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Stem Cell Transplant for Inborn Errors of Metabolism
This study is ongoing, but not recruiting participants.
Study NCT00176904   Information provided by Masonic Cancer Center, University of Minnesota
First Received: September 12, 2005   Last Updated: September 16, 2009   History of Changes

September 12, 2005
September 16, 2009
January 1995
June 2010   (final data collection date for primary outcome measure)
Overall outcome - Compare patients treated by bone marrow, peripheral blood, or umbilical cord blood transplantation after March of 2001 with historical controls with bone marrow transplant (BMT) for these patients over the last 5 years. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
We will evaluate whether patients treated by bone marrow, peripheral blood, or umbilical cord blood transplantation after March of 2001 have equivalent or better outcome than historical controls with BMT for these patients over the last 5 years.
Complete list of historical versions of study NCT00176904 on ClinicalTrials.gov Archive Site
  • Survival [ Time Frame: at 100 days, 1 year and 3 years ] [ Designated as safety issue: No ]
  • Change in neuropsychometric function. [ Time Frame: at 6 months, 1 year, 2 years and 3 years ] [ Designated as safety issue: No ]
  • Toxicity of hematopoietic cell transplant therapy [ Time Frame: Day 100, 6 months, 1 year, 2 years, 3 years ] [ Designated as safety issue: Yes ]
  • estimate the rate of hematological donor cell engraftment. [ Time Frame: through 6 months, 1 year, 2 years and 3 years ] [ Designated as safety issue: No ]
  • estimate the incidence of graft-versus-host disease (GVHD). [ Time Frame: Through 3 years post BMT ] [ Designated as safety issue: No ]
  • primary pharmacokinetic parameters investigated will be AUC and Cpmin of total and free MPA [ Time Frame: 0, 1, 2, 4, 6 and 8 Hours post-dose ] [ Designated as safety issue: No ]
  • estimate survival at 100 days, 1 year and 3 years.
  • estimate change in neuropsychometric function at 6 months, 1 year, 2 years and 3 years.
  • estimate the toxicity of hematopoietic cell transplant therapy:
  • estimate the rate of hematological donor cell engraftment.
  • estimate the incidence of graft-versus-host disease (GVHD).
 
Stem Cell Transplant for Inborn Errors of Metabolism
Treatment of Lysosomal and Peroxisomal Inborn Errors of Metabolism by Bone Marrow Transplantation

The purpose of this study is to determine the safety and engraftment of donor hematopoietic cells using this conditioning regimen in patients undergoing a hematopoietic (blood forming) cell transplant for an inherited metabolic storage disease.

Prior to transplantation, subjects will receive Busulfan intravenously (IV) via the Hickman line four times daily for 4 days, Cyclophosphamide intravenously via the Hickman line once a day for 4 days, and Anti-Thymocyte Globulin IV via the Hickman line twice daily for three days before the transplant. These three drugs are being given to subjects to help the new marrow "take" and grow.

On the day of transplantation, the donor's hematopoietic cells will be transfused via central venous catheter.

After hematopoietic cell transplant, subjects will then receive two drugs, cyclosporin and either methylprednisolone or Mycophenolate Mofetil (MMF). Cyclosporin and methylprednisolone or MMF are given to help prevent the complication of graft-versus-host disease and to decrease the chance that the new donor cells will be rejected.

Phase II, Phase III
Interventional
Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Efficacy Study
  • Adrenoleukodystrophy
  • Metachromatic Leukodystrophy
  • Globoid Cell Leukodystrophy
  • Gaucher's Disease
  • Fucosidosis
  • Wolman Disease
  • Niemann-Pick Disease
  • Batten Disease
  • GM1 Gangliosidosis
  • Tay Sachs Disease
  • Sandhoff Disease
  • Procedure: Stem Cell Transplant
  • Drug: Busulfan, Cyclophosphamide, ATG
Experimental: All patients treated with protocol regimen (chemotherapy and surgery).
 

