AzTrials
AzTrials

Myelodysplastic SyndromePhase 2NCT01338987

Pilot Study of Leuprolide to Improve Immune Function After Allogeneic Bone Marrow Transplantation

A Phase 2 study testing First Allogeneic Bone Marrow Transplant (BMT), Leuprolide and 18F FLT in people with Myelodysplastic Syndrome and Acute Lymphocytic Leukemia, run by National Cancer Institute (NCI) at 3 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: One way to treat certain cancers of the blood and immune system is to give a patient stem cells from the bone marrow of a donor whose genes are very similar but not identical to the patients. Read more about this study

Who is it for?
Ages 4 to 55 years
What is being tested?
First Allogeneic Bone Marrow Transplant (BMT), Leuprolide and 18F FLT
Could I receive a placebo?
No, everyone receives an active treatment
How many people
76 participants
Where
3 sitesUnited States
Study dates
19 Apr 2011to 19 Nov 2020
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 to 55 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • At National Institutes of Health (NIH). Age greater than or equal to 15 years old and/or greater than or equal to 9 years old and pubertal and less than or equal to 55 years for recipient. Pubertal is defined by: prior menses at any time (females), documentation of clinical Tanner stage greater than 2 at some point pre-chemotherapy or at the current visit. (At this point, sex steroids have been produced for a few years which have driven initial pubertal development). Tanner 2 is defined as: breast buds for females with coarse pubic hair, and coarse pubic hair and testes > 2.5cm for males.
  • At Children's National Medical Center only: age > 4 years old and < 24.
  • At University of Oklahoma: Age greater than or equal to 17 years old and less than or equal to 55 years for recipient.
  • A diagnosis of a hematologic malignancy for which stem cell transplant is standard of care:
  • 4.1. Acute Lymphocytic Leukemia (ALL)
  • Adult: (greater than or equal to 22 years) greater than or equal to compete remission 2 (CR2) OR complete remission 1 (CR1) with:
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  • Matched sibling donor for recipient treated on adult leukemia regimen
  • t(9:22) or bcr-abl+; t(4:11), t(1:19), t(8:14), 11q23 (MLL rearrangements) complex cytogenetics (5 or more chromosomal abnormalities), hypodiploidy (<44 chromosomes). Note that patients with ALL blast crisis who emerge from chronic myeloid leukemia (CML) are also eligible
  • Primary induction failure, defined as failure to achieve CR with primary induction chemotherapy
  • High white blood cell (WBC) (>30,000 for B-cell ALL and >100,000 for T-cell ALL) at diagnosis
  • Persistence of minimal residual disease despite induction chemotherapy
  • Pediatric (< 22 years): greater than or equal to CR2 OR CR1 with high risk features
  • Matched sibling donor for recipient treated on adult leukemia regimen
  • Primary induction failure (M3 (>25% with greater 200 cells counted) marrow at day 29), M2 (5-25% blasts with greater than 200 cells counted) bone marrow or minimal residual disease (MRD) > 1% at day 29 who then fail at day 43 with either an M2 or M3 BM or MRD > 1%
  • Persistent leukemia and t(9;22) (MRD >1% day 29 or MRD > 0.01% end consolidation)
  • 11q23 (MLL) rearrangements detected by cytogenetic or polymerase chain reaction (PCR) at initial diagnosis who are slow early responders (M2/M3 at day 14 or MRD> 0.01% at day 29)
  • Extreme hypodiploidy (< 44 chromosomes or deoxyribonucleic acid (DNA) index of <0.81) detected by cytogenetic/ploidy analysis
  • 4.2 Acute Myelogenous Leukemia
  • Adult: (greater than or equal to 22 years) greater than or equal to CR2 OR CR1 with high one of the following risk features
  • -Adverse or intermediate-risk cytogenetics including:
  • Normal cytogenetics
  • complex karyotype (>2 abnormalities)
  • inv (3) or t (3;3); t(11;19)(q23;p13.1); +13; -17/17p-; -18; -20; (t(6;9); t(6;11); -7, 7q-; -5, 5q-; trisomy 8; t(3;5); t(9:11)(p22q23)
  • monosomy karyotype (presence of an autosomal monosomy in conjunction with at least one other autosomal monosomy or structural abnormality.
  • Any other karyotype EXCEPT t(8;21), t(9;11), inv(16), or t (16;16), and M3 (17; 17) unless ckit mutation present and then eligible.
  • AML emerging from CML (blast crisis) are eligible
  • -Primary induction failure, defined as failure to achieve CR with primary induction chemotherapy
  • Secondary AML, defined as AML related to antecedent myelodysplastic syndrome (MDS), myeloproliferative neoplasms (MPN), or cytotoxic chemotherapy
  • Hyperleukocytosis (White blood cell (WBC) > 100,000 at diagnosis)
  • Mutations in the FMS-like tyrosine kinase 3 (FLT3) gene (FLT3-LM; FLT-ITDs)
  • Bilineage or biphenotypic leukemias are high risk features and eligible.
  • Pediatric (< 22 years): greater than or equal to CR2 OR CR1 with a high risk feature including:
  • -Primary induction failure (greater than or equal to 5% blasts in marrow after induction)
  • Persistent leukemia (>15% after first course of chemotherapy)
  • Complex karyotype, monosomy 7, or -5/-5q, FLT3 ITD-AR (>0.4) EXCEPT if also inv(16)/t(16;16), t(8,21)
