Optimizing Haploidentical Aplastic Anemia Transplantation (BMT CTN 1502)

Completed · Phase 2

Conditions studied: Severe Aplastic Anemia

In brief

This study is a prospective, multicenter phase II study with patients receiving haploidentical transplantation for Severe Aplastic Anemia (SAA). The primary objective is to assess overall survival (OS) at 1 year post-hematopoietic stem cell transplantation (HSCT).

Key facts

Study ID

NCT02918292

Run by

Medical College of Wisconsin

People needed

32

Starts

2017-07-03

Expected to finish

2021-08-17

Last updated by the study team

2026-03-31

Who can join

Age: any, up to 75. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patient is < 75 years of age at time of enrollment.
• Confirmed diagnosis of SAA, either from initial diagnosis or follow-up assessments, defined as:
• Bone marrow cellularity < 25% or marrow cellularity < 50% but with < 30% residual hematopoietic cells.
• Two out of three of the following (in peripheral blood): Neutrophils < 0.5 x10\^9/L, Platelets < 20 x10\^9/L, or Reticulocyte count < 20 x10\^9/L (<60 x 10\^9/L using an automated analysis)
• No suitable fully matched related sibling donor (6/6 match for human leukocyte antigen (HLA)-A and B at intermediate or high resolution and DRB1 at high resolution using DNA-based typing) available.
• Failed at least one trial of immunosuppressive therapy (IST) by being refractory or having relapsed. IST could have included ATG based regimens, calcineurin inhibitors and/or other higher dose therapy directed at the treatment of primary SAA.
• Available relative of the patient who is a haploidentical match, including biological parents, siblings or half siblings, children, uncles/aunts, first cousins, etc. Eligible haploidentical donors will have 2-4 mismatches if HLA-A, -B, -C, and -DRB1 typing is used; 2-5 mismatches if HLA-A, -B, -C, -DRB1, and -DQB1 typing is used; and 2-6 mismatches if HLA-A, -B, -C, -DRB1, -DQB1, and -DPB1 typing is used. A unidirectional mismatch in either the graft versus host or host versus graft direction is considered a mismatch. The donor and recipient must demonstrate that they are a full haplotype match by being identical at a minimum of one allele (at high resolution DNA-based typing) at the following genetic loci: HLA-A, -B, -C, and DRB1 if 8 allele typing is used; HLA-A, -B, -C, -DRB1, and -DQB1 if 10 allele typing is used; and HLA-A, -B, -C, -DRB1-, DQB1, and -DPB1 is 12 allele typing is used by the local center. See Section 2.4 for additional information.
• Patient and/or legal guardian must sign informed consent for HSCT.
• The haplo donor and/or legal guardian must be able to sign informed consent documents.
• The potential haplo donor must be willing and able to donate bone marrow.
• The weight of the haplo donor must be ≥ 20 kg.
• Adequate organ function defined as:
• Cardiac: Left ventricular ejection fraction (LVEF) at rest ≥ 40%. For patients aged < 13 years, shortening fraction (SF) ≥ 26% by echocardiogram or Multi Gated Acquisition Scan (MUGA) may be substituted for LVEF.
• Hepatic: Total bilirubin < 3.0 x the upper limit of normal (ULN) for age (patients who have been diagnosed with Gilbert's Disease are allowed to exceed this limit) and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) < 5.0 x ULN for age.
• Renal: For patients > 13.0 years of age at the time of enrollment: estimated creatinine clearance > 50 mL/minute (using the Cockcroft-Gault formula and actual body weight). For patients < 13.0 years of age at enrollment: Glomerular Filtration Rate (GFR) estimated by the updated Schwartz formula ≥ 90 mL/min/1.73 m2. If the estimated GFR is < 90 mL/min/1.73 m\^2, then renal function must be measured by 24-hour creatinine clearance or nuclear GFR, and must be > 50 mL/min/1.73 m\^2.
• Pulmonary: For patients > 13.0 years of age: Diffusing capacity of the lung for carbon monoxide (DLCO) (corrected/adjusted for hemoglobin) > 40% and forced expiratory volume in one second (FEV1) > 50% predicted (without administration of bronchodilator) and forced vital capacity (FVC) > 50% predicted. For patients < 13.0 years of age unable to perform pulmonary function tests (PFT) due to age or developmental ability: (1) no evidence of dyspnea at rest and (2) no need for supplemental oxygen and (3) O2 saturation > 92% on room air at sea level (with lower levels allowed at higher elevations per established center standard of care (e.g., Utah, 4,200 feet above sea level, does not give supplemental oxygen unless below 90%)).
• Karnofsky or Lansky performance status ≥ 60%.
• Females and males of childbearing potential must agree to practice 2 effective methods of contraception at the same time or agree to abstinence.

