In this phase clinical trail, we evaluate the efficacy and feasibility of azacytidine and venetoclax as leukemia debulking treatment followed by reduced intensity conditioning regimen consisting of Fludarabine + Busulfan + Melphalan as salvage treatment in patients with refractory AML .
In refractory AML, allogeneic hematopoietic stem cell transplantation (allo-HCST) is considered as the only curative regimen. In this phase II clinical trial, we plan to evaluate the efficacy and feasibility of new sequential transplantation protocol. All patients receive azacytidine and venetoclax as leukemia debulking treatment which is followed by reduced intensity conditioning regimen consisting of Fludarabine (150mg/m2) + Busulfan (6.4mg/kg) + Melphalan (70mg/m2). The graft-versus host disease (GVHD) prophylaxis regimen is based on reduced dose of post-transplantation cyclophosphamide (PT-CY) 40mg/kg day+3\~+4, tacrolimus and low-dose anti-thymoglobulin (ATG, 2.5mg/kg) in case of HLA-matched unrelated donor or halo-donor transplantation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
23
aaa-ven treatment followed by allo-HCTS with reduced toxicity conditioning (RTC) of Fludarabine, Busulifan and Melphalan
Blood & Marrow Transplantation Center, RuiJin Hospital
Shanghai, China
RECRUITINGDepartment of Hematology, Shanghai No6 Hospital
Shanghai, China
RECRUITINGShanghai ZhaXin Hospital
Shanghai, China
RECRUITINGrelapse-free survival
event defined as relapse or death of any causes
Time frame: 12 months
overall survival
event defined as death of all causes
Time frame: 12 months
non-relapse mortality
event defined as death of all causes other than leukemia relapse
Time frame: 12 months
relapse
event defined as leukemia relapse
Time frame: 12 months
GVHD and relapse free survival (GRFS)
event defined as leukemia relapse, death of any causes, III-IV aGVHD or moderate to severe cGVHD
Time frame: 12 months
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