  • Normal cytogenetics or abnormal cytogenetics EXCEPT if also inv(16)/t(16;16), t(8,21) are eligible for SIBLING transplant only
  • Bilineage or biphenotypic leukemias are high risk features and eligible.
  • 4.3. Myelodysplastic Syndrome Refractory Anemia with Excess Blasts (RAEB) 1 or 2; cytogenetics showing complex karyotype (3 or more abnormalities), monosomy 7/del(7q), or inv(3)/t(3q)/del(3q); or transfusion dependent.
  • 4.4. Chronic Myelomonocytic Leukemia
  • 4.5. Chronic Myelogenous Leukemia who have failed 2G- tyrosine kinase inhibitors (TKI)
  • 4.6. Standard pediatric indications for myeloablative transplantation for patients undergoing bone marrow transplant at Children's National Medical Center per institutional guidelines
  • 5. Disease status
  • If patients are found to not be in remission at screening, then the patient may be returned to their primary hematologist/oncologist or may receive chemotherapy as per standard of care for the malignant disease. Patients for whom this would be their first allogeneic transplant must be in remission (< 5% malignant blasts in marrow and peripheral blood and no evidence of extramedullary disease) for transplant. Patients enrolled on this protocol for their second transplant do not need to have attained remission prior to transplant.
  • 6. Performance status: Karnofsky or Lansky performance status greater than or equal to 60% AND life expectance of greater than 3 months.
  • 7. Ability to give informed consent. For recipients and donors < 18 years of age, their legal guardian must give informed consent. Pediatric patients will be included in an age appropriate discussion in accordance with institutional guidelines.
  • 8 Hepatic function: Patients must have evidence of adequate liver function prior to enrollment defined by total bilirubin < 2.5 mg/dL (unless documented Gilbert's syndrome) AND transaminases less than or equal to 5 x the upper limit of normal for age appropriate indices.
  • 9. Renal function: Patients must have evidence of adequate renal function to proceed with stem cell transplant, creatinine clearance > 60 ml/min/1.73 m(2). Glomerular filtration rate (GFR) may also demonstrate adequate renal function.
  • 10. Left ventricular ejection fraction greater than or equal to 50% OR shortening fraction of greater than or equal to 27% demonstrated on 2-dimension (2D) echocardiogram or multi-gated acquisition scan (MUGA).
  • 11. Pulmonary function of Diffusing Capacity of the Lung for Carbon Monoxide (DLC0) adj/alveolar volume (VA) and forced expiratory volume 1 (FEV1) greater than or equal to 60% of normal indices for age and height unless the patient has a likely acute reversible etiology of decline and then DLCO adj/VA greater than or equal to 30% of normal. Pediatric patients unable to complete pulmonary function tests (PFTs) may be enrolled as per enrolling institution Standard Operating Procedure (SOP) for recipient guidelines.
  • 12. Patients with prior autologous stem cell transplants will be included. Patients with prior allogeneic stem cell transplants will be eligible for 2nd BMT if not previously transplanted with FLT on this study.
  • 13. Prior experimental systemic therapies must have been completed greater than 2 weeks prior to study entry.
  • Age greater than or equal to 2 and less than or equal to 60 years old and able to give consent or assent. For donors < 18 years old, the legal guardian must be able to provide informed consent and an evaluation by a Licensed Social Worker (LSW) or psychiatric personnel will be needed to determine willingness to participate. Pediatric patients will be included in an age appropriate discussion in accordance with institutional guidelines.
  • Human leukocyte antigen (HLA)-matched related donor, excluding identical twins. Donors must be matched at least 7 loci out of 8 at the allele or antigen level excluding antigen DRB1 mismatch.
  • Donor selection will be in accordance with National Institutes of Health (NIH)/Clinical Center (CC) Department of Transfusion Medicine criteria and must be able to medically endure stem cell collection or as per local institutional guidelines.
  • Donors must be HIV negative, human T-cell leukemia-lymphoma virus (HTLV) negative, hepatitis B surface antigen (HBsA) negative.
  • Donors must be physically able to and willing to tolerate marrow harvest collection preferably, or in the absence of this option, able and willing to donate via peripheral blood pheresis.
  • Unrelated donor matched at HLA-A, B, C, and DR loci by high resolution typing (at 8/8 or 7/8 antigen/allele match) are acceptable donors.
  • The evaluation of donors shall be in accordance with existing National Marrow Donor Program (NMDP) Standard Policies and Procedures at all institutions.
  • INCLUSION CRITERIA- (18F) FLT CANDIDATE TRANSPLANT RECIPIENT
  • Meets criteria for Transplant Recipient
  • Age greater than or equal to 18 years old at National Cancer Institute (NCI), and age > 4 years and < 24 years at Children's National Medical Center
  • Donor who is willing to undergo bone marrow or stem cell harvest.
  • EXCLUSION CRITERIA- (18F) FLT CANDIDATE TRANSPLANT RECIPIENT
  • 1. History of prior fluorothymidine allergy or intolerance.

