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Clinical Phase II Trial to Evaluate the Safety and Efficacy of Treosulfan Based Conditioning Prior to Allogeneic Haematopoietic Stem Cell Transplantation in Patients With Haematological Malignancies


Phase 2
18 Years
69 Years
Open (Enrolling)
Both
Leukemia, Chronic Myeloid Leukemia, Myelodysplastic Syndrome, Diffuse Large Cell Lymphoma, Hodgkin Lymphoma, Chronic Lymphocytic Leukemia, Multiple Myeloma

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Trial Information

Clinical Phase II Trial to Evaluate the Safety and Efficacy of Treosulfan Based Conditioning Prior to Allogeneic Haematopoietic Stem Cell Transplantation in Patients With Haematological Malignancies


Inclusion Criteria:



1. Patients with haematological malignancies, according to WHO classification, such as:

- acute myeloid leukaemia -AML- in CR1 except "low-risk cases" defined by
t(15;17), t(8;21), inv 16 or normal cytogenetics at diagnosis with FLT3-ITD
negative and NPM-1 positive, with no high risk clinical criteria

- any AML beyond CR1

- acute lymphoblast leukaemia -ALL- in CR1 only if at "high risk" defined by
cytogenetics as t(9;22), t(4;11) or for persistence of minimal residual disease
(MRD)

- any ALL beyond CR1

- chronic myeloid leukaemia -CML- in chronic phase (CP) or accelerated phase (AP)
intolerant/not responsive to TK-inhibitors

- myeloproliferative disorders -MPD-

- myelodysplastic syndrome -MDS- with intermediate or high risk International
Prognostic Scoring System (IPSS)

- diffuse large cell lymphoma -DLCL- with a chemosensitive relapse or beyond CR1

- lymphoblastic and Burkitt lymphoma with a chemosensitive relapse or beyond CR1

- mantle cell lymphoma -MCL- with a chemosensitive relapse or beyond CR1

- follicular lymphoma -FCL- with a chemosensitive relapse or beyond CR2

- Hodgkin lymphoma -HD- with a chemosensitive relapse or beyond CR1

- chronic lymphocytic leukaemia -CLL- at "poor risk" in CR1 or with a
chemosensitive relapse

- CLL relapsing after high dose chemotherapy

- T-cell non Hodgkin lymphoma -T-NHL- in CR1 or beyond

- multiple myeloma -MM- at high risk for cytogenetics or ISS stage 3 in CR1
following high dose chemotherapy

- MM at any relapse/progression except refractory disease

2. Availability of an HLA-identical sibling donor (MRD) or HLA-identical unrelated donor
(MUD)

- HLA-identity defined by the following markers: A, B, DRB1, DQB1 or a single or
double Cord Blood unit (CB) with at least a 4 out of 6 HLA-matching by the
following markers: A, B and DRB.

A) identity between the 2 CB units and the recipient;

B) Two identical CB units with one or two mismatches with the recipient;

C) Two CB units with one mismatch between them and two mismatches with the recipient.
We will prefer mismatches either for class I or for class II antigens; we will avoid
mismatches concerning both classes I and II together.

3. Target graft size (unmanipulated, preferably not cryopreserved)

- bone marrow: 2 to 10 x 106 CD34+ cells/kg BW recipient or > 2 x 108 nucleated
cells/kg BW recipient or

- peripheral blood: 4 to 10 x 106 CD34+ cells/kg BW recipient

4. Age > 18 and < 70 years

5. Karnofsky Index > 80 %

6. Adequate contraception in female patients of child-bearing potential

7. Written informed consent

Exclusion Criteria:

1. Secondary malignancies

2. Previous allogeneic transplantation

3. Hematopoietic cell transplantation-specific comorbidity index > 4 (HCT-CI Sorror et
al, Appendix M)

4. Known and manifested malignant involvement of the CNS

5. Active infectious disease

6. HIV- positivity or active hepatitis infection

7. Impaired liver function (Bilirubin > upper normal limit; Transaminases > 3.0 x upper
normal limit)

8. Impaired renal function (Creatinine-clearance < 60 ml/min; Serum Creatinine > 1.5 x
upper normal limit).

9. Pleural effusion or ascites > 1.0 L

10. Pregnancy or lactation

11. Known hypersensitivity to treosulfan and/or fludarabine

12. Participation in another experimental drug trial within 4 weeks before day -6

13. Non-co-operative behaviour or non-compliance

14. Psychiatric diseases or conditions that might impair the ability to give informed
consent

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Efficacy: Evaluation of engraftment

Outcome Time Frame:

28 days

Safety Issue:

No

Principal Investigator

Fabio FC Ciceri, MD

Investigator Role:

Study Director

Authority:

Italy: National Monitoring Centre for Clinical Trials - Ministry of Health

Study ID:

2005-005182-11

NCT ID:

NCT00598624

Start Date:

September 2005

Completion Date:

December 2010

Related Keywords:

  • Leukemia
  • Chronic Myeloid Leukemia
  • Myelodysplastic Syndrome
  • Diffuse Large Cell Lymphoma
  • Hodgkin Lymphoma
  • Chronic Lymphocytic Leukemia
  • Multiple Myeloma
  • Hodgkin Disease
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid
  • Leukemia, Myeloid
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive
  • Lymphoma
  • Lymphoma, Large B-Cell, Diffuse
  • Lymphoma, Non-Hodgkin
  • Multiple Myeloma
  • Neoplasms, Plasma Cell
  • Myelodysplastic Syndromes
  • Preleukemia

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