Treatment of Bone Marrow to Prevent Graft-Versus-Host Disease in Patients With Acute or Chronic Leukemia Undergoing Bone Marrow Transplantation
- Conditions
- LeukemiaGraft Versus Host DiseaseMyelodysplastic Syndromes
- Registration Number
- NCT00004255
- Lead Sponsor
- Chimeric Therapies
- Brief Summary
RATIONALE: Bone marrow that has been treated to remove certain white blood cells may reduce the chance of developing graft-versus-host disease following bone marrow transplantation.
PURPOSE: Randomized phase II/III trial to compare the effectiveness of treated bone marrow with that of untreated bone marrow in preventing graft-versus-host disease in patients with acute or chronic leukemia who are undergoing bone marrow transplantation.
- Detailed Description
OBJECTIVES:
* Compare the efficacy of processed (cell depleted) vs unprocessed (conventional) unrelated bone marrow transplantation in reducing grade III/IV acute graft vs host disease (GVHD) in patients with acute or chronic leukemia or myelodysplastic syndromes.
* Compare the safety of these regimens in these patients.
* Compare the disease-free survival rate at 100 days and at 6 months in patients treated with these regimens.
* Compare the time to engraftment and percent engraftment in patients treated with these regimens.
* Compare the reduction rate of grade II or greater acute and chronic GVHD in patients treated with these regimens.
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to degree of HLA matching and disease (chronic vs acute). Acute myelogenous leukemia patients are further stratified according to prior myelodysplastic syndromes (yes vs no). Patients are randomized to one of two bone marrow transplantation arms.
All patients receive a conditioning regimen comprising fludarabine IV on day -6, cyclophosphamide IV on days -5 and -4, anti-thymocyte globulin IV on days -4 and -2, and total body irradiation on days -3 to 0. Patients also receive methylprednisolone IV every 12 hours for 4 doses on days -2 to 0. Tacrolimus IV is administered continuously on day -1 and continues either orally or IV for 6 months. Bone marrow is infused on day 0. Filgrastim (G-CSF) is administered subcutaneously from day 0 until blood counts recover.
* Arm I: Patients receive allogeneic bone marrow that has been processed to produce a mononuclear cell preparation.
* Arm II: Patients receive unprocessed allogeneic bone marrow. Patients are followed weekly for 100 days and then at 6 months.
PROJECTED ACCRUAL: A total of 260 patients will be accrued for this study within 17 months.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- Not specified
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (15)
University of Texas - MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
Shands Hospital and Clinics, University of Florida
🇺🇸Gainesville, Florida, United States
Presbyterian-St Luke's Medical Center
🇺🇸Denver, Colorado, United States
New York Medical College
🇺🇸Valhalla, New York, United States
Barbara Ann Karmanos Cancer Institute
🇺🇸Detroit, Michigan, United States
University of California San Diego Cancer Center
🇺🇸La Jolla, California, United States
Lombardi Cancer Center
🇺🇸Washington, District of Columbia, United States
Indiana Blood and Marrow Transplantation
🇺🇸Indianapolis, Indiana, United States
James Graham Brown Cancer Center
🇺🇸Louisville, Kentucky, United States
University of Rochester Cancer Center
🇺🇸Rochester, New York, United States
Oregon Cancer Center
🇺🇸Portland, Oregon, United States
Massey Cancer Center
🇺🇸Richmond, Virginia, United States
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
Hahnemann University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
South Texas Cancer Institute
🇺🇸San Antonio, Texas, United States