Who cannot join

  • History of psychiatric disorder which may compromise compliance with transplant protocol, or which does not allow for appropriate informed consent.
  • Active infections not responding to therapy. All efforts should be made to clear the infection prior to enrollment.
  • Clinically significant systemic illness with manifestations of significant organ dysfunction which in the judgment principal investigator (PI) or associate investigator (AI) would render the patient unlikely to tolerate the protocol therapy or complete the study.
  • Presence of active malignancy from an organ system other than hematopoietic.
  • Human immunodeficiency virus (HIV) infection.
  • Chronic active hepatitis B infection. Patients may be hepatitis B core antibody positive but must be surface antigen negative and without active evidence of disease.
Show all 18Show fewer
  • Pregnant or lactating females will be excluded from this trial due to unknown risks to the developing fetus. Patients of child-bearing potential must use an effective form of contraception while on study.
  • Sexually active individuals capable of becoming pregnant who are unable or unwilling to use effective form(s) of contraception during time enrolled on study and for 1 year post-transplant.
  • History of prior Leuprolide intolerance. Note: patients ARE eligible if prior or current leuprolide exposure.
  • History of medical illness that in the estimation of the PI or Department of Transfusion Medicine (DTM) physician precludes donation of marrow.
  • Anemia (Hemoglobin (Hb) < 10 gm/dl) or thrombocytopenia (< 100,000/ ul).
  • Pregnant females (due to risk to fetus).
  • Current psychiatric diagnosis that would compromise compliance with transplant protocol or precludes appropriate informed consent.
  • Presence of any blood transmissible infectious disease that cannot be cleared prior to stem cell collection and poses an unacceptable risk for the recipient (excludes cytomegalovirus (CMV)).
  • Active malignancy will exclude the donor. Any malignancy less than five years postremission will exclude the donor. Non-hematologic malignancies greater than 5 years ago will not exclude the donor. Any history of hematologic malignancy will be considered on a case by case basis.
  • Any medical contraindication to anesthesia or marrow donation will exclude the donor.
  • Donors receiving experimental therapy or investigational agents.
  • Active autoimmune disease that in the opinion of the PI or AI would compromise the success of the transplant.

