- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07563920
TBF Conditioning Regimen for Haploidentical Stem Cell Transplantation in Elderly AML Patients in First Complete Remission (TBF-AML)
A Single-Center, Prospective, Single-Arm Clinical Study Evaluating the Efficacy and Safety of Thiotepa, Busulfan, and Fludarabine (TBF) Conditioning Regimen in Haploidentical Peripheral Blood Stem Cell Transplantation for Elderly Acute Myeloid Leukemia Patients in First Complete Remission
Acute myeloid leukemia (AML) is a serious blood cancer that mainly affects older adults. For patients who achieve their first complete remission (CR1), allogeneic hematopoietic stem cell transplantation (HSCT) may provide a chance for long-term survival. However, relapse after transplantation remains a major challenge.
This study aims to evaluate the effectiveness and safety of a conditioning regimen that combines thiotepa, busulfan, and fludarabine (TBF) before haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) in elderly patients with AML in first complete remission.
Eligible patients will receive the TBF conditioning regimen followed by stem cell transplantation from a partially matched donor. Participants will be followed to assess relapse-free survival, overall survival, transplant-related complications, and infections.
The results of this study may help improve treatment strategies and outcomes for elderly AML patients undergoing transplantation.
Przegląd badań
Status
Warunki
Szczegółowy opis
Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy with increasing incidence in older populations. Despite achieving first complete remission (CR1) after induction chemotherapy, elderly patients remain at high risk of relapse and have poor long-term outcomes.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is considered a potentially curative treatment for AML. With the development of reduced-intensity conditioning regimens and haploidentical transplantation strategies, more elderly patients are now eligible for transplantation. However, relapse after transplantation remains a major limitation.
The conditioning regimen plays a critical role in determining transplant outcomes. The combination of thiotepa, busulfan, and fludarabine (TBF) has been proposed to enhance anti-leukemic activity while maintaining acceptable toxicity. Previous retrospective and registry-based studies suggest that TBF conditioning may reduce relapse risk compared with conventional regimens, but prospective data in elderly AML patients, especially in Asian populations, remain limited.
This study is a single-center, prospective, single-arm clinical trial designed to evaluate the efficacy and safety of the TBF conditioning regimen in elderly AML patients in first complete remission undergoing haploidentical peripheral blood stem cell transplantation (haplo-PBSCT).
Eligible patients aged 55-75 years with AML in CR1 or CRi will receive a conditioning regimen consisting of thiotepa (day -7), busulfan (days -4 and -3), and fludarabine (days -6 to -2), followed by infusion of donor stem cells on day 0.
The primary endpoint is 1-year relapse-free survival (RFS), defined as the time from transplantation to relapse or death from any cause. Secondary endpoints include overall survival, incidence of acute and chronic graft-versus-host disease (GVHD), non-relapse mortality, hematopoietic engraftment, donor chimerism, and infection rates.
Participants will be followed regularly after transplantation with clinical assessments, laboratory tests, and bone marrow evaluations according to protocol-defined schedules.
The findings from this study are expected to provide prospective evidence for the use of TBF conditioning in elderly AML patients and support optimization of transplantation strategies in this population.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Xianmin Song, MD
- Numer telefonu: +86-13501672508
- E-mail: shongxm@sjtu.edu.cn
Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Age 55 to 75 years
- Diagnosed with acute myeloid leukemia (AML) based on morphology, immunophenotyping, cytogenetics, or molecular testing
- First complete remission (CR1) or complete remission with incomplete hematologic recovery (CRi)
- Eligible for haploidentical hematopoietic stem cell transplantation
- Availability of a suitable haploidentical donor
- ECOG performance status 0-2
Adequate organ function:
- Left ventricular ejection fraction ≥50%
- Oxygen saturation >92% on room air
- Serum creatinine ≤1.5 × upper limit of normal (ULN)
- Total bilirubin ≤1.5 × ULN
- AST and ALT ≤2.0 × ULN
- DLCO ≥40% and FEV1 ≥50%
- Ability to understand and sign informed consent
Exclusion Criteria:
- Secondary AML (including AML evolving from myelodysplastic syndrome or therapy-related AML)
- Active, uncontrolled infection
- Severe uncontrolled systemic disease (e.g., unstable cardiovascular disease, recent stroke, or severe organ dysfunction)
- HIV infection
- Active hepatitis B or C requiring antiviral treatment
- Pregnant or breastfeeding women
- Known hypersensitivity to study drugs
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Nie dotyczy
- Model interwencyjny: Zadanie dla jednej grupy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Eksperymentalny: Arms Back to Arms and Interventions * Required * § Required if Study Start Date is on or after Janu
Participants will receive a conditioning regimen consisting of thiotepa, busulfan, and fludarabine (TBF) followed by haploidentical peripheral blood stem cell transplantation.
