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Allo Transplantation with Mylotarg, fludarabine and melphalan for AML, CML and MDS.
This study is currently recruiting patients.
Sponsored by: | M.D. Anderson Cancer Center |
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Information provided by: | M.D. Anderson Cancer Center |
Purpose
Primary Objective: To determine the safety and maximum tolerated dose of Mylotarg as part of a reduced-intensity preparative regimen patients undergoing related, mismatched-related or matched unrelated donor transplantation.
Secondary Objectives: 1. To evaluate response rates, engraftment kinetics and degree of chimerism achievable with this strategy. 2. To evaluate the incidence and severity of GVHD in this population 3. To evaluate disease-free and overall survival and relapse rates.
Condition | Treatment or Intervention | Phase |
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Acute Myelogenous Leukemia Myelodysplastic Syndrome Chronic Lymphocytic Leukemia |
Drug: Mylotarg |
Phase I Phase II |
MedlinePlus related topics: Bone Marrow Diseases; Immune System and Disorders; Leukemia, Adult Acute; Leukemia, Adult Chronic; Leukemia, Childhood; Lymphatic Diseases
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Phase I/II Evaluation of Safety and Activity of Mylotarg plus Melphalan and Fludarabine as Preparative Therapy for Older or Medically Infirm Patients Undergoing Allogeneic Bone Marrow and Peripheral Blood Stem Cell Transplantation
Expected Total Enrollment: 44
Study start: May 2001
Allogeneic bone marrow transplantation is an effective first line and salvage therapy in-patients with AML, CML or MDS. In the past, allogeneic transplantation has been limited to younger patients due to the increased risk of regimen-related toxicity and graft-versus-host disease (GVHD). In order to expand the use of alloBMT to older patients, researchers at MD Anderson Cancer Center have pioneered the use of nonmyeloablative preparative therapy for allogeneic transplantation. Nonmyeloablative therapy utilizes low-dose chemotherapy in order to decrease regimen-related toxicity. The low-dose chemotherapy induces host immunosuppression, spares toxicity, and allows engraftment of donor stem cells. The goal of this therapy is to exploit the anti-tumor effects of donor immune cells.
One shortcoming of nonmyeloablative transplantation is an increased risk of disease relapse, especially in patients with high-risk disease. This includes patients with relapse or refractory AML, advanced MDS and advanced CML. Mylotarg is a novel immunotoxin directed against the CD33 antigen found on most AML, CML and MDS clones. Mylotarg has been shown to have significant anti-leukemia activity with little toxicity. The goal of this Phase I/II protocol is to evaluate the safety and efficacy of adding escalating doses of Mylotarg to Fludarabine and Melphalan in patients with CML, MDS or acute myelogenous leukemia undergoing related, mismatch-related or matched unrelated donor allogeneic transplantation. The hypothesis is that Mylotarg will provide potent anti-leukemic effects without additional toxicity. Mylotarg, Melphalan, and Fludarabine have non-overlapping toxicities. A more potent anti-leukemic response may increase the complete remission rates and induce a state of minimal residual disease (MRD). Therefore, the GVL effect will have a better chance for success.
Eligibility
Ages Eligible for Study: 55 Years - 75 Years, Genders Eligible for Study: Both
Criteria
Inclusion Criteria:
Exclusion Criteria:
Location and Contact Information
More Information
U.S. National Library of Medicine, Contact NLM Customer Service | ||||||||||||||
National Institutes of Health, Department of Health & Human Services | ||||||||||||||
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