Trial locations and contacts

3 sites in 1 country.

United States3 sites

  • National Institutes of Health Clinical Center, 9000 Rockville Pike

    Bethesda, Maryland, 20892

  • University of Oklahoma

    Oklahoma City, Oklahoma, 73104

  • Childrens National Medical Center

    Washington D.C., District of Columbia, 20010

Other trials in United States

About this study

Official title: Multi-Institutional Prospective Pilot Study of Lupron to Enhance Lymphocyte Immune Reconstitution Following Allogeneic Bone Marrow Transplantation in Post-Pubertal Children and Adults With Molecular Imaging Evaluation

Background:

  • One way to treat certain cancers of the blood and immune system is to give a patient stem cells from the bone marrow of a donor whose genes are very similar but not identical to the patients. One problem with these transplants is that the new immune cells may not work as well in the recipient as they did in the donor. The result may be that the immune system will not work as well. This can increase the risk of severe infections and other complications.
  • Researchers are studying the use of drugs that lower hormone levels and may allow the immune system to recover in a way that improves white blood cell function. In this study they will be looking at the drug leuprolide, a drug that lowers estrogen or testosterone levels, to see if it might improve the function of the newly transplanted cells.
Read more

Objectives:

  • To determine whether leuprolide improves immune system function after bone marrow transplant from a donor with similarities in their immune cells (matched to each other).
  • To evaluate the effectiveness of a nuclear medicine test with a radiotracer drug 3-deoxy-3 18F-fluorothymidine (FLT) in imaging studies. FLT will be used to image the immune system function in patients who have received bone marrow from the donor.

Eligibility:

  • People between 15 (or as young as 9 in those who have gone through puberty) and 55 years of age. These patients must have acute myelogenous leukemia, acute lymphocytic leukemia, high-risk myelodysplastic syndrome, chronic myelomonocytic leukemia, or chronic myeloid leukemia. They must also be eligible for a bone marrow transplant.
  • Genetically similar donors for the patients who are eligible for a transplant.

Design:

  • People taking part in the study will be screened with a physical examination, medical history, blood and urine tests, and imaging studies. Patients who are not in remission or who require a bone marrow donor search may receive chemotherapy first.
  • Donors will provide bone marrow for transplant according to standard bone marrow transplant (BMT) procedures.
  • All women and half of the men will receive regular leuprolide doses 2 weeks before BMT to suppress hormone function.
  • All recipients will receive 4 days of radiation followed by 2-4 days of chemotherapy before the bone marrow transplant (depending on age). Recipients will also receive other drugs to prevent transplant rejection and other complications of transplantation.
  • Recipients will be monitored in the hospital for 4 weeks after transplant with blood tests and other studies.
  • Some recipients will have an imaging study with FLT during the protocol. These imaging studies will take place before the transplant, on days 5 and 28 after transplant, and at a later time to be determined by the study researchers.
  • Following discharge, participants will be monitored closely for up to 6 months, with regular but less frequent followup visits for at least 5 years. Study-related medications, including vaccinations for the new immune system, will be provided by the National Institutes of Health during the hospital stay and after discharge.
Read the detailed description

Background:

  • Impaired lymphocyte immune reconstitution is associated with morbidity and mortality following allogeneic bone marrow transplant (BMT).
  • Data suggest that one of the limitations of immunity after BMT is the lack of thymus recovery and proper B cell development.
  • Androgen withdrawal has been shown to enhance T and B lymphopoiesis.
  • Leuprolide is an approved, safe, gonadotropin releasing hormone (GnRH) agonist/antagonist.
  • Noninvasive imaging modalities to study immune reconstitution would be invaluable to predict optimal or impaired immune recovery permitting early institution of therapies.
  • FLT is 3-deoxy-3 18F-fluorothymidine, a radiolabeled thymidine analogue that illustrates dividing hematopoietic cells and may predict immune recovery after allogeneic BMT.
  • FLT has been used safely in patients who have received intensive chemotherapy.

Objectives:

  • Primary: To determine if leuprolide improves B lymphocyte reconstitution after first BMT.
  • Primary: To assess whether 18F FLT positron emission tomography (PET)/computed tomography (CT) could predict early engraftment/immune reconstitution in marrow and thymus after allogeneic BMT.
  • Primary: To assess safety of leuprolide after 2nd BMT evaluated in a separate arm.

