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Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Patients With Mantle Cell Lymphoma

15. juli 2016 opdateret af: Alliance for Clinical Trials in Oncology

Allogeneic Stem Cell Transplantation for Mantle Cell Lymphoma

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. 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 donor peripheral stem cell transplantation in treating patients who have mantle cell lymphoma.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

OBJECTIVES:

  • Determine the long term disease-free survival of patients with mantle cell lymphoma treated with etoposide, carmustine, melphalan, and cytarabine followed by allogeneic peripheral blood stem cell transplantation.
  • Determine the incidence of molecular remissions in these patients treated with this regimen.
  • Correlate the persistence of minimal residual disease with clinical outcome in these patients treated with this regimen.
  • Determine the effect of donor lymphocytes in patients with progressive disease after treatment with this regimen.

OUTLINE: This is a multicenter study.

Patients receive carmustine IV over 2 hours on day -6; etoposide IV over 3 hours and cytarabine IV over 1 hour every 12 hours on days -5 to -2 for a total of 8 doses; and melphalan IV over 20-30 minutes on day -1. Patients undergo allogeneic peripheral blood stem cell (PBSC) transplantation on day 0. Patients also receive tacrolimus IV continuously over 24 hours beginning on day -2 and then orally twice daily until day 120 and methotrexate IV over 30 minutes on days 1, 3, and 6 as graft-versus-host disease (GVHD) prophylaxis. Patients receive sargramostim (GM-CSF) IV or subcutaneously daily beginning on day 7 and continuing until blood counts recover.

Patients with no active GVHD who have persistent disease on day 150 or progressive disease at any time after PBSC transplantation receive donor lymphocytes IV over 2 hours. Patients may receive additional donor lymphocytes at least 8 weeks later if disease persists.

Patients are followed at 6 and 12 months posttransplantation and then annually for 4 years.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

