Study of a Reduced-toxicity Myeloablative Conditioning Regimen Using Fludarabine and Full Doses of Intravenous Busulfan in Pediatric Patients Not Eligible for Standard Myeloablative Conditioning Regimens (FB4-PEDIA)
Phase 2 Study of a Reduced-toxicity Myeloablative Conditionning Regimen Using Fludarabine and Full Doses of iv Busulfan in Pediatric Patients Not Eligible for Standard Myeloablative Conditioning Regimens
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Besançon, France
- University Hospital
-
Bordeaux, France
- University Hospital
-
Clermont-Ferrand, France
- University Hospital
-
Grenoble, France
- University Hospital
-
Lille, France
- University Hospital
-
Lyon, France
- University Hospital
-
Marseille, France
- University Hospital
-
Montpellier, France
- University Hospital
-
Nancy, France
- University Hospital
-
Nantes, France
- University Hospital
-
Paris, France
- University Hospital
-
Paris, France
- University Hopsital
-
Rennes, France
- University Hospital
-
Rouen, France
- University Hopsital
-
Strasbourg, France
- University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
- Children and adolescents aged over 12 months and under 25 years
- Availability of an HLA identical family donor or an HLA-matched unrelated donor (10/10 or 9/10 if the mismatch level is at HLACw for an unrelated donor) or availability of an HLA matched cord blood (5/6 or 6/6)
- Informed consent signed by patients (18-25 years) and patient's legal representative, parent(s) or guardian (cf p13)
- Diagnosis of a hematologic malignancy which is a candidate for allo-HSCT, but not eligible for standard or conventional myeloablative conditioning regimens because of high risk for toxicity.
Are considered as criteria of non-eligibility for standard or conventional myeloablative conditioning:
- a history of autologous or allogeneic stem cell transplantation
- comorbidities or medical history predictive of a prohibitive rate of TRM and toxicity with the use of standard high dose chemotherapy and / or radiotherapy.
Exclusion Criteria:
- Patient has been administered any other systemic chemotherapeutic drug (including Gemtuzumab) within 21 days prior to trial enrollment and start of the conditioning regimen. Hydroxyurea is permitted if indicated to control induction refractory disease, and IT chemotherapy is allowed if indicated as maintenance treatment for previously diagnosed leptomeningeal disease, that has been in remission for at least 3 months prior to enrollment on this study.
- Active infection. Protocol PI will be final arbiter if there is uncertainty regarding whether a previous infection is resolved.
- Children and adolescents who are not older than 12 months and under 25 years
- A donor who is HLA mismatched at the level of more than one locus.
- Poor performance status (Lansky < 50%)
- Life expectancy is severely limited by concomitant illness and expected to be <12 weeks.
- Left ventricular ejection fraction < 30%. Uncontrolled arrhythmias or symptomatic cardiac disease.
- Symptomatic pulmonary disease. FEV1, FVC and DLCO <30% of expected corrected for hemoglobin.
- Creatinine clearance less than 30 mL/m per 1.73 m2 or requiring dialysis
- Evidence of chronic active hepatitis or cirrhosis. If positive hepatitis serology, discuss with Study Chairman and consider liver biopsy.
- Effusion or ascites >1L prior to drainage.
- HIV-positive.
- Female pregnancy
- Absence of effective contraception among boys and girls of childbearing potential (that contraception should be continued until 6 months after stopping treatment)
- Breastfeeding
- Patient's legal representative, parent(s) or guardian not able to sign informed consent.
- children's refusal
- Hypersensitivity to rabbit proteins, to the active substance or to any of the excipients of experimental products
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Drugs
Fludarabine IV- Busulfan IV (Busilvex®) - Anti-thymocyte globulines (Thymoglobuline®)
|
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Transplant-related mortality (TRM)
Time Frame: 12 months
|
Evaluation of the cumulative incidence of TRM at 12 months after transplantation
|
12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of engraftment
Time Frame: Day+42
|
Incidence of engraftment defined as the first day of neutrophil (>500/μl for 3 consecutive days).
Engraftment failure is defined as neutrophil <500/μl at day+42 after allo-SCT.
|
Day+42
|
|
Evaluation of overall (OS) and disease-free survival (DFS)
Time Frame: 12 months
|
Evaluation of overall (OS) and disease-free survival (DFS) at 1 year after transplantation
|
12 months
|
|
Cumulative incidence of relapse, death from disease, and non-relapse mortality (NRM)
Time Frame: 12 months
|
Cumulative incidence of relapse, death from disease, and non-relapse mortality (NRM)
|
12 months
|
|
Cumulative incidences and severity of acute and chronic Graft-versus-Host disease
Time Frame: 12 months
|
Cumulative incidences and severity of acute and chronic Graft-versus-Host disease
|
12 months
|
|
Immune Recovery (to be determined in a subgroup of patients)
Time Frame: 12 months
|
Immune Recovery parameters: blood counts, bone marrow aspiration with evaluation of morphological response.
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Mohamad MOHTY, Professor, Nantes university hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Hematologic Diseases
- Hemic and Lymphatic Diseases
- Hematologic Neoplasms
- Amino Acids, Peptides, and Proteins
- Proteins
- Sulfur Compounds
- Organic Chemicals
- Hydrocarbons, Acyclic
- Hydrocarbons
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Alkanes
- Alcohols
- Butylene Glycols
- Glycols
- Mesylates
- Alkanesulfonates
- Alkanesulfonic Acids
- Sulfonic Acids
- Sulfur Acids
- Biological Products
- Complex Mixtures
- Immune Sera
- Busulfan
- Antilymphocyte Serum
Other Study ID Numbers
Other Study ID Numbers
- BRD/11/06-N
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