Eligibility:

  • Patients > 9 years old and pubertal and/or >15 year and less than or equal to 55 years, with aggressive leukemia (Acute Myelogenous Leukemia (AML), myelodysplastic syndromes (MDS) with high risk cytogenetics, Acute Lymphocytic Leukemia (ALL), CMML, certain CML) requiring BMT will be enrolled at National Cancer Institute (NCI).
  • At University of Oklahoma, Age > 17 years old and less than or equal to 55 years for recipient.
  • Patients > 4 and < 24 years with the above diseases will be enrolled at Children's National Medical Center (CNMC).

Design:

  • This is a prospective pilot study, the primary aims of which are: 1) to assess whether leuprolide enhances lymphocyte recovery after first BMT, 2) whether FLT imaging can be used to predict engraftment/immune reconstitution after first transplant, and 3) whether leuprolide and FLT are tolerable for second HSCT.
  • At NCI and Univ of Oklahoma, post-pubertal pediatric male patients (<18 years) will be randomized to receive a 3 month (11.25 mg) injection and adult male patients will be randomized to receive 4-month preparation of leuprolide (30 mg) or placebo two weeks before the preparative regimen for first BMT. Women and all individuals undergoing 2nd BMT will receive leuprolide at these doses per age and be evaluated in the treated cohort. At Children's National Medical Center, the patients will not receive leuprolide outside of the context of clinical care and will receive myeloablative BMT as per standard of care with FLT imaging for engraftment as the only primary endpoint.
  • A target of 68 evaluable adult patients will be enrolled on this trial, which may necessitate up to 118 patients (118 donors) enrolled to reach this target at NCI and University of Oklahoma. A total of 10 pediatric patients will be enrolled at Children's National Medical Center for FLT imaging only. Sixteen patients will be enrolled to undergo second BMT.
  • At NCI, adults greater than 18 years old both female and adult male patients undergoing 2nd BMT will receive 4-month preparation of leuprolide (30 mg) two weeks before the preparative regimen. All patients will undergo FLT imaging to evaluate whether this may predict BMT response or failure (relapse). This will be a pilot arm of 16 patients total.
  • The planned length of this trial is 7 years with interim analyses at day 100 and day 365.
  • Some of the patients are anticipated to be evaluated using FLT (to include only patients needed for the immunological primary endpoint, not increasing total patient numbers). 23 adult NCI patients in total will undergo FLT PET/CT imaging on day -1, at day +5 or day +9, at 4 weeks, and at a future point to include evidence of graft-versus-host disease (GVHD) relapse, or immune recovery. An estimated 50 patients (including subset of the 23 patients undergoing serial scanning) will be imaged approximately at 1 year for evaluation of thymus reconstitution. The total possible numbers will include no more than 118 patients to achieve the 68 evaluable adults for the immunological primary endpoint. However, all 23 FLT PET/CT imaged NCI patients will undergo a single 1 year FLT for evaluation of thymus reconstitution. Up to 10 pediatric patients at CNMC will undergo FLT PET/CT imaging on Day -1, day+9, and day +28 (if possible). Initial images will be correlated with engraftment and other secondary endpoints.
Being tested
First Allogeneic Bone Marrow Transplant (BMT), Leuprolide, 18F FLT, Cyclophosphamide, Methotrexate
Keywords
FLT, Leuprolide, Thymic Renewal, Stem Cell Transplant, Acute Lymphocytic Leukemia, Acute Myelogenous Leukemia, Myelodysplastic Syndrome
Medical subject headings
Myelodysplastic Syndromes, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Leukemia, Myeloid, Acute, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Leukemia, Myelomonocytic, Chronic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • First Allogeneic Bone Marrow Transplant (BMT)Procedure or surgery

    First Allogeneic Bone Marrow Transplant

  • LeuprolideDrug

    Also called Lupron

    Leuprolide: 30 mg intramuscular injection(for adult) or 11.25 mg (for patients <18 years) between day -13 and day -20 pre-bone marrow transplant but definitely prior to initiation of preparative regimen as a 4 month intramuscular injection for patients > 18 years and as a 3 month injection (adult preparation) for patients < 18 years

