Hyperbaric Oxygen Therapy and Allogeneic Peripheral Blood Stem Cell (PBSC) Transplant
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ClinicalTrials.gov Identifier: NCT03964506 |
Recruitment Status :
Recruiting
First Posted : May 28, 2019
Last Update Posted : May 2, 2024
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Condition or disease | Intervention/treatment | Phase |
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Acute Myeloid Leukemia Myelodysplastic Syndromes Chronic Myelomonocytic Leukemia Atypical Chronic Myeloid Leukemia Chronic Monocytic Leukemia Myelofibrosis Myelodysplastic/Myeloproliferative Neoplasm | Drug: Hyperbaric oxygen | Early Phase 1 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 24 participants |
Allocation: | N/A |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Pilot Study to Determine the Safety and Efficacy of Incorporating Hyperbaric Oxygen Therapy Into RIC Fludarabine and Melphalan and Allogeneic Hematopoietic Stem/Progenitor Transplantation |
Actual Study Start Date : | July 1, 2020 |
Estimated Primary Completion Date : | March 1, 2025 |
Estimated Study Completion Date : | March 1, 2025 |
Arm | Intervention/treatment |
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Experimental: Cohort 1- AML or MDS
Patients with will receive HBO therapy one time on day 0 of the transplant. The treatment consists of exposure to hyperbaric oxygen at 2.5 atmospheric absolutes (ATA) for a total of 90 minutes after compression to 2.5 atmosphere absolutes (ATA) in a monoplace hyperbaric chamber (Model 3200/3200R, Sechrist Industries, Inc., USA), breathing 100% oxygen. The subjects will be in the chamber for a total of 120 minutes as approximately 10-15 minutes were spent during the compression and decompression phases and subjects had 10 minute room air breaks every 30 minutes of hyperbaric oxygen treatment.
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Drug: Hyperbaric oxygen
Reduced intensity conditioning Fludarabine and Melphalan with Hyperbaric Oxygen and Allogeneic Hematopoietic Stem Cell Transplant
Other Name: HBO |
Experimental: Cohort 2- CMML, aCML, CML, CNL, MDS/MPN
Patients with will receive HBO therapy one time on day 0 of the transplant. The treatment consists of exposure to hyperbaric oxygen at 2.5 atmospheric absolutes (ATA) for a total of 90 minutes after compression to 2.5 atmosphere absolutes (ATA) in a monoplace hyperbaric chamber (Model 3200/3200R, Sechrist Industries, Inc., USA), breathing 100% oxygen. The subjects will be in the chamber for a total of 120 minutes as approximately 10-15 minutes were spent during the compression and decompression phases and subjects had 10 minute room air breaks every 30 minutes of hyperbaric oxygen treatment.
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Drug: Hyperbaric oxygen
Reduced intensity conditioning Fludarabine and Melphalan with Hyperbaric Oxygen and Allogeneic Hematopoietic Stem Cell Transplant
Other Name: HBO |
- Immediate safety of hyperbaric oxygen therapy prior to allogeneic stem cell transplantation in Cohort 1 [ Time Frame: 24 hours ]Treatment-limiting toxicities will be assessed 24-hours post-hyperbaric oxygen therapy.
- Immediate safety of hyperbaric oxygen therapy prior to allogeneic stem cell transplantation in cohort 2 [ Time Frame: 24 hours ]Treatment-limiting toxicities will be assessed 24-hours post-hyperbaric oxygen therapy.
- Long term safety of hyperbaric oxygen therapy prior to allogeneic stem cell transplant in Cohort 1 [ Time Frame: 100 days ]Possible long-term effects of hyperbaric oxygen therapy treatment prior to allogeneic peripheral blood stem cell transplant will be assessed at day +100 post-transplant
- Long term safety of hyperbaric oxygen therapy prior to allogeneic stem cell transplant in Cohort 2 [ Time Frame: 100 days ]Possible long-term effects of hyperbaric oxygen therapy treatment prior to allogeneic peripheral blood stem cell transplant will be assessed at day +100 post-transplant
- Time to neutrophil recovery in Cohort 1 [ Time Frame: 100 days ]based on the patient having achieved three consecutive days of Absolute Neutrophile Count (ANC) ≥ 500/microliter
- Time to neutrophil recovery in Cohort 2 [ Time Frame: 100 days ]based on the patient having achieved three consecutive days of Absolute Neutrophile Count (ANC) ≥ 500/microliter
- Time to complete donor chimerism in Cohort 1 [ Time Frame: 100 days ]Bone marrow chimerism will be checked on day +30 and day +100 Bone Marrow (BM) samples according to our standard of care
- Time to complete donor chimerism in Cohort 2 [ Time Frame: 100 days ]Bone marrow chimerism will be checked on day +30 and day +100 Bone Marrow (BM) samples according to our standard of care
- Incidence of mucositis in Cohort 1 [ Time Frame: 100 days ]
- Incidence of graft versus host disease in Cohort 1 [ Time Frame: 100 days ]
- Incidence of infection in Cohort 1 [ Time Frame: 100 days ]
- Incidence of mucositis in Cohort 2 [ Time Frame: 100 days ]
- Incidence of infection in Cohort 2 [ Time Frame: 100 days ]
- Incidence of graft versus host disease in Cohort 2 [ Time Frame: 100 days ]
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years to 75 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Voluntary written informed consent
- Men or women, age ≥ 18 years of age, with upper limit of 75 years old.
