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Stem Cell Transplantation for Hurler

This study has been completed.

Sponsors and Collaborators: Orchard, Paul J., MD
Masonic Cancer Center, University of Minnesota
Information provided by: University of Minnesota
ClinicalTrials.gov Identifier: NCT00176917
  Purpose

The purpose of this study is to determine the safety and engraftment of donor hematopoietic cells using this conditioning regimen in patients undergoing a hematopoietic (blood forming) cell transplant for Hurler syndrome, Maroteaux Lamy syndrome, Mannosidosis, or I-cell disease.


Condition Intervention Phase
Mucopolysaccharidosis I
Mucopolysaccharidosis VI
Mannosidosis
Mucolipidosis Type II (I-Cell Disease)
Procedure: Stem Cell Transplant
Drug: Busulfan, Cyclophosphamide, ATG
Phase II
Phase III

Genetics Home Reference related topics:   alpha-mannosidosis   

Drug Information available for:   Cyclophosphamide    Methylprednisolone    Busulfan   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study
Official Title:   Hematopoietic Stem Cell Transplantation for Hurler Syndrome, Maroteaux Lamy Syndrome (MPS VI), and Alpha Mannosidase Deficiency (Mannosidosis)

Further study details as provided by University of Minnesota:

Primary Outcome Measures:
  • estimate donor-derived engraftment by RFLP and a-L-iduronidase enzyme (Hurler syndrome), arylsulfatase B (Maroteaux Lamy syndrome), or Alpha Mannosidase (Mannosidosis) enzyme activity levels [ Time Frame: at 21 days, 42 days, 60 days, 100 days, 6 months, and 1 year ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • estimate survival . [ Time Frame: at 100 days, 1 year, and 3 years post transplant ] [ Designated as safety issue: No ]

Enrollment:   38
Study Start Date:   May 1999
Study Completion Date:   March 2008
Primary Completion Date:   March 2008 (Final data collection date for primary outcome measure)

Intervention Details:
    Procedure: Stem Cell Transplant
    The purpose of hematopoietic cell transplantation is to introduce hematopoietic cells from a normal donor that contains the enzyme able to get rid of the substances that have accumulated in the body of patients with storage diseases. Hematopoietic cells can come from bone marrow, peripheral blood (i.e., the blood circulating in our body's blood vessels) or umbilical cord blood (i.e. blood taken from the umbilical cord after a baby is born and umbilical cord is cut).
    Drug: Busulfan, Cyclophosphamide, ATG
    Prior to transplantation, subjects will receive BUSULFAN intravenously (IV) via the Hickman line twice daily for 4 days, CYCLOPHOSPHAMIDE intravenously via the Hickman line once a day for 4 days, and ANTI-THYMOCYTE GLOBULIN IV via the Hickman line twice daily for three days before the transplant. These three drugs are being given to help the new marrow "take" and grow. METHYLPREDNISOLONE will be given as a pre-medication for the ATG.
Detailed Description:

Prior to transplantation, subjects will receive Busulfan intravenously (IV) via the Hickman line four times daily for 4 days, Cyclophosphamide intravenously via the Hickman line once a day for 4 days, and Anti-Thymocyte Globulin IV via the Hickman line twice daily for three days before the transplant. These three drugs are being given to subjects to help the new marrow "take" and grow.

On the day of transplantation, the donor's hematopoietic cells will be transfused via central venous catheter.

After hematopoietic cell transplant, subjects will then receive two drugs, cyclosporin and either methylprednisolone or Mycophenolate Mofetil (MMF). Cyclosporin and methylprednisolone or MMF are given to help prevent the complication of graft-versus-host disease and to decrease the chance that the new donor cells will be rejected.

  Eligibility
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  • Patients with Mucopolysaccharidosis, type I (e.g., Hurler syndrome), Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or mismatched (at 1 antigen) related marrow, PBSC, or cord blood donor.
  • Patients with Mucopolysaccharidosis, type I, Maroteaux-Lamy syndrome (MPS VI), Alpha Mannosidosis, or mucolipidosis type II (I-cell disease) who have an HLA-identical or HLA-1 antigen mismatched unrelated marrow, PBSC, or HLA-0-2 antigen mismatched umbilical cord blood donor.
  • Patients with MPS type I, Maroteaux Lamy Syndrome (MPS VI), or mucolipidosis type II (I-cell disease) will have a mental developmental index within two standard deviations of the normal mean, as best as can be determined using Bayley scales of infant development or other standardized testing, recognizing that these may be affected by speech and/or hearing impairment.
  • Adequate organ function:
  • Cardiac: ejection fraction >40%; no decompensated congestive heart failure or uncontrolled arrhythmia
  • Renal: serum creatinine <2.0 mg/dl
  • Hepatic: total bilirubin <3x Upper limits of normal transaminases < 5.0 x Upper limits of normal
  • Signed consent.

Exclusion Criteria:

  • Presence of major organ dysfunction (see above)
  • Pregnancy
  • Evidence of HIV infection or known HIV positive serology
  • Patients or parents are psychologically incapable of undergoing BMT with associated strict isolation or documented history of medical non-compliance
  • Patients >50 kg may be at risk for having cell doses below the goal of ≥ 10 x 106 CD 34 cells/kg and therefore will not be eligible to receive unrelated PBSCs.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00176917

Locations
United States, Minnesota
University of Minnesota Medical Center    
      Minneapolis, Minnesota, United States, 55455

Sponsors and Collaborators
Orchard, Paul J., MD
Masonic Cancer Center, University of Minnesota

Investigators
Principal Investigator:     Paul Orchard, MD     Masonic Cancer Center, University of Minnesota    
  More Information


Responsible Party:   Masonic Cancer Center at the University of Minnesota ( Orchard, Paul J., MD )
Study ID Numbers:   0104M93821, MT1999-07
First Received:   September 12, 2005
Last Updated:   September 12, 2008
ClinicalTrials.gov Identifier:   NCT00176917
Health Authority:   United States: Institutional Review Board

Keywords provided by University of Minnesota:
stem cell transplant  
storage disease  
errors of metabolism  

Study placed in the following topic categories:
Methylprednisolone
Cyclophosphamide
Brain Diseases
Bone Diseases
Alpha-L-iduronidase deficiency
Metabolism, Inborn Errors
Mucopolysaccharidoses
Musculoskeletal Diseases
I cell disease
Connective Tissue Diseases
Brain Diseases, Metabolic, Inborn
Deficiency Diseases
Alpha-Mannosidosis
Metabolic Diseases
Mucolipidoses
Lysosomal Storage Diseases
Mannosidase Deficiency Diseases
Central Nervous System Diseases
Bone Diseases, Metabolic
Mucopolysaccharidosis I
Antilymphocyte Serum
Genetic Diseases, Inborn
Busulfan
Mucopolysaccharidosis
Mucopolysaccharidosis type 6
Metabolic disorder
Hurler syndrome
Mucopolysaccharidosis VI
Brain Diseases, Metabolic

Additional relevant MeSH terms:
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Lysosomal Storage Diseases, Nervous System
Antineoplastic Agents
Nervous System Diseases
Physiological Effects of Drugs
Mucinoses
Immunosuppressive Agents
Pharmacologic Actions
Therapeutic Uses
Myeloablative Agonists
Antineoplastic Agents, Alkylating
Antirheumatic Agents
Carbohydrate Metabolism, Inborn Errors
Alkylating Agents

ClinicalTrials.gov processed this record on October 23, 2008




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