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S9920 Busulfan Compared With Cyclophosphamide in Patients Undergoing Total-Body Irradiation Plus Peripheral Stem Cell Transplantation for Advanced Myelodysplastic Syndrome or Related Acute Myeloid Leukemia

5 marzo 2015 aggiornato da: Southwest Oncology Group

A Phase III Randomized Study Comparing Busulfan-Total Body Irradiation Versus Cyclophosphamide-Total Body Irradiation Preparative Regimen in Patients With Advanced Myelodysplastic Syndrome (MDS) or MDS-Related Acute Myeloid Leukemia (AML) Undergoing HLA-Identical Sibling Peripheral Blood Stem Cell Transplantation, (A BMT Study)

RATIONALE: Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy or radiation therapy used to kill tumor cells. It is not yet known if total-body irradiation plus peripheral stem cell transplantation is more effective with busulfan or with cyclophosphamide for myelodysplastic syndrome or acute myeloid leukemia.

PURPOSE: Randomized phase III trial to compare the effectiveness of busulfan with that of cyclophosphamide in patients undergoing total-body irradiation plus peripheral stem cell transplantation for advanced myelodysplastic syndrome or related acute myeloid leukemia.

Panoramica dello studio

Stato

Completato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

OBJECTIVES: I. Compare event free survival after total body irradiation (TBI) plus busulfan versus TBI plus cyclophosphamide followed by allogeneic peripheral blood stem cell transplantation in patients with advanced myelodysplastic syndrome (MDS) or MDS related acute myeloid leukemia. II. Determine the distribution of pharmacokinetic parameters for busulfan in those patients randomized to the busulfan treatment arm. III. Investigate the prognostic significance for event free survival of prior history of red cell transfusions, cytogenetic pattern, and of functional drug resistance at diagnosis in these patients. IV. Estimate the frequencies of cytogenetic and genetic changes during disease progression in these patients.

OUTLINE: This a randomized, multicenter study. Patients are stratified according to age (40 and under vs 41-55) and diagnosis and International Prognostic Scoring System (IPSS) risk group (myelodysplastic syndrome (MDS)/IPSS - intermediate 1 vs MDS/IPSS - intermediate 2 vs MDS/IPSS high risk vs MDS related acute myeloid leukemia). Patients are randomized to one of two treatment arms. Arm I: Patients receive busulfan IV over 2 hours every 6 hours on days -7 to -4 for a total of 16 doses. Arm II: Patients receive cyclophosphamide IV over 2 hours on days -5 and -4. Patients receive total body irradiation (TBI) twice a day on days -3 to -1; peripheral blood stem cell transplantation from genotypically HLA identical sibling on day 0; cyclosporine IV every 12 hours on days -1 to 60, and then tapering in the absence of graft versus host disease; and methotrexate IV on days 1, 3, 6, and 11. Patients are followed every 6 months for 5 years.

PROJECTED ACCRUAL: A total of 240 patients (120 per treatment arm) will be accrued for this study over 5 years.

Tipo di studio

Interventistico

Iscrizione (Anticipato)