- Subjects with acute myeloid leukemia (AML) or Myelodysplastic Syndrome (MDS) for cohort 1.
- Subjects with chronic myelomonocytic leukemia (CMML), atypical chronic myeloid leukemia (aCML), CML, chronic neutrophilic leukemia (CNL), myelofibrosis, and myelodysplastic/myeloproliferative (MDS/MPN) overlap syndrome for cohort 2.
- Karnofsky performance status (KPS) of ≥ 70%
- Patients should have New York Heart Association (NYHA) Functional Classification, Class I (ordinary physical activity does not cause undue fatigue, palpitation, dyspnea, or anginal pain) or Class II (ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain).
- Adequate hepatic, renal, cardiac and pulmonary function to be eligible for transplant. Minimum criteria include: Hepatic: ALT, AST < 4x IULN and serum total bilirubin ≤ 2.0 mg/dL; Renal: serum creatinine: ≤ 2.0 mg/dL; Left ventricular ejection fraction ≥ 45% measured by 2D-ECHO or MUGA scan; EKG with no clinically significant arrhythmia; FEV1, FVC and DLCO ≥ 50% of predicted value (corrected to serum hemoglobin)
- Women of child-bearing potential and men with partners of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 30 days following completion of therapy. Should a woman or partner become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician and the investigator immediately.
- A woman of child-bearing potential is any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: Has not undergone a hysterectomy or bilateral oophorectomy; or Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)
- Women of child-bearing potential should have a negative urine or serum pregnancy test within 4 weeks of starting preparative regimen
Exclusion Criteria:
- Pregnant or breastfeeding
- Severe chronic obstructive pulmonary disease requiring oxygen supplementation
- History of spontaneous pneumothorax, prior chest surgery requiring thoracotomy or direct chest irradiation to the lungs
- Evidence of pneumothorax or significant pulmonary fibrosis on chest imaging within 60 days of transplant.
- Active malignancy excluding AML, MDS, CMML, aCML CML, CNL, MF and MDS/MPN overlap syndrome.
- Active ear/sinus infection. Patients with chronic sinusitis or sinus headaches are excluded unless cleared by ear, nose, and throat specialist.
- Recent sinus surgery (within the last 5 years).
- Ear surgery excluding myringotomy or ear tubes
- Subjects must agree to refrain from active tobacco or e-cigarette use 72 hours prior to transplant until complete transplant recovery. Nicotine replacement therapy is allowed.
- Claustrophobia
- History of recurrent seizures within 5 years of study enrollment.
- Uncontrolled asthma
- Uncontrolled viral or bacterial infection at the time of study enrollment
- Active or recent (prior 6 months) invasive fungal infection without interdisciplinary (ID) consult and approval
- Patients who had intrathecal chemotherapy within 2 weeks of starting preparative regimen or cranial irradiation within 4 weeks of starting preparative regimen
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03964506
Contact: Regulatory Coordinator | (585) 276-7078 | Lisa_Metzger@URMC.Rochester.edu |
United States, New York | |
Wilmot Cancer Institute, University of Rochester | Recruiting |
Rochester, New York, United States, 14642 | |
Contact: Omar Aljitawi | |
Contact: Lisa Metzger |
Principal Investigator: | Omar S Aljitawi, MBBS | University of Rochester |
Responsible Party: | Omar Aljitawi, Associate Professor of Hematology/Oncology, University of Rochester |
ClinicalTrials.gov Identifier: | NCT03964506 |
Other Study ID Numbers: |
UBMT-19163 |
First Posted: | May 28, 2019 Key Record Dates |
Last Update Posted: | May 2, 2024 |
Last Verified: | May 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Yes |
Plan Description: | All individual participant data collected during the trial will be shared after deidentification, including dictionaries. |
Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Informed Consent Form (ICF) Clinical Study Report (CSR) Analytic Code |
Time Frame: | Data will be available immediately following publication. No end date. |
Access Criteria: | Anyone who wishes to access the data for any type of analyses. |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Allogeneic transplant Hyperbaric Oxygen |
Leukemia Leukemia, Myeloid Leukemia, Myelogenous, Chronic, BCR-ABL Positive Leukemia, Myelomonocytic, Chronic Leukemia, Myelomonocytic, Juvenile Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative Myelodysplastic Syndromes Myeloproliferative Disorders |
Myelodysplastic-Myeloproliferative Diseases Neoplasms by Histologic Type Neoplasms Hematologic Diseases Bone Marrow Diseases Chronic Disease Disease Attributes Pathologic Processes |