Trial Outcomes & Findings for Busulfan, Melphalan, and Fludarabine With Peri-transplant Palifermin, Followed by a T-Cell Depleted Hematopoietic Stem Cell Transplant From HLA Matched or Mismatched Related or Unrelated Donors in Patients With Advanced Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML) (NCT NCT00629798)

NCT ID: NCT00629798

Last Updated: 2021-09-24

Results Overview

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

64 participants

Primary outcome timeframe

conclusion of study

Results posted on

2021-09-24

Participant Flow

Participant milestones

Participant milestones
Measure
Palifermin
This is a single arm phase II trial to assess the efficacy (decrease the transplant related mortality) and safety of peri-transplant Palifermin in combination with a preparative regimen with busulfan, melphalan, fludarabine, and anti-thymocyte globulin (ATG), and a T cell depleted stem cell transplant from a histocompatible related or unrelated donor in patients with advanced MDS and AML evolved from MDS. The addition of Palifermin is to decrease the toxicity and the infection rate associated with this regimen and transplant type and to foster earlier immune reconstitution. Busulfan, Melphalan, Fludarabine, Anti-Thymocyte Globulin, Palifermin, Stem cell transplant: Patients will receive Palifermin 60 mcg/kg/day IV on three consecutive days with the last dose administered no less than 24 and no more than 48 hr prior to start of cytoreduction. The preparative regimen to be used for transplants will consist: of busulfan administered in 12 doses over three days of 0.8 mg/kg IV for patients \> or = to 4 years of age or 1.0 mg/kg IV for patients \< 4 years of age; melphalan 70 mg/m2 IV x 2 days; and, fludarabine 25 mg/m2 IV x 5 days
Overall Study
STARTED
64
Overall Study
COMPLETED
60
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Palifermin
This is a single arm phase II trial to assess the efficacy (decrease the transplant related mortality) and safety of peri-transplant Palifermin in combination with a preparative regimen with busulfan, melphalan, fludarabine, and anti-thymocyte globulin (ATG), and a T cell depleted stem cell transplant from a histocompatible related or unrelated donor in patients with advanced MDS and AML evolved from MDS. The addition of Palifermin is to decrease the toxicity and the infection rate associated with this regimen and transplant type and to foster earlier immune reconstitution. Busulfan, Melphalan, Fludarabine, Anti-Thymocyte Globulin, Palifermin, Stem cell transplant: Patients will receive Palifermin 60 mcg/kg/day IV on three consecutive days with the last dose administered no less than 24 and no more than 48 hr prior to start of cytoreduction. The preparative regimen to be used for transplants will consist: of busulfan administered in 12 doses over three days of 0.8 mg/kg IV for patients \> or = to 4 years of age or 1.0 mg/kg IV for patients \< 4 years of age; melphalan 70 mg/m2 IV x 2 days; and, fludarabine 25 mg/m2 IV x 5 days
Overall Study
Not Treated
4

Baseline Characteristics

Busulfan, Melphalan, and Fludarabine With Peri-transplant Palifermin, Followed by a T-Cell Depleted Hematopoietic Stem Cell Transplant From HLA Matched or Mismatched Related or Unrelated Donors in Patients With Advanced Myelodysplastic Syndromes (MDS) and Acute Myeloid Leukemia (AML)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Palifermin
n=64 Participants
This is a single arm phase II trial to assess the efficacy (decrease the transplant related mortality) and safety of peri-transplant Palifermin in combination with a preparative regimen with busulfan, melphalan, fludarabine, and anti-thymocyte globulin (ATG), and a T cell depleted stem cell transplant from a histocompatible related or unrelated donor in patients with advanced MDS and AML evolved from MDS. The addition of Palifermin is to decrease the toxicity and the infection rate associated with this regimen and transplant type and to foster earlier immune reconstitution. Busulfan, Melphalan, Fludarabine, Anti-Thymocyte Globulin, Palifermin, Stem cell transplant: Patients will receive Palifermin 60 mcg/kg/day IV on three consecutive days with the last dose administered no less than 24 and no more than 48 hr prior to start of cytoreduction. The preparative regimen to be used for transplants will consist: of busulfan administered in 12 doses over three days of 0.8 mg/kg IV for patients \> or = to 4 years of age or 1.0 mg/kg IV for patients \< 4 years of age; melphalan 70 mg/m2 IV x 2 days; and, fludarabine 25 mg/m2 IV x 5 days
Age, Continuous
60 years
n=5 Participants
Sex: Female, Male
Female
34 Participants
n=5 Participants
Sex: Female, Male
Male
30 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
61 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
5 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
Race (NIH/OMB)
White
58 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
United States
64 Participants
n=5 Participants

PRIMARY outcome

Timeframe: conclusion of study

Population: Data were not collected

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: conclusion of study

Population: Data were not collected

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: conclusion of study

Population: Data were not collected

Outcome measures

Outcome data not reported

Adverse Events

Palifermin

Serious events: 28 serious events
Other events: 28 other events
Deaths: 38 deaths

