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Unrelated Donor Transplant for Malignant and Non-Malignant Disorders

Primary Purpose

Leukemia, Lymphoma, Bone Marrow Failure Syndromes

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
UDAlloSCT
Therapy
Sponsored by
Columbia University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Leukemia focused on measuring Allogeneic Stem Cell Transplant, Unrelated donor, Cord blood donor

Eligibility Criteria

undefined - 55 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adequate renal function defined as: serum creatinine 2.0 x normal, or creatinine clearance or radioisotope GFR > 40 ml/min/m2 or > 40 ml/min/1.73 m2 or an equivalent GFR as determined by the institutional normal range.
  • Adequate liver function defined as: total bilirubin < 2.5 x normal; or SGOT (AST) or SGPT (ALT) < 5.0 x normal.
  • Adequate cardiac function defined as: shortening fraction of > 25% by echocardiogram, or ejection fraction of > 40% by radionuclide angiogram or echocardiogram.
  • Adequate pulmonary function defined as: DLCO > 35% by pulmonary function test. For children who are uncooperative, no evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry > 94% in room air.
  • Diseases:

    • CML (CP, AP or BC)
    • AML/MDS/JCML
    • ALL
    • Lymphoma (Hodgkin's and non-Hodgkin's)
    • Non-malignant disorders
  • Bone Marrow Failure Syndromes: Patients with the following diagnoses are eligible:

    • Severe Aplastic Anemia:
    • Fanconi Anemia
    • Severe Congenital Neutropenia (Kostmann's Syndrome)
    • Amegakaryocytic Thrombocytopenia
    • Diamond-Blackfan Anemia
    • Infantile Osteopetrosis
    • Schwachman-Diamond Syndrome
    • Dyskeratosis Congenita
    • Other bone marrow failure syndromes at discretion of Principal Investigator
  • Immunodeficiencies:

    • SCIDS, all subtypes
    • Combined Immunodeficiency Syndrome
    • Wiskott-Aldrich syndrome
    • Chronic Granulomatous Disease
    • Chediak-Higashi Syndrome
    • Leukocyte Adhesion Deficiency
    • Other immunodeficiencies at discretion of Principal Investigator
  • Inborn Errors of Metabolism (IEOM):

    • Transplant is recommended for the following disorders: Hurler syndrome (L-iduronidase deficiency, MPS-I), Maroteaux-Lamy syndrome (galactosamine-4-sulfatase deficiency, MP VI), Sly syndrome (glucuronidase deficiency, MPS-VII), Globoid cell Leukodystrophy (galactocerebrosidasedeficiency), Metachromatic leukodystrophy (arylsulfatase A deficiency), Childhood-onset X-linked adrenoleukodystrophy (X-ALD), Fucosidosis (fucosidase deficiency), Mannosidosis, Aspartylglucosaminuria, Niemann-Pick Disease Type B (acid sphingomyelinase deficiency), Gaucher disease (glucocerebrosidase deficiency) Type I (non neuropathic), Other diagnoses may be considered at the discretion of the Principal Investigator
    • For X-ALD patients greater than 5 years of age, IQ > 80 is required. For other patients greater than 5 years of age, IQ > 70 is required.
    • For patients less than 5 years of age, the developmental quotient or clinical neurodevelopmental examination should demonstrate potential for stabilization at a level of functioning where continuous life support (e.g. mechanical ventilation) would not be predicted to be required in the year following transplantation.
  • Histiocytosis:

    • Hemophagocytic Lymphohistiocytosis (HLH)
    • Familial Erythrophagocytic Lymphohistiocytosis
    • Langerhans Cell Histiocytosis
    • Malignant Histiocytosis
  • Other Malignant and non-malignant diseases: Other malignant and non-malignant diseases not listed above may be eligible if deemed appropriate by the Principal Investigator.

Exclusion Criteria:

  • Women who are pregnant and/or breast feeding are ineligible

Sites / Locations

  • Columbia University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

UDAlloSCT + Therapy

Arm Description

This is a non-randomized study to test the safety and response of unrelated matched donor allogeneic stem cell transplantation (UDAlloSCT) with either myleoablative (full intensity) or reduced intensity conditioning therapy in patients with selected malignant and non-malignant disorders. UDAlloSCT has been performed in both adults and children as an alternative transplant for patients who lack and HLA-matched family donor in both malignant and non-malignant disease with varying degrees of response.

