Hematopoietic Cell Transplantation in Children With Juvenile Myelomonocytic Leukemia
Trial Snapshot
- Phase
- Phase 1
- Status
- Completed
- Enrollment
- 15
- Locations
- 1
- Primary Endpoint
- Determine Probability of Long-term Disease Free Survival in JMML
Study Overview
Brief Summary
The investigators hypothesize that long-term disease-free survival (DFS) in patients with JMML can be achieved with a treatment of busulfan (BU), cyclophosphamide (CY) and melphalan (L-PAM) followed by hematopoietic cell transplantation (HCT).
Detailed Description
Prior to transplantation, subjects will receive BUSULFAN via the central venous line, six times a day for four days, CYCLOPHOSPHAMIDE via the central venous line once a day for two days, and MELPHALAN via the central venous line for one day. Busulfan, cyclophosphamide, and melphalan are given to destroy the subject's leukemia. As well, these drugs will destroy the subject's own immune system to help ensure the new bone marrow takes and grows after transplantation.
On the day of transplantation, bone marrow or umbilical cord blood from the donor will arrive to the bone marrow transplant unit and be transfused via venous line. These new cells will replace the subject's bone marrow.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- — to 18 Years (Child, Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients must have a diagnosis of JMML and fulfill these minimal criteria (International diagnostic criteria for JMML):
- •Leukocytosis (> 13,000) with absolute monocytosis (> 1,000)
- •The presence of immature myeloid cells in the peripheral blood
- •Less than 30% marrow blasts
- •Absence of t(9:22) or BCR-ABL transcript
- •Adequate major organ function including:
- •Cardiac: ejection fraction > 45%
- •Hepatic: no clinical evidence of hepatic failure (e.g. coagulopathy, ascites)
- •Karnofsky performance status > 70% or Lansky score > 50%
- •Creatinine must be < 2 x normal for age
- •Written informed consent.
Exclusion Criteria
- •Active uncontrolled infection within one week of HCT.
Arms & Interventions
Intent-to-Treat
Patients receiving study regimen.
Intervention: Preparative Regimen (Drug)
Intent-to-Treat
Patients receiving study regimen.
Intervention: Stem Cell Transplant (Biological)
Outcomes
Primary Outcomes
Determine Probability of Long-term Disease Free Survival in JMML
Time Frame: at 1 year after transplant
Secondary Outcomes
- Combined Incidence of Neutrophil Engraftment, Graft-versus-host Disease (GVHD), Regimen-related Toxicity, and Relapse.(at 1 year after transplant)