Chronic Myeloproliferative Disorders Clinical Trial
Official title:
Autologous Peripheral Blood Stem Cell Mobilization and Transplantation for Myelofibrosis
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining chemotherapy with peripheral stem cell
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 chemotherapy followed by peripheral
stem cell transplantation in treating patients who have myelofibrosis.
OBJECTIVES: I. Determine the ability of myeloablative chemotherapy followed by peripheral
blood stem cell (PBSC) transplantation to restore effective marrow hematopoieses in patients
with advanced idiopathic myelofibrosis or myelofibrosis secondary to other
myeloproliferative disorders. II. Determine the ability of this regimen to palliate symptoms
and prolong survival in these patients. III. Determine if there is evidence of clonal
hematopoieses before PBSC mobilization, in the PBSC product, and after transplantation in
these patients. IV. Correlate the properties of the peripheral blood before mobilization and
the PBSC product with engraftment in these patients. V. Correlate the markers of
angiogenesis with clinical parameters in these patients.
OUTLINE: Patients with evidence of leukemic progression receive cytoreduction therapy
consisting of idarubicin IV on days 1-3 and cytarabine IV continuously over days 1-7
followed by filgrastim (G-CSF) subcutaneously (SC) daily until blood counts recover and
leukapheresis is completed. Patients undergo leukapheresis beginning when blood counts
recover and continuing until the target number of cells are collected. Patients with no
evidence of leukemic progression receive filgrastim SC daily until leukapheresis is
completed. Patients undergo leukapheresis beginning on day 4 and continuing until the target
number of cells are collected. Patients receive myeloablative therapy consisting of oral
busulfan every six hours on days -5 to -2. Patients with leukemic progression begin
myeloablative therapy at least 28 days after completion of chemotherapy. Patients receive
autologous peripheral blood stem cells IV on day 0. Patients are followed at 1 month, 3
months, 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 10-44 patients will be accrued for this study within 2 years.
;
Primary Purpose: Treatment
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