Outcomes

Primary Outcome Measures

Incidence of toxicity related to myeloablative therapy
To determine the safety and toxicity of myeloablative therapy (TBI + Melphalan) and unrelated donor alloSCT in selected patients with malignant and non-malignant disorders.

Secondary Outcome Measures

Incidence of toxicity related to reduced intensity therapy
To determine the safety and toxicity of reduced intensity therapy (Fludarabine, Busulfan, and Alemtuzumab (FBA) and unrelated donor alloSCT in selected patients with malignant and non malignant disorders
Percentage of donor chimerism
To quantitate the percentage of donor chimerism following both myeloablative and reduced intensity conditioning and unrelated donor alloSCT in selected patients with malignant and non-malignant disorders.
Prevalence of progression free survival
To estimate the progression free survival (PFS), if applicable, event free survival (EFS) and overall survival (OS) following unrelated donor alloSCT in selected patients with malignant and non malignant disorders.

Full Information

First Posted
June 3, 2008
Last Updated
April 14, 2015
Sponsor
Columbia University
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1. Study Identification

Unique Protocol Identification Number
NCT01050439
Brief Title
Unrelated Donor Transplant for Malignant and Non-Malignant Disorders
Official Title
Unrelated Donor Stem Cell Transplant for Patients With Malignant and Non-Malignant Disorders
Study Type
Interventional

2. Study Status

Record Verification Date
April 2015
Overall Recruitment Status
Terminated
Why Stopped
PI left the institution
Study Start Date
November 2002 (undefined)
Primary Completion Date
April 2011 (Actual)
Study Completion Date
April 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Columbia University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Unrelated matched donor (cord blood, bone marrow or peripheral blood) allogeneic stem cell transplantation (UDAlloSCT) with either myeloablative or reduced intensity conditioning will be well tolerated and result in a high degree of engraftment in patients with selected malignant and non malignant disorders.
Detailed Description
This is a non-randomized study to determine the tolerability and degree of engraftment of unrelated matched donor allogeneic stem cell transplantation with either myeloablative or reduced intensity conditioning in patients with selected malignant and non malignant disorders. Patients will receive one of either full intensity or reduced intensity regimen based on the patient's disease status, organ function and performance and determined by the PI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Leukemia, Lymphoma, Bone Marrow Failure Syndromes, Immunodeficiencies, Histiocytosis
Keywords
Allogeneic Stem Cell Transplant, Unrelated donor, Cord blood donor

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
UDAlloSCT + Therapy
Arm Type
Experimental
Arm Description
This is a non-randomized study to test the safety and response of unrelated matched donor allogeneic stem cell transplantation (UDAlloSCT) with either myleoablative (full intensity) or reduced intensity conditioning therapy in patients with selected malignant and non-malignant disorders. UDAlloSCT has been performed in both adults and children as an alternative transplant for patients who lack and HLA-matched family donor in both malignant and non-malignant disease with varying degrees of response.
Intervention Type
Procedure
Intervention Name(s)
UDAlloSCT
Intervention Description
unrelated matched donor allogeneic stem cell transplantation (UDAlloSCT)
Intervention Type
Other
Intervention Name(s)
Therapy
Intervention Description
Full Intensity Therapy (myeloablative) (TBI + Thiotepa + Cyc) OR Reduced Intensity Therapy (Fludarabine, Busulfan, and Alemutuzumab (FBA))
Primary Outcome Measure Information:
Title
Incidence of toxicity related to myeloablative therapy
Description
To determine the safety and toxicity of myeloablative therapy (TBI + Melphalan) and unrelated donor alloSCT in selected patients with malignant and non-malignant disorders.
Time Frame
Up to 10 years from start of study
Secondary Outcome Measure Information:
Title
Incidence of toxicity related to reduced intensity therapy
Description
To determine the safety and toxicity of reduced intensity therapy (Fludarabine, Busulfan, and Alemtuzumab (FBA) and unrelated donor alloSCT in selected patients with malignant and non malignant disorders
Time Frame
Up to 10 years from start of study
Title
Percentage of donor chimerism
Description
To quantitate the percentage of donor chimerism following both myeloablative and reduced intensity conditioning and unrelated donor alloSCT in selected patients with malignant and non-malignant disorders.
Time Frame
Up to 10 years from start of study
Title
Prevalence of progression free survival
Description
To estimate the progression free survival (PFS), if applicable, event free survival (EFS) and overall survival (OS) following unrelated donor alloSCT in selected patients with malignant and non malignant disorders.
Time Frame
Up to 10 years from start of study

