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Because the anti-leukemic activity of busulfan, this dug is largely used in graft conditioning but in elderly and/or cormobid patienth an excess of toxicity is observed. This study focus on the possibility of significanty reducing this toxicity by customizing the doses of busulfan to individual PK parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| busulfan treatment | Experimental | Personalized BU administration |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Busulfan Injection | Drug | injections doses will be personalized by PK at days -7 and -4 |
|
| Measure | Description | Time Frame |
|---|---|---|
| non-relapse mortality evaluation | non-relapse mortality evaluation | 100 days post graft |
| Measure | Description | Time Frame |
|---|---|---|
| incidence of grade 3 or 4 toxicities | To evaluate toxicities linked to sequential bususlfan administration | 1 month |
| graft taking after sequential busulfan conditioning | incidence of hematological reconstituation |
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Inclusion Criteria:
Adult patient up to 65 years old
Acute leukemia, myelodysplastic syndrome or myeloproliferative neoplasia eligible for an allogeneic transplant
Chemosensitive disease, in complete or partial or stable remission
Allograft from an identical HLA related donor, Haplo-identical or unrelated (HLA compatibility from 8/10 to 10/10 according to HLA-A, -B, -C, -DR, -DQ allelics)
Signed consent to participate
-. Affiliation to a social security regimen or beneficiary of this regimen
Patient not eligible for standard myeloablative conditioning due to age> = 45 years and / or the presence of an HCT-CI comorbidity score> = 3
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dominique Genre, MD | Contact | +33491223778 | drci.up@ipc.unicancer.fr |
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| day 30 and day 100 post graft |
| incidence of transfusion needs for red blood cells | number of transfusions after graft | day 30 post graft |
| incidence of transfusion needs for red blood cells | number of transfusions after graft | day 60 post graft |
| incidence in graft taking after sequential busulfan conditioning | Lymphocyte chimerism | day 100 post graft |
| anti-tumoral efficacy of sequential busulfan conditioning: incidence of acute GVH | incidence of acute GVH | 1 year |
| anti-tumoral efficacy of sequential busulfan conditioning: incidence of acute GVH | incidence of acute GVH | 5 years |
| the anti-tumoral efficacy of sequential busulfan conditioning: incidence of chronic GVH | incidence of chronic GVH | 1 and 5 years |
| the anti-tumoral efficacy of sequential busulfan conditioning: incidence of chronic GVH | incidence of chronic GVH | 1 year |
| anti-tumoral efficacy of sequential busulfan conditioning: progression-free survival | progression-free survival | 5 years |
| anti-tumoral efficacy of sequential busulfan conditioning: progression-free survival | overall survival | 1 year |
| anti-tumoral efficacy of sequential busulfan conditioning: progression-free survival | overall survival | 5 years |
| anti-tumoral efficacy of sequential busulfan conditioning: Incidence of relapse | Incidence of relapse | 1 year |
| Differences between the theoretical target AUC and the measured a posteriori | To study the pharmacokinetics of the sequential administration of busulfan | 1 month |
| ID | Term |
|---|---|
| D009196 | Myeloproliferative Disorders |
| ID | Term |
|---|---|
| D001855 | Bone Marrow Diseases |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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| ID | Term |
|---|---|
| D002066 | Busulfan |
| ID | Term |
|---|---|
| D002072 | Butylene Glycols |
| D006018 | Glycols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D008698 | Mesylates |
| D000476 | Alkanesulfonates |
| D017738 | Alkanesulfonic Acids |
| D000473 | Alkanes |
| D006839 | Hydrocarbons, Acyclic |
| D006838 | Hydrocarbons |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
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