Cord Blood Transplant for High-Risk Blood Cancers
This study is testing a treatment for high-risk blood cancers like leukemia. It combines a cord blood transplant with chemotherapy drugs (cyclophosphamide and fludarabine) and total-body irradiation (TBI) to prepare your body for the transplant. The goal is to see how well these treatments work together to fight the cancer and help your body make healthy blood cells. Researchers will measure how long patients live after one year to see if the treatment is successful. You might be able to join if you are between 6 months and 65 years old and have certain types of leukemia that are in remission (meaning the cancer is not active). The current status of this study is unclear.
- Study design
- This is a Phase II interventional study planning to enroll 54 participants. Participants will be assigned to one of two treatment groups based on age.
- What's involved
- You would undergo blood sample collections, bone marrow aspirates, diagnostic imaging, and receive intravenous (IV) and oral medications. These procedures occur during screening and throughout the study.
- Compensation
- Not stated in the trial record.
- Follow-up
- The primary goal is to measure overall survival at one year after the transplant.
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NCT06013423
Cord Blood Transplant, Cyclophosphamide, Fludarabine, and Total-Body Irradiation in Treating Patients With High-Risk Hematologic Diseases
Recruiting
PHASE2Ages 6–65InterventionalTreatmentFred Hutchinson Cancer CenterInvestigator-initiated
~54 participants
Updated 2026-07-22 on ClinicalTrials.gov
What's tested:Biospecimen CollectionBone Marrow AspirateCyclophosphamideCyclosporineDiagnostic ImagingEchocardiography
At a glance
Recruiting sites
1 of 1 listed site is recruiting right now
RecruitingSuspended, closed, or not yet open
What they're measuring
Overall survival
Measured over At 1 year
Conditions
Where it's being run
1 sites across 1 statesWashington1
Study leadership
- Ann Dahlberg · PRINCIPAL_INVESTIGATOR · Fred Hutch/University of Washington Cancer Consortium
Who to contact
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Do you actually qualify for this trial?
Add a private profile and we'll compare every criterion below against your situation — and tell you which ones are met, uncertain, or excluding.
Eligibility criteria
Inclusion
Patients aged 6 months to =\< 65 years at time of consent.
Acute myelogenous leukemia (AML):
Complete first remission (CR1), complete second remission (CR2) or greater (CR2+), must have \< 5% marrow blasts at the time of transplant.
Patients in morphologic remission with persistent cytogenetic, flow cytometric, or molecular aberrations are eligible.
Acute lymphoblastic leukemia (ALL):
Complete first remission (CR1) at high risk for relapse such as any of the following:
Presence of any high-risk cytogenetic abnormalities such as t(9;22), t(1;19), t(4;11) or other MLL rearrangements (11q23) or other high-risk molecular abnormality.
Failure to achieve MRD- complete remission after induction therapy.
Persistence or recurrence of minimal residual disease on therapy.
Any patient unable to tolerate consolidation and/or maintenance chemotherapy as would have been deemed appropriate by the treating physician.
Other high-risk features not defined above.
Complete second remission (CR2) or greater (CR2+).
Note: ALL with less than 5% blasts at time of transplant but persistent cytogenetic, flow cytometric or molecular aberrations are eligible.
Other acute leukemias: Acute leukemias of ambiguous lineage or mixed phenotype with less than 5% blasts. Leukemias in morphologic remission with persistent cytogenetic, flow cytometric or molecular aberrations are eligible.
Chronic Myeloid Leukemia (CML): Excluding refractory blast crisis. To be eligible in first chronic phase (CP1) patient must have failed or be intolerant to tyrosine kinase inhibitor therapy.
Myelodysplastic syndromes (MDS) and myeloproliferative disorders (MPD) other than myelofibrosis:
MDS/MPD overlap syndromes without myelofibrosis.
MDS/ MPD patients must have less than 10% bone marrow myeloblasts and absolute neutrophil count (ANC) \> 0.2 (growth factor supported if necessary) at transplant work-up.
Non-Hodgkin lymphoma (NHL) at high-risk of relapse or progression if not in remission:
Eligible patients with aggressive histology (such as, but not limited to, diffuse large B-cell NHL, mantle cell NHL, and T-cell histology) in CR by PET/CT imaging.
Eligible patients with indolent B-cell NHL (such as, but not limited to, follicular, small cell or marginal zone NHL) will have 2nd or subsequent progression with PR or CR by PET/CT imaging.
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) in morphologic remission.
Only for adult patients, to prevent graft rejection, patients who received only non-lymphodepleting agents for their malignancy (hypomethylating agents, venetoclax, hydroxyurea, TKIs etc.), or patients who received lymphodepleting chemotherapy \> 3 months prior to scheduled admission, may receive fludarabine 25 mg/m\^2 daily x 3 days for lymphodepletion 14-42 days (aiming for 2-4 weeks) at the discretion of the principal investigator (PI).
For patients \> 18 years old, Karnofsky score ≥ 70%. For patients =\< 18 years old, Lansky score ≥ 50%.
Calculated creatinine clearance \> 70 ml/min.
Bilirubin \< 1.5 mg/dL (unless benign congenital hyperbilirubinemia or hemolysis).
Alanine transaminase (ALT) \< 3 x upper limit of normal (ULN).
For patients \> 18 years old, pulmonary function (spirometry and corrected diffusing capacity for carbon monoxide \[DLCO\]) \> 60% predicted. For patients =\< 18 years old, or any patient unable to perform pulmonary function tests, O2 saturation \> 92% on room air.
Left ventricular ejection fraction \> 50%.
Albumin \> 3.0 g/dL.
For patients \> 18 years old, Hematopoietic Cell Transplantation Comorbidity index (HCT-CI) =\< 5.
UCB units will be selected according to current umbilical cord blood graft selection algorithm. One or two UCB units may be used to achieve the required cell dose.
The UCB graft is matched at 4-6 HLA-A, B, DRB1 antigens with the recipient. This may include 0-2 antigen mismatches at the A or B or DRB1 loci. Unit selection based on cryopreserved nucleated cell dose and HLA-A, B, DRB1 using intermediate resolution A, B antigen and DRB1 allele typing.
Exclusion
Diagnosis of myelofibrosis or other malignancy with moderate-severe bone marrow fibrosis.
Patients persistent with central nervous system (CNS) involvement in cerebrospinal fluid (CSF) or CNS imaging at time of screening0
Prior checkpoint inhibitors/ blockade in the last 12 months.
Two prior stem cell transplants of any kind.
One prior autologous stem cell transplant within the preceding 12 months.
Prior allogeneic transplantation.
Prior involved field radiation therapy that would preclude safe delivery of 400cGy total body irradiation (TBI) in the opinion of radiation oncology.
Active and uncontrolled infection at time of transplantation.
HIV infection.
Inadequate performance status/ organ function.
Pregnancy or breast feeding.
Patient or guardian unable to give informed consent or unable to comply with the treatment protocol including appropriate supportive care, long-term follow-up, and research tests.
What this trial measures
- Overall survivalAt 1 year
Will be assessed after optimized cord blood transplant (CBT) in adults and children with hematologic malignancies. Will be calculated using the Kaplan-Meier method.