Acute Myeloid Leukemia
Conditions
Keywords
Acute Myeloid Leukemia, Micro-transplantation, Elderly, Graft-versus-leukemia
Brief summary
This study aims at evaluating the safety and the tolerance of the micro-transplantation in elderly patients with acute myeloid leukemia who are ineligible to conventional allogeneic transplantation.
Detailed description
Acute Myeloid Leukemia (AML) is an aggressive hematological malignancy with a median age at diagnosis of 65 years. Outcomes of AML in elderly population remain unsatisfactory with low rates of complete remission, poor disease-free and overall survival. Therapeutic management of older patients with AML deals with patient-related features (i.e. comorbid conditions and performance status) as well as disease-related prognostic factors (i.e. cytogenetics and molecular genetics). Even if allogeneic hematopoietic-cell transplantation provides the strongest antineoplasic effect, this treatment option remains limited for older patients owing to toxicities, the development of significant graft-versus-host disease (GVHD) and logistics of donor availability. More recently, micro-transplantation has emerged as an alternative strategy based on the infusion of mobilized HLA-mismatched related donor cells after induction chemotherapy, thus exerting a graft-versus-leukemia effect without substantial donor engraftment and GVHD. Therefore, there is much of interest in investigating the efficacy and the safety of this method for older patients with AML who are not candidates for allogeneic stem cell transplantation.
Interventions
OTHERHLA-mismatched micro-transplantation after induction chemotherapy
HLA-mismatched micro-transplantation after induction chemotherapy
Sponsors
Institut de Cancérologie de la Loire
Centre Hospitalier Universitaire de Saint Etienne
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Patient affiliated to a social security regimen or beneficiary of the same * Signed written informed consent form * Patient, ≥ 60 years-old - \< 75 years-old, with established diagnosis of de novo or secondary AML with intermediate-risk or adverse-risk cytogenetic profile, or with established myelodysplasic syndromes (RAEB), in pathologically confirmed complete remission following anti-leukemic induction therapy (\<5% blasts) * Contra-indication to conditioning regimen in conventional allogeneic transplantation
Exclusion criteria
* Patient with established diagnosis of acute myeloid leukemia with standard-risk cytogenetic profile * Promyelocytic leukemia t(15;17) * CBF-AML t(8;21) or inv(16) * Normal karyotype with a favorable molecular profile: NPM1+ and FLT3-; NPM1+, FLT3- and double mutation CEBPα or chronic myeloid leukemia in blastic phase * Patient under guardianship or deprived of his liberty or any condition that may affect the patient's ability to understand and sign the informed consent * Refusing participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of overall survival | 2 years | Rate of overall survival will be reported. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of complete remission | 2 years | Rate of complete remission : |
| GVHD (graft versus host disease) | 2 years | Presence of graft versus host disease will be reported. |
| Hematopoietic recovery | 3 months | Number of platelets will be reported. |
| Median progression-free survival | 2 years | Median progression-free survival will be calculated. |
| Microchimerism | 3 months | Presence of microchimerism will be reported. |
| Median overall survival | 2 years | Median overall survival will be calculated. |
Countries
France
Contacts
Primary ContactJérôme Cornillon, MD
Backup ContactElisabeth Daguenet, PhD
Outcome results
None listed