Lymphoma Clinical Trial
Official title:
Allogeneic Stem Cell Transplantation for Mantle Cell Lymphoma
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Combining more than one drug may kill more cancer cells.
Peripheral stem cell transplantation may be able to replace immune cells that were destroyed
by chemotherapy used to kill cancer cells.
PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by
donor peripheral stem cell transplantation in treating patients who have mantle cell
lymphoma.
OBJECTIVES:
- Determine the long term disease-free survival of patients with mantle cell lymphoma
treated with etoposide, carmustine, melphalan, and cytarabine followed by allogeneic
peripheral blood stem cell transplantation.
- Determine the incidence of molecular remissions in these patients treated with this
regimen.
- Correlate the persistence of minimal residual disease with clinical outcome in these
patients treated with this regimen.
- Determine the effect of donor lymphocytes in patients with progressive disease after
treatment with this regimen.
OUTLINE: This is a multicenter study.
Patients receive carmustine IV over 2 hours on day -6; etoposide IV over 3 hours and
cytarabine IV over 1 hour every 12 hours on days -5 to -2 for a total of 8 doses; and
melphalan IV over 20-30 minutes on day -1. Patients undergo allogeneic peripheral blood stem
cell (PBSC) transplantation on day 0. Patients also receive tacrolimus IV continuously over
24 hours beginning on day -2 and then orally twice daily until day 120 and methotrexate IV
over 30 minutes on days 1, 3, and 6 as graft-versus-host disease (GVHD) prophylaxis.
Patients receive sargramostim (GM-CSF) IV or subcutaneously daily beginning on day 7 and
continuing until blood counts recover.
Patients with no active GVHD who have persistent disease on day 150 or progressive disease
at any time after PBSC transplantation receive donor lymphocytes IV over 2 hours. Patients
may receive additional donor lymphocytes at least 8 weeks later if disease persists.
Patients are followed at 6 and 12 months posttransplantation and then annually for 4 years.
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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