Clinical Trial: Study of Fludarabine Based Conditioning for Allogeneic Stem Cell Transplantation for Myelofibrosis

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Study of Fludarabine Based Conditioning for Allogeneic Stem Cell Transplantation for Myelofibrosis

Brief Summary:

Stem cell transplantation is used to treat may types of diseases. There a 2 types of transplants, conventional (very intense) and reduced intensity-non-myeloablative, also called mini-transplants.

This study proposes to use a conditioning regimen for allogeneic transplantation along with a reduced intensity transplant. Conditioning regiment is the name for the combination of chemotherapy drugs that is given to patients before receiving a transplantation of donor stem cells. It is hoped that the regimen designed for this study proves to be less toxic and has an equal or better anticancer effect than the regimens that are normally used. The regimen being used is a combination of two chemotherapy drugs, fludarabine and melphalan. This regimen has been studied in recipients of matched sibling transplants and in recipients of alternative donor stem cells in other hematologic malignancies. Those subjects, who receive stem cells from an unrelated donor, will also receive and additional drug called ATG or anti thymocyte globulin. ATG suppresses the immune system, thus reducing the chances for the recipient rejecting the transplant (graft).

The purpose of this study is to observe if reduced intensity transplants can be used to allow engraftment or "take" of the donor's bone marrow. Studies conducted in the past show this type of transplant is much less toxic than traditional bone marrow transplants. Reduced intensity transplants may be better tolerated by patients who may experience serious side effects from standard (very intense) stem cell transplant.

The study has been recently amended to follow all subjects for survival.


Detailed Summary:

This study is designed as a single arm Phase II clinical trial in patients with myelofibrosis who are eligible for transplantation from a related donor or from an unrelated donor source. Patients will be accrued into two separate strata defined by donor type. Each of the two strata will be analyzed separately.

Patients will be followed yearly from time of enrollment into the study to assess clinical response and overall, progression and event free survival, as well as incidence and degree of acute and chronic GVHD. We will estimate cumulative survival and transplant related mortality in patients enrolled in each of the two strata.


Sponsor: John Mascarenhas

Current Primary Outcome: The Primary Endpoint is Progression-free Survival. [ Time Frame: 2 years ]

Number of participants alive at 2 years who are progression-free


Original Primary Outcome: The Primary Endpoint is Progression-free Survival. [ Time Frame: 2 years ]

Current Secondary Outcome:

  • Response Outcomes [ Time Frame: 180 days ]
    assessed according to the IWG Criteria
  • Overall Survival [ Time Frame: 73 months ]
    The number of patients alive at last follow-up.
  • Absolute Neutrophil Count (ANC) [ Time Frame: 2 years ]
    Patients with ANC ≥0.5 × 10^9/L
  • PLT [ Time Frame: 2 years ]
    Patients with PLT ≥20 × 109/L
  • Transplant-related Mortality [ Time Frame: 2 years ]
    Transplant-related Mortality including Graft-versus-host disease (GVHD)


Original Secondary Outcome: Secondary endpoints will include the proportion of patients "cured" (resolution of splenokegaly and normalization of blood counts), duration of cure, rates of transplant-related mortality, and overall survival. [ Time Frame: 2 years ]

Information By: Icahn School of Medicine at Mount Sinai

Dates:
Date Received: December 11, 2007
Date Started: August 2007
Date Completion:
Last Updated: April 7, 2017
Last Verified: April 2017