Allogeneic Hematopoietic Cell Transplantation for Patients With Hematologic Disorders Who Are Ineligible or Inappropriate for Treatment With a More Intensive Therapeutic Regimen
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 71
- 试验地点
- 1
- 主要终点
- Treatment-related Mortality
研究概览
简要总结
RATIONALE: Giving low doses of chemotherapy, such as busulfan and fludarabine, before a donor stem cell transplant helps stop the growth of cancer and abnormal cells. It also helps stop the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer or abnormal cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Immunosuppressive therapy may improve bone marrow function and may be an effective treatment for hematologic cancer or other disease.
PURPOSE: This clinical trial is studying the side effects and how well giving busulfan and fludarabine with or without antithymocyte globulin followed by donor stem cell transplant works in treating patients with hematologic cancer or other disease.
详细描述
OBJECTIVES:
Primary
- Determine the clinical efficacy and toxicity profiles of a nonmyeloablative preparative regimen comprising busulfan and fludarabine with or without anti-thymocyte globulin followed by allogeneic hematopoietic stem cell transplantation in patients with hematologic cancers or other diseases.
- Determine the feasibility of this regimen in these patients.
- Establish a treatment-related mortality during the first 6 months that is less than 20% in patients treated with this regimen.
Secondary
- Determine the response rates (disease-specific partial response and complete response) in patients treated with this regimen.
- Determine overall and progression-free survival of patients treated with this regimen.
- Determine the percent donor chimerism and immunologic recovery, including dendritic cell recovery, in patients treated with this regimen.
- Determine the risk of acute and chronic graft-versus-host disease and other toxicities in patients treated with this regimen.
- Assess the overall nonhematologic grades 3 and 4 toxicity of this regimen, including the incidence of veno-occlusive disease and pulmonary toxicity, in these patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 10 Years 至 —(Child, Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
研究组 & 干预措施
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: sargramostim (Biological)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: therapeutic allogeneic lymphocytes (Biological)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: busulfan (Drug)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: fludarabine phosphate (Drug)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: methotrexate (Drug)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: tacrolimus (Drug)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: nonmyeloablative allogeneic hematopoietic stem cell transplantation (Procedure)
Methotrexate Only Arm
GVHD Prophylaxis with Methotrexate
干预措施: peripheral blood stem cell transplantation (Procedure)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: anti-thymocyte globulin (Biological)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: sargramostim (Biological)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: therapeutic allogeneic lymphocytes (Biological)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: busulfan (Drug)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: fludarabine phosphate (Drug)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: methotrexate (Drug)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: tacrolimus (Drug)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: nonmyeloablative allogeneic hematopoietic stem cell transplantation (Procedure)
2 Doses ATG + Methotrexate
GVHD prophylaxis with antithymocyte globulin (ATG) + Methotrexate
干预措施: peripheral blood stem cell transplantation (Procedure)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: anti-thymocyte globulin (Biological)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: sargramostim (Biological)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: therapeutic allogeneic lymphocytes (Biological)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: busulfan (Drug)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: fludarabine phosphate (Drug)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: tacrolimus (Drug)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: nonmyeloablative allogeneic hematopoietic stem cell transplantation (Procedure)
2 Doses ATG
GVHD prophylaxis with 2 doses ATG
干预措施: peripheral blood stem cell transplantation (Procedure)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: anti-thymocyte globulin (Biological)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: sargramostim (Biological)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: therapeutic allogeneic lymphocytes (Biological)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: busulfan (Drug)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: fludarabine phosphate (Drug)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: tacrolimus (Drug)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: nonmyeloablative allogeneic hematopoietic stem cell transplantation (Procedure)
3 Doses ATG
GVHD prophylaxis with 3 doses ATG
干预措施: peripheral blood stem cell transplantation (Procedure)
结局指标
主要结局
Treatment-related Mortality
时间窗: 6 months
Treatment related mortality for first 6 months. Defined as the number of treatment related deaths excluding deaths due to disease relapse.
次要结局
- 5-year Disease-free Survival(Year 5)
- Complete Response at 6 and 12 Months Post-transplant(6 and 12 months)
- Complete or Mixed Donor Chimerism at 30, 60, and 90 Days Post-transplant(Days 30, 60, and 90)
- Graft-vs-host Disease at 6 Months Post-transplant(6 Months)
