Treatment of Graft Failure After Hematopoietic Stem Cell Transplantation

NCT ID: NCT02161783

Last Updated: 2024-12-19

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

RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-10-06

Study Completion Date

2032-01-30

Brief Summary

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This is a guideline for the treatment of graft failure after hematopoietic stem cell transplant (HSCT). This regimen, consisting of cyclophosphamide and fludarabine with low dose total body irradiation (TBI) is designed to promote donor engraftment by day 42 after initial graft failure.

The graft will consist of bone marrow or G-CSF mobilized peripheral blood from a haploidentical related donor. The source of stem cells will be determined by the transplant team based on factors such as patient's age, medical history, donor availability and will be according to the current University of Minnesota Blood and Marrow Transplantation Program selection guidelines.

Detailed Description

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Conditions

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Primary Graft Failure Secondary Graft Failure

Keywords

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Hematopoietic stem cell transplant

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Treatment

This regimen consists of cyclophosphamide and fludarabine with low dose total body irradiation (TBI), followed by hematopoietic stem cell infusion.

Fludarabine

Intervention Type DRUG

Fludarabine 30 mg/m2 IV over 1 hour given on days -6 through -2 of transplant.

Cyclophosphamide

Intervention Type DRUG

Cyclophosphamide 14.5 mg/kg IV over 1-2 hours given on days -6 and -5 from transplant. And Cyclophosphamide 50 mg/kg IV over 2 hours given on days +3 and +4 from transplant.

Total Body Irradiation

Intervention Type RADIATION

TBI 200cGy in a single fraction on day -1 from transplant.

Hematopoietic stem cell infusion

Intervention Type BIOLOGICAL

Hematopoietic stem cell infusion given on day 0.

Interventions

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Fludarabine

Fludarabine 30 mg/m2 IV over 1 hour given on days -6 through -2 of transplant.

Intervention Type DRUG

Cyclophosphamide

Cyclophosphamide 14.5 mg/kg IV over 1-2 hours given on days -6 and -5 from transplant. And Cyclophosphamide 50 mg/kg IV over 2 hours given on days +3 and +4 from transplant.

Intervention Type DRUG

Total Body Irradiation

TBI 200cGy in a single fraction on day -1 from transplant.

Intervention Type RADIATION

Hematopoietic stem cell infusion

Hematopoietic stem cell infusion given on day 0.

Intervention Type BIOLOGICAL

Other Intervention Names

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Fludara TBI HSCT

Eligibility Criteria

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Inclusion Criteria

* Patients with primary or secondary graft failure, as defined below, may receive a second transplant:

* Primary graft failure is defined as not achieving an ANC ≥0.5x10\^9/L for three consecutive days by day 35 - 42 following the first transplant.
* Secondary graft failure is defined as achieving an ANC ≥0.5x10\^9/L for three consecutive days by day 35 - 42, but subsequently drops below 0.5x10\^9/L without recovery.
* Loss of chimerism is defined as achieving an ANC ≥0.5x10\^9/L for three consecutive, but with less than 10% CD15+ donor cells in the marrow or peripheral blood.
* Recipients should have acceptable organ function defined as:

* Renal: creatinine \< 2.0 (adults) and creatinine clearance \> 30. For creatinine clearance \< 70, consultation with a BMT pharmacist is necessary for chemotherapy dose adjustments.
* Hepatic: bilirubin, AST/ALT, ALP \< 10 x upper limit of normal
* Cardiac: left ventricular ejection fraction \> 40%

Exclusion Criteria

* Uncontrolled infection at the time of transplant.
* Patients with Fanconi Anemia or other DNA breakage syndromes.
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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Responsibility Role SPONSOR

Principal Investigators

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Troy C Lund, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Locations

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University of Minnesota Medical Center, Fairview

Minneapolis, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Timothy Krepski

Role: CONTACT

Phone: 612-273-2800

Email: [email protected]

Facility Contacts

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Timothy Krepski

Role: primary

Other Identifiers

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MT2013-06C

Identifier Type: OTHER

Identifier Source: secondary_id

2013OC003

Identifier Type: -

Identifier Source: org_study_id