- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT00258427
Hematopoietic Stem Cell Transplantation in High Risk Patients With Fanconi Anemia
Hematopoietic Stem Cell Transplantation in High Risk Patients With Fanconi Anemia MT2002-02
RATIONALE: A bone marrow or umbilical cord blood transplant may be able to replace blood-forming cells that were destroyed by chemotherapy. Giving combination chemotherapy before a donor stem cell transplant may make the transplant more likely to work. This may be an effective treatment for patients with high risk Fanconi's anemia.
PURPOSE: This clinical trial is studying how well combination chemotherapy works in treating high risk patients who are undergoing a donor stem cell transplant for Fanconi's anemia.
Visão geral do estudo
Status
Condições
Descrição detalhada
OBJECTIVES:
Primary
- Determine whether the incidence of neutrophil engraftment is acceptable in high-risk patients with Fanconi's anemia treated with busulfan, cyclophosphamide, fludarabine, and antithymocyte globulin followed by allogeneic hematopoietic stem cell transplantation.
Secondary
- Determine the tolerability of mycophenolate mofetil in these patients.
- Determine the incidence of acute and chronic graft-vs-host disease in patients treated with this regimen.
- Determine the incidence of major infections in patients with a history of major infections treated with this regimen.
- Determine the incidence of relapse in patients with refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or acute myeloid leukemia treated with this regimen
- Determine the probability of 1-year survival of patients treated with this regimen.
OUTLINE: Patients are stratified according to donor/recipient HLA type (identical vs other).
- Cytoreductive combination chemotherapy: Patients receive busulfan intravenously (IV) over 2 hours twice daily on days -7 and -6 and cyclophosphamide IV over 2 hours and fludarabine IV over 30 minutes once daily on days -5 to -2.
- Graft failure prophylaxis: Patients receive methylprednisolone IV twice daily on days -5 to 30 and anti-thymocyte globulin IV over 4-6 hours twice daily on days -5 to -1.
- Graft-vs-host disease prophylaxis: Patients receive cyclosporine IV over 2 hours twice daily on days -3 to 100 (if patient has a matched sibling donor) or days -3 to 180 (if patient has another donor type). Patients also receive mycophenolate mofetil orally or IV twice daily on days -3 to 45.
- Allogeneic hematopoietic stem cell transplantation (HSCT): Patients undergo allogeneic HSCT (using bone marrow or umbilical cord blood) on day 0. Patients receive filgrastim (G-CSF) subcutaneously beginning on day 1 and continuing until blood counts recover.
After completion of study treatment, patients are followed periodically for 3 years.
Tipo de estudo
Inscrição (Real)
Estágio
- Fase 2
Contactos e Locais
Locais de estudo
-
-
Minnesota
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Minneapolis, Minnesota, Estados Unidos, 55455
- Masonic Cancer Center, University of Minnesota
-
-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
Patients must be <45 years of age with a diagnosis of Fanconi anemia with:
- Biallelic BRCA2 mutations, or
- Aplastic anemia, or advanced myelodysplastic syndrome (MDS) (MDS with ≥5% blasts), or acute leukemia who are ineligible for total body irradiation. Aplastic anemia is defined as having at least one of the following (with or without cytogenetic abnormalities): platelet count <20 * 10^9, - absolute neutrophil count (ANC) <5 * 10^8/L, - Hgb <8 g/dL
- Patients must have an HLA-A, B, DRB1 identical or 1 antigen mismatched related or unrelated BM donor or have an HLA-A, B, DRB1 identical, 1 antigen or 2 antigen mismatched related or unrelated umbilical cord blood (UCB) donor. Patients and donors will be typed for HLA-A and B using serological level typing and for DRB1 using high resolution molecular typing.
Adequate major organ function including:
- Cardiac: ejection fraction >45%
- Hepatic: no clinical evidence of hepatic failure (e.g. coagulopathy, ascites, no cirrhosis)
- Karnofsky performance status >70% or Lansky >50%
- Women of child bearing potential must be using adequate birth control and have a negative pregnancy test.
