This research is being done to see if the drug Inqov is effective in reducing the chance of myelodysplastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML) relapsing after standard of care stem cell transplant.
* This research study involves the study drug Inqovi, which is a combination of the drugs decitabine and cedazuridine.
Who can participate
Age range18 Years
SexALL
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Inclusion Criteria:
* Pathologically confirmed diagnosis of myelodysplastic syndrome (MDS) or chronic myelomonocytic leukemia (CMML).
* Subjects should have less than 5% myeloblasts on a bone marrow biopsy within 42 days prior to the start of conditioning.
* Age ≥ 18
* Will undergo first allogeneic hematopoietic stem cell transplantation (HSCT) for their malignancy.
* Transplantation will be performed with the use of reduced intensity conditioning (RIC).
* HSCT Donor will be one of the following:
* 5/6 or 6/6 (HLA-A, B, DR) matched related donor
* 7/8 or 8/8 (HLA-A, B, DR, C) matched unrelated donor. Matching in the unrelated setting must be at the allele level.
* Haploidentical related donor, defined as ≥ 3/6 (HLA-A, B, DR) matched
* ≥ 4/6 (HLA-A, B, DR) umbilical cord blood (UCB). Matching in the UCB setting is at the antigen level. Recipients may receive either one or two UCB units. In the case of 2 UCB units, both units must have been at least 4/6 matched with the recipient.
* ECOG performance status 0-2.
* Participants must have normal organ and function as defined below:
* AST (SGOT), ALT (SGPT) and Alkaline phosphatase \< 3x institutional upper limit of normal (ULN)
* Total bilirubin \< 1.5 x ULN (with the exception of subjects with a history of Gilbert's syndrome)
* Calculated creatinine clearance ≥ 30 mL/min (Cockcroft-Gault formula)
* LVEF must be equal to or greater than 50%, as measured by MUGA scan or echocardiogram
* Female patients of childb…