Lymphoma Clinical Trial
Official title:
A Pilot Study of Double Cord Blood Stem Cell Transplantation in Patients With Hematologic Malignancies
RATIONALE: Giving low doses of chemotherapy and total-body irradiation before a donor
umbilical cord blood stem cell transplant helps stop the growth of cancer or abnormal cells.
It also stops the patient's immune system from rejecting the donor's stem cells. The donated
stem cells may replace the patient's immune cells and help destroy any remaining cancer or
abnormal cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor
can also make an immune response against the body's normal cells. Giving tacrolimus and
mycophenolate mofetil before the transplant may stop this from happening.
PURPOSE: This clinical trial is studying how well umbilical cord blood stem cell transplant
works in treating patients with hematologic cancer or other disease.
OBJECTIVES:
Primary
- Determine the efficacy of double umbilical cord blood stem cell transplantation using a
conditioning regimen comprising lower doses of busulfan and fludarabine phosphate and
low-dose total body irradiation, in terms of stem cell engraftment at 60 days post
transplantation, in patients with hematologic cancer or other diseases.
- Determine the merits of conducting a larger, comparative study of this regimen.
Secondary
- Determine mortality within 100 days of transplantation in these patients.
OUTLINE: This is a pilot study.
- Reduced-intensity conditioning regimen: Patients receive busulfan IV over 3 hours on
days -9 to -8 and fludarabine phosphate IV on days -7 to -3. Patients then undergo
low-dose total body irradiation on day 0.
- Graft-versus-host disease prophylaxis: Patients receive tacrolimus IV twice daily and
mycophenolate orally or IV three times daily beginning on day -3.
- CNS prophylaxis and/or treatment: Patients with a history of CNS involvement receive
prophylactic cytarabine (Ara-C) intrathecally (IT) prior to transplant. Patients also
undergo lumbar puncture (LP) to test for active CNS disease. Patients with
cerebrospinal fluid positive for leukemia receive Ara-C IT every 2-3 days until a
repeat LP shows no remaining leukemic cells. Three days after the last LP and after one
final dose of Ara-C, patients begin the conditioning regimen.
- Double umbilical cord blood (UCB) donor stem cell transplantation (SCT): Patients
undergo double UCB donor SCT on day 0.
PROJECTED ACCRUAL: A total of 30 patients will be accrued for this study.
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N/A
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