About this trial
This phase II trial studies how well a donor stem cell transplant, treosulfan, fludarabine, and total-body irradiation work in treating patients with blood cancers (hematological malignancies). Giving chemotherapy and total-body irradiation before a donor stem cell transplant helps stop the growth of cells in the bone marrow, including normal blood-forming cells (stem cells) and cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells from a donor are infused into the patient, they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. The donated stem cells may also replace the patient's immune cells and help destroy any remaining cancer cells.
Eligibility criteria
Qualifiers
Acute leukemia (AL) that includes acute myeloid leukemia (AML) / acute lymphoblastic leukemia (ALL) / mixed phenotype leukemia (MPAL) in complete morphological remission (CR) with or without detectable minimal residual disease (MRD); complete morphological remission is defined by the presence of less than 5% of detectable blasts in bone marrow specimen, evaluated per standard of care. Patients with documented CR but without hematologic recovery since last chemotherapy are considered eligible to the study
Chronic myelogenous leukemia (CML), except refractory blast crisis. To be eligible in first chronic phase, patients must have failed or be intolerant to at least one tyrosine-kinase inhibitor
Chronic myelomonocytic leukemia (CMML)
Myelodysplastic syndromes (MDS)
Disqualifiers
Active, uncontrolled, life-threatening viral, bacterial or fungal infection requiring treatment at time of conditioning regiment administration and transplantation
Presence of a malignancy other than the one for which the transplant is being performed, with an expected survival less than 75% at 5 years
Pregnant or breastfeeding
Known hypersensitivity to treosulfan, fludarabine or cyclophosphamide
Trial design
Treatments tested in this trial
- Allogeneic Hematopoietic Stem Cell Transplantation
- Cyclophosphamide
- Cyclosporine
- Filgrastim
- Fludarabine
- Mycophenolate Mofetil
- Mycophenolate Sodium
- Total-Body Irradiation
- Treosulfan
- Bone Marrow Aspiration
- Bone Marrow Biopsy
- Echocardiography Test
- Biospecimen Collection
- Computed Tomography
- Positron Emission Tomography
Treatment groups
Sponsors and collaborators
Fred Hutchinson Cancer Center
Lead sponsor
medac GmbH
Collaborator