10. Eligibility

Sex
All
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adequate renal function defined as: serum creatinine 2.0 x normal, or creatinine clearance or radioisotope GFR > 40 ml/min/m2 or > 40 ml/min/1.73 m2 or an equivalent GFR as determined by the institutional normal range. Adequate liver function defined as: total bilirubin < 2.5 x normal; or SGOT (AST) or SGPT (ALT) < 5.0 x normal. Adequate cardiac function defined as: shortening fraction of > 25% by echocardiogram, or ejection fraction of > 40% by radionuclide angiogram or echocardiogram. Adequate pulmonary function defined as: DLCO > 35% by pulmonary function test. For children who are uncooperative, no evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry > 94% in room air. Diseases: CML (CP, AP or BC) AML/MDS/JCML ALL Lymphoma (Hodgkin's and non-Hodgkin's) Non-malignant disorders Bone Marrow Failure Syndromes: Patients with the following diagnoses are eligible: Severe Aplastic Anemia: Fanconi Anemia Severe Congenital Neutropenia (Kostmann's Syndrome) Amegakaryocytic Thrombocytopenia Diamond-Blackfan Anemia Infantile Osteopetrosis Schwachman-Diamond Syndrome Dyskeratosis Congenita Other bone marrow failure syndromes at discretion of Principal Investigator Immunodeficiencies: SCIDS, all subtypes Combined Immunodeficiency Syndrome Wiskott-Aldrich syndrome Chronic Granulomatous Disease Chediak-Higashi Syndrome Leukocyte Adhesion Deficiency Other immunodeficiencies at discretion of Principal Investigator Inborn Errors of Metabolism (IEOM): Transplant is recommended for the following disorders: Hurler syndrome (L-iduronidase deficiency, MPS-I), Maroteaux-Lamy syndrome (galactosamine-4-sulfatase deficiency, MP VI), Sly syndrome (glucuronidase deficiency, MPS-VII), Globoid cell Leukodystrophy (galactocerebrosidasedeficiency), Metachromatic leukodystrophy (arylsulfatase A deficiency), Childhood-onset X-linked adrenoleukodystrophy (X-ALD), Fucosidosis (fucosidase deficiency), Mannosidosis, Aspartylglucosaminuria, Niemann-Pick Disease Type B (acid sphingomyelinase deficiency), Gaucher disease (glucocerebrosidase deficiency) Type I (non neuropathic), Other diagnoses may be considered at the discretion of the Principal Investigator For X-ALD patients greater than 5 years of age, IQ > 80 is required. For other patients greater than 5 years of age, IQ > 70 is required. For patients less than 5 years of age, the developmental quotient or clinical neurodevelopmental examination should demonstrate potential for stabilization at a level of functioning where continuous life support (e.g. mechanical ventilation) would not be predicted to be required in the year following transplantation. Histiocytosis: Hemophagocytic Lymphohistiocytosis (HLH) Familial Erythrophagocytic Lymphohistiocytosis Langerhans Cell Histiocytosis Malignant Histiocytosis Other Malignant and non-malignant diseases: Other malignant and non-malignant diseases not listed above may be eligible if deemed appropriate by the Principal Investigator. Exclusion Criteria: Women who are pregnant and/or breast feeding are ineligible
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mitchell S Cairo, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States

12. IPD Sharing Statement

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Unrelated Donor Transplant for Malignant and Non-Malignant Disorders

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