Full Text View  
  Tabular View  
  Contacts and Locations  
  No Study Results Posted  
  Related Studies  
A Monoclonal Antibody Conditioning Regimen for Allogeneic Stem Cell Transplant in Patients With Fanconi Anemia. (MAFIA)
This study is currently recruiting participants.
Verified by Baylor College of Medicine, December 2007
Sponsors and Collaborators: Baylor College of Medicine
Texas Children's Hospital
The Methodist Hospital System
Center for Cell and Gene Therapy
Information provided by: Baylor College of Medicine
ClinicalTrials.gov Identifier: NCT00058565
  Purpose

Patients eligible for this study have an aggressive blood disease, Fanconi Anemia (FA) that requires an allogeneic (meaning the cells come from a donor) stem cell transplant using a family member or nearly identical matched donor. Stem cells are cells in the bone marrow and blood that can form a whole new blood system.

Usually, these patients are given high doses of chemotherapy before receiving a stem cell transplant in order to keep the immune system from rejecting the donor stem cells, and to kill any diseased cells that remain in the body. However, some patients, due to complications with their condition, may have a high risk of acquiring possibly life-threatening treatment-related side effects such as graft versus host disease (GVHD). GVHD occurs when the new stem cells (graft) recognize that the body tissues of the patient (host) are different from those of the donor. When this happens, cells in the graft may attack the host organs, primarily the skin, the liver and the intestines. Even with the strongest available treatments, graft rejection can occur or some diseased cells may survive and cause relapse.

Instead of the high dose chemotherapy usually given before a transplant, this research study uses a new pre-treatment combination of two drugs, Anti-CD45 and CAMPATH-1H. Anti-CD45 and CAMPATH-1H are antibodies against certain types of blood cells, including FA cells. CAMPATH-1H is particularly important because it stays active in the body for a long time after infusion, which means it may work longer at preventing GVHD symptoms.


Condition Intervention Phase
Fanconi's Anemia
Drug: Campath-1H
Drug: anti-CD45
Drug: Fludarabine
Phase I
Phase II

MedlinePlus related topics: Anemia
Drug Information available for: Fludarabine Fludarabine monophosphate Alemtuzumab Immunoglobulins Globulin, Immune Campath
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Active Control, Single Group Assignment, Safety/Efficacy Study
Official Title: CD45 (YTH-24 and YTH 54) and CD52 (CamPath-1H) Monoclonal Antibody Conditioning Regimen for Allogeneic Donor Stem Cell Transplantation of Patients With Fanconi Anemia.

Further study details as provided by Baylor College of Medicine:

Primary Outcome Measures:
  • Incidence of non-engraftment and graft rejection, Incidence of grade II-IV and grade III-IV acute GvHD 100d, Incidence of extensive and limited chronic GvHD from 100d to 365d, and Incidence of regimen-related morbidity and mortality 100d [ Time Frame: Day100 and Day 365 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Days to absolute neutrophil count (ANC) of 500/mm3, Days to achieve a platelet count of 20,000 and 50,000/mm3 w/o transfusions Day to last red cell transfusion Survival at 1 year will also be estimated [ Time Frame: 1 year ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 27
Study Start Date: October 2001
Intervention Details:
    Drug: Campath-1H
    Day-8 through Day-6 dosing per institutional SOP
    Drug: anti-CD45
    Day-5 through Day-2 400ug/kg over 6 hr
    Drug: Fludarabine
    Day-8 through Day-4 30 mg/m2
Detailed Description:

Before treatment begins, patients will be evaluated to confirm that they meet the requirements of this study. Participants will need to have a central line. This is a thin plastic catheter or tube that is placed during surgery into one of the large veins in the chest or neck. Central lines are used to give intravenous (IV) medications (medicines that go directly into the vein) or to take blood samples without you having to endure frequent needle sticks.

CAMPATH-1H will be given as a daily 4-hour IV (intravenous, by vein) infusion for three days. Anti-CD45 will be given as a daily 6-hour IV infusion over the next 4 days. There will then be a one-day rest period before receiving the stem cell transplant.

