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Phase II Study of IV Busulfan Combined With 12 cGy of Fractionated Total Body Irradiation (FTBI) and Etoposide (VP-16) as a Preparative Regimen for Allogeneic Bone Marrow Transplantation for Patients With Advanced Hematological Malignancies


Phase 2
16 Years
50 Years
Open (Enrolling)
Both
Leukemia, Myelodysplastic Syndromes

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Trial Information

Phase II Study of IV Busulfan Combined With 12 cGy of Fractionated Total Body Irradiation (FTBI) and Etoposide (VP-16) as a Preparative Regimen for Allogeneic Bone Marrow Transplantation for Patients With Advanced Hematological Malignancies


OBJECTIVES:

- To determine the efficacy of a preparative regimen comprising dose targeted busulfan,
etoposide, and fractionated total-body irradiation followed by allogeneic hematopoietic
stem cell or bone marrow transplantation in patients with advanced hematologic
malignancies.

- To determine the efficacy of this regimen in patients with acute myeloid leukemia in
first remission with unfavorable cytogenetics.

- To evaluate the early and late toxicities of this regimen.

OUTLINE:

- Preparative chemotherapy regimen: Patients receive busulfan IV over 2 hours once every
6 hours on days -14 to -8 for a total of 16 doses and etoposide IV on day -3.* NOTE:
*Patients also receive oral or IV dilantin 1-3 times daily on days -18 to -5 for
prophylaxis of grand mal seizures.

- Fractionated total-body irradiation (FTBI): Patients undergo FTBI on days -7 to -4 for
a total of 10 fractions.

- Allogeneic transplantation: Patients undergo allogeneic peripheral blood stem cell
transplantation or bone marrow transplantation on day 0.

- Graft-versus-host disease (GVHD) prophylaxis: Patients receive cyclosporine IV or
orally on days -1 to 50 followed by a taper to day 180 in the absence of GVHD. Patients
also receive mycophenolate mofetil orally or IV over 2 hours twice daily on days 0-27,
followed by a taper until day 56.

After completion of study treatment, patients are followed annually for 2 years.

Inclusion Criteria


DISEASE CHARACTERISTICS:

- Diagnosis of 1 of the following:

- Acute myeloid leukemia (AML)

- Failed remission induction therapy or in relapse beyond second remission

- In first remission with poor risk cytogenetics (e.g., 11q abnormalities,
-7, -5, complex abnormalities [i.e., > 3 abnormalities, 6;9 translocation
and 3q abnormalities del (7q), del (5q), complex abnormalities ≥
abnormalities, 9q, 20q, 21q, 17q, t(9;21)])

- Acute lymphoblastic leukemia (ALL)

- Failed remission induction therapy or in relapse beyond second remission

- Blastic phase chronic myelogenous leukemia

- Refractory anemia with excess blasts

- Refractory anemia with excess blasts in transformation

- HLA -A, -B, -C, -DR identical sibling donor match available

- No relapse after prior bone marrow transplantation

PATIENT CHARACTERISTICS:

- Cardiac ejection fraction ≥ 50%

- Serum creatinine ≤ 1.2 times upper limit of normal (ULN) or creatinine clearance > 80
mL/min

- Bilirubin ≤ 1.5 times ULN

- AST and ALT < 5 times ULN

- FEV_1 ≥ 50% of predicted normal

- DLCO ≥ 50% of predicted normal

- No psychological or medical condition that would preclude allogeneic transplantation
(in the opinion of the treating physician)

- Not pregnant

- Negative pregnancy test

PRIOR CONCURRENT THERAPY:

- See Disease Characteristics

- At least 28 days since prior induction or reinduction therapy

- Prior etoposide and busulfan allowed

- No prior radiation therapy that would exclude total-body irradiation

Type of Study:

Interventional

Study Design:

Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Efficacy

Safety Issue:

No

Principal Investigator

Anthony S. Stein, MD

Investigator Role:

Study Chair

Investigator Affiliation:

Beckman Research Institute

Authority:

United States: Federal Government

Study ID:

99041

NCT ID:

NCT00534430

Start Date:

January 2000

Completion Date:

Related Keywords:

  • Leukemia
  • Myelodysplastic Syndromes
  • adult acute myeloid leukemia with 11q23 (MLL) abnormalities
  • adult acute myeloid leukemia with inv(16)(p13;q22)
  • adult acute myeloid leukemia with t(15;17)(q22;q12)
  • adult acute myeloid leukemia with t(16;16)(p13;q22)
  • adult acute myeloid leukemia with t(8;21)(q22;q22)
  • recurrent adult acute myeloid leukemia
  • adult acute myeloid leukemia in remission
  • recurrent childhood acute myeloid leukemia
  • recurrent adult acute lymphoblastic leukemia
  • recurrent childhood acute lymphoblastic leukemia
  • blastic phase chronic myelogenous leukemia
  • refractory anemia with excess blasts in transformation
  • refractory anemia with excess blasts
  • previously treated myelodysplastic syndromes
  • secondary myelodysplastic syndromes
  • Leukemia
  • Myelodysplastic Syndromes
  • Preleukemia

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