Lymphoma Clinical Trial
Official title:
Phase II Study Evaluating Busulfan and Fludarabine as Preparative Therapy in Adults With Hematopoietic Disorders Undergoing Matched Unrelated Donor Stem Cell Transplantation
RATIONALE: Drugs used in chemotherapy, such as busulfan and fludarabine, work in different
ways to stop the growth of cancer cells, either by killing the cells or by stopping them
from dividing. Giving chemotherapy with a peripheral stem cell or bone marrow transplant may
allow more chemotherapy to be given so that more cancer cells are killed. Sometimes the
transplanted cells from a donor can make an immune response against the body's normal cells.
Tacrolimus and methotrexate may stop this from happening.
PURPOSE: This phase II trial is studying how well giving busulfan together with fludarabine
before donor stem cell transplant works in treating patients with hematologic cancer.
OBJECTIVES:
Primary
- Determine the safety, in terms of treatment-related mortality at 100 days
post-transplantation, of a myeloablative preparative regimen comprising busulfan and
fludarabine and graft-vs-host disease (GVHD) prophylaxis comprising tacrolimus and
methotrexate in patients with hematopoietic disorders undergoing matched unrelated
donor stem cell transplantation.
- Determine the efficacy, in terms of overall survival at 1-year post-transplantation, in
patients treated with this regimen.
Secondary
- Determine organ toxicity in patients treated with this regimen.
- Determine neutrophil and platelet recovery in patients treated with this regimen.
- Determine the incidence and severity of acute and chronic GVHD in patients treated with
this regimen.
OUTLINE:
- Myeloablative preparative regimen: Patients receive busulfan IV over 2 hours every 6
hours on days -7 to -4 and fludarabine IV over 30 minutes on days -7 to -3.
- Allogeneic stem cell transplantation: Patients undergo allogeneic peripheral blood stem
cell or bone marrow transplantation on day 0. Patients also receive filgrastim (G-CSF)
subcutaneously daily beginning on day 7 and continuing until blood counts recover.
- Graft-vs-host disease prophylaxis: Patients receive tacrolimus IV continuously
beginning on day -2 and continuing until discharged from the hospital (may convert to
oral dosing administered twice daily when tolerated) and methotrexate IV over 15-30
minutes on days 1, 3, 6, and 11.
After completion of study therapy, patients are followed periodically.
PROJECTED ACCRUAL: A total of 36 patients will be accrued for this study.
;
Masking: Open Label, Primary Purpose: Treatment
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