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CompletedNCT00305708Updated Nov 12, 2012

Busulfan, Antithymocyte Globulin, and Fludarabine Followed By a Donor Stem Cell Transplant in Treating Young Patients With Blood Disorders, Bone Marrow Disorders, Chronic Myelogenous Leukemia in First Chronic Phase, or Acute Myeloid Leukemia in First Remission

A Phase 1/2 interventional study of anti-thymocyte globulin and busulfan in Congenital Amegakaryocytic Thrombocytopenia, Diamond-blackfan Anemia and Fanconi Anemia, sponsored by University of California, San Francisco. Completed at 1 site in United States. Open to participants aged Up to 17 Years. Per ClinicalTrials.gov, last updated 2012-11-12.

Sponsored by University of California, San Francisco · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
40
Ages
Up to 17 Years
Sex
All
01

Study summary

RATIONALE: Drugs used in chemotherapy, such as busulfan and fludarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. A donor peripheral blood, bone marrow , or umbilical cord blood transplant may be able to replace blood-forming cells that were destroyed by chemotherapy. Sometimes the transplanted cells from a donor can make an immune response against the body's normal cells. Giving antithymocyte globulin before the transplant may stop this from happening.

PURPOSE: This phase I/II trial is studying the side effects of busulfan, antithymocyte globulin, and fludarabine when given together with a donor stem cell transplant in treating young patients with blood disorders, bone marrow disorders, chronic myelogenous leukemia in first chronic phase, or acute myeloid leukemia in first remission.

Read the detailed description

OBJECTIVES:

Primary

  • Determine the efficacy, in terms of graft rejection at 4 weeks, of a conditioning regimen comprising busulfan, anti-thymocyte globulin, and fludarabine followed by donor stem cell transplantation (SCT) in children with stem cell defects, marrow failure syndromes, chronic myelogenous leukemia in first chronic phase, or acute myeloid leukemia in first remission.
  • Determine the pharmacokinetics of busulfan in children undergoing donor SCT.

Secondary

  • Determine the toxicity of this regimen in these patients.
  • Determine engraftment at 3, 6, 9, and 12 months and mixed chimerism in patients treated with this regimen.
  • Determine overall and disease-free survival of patients treated with this regimen.

OUTLINE: Patients receive one of the following cytoreductive regimens:

  • Regimen 1 (patients with an HLA genotypic matched sibling donor): Patients receive busulfan IV over 2 hours every 6 hours on days -9 to -6, fludarabine IV on days -5 to -2, and anti-thymocyte globulin (ATG) IV over 10 hours on days -3 to -1.
  • Regimen 2 (patients with an HLA closely matched related [not genotypic] or unrelated donor): Patients receive busulfan and fludarabine as in regimen 1, and ATG IV over 10 hours on days -4 to -1.
  • Regimen 3 (patients with Fanconi's anemia or severe aplastic anemia with genotypic matched sibling donor): Patients receive fludarabine as in regimen 1 and ATG as in regimen 2.
  • Regimen 4 (patients with Fanconi's anemia who have a closely matched related [not genotypic] or unrelated donor): Patients undergo thoracoabdominal irradiation on day -6 and receive fludarabine as in regimen 1 and ATG as in regimen 2.

All patients undergo allogeneic bone marrow, umbilical cord blood, or peripheral blood stem cell transplantation on day 0.

After the completion of study treatment, patients are followed periodically for 20 years.

PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study.

02

Conditions studied

  • Congenital Amegakaryocytic Thrombocytopenia
  • Diamond-blackfan Anemia
  • Fanconi Anemia
  • Leukemia
  • Severe Congenital Neutropenia
  • Thrombocytopenia

Keywords

  • thrombocytopenia
  • childhood acute myeloid leukemia in remission
  • childhood chronic myelogenous leukemia
  • Diamond-Blackfan anemia
  • congenital amegakaryocytic thrombocytopenia
  • Fanconi anemia
  • severe congenital neutropenia
  • chronic phase chronic myelogenous leukemia
03

In context

Leukemia

5,441 studies on the registry are indexed under Leukemia; 636 are open to participants now.

