Allogeneic Transplantation For Severe Osteopetrosis
- Full Text View
- Tabular View
- No Study Results Posted
- Disclaimer
- How to Read a Study Record
Purpose
The purpose of this research is to explore what we believe may be a safer and more effective means of performing stem cell transplantation in patients with Osteopetrosis, using chemotherapy and radiation designed to bring about engraftment and lessen transplant mortality. Prior multi-institutional data in past studies found that approximately 30% of Osteopetrosis patients do not engraft. Therefore, in this study, we utilize a reduced intensity design of pre-transplant drugs to try to make transplants safer for this disease, as well as to provide a second infusion of stem cells in patients with matched related or unrelated donors.
| Condition | Intervention | Phase |
|---|---|---|
|
Severe Osteopetrosis |
Procedure: Stem Cell Transplantation Drug: Conditioning for transplantation-donor graft Radiation: Total Lymphoid Irradiation Drug: Conditioning for cord blood transplant |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Allogeneic Hematopoietic Stem Cell Transplantation For Severe Osteopetrosis |
- Estimate the rate of donor engraftment for patients treated by hematopoietic stem cell transplantation [ Time Frame: Day 100 ] [ Designated as safety issue: No ]
- Estimate Peri-transplant mortality (deaths) [ Time Frame: day 100 ] [ Designated as safety issue: Yes ]
- Transplant related toxicity [ Time Frame: Day 100 post transplant ] [ Designated as safety issue: Yes ]
- Graft-versus-host disease (incidence and severity) [ Time Frame: after transplantation ] [ Designated as safety issue: Yes ]
- Tolerance of Campath-1H administration [ Time Frame: During study ] [ Designated as safety issue: Yes ]
- Clinical Disease Monitoring [ Time Frame: post transplant ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 23 |
| Study Start Date: | October 2008 |
| Estimated Study Completion Date: | October 2015 |
| Estimated Primary Completion Date: | October 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Patients with Donor Grafts
This group includes patients that are recipients of unrelated or matched related donor grafts (both peripheral blood and marrow) with a second CD34 cell infusion administered on Day 42.
|
Procedure: Stem Cell Transplantation
Undergo allogeneic hematopoietic stem cell transplantation using marrow, peripheral blood or cord blood grafts
Other Names:
Drug: Conditioning for transplantation-donor graft
The pre-transplant conditioning will include: Campath-1H, Busulfan, Fludarabine (marrow and peripheral blood)
Other Name: Busulfex, Fludara, Campath
Radiation: Total Lymphoid Irradiation
Dose 500 cGy via anteroposterior (AP) and posteroanterior(PA) fields (250 cGy AP and 250 cGy PA).
Other Name: TLI
|
|
Active Comparator: Patients With Cord Blood Transplant
This group includes patients who received cord blood transplants with more intensive chemotherapy regimen.
|
Procedure: Stem Cell Transplantation
Undergo allogeneic hematopoietic stem cell transplantation using marrow, peripheral blood or cord blood grafts
Other Names:
Radiation: Total Lymphoid Irradiation
Dose 500 cGy via anteroposterior (AP) and posteroanterior(PA) fields (250 cGy AP and 250 cGy PA).
Other Name: TLI
Drug: Conditioning for cord blood transplant
The pre-transplant conditioning will include: Campath-1H, Busulfan, and Cyclophosphamide
Other Name: Busulfex, Campath, Cytoxan
|
Detailed Description:
This revised transplant protocol will test the following: 1) the ability to achieve engraftment with the reduced intensity protocol and a second infusion of stem cells on day 42, 2) the mortality associated with transplant by day 100, 3) patient outcomes, based on differential imaging and biologic evaluations prior to transplantation and at designated points after transplantation (day 100, 6 months, 1, 2 and 5 years). Additional biologic studies will include microarray analysis, and evaluation of blood parameters and genes that may be important in the disease process. In older patients, studies to evaluation osteoclast differentiation and function will also be offered.
Eligibility| Ages Eligible for Study: | up to 45 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients eligible for transplantation under this protocol will be < or = 45 years of age, and will be diagnosed with severe osteopetrosis. This will be defined as having the following manifestations of the disease.
- Bones that are uniformly markedly dense based on skeletal survey
- No history that would suggest autosomal dominant inheritance
- Evidence of hematologic changes that are attributed to the underlying disease, including
- the need for ongoing transfusions, OR
- the presence of progressive anemia or thrombocytopenia, OR
- a white blood cell differential with a predominance of immature forms and evidence of extramedullary hematopoiesis, OR
- persistence of serious infectious complications that are thought to be due to the abnormal architecture of the bone that are resistant to surgical and medical interventions.
Exclusion Criteria:
- Patients >45 years of age
- Evidence of hepatic failure
- Pulmonary dysfunction sufficient to significantly increase the risk of transplant.
- Renal dysfunction with glomerular filtration rate (GFR) <30% of predicted.
- Cardiac compromise sufficient to substantially increase the risk of transplantation
- Severe, stable neurologic impairment.
- Human immunodeficiency virus (HIV) positivity.
- Pregnant or lactating females
Contacts and Locations| Contact: Paul Orchard, MD | 612-626-1926 | orcha001@umn.edu |
| Contact: Teresa Kivisto, RN | 612-273-2800 | tkivist1@fairview.org |
| United States, Minnesota | |
| University of MInnesota, Fairview | Recruiting |
| Minneapolis, Minnesota, United States, 55455 | |
| Contact: Patricia Kleinke, RN 612-273-0857 pkleink1@fairview.org | |
| Contact: Cyndie Hibbs 612-625-8542 | |
| Principal Investigator: | Paul Orchard, MD | Masonic Cancer Center, University of Minnesota |
More Information
No publications provided
| Responsible Party: | Masonic Cancer Center, University of Minnesota |
| ClinicalTrials.gov Identifier: | NCT00775931 History of Changes |
| Other Study ID Numbers: | MT2008-20, 0808M42261 |
| Study First Received: | October 16, 2008 |
| Last Updated: | October 30, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Masonic Cancer Center, University of Minnesota:
|
osteopetrosis |
Additional relevant MeSH terms:
|
Osteopetrosis Osteosclerosis Osteochondrodysplasias Bone Diseases, Developmental Bone Diseases Musculoskeletal Diseases Busulfan Alemtuzumab Immunosuppressive Agents |
Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Therapeutic Uses Myeloablative Agonists |
ClinicalTrials.gov processed this record on May 16, 2013