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Hemophagocytic Lymphohistiocytosis (HLH)Phase 1/2C-HLHNCT02472054

Treatment of Familiar Lymphohistiocytosis

A Phase 1/2 study testing Alemtuzumab, Methyl Prednisolone (MP) and Cyclosporin A (CSA) in people with Hemophagocytic Lymphohistiocytosis (HLH), run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this project is to study the number of surviving patients until hematopoietic stem cell transplantation (HSCT) after first line treatment of hemophagocytic lymphohistiocytosis (HLH) by Alemtuzumab Read more about this study

Who is it for?
Ages Up to 17 years
Conditions the study is for
Hemophagocytic Lymphohistiocytosis (HLH)
What is being tested?
Alemtuzumab, Methyl Prednisolone (MP) and Cyclosporin A (CSA)
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
29 participants
Where
1 siteFrance
Study dates
29 Jun 2015to 20 May 2020
Phase
Phase 1/2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Up to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Patient < 18 years
  • Patient with diagnosis of hemophagocytic lymphohistiocytic syndrome confirmed by at least one of the following two criteria :
  • Genetic diagnosis FHL or other genetic disease predisposing to HLH like Chediak-Higashi syndrome, Griscelli syndrome type II and X-linked lymphoproliferative syndrome type I and II (XLP-1 and XLP-2) or positive family history of HLH
  • Presence of at least 5 of the following 8 criteria (diagnostic criteria as defined by the "Histiocyte Society" ) :
  • Fever
  • Splenomegaly
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  • Cytopenia (affecting at least two cell lineages : Hemoglobin <9.0 g / dl, Platelets <100.000/μl, Absolute neutrophil count (ANC) <1.000/µl)
  • Hypertriglyceridemia and / or hypofibrinogenemia (Fasting triglycerides ≥ 3 mmol / l, Fibrinogen ≤ 1.5 g / l)
  • Haemophagocytosis found in a histological specimen (without evidence of a malignant process and rheumatic disease)
  • Decreased or absent NK function (<10% of the laboratory standard)
  • Ferritin ≥ 500μg / l
  • Soluble CD25 ≥ 2.400U/ml or presence of activated T cells in the immune phenotyping
  • Patient without prior specific treatment of lymphohistiocytic activation syndrome or under treatment with corticosteroids and / or ciclosporin.
  • Patient beneficiary of a health insurance scheme
  • Holder (s) of parental authority who signed the informed consent
  • Man or woman in reproductive age willing to take reliable contraceptive measures during the treatment and 6 months after the end of the treatment
  • Specific situation of patients with neurological involvement :
  • Most patients with neurological involvement caused by a HLH will meet the inclusion criteria. However some patients may present an isolated neurological involvement as the first manifestation of familiar lymphohistiocytosis as described in the literature. These patients do not always present all the inclusion criteria. However their clinical condition may justify their inclusion prior to the confirmation of a genetic diagnosis and/or the detection of all required diagnostic inclusion criteria.
  • In the absence of the required 5 out of 8 diagnostic criteria, the eventual inclusion of patients with predominant neurological involvement will be evaluated by a scientific committee to judge their inclusion or not in the study. The remaining inclusion and exclusion criteria must be fulfilled. A written report will be established.

Who cannot join

  • Age ≥ 18 years
  • Patients previously treated with Anti-Thymoglobulin (SAL), etoposide (VP16) or Alemtuzumab.
  • Confirmed or suspected diagnosis of a malignant or rheumatic disease
  • Contraindication (s) to the administration of Alemtuzumab :
  • Hypersensitivity to murine proteins or to any of the excipients (sodium chloride, dibasic sodium phosphate, potassium chloride, potassium dihydrogen phosphate, polysorbate 80, disodium edetate dihydrate, and water for injection)
  • General evolving infection except infections that are the triggering factor of the HLH .
Show all 9Show fewer
  • HIV
  • Progressing malignant tumors
  • Pregnancy

Trial locations and contacts

1 site in 1 country.

France1 site
  • Hôpital Necker-Enfants Malades

    Paris, 75015

Other trials in France

About this study

Official title: First Line Treatment of Familiar Lymphohistiocytosis by Alemtuzumab (CAMPATH®)

The purpose of this project is to study the number of surviving patients until hematopoietic stem cell transplantation (HSCT) after first line treatment of hemophagocytic lymphohistiocytosis (HLH) by Alemtuzumab

Read the detailed description

The hemophagocytic lymphohistiocytosis (HLH) or lymphohistiocytic activation syndrome is an inflammatory condition caused by a uncontrolled proliferation of activated lymphocytes and macrophages secreting an excess of inflammatory cytokines. Familial hemophagocytic lymphohistiocytosis (FHL) is a rare disorder of the immune system, which is invariably fatal when untreated. Treatment requires the achievement of remission of HLH prior to allogeneic hematopoietic stem cell transplantation, the only curative therapy to date.

