Lymphoma Clinical Trial
Official title:
Multi-center, Phase II Study to Assess the Safety and Efficacy of Haploidentical Bone Marrow Transplantation Using Reduced Intensity Conditioning(RIC)Regimen and Post-transplant Cyclophosphamide,in Patients With Poor Prognosis Lymphomas
Study to test feasibility and efficacy of T-replete Bone Marrow (BM), infused after a RIC regimen and post-transplantation Cyclophosphamide (Cy), in patients with poor prognosis lymphomas.
Status | Recruiting |
Enrollment | 47 |
Est. completion date | November 2016 |
Est. primary completion date | August 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 70 Years |
Eligibility |
- Signed and dated IEC-approved informed consent - Age = 18-70 years old. - Performance Status Karnofsky = 80% (see appendix B) - HLA typing will be performed at high resolution (allele level) for the HLA-A, HLA -B, HLA Cw, HLA-DRB1, and HLA-DQB1 loci. A minimum match of 5/10 is required. An unrelated donor search is not required for a patient to be eligible for this protocol if the clinical situation dictates an urgent transplant. - The donor and recipient must be identical, as determined by high resolution typing, at least one allele of each of the following genetic loci: HLA-A, HLA-B, HLA-Cw, HLA-DRB1, and HLA-DQB1. - Patients with lymphoma (any histology) relapsed after high dose chemotherapy and in partial remission, complete remission or stable disease after the last CT line. 1. Hodgkin's lymphoma: Patients refractory to at least 2 CT lines, and included in tandem auto-allo program 2. Diffuse large B cell lymphoma: Refractory to second line salvage chemotherapy (patients in partial remission, stable disease or progressive). These patients have to be in partial remission, complete remission or stable disease after one o more further CT line. 3. Peripheral T cell lymphoma: Patients failing to achieve a complete remission after first line CT. 4. Low grade lymphomas (follicular and non follicular: Patients refractory to rituximab containing regimens. Patients relapsing after at least 2 lines CT. The duration of remission should be < 1 year. 5. Chronic lymphatic leukemia: Patients with refractory or relapsing (response duration < 1 year) disease after R-Fludarabine CT 6. Mantle cell lymphoma: Patients relapsing or refractory after first line conventional CT. - Absence of HLA identical sibling and 10/10 unrelated donor - Patients with adequate physical function as measured by: Cardiac: Left ventricular ejection fraction at rest must be = 40% Hepatic: Bilirubin = 2.5 mg/dL; and ALT, AST, and Alkaline Phosphatase = 5 x ULN. Renal: Creatinine clearance or GFR = 50 mL/min/1.73 m2. Pulmonary: FEV1, FVC, DLCO = 50% predicted (corrected for hemoglobin); if unable to perform pulmonary function tests, then O2 saturation = 92% on room air. Exclusion Criteria: - Presence of HLA-matched, related donor (HLA-A, -B, -DRB1) - Presence of matched unrelated donor (10/10), available on time. - Pregnancy or breast-feeding. - Evidence of HIV infection or known HIV positive serology. - Current uncontrolled bacterial, viral or fungal infection - Evidence of progression of clinical symptoms or radiologic findings. - Prior allogeneic hematopoietic stem cell transplant. - Central Nervous System (CNS) lymphoma localization |
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Italy | Istituto Clinico Humanitas | Rozzano | MI |
Lead Sponsor | Collaborator |
---|---|
Istituto Clinico Humanitas |
Italy,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Procedure activity | 1-year Progression Free Survival (PFS) to evaluate the activity of the procedure (taking into account an excess of toxicity). It is assumed that at 1-year a proportion of patients progression free of 20% or lower will be considered to be clinically unworthy, whereas a proportion of 40% or higher will be assumed to be of potential interest. | 1 year | No |
Secondary | Neutrophils recovery | Neutrophils will be measured at different time points of increasing lenght up to 1 year after transplant and then if clinically indicated | 1 year | Yes |
Secondary | Platelets recovery | Platelets will be measured at different time points of increasing lenght up to 1 year after transplant and then if clinically indicated | 1 year | Yes |
Secondary | Incidence of graft failure | 1 year | Yes | |
Secondary | Cumulative incidence of acute and chronic GVHD | 1 year | Yes | |
Secondary | Incidence of infections | Possible infections will be monitored for a time period of 1 year post-transplantation and then if clinically required | 1 year | Yes |
Secondary | Cumulative incidence of relapse/progression | 1 year | No | |
Secondary | Treatment related mortality (TRM) | 1 year | Yes | |
Secondary | Immunological reconstitution | T, B and NK subsets will be analysed in deep using cytofluorimetry and functional tests. | 1 year | No |
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