NCT01850108

Non-Myeloablative Conditioning and Bone Marrow Transplantation

A Non-Myeloablative Conditioning and Transplantation of Partially HLA-Mismatched and HLA-Matched Bone Marrow for Patients With Sickle Cell Disease and Other Hemoglobinopathies

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 26 (actual)
• Sponsor: Vanderbilt-Ingram Cancer Center · Academic / Other
• Sex: All
• Age: 1 Year – 70 Years
• Healthy volunteers: Accepted

Summary

Allogeneic blood or marrow transplantation (alloBMT) is a curative therapy for a variety of hematologic disorders, including sickle cell disease and thalassemia. Even when it is clear that alloBMT can give to these patients an improvement in their disease, myeloablative transplants have important toxicities and mortalities associated. The lack of suitable donors continues to be a limit to access to transplantation. Substantial progress has been made recently in the development of pre-treatment regimens that facilitate the sustained engraftment of donor marrow with reduced toxicity. Most of these regimens incorporate highly immunosuppressive drugs, which allow the reduction or elimination of myeloablative agents or total body irradiation without endangering the sustained engraftment of HLA-identical allogeneic stem cells. Preliminary results of non-myeloablative allogeneic stem cell transplantation suggest that the procedure can be performed in patients who are ineligible for myeloablative alloBMT, and that sustained remissions of several hematologic malignancies can be obtained.

Conditions

• Sickle Cell Disease
• Hemoglobinopathies

Interventions

Type	Name	Description
DRUG	Thymoglobulin	Day 9 before BMT: 0.5mg/kg IV; Days 8 \& 7 before BMT: 2mg/kg IV Days 8 \& 7 - 2mg/kg IV before BMT
DRUG	Fludarabine	Days 6 and 2 before BMT: 30mg/m2/day IV
DRUG	Cyclophosphamide (CTX)	Days 6 and 5 before BMT: 14.5mg/kg IV; Days 3 and 4 after BMT: 50mg/kg/day
DRUG	Mesna	Days 3 \& 4 after BMT: 40 mg/kg IV
DRUG	Sirolimus	Adjusted to maintain a serum trough level of 3-12 ng/mL, taken orally beginning on 5 days after BMT and taken to 1 year after BMT.
DRUG	Mycophenolate mofetil (MMF)	15 mg/kg orally with maximum dose 3 mg/day beginning 5 days after BMT and taken to day 35 after BMT
PROCEDURE	Bone marrow transplantation	Day 0 - Transplantation of hematopoietic cells derived from bone marrow of a donor to a recipient as treatment for hematologic disorders
RADIATION	Total body irradiation	200 cGy on the day before BMT. Radiation delivered to the entire body of the recipient to eradicate bone marrow cells in the recipient to prepare the recipient to receive the transplanted

Timeline

• Start date: 2013-05-01
• Primary completion: 2023-11-01
• Completion: 2024-12-31
• First posted: 2013-05-09
• Last updated: 2024-01-10
• Results posted: 2024-01-10

Locations

3 sites across 3 countries: United States, France, United Kingdom