Intensity Modulated Total Marrow Irradiation in Fully Human Leukocyte Antigen (HLA)-Matched and Partially-HLA Mismatched Allogeneic Transplantation Patients With High-Risk Acute Myeloid Leukemia (AML), Chronic Myeloid Leukemia (CML), and Myelodysplastic Syndrome (MDS)
BMT-13
A Phase II Study of Intensity Modulated Total Marrow Irradiation (IM-TMI) in Addition to Myeloablative Fludarabine/Busulfan and Post-Transplant Cyclophosphamide (PTCY) for Fully Human Leukocyte Antigen (HLA)-Matched and Partially-HLA Mismatched Allogeneic Transplantation Patients With High-Risk AML, CML, and MDS
Planned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
March 2032
Estimated
Planned date reported by the registry; this milestone is not confirmed as achieved.
Brief Summary
The study is a Phase II clinical trial. Patients will receive intensity-modulated total marrow irradiation (TMI) at a dose of 9 Gray (Gy) with standard myeloablative fludarabine intravenous (IV) and targeted busulfan (FluBu4) conditioning prior to allogeneic hematopoietic stem cell transplant (HSCT). Graft-versus-host disease (GVHD) prophylaxis will include Cyclophosphamide on Day +3 and +4, tacrolimus, and mycophenolate mofetil.
Registry Overview
Registry-reported information. Elapsed time and enrollment totals alone do not measure study progress or recruitment pace.
Recruitment status
recruiting
Estimated enrollment
38 participants
Study completion date
March 2032
Estimated
Planned date reported by the registry; this milestone is not confirmed as achieved.
Listed locations
1 countries · 1 sites
Trial Relationships
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Study Timeline
Dates and qualifiers reported by the registry. Estimated dates do not confirm that a milestone has occurred.
First Submitted
January 28, 2025
Actual (reported)
First Posted
January 31, 2025
Actual (reported)
Study Start
February 4, 2025
Actual (reported)
Primary Completion
March 2030
Estimated
Planned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
March 2032
Estimated
Planned date reported by the registry; this milestone is not confirmed as achieved.
Total Marrow IrradiationStem Cell TransplantAllogenic Transplant
Outcome Measures
Primary Outcomes (1)
GVHD-Free Relapse-Free Survival after Stem Cell Transplant
The 1-year GVHD- free relapse-free survival after HSCT (hematopoietic stem cell transplantation) conditioned with a 9Gy TMI in combination with FluBu4 and PTCY in patients with acute myeloid leukemia (AML), chronic myeloid leukemia (CML), Myelodysplastic Syndrome (MDS) at high risk of relapse.
1 Year Post-Stem Cell Transplant
Secondary Outcomes (19)
Overall Survival
2 Years Post-Stem Cell Transplant
Time To Engraftment
30 Days Post-Stem Cell Transplant
Study Arms (1)
Treatment Regimen
EXPERIMENTAL
Days -5 through -2: Fludarabine 40 mg/m2 IVPB daily and Busulfan targeting AUC 4800μM/min daily Day -3 through -1: Intensity modulated total marrow irradiation (9Gy fractionated) Day 0: Infuse peripheral blood mobilized stem cells Days +3 and +4: Cyclophosphamide 50 mg/kg/day Day 5: Mycophenolate mofetil and Tacrolimus (dose adjustment dependent on trough level) Day 30: Follow up Day 60: Follow up Day 90: Follow up Day 180: Follow up
1. year: Follow up
2. year: Follow up
Radiation: Intensity modulated total marrow irradiationDrug: Cyclophosphamide (CTX)Drug: Fludarabine (Fludara)Drug: Busulfan (conditioning for ALLO Transplant)
This study will determine the safety of the combination of Total Marrow Irradiation (TMI) and Post-Transplant Cyclophosphamide using a myeloablative fludarabine and iv targeted busulfan (Flu/Bu4) conditioning regimen.
Treatment Regimen
Eligibility Criteria
Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
You may qualify if:
\. Age 18-65 years.
\. Patients with CML, AML, or MDS who meet one of the following criteria: 2a. Relapsed or refractory AML (including AML in CR2) 2b. Poor-risk AML in first remission, with remission defined as \<5% bone marrow blasts morphologically:
AML arising from MDS, a myeloproliferative disorder, or secondary AML
Poor risk molecular features according to Leukemia Net including ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, and/or ZRSR2
Poor-risk cytogenetics: Monosomal karyotype, complex karyotype (\> 3 abnormalities), inv (3), t(3;3), t(6;9), MLL rearrangement with the exception of t(9;11), or abnormalities of chromosome 5 or 7. 2c. Primary refractory disease 2d. MDS with at least one of the following poor-risk features:
Poor-risk cytogenetics including 3q abnormalities, 7/7q minus or complex cytogenetics (\>3 abnormalities).
Current or previous INT-2 or high IPSS score.
Treatment-related MDS.
MDS diagnosed before the age of 21 years.
Progression on or lack of response to standard DNA-methyltransferase inhibitor therapy.
Life-threatening cytopenias, including those requiring regular PRBC or platelet transfusions. 2e. CML with a history of accelerated or blast phase.
You may not qualify if:
\. Presence of significant co-morbidity as shown by:
a. Left ventricular ejection fraction \< 50%
b. Creatinine clearance \<30ml/min.
c. Bilirubin \> 2.0 mg/dL (unless due to Gilbert's syndrome or hemolysis), and ALT and AST \> 5 x ULN.
d. FEV1 and FVC \< 50% of predicted or DLCO \<50% of predicted once corrected for anemia.
e. Karnofsky score \<70
f. Active viral hepatitis or HIV infection.
g. Cirrhosis.
\. Pregnancy or breast feeding
\. Patients unable to sign informed consent.
\. Patients previously received radiation to \>20% of bone marrow-containing areas.
Planned date reported by the registry; this milestone is not confirmed as achieved.
Study Completion
March 2032
Estimated
Planned date reported by the registry; this milestone is not confirmed as achieved.
Last Updated
June 26, 2026
Record last verified: 2026-06
Source record
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Source: ClinicalTrials.gov.
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