Supplementary Table 1 | Clinical trials (active, recruiting) investigating GVHD prevention strategies† Identifier Study Name Investigational Agent Eligibility Primary Outcome Measure Site NCT01788501 Tacrolimus-MTX versus CSA-MTX for prophylaxis of GVHD in pediatric patients Tacrolimus-MTX vs CSA-MTX Disease: Hematologic malignancy Donor: Not Specified Age: < 18 years Conditioning: Not Specified Acute GVHD (day 100) Korea NCT00520130 Phase II trial of targeting immunedepleting chemotherapy and reduced intensity allogeneic HSCT using 8/8 and 7/8 HLA-matched unrelated donors and two GVHD prophylaxis regimens for the treatment of leukemias, lymphomas, and pre-malignant blood disorders Multicenter trials to evaluate the efficacy and toxicity of sirolimus/tacrolimus combination as a GVHD prophylaxis after HLA matched related PBSCT Tacrolimus-MTXSirolimus vs Campath-CSA Disease: Hematologic malignancy Donor: HLA match (related: 69-74 years) or 1-antigen mismatch (unrelated: 18-74 years) Age: 18-74 years Conditioning: Reduced Efficacy and safety of tacrolimus-MTXsirolimus vs alemtuzumab-CSA (for example, engraftment, acute GVHD, early and late treatment related mortality and overall survival) (1 year) USA Tacrolimus-Sirolimus Disease: Hematologic malignancy Donor: HLA match (related) Age: 20 – 60 years Conditioning: Not Specified Grade 2-4 acute GVHD (day 100) Korea NCT01203722 Reduced intensity, partially HLA mismatched allogeneic BMT for hematologic malignancies using donors other than first-degree relatives Tacrolimus-MMF vs Sirolimus-MMF Disease: Hematologic malignancy Donor: HLA-mismatch (unrelated) Age: 0.5 – 75 years Conditioning: Myeloablative or reduced Phase I: Severe acute GVHD (<25%) and non-relapse mortality (<20%) (day 100) Phase II: Survival without grade 3-4 GVHD or evidence of graft failure (day 180) USA NCT01303965 Phase I/II trial of allogeneic PBSCT followed by maintenance therapy with lenalidomide and sirolimus in patients with high risk multiple myeloma Tacrolimus-SirolimusLenolidomide Disease: Multiple myeloma Donor: HLA-match (related or unrelated) Age: ≥ 18 years Conditioning: Reduced Phase I: Safety Phase II: 60% of patients alive and progression-free (1 year) USA NCT01534143 A pilot study using high dose busulfan and bortezomib as part of allogeneic transplant conditioning regimen for high Tacrolimus-SirolimusATG Disease: Multiple myeloma Donor: HLA-match (related or unrelated) Acute GVHD (6 months) USA NCT01488253 1 risk multiple myeloma patients NCT01428973 Age: 18 – 70 years Conditioning: Reduced Allogeneic HCT from HLA-matched donors after reduced intensity conditioning: a phase II randomized study comparing two GVHD prophylaxis regimens Tacrolimus-Sirolimus Disease: Hematologic malignancy Donor: HLA-match (related or unrelated) Age: 16 – 75 years Conditioning: Reduced Progression-free survival (1 year) Belgium NCT01251575 A phase II study to assess immunosuppression with sirolimus combined with cyclosporine and MMF for prevention of acute GVHD after nonmyeloablative HLA class I or II mismatched donor HCT – a multi-center trial CSA-MMF-Sirolimus Disease: Hematologic malignancy Donor: HLA-mismatch (related or unrelated) Age: Not Specified Conditioning: Reduced Grade 2-4 acute GVHD (day 100) USA NCT01231412 A randomized phase 3 study to determine the most promising postgafting immunosuppression for prevention of acute GVHD after unrelated donor hematopoietic cell transplantation using nonmyeloablative conditioning for patients with hematologic malignancies: a multicenter trial CSA-MMF-Sirolimus vs CSA-MMF Disease: Hematologic malignancy Donor: HLA-match (unrelated) Age: > 50 years Conditioning: Reduced Grade 2-4 acute GVHD (day 100) USA NCT00074490 Allogeneic HSCT without preparative chemotherapy