Extended Dose - Total Body Irradiation Followed By Allogeneic Stem Cell Transplantation For The Treatment Of Refractory Acute Leukemia And Advanced Myelodysplastic Syndrome
Acute myeloid leukemia (AML) is a rapidly fatal malignancy of the bone marrow. It can be
treated with chemotherapy alone, in some cases, but in the majority of cases, the only
treatment that can cure the disease is an allogeneic stem cell transplant, with a cure rate
of 30-40%. In another subset, the disease is less responsive to chemotherapy and in these
aggressive forms, its cure rate is no better than 20% beyond 2 years, and is usually rapidly
fatal within 6 months.
Therefore, for this most aggressive form of the disease, modifications to the transplant
protocol are required in order to try to improve on these poor results. There are a number
of areas within the transplant protocol on which modifications can be made in order to
achieve these goals. These include: higher doses of chemotherapy and or radiation;
alterations of the new bone marrow graft; and alterations of the immune suppression,
enhancing the graft vs. leukemia effect. By focusing on one or more of these components, one
might be able to enhance the anti-leukemic aspect of the treatment resulting in a more
One aspect the investigators, in Ottawa, have focused on is the initial intensive
conditioning regimen, specifically the radiation component. It is the investigators belief
that in the most resistant disease it is important to use the highest tolerable
anti-leukemic treatment upfront, specifically, enhancing the radiation component of the
initial conditioning regimen. Previous studies have suggested that higher doses of radiation
might be more effective at eliminating the disease, however, toxicity and logistics of
delivering the radiation have limited its use. Technical advances in the delivery of
radiation have now permitted the safer use of high doses of radiation.
Through modifications to the transplant procedure, the investigators believe that they can
deliver higher doses of radiation safely and this will translate into improved outcomes in
this high-risk subgroup of patients with AML.
The goal of this study is to determine if a total dose of 18Gy ED-TBI followed by an
alloHSCT for patients with refractory AML will result in an improved progression-free
View this trial on ClinicalTrials.gov
Print this page and take it to your doctor to discuss your eligibilty and treatment options. Only your doctor can refer you to a clinical trial.
These resources are provided in partnership with the
Canadian Cancer Society