An interventional study of Lymphoplasma exchange in Leukemia, sponsored by Ruijin Hospital. Status unknown at 1 site in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2023-12-20.
Sponsored by Ruijin Hospital · Not applicable, Interventional, and Treatment
The aim of this study is to prospectively explore the effectiveness and safety of LPE in clearing DSA, and to investigate the clinical efficacy of a combination therapy with LPE in patients undergoing genetic hematopoietic stem cell transplantation.
We recruited 38 patients according to the inclusion criteria.(Inclusion criteria: 1. Serum DSA positive: MFI ≥ 2000；Between the ages of 18 and 65, male and female are not limited；Planned to undergo allo-HSCT , with an estimated survival time of>3 months and an ECOG physical fitness score of 0-2；Normal renal function (BUN, Cr ≤ 1.5 times the upper limit of normal value, Ccr>80ml/min). 2. Normal liver function (defined as ALT and AST ≤ 1.5 times the upper limit of normal. 3. TBiL ≤ 1.5 times the upper limit of normal). 4. ECG did not indicate any AMI, arrhythmia, or IAVB. 5. No CI (defined as LVEF ≥ 50%, normal MYO and BNP). 6. Non active RHD. 7. Chest X-ray or physical examination did not indicate cardiac dilatation. 8. Normal lung function (defined as FEV1, FVC, DLCO ≥ 60% predicted value).)
Sample the peripheral blood of the patient at four timepoints（Before LPE treatment (D0); Before stem cell transfusion; On the 10th day of stem cell transfusion;On the 30th day of stem cell transfusion).Using multiplex bead analysis on the Luminex platform (Luminex Corporation, Austin, TX, USA), including the LAB screening PRA and LAB screening hybrid method, all patients' ethylenediamine tetraacetic acid (EDTA)-treated serum was tested for anti-HLA class I and class II antibodies.According to the manufacturer's instructions, the semi-quantitative measurement of DSA levels was performed by LAB screening single antigen beads assay (One Lambda; ThermoFisher), and the results were expressed as MFI.The cumulative DSA MFI was calculated by summing the MFI of all detected DSA under HLA antigen resolution.
Evaluate the effectiveness of LPE by comparing it with the historical control group that has undergone TPE treatment in the past
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Exclusion criteria：
1. Serum DSA positive: MFI ≥ 2000；Between the ages of 18 and 65, male and female are not limited；Planned to undergo allo-HSCT , with an estimated survival time of\>3 months and an ECOG physical fitness score of 0-2；Normal renal function (BUN, Cr ≤ 1.5 times the upper limit of normal value, Ccr\>80ml/min) 2. Normal liver function (defined as ALT and AST ≤ 1.5 times the upper limit of normal 3. TBiL ≤ 1.5 times the upper limit of normal) 4. ECG did not indicate any AMI, arrhythmia, or IAVB 5. No CI (defined as LVEF ≥ 50%, normal MYO and BNP) 6. Non active RHD 7. Chest X-ray or physical examination did not indicate cardiac dilatation 8. Normal lung function (defined as FEV1, FVC, DLCO ≥ 60% predicted value).
Procedure: Lymphoplasma exchange
The LPE treatment regimen is: LPE\*2 times (20-30ml/kg, treatment interval of 2 days);CD20 monoclonal antibody 375mg/m2\*2 times, gamma globulin 0.4g/kg/d\*5d.
The degree of decrease in DSA
A semiquantitative measurement of the DSA level was performed by LAB screen single antigen bead assays (One Lambda; Thermo Fisher) and the results were expressed as MFI
Time frame: Before LPE treatment (D0); Before stem cell transfusion; On the 10th day of stem cell transfusion；On the 30th day of stem cell transfusion
Plan to share: No — We will protect the personal information of the subjects
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This study is status unknown, as verified in Nov 2023. You cannot join it, but the record below documents what was studied.
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