A Pilot Study of a Novel Sequential Treatment Utilizing CPX-351 as Salvage Chemotherapy Followed by Allogeneic Stem-Cell Transplantation (SCT) Utilizing a Haplo-cord Graft for Patients With Relapsed or Refractory Leukemia or Myelodysplastic Syndrome
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 14
- 试验地点
- 1
- 主要终点
- Overall Survival at Day 100, 6 months, and 1 year
研究概览
简要总结
This pilot study is designed to evaluate outcomes with the combination of CPX-351 salvage therapy and haplo-cord graft stem cell transplantation for subjects with relapsed or refractory AML or myelodysplastic syndrome.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 89 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subject must have refractory or relapsed Acute Myeloid Leukemia (AML) according to previously established criteria:
- •Primary induction failure (PIF) after ≥ 2 cycles of chemotherapy
- •First relapse
- •Relapse refractory to salvage chemotherapy
- •Second or subsequent relapse
- •Subjects with Myelodysplastic Syndrome (MDS):
- •(a) Either Refractory Anemia with Excess Blasts I or Refractory Anemia with Excess Blasts II (RAEB I or RAEB II)
- •Karnofsky performance status ≥ 70
- •Willing to participate as a research subject and sign an informed consent form
- •Adequate physical function measured by:
- •Cardiac: asymptomatic, or if symptomatic then Left Ventricular Ejection Fraction (LVEF) at rest must be ≥ 45% and must improve with exercise
- •Hepatic: ≤3 x upper limit of normal (ULN) alanine aminotransferase (ALT) and ≤ 1.5 total serum bilirubin, unless liver is involved with the disease or there is congenital benign hyperbilirubinemia
- •Renal: serum creatinine within normal range, or if serum creatinine is outside the normal range, then calculated creatinine clearance ≥ 60 ml/min
- •Pulmonary: asymptomatic, or if symptomatic, diffusing capacity of the lungs for carbon monoxide (DLCO) ≥ 45% of predicted (corrected for hemoglobin)
- •If subject has prior malignancy, must be without any evidence of disease of that prior malignancy for at least 2 years (excludes skin cancers that may have been excised within that 2 year period).
排除标准
- •Serious active or uncontrolled infection or medical condition
- •Women who are pregnant or breast feeding. Women of childbearing age must use adequate contraception and have a negative pregnancy test.
- •Prior daunorubicin therapy with a cumulative dose of more than 368 mg/m2 or equivalent
- •Other systemic anticancer therapy or ongoing clinically relevant toxicities from such therapy (at discretion of the investigator)
- •History of and/or current evidence of myocardial impairment (e.g. cardiomyopathy, ischemic heart disease, significant valvular dysfunction, hypertensive heart disease, congestive heart failure), resulting in heart failure by New York Heart Association Class III or IV staging.
- •Subjects with Wilson disease or other Copper-related disorders.
研究组 & 干预措施
CPX-351 Salvage Therapy and Transplant
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
干预措施: CPX-351 (Drug)
CPX-351 Salvage Therapy and Transplant
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
干预措施: Fludarabine (Drug)
CPX-351 Salvage Therapy and Transplant
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
干预措施: Melphalan (Drug)
CPX-351 Salvage Therapy and Transplant
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
干预措施: Rabbit Anti-Human T-Lymphocyte Globulin (Drug)
CPX-351 Salvage Therapy and Transplant
Subjects will receive CPX-351 salvage chemotherapy on Day -21, -19, and -17 as a bridge to allogeneic stem cell transplantation using a Fludarabine/Melphalan/rATG conditioning regimen and a haplo-cord graft.
干预措施: Haplo-Cord Stem Cell Transplantation (Biological)
结局指标
主要结局
Overall Survival at Day 100, 6 months, and 1 year
时间窗: Day 100, 6 months, and 1 year post-transplant
Evaluate survival of subjects alive, with or without presence of disease, at the designated time points
Neutrophil Engraftment
时间窗: 100 days
Evaluate the time to neutrophil engraftment, defined as the first day in which absolute neutrophil count (ANC) \>500/mm3 for three consecutive days
Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]
时间窗: 1 year
Evaluated using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE)
Disease-Free Survival at Day 100, 6 months, and 1 year
时间窗: Day 100, 6 months, and 1 year post-transplant
Evaluate survival of subjects alive without disease at the designated time points
次要结局
- Non-Relapse Mortality(Day 100)
- Relapse Rate(Day 100, 6 months, 1 year)
