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Trial record 1 of 1 for:    nct 04460235
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Immunogenicity of an Anti-pneumococcal Combined Vaccination in Acute Leukemia or Lymphoma (HEMATOVAC)

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ClinicalTrials.gov Identifier: NCT04460235
Recruitment Status : Recruiting
First Posted : July 7, 2020
Last Update Posted : February 12, 2024
Sponsor:
Information provided by (Responsible Party):
Poitiers University Hospital

Brief Summary:
The French Public Health Council recommended pneumococcal vaccination combined strategy for all immunocompromised patients in 2012. This strategy consisted in conjugated 13-valent pneumococcal injection followed 2 months later by polysaccharide 23-valent vaccine injection. General practitioners are usually in charge of this vaccination. Conjugated pneumococcal vaccine enhances the immunogenicity of the polysaccharide vaccine. Acute leukemia and lymphoma are treated with multiple courses of chemotherapy, impairing the immune system and potentially the response to vaccination. These patients are more at risk for developing pneumococcal invasive diseases than the general population. However, efficacy of pneumococcal vaccination is poorly documented in this setting. We assume that 70% of the patients are non-responders to vaccination, according to their anti-pneumococcal immunoglobulin G titers and the opsonophagocytic activity. To assess the immunogenicity of the pneumococcal vaccination combined strategy in adult population of acute leukemia and lymphoma, the investigator will measure anti-pneumococcal serotype-specific immunoglobulin G titers and opsonophagocytic activity at different time-points after completion of the combined vaccine strategy. The primary objective is to assess the immunogenicity of pneumococcal vaccination combined strategy at 3 months after the 13-valent pneumococcal injection (corresponding to 1 month after the end of the combined strategy) using immunoglobulin G titers and opsonophagocytic activity. At different time points (day 0, 1 month after the 13-valent pneumococcal injection, the day of the injection of the polysaccharide 23-valent vaccine, one month after the injection of the polysaccharide 23-valent vaccine, 3-6 months after the polysaccharide 23-valent vaccine,9-12 months after the polysaccharide 23-valent vaccine), the immunological response to vaccination will be monitored using specific-serotype immunoglobulin G titers, opsonophagocytic activity, and total anti-pneumococcal Immunoglobulin. The investigator will determine predictive factors of non-response to vaccination by comparing demographic data, biological data and treatment received by both acute myeloblastic leukemia and lymphoma patients. The tolerance and safety of the vaccination strategy will also be assessed in this specific hematological population.

Condition or disease Intervention/treatment Phase
Vaccine Streptococcus Pneumoniae Acute Myeloid Leukemia Lymphoma, Non-Hodgkin Drug: Prevenar13 Pneumo-23 Phase 4

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 160 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Immunogénicité de la Vaccination Anti-pneumococcique Dans la leucémie aiguë et le Lymphome Chez l'Adulte
Actual Study Start Date : September 9, 2021
Estimated Primary Completion Date : June 2026
Estimated Study Completion Date : June 2026


Arm Intervention/treatment
Vaccination
All patients will be vaccinated according to national guidelines
Drug: Prevenar13 Pneumo-23
Vaccination according national guidelines




Primary Outcome Measures :
  1. Proportion of patients having a good response to combined strategy [ Time Frame: 39 months ]
    Proportion of patients having a good response to combined strategy at 4 weeks after the end of the combined strategy. A good response to vaccination is defined by 4/7 tested serotypes responding to these 4 criteria: a serotype-specific immunoglobulin G titer ≥ 1μg/L (WHO threshold), a two-fold increase of this immunoglobulin G titer compare to baseline before vaccination, a serotype-specific opsonophagocytic activity ≥1/8, and a four-fold increase of functional antibodies compare to baseline.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient ≥ 18 year-old.
  • AND medical follow-up in hematology unit
  • AND had received a first course of chemotherapy except demethylating for acute myeloblastic leukemia without ProMyelogenousLeukemia-RetinoicAcidReceptor alpha and no planned allogeneic hematopoietic stem cell transplantation (anti-IDH treatment authorized) or for diffuse large B cell lymphoma or for follicular lymphoma
  • Life expectancy > 6 months
  • Having signed the consent form
  • Having an health insurance

Exclusion Criteria:

  • Receiving monoclonal antibodies or biotherapies altering the immune response, other than anti-Cluster of differentiation number 20 antibodies in the chemotherapy protocol.
  • Uncontrolled bacterial, viral or fungal infection less than 7 days
  • Previous vaccination with 13-valent pneumococcal vaccine or polysaccharide 23-valent vaccine (unless 13-valent pneumococcal vaccine was administered in childhood. The last injection must be performed at least five years ago)
  • Preexisting condition that altered the immune response: splenectomy, HIV, primary or secondary immune deficiency, nephrotic syndrome, sickle cell anemia, autoimmune disorder, solid organ transplantation, immunosuppressive drugs or biotherapy not included in the chemotherapy
  • Patient who already received chemotherapy for malignancy in the previous 2 years before the inclusion
  • Allogeneic hematopoietic stem cell transplantation planned in the following 3 months after the first chemotherapy course
  • Major blood clotting disorders preventing intramuscular injection
  • Medical history of anaphylactic reaction to vaccination
  • Known allergy to one of the vaccine components
  • Involvement to another vaccine biomedical research
  • Protected person
  • Pregnant women or women of childbearing age without appropriate contraceptive measures
  • Perfusion of polyvalent immunoglobulins during follow-up
  • Participants with hypersensitivity to aluminum phosphate, phenol or CRM197 protein, protein derived from Corynebacterium diphtheria.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04460235


Contacts
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Contact: Mathieu Puyade, MD, PhD 0033 5 49 44 32 76 mathieu.puyade@chu-poitiers.fr
Contact: Fanny Abriat 0033 5 49 44 37 96 fanny.abriat@chu-poitiers.fr

Locations
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France
Chu Angers Recruiting
Angers, France
Contact: Mathilde HUNAULT, Pr         
CHU Bordeaux Recruiting
Bordeaux, France
Contact: François-Xavier GROS, Dr         
CHU Limoges Recruiting
Limoges, France
Contact: Arnaud JACCARD, Pr         
Chu Nantes Recruiting
Nantes, France
Contact: Pierre PETERLIN, Dr         
CHU Poitiers Recruiting
Poitiers, France
Contact: Maria Pilar GALLEGO HERNANZ, Dr         
Ch Perigueux Recruiting
Périgueux, France
Contact: Claire CALMETTES, Dr         
CHU Tours Recruiting
Tours, France
Contact: Antoine MACHET, Dr         
Sponsors and Collaborators
Poitiers University Hospital
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Responsible Party: Poitiers University Hospital
ClinicalTrials.gov Identifier: NCT04460235    
Other Study ID Numbers: HEMATOVAC
First Posted: July 7, 2020    Key Record Dates
Last Update Posted: February 12, 2024
Last Verified: January 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Plan Description: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Pneumonia, Pneumococcal
Lymphoma
Leukemia
Lymphoma, Non-Hodgkin
Neoplasms by Histologic Type
Neoplasms
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Hematologic Diseases
Pneumonia
Respiratory Tract Infections
Infections
Lung Diseases
Respiratory Tract Diseases
Pneumococcal Infections
Streptococcal Infections
Gram-Positive Bacterial Infections
Bacterial Infections
Bacterial Infections and Mycoses
Pneumonia, Bacterial
Heptavalent Pneumococcal Conjugate Vaccine
Immunologic Factors
Physiological Effects of Drugs