Clinical Study of TBF Regimen in Allo-HSCT in Patients With CNS Leukemia
Study Details
Study Description
Brief Summary
Central nervous system (CNS) leukemia is a poor prognostic factor for allogeneic hematopoietic stem cell transplantation (allo-HSCT). Thiotepa can penetrate the blood-brain barrier and has immunosuppressive effects and similar effects to irradiation in allo-HSCT. This project aims to investigate whether the TBF regimen is superior to the traditional modified BuCY2 regimen to improve the long-term survival of the CNS leukemia patients.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
Central nervous system (CNS) leukemia is a common extramedullary leukemia and a poor prognostic factor for allogeneic hematopoietic stem cell transplantation (allo-HSCT). There is a blood-brain barrier (BBB) in the CNS. The treatment effect of CNS leukemia is seriously limited by the low penetration of conventional chemotherapy drugs into cerebrospinal fluid. Thiotepa can penetrate the BBB and has immunosuppressive effect and myeloablative effect similar to irradiation in transplantation. Therefore, it is speculated that cestipide has certain advantages as a conditioning regimen in transplantation for CNS leukemia. This project aims to investigate whether the TBF regimen is superior to the traditional modified BuCY2 regimen to improve the long-term survival of the CNS leukemia patients.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: TBF group The subjects receive TBF conditioning regimen. |
Drug: TBF regimen
The subjects receive TBF conditioning regimen (Thiotepa, Busulfan, Fludarabine) before allo-HSCT.
Other Names:
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| Active Comparator: Modified BuCY2 group The subjects receive modified BuCY2 conditioning regimen. |
Drug: modified BuCY2 regimen
The subjects receive modified BuCY2 conditioning regimen (Busulfan, Cytarabine, ATG, Cyclophosphamide, CCNU) before allo-HSCT.
Other Names:
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Outcome Measures
Primary Outcome Measures
- Recurrence rate of central nervous system (CNS) leukemia [From date of the treatment with the conditioning regimen until CNS leukemia relapse, the end of follow-up or the date of death from any cause, whichever came first, assessed up to 36 months.]
The proportion of patients with recurrent central nervous system leukemia in the total enrolled population
Secondary Outcome Measures
- Hematopoietic implantation rate [From date of the treatment with the conditioning regimen until hematopoietic implantation, assessed up to 100 days..]
Hematopoiesis was achieved within 100 days after allo-HSCT
- NRM [From date of allo-HSCT until the date of death from any cause or the end of follow-up, whichever came first, assessed up to 36 months.]
non-recurrence mortality
- OS [From date of the treatment with the conditioning regimen until the end of follow-up or the date of death from any cause, whichever came first, assessed up to 36 months.]
overall survival
- PFS [From date of the treatment with the conditioning regimen until leukemia progression, the end of follow-up or the date of death from any cause, whichever came first, assessed up to 36 months.]
progression-free survival
- AEs [From date of the treatment with the conditioning regimen until the occurrence of adverse effects, the end of follow-up or the date of death from any cause, whichever came first, assessed up to 36 months.]
adverse effects
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients diagnosed with central nervous system leukemia by MICM meet one of the following conditions: corresponding symptoms and signs of central nervous system involvement; cerebrospinal fluid pressure increased by 200 mm water column; the white blood cell count in cerebrospinal fluid was 0.01×10^9/L; cerebrospinal fluid protein qualitative test was positive or protein quantification was 45 mg/dL; leukemic cells can be found in the cerebrospinal fluid; cranial imaging suggested central involvement.
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Aged 14-60 years, male or female.
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KPS score: ≥80.
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Signed the informed consent.
Exclusion Criteria:
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Patients intending to receive autologous hematopoietic stem cell transplantation.
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Patients with transplantation contraindications.
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Those who refuse to sign the informed consent form.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | First Affiliated Hospital of Xi'an Jiaotong University | Xi'an | Shaanxi | China | 710061 |
Sponsors and Collaborators
- First Affiliated Hospital Xi'an Jiaotong University
Investigators
- Principal Investigator: Pengcheng He, MD, First Affiliated Hospital of Xian Jiaotong University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- XJTU1AF2022LSK-307