240

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5G 2M9
        • Princess Margaret Hospital
  • Stati Uniti
    • Arizona
      • Phoenix, Arizona, Stati Uniti, 85062-2989
        • Good Samaritan Medical Center
      • Tucson, Arizona, Stati Uniti, 85724
        • Arizona Cancer Center
    • Arkansas
      • Little Rock, Arkansas, Stati Uniti, 72205
        • University of Arkansas for Medical Sciences
    • California
      • Berkeley, California, Stati Uniti, 94704
        • Alta Bates Comprehensive Cancer Center
      • Duarte, California, Stati Uniti, 91010-3000
        • Cancer Center and Beckman Research Institute, City of Hope
      • La Jolla, California, Stati Uniti, 92037
        • Scripps Clinic
      • Los Angeles, California, Stati Uniti, 90095-1781
        • Jonsson Comprehensive Cancer Center, UCLA
      • Los Angeles, California, Stati Uniti, 90033-0804
        • USC/Norris Comprehensive Cancer Center and Hospital
      • Orange, California, Stati Uniti, 92868
        • Chao Family Comprehensive Cancer Center
      • Orange, California, Stati Uniti, 92613-5600
        • St. Joseph Hospital - Orange
      • Sacramento, California, Stati Uniti, 95816
        • Sutter Cancer Center
      • Sacramento, California, Stati Uniti, 95817
        • University of California Davis Cancer Center
      • Stanford, California, Stati Uniti, 94305-5408
        • Stanford University Medical Center
      • Walnut Creek, California, Stati Uniti, 94598
        • Northern California Cancer Specialists Medical Clinic
    • Colorado
      • Denver, Colorado, Stati Uniti, 80010
        • University of Colorado Cancer Center
    • Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Queen's Medical Center
      • Honolulu, Hawaii, Stati Uniti, 96813
        • Cancer Research Center of Hawaii
      • Honolulu, Hawaii, Stati Uniti, 96817
        • St. Francis Medical Center
    • Idaho
      • Boise, Idaho, Stati Uniti, 83712
        • Mountain States Tumor Institute
    • Illinois
      • Maywood, Illinois, Stati Uniti, 60153
        • Loyola University Medical Center
    • Kansas
      • Kansas City, Kansas, Stati Uniti, 66160-7357
        • University of Kansas Medical Center
      • Wichita, Kansas, Stati Uniti, 67214
        • Cancer Center of Kansas - Wichita
      • Wichita, Kansas, Stati Uniti, 67214-3882
        • CCOP - Wichita
    • Kentucky
      • Lexington, Kentucky, Stati Uniti, 40536-0084
        • Albert B. Chandler Medical Center, University of Kentucky
      • Lexington, Kentucky, Stati Uniti, 40536-0093
        • Lucille Parker Markey Cancer Center, University of Kentucky
    • Louisiana
      • New Orleans, Louisiana, Stati Uniti, 70112
        • Tulane University School of Medicine
      • New Orleans, Louisiana, Stati Uniti, 70112
        • MBCCOP - LSU Health Sciences Center
      • New Orleans, Louisiana, Stati Uniti, 70112-2822
        • Louisiana State University School of Medicine
      • New Orleans, Louisiana, Stati Uniti, 70115
        • Memorial Medical Center
      • Shreveport, Louisiana, Stati Uniti, 71130-3932
        • Louisiana State University Health Sciences Center - Shreveport
    • Massachusetts
      • Boston, Massachusetts, Stati Uniti, 02118
        • Boston Medical Center
      • Boston, Massachusetts, Stati Uniti, 02118
        • Cancer Research Center
    • Michigan
      • Ann Arbor, Michigan, Stati Uniti, 48109-0752
        • University Of Michigan Comprehensive Cancer Center
      • Detroit, Michigan, Stati Uniti, 48202
        • Henry Ford Hospital
      • Detroit, Michigan, Stati Uniti, 48201-1379
        • Barbara Ann Karmanos Cancer Institute
    • Mississippi
      • Jackson, Mississippi, Stati Uniti, 39216-4505
        • University of Mississippi Medical Center
    • Missouri
      • Saint Louis, Missouri, Stati Uniti, 63110-0250
        • St. Louis University Health Sciences Center
      • Springfield, Missouri, Stati Uniti, 65807
        • CCOP - Cancer Research for the Ozarks
      • Springfield, Missouri, Stati Uniti, 65804
        • St. John's Health System
    • New York
      • New York, New York, Stati Uniti, 10032
        • Herbert Irving Comprehensive Cancer Center
    • Ohio
      • Cincinnati, Ohio, Stati Uniti, 45236
        • Jewish Hospital of Cincinnati, Inc.
      • Cleveland, Ohio, Stati Uniti, 44195
        • Cleveland Clinic Taussig Cancer Center
      • Dayton, Ohio, Stati Uniti, 45409
        • Miami Valley Hospital
      • Kettering, Ohio, Stati Uniti, 45429
        • CCOP - Dayton
    • Oklahoma
      • Oklahoma City, Oklahoma, Stati Uniti, 73190
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Portland, Oregon, Stati Uniti, 97213
        • CCOP - Columbia River Program
      • Portland, Oregon, Stati Uniti, 97201-3098
        • Oregon Cancer Center
      • Portland, Oregon, Stati Uniti, 97225
        • Providence St. Vincent Medical Center
      • Portland, Oregon, Stati Uniti, 97210
        • Legacy Cancer Services
    • Texas
      • Fort Sam Houston, Texas, Stati Uniti, 78234
        • Brooke Army Medical Center
      • Lackland Air Force Base, Texas, Stati Uniti, 78236-5300
        • Wilford Hall - 59th Medical Wing
      • Lubbock, Texas, Stati Uniti, 79423
        • Texas Tech University Health Science Center
      • Lubbock, Texas, Stati Uniti, 79430
        • Health Science Center
      • San Antonio, Texas, Stati Uniti, 78284-7811
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Stati Uniti, 78229
        • Methodist Health Care System
      • Temple, Texas, Stati Uniti, 76508
        • Scott and White Clinic
      • Temple, Texas, Stati Uniti, 76508
        • CCOP - Scott and White Hospital
    • Utah
      • Salt Lake City, Utah, Stati Uniti, 84112
        • Huntsman Cancer Institute
      • Salt Lake City, Utah, Stati Uniti, 84143
        • LDS Hospital
    • Washington
      • Seattle, Washington, Stati Uniti, 98101
        • CCOP - Virginia Mason Research Center
      • Seattle, Washington, Stati Uniti, 98104
        • Swedish Cancer Institute
      • Seattle, Washington, Stati Uniti, 98109-1024
        • Fred Hutchinson Cancer Research Center
      • Seattle, Washington, Stati Uniti, 98195-6043
        • University of Washington Medical Center
      • Tacoma, Washington, Stati Uniti, 98405-0986
        • CCOP - Northwest
      • Tacoma, Washington, Stati Uniti, 98401-2197
        • Franciscan Health System

