Hematologic Malignancies Clinical Trial
Official title:
Phase I/II Study of Allogeneic Stem Cell Transplantation for Patients With Hematologic Diseases Using Haploidentical Family Donors and Sub-Myeloablative Conditioning With Campath 1H
Patients are being asked to participate in this study because they have a cancer in their
blood, Fanconi's Anemia, or have been unsuccessfully treated for bone marrow failure such as
Aplastic Anemia or Paroxysmal Nocturnal Hemoglobinuria. Any of these conditions could
benefit from an allogeneic stem cell transplant using a donor that is related to the
patient.
Stem cells are created in the bone marrow. They grow into different types of blood cells
that the patient needs, including red blood cells, white blood cells, and platelets. In a
transplant, the patient's own stem cells are killed and then replaced by stem cells from the
donor.
Usually, patients are given very strong doses of chemotherapy prior to receiving a stem cell
transplant. However, because of the patient's condition, they have a high risk of
experiencing life-threatening treatment-related side-effects. Recently, some doctors have
begun to use chemotherapy that does not cause as many side-effects before patients receive a
transplant.
This research study adds CAMPATH 1H to a low-dose chemotherapy regimen, followed by an
allogeneic stem cell transplantation. We want to see whether adding CAMPATH 1H to the
transplant medications helps in treating the disease. We also want to see whether there are
fewer life-threatening side-effects from the treatment. CAMPATH 1H is a drug that is still
being studied. CAMPATH 1H stays active in the body for a long time after patients receive
it, which means it may work longer at preventing graft-versus-host-disease (GvHD) symptoms.
Before treatment begins, stem cells will be collected from the donor's blood or bone marrow.
The stem cells will be collected and frozen before we start to give the patient
chemotherapy.
After admission to the hospital, patients will receive total body irradiation (very strong
x-rays that kill cells in the bone marrow), Fludarabine and Campath 1H prior to the stem
cell transplant (infusion of the donor's stem cells).
Starting 7 days after the transplant, the patient will be given G-CSF by subcutaneous
injection, until a blood test shows that numbers of granulocytes (a type of white blood
cell) in the blood are more than 1,000/uL. This is to help increase blood cell counts.
After transplantation, the patient will undergo several evaluations at different times.
These are standard evaluations and tests performed for any patient who has received a stem
cell transplant, as part of routine clinical monitoring.
We will also be looking at the patient's immune function (how the body protects itself to
prevent and fight infections and diseases). To do this, blood tests will be performed at
regular intervals (every 3 to 6 months) for 2 years.
Depending on how well the donor stem cells work in the body after the transplant, the
patient may receive one or more Donor Leukocyte Infusions (DLI). This is when leukocytes (a
type of white blood cell) collected from the same donor that provided the stem cells are
given to the patient through a central line into a vein.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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