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Active, not recruiting
134
June 2010
June 2010   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Patients with adrenoleukodystrophy, metachromatic leukodystrophy, globoid cell leukodystrophy, Gaucher's disease, Fucosidosis, Wolman disease, Niemann-Pick disease and Batten disease (CLN3) who have a human leukocyte antigen (HLA)-identical or haplotype mismatched (at 1-3 antigens) related marrow, or umbilical cord blood donor. One or two umbilical cord blood (UCB) units may be used.
  • Patients with GM1 gangliosidosis, Tay Sachs disease or Sandhoff disease who have a HLA-identical or 1 antigen mismatched related or unrelated donor, or suitably matched umbilical cord blood unit(s). One or two UCB units may be used.
  • Patients with adrenoleukodystrophy must have magnetic resonance imaging (MRI) findings, neurological and neuropsychometric function consistent with the diagnosis, and for boys with parietal-occipital dysmyelination a performance intelligence quotient (IQ) ≥80. In cases, when the performance IQ is not ≥80, the protocol committee may recommend transplant if the patient's clinical condition and neuropsychometric status are deemed to be acceptable based upon consideration of such factors as age at onset of cerebral disease, magnitude of change in performance IQ and neurologic deficits.
  • Patients with arylsulfatase A deficiency (Metachromatic Leukodystrophy) must have either the presymptomatic late infantile, juvenile or adult form of the disease and must have acceptable neurological and neuropsychometric function.
  • Patients with galactocerebrosidase deficiency (Globoid Cell Leukodystrophy) must have acceptable neurological and neuropsychometric function.
  • Patients with acid lipase deficiency (Wolman disease) must have a liver biopsy that documents no evidence of hepatic cirrhosis, and acceptable neurological and neuropsychometric function.
  • Patients with fucosidase deficiency (Fucosidosis) must have acceptable neurological and neuropsychometric function.
  • Patients with glucocerebrosidase deficiency (Gaucher's Disease) must have acceptable neurologic and neuropsychometric function.
  • Patients with Batten's disease (CLN3) must have acceptable Neurological and neuropsychometric function.
  • Absence of major organ dysfunction. Organ evaluation results as follows:
  • Cardiac: ejection fraction >30%
  • Renal: serum creatinine <2x normal or creatinine clearance 60 mL/min.
  • Hepatic: total bilirubin <2x normal and Aspartate aminotransferase (AST) <2x normal
  • Signed consent.

Exclusion Criteria:

  • Patients with symptomatic late infantile form of metachromatic leukodystrophy.
  • Patients with symptomatic infantile globoid leukodystrophy.
  • Note: Patients with Hurler syndrome, mucopolysaccharidosis (MPS) VI, or Mannosidosis disease are no longer eligible for this protocol, but can be transplanted under protocol MT 9907 (NCT00176917 - Hematopoietic Cell Transplantation for Hurler Syndrome, Maroteaux Lamy Syndrome (MPS VI), and Alpha Mannosidase Deficiency (Mannosidosis)).
  • Pregnancy
  • Evidence of human immunodeficiency virus (HIV) infection or known HIV positive serology
  • Patients or parents are psychologically incapable of undergoing bone marrow transplant (BMT) with associated strict isolation or documented history of medical non-compliance.
  • Patients ≥ 50 kg may be at risk for having cell doses below the goal of ≥ 10 x 106 CD34 cells/kg and therefore will not be eligible to receive unrelated peripheral blood stem cells (PBSCs)
Both
 
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00176904
Orchard, Paul J., MD, Masonic Cancer Center, University of Minnesota
9412M09107, MT1995-01
Masonic Cancer Center, University of Minnesota
 
Principal Investigator: Paul Orchard, MD Masonic Cancer Center, University of Minnesota
Masonic Cancer Center, University of Minnesota
September 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP