Leukemia Clinical Trial
Official title:
Treatment Protocol: Umbilical Cord Blood (UCB) Transplantation in Pediatric Patients With High Risk Leukemia and Myelodysplasia Using Conditioning Regimen Without Radiation
Unrelated Cord Blood (UCB) transplant in children is a viable stem cell transplant modality for patients with leukemia and myelodysplasia. UCB is now considered "Standard Of Care" in cases where a suitable living bone marrow donor is not available. The survival of UCB is similar to Matched Unrelated Marrow Transplant. This study is considered "Research" since UCB is not a licensed product and requires investigational new drug (IND). THERE ARE NO SPECIFIC RESEARCH QUESTIONS IN THIS PROTOCOL. This protocol merely provides UCB as a stem cell treatment modality to pediatric patients who may require it after a conditioning regimen that excludes Total Body Irradiation.
The preparative regimen will consist of:
- Fludarabine: 25 mg/m2/day IV x 5 doses on Days -13, to -9
- Busulfan 1mg/kg IV every 6 hrs x 16 doses on Days -8 to -5
- Melphalan 45 mg/m2/day IV x 3 doses on days -4 to -2
- ATGAM 30mg/kg/day x 3 doses on Days -3 to -1
- Day 0 will be the day of the UCB Transplant
- The graft-versus-host-disease (GVHD) prophylaxis will be Cyclosporin A to maintain
level 200-400 beginning on Day -3, through 200-400. Solumedrol at 1mg/kg/day on Day 1
until D+4, then solumedrol 2mg/kg/day until Day +19 or till absolute neutrophil count
(ANC) reaches 500/mm2, then taper by 0.2 mg/kg/week.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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