- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01877837
Stem Cell Transplantation for Sickle Cell Anemia
Reduced Intensity Matched Sibling Bone Marrow Transplantation for Sickle Cell Anemia in Patients 2-30 Years Old
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Primary objective:
1) To determine disease free survival (DFS) at two years after matched sibling transplant using bone marrow (BM) after a conditioning regimen consisting of distal timed Alemtuzumab, Fludarabine, and Melphalan for patients 2-30 y/o
Secondary objectives:
- Overall survival
- Rate of neutrophil and platelet engraftment for BM
- Incidence of graft failure
- Incidence of grade II-IV and grade III-IV acute graft vs host disease (GVHD)
- Incidence of chronic GVHD
- Incidence of other transplant complications, such as veno-occlusive disease, central nervous system (CNS) toxicity, and idiopathic pneumonia syndrome (IPS)
- Incidence of reactivation of CMV, EBV, adenovirus, BK/JC virus
- Incidence of invasive fungal disease
- Time to immune reconstitution via monitoring of lymphocyte subpopulations and immunoglobulin levels
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
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New Jersey
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Hackensack, New Jersey, United States, 07601
- Hackensack University Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Patient Eligibility
1) Matched sibling donors (9-10/10 marrow/PBSC or 5-6/6 UCB (single or double) with a total TNC dose of greater than 5 x 107/kg recipient weight)
- Age 2-30
- Hb SS, S-thal0, S-thal+, SC
- Evidence of ongoing hemolysis: Hb<10, retic >5%, LDH > 500, TB>2
- Karnofsky/Lansky score >50
- LVSF>26% or LVEF>40%
- DLCO >40% or O2 sat >85% for those patients that can't perform PFTs
- GFR >70 and serum creatinine < 1.5 * ULN for age
- ALT and AST < 5 x ULN, direct bilirubin <2 x ULN
- If the patient has been on chronic transfusion or has a ferritin >1000, liver biopsy should be done and show no evidence of bridging fibrosis or cirrhosis
Exclusion criteria
- Evidence of uncontrolled bacterial, viral, or fungal infection within one month prior to initiation of the conditioning regimen
- Pregnant or breastfeeding
- HIV positive
- Written informed consent not obtained
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Related donor
Matched sibling donors (9-10/10 marrow/PBSC or 5-6/6 UCB (single) with a total TNC dose of greater than 5 x 107/kg recipient weight), age 2-30 years after conditioning regimen Alemtuzumab , Fludarabine, and Melphalan. 1) Patients will receive a conditioning regimen composed of Alemtuzumab, Fludarabine, and Melphalan as detailed in the table below. Day Treatment
|
Adjusted Ideal Body Weight Formula: AIBW = IBW + [(0.4) x (ABW - IBW)] b) Medications i.) Alemtuzumab I. Hb S% must be < or = 45% within 7 days prior to initiation of Alemtuzumab II. Iron chelation and hydroxyurea must be discontinued >48 hours before initiating therapy III. Alemtuzumab will be diluted in 100mL of 0.9% NS and infused at a rate as below
Other Names:
I. Fludarabine should be diluted in 100 ml 0.9%NS and given over 30 minutes.
II.
A daily dose of an antiemetic should be given 30 minutes prior to administration of the Fludarabine
Other Names:
I. Melphalan should be diluted in 0.9%NS to a concentration of 0.1 -0.45 mg/mL and given over 45 minutes. *Entire dose must be infused within 60 minutes of reconstitution in Pharmacy. II. A daily dose of an antiemetic should be given 30 minutes prior to administration of the Melphalan III. Patients should be encouraged to suck on a popsicle or something similar during the Melphalan infusion.
Other Names:
Infusion of Hematopoietic Stem Cells
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Graft Failure
Time Frame: 2 years
|
Primary endpoint: In each group, the Number of participants with Graft Failure at the 2 years endpoint will be estimated using the Kaplan Meier product limit estimator. |
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Survival
Time Frame: 2 years
|
Secondary endpoints: Overall survival: The distribution of time to death from any cause will be estimated by Kaplan- Meier product limit function and plotted. The overall survival will be measured from the time of transplant to any death and patients will be followed for 2 years. |
2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jennifer Krajewski, MD, Hackensack Meridian Health
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Hematologic Diseases
- Genetic Diseases, Inborn
- Anemia
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Hemoglobinopathies
- Anemia, Sickle Cell
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Antineoplastic Agents, Alkylating
- Alkylating Agents
- Myeloablative Agonists
- Antineoplastic Agents, Immunological
- Melphalan
- Fludarabine
- Fludarabine phosphate
- Alemtuzumab
Other Study ID Numbers
- Pro00001894
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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