You may not qualify if…

• Inherited bone marrow failure syndromes such as Fanconi anemia must be ruled out according to center standard.
• Clonal cytogenetic abnormalities consistent with pre-myelodysplastic syndrome (pre-MDS) or MDS on marrow examination (e.g. Monosomy 7).
• Presence of anti-donor HLA antibodies (positive anti-donor HLA antibody is defined as a positive cross-match test of any titer by complement-dependent cytotoxicity or flow cytometric testing or the presence of anti-donor HLA antibody to the high expression loci HLA-A, B, C, DRB1, or DPB1 with mean fluorescence intensity (MFI) > 1000 by solid phase immunoassay).
• Prior allogeneic stem cell transplant.
• Prior solid organ transplant.
• Known life-threatening reaction (i.e., anaphylaxis) to Thymoglobulin® that would prohibit use for the patient as this study requires use of the Thymoglobulin® preparation of ATG.
• Uncontrolled bacterial, viral, or fungal infection at the time of enrollment. Uncontrolled is defined as currently taking medication and with progression or no clinical improvement on adequate medical treatment.
• Seropositive for the human immunodeficiency virus (HIV).
• Active Hepatitis B or C determined by a detectable viral load of HBV or HCV.
• Female patients who are pregnant (per institutional practice) or breast-feeding.
• Prior malignancies except resected basal cell carcinoma or treated cervical carcinoma in situ. Cancer treated with curative intent > 5 years previously will be allowed. Cancer treated with curative intent ≤ 5 years previously will not be allowed unless approved by the Protocol Chairs and/or Protocol Officer.
• Alemtuzumab or ATG within 2 weeks of enrollment.

Where it is running

• City of Hope National Medical Center — Duarte, California, United States
• Children's Hospital of Los Angeles — Los Angeles, California, United States
• Children's Hospital and Research Center Oakland — Oakland, California, United States
• Stanford Hospital and Clinics — Stanford, California, United States
• Children's National Medical Center — Washington D.C., District of Columbia, United States
• University of Florida College of Medicine — Gainesville, Florida, United States
• Miami Children's Hospital — Miami, Florida, United States
• All Children's Hospital — St. Petersburg, Florida, United States
• H. Lee Moffitt Cancer Center — Tampa, Florida, United States
• Northside Hospital — Atlanta, Georgia, United States
• Indiana University Medical Center/ Riley Hospital for Children — Indianapolis, Indiana, United States
• University of Louisville/Kosair Children's Hospital — Louisville, Kentucky, United States
• Johns Hopkins Unversity — Baltimore, Maryland, United States
• University of Michigan Medical Center — Ann Arbor, Michigan, United States
• Karmanos Cancer Institute/Children's Hospital of Michigan — Detroit, Michigan, United States
• Children's Mercy Hospital and Clinics — Kansas City, Missouri, United States
• Washington University/Barnes Jewish Hospital — St Louis, Missouri, United States
• Hackensack University Medical Center — Hackensack, New Jersey, United States
• Roswell Park Cancer Institute — Buffalo, New York, United States
• Duke University Medical Center — Durham, North Carolina, United States
• Oregon Health and Science University — Portland, Oregon, United States
• Penn State College of Medicine/The Milton S. Hershey Medical Center — Hershey, Pennsylvania, United States
• University of Pennsylvania Cancer Center — Philadelphia, Pennsylvania, United States
• Baylor College of Medicine — Houston, Texas, United States
• University of Texas/MD Anderson Cancer Center — Houston, Texas, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.