The Rapid Study: Randomized Phase II Study To Expedite Allogeneic Transplant With Immediate Haploidentical Plus Unrelated Cord Donor Search Versus Matched Unrelated Donor Search For AML And High-Risk MDS Patients
The Rapid Study: Randomized (RA) Phase (P) II Study To Expedite Allogeneic Transplant With Immediate (I) Haploidentical Plus Unrelated Cord Donor (D) Search Versus Matched Unrelated Donor Search For AML And High-Risk MDS Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Primary Objectives
To compare time from formal search to hematopoietic cell transplantation (HCT) for patients 18 years and older, randomized between haplo-cord search and matched unrelated donor (MUD) search for patients with acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS)
Secondary Objectives
- To compare the percentage of patients who undergo HCT in each study cohort
- To evaluate overall survival from time to randomization by study cohort
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Illinois
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Chicago, Illinois, United States, 60637
- University of Chicago Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria for Search Phase:
- Diagnosis of acute myeloid leukemia (AML) or high or very high-risk MDS by international prognostic scoring system revised for whom transplant is recommended
- 18 years of age or older
- Subject is likely to be considered for allogeneic transplant in the opinion of the transplant physician (based on age of patient, health, cytogenetics, and/or molecular characteristics).
- Karnofsky Performance Status (KPS) >/= 70% at time of enrollment. An exception will be made for those with lower KPS at enrollment with an acute worsening that is likely to resolve in the treating physicians judgment (e.g., reversible infection,trauma, medication reaction, etc)
- Ability to understand and the willingness to sign a written informed consent document for the Search Phase.
- Patient willing to consider HCT
A preliminary search has identified:
- An appropriate minimum 4/6 matched umbilical cord unit at intermediate resolution at HLA-A and B, and high resolution at HLA-DRB with a cell dose above 1 x 10(7) TNC/kg for a single umbilical cord blood (UCB) transplant AND
- At least one potential 8/8 HLA-matched (HLA-A, -B, -C, and -DRB1) unrelated donor with a probability of 70% AND
- Availability of a potential related haploidentical donor.
Exclusion Criteria for Search Phase:
- Prior formal search was instituted
- Diagnosis of acute promyelocytic leukemia (APL)
- Known HLA matched related donor without contraindications to donate
- Life expectancy severely limited by concomitant illness or uncontrolled infection
Inclusion Criteria for Transplant Phase
- High-risk AML for which transplant is recommend based on cytogenetic, molecular and morphologic features. Patients must meet institutional standards for disease control prior to transplant.
- For MDS. IPSS-revised criteria of high or very high at diagnosis.
Subject meets institutional criteria for transplant and has acceptable organ and marrow function as defined below:
- Serum bilirubin < 2.0mg/dL unless Gilberts disease
- Creatinine Clearance > 45 mL/min.1.73m2 as estimated by modified MDRD equation
- Left ventricular function 40% or greater
- DLCO corrected for hemoglobin >50%
- KPS 70% or greater
An adequate graft for the defined donor type
- Haplo-cord requires a haploidentical adult donor of 14 years of age and at least 50 kg, and a cord blood unit with at least 1.0 x 10(7) TNC/kg and a match of at least 4/6 by intermediate resolution for HLA-A and B and high resolution at DRB1. Donor provides standard of care consent for harvest following institutional policy. Any donor samples or donor research data would be obtained on separate donor research protocol.
- For MUD requires a 7/8 or 8/8 HLA matched unrelated donor with high resolution matching at HLA-A, -B, -C, and DRB1. DP matching or DP permissive should be achieved when possible using T-cell epitope strategy.
- Written informed consent for the transplant phase
Exclusion Criteria for Transplant Phase
- Life expectancy severely limited by concomitant illness or uncontrolled infection
- HIV-positive
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 |
|---|---|
|
Other: Haplo-Cord Search
If subject meets the inclusion criteria and consents, will undergo a haplo-cord transplant.
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For conditioning regimens, haplo-identical grafts will be selected by the Miltenyi Device
|
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Other: Matched Unrelated Donor Search (MUD)
If subject meets the inclusion criteria and consents, will undergo a MUD transplant.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to Transplant
Time Frame: Through one year after formal search
|
Time to transplant will be measured from time of date of formal request to stem cell infusion date.
Will also capture time from preliminary search to both formal search and transplant date.
|
Through one year after formal search
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percentage of Patients Who Undergo Hematopoietic Cell Transplantation (HCT)
Time Frame: Through one year after formal search
|
Compare percentage of patients who undergo HCT in each study cohort
|
Through one year after formal search
|
|
Estimated Survival Time
Time Frame: From date of randomization up to 3 years
|
Overall survival time was estimated from date of randomization and from date of transplant using Kaplan-Meier method.
|
From date of randomization up to 3 years
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Collaborators and Investigators
Sponsor
Sponsor
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 (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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB15-0866
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