Lymphoma Clinical Trial
Official title:
Phase I/II Study of Pentostatin Combined With Tacrolimus and Mini-Methotrexate for GVHD Prevention After Matched-Unrelated Donor Blood and Marrow Transplantation
Primary Objective:
1. To determine efficacy of escalating doses of pentostatin in combination with tacrolimus
and methotrexate for the prevention of acute graft-versus-host disease (GVHD) in the context
of unrelated donor and one antigen mismatched related donor transplantation.
Secondary Objectives:
1. To determine safety of escalating doses of pentostatin in combination with tacrolimus
and methotrexate.
2. To reduce the incidence of acute GVHD following transplants with unrelated donor to
40%.
3. To document blood levels of tacrolimus when combined with pentostatin.
During the study, patients will have blood, urine, bone marrow, and X-ray exams done. These
exams are done to monitor the results of the transplantation. Blood tests will be done daily
while patients are hospitalized.
Patients in this study will receive chemotherapy and/or radiation to treat their malignancy
and prevent graft rejection. This is given before the infusion of donor cells.
Patients with myeloid leukemias may receive busulfan by vein (IV) for 4 days and
cyclophosphamide by vein for 2 days.
Patients with lymphoid malignancies may receive thiotepa by vein in one dose,
cyclophosphamide by vein for 2 days, and irradiation for 4 days.
Other chemotherapy treatments may be used before donor cell infusion.
IV injections will be given through a previously inserted catheter that extends into the
vena cava (a large chest vein).
Patients will be randomly picked (as in the toss of a coin) to receive one of five different
treatments. This is done to learn the benefit of pentostatin treatment and the appropriate
dose. Four of the treatments will use different dose schedules of pentostatin. The fifth
treatment group will receive no pentostatin at all. All patients receive tacrolimus and
methotrexate.
Pentostatin will be given by vein in 4 doses during the first month after transplant.
Tacrolimus (FK506) will be given by vein or mouth for 6 months. Methotrexate will be given
by vein for 3 doses in the first week after transplant.
Patients will receive blood and platelet transfusions after the transplant. The number of
transfusions will depend on how quickly the blood cell counts return to a normal range.
Patients will remain in the hospital for about 4-6 weeks and in the Houston area for 100
days after the transplant.
This is an investigational study. All of the study drugs are commercially available.
Pentostatin will not be used for GVHD prevention outside of this study. A total of 150
patients will take part in this study.
;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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