Nonmalignant Neoplasm Clinical Trial
Official title:
Alemtuzumab and Low-Dose Cyclosporine-A as Alternative Immunosuppressive Treatment for Severe Aplastic Anemia (SAA) and Single-Lineage Aplastic Patients
RATIONALE: Immunosuppressive therapies, such as alemtuzumab and cyclosporine, may improve
bone marrow function and increase blood cell counts. Giving alemtuzumab together with
cyclosporine may be an effective treatment for severe aplastic anemia or acquired marrow
failure.
PURPOSE: This phase II trial is studying the side effects of giving alemtuzumab together
with cyclosporine and to see how well it works in treating patients with severe aplastic
anemia or acquired marrow failure.
OBJECTIVES:
Primary
- Determine the safety of alemtuzumab and low-dose cyclosporine, as defined by occurrence
of adverse effects, in patients with severe aplastic anemia or single lineage acquired
marrow failure.
- Determine the efficacy of this regimen, in terms of overall survival, hematological
response (partial and complete response, including time to response) and failure-free
survival (failure is defined as no response, chronic treatment-maintained response, or
relapse), in these patients.
Secondary
- Evaluate the incidence of adverse effects after treatment.
- Evaluate the long-term safety of alemtuzumab treatment.
- Determine the time to achieve a complete hematological response.
- Determine the proportion of patients maintaining hematological response free of any
treatment.
- Determine the incidence of relapse in responding patients.
- Determine the incidence of severe infections.
- Determine the requirement for IV antibiotics and antifungal therapy.
- Determine the requirement for red cell and platelet transfusion.
- Determine the incidence of CMV reactivation.
- Determine the kinetics of immune reconstitution.
- Determine the incidence of paroxysmal nocturnal hemoglobinuria clone (lymphoid or
myeloid) development.
- Determine the incidence of clonal evolution (i.e., karyotypic abnormalities or
secondary myelodysplasia/leukemia).
OUTLINE: Patients receive alemtuzumab subcutaneously on days 1-5*. Patients also receive
oral cyclosporine beginning on day 7 and continuing for ≥ 180 days, followed by a taper
according to clinical condition.
NOTE: *Patients with single lineage aquired marrow failure receive alemtuzumab on days 1-4.
After completion of study therapy, patients will be followed up every 3 months for up to 2
years.
;
Allocation: Non-Randomized, Masking: Open Label, Primary Purpose: Treatment
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