Cyclophosphamide and Filgrastim Followed By SCT in Patients With Chronic or Accelerated Phase Myelogenous Leukemia

NCT ID: NCT00005984

Last Updated: 2017-11-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-08-31

Study Completion Date

2005-09-30

Brief Summary

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RATIONALE: Giving colony-stimulating factors, such as G-CSF, and cyclophosphamide helps stem cells move from the patient's bone marrow to the blood so they can be collected and stored. Chemotherapy and radiation therapy is then given to prepare the bone marrow for the stem cell transplant. The stem cells are returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy and radiation therapy.

PURPOSE: This phase II trial is studying how well cyclophosphamide plus filgrastim followed by stem cell transplant works in treating patients with chronic phase or accelerated phase chronic myelogenous leukemia.

Detailed Description

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OBJECTIVES:

* Assess the clinical outcomes, survival, and morbidity of patients with chronic or accelerated phase chronic myelogenous leukemia when treated with cyclophosphamide and filgrastim (G-CSF) followed by autologous peripheral blood stem cell transplantation.
* Determine whether priming with cyclophosphamide and filgrastim (G-CSF) increases the fraction of benign Philadelphia chromosome negative hematopoietic progenitors in peripheral blood stem cells (PBSC) and reduces the incidence of persistent or recurrent leukemia after autologous transplantation with mobilized PBSC in these patients.

OUTLINE: Patients receive priming therapy consisting of cyclophosphamide IV over 2 hours on day 1 and filgrastim (G-CSF) daily subcutaneously (SQ) starting on day 5 and continuing until completion of leukapheresis. Peripheral blood stem cells (PBSC) are collected between days 14-21.

Patients then receive preparative therapy for transplant consisting of cyclophosphamide IV over 2 hours on days -7 and -6 and total body irradiation twice a day on days -4 through -1. Patients receive the PBSC transplantation on day 0. Patients also receive G-CSF IV starting on day 0 and continuing until blood counts recover. Patients then receive interferon alfa SQ daily in the absence of unacceptable toxicity or disease progression.

Patients are followed at 3 weeks; then at 3, 6, 9, 12, and 18 months; and then annually for 5 years.

PROJECTED ACCRUAL: Not specified

Conditions

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Leukemia

Keywords

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chronic phase myelogenous leukemia accelerated phase myelogenous leukemia

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Patients with CML

Patients treated for chronic accelerated phase and/or chronic myelogenous leukemia (CML)

Group Type EXPERIMENTAL

cyclophosphamide

Intervention Type DRUG

intravenously over 2 hours on day 1 and on days -7 and -6

filgrastim

Intervention Type DRUG

filgrastim (G-CSF) daily subcutaneously (SQ) starting on day 5 and continuing until completion of leukapheresis. Patients also receive G-CSF IV starting on day 0 and continuing until blood counts recover

recombinant interferon alfa

Intervention Type DRUG

Beginning on Day 1, subcutaneous (SQ) daily administration in the absence of unacceptable toxicity or disease progression

peripheral blood stem cell transplantation

Intervention Type PROCEDURE

Patients receive the PBSC transplantation on day 0.

radiation therapy

Intervention Type PROCEDURE

total body irradiation twice a day on days -4 through -1

Interventions

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cyclophosphamide

intravenously over 2 hours on day 1 and on days -7 and -6

Intervention Type DRUG

filgrastim

filgrastim (G-CSF) daily subcutaneously (SQ) starting on day 5 and continuing until completion of leukapheresis. Patients also receive G-CSF IV starting on day 0 and continuing until blood counts recover

Intervention Type DRUG

recombinant interferon alfa

Beginning on Day 1, subcutaneous (SQ) daily administration in the absence of unacceptable toxicity or disease progression

Intervention Type DRUG

peripheral blood stem cell transplantation

Patients receive the PBSC transplantation on day 0.

Intervention Type PROCEDURE

radiation therapy

total body irradiation twice a day on days -4 through -1

Intervention Type PROCEDURE

Other Intervention Names

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Endoxan Cytoxan NEUPOGEN® INTRON® A bone marrow transplant irradiation

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed chronic or accelerated phase chronic myelogenous leukemia (CML)

* Philadelphia chromosome positive OR
* BCR/ABL rearrangement
* Ineligible or refused to participate in ongoing allogeneic marrow donor transplant protocols
* 70 and under
* Performance status:

* Age 65-70 years:
* Karnofsky 80-100%
* Under 65 years:
* Karnofsky 90-100%
* Renal:

* Age 65-70 years:
* Creatinine clearance greater than 60 mL/min (if creatinine at least 1.5 mg/dL)
* Under 65 years:
* Not specified
* Cardiovascular:

* Age 65-70 years:
* LVEF at least 45%
* Pulmonary:

* Age 65-70 years:
* If history of smoking or respiratory symptoms, spirometry and DLCO must be greater then 50% of predicted
* Normal organ function (excluding bone marrow)

Exclusion Criteria

* Blast crisis or post blast crisis
* Severe fibrosis defined by bilateral trephine biopsies
* Splenomegaly (below umbilicus) that does not respond to chemotherapy and/or radiotherapy
Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Masonic Cancer Center, University of Minnesota

OTHER

Sponsor Role lead

Responsible Party

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Masonic Cancer Center, University of Minnesota

Principal Investigators

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Catherine M. Verfaillie, MD

Role: STUDY_CHAIR

Masonic Cancer Center, University of Minnesota

Locations

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University of Minnesota Cancer Center

Minneapolis, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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UMN-MT-1996-11

Identifier Type: OTHER

Identifier Source: secondary_id

1996LS183

Identifier Type: -

Identifier Source: org_study_id