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- Klinische proef NCT00005866
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
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.
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Verwacht)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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Ontario
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Toronto, Ontario, Canada, M5G 2M9
- Princess Margaret Hospital
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Arizona
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Phoenix, Arizona, Verenigde Staten, 85062-2989
- Good Samaritan Medical Center
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Tucson, Arizona, Verenigde Staten, 85724
- Arizona Cancer Center
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Arkansas
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Little Rock, Arkansas, Verenigde Staten, 72205
- University of Arkansas for Medical Sciences
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California
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Berkeley, California, Verenigde Staten, 94704
- Alta Bates Comprehensive Cancer Center
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Duarte, California, Verenigde Staten, 91010-3000
- Cancer Center and Beckman Research Institute, City of Hope
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La Jolla, California, Verenigde Staten, 92037
- Scripps Clinic
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Los Angeles, California, Verenigde Staten, 90095-1781
- Jonsson Comprehensive Cancer Center, UCLA
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Los Angeles, California, Verenigde Staten, 90033-0804
- USC/Norris Comprehensive Cancer Center and Hospital
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Orange, California, Verenigde Staten, 92868
- Chao Family Comprehensive Cancer Center
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Orange, California, Verenigde Staten, 92613-5600
- St. Joseph Hospital - Orange
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Sacramento, California, Verenigde Staten, 95816
- Sutter Cancer Center
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Sacramento, California, Verenigde Staten, 95817
- University of California Davis Cancer Center
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Stanford, California, Verenigde Staten, 94305-5408
- Stanford University Medical Center
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Walnut Creek, California, Verenigde Staten, 94598
- Northern California Cancer Specialists Medical Clinic
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Colorado
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Denver, Colorado, Verenigde Staten, 80010
- University of Colorado Cancer Center
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Hawaii
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Honolulu, Hawaii, Verenigde Staten, 96813
- Queen's Medical Center
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Honolulu, Hawaii, Verenigde Staten, 96813
- Cancer Research Center of Hawaii
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Honolulu, Hawaii, Verenigde Staten, 96817
- St. Francis Medical Center
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Idaho
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Boise, Idaho, Verenigde Staten, 83712
- Mountain States Tumor Institute
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Illinois
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Maywood, Illinois, Verenigde Staten, 60153
- Loyola University Medical Center
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Kansas
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Kansas City, Kansas, Verenigde Staten, 66160-7357
- University of Kansas Medical Center
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Wichita, Kansas, Verenigde Staten, 67214
- Cancer Center of Kansas - Wichita
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Wichita, Kansas, Verenigde Staten, 67214-3882
- CCOP - Wichita
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Kentucky
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Lexington, Kentucky, Verenigde Staten, 40536-0084
- Albert B. Chandler Medical Center, University of Kentucky
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Lexington, Kentucky, Verenigde Staten, 40536-0093
- Lucille Parker Markey Cancer Center, University of Kentucky
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Louisiana
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New Orleans, Louisiana, Verenigde Staten, 70112
- Tulane University School of Medicine
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New Orleans, Louisiana, Verenigde Staten, 70112
- MBCCOP - LSU Health Sciences Center
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New Orleans, Louisiana, Verenigde Staten, 70112-2822
- Louisiana State University School of Medicine
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New Orleans, Louisiana, Verenigde Staten, 70115
- Memorial Medical Center
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Shreveport, Louisiana, Verenigde Staten, 71130-3932
- Louisiana State University Health Sciences Center - Shreveport
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02118
- Boston Medical Center
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Boston, Massachusetts, Verenigde Staten, 02118
- Cancer Research Center
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Michigan
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Ann Arbor, Michigan, Verenigde Staten, 48109-0752
- University Of Michigan Comprehensive Cancer Center
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Detroit, Michigan, Verenigde Staten, 48202
- Henry Ford Hospital
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Detroit, Michigan, Verenigde Staten, 48201-1379
- Barbara Ann Karmanos Cancer Institute
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Mississippi
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Jackson, Mississippi, Verenigde Staten, 39216-4505
- University of Mississippi Medical Center
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Missouri
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Saint Louis, Missouri, Verenigde Staten, 63110-0250
- St. Louis University Health Sciences Center
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Springfield, Missouri, Verenigde Staten, 65807
- CCOP - Cancer Research for the Ozarks
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Springfield, Missouri, Verenigde Staten, 65804
- St. John's Health System
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New York
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New York, New York, Verenigde Staten, 10032
- Herbert Irving Comprehensive Cancer Center
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Ohio
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Cincinnati, Ohio, Verenigde Staten, 45236
- Jewish Hospital of Cincinnati, Inc.
