Lymphoma Clinical Trial
Official title:
A Phase II Study of Reduced Intensity Sibling Allogeneic Transplantation for Relapsed, Chemosensitive, PET-positive Hodgkin Lymphoma
RATIONALE: Giving chemotherapy 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 alemtuzumab, can find cancer cells and either
kill them or deliver cancer-killing substances to them without harming normal cells. When
the healthy stem cells from a donor are infused into the patient they may help the patient's
bone marrow make stem cells, red blood cells, white blood cells, and platelets. Sometimes
the transplanted cells from a donor can make an immune response against the body's normal
cells. Giving cyclosporine before and after the transplant may stop this from happening.
Once the donated stem cells begin working, the patient's immune system may see the remaining
cancer cells as not belonging in the patient's body and destroy them (called
graft-versus-tumor effect). Giving an infusion of the donor's white blood cells (donor
lymphocyte infusion) may boost this effect.
PURPOSE: This phase II trial is studying the side effects of fludarabine phosphate,
melphalan, and alemtuzumab followed by donor stem cell transplant in treating patients with
relapsed Hodgkin lymphoma.
OBJECTIVES:
- To document the toxicity, feasibility, and survival after reduced-intensity
conditioning followed by allogeneic hematopoietic stem cell transplantation from a
matched sibling donor in patients with relapsed, chemosensitive Hodgkin lymphoma.
OUTLINE: This is a multicenter study.
- Reduced-intensity conditioning: Patients receive fludarabine phosphate IV on days -7 to
-3, melphalan IV over 30 minutes on day -2, and alemtuzumab IV on day -1.
- Transplantation: Patients undergo donor stem cell infusion on day 0.
- Graft-vs-host disease (GVHD) prophylaxis: Patients receive cyclosporine IV or orally on
days -1 to 60, followed by a taper until 3 months post-transplantation, in the absence
of GVHD.
- Donor-lymphocyte infusion (DLI): DLI is used for the eradication of mixed chimerism and
for the management of residual or relapsed disease. If necessary, patients undergo DLI
every 3 months until the desired endpoint is achieved or GVHD develops.
After completion of study therapy, patients are followed up every 3 months for 3 years.
This study is peer reviewed and funded or endorsed by Cancer Research UK.
;
Masking: Open Label, Primary Purpose: Treatment
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