Despite significant progress in the treatment, mortality remains high and an important number of patients will die before being eligible for HSCT.

A better understanding of the pathophysiology of FHL has opened new avenues for immunotherapy. Based on previous observations concerning the utilization of Anti-thymoglobulins (ATG) for the treatment of patients with FHL, the protocol propose a new therapeutic strategy using Alemtuzumab in association with steroids as first line treatment in FHL. This proposition is based on the hypothesis that Alemtuzumab, capable of killing T lymphocytes efficiently in vivo, should be better tolerated than ATG. In fact, in contrast to the mechanism of action of ATG, Alemtuzumab does not activate T lymphocytes.

A better tolerance and efficacy of Alemtuzumab is expected in the treatment of the hemophagocytic lymphohistiocytic syndrome. This may have a positive impact not only on survival until HSCT, but also on overall survival and quality of life with regard to long-term neurological sequelae.

This is a multicenter, open, phase I/II, non-comparative, non randomized study. Patients are recruited by the investigators during hospitalization for a first episode of lymphohistiocytic activation syndrome requiring specific treatment.

Several visits (including the final visit) are scheduled within the trial over a period of approximately 10 months for all patients, from the signature of the consent up to 6 months after hematopoietic stem cell transplantation.

The recruitment period will be 48 months; the total period of the study is 58 months. The treatment consists in an intravenous administration of CAMPATH®.

For the research purpose, investigators will collect specific samples for:

  • biobank (Cytokine dosage) at the inclusion visit and the day prior to the conditioning;
  • pharmacokinetics of CAMPATH® : at every cure of CAMPATH® and every week. Also diagnostic lumbar puncture at the inclusion visit, day 14 is required to document the response to treatment and to determine the result of the therapeutic care.

The efficacy of the treatment will be measured to Day14, Day21 and Day28. All adverse events must be reported in the e-Case Report Form (e-CRF)

Being tested
Alemtuzumab, Methyl Prednisolone (MP), Cyclosporin A (CSA)
Keywords
hemophagocytic lymphohistiocytosis (HLH), Alemtuzumab (CAMPATH®)
Medical subject headings
Lymphohistiocytosis, Hemophagocytic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AlemtuzumabDrug

    Also called CAMPATH®

  • Methyl Prednisolone (MP)Drug

  • Cyclosporin A (CSA)Drug

Study groups in NCT02472054
Study groupRoleWhat they receive
hemophagocytic lymphohistiocytosis (HLH)ExperimentalAlemtuzumab (CAMPATH®) 1. Initial Treatment (D1 to D3) D1: 0.5 mg / kg / day Alemtuzumab combined with 2 mg /kg/d of IV Methylprednisolone (MP) or PO Prednisolone, and IVC or PO cyclosporine (CSA) (target rate from 150 to 200 ng / ml in the absence of renal failure) D2 and D3: 1 mg / kg / day Alemtuzumab combined with 2 mg / kg / d of IV MP or PO Prednisolone and IVC or PO CSA (target rate 150-200 ng / ml) The maximum dose of Alemtuzumab is limited to 30 mg per day (1 vial). 2. Maintenance treatment (D4 to D14) * MP/Prednisolone progressive tapering starting at D4 (2 mg / kg / day) to reach the dose 0.5 mg / kg / day at D14 * CSA IVC or PO at a target rate of 150-200 ng / ml
Receives: Drug: Alemtuzumab; Drug: Methyl Prednisolone (MP); Drug: Cyclosporin A (CSA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of surviving patients until HSCT

    Measured: Day 1 until transplantation, up to 4 months

Secondary outcomes (4)
  1. Number of complete remissions following treatment

    To assess the efficacy of the Alemtuzumab

    Measured: Day 14, Day 21, Day 28

  2. Time of delay between the first administration of Alemtuzumab and complete remission

    To assess the efficacy of the Alemtuzumab

    Measured: Day 14, Day 21, Day 28

  3. Dosage of Alemtuzumab

    Pharmacokinetic

    Measured: Day1-3, Day7, Day15-16, Day22-23, Day28

  4. Number of side effects

    To assess the tolerance of the Alemtuzumab

    Measured: Day 1 until transplantation, up to 4 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Jun 2015 (estimated)
  2. Study start29 Jun 2015
  3. Primary completion12 Sep 2019
  4. Study completion20 May 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
29 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02472054
Sponsor's protocol ID
P120109
Other IDs
2014-005585-30, 2014
Acronym
C-HLH
Status last verified
Mar 2026
First submitted
8 Jun 2015
Last updated
30 Mar 2026
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Alemtuzumab, Methyl Prednisolone (MP) and Cyclosporin A (CSA) in people with Hemophagocytic Lymphohistiocytosis (HLH), run by Assistance Publique - Hôpitaux de Paris at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 19 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of surviving patients until HSCT (time frame: Day 1 until transplantation, up to 4 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Mar 2026.

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