Clinical Trials /

A Study of Bone Marrow Transplantation Using Fully-Matched Relatives as Donors for Patients With Hematological Malignancies

NCT01315132

Description:

This research study uses a drug called cyclophosphamide to decrease the incidence of GVHD in matched sibling hematopoietic stem cell transplant. In doing so, the goal of the study is to increase overall survival.

Related Conditions:
  • Acute Leukemia
  • Acute Lymphoblastic Leukemia
  • Chronic Myeloid Leukemia
  • Hodgkin Lymphoma
  • Myelodysplastic Syndromes
  • Myeloproliferative Neoplasm
  • Non-Hodgkin Lymphoma
Recruiting Status:

Completed

Phase:

Phase 2

Trial Eligibility

Document

Title

  • Brief Title: A Study of Bone Marrow Transplantation Using Fully-Matched Relatives as Donors for Patients With Hematological Malignancies
  • Official Title: A Two Step Approach To Matched-Sibling Allogeneic Hematopoietic Stem Cell Transplantation for High-Risk Hematological Malignancies

Clinical Trial IDs

  • ORG STUDY ID: 08D.85
  • SECONDARY ID: 2007-61
  • NCT ID: NCT01315132

Conditions

  • Hematological Malignancies
  • Leukemia
  • Lymphoma
  • Multiple Myeloma
  • Hodgkin's Disease

Purpose

This research study uses a drug called cyclophosphamide to decrease the incidence of GVHD in matched sibling hematopoietic stem cell transplant. In doing so, the goal of the study is to increase overall survival.

Detailed Description

      This research protocol has been developed for patients undergoing matched-sibling
      hematopoietic stem cell transplant (HSCT). The patients who are treated according to this 2
      step allogeneic HSCT protocol will receive cyclophosphamide to induce in-vivo tolerization of
      both autologous and allogeneic lymphocytes, followed by an allogeneic CD34-selected HSCT. The
      primary research questions relate to immune reconstitution, incidence of GVHD, and relapse in
      patients who receive lymphocyte treatment of this type in allogeneic HSCT and how it impacts
      overall survival.
    

Trial Arms

NameTypeDescriptionInterventions
Allogeneic TransplantationExperimentalMatched Sibling Allogeneic Transplantation

    Eligibility Criteria

            Inclusion Criteria:
    
              1. Any patient with a hematologic or oncologic diagnosis in which allogeneic HSCT is
                 thought to be beneficial, and in whom front-line therapy has already been applied.
                 Patients will be considered high-risk if they have any of the following:
    
                   1. Age > 50 years
    
                   2. ECOG Performance status of <2
    
                   3. Acute leukemia: requiring more than one chemotherapy regimen to obtain 1st CR;
                      second or greater CR, 1st relapse; any ph+ ALL
    
                   4. CML 2nd chronic phase, accelerated phase, or blastic phase
    
                   5. MDS with IPS of Intermediate 2 or greater
    
                   6. Any myeloproliferative disorder
    
                   7. Hodgkin lymphoma: relapsed, refractory, or primary induction failure
    
                   8. Non-Hodgkin lymphoma: relapsed, refractory, primary treatment failure, or not
                      eligible for an autologous HSCT
    
                   9. Other conditions not listed will be assessed as high-risk by the PI
    
              2. Patients must have a related donor who is either HLA-identical or a one antigen
                 mismatch at the HLA- A; B; C; and DR loci.
    
              3. Patients must adequate organ function:
    
                   1. LVEF of >45%
    
                   2. DLCO (adjusted for hemoglobin) >45% of predicted
    
                   3. Adequate liver function as defined by a serum bilirubin <1.8, AST or ALT < 2.5X
                      upper limit of normal
    
                   4. Creatinine clearance of > 60 ml/min
    
              4. Patients must be willing to use contraception if they have childbearing potential
    
              5. Able to give informed consent
    
            Exclusion Criteria:
    
              1. ECOG performance status of 3 or 4.
    
              2. HIV positive
    
              3. Active involvement of the central nervous system with malignancy
    
              4. Psychiatric disorder that would preclude patients from signing an informed consent
    
              5. Pregnancy
    
              6. Patients with life expectancy of < 6 months for reasons other than their underlying
                 hematologic/oncologic disorder.
          
    Maximum Eligible Age:N/A
    Minimum Eligible Age:18 Years
    Eligible Gender:All
    Healthy Volunteers:No

    Primary Outcome Measures

    Measure:Number of Patients With Overall Survival
    Time Frame:1 Year after transplant
    Safety Issue:
    Description:The primary objective of this prospective, phase II trial was to obtain an OS rate of >60% at 1 year in patients undergoing a 2 step HSCT from an HLA compatible family donor. The >60% threshold was selected as a composite efficacy measure as patients with any hematologic diagnosis, stage of disease, or age as old as 65 years were eligible for this treatment protocol.

    Secondary Outcome Measures

    Measure:Graft Versus Host Disease (GVHD)
    Time Frame:1 Year after transplant
    Safety Issue:
    Description:

    Details

    Phase:Phase 2
    Primary Purpose:Interventional
    Overall Status:Completed
    Lead Sponsor:Sidney Kimmel Cancer Center at Thomas Jefferson University

    Trial Keywords

    • Myeloablative Hematopoietic Stem Cell Transplant
    • Cyclophosphamide tolerization
    • 2 Step Approach
    • Hematological malignancies
    • leukemia
    • lymphoma
    • multiple myeloma
    • Hodgkin's Disease

    Last Updated

    October 15, 2019