or ALL). Patients must have a matching related peripheral blood stem cell donor. Patients from or referred to the KFSH\&RC for allogeneic transplant consideration will be offered the opportunity to participate in this trial.

Treatment Description:

Patients will be randomized on one of the arms; an intervention or a standard of care arm.

02

Conditions studied

  • Acute Lymphoblastic Leukemia (ALL) in Complete Remission
  • Acute Myeloid Leukemia (AML) in Remission

Keywords

  • Sibling Donor Transplant
  • Allogeneic hematopoietic cell transplantation
  • GvHD Prophylaxis
  • Myeloablative regimen
03

In context

Precursor Cell Lymphoblastic Leukemia-Lymphoma

2,584 studies on the registry are indexed under Precursor Cell Lymphoblastic Leukemia-Lymphoma; 473 are open to participants now.

This study's planned enrollment of 264 is above the median of 40 across 1,952 interventional studies indexed under Precursor Cell Lymphoblastic Leukemia-Lymphoma.

Browse Precursor Cell Lymphoblastic Leukemia-Lymphoma studies →

Lead sponsor

King Faisal Specialist Hospital & Research Center is the lead sponsor of 99 studies on the registry; 18 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
14 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients with Acute Leukemias (AML, ALL) in morphologic complete remission with or without hematologic recovery
  • Patients must have a fully matched (8/8) related donor willing to donate peripheral blood stem cells and must meet institutional criteria for donation
  • Planned Myeloablative conditioning regimen
  • Cardiac function: at rest ≥ 50% by MUGA or TTE
  • Estimated greater than 50 mL/minute
  • Pulmonary function: DLCO ≥ 50% (adjusted for ), and FVC and ≥ 50%
  • Liver function: total \< 2x the (unless elevated bilirubin is attributed to Gilbert's Syndrome) and /AST \< 2.5x the upper normal limit
  • Signed

Exclusion criteria

Exclusion Criteria:

  • or Lansky Performance Score \< 70%.
  • Active disease
  • Patients with uncontrolled bacterial, viral, or fungal infections
  • Presence of fluid collection (ascites, pleural or pericardial effusion) that interferes with methotrexate clearance or makes methotrexate use
  • Patients seropositive for -1 or -2
  • Patients seropositive for HTLV-I or -II
  • Patients with active or C viral replication by PCR
  • Women who are pregnant (positive serum or urine βHCG) or breastfeeding
  • Females with (FCBP) or men who have sexual contact with FCBP unwilling to use effective forms of or abstinence for one year after transplantation
  • History of uncontrolled disease or on active treatment
  • Patients with prior , except resected non-melanoma skin cancer or treated cervical carcinoma in situ; cancer treated with curative intent ≥ 5 years previously will be allowed; cancer treated with curative intent \< 5 years previously will not be allowed.
Terms in these criteria, in plain language(16)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
264 participants (estimated)

Study arms

  • Experimental
    Arm 1: Intervention

    Peripheral blood matched related donor HCT, using myeloablative conditioning regimen (IV Busulfan/IV Fludarabine for AML, IV VP16/TBI for ALL) HCT with cyclophosphamide, and oral tacrolimus (or another calcineurin inhibitor if intolerant for tacrolimus) for GVHD prophylaxis. Cyclophosphamide will be given at a dose of 50 mg/kg/day IV on Day +3 and Day +5 post stem cell infusion (only 2 doses).

    Drug: Cyclophosphamide 50mg

  • Active comparator
    Arm 2: Standard of Care

    Peripheral blood matched related donor HCT, using myeloablative conditioning regimen (IV Busulfan/IV Fludarabine for AML, IV VP16/TBI for ALL) HCT with methotrexate, and oral tacrolimus (or another calcineurin inhibitor if intolerant for tacrolimus) for GVHD prophylaxis

    Drug: Methotrexate

Interventions

  • Cyclophosphamide as GVHD prophylaxis will be on day +3 and day +5

  • Methotrexate as GVHD prophylaxis will be on day +1, day +3, and day +6

06

What researchers measure

Primary outcomes

  1. GRFS (GVHD-free/relapse-free survival)

    Defined as the non-occurrence of a grade 3-4 acute GVHD, or systemic therapy-requiring chronic GVHD, or relapse, or death during the first post-transplant year.

    Time frame: One-year post-transplant

Secondary outcomes

  1. Acute Graft versus Host Disease (aGVHD)

    The probabilities of grade II-IV and III-IV acute GVHD will be determined. Acute GVHD will be graded according to Glucksberg and NIH 2014 criteria.

    Time frame: 100 Day post transplant

  2. Chronic Graft versus Host Disease (cGVHD)

    The cumulative incidence of systemic therapy-requiring chronic GVHD will be determined. Moderate and severe chronic GVHD will be defined per the NIH 2014 criteria.

    Time frame: One year Post-transplant

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2021 (actual). Primary completion is estimated for Dec 2025, 52 months after the start.

Of 43 non-industry phase 3 interventional studies under Precursor Cell Lymphoblastic Leukemia-Lymphoma, half reached primary completion within 95 months of starting (the median), counting those still running; a quarter within 65 and three quarters within 109. This study's planned 52 months is below that.

Counting every sponsor, half of 59 studies reached it within 86 months; a quarter within 46 and three quarters within 104.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 17, 2020
First posted
Mar 19, 2020
StartActual
Aug 15, 2021
Primary completionEst.
Dec 2025
CompletionEst.
Dec 2026
Last update
Mar 13, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 13, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04314219
Lead sponsor
King Faisal Specialist Hospital & Research Center
Responsible party
Sponsor
First posted
Mar 19, 2020
Start date
Aug 15, 2021
Primary completion
Dec 2025 (estimated)
Completion
Dec 2026 (estimated)
Last update
Mar 13, 2025

Study contacts

Riad O El Fakih, MD
Contact
relfakih1@kfshrc.edu.sa
+ 966114647272 ext. 34760
Riad O El Fakih, MD
principal investigator · KFSH&RC
Mahmoud D Aljurf, MD, MPH
principal investigator · KFSH&RC
Marwan Y Shaheen, MD
principal investigator · KFSH&RC

Oversight

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

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Studies of the drug tested here: Cyclophosphamide

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