Lymphoma Clinical Trial
Official title:
A Prospective Randomized Trial of VP-16 Plus G-CSF Plus Rituximab vs VP-16 Plus G-CSF Alone for Peripheral Blood Progenitor Cell Mobilization Prior to Autologous Stem Cell Transplantation for B Cell Lymphoid Malignancies
RATIONALE: Drugs used in chemotherapy, such as busulfan, etoposide, and cyclophosphamide,
work in different ways to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. Giving colony-stimulating factors, such as G-CSF, monoclonal
antibodies, such as rituximab, or chemotherapy, such as etoposide, helps stem cells move
from the bone marrow to the blood so they can be collected and stored until transplant.
Giving etoposide and G-CSF together with rituximab before a peripheral stem cell transplant
may be an effective treatment for non-Hodgkin's lymphoma.
PURPOSE: This randomized clinical trial is studying how well giving etoposide and G-CSF with
or without rituximab works in treating patients who are undergoing an autologous peripheral
stem cell transplant for B-cell non-Hodgkin's lymphoma.
OBJECTIVES:
- Determine whether mobilization with etoposide and filgrastim (G-CSF) with or without
rituximab influences CD34+ cell yield in patients undergoing autologous peripheral
blood stem cell transplantation for B-cell non-Hodgkin's lymphoma.
- Determine the acute toxicity of rituximab in combination with etoposide and G-CSF for
peripheral blood stem cell mobilization in these patients.
OUTLINE: This is a randomized study.
- Stem cell mobilization: Patients are randomized to 1 of 2 mobilization arms.
- Arm I: Patients receive rituximab IV over 4 hours on days 1, 8, and 15. Patients
also receive etoposide IV over 4 hours on day 15 and filgrastim (G-CSF)
subcutaneously (SC) beginning on day 17 and continuing until approximately day 25.
Patients then undergo apheresis over 5 days or until an adequate amount of stem
cells are collected. After stem cell collection is completed, patients proceed to
the preparative regimen.
- Arm II: Patients receive etoposide IV over 4 hours on day 1 and G-CSF SC beginning
on day 3 and continuing until approximately day 11. Patients then undergo
apheresis over 5 days or until an adequate amount of stem cells are collected.
After stem cell collection is completed, patients proceed to the preparative
regimen.
- Preparative regimen: Patients receive oral busulfan once daily on days -8 to -4,
etoposide IV over 4 hours on day -4, and cyclophosphamide IV over 2 hours on days -3
and -2.
- Autologous peripheral blood stem cell transplantation (PBSCT): Patients undergo
autologous PBSCT on day 0. Beginning on day 5, patients receive G-CSF SC or IV once
daily until blood counts recover.
After completion study treatment, patients are followed periodically for 10 years.
PROJECTED ACCRUAL: A total of 54 patients will be accrued for this study.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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