trial to evaluate palifermin in the reduction of acute graft versus host disease in patients with hematologic malignancies undergoing allogeneic marrow/peripheral blood progenitor cell (pbpc) transplantation

Conditions: Graft Versus Host Disease; Hematologic Malignancies

Summary: the main purpose of this study is to evaluate the effect of palifermin versus placebo in the reduction of severe acute graft versus host disease (gvhd) and severe oral mucositis.


Eligibility criteria:
inclusion criteria: * subjects with hematologic malignancies (including myelodysplastic syndromes \[mds\]) who are considered eligible for cyclophosphamide (cy)/total body irradiation(tbi) +/- etoposide (vp-16); total body irradiation(tbi)/ etoposide(vp-16); melphalan(mel) / total body irradiation(tbi); busulfan(bu)/ cyclophosphamide(cy); busulfan(bu)/ melphalan (mel); or fludarabine(flu)/ melphalan(mel) conditioning therapy with allogeneic stem cell support * subjects with a 6/6 human leukocyte antigen (hla)-matched family member or unrelated donor who would provide donor marrow/ peripheral progenitor stem cells. \[for unrelated matched donors, molecular typing of class i and class ii is mandatory\] * karnofsky performance status \>= 70% * 18 years of age or older at time of informed consent * before any study-specific procedure, the appropriate written informed consent must be obtained exclusion criteria: * cancer other than non-hodgkin's lymphoma, hodgkin's disease, acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, chronic lymphocytic leukemia, myelodysplastic syndrome or multiple myeloma (except: adequately treated basal cell carcinoma of the skin) * prior autologous or allogeneic bone marrow or peripheral blood stem cell transplantation * previous use of palifermin * current active infection (including human immunodeficiency virus (hiv) and hepatitis) or oral mucositis * congestive heart failure as defined by new york heart association class iii or iv * graft t-cell depletion for graft-versus-host disease (gvhd) prophylaxis * inadequate renal function (serum creatinine \> 1.5x the upper limit of normal per the institutional guidelines or clearance \< 40 ml/min adjusted for age) * inadequate liver function (total bilirubin \> 1.5x the upper limit of normal, aspartate aminotransferase (ast) \> 3x upper limit of normal and/or alanine aminotransferase (alt) \> 3x upper limit of normal per the institutional guidelines) * inadequate pulmonary function as measured by a corrected dlco (diffusing capacity of the lung for carbon monoxide lung function test) \<50% of predicted * subject is currently enrolled in or has not yet completed at least 30 days since ending other investigational device or drug trial(s), or subject is receiving other investigational agent(s) * subject of child-bearing potential is evidently pregnant (e.g. positive human chorionic gonadotropin- hcg test) or is breast feeding during part a of the study * subject or partner of subject is not using or refuses to use adequate contraceptive precautions during part a of the study * subject has known sensitivity to any of the products to be administered during dosing including escherichia coli-derived products * subject was previously randomized into this study * subject will not be available for follow-up assessments * subject has any kind of disorder that compromises the ability of the subject to give written informed consent and/or to comply with study procedures

Keywords: hematological malignancies graft-versus-host-disease oral mucositis allogeneic transplantation