Autologous Bone Marrow Transplant for Children With Acute Myelogenous Leukemia (AML) in First Complete Remission

St. Jude Children's Research Hospital

Status and phase: Completed; Phase 1

Conditions: Acute Myeloid Leukemia

Treatments: Drug: Cyclophosphamide; Drug: Busulfan; Drug: Mesna

Study type: Interventional

Funder types: Other

Identifiers

NCT00667927

AMLREM

Details and patient eligibility

About

This study proposes to transfer marker genes (detectable genetic traits or segments of DNA that can be identified and tracked) into aliquots of marrow obtained for Bone Marrow Transplant (BTM) in patients in remission of Acute Myelogenous Leukemia (AML).

Full description

The primary objective of this study was to estimate the continuous complete remission rate at 2 years post transplant for children with AML in first complete remission treated with autologous BMT.

Secondary objectives used transduction of marker genes into autologous marrow to determine the following:

1. whether the source of relapse after BMT for AML is residual malignant cells in the harvested marrow or in the patient, and whether marrow purging is therefore rational.
2. whether the majority of AML, which lack genetic markers, represent abnormalities in a multi-lineage progenitor cell, and whether therefore, auto grafting/intensified chemotherapy is ever likely to augment the cure rate.
3. the mechanisms of autologous reconstitution, and the effects of stimuli which modify the process.

Enrollment: 17 patients

Sex: All

Ages: 1 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged between 1 and 18 years at diagnosis with acute nonlymphocytic leukemia in first remission are eligible for this protocol.
• Patients enrolled on the AML-87 study in second or subsequent remission are eligible for this protocol.

Exclusion criteria

• Has an HLA-matched, MLC-compatible donor(unless parents and/or patient refuses transplant.
• Diagnosis of FAB M3 or FAB M3v (acute progranulocytic leukemia)
• Life expectancy limited by disease other than leukemia
• Significant cardiac disease (echo shortening fraction <25% or MUGA scan <50%)
• Severe renal dysfunction, i.e., creatinine clearance less than 60cc/1.73 m2/min
• Severe restrictive pulmonary disease (FCV less than 40% of predicted)
• Severe hepatic disease (bilirubin greater than 3 mg/dl or SGPT greater than 500IU)
• Severe personality disorder or mental illness
• Previous severe cystitis from cyclophosphamide
• Previous total dose of anthracyclines of >450 mg/m2
• Sever infection that on evaluation by the PI precludes ablative chemotherapy or successful transplantation
• Previous autologous transplant
• HIV reactivity
• Karnofsky score <70%

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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17 participants in 1 patient group

1

Other group

Treatment:

Drug: Mesna

Drug: Busulfan

Drug: Cyclophosphamide