Leukemia Clinical Trial
Official title:
Pilot Study Of T-Cell-Depleted Peripheral Blood Stem Cell Transplantation From Partially Matched Related Donors For Patients With High-Risk Leukemia
RATIONALE: Giving chemotherapy and total-body irradiation before a donor peripheral stem
cell transplant helps stop the growth of cancer and abnormal cells and helps stop the
patient's immune system from rejecting the donor's stem cells. When the stem cells from a
related donor, that do not exactly match the patient's blood, are infused into the patient
they may help the patient's bone marrow make stem cells, red blood cells, white blood cells,
and platelets.
PURPOSE: This phase II trial is studying how well peripheral stem cell transplant works in
treating patients with high-risk leukemia.
OBJECTIVES:
- Determine the safety of a preparative regimen comprising total body irradiation,
cyclophosphamide, thiotepa, and fludarabine, but without anti-thymocyte globulin, in
patients with high-risk leukemia treated with peripheral blood stem cell
transplantation from partially matched related donors.
- Determine the incidence of graft failure, acute graft-versus-host disease (GVHD), and
treatment-related mortality in patients treated with this regimen.
- Determine rates of chronic GVHD and relapse in patients treated with this regimen.
- Determine disease-free and overall survival in patients treated with this regimen.
OUTLINE: This is a pilot study.
Patients receive a preparative regimen comprising total lymphoid irradiation once daily on
days -13 to -11; cyclophosphamide IV over 1 hour on days -8 and -7; thiotepa IV over 4 hours
every 12 hours on day -6; fludarabine IV over 30 minutes on days -5 to -1; and total body
irradiation once on day -1. Patients also receive cyclosporine IV over 12 hours on days -8
to -1 and methylprednisolone IV twice daily on days -3 and -2. Patients receive
CD34-enriched T-cell-depleted allogeneic stem cell infusion on day 0.
Patients with disease progression or uncontrolled infection but without grade II or greater
graft-versus-host disease may receive up to 3 donor lymphocyte infusions at least 4 weeks
apart until disease regression.
Patients are followed at least weekly until day 100 and then at 6, 12, 18, 24, 36, and 48
months.
PROJECTED ACCRUAL: A total of 20-51 patients will be accrued for this study.
;
Masking: Open Label, Primary Purpose: Treatment
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