Lymphoma Clinical Trial
Official title:
A Randomized Phase III Trial Comparing Early High Dose Chemotherapy and an Autologous Stem Cell Transplant to Conventional Dose ABVD Chemotherapy for Patients With Advanced Stage Poor Prognosis Hodgkin's Disease as Defined by the International Prognostic Factors Project on Advanced Hodgkin's Disease
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Combining chemotherapy with peripheral stem cell
transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill
more tumor cells. It is not yet known if combination chemotherapy is more effective with or
without peripheral stem cell transplantation in treating Hodgkin's Disease.
PURPOSE: Randomized phase III trial to compare the effectiveness of combination chemotherapy
with or without peripheral stem cell transplantation in treating men who have stage III or
stage IV Hodgkin's disease.
OBJECTIVES:
- Compare progression-free and overall survival of patients with stage III or IV
Hodgkin's disease treated with doxorubicin, bleomycin, vinblastine, and dacarbazine
with or without autologous peripheral blood stem cell transplantation and high-dose
chemotherapy.
- Compare the toxic effects of these treatment regimens in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
number of poor prognostic factors (3 vs 4 vs 5) and stage of disease (III vs IV).
Patients receive induction chemotherapy consisting of doxorubicin IV over 5 minutes,
bleomycin IV over 10 minutes, vinblastine IV over 5 minutes, and dacarbazine IV over 15-30
minutes on days 1 and 15. Treatment repeats every 28 days for 5 courses in the absence of
disease progression or unacceptable toxicity. Patients who show at least partial response
after the fifth course of induction chemotherapy and whose blood counts have recovered are
randomized to 1 of 2 treatment arms.
- Arm I: Patients receive 3 additional courses of induction chemotherapy for a total of 8
courses.
- Arm II: Patients receive 1 additional course of induction chemotherapy followed by stem
cell collection. Patients then receive high-dose chemotherapy with carmustine IV over 2
hours on days -6 to -4, etoposide IV over 4 hours on day -4, and cyclophosphamide IV on
day -2. Patients undergo autologous peripheral blood stem cell transplantation on day
0.
Patients are followed at 60 days, every 3 months for 1 year, every 6 months for 2 years, and
then annually thereafter.
PROJECTED ACCRUAL: Approximately 460 patients will be accrued for this study within 4 years.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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