Exclusion Criteria:
- Active CNS leukemia at time of HSCT.
- Active uncontrolled infection within one week of hematopoietic stem cell transplant (HSCT).
- Pregnant or lactating female.
Donor Inclusion Criteria:
- Donor must be in good health based on review of systems and results of physical examination.
- Donor must have a normal hemoglobin, white count, platelet count and partial thromboplastin time (PTT), and a negative diepoxybutane (DEB) test.
- HIV-NAT negative, HTLV-1, HTLV-2 negative, Hepatitis B and C negative.
- Female donors of childbearing potential must have a negative pregnancy test.
- Unrelated donors must agree to peripheral blood stem cell (PBSC) donation
Donor Exclusion Criteria:
- Donor is a lactating female.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Não randomizado
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
---|---|
Experimental: Marrow Isolex
Bone marrow processed using Isolex300i
|
Given 15 mg/kg/day intravenously every 12 hours on Days -5 through -1.
Outros nomes:
given 5 mcg/kg/day intravenously on Day 1 (continue until absolute neutrophil count (ANC) ≥2.5 x 10^9/L)
Outros nomes:
Busulfan 0.8 mg/kg intravenously (IV) every 12 hours on Days -7 and -6 (1.0 mg/kg IV if <4 years old)
Outros nomes:
10 mg/kg intravenously (IV) on Days -5 through -2.
Outros nomes:
35 mg/m^2 intravenously (IV) on Days -5 through -2.
Outros nomes:
1 mg/kg intravenously (IV) every 12 hours on Days -5 through -1.
Outros nomes:
Infused on Day 0 - Donor bone marrow or umbilical cord blood will be collected in the usual sterile manner using established parameters determined by the National Marrow Donor Program.
Outros nomes:
|
Experimental: USB arm
No processing
|
Given 15 mg/kg/day intravenously every 12 hours on Days -5 through -1.
Outros nomes:
given 5 mcg/kg/day intravenously on Day 1 (continue until absolute neutrophil count (ANC) ≥2.5 x 10^9/L)
Outros nomes:
Busulfan 0.8 mg/kg intravenously (IV) every 12 hours on Days -7 and -6 (1.0 mg/kg IV if <4 years old)
Outros nomes:
10 mg/kg intravenously (IV) on Days -5 through -2.
Outros nomes:
35 mg/m^2 intravenously (IV) on Days -5 through -2.
Outros nomes:
1 mg/kg intravenously (IV) every 12 hours on Days -5 through -1.
Outros nomes:
Infused on Day 0 - Donor bone marrow or umbilical cord blood will be collected in the usual sterile manner using established parameters determined by the National Marrow Donor Program.
Outros nomes:
|
Experimental: Marrow Clinimacs
Bone marrow processed using CliniMACS system
|
Given 15 mg/kg/day intravenously every 12 hours on Days -5 through -1.
Outros nomes:
given 5 mcg/kg/day intravenously on Day 1 (continue until absolute neutrophil count (ANC) ≥2.5 x 10^9/L)
Outros nomes:
Busulfan 0.8 mg/kg intravenously (IV) every 12 hours on Days -7 and -6 (1.0 mg/kg IV if <4 years old)
Outros nomes:
10 mg/kg intravenously (IV) on Days -5 through -2.
Outros nomes:
35 mg/m^2 intravenously (IV) on Days -5 through -2.
Outros nomes:
1 mg/kg intravenously (IV) every 12 hours on Days -5 through -1.
Outros nomes:
Infused on Day 0 - Donor bone marrow or umbilical cord blood will be collected in the usual sterile manner using established parameters determined by the National Marrow Donor Program.
Outros nomes:
|
Experimental: Sibling without CliniMacs
Sibling donor without the use of CliniMACS system
|
Given 15 mg/kg/day intravenously every 12 hours on Days -5 through -1.
Outros nomes:
given 5 mcg/kg/day intravenously on Day 1 (continue until absolute neutrophil count (ANC) ≥2.5 x 10^9/L)
Outros nomes:
Busulfan 0.8 mg/kg intravenously (IV) every 12 hours on Days -7 and -6 (1.0 mg/kg IV if <4 years old)
Outros nomes:
10 mg/kg intravenously (IV) on Days -5 through -2.