  • 18F FLTDrug

    Also called [18F]fluorothymidine

    For the first 23 patients undergoing 1st bone marrow transplant (BMT):[18F]fluorothymidine (18F FLT): 0.07 mCi/kg with a maximum of 3 mCi On day + 28 (+/- 5 days) For 2nd BMT: 18F FLT: 0.07 mCi/kg with a maximum of 3 mCi On day -1, + 28, day 60 and at relapse (+/- 5 days)

  • CyclophosphamideDrug

    Also called Cytoxan

    Cyclophosphamide: 60 mg/kg intravenous (IV) on days -4 and -3 (for Adults > 22 years) or Cyclophosphamide: cyclophosphamide 50 mg/kg IV, Days -5, -4, -3, -2. (For Pediatric </= 22 years)

  • MethotrexateDrug

    Also called Trexall

    Methotrexate:10 mg/m(2) intravenous (IV) on day +1, and 5 mg/m(2) IV Days + 3, 6, 11

  • TacrolimusDrug

    Also called Prograf

    Tacrolimus:0.02 mg/kg/day continuous intravenous infusion (CIV) on day -1.

  • Total Body IrradiationRadiation

    Total Body Irradiation (TBI) 1200 cGy fractionate twice daily (lung block) Days -8, -7, -6, -5 (adult), -9, -8, -7, -6 (ped)

  • BusulfanDrug

    Also called Busulfex

    Second choice is Busulfan (with goal steady state of 800-1000) with fludarabine or cyclophosphamide at myeloablative dosing or non-myeloablative dosing.

  • FludarabineDrug

    Also called Fludara

    Given with Busulfan as alternative to cyclophosphamide in second transplant setting only

  • Second Allogeneic Bone Marrow TransplantationProcedure or surgery

    Second Allogeneic Bone Marrow Transplantation

Study groups in NCT01338987
Study groupRoleWhat they receive
Arm1 First Transplt/males/leuprolide/+/-FLT ImagingActive comparatorMales randomized to leuprolide for first transplant. [18F]fluorothymidine (FLT) imaging
Receives: Procedure: First Allogeneic Bone Marrow Transplant (BMT); Drug: Leuprolide; Drug: 18F FLT; Drug: Cyclophosphamide; Drug: Methotrexate; Drug: Tacrolimus; Radiation: Total Body Irradiation
Arm2 First Transplt/males/No Leuprolide/+/- FLT ImagingActive comparatorMales not receiving leuprolide for first transplant [18F]fluorothymidine (FLT) imaging
Receives: Procedure: First Allogeneic Bone Marrow Transplant (BMT); Drug: 18F FLT; Drug: Cyclophosphamide; Drug: Methotrexate; Drug: Tacrolimus; Radiation: Total Body Irradiation
Arm3 First Transplt/females/leuprolide+/- FLT ImagingExperimentalFemales receiving leuprolide for first transplant. [18F]fluorothymidine (FLT) imaging
Receives: Procedure: First Allogeneic Bone Marrow Transplant (BMT); Drug: 18F FLT; Drug: Cyclophosphamide; Drug: Methotrexate; Drug: Tacrolimus; Radiation: Total Body Irradiation
Arm4-Second Transplt/leuprolide and FLT ImagingExperimentalSecond transplant with leuprolide and [18F]fluorothymidine (FLT) imaging
Receives: Drug: Leuprolide; Drug: 18F FLT; Drug: Cyclophosphamide; Radiation: Total Body Irradiation; Drug: Busulfan; Drug: Fludarabine; Procedure: Second Allogeneic Bone Marrow Transplantation
Healthy Volunteer - Arm 5No interventionHealthy Volunteer

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of B Cells at One Year Post-transplant in Participants Who Did/Did Not Receive Leuprolide Following Bone Marrow Transplant (BMT)

    B cell percentage is defined as the percentage of lymphocytes that are B cells.

