Lymphoma Clinical Trial
Official title:
A Non-Myeloablative Conditioning Regimen With Peri-Transplant Rituximab and the Transplantation of Hematopoietic Stem Cells From HLA-Compatible Related or Unrelated Donors in Patients With B Cell Lymphoid Malignancies
Verified date | February 2017 |
Source | Memorial Sloan Kettering Cancer Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
RATIONALE: Giving low doses of chemotherapy and total-body irradiation before a donor stem
cell transplant helps stop the growth of cancer cells. It also helps stop the patient's
immune system from rejecting the donor's stem cells. Also, monoclonal antibodies, such as
rituximab, can find cancer cells and either kill them or deliver cancer-killing substances to
them without harming normal cells. The donated stem cells may replace the patient's immune
cells and help destroy any remaining cancer 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 rituximab before transplant and cyclosporine and mycophenolate mofetil after
transplant may stop this from happening.
PURPOSE: This phase II trial is studying the side effects and how well giving chemotherapy
and radiation therapy together with rituximab and donor stem cell transplant works in
treating patients with B-cell non-Hodgkin's lymphoma or chronic lymphocytic leukemia.
Status | Completed |
Enrollment | 61 |
Est. completion date | October 28, 2016 |
Est. primary completion date | October 28, 2016 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 70 Years |
Eligibility |
DISEASE CHARACTERISTICS: - Diagnosis of 1 of the following: - CD20-positive aggressive B-cell non-Hodgkin's lymphoma (NHL), including any of the following subtypes: - Diffuse large cell lymphoma*, meeting 1 of the following criteria: - Relapsed disease after initial therapy, but failed to mobilize or had bone marrow involvement and therefore is not suitable for an autologous stem cell transplantation - High-intermediate- or high-risk second-line, age-adjusted International Prognostic Index score and in second complete remission (CR) or partial remission (PR) after autologous stem cell transplantation - Failed prior autologous stem cell transplantation and in PR or better after salvage chemotherapy - Large cell transformation of indolent NHL or chronic lymphocytic leukemia (CLL), meeting the following criteria: - In CR or PR of the large cell component of disease after salvage chemotherapy or autologous stem cell transplantation - Mantle cell lymphoma*, meeting 1 of the following criteria: - High-risk disease (e.g., p53 positivity) and in first CR or PR after initial therapy - Relapsed disease after initial therapy and in second or third CR or PR after salvage chemotherapy NOTE: *No progressive disease at allograft work-up - CD20-positive indolent NHL (e.g., follicular lymphoma, small cell lymphoma, or marginal zone NHL) OR CLL - Second or subsequent progression (pre-allograft cytoreduction necessary, but CR or PR not required) - Relapsed disease must be biopsy-proven - Must have received pre-allograft salvage chemotherapy, including 1 of the following: - Single autologous stem cell transplantation using high-dose chemotherapy conditioning within the past 120 days - At least 2 courses of intensive combination chemotherapy (e.g., RICE [rituximab, ifosfamide, carboplatin, etoposide]), according to diagnosis, within the past 80 days - CLL patients who have received CAMPATH do not have to receive pre-allograft salvage chemotherapy - HLA-compatible related or unrelated donor available - HLA-matched = 9/10 of the A, B, C, DRB1, and DQB1 loci, as tested by high resolution typing - One allele mismatch allowed PATIENT CHARACTERISTICS: - Karnofsky performance status 70-100% - Creatinine < 1.2 mg/mL OR creatinine clearance = 50 mL/min - Bilirubin < 2.5 mg/dL - AST and ALT = 3 times upper limit of normal (unless benign congenital hyperbilirubinemia is present) - Spirometry and corrected DLCO = 50% of normal - LVEF = 40% - Albumin = 2.5 g/dL - Not pregnant or nursing - Negative pregnancy test - Fertile patients must use effective contraception - No active uncontrolled infection, including active infection with Aspergillus or other mold - No HIV infection - No hepatitis B antibody or antigen positivity PRIOR CONCURRENT THERAPY: - See Disease Characteristics - No prior allogeneic transplantation |
Country | Name | City | State |
---|---|---|---|
United States | Memorial Sloan Kettering Cancer Center | New York | New York |
Lead Sponsor | Collaborator |
---|---|
Memorial Sloan Kettering Cancer Center | National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Overall Survival at 1 Year | 1 year | ||
Secondary | Time to Neutrophil Engraftment | 2 years | ||
Secondary | Time to Platelet Engraftment | 1 year | ||
Secondary | Incidence of Moderate to Severe Grades II to IV Graft Versus Host Disease (GVHD) at 100 Days | 100 days | ||
Secondary | Incidence of Chronic GVHD at 1 Year | 1 year | ||
Secondary | Immune Reconstruction/CD4+ Count at 3 Months | 3 months | ||
Secondary | Response to Treatment | 2 years | ||
Secondary | Immune Reconstruction/CD4+ Count at 6 Months | 6 months | ||
Secondary | Immune Reconstruction/CD4+ Count at 1 Year | 1 year |
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