Single vs Double Umbilical Cord Blood Transplants in Children With High Risk Leukemia and Myelodysplasia (BMT CTN 0501)
Multi-center, Open Label, Randomized Trial Comparing Single Versus Double Umbilical Cord Blood (UCB) Transplantation in Pediatric Patients With High Risk Leukemia and Myelodysplasia (BMT CTN #0501)
This date has not been verified as actual or estimated.
Primary Completion
March 2014
Actual (reported)
Study Completion
October 2014
Actual (reported)
Brief Summary
This study is a Phase III, randomized, open-label, multi-center, prospective study of single umbilical cord blood (UCB) transplantation versus double UCB transplantation in pediatric patients with hematologic malignancies.
Registry Overview
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
Recruitment status
completed
Actual enrollment (reported)
224 participants
Study completion date
October 2014
Actual (reported)
Listed locations
3 countries · 38 sites
Trial Relationships
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Related Scientific Literature
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Study Timeline
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
Study Start
December 2006
Date type not reported
This date has not been verified as actual or estimated.
Overall survival is defined as survival of death from any cause.
1 year post-randomization
Secondary Outcomes (9)
Percentage of Participants With Disease-free Survival
1 year post-randomization
Percentage of Participants With Neutrophil and Platelet Engraftment
Days 42 and 100
Study Arms (2)
Single Cord Blood Transplant
EXPERIMENTAL
Unrelated donor, single umbilical cord blood unit transplant; conditioning regimen: Total Body Irradiation/cyclophosphamide/fludarabine; GVHD prophylaxis: Cyclosporine A/Mycophenolate Mofetil
Biological: Single Umbilical Cord Blood Unit TransplantRadiation: Total Body IrradiationDrug: CyclophosphamideDrug: FludarabineDrug: Cyclosporine ADrug: Mycophenolate Mofetil
Double Cord Blood Transplant
EXPERIMENTAL
Unrelated donor, double umbilical cord blood unit transplant; Conditioning regimen: Total Body Irradiation/cyclophosphamide/fludarabine; GVHD prophylaxis: Cyclosporine A/Mycophenolate Mofetil
Two partially HLA-matched UCB units. Units must be HLA-matched minimally at 4 of 6 HLA-A and B (at intermediate resolution by molecular typing) and DRB1 (at high resolution by molecular typing) loci with the patient, and the units must be HLA-matched at 3 of 6 HLA- A, B, DRB1 loci with each other (using same resolution of molecular typing as indicated above). Two appropriately HLA-matched units must be available such that one unit delivers a pre-cryopreserved nucleated cell dose of at least 2.5 x 10\^7 per kilogram and the second unit at least 1.5 x 10\^7 per kilogram.
Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE, Hackman R, Tsoi MS, Storb R, Thomas ED. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med. 1980 Aug;69(2):204-17. doi: 10.1016/0002-9343(80)90380-0.
Wagner JE Jr, Eapen M, Carter S, Wang Y, Schultz KR, Wall DA, Bunin N, Delaney C, Haut P, Margolis D, Peres E, Verneris MR, Walters M, Horowitz MM, Kurtzberg J; Blood and Marrow Transplant Clinical Trials Network. One-unit versus two-unit cord-blood transplantation for hematologic cancers. N Engl J Med. 2014 Oct 30;371(18):1685-94. doi: 10.1056/NEJMoa1405584.
The TBI will be delivered from either a linear accelerator or cobalt source at a dose rate of between 4 and 26 cGy/minute using energies of between 1 and 25 MV.
Fludarabine 25 mg/m2/day will be administered over 30-60 minutes intravenous infusion on Days -10 through -8. Fludarabine will not be dose adjusted for body weight.
CSA will be administered beginning on Day -3 and doses will be adjusted to maintain a level of 200-400 ng/mL by TDX method (or 100-250 ng/mL by Tandem MS or equivalent level for other CSA testing methods). CSA can be administered per institutional practice.
Registry-reported names are shown in full. Names without a link have not yet been matched to a Syfrah profile.
Acute myelogenous leukemia (AML) at the following stages:
High risk first complete remission (CR1), defined as the following:
Having preceding myelodysplasia (MDS)
High risk cytogenetics (high risk cytogenetics: del (5q) -5, -7, abn (3q), t (6;9) complex karyotype \[at least 5 abnormalities\],)the presence of a high FLT3 ITD-AR (\> 0.4)
Requiring more than 1 cycle of chemotherapy to obtain complete remission (CR);
FAB M6
Second or greater CR
First relapse with less than 25% blasts in bone marrow
Morphologic complete remission with incomplete blood count recovery
Therapy-related AML for which prior malignancy has been in remission for at least 12 months
Acute lymphocytic leukemia (ALL) at the following stages:
High risk first remission, defined as one of the following conditions:
Philadelphia chromosome-positive adult lymphoblastic leukemia (Ph+ ALL)
Mixed lineage leukemia (MLL) rearrangement with slow early response (defined as having M2 \[5-25% blasts\] or M3 \[more than 25% blasts on bone marrow examination on Day 14 of induction therapy\])
+23 more criteria
You may not qualify if:
Pregnant (β-positive human chorionic gonadotropin \[HCG\]) or breastfeeding
Evidence of HIV infection or HIV positive serology
Current uncontrolled bacterial, viral, or fungal infection (currently taking medication and progression of clinical symptoms)
Autologous transplant less than 12 months prior to enrollment
Prior autologous transplant for the disease for which the UCB transplant will be performed
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Source: ClinicalTrials.gov.
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