Cyclophosphamide and Busulfan as Conditioning Regimen Before Allogeneic HSCT
Cyclophosphamide-Busulfan Versus Busulfan-Cyclophosphamide as Conditioning Regimen Before Allogeneic Hematopoietic Stem Cell Transplantation for Leukemia: a Prospective Randomized Study to Assess Liver Toxicity
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Basel, Switzerland, 4031
- University Hospital, Basel
-
Geneva, Switzerland, 1205
- University Hospital Geneva
-
Zurich, Switzerland, 8091
- University Hospital Zürich
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients planned to undergo an allogeneic HSCT with myeloablative conditioning
- Age 18 - 65 years
- Myeloid leukemia respectively related precursor neoplasms (acute myeloid leukemia, chronic myeloid leukemia, myelodysplastic syndrome), or lymphoid neoplasms (acute lymphoblastic leukemia/lymphoma, mature B-/T-/natural killer (NK)-cell neoplasms).
- Human Leukocyte Antigen (HLA)-identical sibling donor or matched unrelated (min. 10/10 Ag matched)
- Patients with a history of hepatitis might be included, if no contraindication for HSCT exists.
- Patient must give written informed consent
Exclusion Criteria:
- Indication other than myeloid leukemia respectively related precursor neoplasms, or lymphoid neoplasms.
- Severe liver damage for > 2 weeks (bilirubin > 3xupper limit normal (ULN) or ASAT/ALAT > 5xULN)
- HIV infection
- Donor other than HLA-identical sibling or min. 10/10 matched unrelated donor
- Pregnant or lactating women
- Lack of written informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: BU-CY
Group A (standard group): conditioning regimen with Busulfan (BU) followed by Cyclophosphamide (CY)
|
Test the hypothesis, that the order of application of Busulfan (BU) and Cyclophosphamide (CY) has an impact on toxicity after allogeneic Hematopoietic stem cell transplantation (HSCT) and that CY-BU reduces liver toxicity compared to BU-CY.
|
|
Experimental: CY-BU
Group B (experimental group): conditioning regimen with Cyclophosphamide (CY) followed by Busulfan (BU)
|
Test the hypothesis, that the order of application of Busulfan (BU) and Cyclophosphamide (CY) has an impact on toxicity after allogeneic Hematopoietic stem cell transplantation (HSCT) and that CY-BU reduces liver toxicity compared to BU-CY.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Liver toxicity
Time Frame: Day 30
|
Liver toxicity, assessed as absolute serum values of ASAT, ALAT, GGT, Alkaline Phosphatase, bilirubin at day 30.
|
Day 30
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
VOD
Time Frame: Day 30
|
Incidence and severity of "veno occlusive disease (VOD)" at day 30
|
Day 30
|
|
Acute graft-versus-host disease (GvHD)
Time Frame: Day 30 and Day 100
|
Incidence and severity of acute GVHD, by organ (skin, liver, gut) at day 30 and day 100
|
Day 30 and Day 100
|
|
Toxicity
Time Frame: Day 30 and Day 100
|
Organ toxicity at day 30 and day 100
|
Day 30 and Day 100
|
|
Efficacy
Time Frame: Day 30 and Day 100
|
Survival, relapse and non-relapse mortality at day 30 and day 100
|
Day 30 and Day 100
|
|
Cumulative liver values
Time Frame: Day 0, 10, 20 and 30
|
Cumulative serum values of aspartate transaminase (ASAT), alanine aminotransferase (ALAT), gamma-glutamyltransferase (GGT), Alkaline Phosphatase, bilirubin for days 0, 10, 20 and 30
|
Day 0, 10, 20 and 30
|
|
Maximum liver values
Time Frame: Day 0, 10, 20 and 30
|
Maximum serum values of ASAT, ALAT, GGT, alkaline phosphatase (AP), bilirubin at any time between day 0 and day 30
|
Day 0, 10, 20 and 30
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cytokines measurement
Time Frame: Day -8, 0, 10, 20 and 30
|
To test the correlation between order of application of the conditioning regimen and the levels of proinflammatory cytokines as well as the correlation between levels of cytokines and development of acute GVHD, plasma samples will be collected at different time points.
|
Day -8, 0, 10, 20 and 30
|
|
Pharmacogenomics
Time Frame: Day -8, -3 and 0
|
The current hypothesis is that some functional polymorphisms of genes, which control important enzymes in BU and CY metabolism, contribute to the observed interindividual variability in toxicity after allogeneic HSCT.
|
Day -8, -3 and 0
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Nathan Cantoni, MD, Kantonsspital Aarau, Switzerland
- Principal Investigator: Sabine Gerull, MD, University Hospital, Basel, Switzerland
- Principal Investigator: Gayathri Nair, MD, University Hospital, Zürich
- Principal Investigator: Yves Chalandon, MD, University Hospital Geneva, Switzerland
- Principal Investigator: Jakob Passweg, MD, University Hospital, Basel, Switzerland
Publications and helpful links
Study record dates
Study Major Dates
Study Start
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 (Estimate)
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 Histologic Type
- Neoplasms
- Leukemia
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Cyclophosphamide
- Busulfan
Other Study ID Numbers
Other Study ID Numbers
- BuCyBu study
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