Memorial Sloan Kettering Cancer Center
The purpose of this study is to find out whether Cord Blood Transplantation/CBT as the first or second transplant is an effective treatment for children and young adults with blood cancer.
Inclusion Criteria: A patient cannot be considered eligible for this study unless ALL of the following conditions are met. ° Disease type Cohort 1, High Risk Disease: Patients with age ≤ 26 years at the time of informed consent with no available and suitably matched related or unrelated donor within 4 weeks, with one of the following diagnoses: I. Acute myelogenous leukemia (AML): * Complete first remission (CR1) with blast count \< 5% by bone marrow morphology at high risk for relapse such as any of the following: * Known prior diagnosis of myelodysplasia (MDS) * High risk cytogenet…
Cord Blood \[(HPC(CB)\] products are minimally manipulated unrelated allogeneic cord blood units that have been collected, processed and stored in public Cord Blood banks
Hyper-fractionated TBI is administered by a linear accelerator at a dose rate of \<20 cGy/minute. Treatment planning begins with simulation.
Cyclophosphamide is an alkylating agent that prevents cell division by cross-linking DNA strands and decreasing DNA synthesis.
Fludarabine phosphate is rapidly dephosphorylated to 2- fluoro-ara- A and then phosphorylated intracellularly by deoxycytidine kinase to the active triphosphate, 2- fluoro-ara-ATP
Clofarabine, a purine (deoxyadenosine) nucleoside analog, is metabolized to clofarabine 5'-triphosphate.
Busulfan is a bifunctional alkylating agent known chemically as 1,4- butanediol, dimethanesulfonate.
Thiotepa is an alkylating agent which produces cross-linking of DNA strands leading to inhibition of DNA, RNA, and protein synthesis; thiotepa is cell-cycle independent.
Tacrolimus inhibits T-lymphocyte activation
Mycophenolate exhibits a cytostatic effect on T and B lymphocytes.
Cyclosporine is a calcineurin inhibitor that inhibits production and release of interleukin II and inhibits interleukin II-induced activation of resting T-lymphocytes.
Arctuva estimate
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