Lymphoma Clinical Trial
Official title:
Allogeneic Hematopoietic Stem Cell Transplantation for Hematologic Malignancies After a Non-Myeloablative Conditioning Regimen From HLA-Matched Sibling Donors
RATIONALE: Monoclonal antibodies such as daclizumab can locate tumor cells and either kill
them or deliver tumor-killing substances to them without harming normal cells. Peripheral
stem cell transplantation from a brother or sister may be effective treatment for hematologic
cancer. Sometimes the transplanted cells can be rejected by the body's tissue. Mycophenolate
mofetil, tacrolimus, and donor white blood cells may prevent this from happening.
PURPOSE: Phase II trial to study the effectiveness of mycophenolate mofetil, tacrolimus,
daclizumab, and donor peripheral stem cell transplantation in treating patients who have
hematologic cancer.
OBJECTIVES: I. Determine whether donor hematopoiesis can be safely established using a
nonmyeloablative conditioning regimen followed by HLA matched sibling donor peripheral blood
stem cell transplantation in patients with hematologic malignancies. II. Determine whether
mixed chimerism can be safely converted to full donor hematopoiesis with this treatment
regimen in these patients. III. Determine the toxicity and incidence of aplasia and graft
versus host disease in these patients treated with this regimen. IV. Determine the antitumor
potential of this treatment regimen in these patients. V. Determine the role of NFkB in the
modulation of the cytokine secretion profile of T lymphocytes during an alloimmune response
in these patients treated with this regimen.
OUTLINE: Patients receive immunosuppressive medications consisting of oral mycophenolate
mofetil and tacrolimus twice a day beginning on day -8 and continuing through day 45 (in the
absence of graft versus host disease). Patients also receive daclizumab IV over 30 minutes on
days -1, 3, and 8. Patients undergo allogeneic peripheral blood stem cell (PBSC)
transplantation with donor CD34+ cells IV on day 0. If there is 0-80% donor hematopoiesis,
patients receive donor lymphocyte infusions with CD3+ cells IV on days 75, 165, and 270.
PROJECTED ACCRUAL: A total of 10-45 patients will be accrued for this study.
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