About this trial
The study is a Phase II clinical trial. Patients will receive intensity-modulated total marrow irradiation (TMI) at a dose of 9 Gray (Gy) with standard myeloablative fludarabine intravenous (IV) and targeted busulfan (FluBu4) conditioning prior to allogeneic hematopoietic stem cell transplant (HSCT). Graft-versus-host disease (GVHD) prophylaxis will include Cyclophosphamide on Day +3 and +4, tacrolimus, and mycophenolate mofetil.
Eligibility criteria
Qualifiers
1. Age 18-65 years.
AML arising from MDS, a myeloproliferative disorder, or secondary AML
Poor risk molecular features according to Leukemia Net including ASXL1, BCOR, EZH2, RUNX1, SF3B1, SRSF2, STAG2, U2AF1, and/or ZRSR2
Poor-risk cytogenetics including 3q abnormalities, 7/7q minus or complex cytogenetics (>3 abnormalities).
Disqualifiers
1a. Left ventricular ejection fraction < 50%
2b. Creatinine clearance <30ml/min.
3c. Bilirubin > 2.0 mg/dL (unless due to Gilbert's syndrome or hemolysis), and ALT and AST > 5 x ULN.
4d. FEV1 and FVC < 50% of predicted or DLCO <50% of predicted once corrected for anemia.
Trial design
Treatments tested in this trial
- Intensity modulated total marrow irradiation
- Cyclophosphamide (CTX)
- Fludarabine (Fludara)
- Busulfan (conditioning for ALLO Transplant)