Trial | NCT00426101  Report issue

Title

Treatment Protocol for Hemophagocytic Lymphohistiocytosis 2004
HLH-2004 Treatment Protocol

  • Phase

    Phase 3

  • Study Type

    Interventional

  • Status

    Completed No Results Posted

  • Study Participants

    368
Without therapy HLH is often fatal, and often rapidly fatal. The treatment protocol HLH-94 has improved survival markedly as compared to the survival earlier. We now aim to improve survival further.
The most dangerous period after HLH diagnosis is the first 2 months. In HLH-2004 we provide additional therapy during this period as compared to in HLH-94.
Study Started
Jan 31
2004
Primary Completion
Dec 31
2011
Study Completion
Dec 31
2017
Last Update
Jul 05
2018

Drug Dexamethasone

10 mg/m2 daily wk 1-2 5 mg/m2 daily wk 3-4 2.5 mg/m2 daily wk 5-6 1.25 mg/m2 daily wk 7 Steroids tapered wk 8 If continuation: Pulses every 2nd wk, 10 mg/m2 for 3 days

Drug Etoposide

150 mg/m2 iv twice/wk (wk 1-2) 150 mg/m2 iv once/wk (wk 3-8) If continuation: 150 mg/m2 iv, every 2nd wk

Drug Cyclosporin

WK 1-8: - Aim at around 200 microgram/L (trough value). Start: 6 mg/kg daily (divided in 2 daily doses) wk 1, if kidney function is normal. If continuation: - Aim for around 200 microgram/L. Monitor GFR.

Procedure Intrathecal therapy

If at 2 wks there are progressive neurological symptoms or if an abnormal CSF (cell count and protein) has not improved, then give 4 wkly intrathecal inj. Be aware that some pat may have increased intracranial pressure. Methotrexate: <1 yr 6 mg, 1-2 yrs 8 mg, 2-3 yrs 10 mg, >3 yrs 12 mg. Prednisolone: <1 yr 4 mg, 1-2 yrs 6 mg, 2-3 yrs 8 mg, >3 yrs 10 mg.

Procedure Stem cell transplant

The SCT procedure is up to the treating physician. However, a suggested regimen is provided.

Etoposide, Dexamethasone, Cyclosporin A plus IT MTX & Steroids Experimental

As compared to the HLH-94 treatment, the main changes are that Cyclosporin A is administered from day 1 and Intrathecal steroids are added to the intrathecal methotrexate. Drugs, dosage, frequency and duration are described in the paragraph "Interventions" below.

Criteria 

Inclusion Criteria:

Patients who fulfil the diagnostic criteria of HLH.

Exclusion Criteria:

Prior cytotoxic or cyclosporin treatment for HLH.
No Results Posted