Dose-range Finding Treosulfan-based Conditioning
Hematological Malignancies
About this trial
This is an interventional treatment trial for Hematological Malignancies focused on measuring Treosulfan, Allogeneic stem cell transplantation, Conditioning therapy
Eligibility Criteria
Inclusion Criteria:
Patients with a haematological chemosensitive malignancy indicated for an allogeneic transplantation, but presenting an increased toxicity risk for classical (high-dose busulfan or standard-dose total body irradiation) conditioning therapies (remission criteria ref. to Appendix L):
- CML in first or subsequent chronic phase
- NHL in 2nd CR/PR, chemosensitive PR after autologous transplantation ; CLL in 2nd or subsequent CR/PR
- Relapsed Morbus Hodgkin (MH) after autologous transplantation
- Multiple Myeloma (MM) stage II and III according to Durie and Salmon
- AML in 2nd CR/PR or high-risk AML in 1st CR/PR
High-risk defined for example by the following:
- Cytogenetics: -5/5q, -7/7q, del(5q), abnormalities of 3q, complex karyotype (> 3 abnormalities), or
- PR after 1 cycle of induction therapy
- ALL in 2nd CR/PR or high-risk ALL in 1st CR/PR
High-risk defined as follows:
- Leukocytes > 3000/µl (B-Linage) or > 100000/µl (T-Linage);
- Pro-B-ALL, pre-T-ALL
- Cytogenetics: t(9;22)/BCR-ABL; t(4;11)/ALL1-AF
- MDS (patients without prior chemotherapy may be included)
Availability of an HLA-identical sibling donor (MRD) or HLA-identical unrelated donor (MUD) or one mismatch (out of the 6 standard markers) sibling donor (1 misMRD):
• HLA-identity defined by the following markers: A, B, DRB1. DQB1 must be recorded.
- Age > 18 years
- Karnofsky Index > 80 %
- Adequate contraception in female patients of child-bearing potential
- Co-operative behavior of individual patients
- Written informed consent
Exclusion Criteria:
- Completely chemotherapy-resistant disease
- Severe cardiac insufficiency, severe cardio-vascular or other severe concomitant diseases
- Symptomatic malignant involvement of the CNS
- Active infectious disease
- HIV-positive or active hepatitis infection
- Impaired liver function (Bilirubin > 1.5 x upper normal limit; Transaminases > 3.0 x upper normal limit)
- Impaired renal function (Creatinine-clearance < 60 ml/min; Serum Creatinine > 1.5 x upper normal limit).
- Pleural effusion or ascites > 1.0 L
- Pregnancy or lactation
- Known hypersensitivity to fludarabine and/or treosulfan
- Parallel participation in another experimental drug trial
Sites / Locations
- Helsinki University Central Hospital
- Charité University Hospital Berlin
- University Hospital Hamburg Eppendorf
- 5th Medical Clinic, Clinic North
- University Hospital Rostock
- Silesian Medical University
- Karolinska University Hospital & Karolinska Institute
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Experimental
1
2
3
Treosulfan: 10 g/m² i.v. on 3 consecutive days (day -6 to -4)
Treosulfan:12 g/m² i.v. on 3 consecutive days (day -6 to -4)
Treosulfan: 14 g/m² i.v. on 3 consecutive days (day -6 to -4)