or with low-intensity preparative chemotherapy using sirolimus and sirolimus-generated donor Th2 cells for therapy of refractory leukemia, lymphoma, myeloma or myelodysplastic syndrome CSA-Sirolimus Disease: Hematologic malignancy Donor: HLA-match (related) Age: 16 to 75 years Conditioning: Reduced Safety and feasibility GVHD rate USA NCT01582048 Multicenter phase II study of peritransplantation immunosuppression using ATG, rituximab, sirolimus and MMF in patients receiving mismatched HCT after reduced intensity conditioning with Sirolimus-MMF-ATGRituximab Disease: Hematologic malignancy Donor: HLA-mismatch (unrelated) Age: 18 – 75 years Conditioning: Reduced Treatment related mortality (1 year) Germany vs Tacrolimus-MMF 2 fludarabine and treosulfan NCT00305682 Transplantation of unrelated donor umbilical cord blood in patients with hematological malignancies using a nonmyeloablative preparative regimen Sirolimus-MMF Disease: Hematologic malignancy Donor: UCB Age: up to 75 years Conditioning: Reduced Overall survival (1 year) USA NCT01713400 Tacrolimus, sirolimus and ustekinumab vs tacrolimus and sirolimus for the prevention of acute GVHD following allogeneic HCT Tacrolimus-SirolimusUstekinumab vs Tacrolimus-Sirolimus Disease: Hematologic malignancy Donor: Not Specified Age: 18 – 70 years Conditioning: Myeloablative or reduced Treg/total CD4+ ratio (day 30) USA NCT00426517 Allogeneic and matched unrelated donor stem cell transplantation for congenital immunodeficiencies or patients with autoinflammatory/ immunodysregulatory conditions: busulfan-based conditioning with Campath-1H or h-ATG, radiation, and sirolimus Nonmyeloablative haploidentical peripheral blood mobilized hematopoietic precursor cell transplantation for severe congenital anemias including sickle cell disease and betathalassemia Campath or ATGSirolimus Disease: Non-malignant Donor: HLA-match (related or unrelated) or UCB Age: 2- 65 years Conditioning: Reduced Phenotypic correction of the disease USA AlemtuzumabSirolimus-Cy Disease: Severe congenital anemias Donor: HLA-haplotype (related) Age: ≥2 years Conditioning: Reduced Sustained donor type hemoglobin for patients with sickle cell disease or are transfusion-independent for patients with thalassemia and not have severe GVHD (1 year) USA NCT00061568 Non-myeloablative allogeneic peripheral blood mobilized hematopoietic precursor cell transplantation for severe congenital anemias including sickle cell disease, thalassemia, and diamond blackfan anemia Campath-Sirolimus Disease: Severe congenital anemias Donor: HLA-match (related) Age: 2 to 65 years Conditioning: Reduced Rate of engraftment (5 years) USA NCT01499888 Phase I/II study of allogeneic stem cell transplantation to treat clinically aggressive sickle cell disease Campath-Sirolimus Disease: Sickle cell disease Donor: HLA-match (related) Age: 18 – 60 years Conditioning: Reduced Engraftment (30 days) USA NCT01810926 A phase II multicentre, randomized, controlled open-label study on the use of MRD: CSA-MTXATG-F vs Disease: Non-malignant Donor: HLA match (related or MRD: graft failure, grade 2-4 acute GVHD, chronic GVHD, or death (first Italy NCT00977691 3 ATG-F and rituximab for immunomodulation of GVHD in allogeneic matched transplants for non-malignancies CSA-MTX MUD: CSA-MTXATG-F-Rituximab vs CSA-MTX-ATG-F CSA-MMF-ATG unrelated) Age: up to 64 years Conditioning: Myeloablative event) MUD: grade 2-4 acute GVHD or EBV viremia (first event) Disease: Hematologic malignancy Donor: HLA-match (related) Age: up to 70 years Conditioning: Reduced Measure how frequently and to what degree a complication of acute GVHD occurs USA NCT00185640 Allogeneic HCT using a non-myeloablative preparative regimen of total lymphoid irradiation and ATG for older patients with