    Measured: after first Bone Marrow Transplant, approximately 12 months post-transplant

  2. Time to Engraftment in First Transplant Recipients Only With Median Thoracic Spine Standardized Uptake Values (SUV) of 1.4 or Greater Than Those Patients With SUV's Less Than 1.4

    18F-FLT imaging was performed serially on patients post transplant to identify the level of uptake of 18F-FLT at a day +5 to +12 scan and the day at which neutrophils recover to >500 (i.e., subclinical bone-marrow recovery within 5 days of Bone Marrow Transplantation (BMT infusion)). On each image for each patient, the region of interest was drawn within each thoracic medullary space (n=12), generating the SUV for each space. The mean of these was calculated for each scan. The analysis was the median of the means of the SUV of the thorax values of the day 5-12 scan (averaged the SUV of the thorax for each patient and then took the medians of these).

    Measured: 18F FLT scan done between days +5 to +12 and then time from that scan to engraftment measured

  3. Number of Adverse Events Related to Study Drug Experienced by Participants After Second Bone Marrow Transplant (BMT)

    Serious and non-serious adverse events were assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

    Measured: 12 months after second BMT

Secondary outcomes (1)

  1. Number of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0)

    Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

    Measured: Date treatment consent signed to date off study, approximately 79 months and 11 days.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Apr 2011 (estimated)
  2. Study start19 Apr 2011
  3. Primary completion1 Dec 2017
  4. Study completion19 Nov 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
76 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01338987
Sponsor's protocol ID
110136
Other IDs
11-C-0136
Status last verified
Mar 2021
First submitted
19 Apr 2011
Last updated
18 Mar 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hakim FT, Cepeda R, Kaimei S, Mackall CL, McAtee N, Zujewski J, Cowan K, Gress RE. Constraints on CD4 recovery postchemotherapy in adults: thymic insufficiency and apoptotic decline of expanded peripheral CD4 cells. Blood. 1997 Nov 1;90(9):3789-98.

    PubMed 9345067

  • Hazenberg MD, Otto SA, de Pauw ES, Roelofs H, Fibbe WE, Hamann D, Miedema F. T-cell receptor excision circle and T-cell dynamics after allogeneic stem cell transplantation are related to clinical events. Blood. 2002 May 1;99(9):3449-53. doi: 10.1182/blood.v99.9.3449.

    PubMed 11964316

  • Storek J, Gooley T, Witherspoon RP, Sullivan KM, Storb R. Infectious morbidity in long-term survivors of allogeneic marrow transplantation is associated with low CD4 T cell counts. Am J Hematol. 1997 Feb;54(2):131-8. doi: 10.1002/(sici)1096-8652(199702)54:23.0.co;2-y.

    PubMed 9034287

  • Williams KM, Holter-Chakrabarty J, Lindenberg L, Duong Q, Vesely SK, Nguyen CT, Havlicek JP, Kurdziel K, Gea-Banacloche J, Lin FI, Avila DN, Selby G, Kanakry CG, Li S, Scordino T, Adler S, Bollard CM, Choyke P, Gress RE. Imaging of subclinical haemopoiesis after stem-cell transplantation in patients with haematological malignancies: a prospective pilot study. Lancet Haematol. 2018 Jan;5(1):e44-e52. doi: 10.1016/S2352-3026(17)30215-6. Epub 2017 Dec 14.

    PubMed 29248669

  • Holter-Chakrabarty J, McNally L, Levine J, Ferrara J, Vesely SK, Kanakry CG, Garwe T, Han Z, Pandey M, Glover J, Wen Y, Gress R, Williams KM. 18F-FLT PET and Blood-based Biomarkers for Identifying Gastrointestinal Graft versus Host Disease after Allogeneic Cell Transplantation. Radiol Imaging Cancer. 2025 Jan;7(1):e240096. doi: 10.1148/rycan.240096.

    PubMed 39670843

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing First Allogeneic Bone Marrow Transplant (BMT), Leuprolide and 18F FLT in people with Myelodysplastic Syndrome and Acute Lymphocytic Leukemia, run by National Cancer Institute (NCI) at 3 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 64 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 23 Apr 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of B Cells at One Year Post-transplant in Participants Who Did/Did Not Receive Leuprolide Following Bone Marrow Transplant (BMT) (time frame: after first Bone Marrow Transplant, approximately 12 months post-transplant). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01338987, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2021; AzTrials last refreshed its copy on 1 Nov 2026.

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