Pilot Study of Reduced Intensity Haematopoietic Stem Cell Transplantation in Patients With Poor Risk Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukaemia (AML) Utilising Conditioning With Fludarabine, Busulphan and Thymoglobulin (FB-ATG)
Pilot Study of Reduced Intensity Haematopoietic Stem Cell Transplantation in Patients With Poor Risk Myelodysplastic Syndrome and Acute Myeloid Leukaemia Utilising Conditioning With Fludarabine, Busulphan and Thymoglobulin
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Forventet)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
-
-
-
London, Det Forenede Kongerige, SE5 9RS
- King's College Hospital NHS Foundation Trust
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Patient Selection
- Availability of a HLA compatible sibling donor
- Age >18 years
- Myelodysplastic Syndromes with IPSS Intermediate-2 or High.
- Poor risk acute myeloid leukaemia, de novo or transformed from MDS
- Ineligibility for standard conditioning allograft due to age or co-existing morbidities
Donor selection
1. Related donors compatible for HLA-A, B, C, DRB1 and DQB1 by molecular typing.
Exclusion Criteria:
Patient selection
- Cardiac insufficiency requiring treatment or symptomatic coronary artery disease.
- Hepatic disease, with AST > 2 times normal.
- Severe hypoxaemia, pO2 < 70 mm Hg, with decreased DLCO < 70% of predicted; or mild hypoxemia, pO2 < 80 mm Hg with severely decreased DLCO < 60% of predicted.
- Impaired renal function (creatinine > 2 times upper limit of normal or creatinine clearance < 50% for age, gender, weight).
- Patients who have received previous treatment with Thymoglobuline
- HIV-positive patients.
- Female patients who are pregnant or breast feeding due to risks to foetus from conditioning regimen and potential risks to nursing infants.
- Life expectancy severely limited by diseases other than MDS or MPD.
- Serious concurrent untreated infection
- Patients with limited life expectancy for other reasons
- Serious psychiatric/ psychological disorders
- Absence of /inability to provide informed consent
Donor selection
- Age >75 years, unless independently assessed to be medically fit to donate
- Donors who for any reason are unable to tolerate the leukapheresis procedure and cannot undergo anaesthesia for marrow harvest.
- Donors who are HIV-positive, or hepatitis B or C PCR positive.
- Donors who are medically unsuitable to donate
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: FBATG
Haematopoietic stem cell transplantation utilising conditioning with Fludarabine, Busulphan and Thymoglobuline
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Fludarabine 30mg/m2 intravenously daily on days -9 to -5 inclusive of stem cell infusion.
Busulphan 0.8mg/kg intravenously 6 hourly on days -4 and -3 of stem cell infusion.
Thymoglobuline will be given intravenously over a minimum of 6 hours for the first two doses and 4 hours for the subsequent doses.
Acute side effects of ATG appear to be reduced if a very low dose is given for the first injection.
Thymoglobuline 0.5mg/kg iv on day -4, 1.5mg/kg/day on day -3; and 2mg/kg/day iv on day -2 to -1 inclusive.
The source of stem cells will be PBSC wherever possible.
Patients whose donors decline or are unable to donate PBSC will be transplanted with marrow cells.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Treatment related mortality to Day 100
Tidsramme: Days 28, 56 and 100
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Days 28, 56 and 100
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Incidence of single or multi-organ acute toxicity
Tidsramme: Days 28, 56 and 100
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Days 28, 56 and 100
|
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Incidence of graft failure/rejection
Tidsramme: Days 28, 56 and 100
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Days 28, 56 and 100
|
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Incidence of acute graft-versus-host disease
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Incidence of systemic infections
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Days 28, 56, 100 and months 6, 9, 12, 18 and 24
|
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EBV activation
Tidsramme: Fortnightly for first 6 weeks after transplantation and then weekly for the first 6 months.
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Fortnightly for first 6 weeks after transplantation and then weekly for the first 6 months.
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Overall survival
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Disease free survival/relapse risk
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Days 28, 56, 100 and months 6, 9, 12, 18 and 24
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Patologiske processer
- Neoplasmer efter histologisk type
- Neoplasmer
- Sygdom
- Knoglemarvssygdomme
- Hæmatologiske sygdomme
- Forstadier til kræft
- Syndrom
- Myelodysplastiske syndromer
- Leukæmi
- Leukæmi, myeloid
- Leukæmi, Myeloid, Akut
- Præleukæmi
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Fludarabin
- Busulfan
- Thymoglobulin
- Antimfocyt serum
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 06CC12
- REC - 06/Q0703/208
- EudraCT - 2006-004452-20
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