hematologic malignancies NCT01856803 ATG for GVHD prophylaxis after HLAmatched sibling stem cell transplantation in patients at 40 years of age or more with hematological malignancies CSA-MTX-MMF vs CSA-MTX-MMF-ATG Disease: Hematologic malignancy Donor: HLA-match (related) Age: 40 – 60 years Conditioning: Myeloablative Acute and chronic GVHD (2 years) China NCT01883180 Viral infection in haploidentical hematopoietic stem cell transplantation with different dose of ATG for acute GVHD prophylaxis CSA-MTX-MMF-ATG Disease: Require allogeneic HSCT Donor: HLA-Haplotype (related) Age: 14 – 65 years Conditioning: Not Specified Incidence of EBV and CMV infections (2 years) China NCT01295710 Phase 3 study of US-ATG-F to prevent moderate to severe chronic GVHD in adult AML, ALL, or MDS patients after allogeneic stem cell transplantation from unrelated donors CD34+ stem cell selection for patients receiving partially matched family or matched unrelated adult donor allogeneic stem cell transplantations for malignant and non-malignant disease US-ATG-F vs placebo Moderate to severe chronic GVHD or death USA Safety, toxicity and feasibility of CD34+ stem cell selection in children, adolescents and young adults (10 years) USA CD34 selection for ex vivo T cell depletion of mobilized peripheral blood stem cells for recipients of HLA haploidentical related donor stem cell grafts receiving intensive conditioning T-cell depletion Disease: Require allogeneic HSCT for AML, ALL, or MDS Donor: HLA-match unrelated Age: 18-65 years Conditioning: Not specified Disease: Hematologic malignancy and non-malignant conditions Donor: HLA-match (unrelated) or mismatch (related) Age: up to 26 years Conditioning: Myeloablative or reduced Disease: Hematologic malignancy Donor: Lack of 5/6 or 6/6 HLA-match Age: ≤ 55 years Conditioning: Myeloablative Engraftment & acute GVHD (day 100) Severe chronic GVHD (1 year) USA NCT01049854 NCT00368355 T-cell depletion 4 NCT01119066 A phase II trial of transplants from HLAcompatible related or unrelated donors with CD34+ enriched, T cell depleted PBSC isolated by the cliniMACS system in the treatment of patients with hematolgic malignancies and other lethal hematologic disorders A reduced intensity conditioning regimen with CD3 depleted hematopoietic stem cells to improve survival for patients with hematologic malignancies undergoing haploidentical stem cell transplantation T-cell depletion Disease: Hematologic malignancy Donor: HLA-matched (related or unrelated) Age: up to 69 years Conditioning: Myeloablative Engraftment (3 years) Acute and chronic GVHD (3 years) Non-relapse mortality, survival, and disease-free survival (2 years) USA T-cell depletion Disease: Hematologic malignancy Donor: HLA-haplotype (related) Age: up to 21 years Conditioning: reduced Event-free survival (1 year) USA Haploidentical stem cell transplantation with fixed dose of T cells after in vitro T cell depletion using CD3 monoclonal antibody for children with acquired severe aplastic anemia Allogeneic HSCT for severe aplastic anemia and other bone marrow failure syndromes using G-CSF mobilized CD34+ selected hematopoietic precursor cells coinfused with a reduced dose of nonmobilized donor T cells An investigator initiated double blind randomized study of alefacept treatment prevention of GVHD in myeloablative stem cell transplantation T-cell depletion Disease: Severe aplastic anemia Donor: HLA-haplotype (related) Age: up to 21 years Conditioning: Reduced Engraftment and survival (2 years) Korea T-cell depletion + non-mobilized CD3+ T cells Disease: Bone marrow failure syndromes Donor: HLA-match (related) Age: 6 – 80 years Conditioning: Reduced Chronic GVHD (1 year) USA Alefacept Disease: Require allogeneic HSCT Donor: HLA-matched (related or unrelated) Age: 