Bone Marrow Transplantation in Treating Children With Sickle Cell Disease
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Purpose
RATIONALE: Sickle cell disease is an inherited disorder in which abnormal, crescent-shaped red blood cells interfere with the ability of the blood to carry oxygen through the body and can cause severe pain, stroke, and organ damage. Bone marrow transplantation, is a procedure in which the soft, sponge-like tissue in the center of bones producing white blood cells, red blood cells, and platelets is replaced by bone marrow from a another person. Bone marrow transplantation may be an effective treatment in relieving the symptoms of sickle cell disease.
PURPOSE: Phase I/II trial to study the effectiveness of bone marrow transplantation in treating children who have sickle cell disease.
| Condition | Intervention | Phase |
|---|---|---|
|
Sickle Cell Anemia |
Drug: cyclosporine Drug: fludarabine Drug: mycophenolate mofetil Procedure: Bone Marrow Transplantation |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Primary Purpose: Treatment |
| Official Title: | Phase I/II Study of Induction of Stable Mixed Chimerism After Bone Marrow Transplantation From HLA-Identical Donors in Children With Sickle Cell Disease |
| Estimated Enrollment: | 50 |
| Study Start Date: | December 1999 |
| Primary Completion Date: | August 2007 (Final data collection date for primary outcome measure) |
PROTOCOL OUTLINE: This is a multicenter study. Patients undergo total body irradiation on day 0, followed by allogeneic bone marrow transfusion. Patients also receive fludarabine IV daily and cyclosporine IV twice a day on days -1 to 1. Patients then receive oral cyclosporine on days 1-90, and oral mycophenolate mofetil twice a day on days 0-27.
Patients are followed for 100 days, monthly for 6 months and then annually for 2 years.
Eligibility| Ages Eligible for Study: | up to 16 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
PROTOCOL ENTRY CRITERIA:
--Disease Characteristics--
Diagnosis of sickle cell anemia with clinically severe disease manifestations defined by: Recurrent painful events (at least 2 painful events in past year) which cannot be explained by other causes Pain lasts at least 4 hours Requires treatment with parenteral narcotics, equianalgesic dose of oral narcotics, or parenteral nonsteroidal antiinflammatory drugs Acute chest syndrome (ACS) with at least 2 episodes within past 2 years that required hospitalization, oxygen, and RBC transfusion Any combination of painful events and ACS episodes that total 2 events within the past year Abnormal cerebral MRI, abnormal angiography (MR or conventional), and abnormal neuropsychologic testing performance
No stage III or IV sickle cell lung disease
Genotypically HLA identical sibling donor available
--Prior/Concurrent Therapy--
No prior transfusions with greater than 5 units RBC
--Patient Characteristics--
Performance status: Karnofsky 70-100%
Hepatic:
- No active hepatitis
- No moderate/severe portal fibrosis
Renal: Glomerular filtration rate at least 30% predicted for age
Neurologic:
- No severe residual functional neurologic impairment
- Hemiplegia alone allowed
Other:
- HIV negative
- Not pregnant or nursing
- Fertile patients must use effective contraception
Contacts and Locations| United States, California | |
| Children's Hospital of Oakland | |
| Oakland, California, United States, 94609 | |
| United States, Washington | |
| Fred Hutchinson Cancer Research Center | |
| Seattle, Washington, United States, 98109 | |
| Study Chair: | Mark Walters | Children's Hospital of Oakland |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00004485 History of Changes |
| Other Study ID Numbers: | 199/14243, FHCRC-1373.00 |
| Study First Received: | October 18, 1999 |
| Last Updated: | September 8, 2008 |
| Health Authority: | Unspecified |
Keywords provided by Office of Rare Diseases (ORD):
|
genetic diseases and dysmorphic syndromes hematologic disorders rare disease sickle cell anemia |
Additional relevant MeSH terms:
|
Anemia Anemia, Sickle Cell Hematologic Diseases Anemia, Hemolytic, Congenital Anemia, Hemolytic Hemoglobinopathies Genetic Diseases, Inborn Cyclosporins Cyclosporine Mycophenolic Acid Mycophenolate mofetil Fludarabine monophosphate Fludarabine Enzyme Inhibitors |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antifungal Agents Anti-Infective Agents Therapeutic Uses Dermatologic Agents Antirheumatic Agents Antibiotics, Antineoplastic Antineoplastic Agents Antimetabolites, Antineoplastic Antimetabolites |
ClinicalTrials.gov processed this record on May 19, 2013