Status:
TERMINATED
SALT: Alternative Donor Bone Marrow and Cord Blood Transplantation for High Risk Sickle Cell Disease
Lead Sponsor:
Emory University
Conditions:
Sickle Cell Disease
Eligibility:
All Genders
Up to 16 years
Phase:
EARLY_PHASE1
Brief Summary
We hope to gain valuable information about the safety, success of engraftment, and rates of complications using alternate donor transplantation for children with severe SCD. Crucial information will b...
Detailed Description
Unfortunately, less than 1/4th of patients with severe SCD will have a matched sibling donor that can serve as a BMT donor. This research protocol proposes to study the safety and usefulness of "alter...
Eligibility Criteria
Inclusion
- Hemoglobin SS, hemoglobin SC, or hemoglobin S0 thalassemia
- Donor available: Partially (5/6) HLA-matched relative (PMRD), matched (6/6) unrelated marrow donor or umbilical cord (5/6 or 6/6) of appropriate size (see 6.3.2) , using high-resolution HLA typing. Donor must not be homozygous for HgbS and must meet standard donor eligibility criteria of the Blood and Marrow Transplant Program.
- Severe SCD, defined by one of the following (modified Walters criteria):
- oPrevious (6 months prior) central nervous system event lasting longer than 24 hours, plus objective imaging evidence of CNS vasculopathy, with or without residual neurologic findings oFrequent (3 per year for 2 years) painful vaso-occlusive episodes (defined as episode lasting 4 hours and requiring hospitalization or outpatient treatment with parenteral narcotics) oRecurrent (3 in lifetime) acute chest syndrome events which have necessitated exchange transfusion or chronic transfusion therapy. Must have failed a good-faith trial of hydroxyurea (failure defined as a reduction of less than 50% in the incidence of vaso-occlusive events over a period of at least 18 months) or have demonstrated an inability to take the drug due to side effects.
- oAny combination of 3 acute chest syndrome episodes and vaso-occlusive pain episodes (defined as above) yearly for 3 years. Must have failed a good-faith trial of hydroxyurea (failure defined as a reduction of less than 50% in the incidence of vaso-occlusive events over a period of at least 18 months) or have demonstrated an inability to take the drug due to side effects.
- oStage I or II sickle lung disease oRed-cell alloimmunization (2 antibodies) on chronic transfusion therapy
Exclusion
- oSuitable HLA-identical relative donor is available oBiopsy proven chronic active hepatitis, portal fibrosis, or cirrhosis, or serologic evidence of active hepatitis.
- oSCD chronic lung disease stage III (see Appendix) oSevere renal dysfunction defined as \<50% of predicted normal GFR for age. oSevere cardiac dysfunction defined as shortening fraction \< 25%. oSevere residual neurologic impairment other than hemiplegia alone, defined as full-scale IQ 70, quadriplegia or paraplegia, inability to ambulate, inability to communicate without assistive device, or any impairment resulting in decline of Lansky performance score to \<70%.
- oCNS event occurring within 6 months prior to transplant oKarnofsky or Lansky functional performance score \< 70% (see Appendix) oConfirmed HIV seropositivity. oPatient with unspecified chronic toxicity serious enough to detrimentally affect the patient's capacity to tolerate bone marrow transplantation.
- oPatient or patient's guardian(s) unable to understand the nature and risks inherent in the BMT process.
- oHistory of lack of compliance with medical care that would jeopardize transplant course.
Key Trial Info
Start Date :
January 1 2006
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
August 1 2012
Estimated Enrollment :
3 Patients enrolled
Trial Details
Trial ID
NCT00257543
Start Date
January 1 2006
End Date
August 1 2012
Last Update
September 17 2013
Active Locations (1)
Enter a location and click search to find clinical trials sorted by distance.
1
Children's Healthcare of Altanta
Atlanta, Georgia, United States, 30322