Phase I/II Study of Total Body Irradiation, Cyclophosphamide, and Fludarabine Followed by Alternate Donor Hematopoietic Cell Transplantation in Patients With Fanconi's Anemia
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Purpose
OBJECTIVES: I. Determine the probability of engraftment with total body irradiation, cyclophosphamide, fludarabine, and anti-thymocyte globulin followed by HLA nongenotypically identical donor, T-cell depleted hematopoietic cell transplantation in patients with Fanconi's anemia.
II. Determine the incidence of acute and chronic graft-versus-host disease in these patients after undergoing this treatment regimen.
III. Determine the one-year survival rate in these patients after undergoing this treatment regimen.
IV. Determine the toxicity of this treatment regimen in these patients. V. Determine the incidence of relapse in patients with myelodysplastic syndrome or acute myeloid leukemia after undergoing this treatment regimen.
| Condition | Intervention | Phase |
|---|---|---|
|
Fanconi's Anemia |
Drug: anti-thymocyte globulin Drug: cyclophosphamide Drug: cyclosporine Drug: filgrastim Drug: fludarabine Drug: methylprednisolone |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Primary Purpose: Treatment |
| Estimated Enrollment: | 30 |
| Study Start Date: | February 2000 |
PROTOCOL OUTLINE: Donor bone marrow, peripheral blood, or umbilical cord blood is processed to harvest CD34+ cells.
Patients receive preparative cytoreductive therapy comprising total body irradiation on day -6; cyclophosphamide IV over 2 hours on days -5 to -2; fludarabine IV over 30 minutes on days -5 to -2; methylprednisone IV on days -5 to 24; anti-thymocyte globulin IV over 4-6 hours on days -5 to -1; cyclosporine IV over 2 hours every 12 hours (every 8 hours for patients less than 40 kg in weight) on days -3 to 180, and then tapering in the absence of graft-versus-host disease; hematopoietic cell transplantation on day 0; and filgrastim (G-CSF) IV starting on day 1 and continuing until blood counts recover.
Patients are followed at days 60, 90, and 180, and then annually for 3 years.
Eligibility| Ages Eligible for Study: | up to 34 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
PROTOCOL ENTRY CRITERIA:
--Disease Characteristics--
- Patients with a diagnosis of Fanconi's anemia AND Aplastic anemia OR Myelodysplastic syndrome OR Acute leukemia with or without chromosomal anomalies Aplastic anemia as defined by having at least one of the following: Platelet count less than 20,000/mm3 Absolute neutrophil count less than 500/mm3 Hemoglobin less than 8 g/dL
- Myelodysplastic syndrome with multilineage dysplasia With or without chromosomal anomalies
- Hematologic malignancy (e.g., acute myeloid leukemia, acute lymphoblastic leukemia, or B-cell non-Hodgkin's lymphoma)
- No greater than 30% blasts in bone marrow or greater than 5% blasts in peripheral blood
- No active CNS leukemia at time of transplantation
- Must have an HLA A, B, DRB1 identical or 1 antigen mismatched related (nonsibling) or unrelated bone marrow, peripheral blood, or umbilical cord blood donor
--Prior/Concurrent Therapy--
- Radiotherapy: No prior radiotherapy that would preclude total body irradiation
- Surgery: Not specified
--Patient Characteristics--
- Performance status: Karnofsky 70-100% OR Lansky 50-100%
- Hematopoietic: See Disease Characteristics
- Hepatic: No hepatic failure (e.g., coagulopathy or ascites)
- Renal: Creatinine clearance at least 40 mL/min
- Cardiovascular: Ejection fraction at least 45%
- Other: No active uncontrolled infection within one week of transplantation No malignant solid tumor (e.g., squamous cell carcinoma of the head, neck, or cervix) within 2 years of transplantation Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception
Contacts and Locations| United States, Minnesota | |
| University of Minnesota Cancer Center | |
| Minneapolis, Minnesota, United States, 55455 | |
| Study Chair: | John E. Wagner, Jr. | University of Minnesota - Clinical and Translational Science Institute |
More Information
No publications provided
| ClinicalTrials.gov Identifier: | NCT00005898 History of Changes |
| Other Study ID Numbers: | 199/15109, UMN-MT-1999-05, UMN-MT9905 |
| Study First Received: | June 2, 2000 |
| Last Updated: | June 23, 2005 |
| Health Authority: | Unspecified |
Additional relevant MeSH terms:
|
Anemia Fanconi Anemia Fanconi Syndrome Hematologic Diseases Anemia, Hypoplastic, Congenital Anemia, Aplastic Bone Marrow Diseases Genetic Diseases, Inborn DNA Repair-Deficiency Disorders Metabolic Diseases Kidney Diseases Urologic Diseases Renal Tubular Transport, Inborn Errors Metabolism, Inborn Errors Antilymphocyte Serum |
Cyclophosphamide Cyclosporins Cyclosporine Fludarabine monophosphate Lenograstim Fludarabine Methylprednisolone Hemisuccinate Prednisolone Methylprednisolone acetate Prednisolone acetate Methylprednisolone Prednisolone hemisuccinate Prednisolone phosphate Immunosuppressive Agents Immunologic Factors |
ClinicalTrials.gov processed this record on May 19, 2013