CALIPSO: Calfactant for Acute Lung Injury in Pediatric Stem Cell Transplant and Oncology Patients



Status:Completed
Conditions:Hospital, Pulmonary
Therapuetic Areas:Pulmonary / Respiratory Diseases, Other
Healthy:No
Age Range:Any - 21
Updated:4/17/2018
Start Date:June 2010
End Date:October 2015

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A Phase 3 Trial of Calfactant for ALI in Pediatric Leukemia and HSCT Patients

Acute lung injury (ALI) is a common, life-threatening complication among pediatric leukemia
and lymphoma and hematopoietic stem cell transplant (HSCT) recipients. Although these
children represent a relatively small and unique patient population, they account for the
largest proportion of deaths of all pediatric diseases. The long-term goal of this project is
to improve outcomes among these patients. Recently, the intratracheal administration of
calfactant has resulted in decreased mortality among children with ALI including promising
results among children with cancer and following HSCT. Consequently, the primary specific aim
of this study is to assess the effect of calfactant on intensive care (PICU) survival among
pediatric leukemia and lymphoma and HSCT patients with ALI. Secondary aims include assessment
of the effect of calfactant on oxygenation and on the length of mechanical ventilation, PICU
stay, and hospital stay. Calfactant therapy has been found to be of benefit in acute lung
injury in the overall pediatric population by improving oxygenation and decreasing mortality.
These findings, in conjunction with recent subgroup analysis in which calfactant therapy
appeared to improve outcomes in immunocompromised children provide the rationale for
assessing calfactant therapy in this patient population.

Funding Source - FDA Office of Orphan Products Development (OOPD)


Inclusion Criteria:

1. Patients must meet criteria for acute lung injury

- Intubated, mechanically ventilated, with respiratory failure secondary to
diffuse, bilateral parenchymal lung disease (as judged by chest x-ray).

- Oxygenation index (OI) > 13, but < 37, for two consecutive blood gases which
should be separated by at least one hour within 48 hours of the initiation of
mechanical ventilation.

- Arterial catheter placement

- Parental informed consent

2. Patients must have a diagnosis of leukemia/lymphoma undergoing active treatment or
following HSCT for any indication. Leukemia/lymphoma will be defined according to the
National Cancer Institute Surveillance Epidemiology and End Results Collaborative
Staging Manual including those conditions defined as borderline such as
myelodysplastic syndromes. All forms of HSCT will be eligible, allogeneic as well as
autologous.

Exclusion Criteria:

1. Clinical diagnosis of congestive heart failure and/or pulmonary capillary wedge
pressure >15 mmHg, or uncorrected congenital heart disease.

2. Glasgow Coma Score < 8 (prior to respiratory failure).

3. Pre-existing limitations on care options, (Do Not Attempt Resuscitation Orders, etc).

4. Patients with impending death from another disease.

5. Patients moribund or with other organ failure at possible randomization:

- hypotension unresponsive to treatment (mean BP < 60 or < 5th % for age),

- persistent cardiac tachyarrhythmia >150/minute, or persistent bradyarrythmia <
50/minute, or age appropriate criteria for younger children,

- metabolic acidosis > - 10 milliequivalent (mEq)/L for more than 2 hours,

- persistent arterial oxygen desaturation, arterial partial pressure of oxygen
(PaO2) < 50 or oxygen saturation (SaO2) saturation < 80%,

- hyperkalemia, serum K+ > 6.5 plus widening of QRS complex on EKG (QRS complex
corresponds to the depolarization of the right and left ventricles of the heart).
We found this trial at
16
sites
700 Childrens Drive
Columbus, Ohio 43205
(616) 722-2000
Nationwide Children's Hospital At Nationwide Children’s, we are creating the future of pediatric health care....
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4650 Sunset Blvd
Los Angeles, California 90027
 (323) 660-2450
Childrens Hospital Los Angeles Children's Hospital Los Angeles is a 501(c)(3) nonprofit hospital for pediatric...
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262 Danny Thomas Pl
Memphis, Tennessee 38105
(901) 495-3300
St. Jude Children's Research Hospital St. Jude is unlike any other pediatric treatment and research...
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South 34th Street
Philadelphia, Pennsylvania 19104
 215-590-1000
Children's Hospital of Philadelphia Since its start in 1855 as the nation's first hospital devoted...
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Philadelphia, PA
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Cleveland, Ohio
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30 Prospect Ave
Hackensack, New Jersey 07601
(201) 996-2000
Hackensack University Medical Center Hackensack University Medical Center, part of the Hackensack University Health Network,...
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Hershey, PA
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6621 Fannin St
Houston, Texas 77030
(832) 824-1000
Texas Children's Hospital Texas Children's Hospital, located in Houston, Texas, is a not-for-profit organization whose...
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Indianapolis, Indiana 46202
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9000 W Wisconsin Ave #270
Milwaukee, Wisconsin 53226
(414) 266-2000
Children's Hospital of Wisconsin Nothing matters more than our children. At Children's Hospital of Wisconsin,...
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Montreal, Quebec
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New York, New York 10065
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1919 E Thomas Rd
Phoenix, Arizona 85006
(602) 933-1000
Phoenix Children's Hospital Phoenix Children's Hospital has provided hope, healing, and the best healthcare for...
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3414 Fifth Avenue
Pittsburgh, Pennsylvania 15213
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San Francisco, California 94143
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Valhalla, New York 10595
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