Busulfan and Cyclophosphamide Followed by Bone Marrow Transplantation in Treating Patients With Acute Myelogenous Leukemia or Myelodysplastic Syndrome

Northwestern University

Overview

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining chemotherapy with donor bone marrow transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells. PURPOSE: Phase II trial to study the effectiveness of busulfan and cyclophosphamide followed by bone marrow transplantation in treating patients who have acute myelogenous leukemia or myelodysplastic syndrome.

OBJECTIVES: * Determine the remission duration, disease-free survival, and overall survival of patients with acute myelogenous leukemia in remission or early relapse or myelodysplastic syndrome treated with high-dose busulfan and cyclophosphamide followed by allogeneic bone marrow transplantation. OUTLINE: Patients receive oral high-dose busulfan every 6 hours for 14-16 doses on days -9 to -6, followed by high-dose cyclophosphamide IV over 1 hour on days -5 to -2. Allogeneic bone marrow is infused on day 0. Patients who have already had 1 transplant receive high-dose cyclophosphamide IV on days -6 and -5, total body irradiation twice a day on days -4 to -1, and allogeneic bone marrow infusion on day 0. All patients receive prophylaxis for graft versus host disease. Patients are followed every 6 months for at least 2 years. PROJECTED ACCRUAL: A total of 25-40 patients will be accrued for this study.

Study Type

INTERVENTIONAL

Purpose

TREATMENT

Masking

NONE

Conditions

Leukemia Myelodysplastic Syndromes Myelodysplastic/Myeloproliferative Diseases

Interventions

busulfanDRUG

cyclophosphamideDRUG

allogeneic bone marrow transplantationPROCEDURE

bone marrow ablation with stem cell supportPROCEDURE

Eligibility

Sex: ALLMin age: 16 YearsMax age: 60 Years

Medical Language ↔ Plain English

DISEASE CHARACTERISTICS: * Morphologically proven (from bone marrow aspirate smears or touch preps of marrow biopsy) acute myelogenous leukemia or myelodysplastic syndrome of 1 of the following subtypes: * Acute myeloblastic leukemia (M1, M2) * Acute promyelocytic leukemia (M3) * Acute myelomonocytic leukemia (M4) * Acute monocytic leukemia (M5) * Acute erythroleukemia (M6) * Acute megakaryocytic leukemia (M7) * Refractory anemia * Refractory anemia with excess blasts * Refractory anemia with excess blasts in transformation * Refractory anemia with ringed sideroblasts * Chronic myelomonocytic leukemia * In remission or in early relapse as defined by less than 20% blast cells in the marrow or overt active acute myeloid leukemia * Suitable marrow donor, defined as a sibling donor matched at the HLA-A, HLA-B, and HLA-D/DR locus nonreactive in bidirectional mixed lymphocyte culture or a donor who is mismatched at 1 antigen loci * Active CNS disease allowed PATIENT CHARACTERISTICS: Age: * 16 to physiologic 60 Performance status: * ECOG 0-2 Life expectancy: * Not specified Hematopoietic: * Not specified Hepatic: * Bilirubin no greater than 3 times upper limit of normal (ULN) unless due to Gilbert's disease * SGOT no greater than 3 times ULN Renal: * Creatinine no greater than 2.0 mg/dL Cardiovascular: * Cardiac ejection fraction normal Pulmonary: * FEV\_1 at least 50% of predicted * DLCO at least 50% of predicted Other: * HIV negative * No evidence of persistent infection * No concurrent organ damage or medical problems that would preclude study therapy PRIOR CONCURRENT THERAPY: Biologic therapy: * Not specified Chemotherapy: * Not specified Endocrine therapy: * Not specified Radiotherapy: * Not specified Surgery: * Not specified Other: * No concurrent antibiotics

Locations (1)

Robert H. Lurie Comprehensive Cancer Center at Northwestern University

Chicago, Illinois, United States

Data from ClinicalTrials.gov

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