Lymphoma Clinical Trial
Official title:
Treatment of Patients With Hematological Malignancies Using Marrow Transplantation From Unrelated Donors Incompatible for One HLA Locus Antigen
RATIONALE: Radiation therapy uses high-energy x-rays to damage cancer cells. Drugs used in
chemotherapy use different ways to stop cancer cells from dividing so they stop growing or
die. Combining chemotherapy with bone marrow transplantation may allow the doctor to give
higher doses of chemotherapy drugs and kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of bone marrow transplantation in
treating patients who have hematologic cancer.
OBJECTIVES:
- Compare the incidence of graft-versus-host disease (GVHD) grades III and IV in patients
with hematologic malignancies treated with bone marrow transplantation (BMT) using
donors with 1 HLA-A or B non-cross-reactive group mismatch vs control patients
previously treated with BMT using donors with 1 HLA-A or B cross-reactive group (CREG)
mismatch.
- Compare the incidence of GVHD grades III and IV in patients with hematologic
malignancies treated with BMT using donors with 1 HLA-A or B CREG mismatch vs control
patients previously treated with BMT using matched donors.
- Determine the relevance of HLA-DRB1 or DQB1 allele mismatching in BMT using donors
matched for HLA-A, B, and C.
OUTLINE: Beginning at least 3 weeks after completion of cytoreductive combination
chemotherapy, patients under age 18 undergo total body irradiation (TBI) twice a day on days
-7 to -4. Patients age 18 and over undergo TBI twice a day on days -6 to -4. All patients
then receive cyclophosphamide IV daily on days -3 and -2. Males with acute lymphocytic
leukemia, high-grade lymphoma, intermediate-grade lymphoma, or marrow or CNS involvement
receive radiotherapy boost to the testes. On day 0, patients receive infusion of bone marrow
from unrelated donors with 1 of the following: 1 HLA-A or B non-cross-reactive group
mismatch; 1 HLA-A or B cross-reactive group mismatch; or an HLA-A, B, and C match with an
HLA-DRB1 or DQB1 mismatch.
Patients are followed every 6 months for 2 years and then annually thereafter.
PROJECTED ACCRUAL: A total of 150 patients will be accrued for this study within 5 years.
;
Primary Purpose: Treatment
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