Lymphoma Clinical Trial
Official title:
Autologous Transplantation for Non-Hodgkin's Lymphoma and Hodgkin's Disease Using Retrovirally Marked Peripheral Blood Progenitor Cells Obtained After In Vivo Mobilization Using Hematopoietic Cytokines Plus Chemotherapy
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer
cells. Combining chemotherapy and radiation therapy with peripheral stem cell transplantation
using specially treated stem cells may allow the doctor to give higher doses of chemotherapy
drugs and radiation therapy and kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of peripheral stem cell transplantation
using specially treated stem cells in treating patients who have non-Hodgkin's lymphoma or
Hodgkin's disease.
OBJECTIVES:
- Determine whether priming with hematopoietic cytokines and chemotherapy increases the
yield of hematopoietic progenitors in peripheral blood stem cells (PBSC) in patients
with non-Hodgkin's lymphoma or Hodgkin's disease undergoing autologous PBSC
transplantation.
- Determine whether in vitro studies can predict the transduction efficiency of early and
late engrafting hematopoietic stem cells in this patient population undergoing this
treatment.
- Determine whether in vitro transduction of a graft product stable long term transduction
of marrow cells in these patients after autologous transplantation.
OUTLINE: Patients receive filgrastim (G-CSF) subcutaneously (SC) twice daily on days 1-7.
Peripheral blood stem cells (PBSC) are collected on days 5-7. Patients receive
cyclophosphamide IV over 2 hours, mitoxantrone IV, and cytarabine IV every 12 hours for 2
doses on day 10, and dexamethasone every 12 hours for 4 doses on days 10 and 11. Patients
receive G-CSF SC for the next 10-20 days. Additional PBSC are collected on days 25-28 or 29.
Beginning 7 days before PBSC transplantation, patients receive cyclophosphamide IV over 2
hours on days -7 and -6 and total body irradiation (TBI) twice daily on days -4 to -1.
Patients unable to tolerate TBI receive cyclophosphamide IV over 2 hours on days -6 to -3,
carmustine IV over 1 hour on days -6, and etoposide IV over 1 hour every 12 hours on days -6
to -4. Retrovirally transduced PBSC are reinfused on day 0 followed by another course of
G-CSF SC until hematopoietic recovery.
Patients are followed at 1, 3, 6, 9, 12, 18, and 24 months and then annually thereafter.
PROJECTED ACCRUAL: A total of 15-20 patients will be accrued for this study within 12-15
months.
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