Serious adverse events

Serious adverse events
Measure
Palifermin
n=64 participants at risk
This is a single arm phase II trial to assess the efficacy (decrease the transplant related mortality) and safety of peri-transplant Palifermin in combination with a preparative regimen with busulfan, melphalan, fludarabine, and anti-thymocyte globulin (ATG), and a T cell depleted stem cell transplant from a histocompatible related or unrelated donor in patients with advanced MDS and AML evolved from MDS. The addition of Palifermin is to decrease the toxicity and the infection rate associated with this regimen and transplant type and to foster earlier immune reconstitution. Busulfan, Melphalan, Fludarabine, Anti-Thymocyte Globulin, Palifermin, Stem cell transplant: Patients will receive Palifermin 60 mcg/kg/day IV on three consecutive days with the last dose administered no less than 24 and no more than 48 hr prior to start of cytoreduction. The preparative regimen to be used for transplants will consist: of busulfan administered in 12 doses over three days of 0.8 mg/kg IV for patients \> or = to 4 years of age or 1.0 mg/kg IV for patients \< 4 years of age; melphalan 70 mg/m2 IV x 2 days; and, fludarabine 25 mg/m2 IV x 5 days
Metabolism and nutrition disorders
Acidosis (metabolic/respiratory)
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Adult Respiratory Distress Synd (ARDS)
3.1%
2/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Atelectasis
1.6%
1/64 • 1 year
Cardiac disorders
Atrial Fibrillation
1.6%
1/64 • 1 year
Investigations
Bilirubin (hyperbilirubinemia)
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Cough
1.6%
1/64 • 1 year
General disorders
Death not assoc w CTCAE term - Death NOS
6.2%
4/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Dyspnea (shortness of breath)
1.6%
1/64 • 1 year
Nervous system disorders
Encephalopathy
1.6%
1/64 • 1 year
Blood and lymphatic system disorders
Febrile neutropenia
1.6%
1/64 • 1 year
General disorders
Fever (in the absence of neutropenia)
1.6%
1/64 • 1 year
Gastrointestinal disorders
Hemorrhage, Upper GI NOS
1.6%
1/64 • 1 year
Blood and lymphatic system disorders
Hemorrhage/Bleeding, other
1.6%
1/64 • 1 year
Vascular disorders
Hypotension
3.1%
2/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Hypoxia
17.2%
11/64 • 1 year
Infections and infestations
Inf norm ANC/gr1/2 neut-Pneumonia (lung)
4.7%
3/64 • 1 year
Infections and infestations
Infection, other
15.6%
10/64 • 1 year
Renal and urinary disorders
Liver dysfunction/failure
3.1%
2/64 • 1 year
Investigations
Neutrophils/granulocytes (ANC/AGC)
3.1%
2/64 • 1 year
Musculoskeletal and connective tissue disorders
Pain - Extremity-limb
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Pain - Sinus
1.6%
1/64 • 1 year
Investigations
Platelets
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Pleural effusion (non-malig)
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Pneumonitis/pulm inflitrates
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Pulm/upp respiratory - Other (spec)
1.6%
1/64 • 1 year
Respiratory, thoracic and mediastinal disorders
Pulmonary hypertension
3.1%
2/64 • 1 year
Renal and urinary disorders
Renal failure
1.6%
1/64 • 1 year
Renal and urinary disorders
Renal/Genitourinary-Other Specify
4.7%
3/64 • 1 year
Nervous system disorders
Seizure
1.6%
1/64 • 1 year
Cardiac disorders
Sinus tachycardia
1.6%
1/64 • 1 year
Gastrointestinal disorders
Vomiting
1.6%
1/64 • 1 year

Other adverse events

Other adverse events
Measure
Palifermin
n=64 participants at risk
This is a single arm phase II trial to assess the efficacy (decrease the transplant related mortality) and safety of peri-transplant Palifermin in combination with a preparative regimen with busulfan, melphalan, fludarabine, and anti-thymocyte globulin (ATG), and a T cell depleted stem cell transplant from a histocompatible related or unrelated donor in patients with advanced MDS and AML evolved from MDS. The addition of Palifermin is to decrease the toxicity and the infection rate associated with this regimen and transplant type and to foster earlier immune reconstitution. Busulfan, Melphalan, Fludarabine, Anti-Thymocyte Globulin, Palifermin, Stem cell transplant: Patients will receive Palifermin 60 mcg/kg/day IV on three consecutive days with the last dose administered no less than 24 and no more than 48 hr prior to start of cytoreduction. The preparative regimen to be used for transplants will consist: of busulfan administered in 12 doses over three days of 0.8 mg/kg IV for patients \> or = to 4 years of age or 1.0 mg/kg IV for patients \< 4 years of age; melphalan 70 mg/m2 IV x 2 days; and, fludarabine 25 mg/m2 IV x 5 days
Metabolism and nutrition disorders
Glucose, high (hyperglycemia)
40.6%
26/64 • 1 year
Investigations
ALT, SGPT
32.8%
21/64 • 1 year
Investigations
Creatinine
28.1%
18/64 • 1 year
Metabolism and nutrition disorders
Magnesium, high (hypermagnesemia)
21.9%
14/64 • 1 year
Investigations
AST/SGOT
18.8%
12/64 • 1 year
Investigations
Bilirubin (hyperbilirubinemia)
15.6%
10/64 • 1 year
Investigations
Alkaline phosphatase
14.1%
9/64 • 1 year

Additional Information

Dr. Roni Tamari, MD

Memorial Sloan Kettering Cancer Center

Phone: 646-608-3738

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place