Status:

TERMINATED

Fludarabine, Cyclophosphamide, and Total-Body Irradiation Followed by Cyclosporine and Mycophenolate Mofetil in Treating Patients Who Are Undergoing a Donor Umbilical Cord Blood Transplant for Hematologic Cancer

Lead Sponsor:

University of Rochester

Conditions:

Chronic Myeloproliferative Disorders

Graft Versus Host Disease

Eligibility:

All Genders

Up to 75 years

Phase:

NA

Brief Summary

RATIONALE: Giving low doses of chemotherapy, such as fludarabine and cyclophosphamide, and radiation therapy before a donor umbilical cord blood stem cell transplant helps stop the growth of cancer ce...

Detailed Description

OBJECTIVES: * Determine the frequency, extent, and rate of donor (myeloid and lymphoid) engraftment in patients with serious hematologic malignancies treated with nonmyeloablative conditioning regime...

Eligibility Criteria

Inclusion

  • DISEASE CHARACTERISTICS:
  • Diagnosis of 1 of the following hematologic malignancies:
  • Acute myeloid leukemia (AML) with or without history of myelodysplastic syndromes, meeting 1 of the following criteria:
  • In first complete remission (CR-1) with unfavorable cytogenetics and/or achieved CR-1 after ≥ 1 course of induction therapy
  • Secondary or treatment-related AML
  • In second or further complete remission
  • Relapsed with ≤ 20% blasts in the bone marrow AND no circulating blasts
  • Acute lymphoblastic leukemia (ALL), meeting 1 of the following criteria:
  • In CR-1 with unfavorable cytogenetics or elevated WBC at presentation OR failed to achieve CR-1 after ≥ 4 weeks of induction therapy
  • In second or further complete remission
  • Relapsed with ≤ 20% blasts in the bone marrow AND no circulating blasts
  • Other acute leukemic variants allowed at the discretion of the principal investigator
  • Chronic myelogenous leukemia (CML), meeting 1 of the following criteria:
  • In first chronic phase AND refractory to or unable to tolerate imatinib mesylate
  • In second or further chronic phase
  • In first or second accelerated phase
  • Myelodysplastic syndromes with intermediate 2- or high-risk International Prognosis Scoring System (IPSS) score, including any of the following:
  • Refractory anemia
  • Refractory anemia with excess blasts
  • Chronic myelomonocytic leukemia
  • Myeloproliferative disorders with poor prognosis, including any of the following:
  • Myelofibrosis with myeloid metaplasia
  • No ≥ grade 3 myelofibrosis
  • Atypical CML
  • Juvenile myelomonocytic leukemia
  • Other clonal hemopathies with an accepted poor prognosis
  • Multiple myeloma with chromosome 13 abnormalities and/or progression after prior autologous bone marrow transplantation (BMT)
  • Chronic lymphocytic leukemia, meeting 1 of the following criteria:
  • Primary refractory OR relapsed and refractory disease (less than partial remission)
  • Relapsed twice on or after prior chemotherapy
  • Lymphoma, meeting both of the following criteria:
  • Hodgkin's or non-Hodgkin's lymphoma in \> CR-1 OR failed primary induction
  • Chemosensitive disease, defined as \> 50% reduction in mass size after the most recent chemotherapy
  • Must meet ≥ 1 of the following criteria:
  • Over 45 years of age
  • Has undergone prior autologous or allogeneic BMT
  • Charlson\^ comorbidity score ≥ 2
  • Must have a high degree of tumor control (salvage therapy allowed)
  • At high risk for treatment-related mortality with a myeloablative conditioning regimen
  • No massive splenomegaly
  • Patients may become eligible after splenectomy or radiotherapy to the spleen
  • No 5/6 or 6/6 HLA-matched related donor available
  • No well-matched (i.e., ≥ 9/10 HLA match by high-resolution typing) unrelated donor available
  • PATIENT CHARACTERISTICS:
  • Performance status
  • Not specified
  • Life expectancy
  • Not specified
  • Hematopoietic
  • See Disease Characteristics
  • Hepatic
  • Bilirubin ≤ 2 times upper limit of normal (ULN)
  • Transaminases ≤ 4 times ULN (unless due to underlying disease)
  • Renal
  • Creatinine clearance ≥ 50 mL/min
  • Cardiovascular
  • Ejection fraction ≥ 30%
  • Pulmonary
  • DCLO ≥ 35%
  • Other
  • Negative pregnancy test
  • No uncontrolled viral, bacterial, or fungal infection
  • HIV negative
  • PRIOR CONCURRENT THERAPY:
  • Biologic therapy
  • See Disease Characteristics
  • Chemotherapy
  • See Disease Characteristics
  • Radiotherapy
  • See Disease Characteristics
  • Other
  • At least 3 months since prior immunosuppressive therapy
  • At least 10 days since prior salvage therapy for patients not in at least morphologic or radiologic complete remission

Exclusion

    Key Trial Info

    Start Date :

    December 1 2003

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    June 1 2016

    Estimated Enrollment :

    16 Patients enrolled

    Trial Details

    Trial ID

    NCT00255684

    Start Date

    December 1 2003

    End Date

    June 1 2016

    Last Update

    November 3 2016

    Active Locations (1)

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    1

    James P. Wilmot Cancer Center at University of Rochester Medical Center

    Rochester, New York, United States, 14642