Lymphoma Clinical Trial
Official title:
Purine-Analog-Containing Non-Myeloablative Allogeneic Stem Cell Transplantation for Treatment of Hematologic Malignancies and Severe Aplastic Anemia
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Peripheral stem cell transplantation may be able to replace
immune cells that were destroyed by chemotherapy used to kill cancer cells.
PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by
peripheral stem cell transplantation in treating patients who have hematologic cancer or
aplastic anemia.
OBJECTIVES:
- Determine the rates of durable full donor hematologic engraftment in patients with
high-risk hematologic malignancies or severe aplastic anemia treated with
non-myeloablative conditioning using fludarabine, cyclophosphamide, and anti-thymocyte
globulin followed by allogeneic peripheral blood stem cell transplantation.
- Determine the acute and delayed toxic effects of this non-myeloablative conditioning
regimen in this patient population.
- Determine the event-free and overall survival of patients treated with this regimen.
- Determine the incidence and severity of acute and chronic graft-versus-host disease in
patients treated with this regimen.
- Determine the rate and quality of immune reconstitution in patients treated with this
regimen.
- Determine the rate of disease relapse and incidence of post-transplantation
lymphoproliferative disease in these patients.
OUTLINE: Patients are stratified according to disease category (malignant vs non-malignant)
and graft source (unrelated vs HLA-matched sibling).
Beginning at least 4 weeks after conventional-dose chemotherapy, patients receive
non-myeloablative conditioning comprising fludarabine IV over 30 minutes on days -8 to -4,
cyclophosphamide IV over 2 hours on days -3 to -2, and anti-thymocyte globulin IV over at
least 4 hours on days -2 and -1. Patients undergo filgrastim (G-CSF)-mobilized allogeneic
peripheral blood stem cell transplantation on day 0.
Patients are followed weekly for 3 months, every 2 weeks for 3 months, monthly for 6 months,
and then every 2 months thereafter.
PROJECTED ACCRUAL: A minimum of 30 patients will be accrued for this study within 4 years.
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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