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G-CSF+DAC+BUCY vs G-CSF+DAC+BF Conditioning Regimen for Secondary Acute Myeloid Leukemia Undergoing Allo-HSCT

Phase 2
Recruiting
Conditions
Conditioning
Secondary Acute Myeloid Leukemia Evolving From MDS
Allogeneic Hematopoietic Stem Cell Transplantation
Interventions
Registration Number
NCT05449899
Lead Sponsor
Nanfang Hospital, Southern Medical University
Brief Summary

Allo-HSCT is the most effective way to cure sAML patients. At present, the best conditioning regimen for sAML patients undergoing allo-HSCT remains in discussion. In this prospective study, the safety and efficacy of G-CSF+DAC+BUCY and G-CSF+DAC+BF conditioning regimens in sAML patients undergoing allo-HSCT are evaluated.

Detailed Description

Allo-HSCT is the most effective way to cure secondary acute myeloid leukemia evolving from MDS (sAML) patients. At present, the best conditioning regimen for sAML patients undergoing allo-HSCT remains in discussion. Our previous study has showed that G-CSF+DAC+BUCY conditioning regimen could reduce the relapse and improve the survival compared with BUCY conditioning regimen, while the two conditioning regimens both have high non-relapse mortality (NRM). Several retrospective and prospective studies including ours have demonstrated that BF conditioning regimen has a lower NRM compared with BUCY conditioning regimen, while the relapse and survival are similar in patients undergoing BF and BUCY conditioning regimens. Based on the above, we design the prospective randomized controlled study to evaluate the safety and efficacy of G-CSF+DAC+ BUCY and G-CSF+DAC+BF conditioning regimens in sAML patients undergoing allo-HSCT.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
232
Inclusion Criteria
  • Had a diagnosis of sAML
  • Age 18 to 65 years old
  • ECOG performance status of 0-2
  • HCT-CI of 0-2
  • Were willing to undergo allo-HSCT
Exclusion Criteria
  • Therapy-related MDS
  • Previous allo-HSCT
  • Uncontrolled infections
  • Liver or renal dysfunction
  • Severe concomitant conditions not suitable for the trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
G-CSF+DAC+BUCYBusulfan (BU)For patients with sAML undergoing allo-HSCT, Granulocyte Colony -Stimulating Factor (G-CSF)+Decitabine+BUCY conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -7 to -4, Cyclophosphamide (CY) 60 mg/kg/day on days -3, -2.
G-CSF+DAC+BFFludarabine (FLU)For patients with sAML undergoing allo-HSCT, Granulocyte Colony-Stimulating Factor (G-CSF)+Decitabine+BF conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -6 to -3, Fludarabine (FLU) 30mg/m2/ day on days -7 to -3.
G-CSF+DAC+BFDecitabine (DAC)For patients with sAML undergoing allo-HSCT, Granulocyte Colony-Stimulating Factor (G-CSF)+Decitabine+BF conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -6 to -3, Fludarabine (FLU) 30mg/m2/ day on days -7 to -3.
G-CSF+DAC+BFBusulfan (BU)For patients with sAML undergoing allo-HSCT, Granulocyte Colony-Stimulating Factor (G-CSF)+Decitabine+BF conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -6 to -3, Fludarabine (FLU) 30mg/m2/ day on days -7 to -3.
G-CSF+DAC+BUCYGranulocyte Colony-Stimulating Factor(G-CSF)For patients with sAML undergoing allo-HSCT, Granulocyte Colony -Stimulating Factor (G-CSF)+Decitabine+BUCY conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -7 to -4, Cyclophosphamide (CY) 60 mg/kg/day on days -3, -2.
G-CSF+DAC+BUCYDecitabine (DAC)For patients with sAML undergoing allo-HSCT, Granulocyte Colony -Stimulating Factor (G-CSF)+Decitabine+BUCY conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -7 to -4, Cyclophosphamide (CY) 60 mg/kg/day on days -3, -2.
G-CSF+DAC+BFGranulocyte Colony-Stimulating Factor(G-CSF)For patients with sAML undergoing allo-HSCT, Granulocyte Colony-Stimulating Factor (G-CSF)+Decitabine+BF conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -6 to -3, Fludarabine (FLU) 30mg/m2/ day on days -7 to -3.
G-CSF+DAC+BUCYCyclophosphamide (CY)For patients with sAML undergoing allo-HSCT, Granulocyte Colony -Stimulating Factor (G-CSF)+Decitabine+BUCY conditioning regimen was G-CSF 5ug/kg/day on days -17 to -10 (when white blood cell is more than 20G/L, stop using G-CSF), Decitabine 20mg/m2/day on days -14 to -10, Busulfan (BU) 3.2 mg/kg/day on days -7 to -4, Cyclophosphamide (CY) 60 mg/kg/day on days -3, -2.
Primary Outcome Measures
NameTimeMethod
Non-relapse mortality (NRM)1 year
Secondary Outcome Measures
NameTimeMethod
Overall survival (OS)1 year
Disease-free survival (DFS)1 year
Cumulative incidence of relapse1 year
Adverse effectswithin 100 days post-transplantation

Trial Locations

Locations (1)

Department of Hematology,Nanfang Hospital, Southern Medical University

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Guangzhou, Guangdong, China

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