Cyclophosphamide, Fludarabine and Antithymocyte Globulin Conditioning in Myelodysplastic Syndrome (MDS) (CyFluATG)
Conditioning With Cyclophosphamide, Fludarabine and Antithymocyte Globulin for Allogeneic Hematopoietic Cell Transplantation in Lower Risk Myelodysplastic Syndrome
Study Overview
Status
Status
Conditions
Conditions
Detailed Description
Conditioning therapy
- Cytoxan 50 mg/kg/d on d-3 to -2
- Fludarabine 30 mg/m2 on d-6 to -2
- Antithymocyte globulin (ATG; Thymoglobulin®) 1.5 mg/kg/d (for HLA-matched sibling donor HCT) or 3.0 mg/kg/d (for other alternative donor HCT)
- Methylpd 2 mg/kg/d on d-4 to -1
Mobilization and harvest
- G-CSF 10 mcg/kg/d s.c. on d-3 to 0
- Harvest of PBMCs on d 0 to +1
Donor G PBMC infusion
- Infuse G-PBMCs on d 0 to d+1.
GVHD prophylaxis
- Cyclosporine 1.5 mg/kg i.v. q 12 hrs beginning on d-1 and changed to oral dosing (with twice the i.v. dose) when oral intake is possible. Tapered beginning between d+30 and d+60.
- Methotrexate 15 mg/m2 i.v. on d+2, and 10 mg/m2 i.v. on d+4 and d+7
Preemptive dose-escalating DLIs
- Begin at d+120 or at least 2 wks after IST discontinuation.
- Failure to achieve full donor chimerism No evidence of GVHD
- CD3+ cell dose increment q 4 wks -+ cell dose: HLA-matched donor HCT (1 x 107/kg, 5 x 107/kg, 1 x 108/kg), HLA-matched unrelated donor HCT (1 x 106/kg, 5 x 106/kg, 1 x 107/kg), HLA-matched familial donor HCT (1 x 105/kg, 5 x 105/kg, 1 x 106/kg)
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Je-Hwan Lee, Doctor
- Phone Number: 82-2-3010-3218
- Email: jhlee3@amc.seoul.kr
Study Contact Backup
- Name: Ya-Eun Jang, Nurse
- Phone Number: 82-2-3010-6378
- Email: redpin75@paran.com
Study Locations
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Asanbyeongwon-gil, songpa-gu
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Seoul, Asanbyeongwon-gil, songpa-gu, Korea, Republic of, 138-736
- Recruiting
- Asan Medical Center
-
Contact:
- Yae-Eun Jang, nurse
- Phone Number: 82-2-3010-6378
- Email: redpin75@paran.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with lower risk MDS (bone marrow blast percentage < 5%)
- Patients with appropriate hematopoietic cell donor
- Adequate performance status (Karnofsky score of 70 or more; see Appendix II)
- Adequate hepatic and renal function (AST, ALT, and bilirubin < 3.0 x upper normal limit, and creatinine < 2.0 mg/dL).
- Adequate cardiac function (left ventricular ejection fraction of 40% or more on heart scan or echocardiogram)
- Signed and dated informed consent must be obtained from both recipient and donor.
Exclusion Criteria:
- Presence of significant active infection
- Presence of uncontrolled bleeding
- Any coexisting major illness or organ failure
- Patients with a diagnosis of prior malignancy unless disease-free for at least 5 years following therapy with curative intent (except curatively treated nonmelanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia)
- Patients with psychiatric disorder or mental deficiency severe as to make compliance with the treatment unlike, and making informed consent impossible
- Nursing women, pregnant women, women of childbearing potential who do not want adequate contraception
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
feasibility and efficacy
Time Frame: 4years
|
To evaluate the feasibility and efficacy of the conditioning regimen with cyclophosphamide, fludarabine and antithymocyte globulin (CyFluATG) for allogeneic hematopoietic cell transplantation (HCT) in patients with lower risk myelodysplastic syndrome (MDS).
The efficacy of the treatment will be measured in terms of engraftment and non-relapse mortality (the primary endpoints)
|
4years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
progression-free survival, and overall survival
Time Frame: 4 years
|
This study will also evaluate donor chimerism, secondary graft failure, acute and chronic graft-versus-host disease (GVHD), immune recovery, infections, progression-free survival, and overall survival.
|
4 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Je-Hwan Lee, Doctor, Asan Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Allo-038
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