Lymphoma Clinical Trial
Official title:
Tandem Autologous Stem Cell Transplantation for Patients With Primary Progressive or Recurrent Hodgkin's Disease (A BMT Study), Phase II
RATIONALE: Radiation therapy uses high-energy x-rays to kill cancer cells. Drugs used in
chemotherapy work in different ways to stop the growth of cancer cells, either by killing the
cells or by stopping them from dividing. Giving chemotherapy with a peripheral stem cell
transplant may allow more chemotherapy to be given so that more cancer cells are killed.
Tandem (two) autologous stem cell transplants may be an effective treatment for Hodgkin's
lymphoma.
PURPOSE: This phase II trial is studying how well tandem stem cell transplantation works in
treating patients with progressive or recurrent Hodgkin's lymphoma.
OBJECTIVES:
- Determine the 2-year progression-free survival of patients with progressive or recurrent
Hodgkin's lymphoma treated with tandem autologous stem cell transplantation (2 courses
of high-dose therapy with autologous stem cell rescue).
- Determine the response rate in patients treated with this regimen.
- Determine the toxic effects of this regimen in these patients.
OUTLINE: This is a multicenter study.
- Salvage therapy (for patients with relapsed disease after achieving a previous complete
response): Patients receive at least 2 courses of salvage chemotherapy or radiotherapy.
No more than 6 weeks later, patients proceed to autologous hematopoietic stem cell
collection.
- Autologous hematopoietic stem cell collection: Patients undergo autologous hematopoietic
stem cell collection. Patients with an inadequate number of collected stem cells are
removed from the study.
- Pre-transplant salvage radiation: Patients with residual tumor greater than 5 cm after
initial salvage therapy undergo involved-field radiotherapy. All patients then proceed
to the first preparative regimen.
- First preparative regimen: Patients receive high-dose melphalan IV on day -1.
- First autologous stem cell transplantation (SCT): Patients undergo autologous SCT on day
0. At least 28 days later, patients proceed to second preparative regimen.
- Second preparative regimen: Patients receive 1 of the following preparative regimens:
- Total-body irradiation (TBI)-based regimen: Patients undergo TBI twice daily on
days -8 to -5. Patients also receive etoposide IV over 4 hours on day -4 and
cyclophosphamide IV over 1 hour on day -2.
- Carmustine-based regimen: Patients receive carmustine IV over 2 hours on days -6 to
-4, etoposide IV over 4 hours on day -4, and cyclophosphamide IV over 1 hour on day
-2.
- Second autologous SCT: Patients undergo second autologous SCT on day 0. After completion
of study treatment, patients are followed every 6 months for 2 years and then annually
for up to 7 years.
PROJECTED ACCRUAL: A total of 85 patients will be accrued for this study over 2 years.
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