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TIDaL trial

This trial is for people who have developed post-transplant lymphoproliferative disorders (PTLD) following a stem cell transplant. Current treatment methods do not work for everyone and researchers are trialling a new treatment aiming to help these people.

The context

Stem cell transplants (also known as bone marrow transplants) are used to treat conditions where the bone marrow is no longer able to produce healthy blood cells.  The transplant replaces damaged blood cells with healthy ones. People who have had a transplant take immunosuppressants, medications that dampen down the immune system. This is to prevent either the donor or the recipient’s immune system recognising the other as “foreign” and attacking them. A small number of people taking immunosuppressants may develop a condition called post-transplant lymphoproliferative disorders (PTLD). This is where white blood cells are over produced by the body and sometimes these cells can become cancerous.

Usually people with PTLD are treated with a drug called rituximab. However, not everyone with PTLD responds to rituximab and some people need to have additional chemotherapy. This treatment does not work for everyone and doctors are trying to find out if combining standard treatments with a new drug, called ibrutinib, can be used to develop better and more effective treatments for people with PTLD.

The project

In this study researchers are trying to find out if by combining rituximab and ibrutinib during the first stage of treatment they can help treat people with PTLD and reduce the number of people who need additional chemotherapy. Additionally, even if people do require further treatment of ibrutinib and chemotherapy, they want to see whether this improves the long term survival for these people.

The aims

  • Researchers want to see how well rituximab and ibrutinib work together in treating people with PTLD
  • Find out what side-effects people having rituximab and taking ibrutinib experience