Recurrent Mantle Cell Lymphoma Clinical Trial
Official title:
Campath® [Alemtuzumab] Dose Escalation, Low-Dose TBI and Fludarabine Followed by HLA Class I Mismatched Donor Stem Cell Transplantation for Patients With Hematologic Malignancies - A Multi-Center Trial
This phase II trial studies the side effects and the best dose of alemtuzumab when given together with fludarabine phosphate and low-dose total body irradiation (TBI) and how well it works before donor stem cell transplant in treating patients with hematological malignancies. Giving chemotherapy and low-dose TBI before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. Also, monoclonal antibodies, such as alemtuzumab, can find cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving cyclosporine (CSP) and mycophenolate mofetil (MMF) after transplant may stop this from happening.
PRIMARY OBJECTIVES:
I. To determine whether stable allogeneic engraftment from related and unrelated human
leukocyte antigen (HLA)-mismatched stem cell donors can be safely established using a
non-myeloablative conditioning regimen plus escalating doses of the anti-CD52 monoclonal
antibody (mAb) Campath (alemtuzumab) in patients with hematologic malignancies.
SECONDARY OBJECTIVES:
I. Evaluate the risk of occurrence of acute and chronic graft-vs-host disease (GVHD).
II. Evaluate the risk/incidence of infections.
III. Determine whether engraftment can be maintained with a single dose fludarabine, donor
lymphocyte infusion (DLI) and continued MMF/CSP.
IV. Evaluate the risk for disease progression and relapse.
OUTLINE: This is a dose-escalation study of alemtuzumab.
CONDITIONING REGIMEN: Patients receive alemtuzumab intravenously (IV) over 2 hours on days -8
to -5 and fludarabine phosphate IV on days -4 to -2. Patients also undergo low-dose TBI on
day 0.
HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT): Patients undergo allogeneic peripheral blood
stem cell transplantation on day 0.
IMMUNOSUPPRESSION: Patients receive CSP IV or orally (PO) twice daily (BID) on days -3 to 180
with taper to day 365 and MMF PO thrice daily (TID) on days 0-100 with taper to day 156.
After completion of study treatment, patients are followed up periodically.
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