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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)

16. august 2011 opdateret af: King's College Hospital NHS Trust

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

The purpose of this study is to determine the safety and feasibility of conditioning with fludarabine, busulphan and thymoglobuline in patients with myelodysplastic syndrome (MDS), myelodysplastic/myeloproliferative disorders (MDS/MPD) or acute myeloid leukaemia (AML) undergoing haematopoietic stem cell allograft with granulocyte colony-stimulating factor (G-CSF)-mobilised peripheral blood stem cells (PBSC) (or bone marrow) from HLA compatible sibling donors.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

20

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

Patient Selection

  1. Availability of a HLA compatible sibling donor
  2. Age >18 years
  3. Myelodysplastic Syndromes with IPSS Intermediate-2 or High.
  4. Poor risk acute myeloid leukaemia, de novo or transformed from MDS
  5. 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

  1. Cardiac insufficiency requiring treatment or symptomatic coronary artery disease.
  2. Hepatic disease, with AST > 2 times normal.
  3. 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.
  4. Impaired renal function (creatinine > 2 times upper limit of normal or creatinine clearance < 50% for age, gender, weight).
  5. Patients who have received previous treatment with Thymoglobuline
  6. HIV-positive patients.
  7. Female patients who are pregnant or breast feeding due to risks to foetus from conditioning regimen and potential risks to nursing infants.
  8. Life expectancy severely limited by diseases other than MDS or MPD.
  9. Serious concurrent untreated infection
  10. Patients with limited life expectancy for other reasons
  11. Serious psychiatric/ psychological disorders
  12. Absence of /inability to provide informed consent

Donor selection

  1. Age >75 years, unless independently assessed to be medically fit to donate
  2. Donors who for any reason are unable to tolerate the leukapheresis procedure and cannot undergo anaesthesia for marrow harvest.
  3. Donors who are HIV-positive, or hepatitis B or C PCR positive.
  4. Donors who are medically unsuitable to donate

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: FBATG
Haematopoietic stem cell transplantation utilising conditioning with Fludarabine, Busulphan and Thymoglobuline
Medicin: Fludarabine
Fludarabine 30mg/m2 intravenously daily on days -9 to -5 inclusive of stem cell infusion.
Medicin: Busulphan
Busulphan 0.8mg/kg intravenously 6 hourly on days -4 and -3 of stem cell infusion.
Medicin: Thymoglobuline (Anti-thymocyte globulin [rabbit]) - Genzyme
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.
Procedure: Haematopoietic stem cell infusion
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.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Treatment related mortality to Day 100
Tidsramme: Days 28, 56 and 100
Days 28, 56 and 100

Sekundære resultatmål

Resultatmål
Tidsramme
Incidence of single or multi-organ acute toxicity
Tidsramme: Days 28, 56 and 100
Days 28, 56 and 100
Incidence of graft failure/rejection
Tidsramme: Days 28, 56 and 100
Days 28, 56 and 100
Incidence of acute graft-versus-host disease
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Incidence of systemic infections
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Days 28, 56, 100 and months 6, 9, 12, 18 and 24
EBV activation
Tidsramme: Fortnightly for first 6 weeks after transplantation and then weekly for the first 6 months.
Fortnightly for first 6 weeks after transplantation and then weekly for the first 6 months.
Overall survival
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Disease free survival/relapse risk
Tidsramme: Days 28, 56, 100 and months 6, 9, 12, 18 and 24
Days 28, 56, 100 and months 6, 9, 12, 18 and 24

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

King's College Hospital NHS Trust

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. juni 2007

Primær færdiggørelse (Faktiske)

1. juni 2011

Studieafslutning (Faktiske)

1. juni 2011

Datoer for studieregistrering

Først indsendt

5. juni 2009

Først indsendt, der opfyldte QC-kriterier

5. juni 2009

Først opslået (Skøn)

8. juni 2009

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

17. august 2011

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. august 2011

Sidst verificeret

1. juni 2011

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 06CC12
  • REC - 06/Q0703/208
  • EudraCT - 2006-004452-20

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Myelodysplastiske syndromer

Kliniske forsøg med Fludarabine

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Italy

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner