Autologous Peripheral Blood Stem Cell Transplantation (PSCT) Versus a Second Intensive Consolidation Course After a Common Induction and Consolidation Course in Patients With Bad Prognosis Myelodysplastic Syndromes (MDS) and Acute Myelogenous Leukemia Secondary (SAML) to MDS of More Acute Than 6 Months Duration
cytarabine
+ etoposide
+ idarubicin
Anémie+14
+ Maladies de la moelle osseuse
+ Maladie chronique
Étude thérapeutique
Résumé
Date de début de l'étude : 1 décembre 1996
Date à laquelle le premier participant a commencé l'étude.OBJECTIVES: Assess the value of autologous peripheral stem cell transplantation versus high dose cytarabine (Ara-C) performed after a common induction and consolidation course in patients with poor prognosis myelodysplastic syndromes (MDS) or acute myelogenous leukemia secondary to MDS. Compare the disease free survival and overall survival of patients who reached complete recovery according to the presence of an HLA-identical donor. Monitor cytogenetic and clonal remission after intensive antileukemic therapy including stem cell transplantation. Monitor residual disease and the hematopoietic clonal status of autologous peripheral blood stem cells mobilized after one consolidation course. Assess recovery time of granulocyte and platelet counts following each treatment step. OUTLINE: Induction treatment with idarubicin on days 1,3,5; Ara-C from days 1 through 10; etoposide on days 1 through 5. On day 28 there will be assessment of responses. If there is at least partial response, the cycle will repeat the induction course for another 28 days. There is peripheral blood stem cell collection and cryopreservation following family HLA-typing. If there is no HLA match, then those who remained in remission after these consolidation courses will be randomized to either peripheral blood stem cell transplantation or HiDAC treatment. PROJECTED ACCRUAL: 80 patients will be entered per year.
Protocole
Cette section fournit des détails sur le plan de l'étude, y compris la manière dont l'étude est conçue et ce qu'elle évalue.80 participants à inclure
Nombre total de participants que l'essai clinique vise à recruter.Traitement
Éligibilité
Les chercheurs recherchent des patients correspondant à une certaine description appelée critères d'éligibilité : état de santé général ou traitements antérieurs du patient.Tout sexe
Le sexe biologique des participants éligibles à s'inscrire.De 16 à 60 ans
Tranche d'âge des participants éligibles à participer.Volontaires sains non autorisés
Indique si les individus en bonne santé et ne présentant pas la condition étudiée peuvent participer.Conditions
Pathologie
Critères
DISEASE CHARACTERISTICS: Pathological confirmation of one of the following: Untreated refractory anemia with excess blasts (RAEB) in transformation RAEB with greater than 10% blasts cells in the bone marrow Other myelodysplastic syndromes Profound cytopenias Acute myelogenous leukemia (AML) supervening after overt myelodysplastic syndromes (MDS) of more than 6 months duration No blast crisis of chronic myeloid leukemia No leukemias supervening after other myeloproliferative disease No leukemias supervening after overt MDS of less than 6 months duration The following are allowed: Secondary acute leukemias following Hodgkin's disease or other malignancies Secondary leukemias following exposure to alkylating agents or radiation PATIENT CHARACTERISTICS: Age: 16-60 Performance status: WHO 0-2 Hematopoietic: If RAEB, blasts cells of greater than 10% in bone marrow Neutrophil count less than 5,000 or Platelet count less than 200,000 Chronic myelomonocytic leukemia (CMML) with greater than 5% blasts cells in bone marrow, or CMML with neutrophil count greater than 160,000 or monocyte count greater than 2,600 Hepatic: Bilirubin no greater than 1.5 times normal Renal: Creatinine no greater than 1.5 times normal Cardiovascular: No patients with severe heart failure requiring diuretics or an ejection fraction of less than 50% Neurological: No severe concomitant neurological disease PRIOR CONCURRENT THERAPY: Biologic therapy: No treatments within the past 4 weeks of: Biological response modifiers AND/OR Low dose Ara-C Chemotherapy: No prior intensive treatment for MDS or AML Endocrine therapy: Not specified Radiotherapy: No prior treatment for MDS or AML Surgery: Not specified
Centres d'étude
Ce sont les hôpitaux, cliniques ou centres de recherche où l'essai est conduit. Vous pouvez trouver le site le plus proche de vous ainsi que son statut.Cette étude comporte 40 sites
Algemeen Ziekenhuis Middelheim
Antwerp, BelgiumOuvrir Algemeen Ziekenhuis Middelheim dans Google MapsA.Z. St. Jan
Bruges, BelgiumInstitut Jules Bordet
Brussels, BelgiumHopital Universitaire Erasme
Brussels, Belgium