Thiotepa is administered on day -7, busulfan on days -4 and -3, and fludarabine on days -6 to -2.
Donor stem cells are infused on day 0. Standard graft-versus-host disease prophylaxis and supportive care will be provided according to institutional guidelines.
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Thiotepa is administered intravenously at a dose of 5 mg/kg on day -7 as part of the TBF conditioning regimen prior to haploidentical peripheral blood stem cell transplantation.
Busulfan is administered intravenously at a dose of 3.2 mg/kg on days -4 and -3 as part of the TBF conditioning regimen.
Fludarabine is administered intravenously at a dose of 30 mg/m² daily from day -6 to day -2 as part of the conditioning regimen.
Haploidentical peripheral blood stem cell transplantation is performed on day 0 following conditioning.
Donor stem cells are infused, and standard graft-versus-host disease prophylaxis and supportive care are provided according to institutional protocols.
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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1-year Relapse-Free Survival (RFS)
Ramy czasowe: 12 months after transplantation
|
Relapse-free survival (RFS) is defined as the time from transplantation to the first occurrence of disease relapse or death from any cause.
Patients who are alive without relapse at the last follow-up will be censored.
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12 months after transplantation
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Overall Survival (OS)
Ramy czasowe: 12 months after transplantation
|
Overall survival is defined as the time from transplantation to death from any cause.
Patients alive at last follow-up will be censored.
|
12 months after transplantation
|
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Incidence of Acute Graft-Versus-Host Disease (aGVHD)
Ramy czasowe: Up to 180 days after transplantation
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The cumulative incidence of grade I-IV and grade III-IV acute graft-versus-host disease within 180 days after transplantation, assessed according to standard criteria.
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Up to 180 days after transplantation
|
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Incidence of Chronic Graft-Versus-Host Disease (cGVHD)
Ramy czasowe: 12 months after transplantation
|
The cumulative incidence of all-grade and moderate-to-severe chronic graft-versus-host disease, assessed according to NIH consensus criteria.
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12 months after transplantation
|
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Non-Relapse Mortality (NRM)
Ramy czasowe: 12 months after transplantation
|
Non-relapse mortality is defined as death without evidence of disease relapse.
Relapse is treated as a competing event.
|
12 months after transplantation
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Współpracownicy i badacze
Śledczy
- Główny śledczy: Xianmin Song, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Nowotwory
- Nowotwory według typu histologicznego
- Choroby hematologiczne
- Białaczka, mieloidalna
- Białaczka
- Choroby hemowe i limfatyczne
- Białaczka, szpikowa, ostra
- Związki siarki
- Organiczne chemikalia
- Związki heterocykliczne, 1-ring
- Związki heterocykliczne
- Węglowodory, acykliczne
- Węglowodory
- Alkan
- Alkohole
- Glikole butelenowe
- Glikole
- Mesyaty
- Alkanesulfonaty
- Kwasy alkanesulfonowe
- Kwasy sulfonowe
- Kwasy siarkowe
- Fosforamidy
- Związki okorosfosforowe
- Trietylenefosforamid
- Azirydyny
- Aziryny
- Busulfan
- Tiotepa
- Fludarabina
Inne numery identyfikacyjne badania
- SHSYXY-202510-TBF-AML
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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