Allogeneic Stem Cell Transplantation Following Chemotherapy in Patients With Hemoglobinopathies

Dana-Farber Cancer Institute

Status and phase

Completed

Phase 2

Conditions

Thalassemia

Hemoglobinopathies

Sickle Cell Disease

Treatments

Procedure: Stem Cell Transfusion

Drug: Busulfex

Drug: Fludarabine

Drug: Alemtuzumab

Study type

Interventional

Funder types

Other

Identifiers

NCT00153985

03-338

Details and patient eligibility

About

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.

Full description

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.

Enrollment

2 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients with sickle cell disease should have one or more of the following: acute chest syndrome requiring hospitalization; nonhemorrhagic stroke or central nervous system event lasting longer than 24 hours; recurrent caso-occlusive pain or recurrent priapism; sickle neuropathy; bilateral proliferative retinopathy and major visual impairment of at least one eye; osteonecrosis of multiple joints; transfusion dependence; vaso-occlusive.
Patients with thalassemia should have one or more of the following: transfusion dependence; iron overload; presence of 2 or more alloantibodies against red cell antigens.

Exclusion criteria