Clinical Trial: Allogeneic Stem Cell Transplantation Following Chemotherapy in Patients With Hemoglobinopathies

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

Official Title: Multi-Center Study Using Allogeneic Stem Cell Transplantation Following Reduced Intensity Chemotherapy in Patients With Hemoglobinopathies

Brief Summary: The purpose of this study is to determine if treatment with reduced-dose busulfex, fludarabine and alemtuzumab (CAMPATH) followed by sten cell infusion will allow for donor stem cells to grow in patients with hemoglobinopathies bone marrow and restore circulating blood counts. In addition the incidence and severity of side effects and of graft vs. host disease (GVHD) will be monitored.

Detailed Summary:

  • In order to undergo transplant procedure, patients will be admitted to the hospital for approximately 10-14 days.
  • To prepare patient's bone marrow to accept donor stem cells, they will receive fludarabine and busulfex. Fludarabine will be given intravenously once daily for 4 days. Busulfex will be given once daily for the same 4 days.
  • One day before patients receive busulfex and fludarabine, they will also be given alemtuzumab intravenously once daily for 5 days.
  • Three days after the end of chemotherapy, patients will receive the infusion of donor stem cells.
  • If patients have thalassemia, they will receive subcutaneous injections of filgrastim starting on day one after the donor stem cell transfusion and will continue receiving filgrastim every day until it appears that the donor stem cells have been accepted. If the patient has sickle cell disease, filgrastim will not be given,
  • Additional drugs will be given to help prevent infection (i.e. antibiotics).
  • After stem cell infusion patients will be examined and have blood tests weekly for 1 month. Bone marrow biopsies, and blood work will also be performed 1 month, 3 months, 6 months and 1 year after stem cell infusion.
  • Patients will be on the study for about 12 months. After study is completed progress will be monitored on an annual basis.

Sponsor: Dana-Farber Cancer Institute

Current Primary Outcome: Stable Engraftment With Donor Stem Cells in Patients With Severe Hemoglobinopathy. [ Time Frame: 3 years ]

Outcome was measured by ANC >500 for three consecutive days prior to day 30 after PBSC infusion, >25% of hematopoietic cells are donor derived as determined by molecular chimerism assays or cytogenetic methods prior to day 45 after PBSC infusion and >25% of hematopoietic cells are donor derived as determined by molecular chimerism assays or cytogenetic methods after day 180 after PBSC infusion.


Original Primary Outcome: To determine if the preparative regimen of busulfex, fludarabine and alemtuzumab (CAMPATH) will generate stable engraftment with donor stem cells in patients with severe hemoglobinopathy.

Current Secondary Outcome:

  • Solid Organ Toxicity Related to the Conditioning Regimen. [ Time Frame: 3 years ]
    Outcome was measured by the assessment of organ toxicity related to Busulfex, fludarabine and alemtuzumab.
  • The Incidence of Grade II-IV Acute Graft vs. Host Disease. [ Time Frame: 3 years ]
    Outcome was measured by incidence and severity of acute and chronic GVHD following donor stem cell infusion.


Original Secondary Outcome:

  • To assess the safety of busulfex, fludarabine and alemtuzumab
  • to describe the incidence and severity of acute or chronic graft vs. host disease.


Information By: Dana-Farber Cancer Institute

Dates:
Date Received: September 8, 2005
Date Started: March 2004
Date Completion:
Last Updated: July 24, 2013
Last Verified: July 2013