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NCT00258427 | COMPLETED | Fanconi Anemia


Hematopoietic Stem Cell Transplantation in High Risk Patients With Fanconi Anemia
Sponsor:

Masonic Cancer Center, University of Minnesota

Brief Summary:

RATIONALE: A bone marrow or umbilical cord blood transplant may be able to replace blood-forming cells that were destroyed by chemotherapy. Giving combination chemotherapy before a donor stem cell transplant may make the transplant more likely to work. This may be an effective treatment for patients with high risk Fanconi's anemia. PURPOSE: This clinical trial is studying how well combination chemotherapy works in treating high risk patients who are undergoing a donor stem cell transplant for Fanconi's anemia.

Condition or disease

Fanconi Anemia

Intervention/treatment

anti-thymocyte globulin

filgrastim

busulfan

cyclophosphamide

fludarabine phosphate

methylprednisolone

Hematopoietic stem cell transplantation

Phase

PHASE2

Detailed Description:

OBJECTIVES: Primary * Determine whether the incidence of neutrophil engraftment is acceptable in high-risk patients with Fanconi's anemia treated with busulfan, cyclophosphamide, fludarabine, and antithymocyte globulin followed by allogeneic hematopoietic stem cell transplantation. Secondary * Determine the tolerability of mycophenolate mofetil in these patients. * Determine the incidence of acute and chronic graft-vs-host disease in patients treated with this regimen. * Determine the incidence of major infections in patients with a history of major infections treated with this regimen. * Determine the incidence of relapse in patients with refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, or acute myeloid leukemia treated with this regimen * Determine the probability of 1-year survival of patients treated with this regimen. OUTLINE: Patients are stratified according to donor/recipient HLA type (identical vs other). * Cytoreductive combination chemotherapy: Patients receive busulfan intravenously (IV) over 2 hours twice daily on days -7 and -6 and cyclophosphamide IV over 2 hours and fludarabine IV over 30 minutes once daily on days -5 to -2. * Graft failure prophylaxis: Patients receive methylprednisolone IV twice daily on days -5 to 30 and anti-thymocyte globulin IV over 4-6 hours twice daily on days -5 to -1. * Graft-vs-host disease prophylaxis: Patients receive cyclosporine IV over 2 hours twice daily on days -3 to 100 (if patient has a matched sibling donor) or days -3 to 180 (if patient has another donor type). Patients also receive mycophenolate mofetil orally or IV twice daily on days -3 to 45. * Allogeneic hematopoietic stem cell transplantation (HSCT): Patients undergo allogeneic HSCT (using bone marrow or umbilical cord blood) on day 0. Patients receive filgrastim (G-CSF) subcutaneously beginning on day 1 and continuing until blood counts recover. After completion of study treatment, patients are followed periodically for 3 years.

Study Type : INTERVENTIONAL
Estimated Enrollment : 14 participants
Masking : NONE
Primary Purpose : TREATMENT
Official Title : Hematopoietic Stem Cell Transplantation in High Risk Patients With Fanconi Anemia MT2002-02
Actual Study Start Date : 2002-03-26
Estimated Primary Completion Date : 2020-10-10
Estimated Study Completion Date : 2020-10-10

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: to 44 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Patients must be \<45 years of age with a diagnosis of Fanconi anemia with
    • * Biallelic BRCA2 mutations, or
    • * Aplastic anemia, or advanced myelodysplastic syndrome (MDS) (MDS with ≥5% blasts), or acute leukemia who are ineligible for total body irradiation. Aplastic anemia is defined as having at least one of the following (with or without cytogenetic abnormalities): platelet count \<20 \* 10\^9, - absolute neutrophil count (ANC) \<5 \* 10\^8/L, - Hgb \<8 g/dL
    • * Patients must have an HLA-A, B, DRB1 identical or 1 antigen mismatched related or unrelated BM donor or have an HLA-A, B, DRB1 identical, 1 antigen or 2 antigen mismatched related or unrelated umbilical cord blood (UCB) donor. Patients and donors will be typed for HLA-A and B using serological level typing and for DRB1 using high resolution molecular typing.
    • * Adequate major organ function including
      • * Cardiac: ejection fraction \>45%
      • * Hepatic: no clinical evidence of hepatic failure (e.g. coagulopathy, ascites, no cirrhosis)
      • * Karnofsky performance status \>70% or Lansky \>50%
      • * Women of child bearing potential must be using adequate birth control and have a negative pregnancy test.
      Exclusion Criteria
      • * Active CNS leukemia at time of HSCT.
      • * Active uncontrolled infection within one week of hematopoietic stem cell transplant (HSCT).
      • * Pregnant or lactating female.
      • Donor Inclusion Criteria
        • * Donor must be in good health based on review of systems and results of physical examination.
        • * Donor must have a normal hemoglobin, white count, platelet count and partial thromboplastin time (PTT), and a negative diepoxybutane (DEB) test.
        • * HIV-NAT negative, HTLV-1, HTLV-2 negative, Hepatitis B and C negative.
        • * Female donors of childbearing potential must have a negative pregnancy test.
        • * Unrelated donors must agree to peripheral blood stem cell (PBSC) donation
        • Donor Exclusion Criteria
          • * Donor is a lactating female.

Hematopoietic Stem Cell Transplantation in High Risk Patients With Fanconi Anemia

Location Details

NCT00258427


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Locations


Not yet recruiting

United States, Minnesota

Masonic Cancer Center, University of Minnesota

Minneapolis, Minnesota, United States, 55455

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