Umbilical Cord Blood Transplantation From Unrelated Donors

Who is this study for? Patients with a disease or syndrome amenable to therapy with hematopoietic stem cell transplantation
What treatments are being studied? Umbilical Cord Blood Transplantation From Unrelated Donors
Status: Recruiting
Location: See location...
Intervention Type: Procedure, Drug, Radiation
Study Type: Observational
SUMMARY

This study is being done to determine how long it takes for the engraftment (recovery of blood cell counts) of umbilical cord stem cells and also how often engraftment of umbilical cord stem cells transplanted from an unrelated donor fails. Another purpose will be to document the rate of disease-free survival and the rate of relapse (a return of your disease or syndrome) as well as the incidence and severity of graft versus host disease (GvHD) following cord blood stem cell transplantation. GvHD is a complication of stem cell transplants in which white blood cells from the transplanted tissue (graft) attack the transplant recipient's body (host).

Eligibility
Participation Requirements
Sex: All
Minimum Age: 2 months
Maximum Age: 75
Healthy Volunteers: f
View:

• Appropriate diagnosis: Patients must have a disease or syndrome amenable to therapy with hematopoietic stem cell transplantation. Diagnoses include, but are not limited to:

• Congenital and Other Non-malignant Disorders:

• Immunodeficiency disorders (e.g. Severe Combined Immunodeficiency, Wiskott-Aldrich Syndrome)

• Congenital hematopoietic stem cell defects (e.g. Chediak-Higashi Syndrome, Congenital Osteopetrosis, Osteogenesis Imperfecta)

• Metabolic disorders (e.g. Hurler's Syndrome)

• Severe aplastic anemia

• High-Risk Leukemia:

• Acute Myelogenous Leukemia

• Refractory to standard induction therapy (more than 1 cycle required to achieve remission)

‣ Recurrent (in CR ≥ 2)

⁃ Treatment-related AML or MDS

⁃ Evolved from myelodysplastic syndrome

⁃ Presence of FLT3 abnormalities

⁃ FAB M6 or M7

⁃ Adverse cytogenetics

⁃ Myelodysplastic Syndrome

⁃ Acute Lymphoblastic Leukemia including T lymphoblastic leukemia:

⁃ Refractory to standard induction therapy (time to CR \>4 weeks)

⁃ Recurrent (in CR ≥ 2)

⁃ WBC count \>30,000/mcL at diagnosis

⁃ Age \>30 at diagnosis

• Adverse cytogenetics, such as t(9:22), t(1:19), t(4:11), and other MLL rearrangements.

• Chronic Myelogenous Leukemia in accelerated phase or blast crisis

• Biphenotypic or undifferentiated leukemia

• Burkitt's leukemia or lymphoma

• Lymphoma:

• Large cell, Mantle cell, Hodgkin lymphoma refractory or recurrent, chemo-sensitive, and ineligible for an autologous stem cell transplant or previously treated with autologous SCT

• Marginal zone or follicular lymphoma that is progressive after at least two prior therapies

• Multiple Myeloma, recurrent following high-dose therapy and autologous SCT or ineligible for an autologous HSCT

• Solid tumors, with efficacy of allogeneic HSCT demonstrated for the specific disease and disease status

• Adequate organ function:

• Cardiac - LVEF \>45%, or shortening fraction \>25%, Absence of congestive heart failure or conduction disturbances with high risk for sudden death

• Pulmonary - DLCO (corrected for hemoglobin), FEV1 and FVC ≥ 50% predicted;

• Renal - serum Cr \< 1.5 times the upper limit of normal for age or GFR ≥ 50 ml/min/1.73m2

• Hepatic - total bilirubin level \< 2 times the upper limit of normal (except for patients with Gilbert's syndrome or hemolysis); if the primary disease process is causal, this criterion will be reconsidered. ALT, AST, and Alkaline phosphatase ≤ 5 times upper limit of normal.

• Performance Status Karnofsky or Lansky score ≥ 70%.

• Informed Consent must be obtained prior to initiating conditioning therapy.

• Receipt of viable cord blood product(s), single or dual, must be confirmed with the stem cell processing laboratory prior to initiating conditioning therapy.

Locations
United States
New York
Wilmot Cancer Institute
RECRUITING
Rochester
Contact Information
Primary
Omar Aljitawi, MD
omar_aljitawi@urmc.rochester.edu
585-275-4099
Time Frame
Start Date: 2015-06
Estimated Completion Date: 2027-06
Participants
Target number of participants: 30
Treatments
Full Intensity, TBI-based Conditioning
Full Intensity TBI-based Conditioning Total Body Irradiation 1200 cGy in fractions of 150 cGy days -8 or -7 to -4 Cyclophosphamide 60 mg/kg/day x 2 doses days -3 and -2 Mesna 60 mg/kg/day with 20% loading dose with first Cyclophosphamide followed by continuous infusion over 24 hours x 2 doses \[to be completed 24 hours after final Cyclophosphamide dose\] followed by Cord Blood Infusion Other names: TBI/Cy
Full Intensity, Chemo-based Conditioning
Full Intensity, Chemotherapy Conditioning Busulfan days -7 to -4 Recipients \<5 years - 1 mg/kg/dose x 16 doses every 6 hours Recipients \>/= 5 years - 0.8 mg/kg/dose x 16 doses every 6 hours Cyclophosphamide 60 mg/kg/day x 2 doses days -3 and -2 Mesna 60 mg/kg/day with 20% loading dose with first Cyclophosphamide followed by continuous infusion over 24 hours x 2 doses \[to be completed 24 hours after final Cyclophosphamide dose\] followed by Cord Blood Infusion Other names: Bu/Cy
Reduced Intensity Chemotherapy
Reduced Intensity Chemotherapy Fludarabine 30 mg/m2/day x 5 doses days -6 to -2 Melphalan 140 mg/m2/day x 1 dose day -2 Cord Blood Infusion Other names: Flu/Mel
Non-Myeloablative Conditioning
Fludarabine 40 mg/m2/day x 5 doses days -6 to -2 Cyclophosphamide 50 mg/kg/day x 1 dose day -6 Mesna 50 mg/kg/day with 20% loading dose with Cyclophosphamide dose followed by continuous infusion over 24 hours x 1 dose \[to be completed 24 hours after Cyclophosphamide dose\] Total Body Irradiation 200 cGy in a single fraction day -1 Cord Blood Infusion Other names: Flu/Cy/TBI
Sponsors
Leads: University of Rochester

This content was sourced from clinicaltrials.gov