This study's planned enrollment of 40 is close to the median of 38 across 4,247 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

University of California, San Francisco is the lead sponsor of 2,132 studies on the registry; 375 are open to participants now.

Of its 262 completed or terminated interventional studies of FDA-regulated products, 196 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Up to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of one of the following hematopoietic disorders:

    • Severe aplastic anemia with marrow aplasia (i.e., absolute neutrophil count \< 500/mm\^3, platelet and/or red blood cell transfusion dependent), meeting 1 of the following criteria:

      • Closely matched related donor
      • Unresponsive to immunosuppressive therapy within 3 months after follow-up AND alternative matched unrelated donor available
    • Congenital marrow failure syndrome, including any of the following:

      • Primary red blood cell aplasia (Diamond-Blackfan syndrome)
      • Congenital neutropenia (Kostmann's syndrome)
      • Amegakaryocytic thrombocytopenia
    • Hemoglobinopathy including any of the following:

      • β-thalassemia major
      • Sickle cell anemia
    • Severe immunodeficiency disease including any of the following:

      • Chediak-Higashi disease
      • Wiskott-Aldrich syndrome
      • Combined immunodeficiency disease (Nezelof's)
      • Hyperimmunoglobulin M syndrome
      • Bare lymphocyte syndrome
    • Other stem cell defects (e.g., osteopetrosis)
    • Chronic myelogenous leukemia in first chronic phase

      • Not eligible for other ongoing phase II/III studies
    • Acute myeloid leukemia in first remission

      • Not eligible for other ongoing phase II/III studies
    • Inborn errors of metabolism
  • No severe combined immunodeficiency disorder
  • Available donor, meeting 1 of the following criteria:

    • Related donor matched by high resolution DNA typing at both HLA Drβ1 alleles and ≤ 1 mismatch at the 4 HLA-A and -B alleles
    • Unrelated donor, meeting one of the following criteria:

      • Bone marrow matched by high resolution DNA typing at both HLA Drβ1 alleles and ≤ 1 mismatch by high resolution DNA typing at the 4 HLA-A and -B alleles
      • Umbilical cord blood matched at 4/6 HLA-A, -B, and Drβ1 alleles by high resolution typing with ≥ 1 Drβ1 match and ≥ 3 X 10\^7 cells/kg body weight of recipient

PATIENT CHARACTERISTICS:

  • See Disease Characteristics
  • No active bacterial, viral, or fungal infection
  • Cardiac shortening fraction ≥ 27%
  • Creatinine clearance ≥ 60 mL/min
  • DLCO ≥ 60% of predicted (corrected for anemia/lung volume)

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Masking
None (open label)
Enrollment
40 participants (estimated)

Interventions

  • Biologicalanti-thymocyte globulin
  • Drugbusulfan
  • Drugfludarabine phosphate
  • Procedureallogeneic bone marrow transplantation
  • Procedureperipheral blood stem cell transplantation
  • Procedureumbilical cord blood transplantation
  • Radiationradiation therapy
06

What researchers measure

Primary outcomes

  1. Graft rejection measured by ANC < 500 with no evidence of donor cells in blood or marrow from transplantation to week 4 post transplantation

Secondary outcomes

  1. Toxicity grades 3 or 4 assessed from conditioning through 1 year post transplantation

  2. Engraftment at 1, 3, 6, 9, and 12 months post transplantation

  3. Mixed chimerism at 1, 3, 6, 9, and 12 months post transplantation

  4. Survival measured from the day of first dose of conditioning

  5. Disease-free survival measured from the day of first dose of conditioning

07

Study locations

1 site
  • UCSF Comprehensive Cancer Center
    San Francisco, California 94115, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 12, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT00305708
Lead sponsor
University of California, San Francisco
Collaborators
National Cancer Institute (NCI)
Responsible party
Morton Cowan (Professor, University of California, San Francisco) — Principal investigator
First posted
Mar 22, 2006
Start date
Aug 2000
Primary completion
Jul 2004
Completion
Jul 2004
Last update
Nov 12, 2012

Study contacts

Morton J. Cowan, MD
study chair · University of California, San Francisco
View the source record on ClinicalTrials.gov ↗

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