Purified CD34+ Hematopoietic Stem Cell Transplantation From Alternate Donors for Patients With Severe Aplastic Anemia - Full Text View

Sponsored by:	St. Jude Children's Research Hospital
Information provided by:	St. Jude Children's Research Hospital
ClinicalTrials.gov Identifier:	NCT00186797

Purpose

This study is for patients with Severe Aplastic Anemia (SAA). A stem cell transplant from a genetically matched sibling donor can help or cure this disease in 85 to 100 percent of patients. Stem cells are immature blood cells that grow to become red blood cells, white blood cells or platelets. A genetic "match" means a brother or sister has same immune type (HLA type) as the patient. Unfortunately, few patients have a matched sibling donor. The chance of negative outcomes is much higher with other types of donors.

This study will test the success of a new approach to stem cell transplant for SAA. Patients in this study will receive drugs and radiation treatment to destroy their diseased bone marrow and to prepare them for stem cell transplant. Bone marrow is the tissue inside the bones where stem cells are made.Stem cells will be harvested from the blood or bone marrow of genetically matched unrelated donors or partially matched family donors. The stem cells will be filtered using a new device that is currently under study. The patients will receive large doses of the filtered stem cells (stem cell graft). Researchers want to find out how the study treatment affects patients, the disease, and the chances for survival.

Condition	Intervention
Aplastic Anemia	Procedure: Allogeneic stem cell transplant Drug: Fludarabine, Cyclophosphamide

MedlinePlus related topics: Anemia

Drug Information available for: Cyclophosphamide Fludarabine Fludarabine monophosphate

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Parallel Assignment, Safety Study

Further study details as provided by St. Jude Children's Research Hospital:

Primary Outcome Measures:

To learn the safety of stem cell transplantation in patients with unrelated donors or partially matched family donors
To study the effects (good and bad) of this treatment on the patients, the aplastic anemia, and survival
To learn how well the donor bone marrow grows in patients who receive the research treatment
To learn how many patients need extra T-cells or extra stem cells from the donor to help the donor's blood stem cells grow

Estimated Enrollment:	28
Study Start Date:	December 2002
Study Completion Date:	May 2007
Primary Completion Date:	September 2005 (Final data collection date for primary outcome measure)

Eligibility

Ages Eligible for Study:	up to 21 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Age < 21 years
Diagnosis of severe aplastic anemia. (As defined by at least 2 of the following: ANC < 500/μl, platelet count < 20,000/μl, and a reticulocyte count < 1% after correction for the hematocrit. In addition, the diagnostic bone marrow biopsy must contain less than 25% of the normal cellularity).
Patient must have failed one or more courses of immunosuppressive therapy that included ATG. As immunosuppression may take up to 6 months to demonstrate a response, patients must have been observed to have failed immunosuppression for a minimum of six months.
Absence of suitable HLA-matched sibling donor.
Negative serum pregnancy test for females with child bearing potential.
Patient/parent/guardian is able to provide informed consent.

Exclusion Criteria:

Patients with a life expectancy < 6 weeks.
Patients with severe renal disease (creatinine clearance < 40cc/min/1.73m2)
Patients with pre-existing severe restrictive pulmonary disease (FVC <40% of predicted)

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00186797

Locations

United States, Tennessee
St. Jude Children's Research Hospital
Memphis, Tennessee, United States, 38105

Sponsors and Collaborators

St. Jude Children's Research Hospital

Investigators

Principal Investigator:

Paul Woodard, MD

St. Jude Children's Research Hospital

More Information

St. Jude Children's Research Hospital This link exits the ClinicalTrials.gov site

Study ID Numbers:	AACD34
Study First Received:	September 9, 2005
Last Updated:	February 20, 2008
ClinicalTrials.gov Identifier:	NCT00186797
Health Authority:	United States: Food and Drug Administration

Keywords provided by St. Jude Children's Research Hospital:

Aplastic Anemia

Study placed in the following topic categories:

Hematologic Diseases
Anemia, Aplastic
Anemia
Fludarabine

Fludarabine monophosphate
Cyclophosphamide
Aplastic anemia
Bone Marrow Diseases

Additional relevant MeSH terms:

Molecular Mechanisms of Pharmacological Action
Immunologic Factors
Antineoplastic Agents
Therapeutic Uses
Physiological Effects of Drugs
Myeloablative Agonists

Antineoplastic Agents, Alkylating
Antirheumatic Agents
Alkylating Agents
Immunosuppressive Agents
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 15, 2009