Lymphoma Clinical Trial
Official title:
TREATMENT OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES USING MARROW TRANSPLANTATION FROM UNRELATED DONORS MATCHED FOR HLA OR INCOMPATIBLE FOR ONE HLA LOCUS ANTIGEN
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor
cells. Bone marrow transplantation may be able to replace immune cells that were destroyed
by chemotherapy or radiation therapy used to kill tumor cells.
PURPOSE: Phase II trial to study the effectiveness of bone marrow transplantation using
unrelated bone marrow donors in treating patients who have hematologic cancer.
OBJECTIVES: I. Determine whether the use of donors with a one non crossreactive group (CREG)
mismatch for HLA-A or B in patients less than 36 years of age is associated with more
frequent graft versus host disease (GVHD) of grades III-IV than previously observed with
donors with one CREG mismatch. II. Determine whether the use of donors with a one CREG
mismatch for HLA-A or B in patients 36-50 years of age is associated with more frequent GVHD
of grades III-IV than previously observed with matched donors. III. Determine the relevance
of HLA-A allele mismatching in bone marrow transplants from donors matched for HLA-A, B, and
DR phenotypes.
OUTLINE: This is a parallel, open label study. Patients are assigned to 1 of 3 treatment
arms. Arm I: Patients receive cyclophosphamide IV on days -7 and -6 and total body
irradiation (TBI) 3 times a day on days -4 through -1. Allogeneic bone marrow (ABM) is
infused on day 0. Arm II: Patients receive therapy as in arm I, except TBI is administered
twice a day on day -1 only. ABM is infused on day 0. Arm III: Patients receive
cyclophosphamide IV on days -6 and -5 and TBI twice a day on days -3 through -1. ABM is
infused on day 0. Males with ALL receive an additional radiation boost to the testes during
TBI. Patients are followed at least every 6 months for 2 years, then annually thereafter.
PROJECTED ACCRUAL: A total of 50 patients under 36 years old and 50 patients 36-50 years old
will be accrued for this study within 5 years. Additional patients will be accrued for the
standard therapy arm of this study.
;
Primary Purpose: Treatment
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