Outros nomes:
35 mg/m^2 intravenously (IV) on Days -5 through -2.
Outros nomes:
1 mg/kg intravenously (IV) every 12 hours on Days -5 through -1.
Outros nomes:
Infused on Day 0 - Donor bone marrow or umbilical cord blood will be collected in the usual sterile manner using established parameters determined by the National Marrow Donor Program.
Outros nomes:
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Number of Participants Experiencing Graft Failure
Prazo: Day 30
|
Graft failure is defined as absolute neutrophil count( ANC ) <5 x 10^8/L by day 30.
|
Day 30
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
---|---|---|
Number of Participants Experiencing Chronic Graft-Versus-Host Disease
Prazo: Day 42
|
Chronic Graft-Versus-Host Disease is a severe long-term complication created by infusion of donor cellsinto a foreign host.
|
Day 42
|
Number of Participants Experiencing Chronic Graft-Versus-Host Disease
Prazo: 1 year
|
Chronic Graft-Versus-Host Disease is a severe long-term complication created by infusion of donor cellsinto a foreign host.
|
1 year
|
Number of Participants Experiencing Acute Graft-Versus-Host Disease
Prazo: 1 year
|
Acute Graft-Versus-Host Disease is a severe short-term complication created by infusion of donor cells into a foreign host.
|
1 year
|
Number of Participants Experiencing Acute Graft-Versus-Host Disease
Prazo: Day 42
|
Acute Graft-Versus-Host Disease is a severe short-term complication created by infusion of donor cells into a foreign host.
|
Day 42
|
Number of Participants Experiencing Relapse
Prazo: 1 Year
|
Patients with leukemia will have this done by BM biopsy and additional special studies such as cytogenetics or flow cytometry as appropriate.
|
1 Year
|
Number of Participants Experiencing Overall Survival
Prazo: 1 Year
|
Overall Survival - Number of patients alive at 1 year post transplant
|
1 Year
|
Number of Participants Experiencing Major Infections
Prazo: Day 1 through 1 year post-transplant
|
Number of participants experiencing Major Infections by the end of treatment
|
Day 1 through 1 year post-transplant
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Margaret MacMillan, MD, Masonic Cancer Center, University of Minnesota
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doenças Metabólicas
- Doenças renais
- Doenças Urológicas
- Doenças da Medula Óssea
- Doenças Hematológicas
- Doenças Genéticas, Congênitas
- Distúrbios de Deficiência de Reparo do DNA
- Anemia Hipoplástica Congênita
- Anemia Aplástica
- Síndromes de Falha Congênita da Medula Óssea
- Distúrbios de Insuficiência da Medula Óssea
- Transporte Tubular Renal, Erros Inatos
- Anemia
- Síndrome de Fanconi
- Anemia de Fanconi
- Efeitos Fisiológicos das Drogas
- Mecanismos Moleculares de Ação Farmacológica
- Agentes Autônomos
- Agentes do Sistema Nervoso Periférico
- Antiinflamatórios
- Agentes Antirreumáticos
- Antimetabólitos, Antineoplásicos
- Antimetabólitos
- Agentes Antineoplásicos
- Agentes imunossupressores
- Fatores imunológicos
- Antieméticos
- Agentes gastrointestinais
- Glicocorticóides
- Hormônios
- Hormônios, Substitutos Hormonais e Antagonistas Hormonais
- Agentes Neuroprotetores
- Agentes de proteção
- Agentes Antineoplásicos Alquilantes
- Agentes Alquilantes
- Agonistas Mieloablativos
- Metilprednisolona
- Ciclofosfamida
- Fludarabina
- Fosfato de fludarabina
- Busulfan
- Soro Antilinfócito
Outros números de identificação do estudo
- 2002LS014
- MT2002-02 (Outro identificador: Blood and Marrow Transplantation Program)
- 0202M18741 (Outro identificador: IRB, University of Minnesota)
Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .
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