After the transplant, participants will be followed closely. While in hospital, patients will have a physical examination done daily. They will also have a daily urinalysis (where some of your urine is tested to see what it contains) and blood tests done, which are standard for anyone receiving a transplant.

To see how the Anti-CD45 is working in the body, blood will be drawn 2 hours before each infusion of the Anti-CD45, at the end of each infusion of the CD45 and then 24 hours (1 day) and 48 hours (2 days) after the end of the last infusion of Anti-CD45. No more than 42 mls (8-9 teaspoonfuls) of total blood will be drawn over the course of the four Anti-CD45 infusions.

When able to leave the hospital, the patient will be followed in the outpatient clinic and will have visits and tests which are standard (the same) for anyone who receives a transplant.

  Eligibility

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

Eligibility Criteria:

  • Patients with Fanconi anemia of all ages are eligible
  • Diagnosis of Fanconi anemia must be confirmed by studies of peripheral blood or bone marrow sensitivity to mitomycin-C or DEB
  • Severe aplasia as evidenced by a hypocellular bone marrow and at least 2 of the 3 criteria below:

    • ANC < 500/mm3
    • Hemoglobin < 10 gm/dl with reticulocyte count < 1%
    • Platelet count < 50,000/mm3
  • Availability of an HLA matched or mismatched (up to one haplotype) family member who has been documented not to have Fanconi anemia or of an unrelated HLA matched stem cell donor. Fully matched is defined at 6/6 match by high resolution DR based DNA typing.
  • Female patients of childbearing age must have a negative pregnancy test and be willing to use an effective means of birth control.

Exclusion Criteria:

  • Patients with a life expectancy (<6 weeks) limited by diseases other than FA.
  • Patients with leukemic transformation
  • Patients with symptomatic cardiac disease, or evidence of significant cardiac disease by echocardiogram (i.e., shortening fraction <25%).
  • Patients with severe renal disease(Creatinine >2 x normal for age)
  • Patients with known allergy to rat serum products.
  • Patients with a Karnofsky score <70%.
  • Patients with a severe infection that on evaluation by the Principal Investigator precludes ablative chemotherapy or successful transplantation.
  • Patients with severe personality disorder or mental illness.
  • Patients with documented HIV positivity.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00058565

Locations
United States, Texas
Baylor College of Medicine Recruiting
Houston, Texas, United States, 77030
Contact: Malcolm K Brenner, MB, PhD,     832-824-4663     mbrenner@bcm.tmc.edu    
Principal Investigator: Malcolm K Brenner, MB, PhD,            
Texas Children's Hospital Recruiting
Houston, Texas, United States, 77030
Contact: Malcolm M Brenner, MB, PhD     832-824-4668     mbrenner@bcm.tmc.edu    
Principal Investigator: Malcolm K Brenner, MB, PhD            
The Methodist Hospital Recruiting
Houston, Texas, United States, 77030
Contact: Malcolm K Brenner, MB, PhD     832-824-4668     mbrenner@bcm.tmc.edu    
Principal Investigator: Malcolm M Brenner, MB, PhD            
Sponsors and Collaborators
Baylor College of Medicine
Texas Children's Hospital
The Methodist Hospital System
Center for Cell and Gene Therapy
  More Information

Responsible Party: Baylor College of Medicine ( Malcolm Brenner, MD )
Study ID Numbers: H9938, MAFIA
Study First Received: April 8, 2003
Last Updated: December 13, 2007
ClinicalTrials.gov Identifier: NCT00058565  
Health Authority: United States: Food and Drug Administration

Study placed in the following topic categories:
Metabolic Diseases
Hematologic Diseases
Fanconi Anemia
Anemia
Fludarabine monophosphate
Antibodies, Monoclonal
Antibodies
Genetic Diseases, Inborn
Fanconi's anemia
Alemtuzumab
Anemia, Aplastic
Fludarabine
Bone Marrow Diseases
Aplastic anemia
Metabolic disorder
Immunoglobulins

Additional relevant MeSH terms:
Anemia, Hypoplastic, Congenital
Immunologic Factors
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
DNA Repair-Deficiency Disorders
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009