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 16 anni a 55 anni (Bambino, Adulto)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

DISEASE CHARACTERISTICS: Cytologically confirmed myelodysplastic syndrome (MDS) Increased blasts (i.e., greater than 1 to 30% peripheral blood blasts and/or 5 to 30% bone marrow blasts) AND International Prognostic Score intermediate 1, intermediate 2, or high risk Refractory anemia with excess blasts OR Refractory anemia with excess blasts in transformation (no presence of auer rods as sole criteria) OR Chronic myelomonocytic leukemia Greater than 1% blasts in the peripheral blood and/or at least 5% blasts in the bone marrow OR MDS related acute myeloid leukemia Arising after documented MDS of at least 60 days Absolute peripheral blast count no greater than 5,000/mm3 Must have genotypically HLA identical sibling donor Must also be enrolled on SWOG-S9910 and SWOG-9007

PATIENT CHARACTERISTICS: Age: 16 to 55 Performance status: Zubrod 0-2 Life expectancy: Not specified Hematopoietic: See Disease Characteristics Hepatic: Not specified Renal: Not specified Other: No prior malignancy within past 5 years except: Adequately treated basal cell or squamous cell skin cancer Carcinoma in situ of the cervix Adequately treated stage I or II cancer in complete remission HIV negative Not pregnant or nursing Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY: Biologic therapy: No autologous peripheral stem cell transplantation prior to diagnosis of myelodysplastic syndrome (MDS) or MDS related acute myeloid leukemia Chemotherapy: No prior chemotherapy for MDS or MDS related acute myeloid leukemia except oral chemotherapy to control leukocytosis or thrombocytosis (e.g., hydroxyurea or etoposide) Endocrine therapy: Not specified Radiotherapy: No radiotherapy prior to diagnosis of MDS or MDS related acute myeloid leukemia Surgery: Not specified

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: trattamento
Procedura: trapianto allogenico di midollo osseo
giorno 0
Droga: busulfan
arm 1: 0.44 mg/kg every 6 hours, IV over 2 hours, day -7 to -4
Droga: cyclophosphamide
arm 2: 60 mg/kg every 24 hrs for 2 doses, IV over 2 hrs, days -5 and -4
Droga: cyclosporine
both arms per published schedule
Droga: methotrexate
GVHD: 15 mg/m2 day 1, 10 mg/m2 day 3, 6 and 11 by IV
Radiazione: radiation therapy
both arms: 1200 cGy total dose (6 x 200 fractions)

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Lasso di tempo
Event-free survival
Lasso di tempo: every 6 months after stem cell infusion until death or 5 years
every 6 months after stem cell infusion until death or 5 years

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Southwest Oncology Group

Collaboratori

National Cancer Institute (NCI)

Investigatori

  • Cattedra di studio: Jeanne E. Anderson, MD, Katmai Oncology Group

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio

1 febbraio 2000

Completamento primario (Effettivo)

1 marzo 2004

Completamento dello studio (Effettivo)

1 marzo 2006

Date di iscrizione allo studio

Primo inviato

2 giugno 2000

Primo inviato che soddisfa i criteri di controllo qualità

15 marzo 2004

Primo Inserito (Stima)

16 marzo 2004

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Stima)

6 marzo 2015

Ultimo aggiornamento inviato che soddisfa i criteri QC

5 marzo 2015

Ultimo verificato

1 marzo 2015

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • S9920 (Altro identificatore: SWOG)
  • U10CA032102 (Sovvenzione/contratto NIH degli Stati Uniti)

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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