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Cleveland, Ohio, Verenigde Staten, 44195
- Cleveland Clinic Taussig Cancer Center
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Dayton, Ohio, Verenigde Staten, 45409
- Miami Valley Hospital
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Kettering, Ohio, Verenigde Staten, 45429
- CCOP - Dayton
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Oklahoma
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Oklahoma City, Oklahoma, Verenigde Staten, 73190
- University of Oklahoma Health Sciences Center
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Oregon
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Portland, Oregon, Verenigde Staten, 97213
- CCOP - Columbia River Program
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Portland, Oregon, Verenigde Staten, 97201-3098
- Oregon Cancer Center
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Portland, Oregon, Verenigde Staten, 97225
- Providence St. Vincent Medical Center
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Portland, Oregon, Verenigde Staten, 97210
- Legacy Cancer Services
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Texas
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Fort Sam Houston, Texas, Verenigde Staten, 78234
- Brooke Army Medical Center
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Lackland Air Force Base, Texas, Verenigde Staten, 78236-5300
- Wilford Hall - 59th Medical Wing
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Lubbock, Texas, Verenigde Staten, 79423
- Texas Tech University Health Science Center
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Lubbock, Texas, Verenigde Staten, 79430
- Health Science Center
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San Antonio, Texas, Verenigde Staten, 78284-7811
- University of Texas Health Science Center at San Antonio
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San Antonio, Texas, Verenigde Staten, 78229
- Methodist Health Care System
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Temple, Texas, Verenigde Staten, 76508
- Scott and White Clinic
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Temple, Texas, Verenigde Staten, 76508
- CCOP - Scott and White Hospital
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Utah
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Salt Lake City, Utah, Verenigde Staten, 84112
- Huntsman Cancer Institute
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Salt Lake City, Utah, Verenigde Staten, 84143
- LDS Hospital
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Washington
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Seattle, Washington, Verenigde Staten, 98101
- CCOP - Virginia Mason Research Center
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Seattle, Washington, Verenigde Staten, 98104
- Swedish Cancer Institute
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Seattle, Washington, Verenigde Staten, 98109-1024
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, Verenigde Staten, 98195-6043
- University of Washington Medical Center
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Tacoma, Washington, Verenigde Staten, 98405-0986
- CCOP - Northwest
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Tacoma, Washington, Verenigde Staten, 98401-2197
- Franciscan Health System
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: behandeling
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dag 0
arm 1: 0.44 mg/kg every 6 hours, IV over 2 hours, day -7 to -4
arm 2: 60 mg/kg every 24 hrs for 2 doses, IV over 2 hrs, days -5 and -4
both arms per published schedule
GVHD: 15 mg/m2 day 1, 10 mg/m2 day 3, 6 and 11 by IV
both arms: 1200 cGy total dose (6 x 200 fractions)
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Tijdsspanne |
|---|---|
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Event-free survival
Tijdsspanne: every 6 months after stem cell infusion until death or 5 years
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every 6 months after stem cell infusion until death or 5 years
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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Studie stoel: Jeanne E. Anderson, MD, Katmai Oncology Group
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
- vuurvaste bloedarmoede met overmatige ontploffing
- refractaire bloedarmoede met overmatige ontploffing in transformatie
- chronische myelomonocytaire leukemie
- de novo myelodysplastische syndromen
- secundaire myelodysplastische syndromen
- secundaire acute myeloïde leukemie
- myelodysplastische syndromen bij kinderen
- onbehandelde volwassen acute myeloïde leukemie
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Neoplasmata per histologisch type
- Neoplasmata
- Ziekte
- Beenmergziekten
- Hematologische ziekten
- Voorstadia van kanker
- Syndroom
- Myelodysplastische syndromen
- Leukemie
- Leukemie, myeloïde
- Leukemie, myeloïde, acuut
- Preleukemie
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Nucleïnezuursyntheseremmers
- Enzymremmers
- Antireumatische middelen
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Antineoplastische middelen, alkylering
- Alkyleringsmiddelen
- Myeloablatieve agonisten
- Dermatologische middelen
- Antischimmelmiddelen
- Reproductieve controlemiddelen
- Afbrekende middelen, niet-steroïde
- Abortieve agenten
- Foliumzuurantagonisten
- Calcineurineremmers
- Cyclofosfamide
- Methotrexaat
- Busulfan
- Cyclosporine
- Cyclosporines
Andere studie-ID-nummers
- S9920 (Andere identificatie: SWOG)
- U10CA032102 (Subsidie/contract van de Amerikaanse NIH)
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