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Clinical Trial Summary

OBJECTIVES: I. Determine whether there is prompt engraftment after autologous peripheral blood stem cell transplantation using filgrastim (G-CSF) mobilization in patients with life threatening autoimmune diseases.

II. Determine the kinetics of T- and B-cell immune reconstitution after a combination of timed plasmapheresis, high dose cyclophosphamide and total lymphoid irradiation, and posttransplant immunosuppression with cyclosporine in these patients.

III. Determine whether this treatment regimen beneficially influences the clinical course of these patients.


Clinical Trial Description

PROTOCOL OUTLINE: Patients receive filgrastim (G-CSF) SC daily until peripheral blood stem cells (PBSC) are collected. On the fifth day of G-CSF therapy, PBSC are collected. Patients undergo plasmapheresis on days -9 to -7. Patients receive cyclophosphamide IV on days -6 to -3 and total lymphoid irradiation on day -1. PBSC are reinfused on day 0. Following PBSC reinfusion, patients receive prophylaxis with oral prednisone or methylprednisolone IV on days -1 to 28, antithymocyte globulin IV on days 1-3, and cyclosporine every 12 hours on days 1-60.

Patients with autoimmune thrombocytopenia purpura, autoimmune hemolytic anemia, or pure red cell aplasia are followed on days 7, 14, 21, 28, 60, and 100, 6 months, and 1, 2, and 5 years. Patients with rheumatoid arthritis, juvenile rheumatoid arthritis, or systemic lupus erythematosus are followed on days 14, 28, 60, and 100, and then every 6 months. Patients with vasculitis are monitored for abnormal clinical and laboratory parameters characteristic of the individual type of vasculitis. ;


Study Design

Primary Purpose: Treatment


Related Conditions & MeSH terms

  • Anemia, Hemolytic
  • Anemia, Hemolytic, Autoimmune
  • Arteritis
  • Arthritis
  • Arthritis, Juvenile
  • Arthritis, Rheumatoid
  • Autoimmune Thrombocytopenic Purpura
  • Churg-Strauss Syndrome
  • Giant Cell Arteritis
  • Graft Versus Host Disease
  • Graft vs Host Disease
  • Hypersensitivity
  • Hypersensitivity Vasculitis
  • Juvenile Rheumatoid Arthritis
  • Lupus Erythematosus, Systemic
  • Polyarteritis Nodosa
  • Polymyalgia Rheumatica
  • Pure Red Cell Aplasia
  • Purpura
  • Purpura, Schoenlein-Henoch
  • Purpura, Thrombocytopenic
  • Purpura, Thrombocytopenic, Idiopathic
  • Red-Cell Aplasia, Pure
  • Rheumatoid Arthritis
  • Systemic Lupus Erythematosus
  • Takayasu Arteritis
  • Vasculitis
  • Wegener Granulomatosis
  • Wegener's Granulomatosis

NCT number NCT00006055
Study type Interventional
Source Office of Rare Diseases (ORD)
Contact
Status Active, not recruiting
Phase N/A
Start date March 2000

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