Micro-transplantation in Elderly Patients With Acute Myeloid Leukemia (MTSA)

Centre Hospitalier Universitaire de Saint Etienne

Status

Enrolling

Conditions

Acute Myeloid Leukemia

Treatments

Other: HLA-mismatched micro-transplantation after induction chemotherapy

Study type

Interventional

Funder types

Other

Identifiers

NCT03439371

2017-A03572-51 (Other Identifier)

2017-1201

Details and patient eligibility

About

This study aims at evaluating the safety and the tolerance of the micro-transplantation in elderly patients with acute myeloid leukemia who are ineligible to conventional allogeneic transplantation.

Full description

Acute Myeloid Leukemia (AML) is an aggressive hematological malignancy with a median age at diagnosis of 65 years. Outcomes of AML in elderly population remain unsatisfactory with low rates of complete remission, poor disease-free and overall survival. Therapeutic management of older patients with AML deals with patient-related features (i.e. comorbid conditions and performance status) as well as disease-related prognostic factors (i.e. cytogenetics and molecular genetics). Even if allogeneic hematopoietic-cell transplantation provides the strongest antineoplasic effect, this treatment option remains limited for older patients owing to toxicities, the development of significant graft-versus-host disease (GVHD) and logistics of donor availability. More recently, micro-transplantation has emerged as an alternative strategy based on the infusion of mobilized HLA-mismatched related donor cells after induction chemotherapy, thus exerting a graft-versus-leukemia effect without substantial donor engraftment and GVHD. Therefore, there is much of interest in investigating the efficacy and the safety of this method for older patients with AML who are not candidates for allogeneic stem cell transplantation.

Enrollment

21 estimated patients

Sex

All

Ages

60 to 75 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Patient affiliated to a social security regimen or beneficiary of the same
Signed written informed consent form
Patient, ≥ 60 years-old - < 75 years-old, with established diagnosis of de novo or secondary AML with intermediate-risk or adverse-risk cytogenetic profile, or with established myelodysplasic syndromes (RAEB), in pathologically confirmed complete remission following anti-leukemic induction therapy (<5% blasts)
Contra-indication to conditioning regimen in conventional allogeneic transplantation

Exclusion criteria

Patient with established diagnosis of acute myeloid leukemia with standard-risk cytogenetic profile
Promyelocytic leukemia t(15;17)
CBF-AML t(8;21) or inv(16)
Normal karyotype with a favorable molecular profile: NPM1+ and FLT3-; NPM1+, FLT3- and double mutation CEBPα or chronic myeloid leukemia in blastic phase
Patient under guardianship or deprived of his liberty or any condition that may affect the patient's ability to understand and sign the informed consent
Refusing participation