Reduced Intensity Double Umbilical Cord Blood Transplantation

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01408563
Recruitment Status : Completed
First Posted : August 3, 2011
Last Update Posted : October 2, 2017
Information provided by (Responsible Party):
Zachariah Michael DeFilipp, Massachusetts General Hospital

August 2, 2011
August 3, 2011
October 2, 2017
December 2011
June 2017   (Final data collection date for primary outcome measure)
One year significant viral infection rate [ Time Frame: 2.5 years ]
To determine the one year significant viral infection rate (viral infections requiring medical intervention) after double umbilical cord blood transplant using a novel conditioning regimen of fludarabine/melphalan/low dose total body radiation
Same as current
Complete list of historical versions of study NCT01408563 on Archive Site
  • Time to neutrophil and platelet engraftment [ Time Frame: 2.5 years ]
  • Rate of primary graft failure [ Time Frame: 2.5 years ]
  • Rates of Grade II-IV and Grade III-IV acute GVHD at 100 days [ Time Frame: 2.5 years ]
  • The rate of chronic GVHD [ Time Frame: 2.5 years ]
  • 100-day treatment related mortality [ Time Frame: 2.5 years ]
  • Immune reconstitution - CD4 count at 12 months [ Time Frame: 2.5 years ]
  • Relapse-free and overall survival at 1 and 2 years from transplantation [ Time Frame: 2.5 years ]
  • Relapse rate [ Time Frame: 2.5 years ]
  • Rate of post-transplant lymphoma [ Time Frame: 2.5 years ]
  • Thrombopoietin levels after transplant [ Time Frame: 2.5 years ]
    Optional correlate
Same as current
Not Provided
Not Provided
Reduced Intensity Double Umbilical Cord Blood Transplantation
A Phase II Study of Reduced Intensity Double Umbilical Cord Blood Transplantation Using Fludarabine, Melphalan, and Low Dose Total Body Radiation

This trial will use two cord blood units for transplantation using a reduced intensity regimen rather than using intense doses of chemotherapy and radiation therapy. Two cord blood units (double cord blood) are being used, as the numbers of blood cells in one unit are too few to allow successful growth of these cells.

Because the risk of infection, particularly virus infection, is high after double cord blood transplant, this study seeks to reduce the rise of virus infection by using a reduced intensity regimen without a medicine called antithymocyte globulin (ATG), as used in prior cord blood transplants. Subjects will receive two chemotherapy drugs, melphalan and fludarabine, and low dose of total body radiation (one treatment) instead of the ATG. The number of patients with virus infections in this study will be compared to our prior experience using the ATG.

Subjects will receive their transplants as in-patients.

  • IV-Catheter

    • one or two IV catheters will be placed on the day of hospital admission
  • Conditioning

    • Fludarabine IV six days before transplant (days -7, -6, -5. -4, -3, -2)
    • Melphalan IV (day -1)
    • Total body radiation on day 0 (same day as transplant)
  • Immunosuppressive Therapy

    • Tacrolimus and sirolimus beginning day -3, daily for 6-9 months post-transplant. Given IV as in-patient, orally as out-patient
  • Infusion of Cord Blood units

    • 2 cord blood units IV on Day 0 Routine post-transplant supportive care will be provided
Phase 2
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
  • Non-Hodgkin's Lymphoma
  • Hodgkin's Lymphoma
  • Multiple Myeloma
  • Chronic Lymphocytic Leukemia
  • Acute Myelogenous Leukemia
  • Drug: Fludarabine
    30 mg/m2/day IV x 6 days
    Other Name: Fludara
  • Drug: Melphalan
    100 mg/m2/day IV x 1 day
  • Radiation: Total Body Radiation
    200 cGy on Day 0
  • Biological: Cord Blood
    2 cord blood units IV
Experimental: Fludarabine/Melphalan/TBI
All patients receive same therapy
  • Drug: Fludarabine
  • Drug: Melphalan
  • Radiation: Total Body Radiation
  • Biological: Cord Blood
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
Same as current
June 2017
June 2017   (Final data collection date for primary outcome measure)

Inclusion Criteria:

  • Hematologic malignancy for whom allogeneic stem cell transplantation is deemed clinically appropriate
  • Appropriate candidate for reduced intensity regimen, according to the treating physician
  • Lack of 6/6/ or 5/6 HLA-matched related, 8/8/ HLA-matched unrelated donor, or unrelated donor not available with a time frame necessary to perform a potentially curative stem cell transplant
  • Able to comply with the requirements for care after allogeneic stem cell transplantation

Exclusion Criteria:

  • Cardiac disease: symptomatic congestive heart failure or evidence of left ventricular dysfunction
  • Pulmonary disease: symptomatic chronic obstructive lung disease, symptomatic restrictive lung disease
  • Renal disease
  • Hepatic disease
  • Neurologic disease: symptomatic leukoencephalopathy, active CNS malignancy or other neuropsychiatric abnormalities believed to preclude transplantation
  • HIV-positive
  • Uncontrolled infection
  • Pregnant or breast-feeding
Sexes Eligible for Study: All
18 Years to 70 Years   (Adult, Older Adult)
Contact information is only displayed when the study is recruiting subjects
United States
Not Provided
Not Provided
Zachariah Michael DeFilipp, Massachusetts General Hospital
Massachusetts General Hospital
Not Provided
Principal Investigator: Zachariah DeFilipp, MD Massachusetts General Hospital
Massachusetts General Hospital
September 2017

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