14 – 75 years Conditioning: Myeloablative Acute GVHD (day 100) Israel NCT01012492 Safety and tolerability trial of abataceptbased immunosuppression for prevention of acute GVHD during unrelated donor HSCT CSA-MTX-Abatacept Disease: Hematologic malignancy Donor: HLA-match (unrelated) Age: 12 years or older Conditioning: Myeloablative Safety and tolerability (3 years) USA NCT00096161§ Pentostatin and donor lymphocyte infusion for low donor T cell chimerism after HCT – a multi-center trial CSA-MMF-Pentostatin Disease: Require allogeneic HSCT Donor: HLA-match (related or unrelated) Age: Not Specified Conditioning: Not Specified Safety and efficacy (day 100) USA NCT00566696 NCT01759732 NCT01174108 NCT00361413 5 NCT01754389 A 3-arm randomized phase II study of standard-of-care versus bortezomib based GVHD regimen for reduced intensity conditioning HSCT in patients lacking HLAmatched related donors Tacrolimus-MTX vs Tacrolimus-MTXBortezomib vs Tacrolimus-SirolimusBortezomib Disease: Hematologic malignancy Donor: HLA matched (unrelated or 1-antigen mismatched related or unrelated) Age: 18 – 75 years Conditioning: Reduced Grade 2-4 acute GVHD (180 days) USA NCT01926899 A phase I study evaluating the addition of bortezomib to an established acute GVHD prophylaxis regimen in pediatric allogeneic HSCT CSA-MTX-Bortezomib Disease: Require allogeneic HSCT Donor: HLA matched (related or unrelated) Age: 1 – 21 years Conditioning: Not Specified Maximum tolerated dose (day 100) USA NCT01860170 A phase I trial of post-transplant bortezomib and high dose Cy as GVHD prophylaxis after reduced intensity allogeneic HSCT Bortezomib-Cy Disease: Hematologic malignancy Donor: HLA-match (related or unrelated) Age: ≥ 18 years Conditioning: Reduced Dose limiting toxicity (day 90) USA NCT01785810 A phase II study to assess the efficacy of maraviroc a CCR5-antagonist in prophylaxis of GVHD in patients with hematologic malignancies undergoing reduced intensity allogeneic stem cell transplantation from unrelated donors A pilot trial of vorinostat plus tacrolimus and methotrexate to prevent GVHD following unrelated donor HSCT Tacrolimus-MTXMaraviroc Disease: Hematologic malignancy Donor: HLA-match (unrelated) Age: ≥ 18 years Conditioning: Reduced Serious adverse events (day 180) Grade 2-4 acute GVHD (day 180) USA Tacrolimus-MTXVorinostat Feasibility (for example, administration of at least 60% of planned doses for an individual study patient) (day 30) USA NCT01451268 Phase I/II study with oral panobinostat maintenance therapy following allogeneic stem cell transplantation in patients with high risk MDS or AML Standard GVHD prophylaxisPanobinostat Disease: Hematologic malignancy Donor: HLA matched (unrelated) Age: 18 – 75 years Conditioning: Myeloablative Disease: AML, MDS, CMML Donor: HLA-match (related or unrelated) Age: ≥ 18 years Conditioning: Reduced Maximum tolerated dose (28 days after administration) USA NCT01790295 Exploring the potential of dual kinase JAK 1/2 inhibitor ruxolitinib (INC424) with reduced intensity allogeneic HCT in patients with myelofibrosis Ruxolitinib Disease: Primary myelofibrosis Donor: HLA-match (related or unrelated) Age: 18-70 years Conditioning: Reduced Survival without graft failure (day 100) USA NCT01789255 6 NCT00425802 A nonmyeloablative conditioning regimen with peri-transplant rituximab and the transplantation of hematopoietic stem cells from HLA-compatible related or unrelated donors in patients with B cell lymphoid malignancies A pilot study of brentuximab vedotin in the prevention of GVHD after mismatched unrelated allogeneic stem cell transplantation CSA-MMF-Rituximab Disease: B cell lymphoid malignancy Donor: HLA-match (related) Age: 18 – 70 years Conditioning: Reduced Overall and event-free survival (1 year) USA Tacrolimus-MTXBrentuximab Disease: Hematologic malignancy Donor: 6/8- or 8/8 mismatched (unrelated) Age: 18 – 65 years Conditioning: Myeloablative Maximum tolerated dose (37 days) USA NCT01749111 Randomized study to compare post bone marrow transplant Cy with the combination of MTX plus CNI for GVHD prophylaxis (CICLODECH) Cy vs CNI-MTX Disease: Hematologic malignancy Donor: HLA matched (related or unrelated) Age: 18-60 years Conditioning: Not Specified Patients alive, in remission, and without immunosuppression (1-year) Brazil NCT01349101 Post-transplant Cy for unrelated and related allogeneic HSCT for hematological malignancies Tacrolimus-MMF-Cy Disease: Hematologic malignancy Donor: 0-, 1-, 2-, 3-, or 4-antigen mismatch at HLA-A, -B, -C, -DR loci (related) or up to two allele mismatch (unrelated) Age: ≥ 18 years Conditioning: Myeloablative or reduced Engraftment (day 100) USA NCT01315132 A two-step approach to matched sibling allogeneic HSCT for high risk hematological malignancies Cy Disease: Hematologic malignancy Donor: HLA-match (related) Age: ≥ 18 years Conditioning: Myeloablative Overall survival (1 year) USA NCT01749293 Partially HLA mismatched allogeneic BMT for patients with hematologic malignancies Tacrolimus-MMF-Cy Disease: Hematologic malignancy Donor: Lack full HLA-match Age: 10 – 75 years Conditioning: Reduced Engraftment rates and incidence of full donor chimerism (day 60) USA NCT01342289 Shortened-duration tacrolimus following nonmyeloablative, related donor BMT with high-dose posttransplantation Cy Tacrolimus-MMF-Cy Disease: Hematologic malignancy Donor: HLA-haplotype (related) Age: 0.5 – 75 years Safety of reduced duration tacrolimus (day 5 – day 120) USA NCT01700751 7 Conditioning: Reduced NCT00358657 HLA-haploidentical related marrow grafts for the treatment of primary immunodeficiencies and other nonmalignant disorders using conditioning with low-dose cyclophosphamide, TBI, and fludarabine; postgrafting immunosuppression will consist of a single low dose of cyclophosphamide, MMF, and tacrolimus Tacrolimus-MMF-Cy Disease: Nonmalignant disease Donor: HLA-haplotype (related) Age: up to 54 years Conditioning: Reduced Safety (that is, probability of transplantrelated mortality exceeding 25% or of grades 3-4 acute GVHD exceeding 25%) (day 100) USA NCT01747499 Phase I/II trial of intravenous azacitidine in patients undergoing matched unrelated stem cell transplantation Tacrolimus-MTXAzacitidine Disease: Hematologic malignancy Donor: HLA-matched (unrelated) Age: 18 – 65 years Conditioning: Myeloablative or reduced Phase 1: maximum tolerated dose (day 28) Phase 2: Grade 2-4 acute GVHD (day 100) USA NCT01491958 Phase II trial evaluating the safety and efficacy of atorvastatin for the prophylaxis of acute GVHD in patients with hematological malignancies undergoing HLA-matched related donor HSCT Tac-MTX-Atorvastatin Disease: Hematologic malignancy Donor: HLA matched (related) Age: 18 – 75 years Conditioning: Myeloablative or reduced Grade 2-4 acute GVHD (day 100) USA NCT01665677 Phase II study of atorvastatin, micro-dose methotrexate and tacrolimus administered only to transplant recipients for the prophylaxis of acute GVHD following allogeneic HSCT Tac-MTX-Atorvastatin Disease: Hematologic malignancy Donor: HLA matched (related or unrelated) Age: 18 – 75 years Conditioning: Myeloablative or reduced Grade 2-4 acute GVHD (1 year) USA NCT01527045 Donor statin treatment for prevention of severe acute GVHD after nonmyeloablative HCT Donor: Atorvastatin Disease: Hematologic malignancy Donor: HLA matched (related) Age up to 75 years Conditioning: Reduced Grade 3-4 acute GVHD (day 100) USA NCT00651716 Regulatory T cells at engraftment as predictors of acute GVHD outcomes in patients undergoing allogeneic stem cell transplantation T regulatory cells Disease: Require allogeneic HSCT Donor: Not Specified Age: 18 years and older Conditioning: Not Specified Percentage of regulatory T cells at engraftment USA NCT01660607 Phase I/II trial for patients with advanced T-cell depletion Disease: Hematologic malignancy Event free survival post-HCT (1 year) USA 8 hematologic malignancies undergoing myeloablative allogeneic HCT with a T cell depleted graft with simultaneous infusion of conventional T cells and regulatory T cells T regulatory Cells Donor: HLA-match (related) Age: 13 to 60 years Conditioning: Myeloablative NCT00602693 Phase I study of infusion of UCB derived CD25+CD4+ Treg cells after nonmyeloablative cord blood transplantation T regulatory cells Disease: Hematologic malignancy Donor: 3 partial HLA-match (UCB units) Age: 18 – 75 years Conditioning: Reduced Maximum tolerated dose USA NCT01818479 Phase I/II study of Treg/Tcon addback to CD34 selected partially matched related donor stem cells with myeloablative conditioning for high risk hematologic malignancies Phase II trial using low dose IL-2 to induce regulatory T cells in patients after allogeneic HSCT as GVHD prophylaxis T regulatory cells Disease: Hematologic malignancy Donor: 3-5/6 HLA-match (related) Age: up to 70 years Conditioning: Myeloablative Grade 2-4 acute GVHD (day 100) USA IL-2 Disease: Hematologic malignancy Donor: Not Specified Age: up to 70 years Condition: Not Specified Dose limiting toxicity (12 weeks) USA NCT01045382 Co-transplantation of mesenchymal stem cells and HLA-mismatched allogeneic hematopoietic cells after nonmyeloablative conditioning: a phase II randomized double-blind study Mesenchymal Stem Cells Disease: Hematologic malignancy Donor: HLA-mismatch (related or unrelated) Age: ≤ 75 years Conditioning: Reduced Overall survival (1 year) Belgium NCT01941394 Pilot study for safety and effectiveness assessment of bone marrow mesenchymal stem cell infusion for acute GVHD prophylaxis and treatment after allogeneic BMT A phase I/II dose escalation study evaluating safety and feasibility of BPX-501 T cells after partially mismatched, related, T cell-depleted HSCT Mesenchymal Stem Cells Disease: Require allogeneic BMT Donor: HLA-match (related or unrelated) Age: 18 – 60 years Conditioning: Not Specified Disease: ALL, AML, Lymphoma Donor: Lack of 7/8 or 8/8 HLA-match (related or unrelated) Age: 18-65 years Conditioning: Not Specified GVHD (every 30 day for 1 year after BMT) Russia Maximum dose resulting in adjusted cumulative incidence of no more than 45% grade 2-4 acute GVHD and no more than 17% grade 3-4 acute GVHD (day 100) USA NCT00539695 NCT01744223 iCasp9 Suicide Gene 9 NCT01494103 Administration of haploidentical donor T cells transduced with the inducible caspase-9 suicide gene iCasp 9 Suicide Gene Disease: Hematologic malignancy Donor: Lack of 5/6 or 6/6 HLA-match Age: Not Specified Conditioning: Not Specified Effects of AP1903 administration T cell dose that produces >25% risk of ≥ grade 2 GVHD (42 days). Measure immune reconstitution of recipients of iCasp9 T cells USA † As of November, 2013 www.ClinicalTrials.gov Abbreviations: ATG, anti-thymocyte globulin; ATG-F, anti-thymocyte globulin-Fresenius; ALL, acute lymphoid leukemia; AML, acute myeloid leukemia; BMT, bone marrow transplantation,; CMV, cytomegalovirus; CNI, calcineurin inhibitor; CSA, cyclosporine; EBV, epstein barr virus; GVHD, graft-versus-host disease; HCT, hematopoietic cell transplantation; HSCT, hematopoietic stem cell transplantation; iCasp, inducible Caspase; MMF,mycophenolate mofetil; MDS, myelodysplastic syndrome; MRD, matched related donor; MTX, methotrexate; MUD, matched unrelated donor; PBSCT, peripheral blood stem cell transplantation; UCB, umbilical cord blood 10