4

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233-1996
        • Veterans Affairs Medical Center - Birmingham
    • California
      • La Jolla, California, Forenede Stater, 92093-0658
        • University of California San Diego Cancer Center
      • San Francisco, California, Forenede Stater, 94121
        • Veterans Affairs Medical Center - San Francisco
      • San Francisco, California, Forenede Stater, 94143-0128
        • UCSF Cancer Center and Cancer Research Institute
    • Delaware
      • Wilmington, Delaware, Forenede Stater, 19899
        • CCOP - Christiana Care Health Services
    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20307-5000
        • Walter Reed Army Medical Center
      • Washington, District of Columbia, Forenede Stater, 20007
        • Lombardi Cancer Center
    • Florida
      • Miami Beach, Florida, Forenede Stater, 33140
        • CCOP - Mount Sinai Medical Center
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • University of Illinois at Chicago
      • Chicago, Illinois, Forenede Stater, 60612
        • Veterans Affairs Medical Center - Chicago (Westside Hospital)
      • Chicago, Illinois, Forenede Stater, 60637-1470
        • University of Chicago Cancer Research Center
    • Iowa
      • Iowa City, Iowa, Forenede Stater, 52242-1009
        • Holden Comprehensive Cancer Center
    • Maine
      • Togus, Maine, Forenede Stater, 04330
        • Veterans Affairs Medical Center - Togus
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21201
        • Marlene and Stewart Greenebaum Cancer Center, University of Maryland
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02115
        • Dana-Farber Cancer Institute
      • Worcester, Massachusetts, Forenede Stater, 01655
        • University of Massachusetts Memorial Medical Center - University Campus
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55417
        • Veterans Affairs Medical Center - Minneapolis
      • Minneapolis, Minnesota, Forenede Stater, 55455
        • University of Minnesota Cancer Center
    • Missouri
      • Columbia, Missouri, Forenede Stater, 65201
        • Veterans Affairs Medical Center - Columbia (Truman Memorial)
      • Columbia, Missouri, Forenede Stater, 65203
        • Ellis Fischel Cancer Center - Columbia
      • Saint Louis, Missouri, Forenede Stater, 63110
        • Barnes-Jewish Hospital
    • Nebraska
      • Omaha, Nebraska, Forenede Stater, 68198-7680
        • University of Nebraska Medical Center
    • Nevada
      • Las Vegas, Nevada, Forenede Stater, 89106
        • CCOP - Southern Nevada Cancer Research Foundation
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater, 03756-0002
        • Norris Cotton Cancer Center
    • New York
      • Buffalo, New York, Forenede Stater, 14263-0001
        • Roswell Park Cancer Institute
      • Buffalo, New York, Forenede Stater, 14215
        • Veterans Affairs Medical Center - Buffalo
      • Manhasset, New York, Forenede Stater, 11030
        • CCOP - North Shore University Hospital
      • Manhasset, New York, Forenede Stater, 11030
        • North Shore University Hospital
      • New York, New York, Forenede Stater, 10021
        • Memorial Sloan-Kettering Cancer Center
      • New York, New York, Forenede Stater, 10021
        • New York Presbyterian Hospital - Cornell Campus
      • New York, New York, Forenede Stater, 10029
        • Mount Sinai Medical Center, NY
      • Syracuse, New York, Forenede Stater, 13210
        • State University of New York - Upstate Medical University
      • Syracuse, New York, Forenede Stater, 13210
        • Veterans Affairs Medical Center - Syracuse
      • Syracuse, New York, Forenede Stater, 13217
        • CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
    • North Carolina
      • Chapel Hill, North Carolina, Forenede Stater, 27599-7295
        • Lineberger Comprehensive Cancer Center, UNC
      • Durham, North Carolina, Forenede Stater, 27705
        • Veterans Affairs Medical Center - Durham
      • Durham, North Carolina, Forenede Stater, 27710
        • Duke Comprehensive Cancer Center
      • Winston-Salem, North Carolina, Forenede Stater, 27104-4241
        • CCOP - Southeast Cancer Control Consortium
      • Winston-Salem, North Carolina, Forenede Stater, 27157-1082
        • Comprehensive Cancer Center at Wake Forest University
    • Ohio
      • Columbus, Ohio, Forenede Stater, 43210-1240
        • Arthur G. James Cancer Hospital - Ohio State University
    • Rhode Island
      • Providence, Rhode Island, Forenede Stater, 02903
        • Rhode Island Hospital
    • Tennessee
      • Memphis, Tennessee, Forenede Stater, 38104
        • Veterans Affairs Medical Center - Memphis
      • Memphis, Tennessee, Forenede Stater, 38103
        • University of Tennessee Cancer Institute
    • Vermont
      • Bennington, Vermont, Forenede Stater, 05201
        • Green Mountain Oncology Group
      • Burlington, Vermont, Forenede Stater, 05401-3498
        • Vermont Cancer Center
      • White River Junction, Vermont, Forenede Stater, 05009
        • Veterans Affairs Medical Center - White River Junction
    • Virginia
      • Richmond, Virginia, Forenede Stater, 23298-0037
        • MBCCOP - Massey Cancer Center
      • Richmond, Virginia, Forenede Stater, 23249
        • Veterans Affairs Medical Center - Richmond

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

Ikke ældre end 59 år (Barn, Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

  1. Documentation of Disease

    1. Histologically documented mantle cell lymphoma of any stage (needle or core biopsy is not acceptable as the sole means of diagnosis) with at least one of the following confirmatory tests indicative of diagnosis:

      • Immunophenotype with expression of CD5 and CD19 and absence of CD23
      • Cytogenetic analysis with presence of t(11;14)
      • Overexpression of cyclin D1
      • Rearrangement of BCL1 gene
    2. Rebiopsy of a node at relapse is recommended but not required.
    3. Bone marrow biopsy required for pretreatment evaluation. Bilateral biopsies are not required.
  2. Identification of HLA-Matched sibling donor - The sibling donor must meet eligibility criteria outlined in section 5.0

  3. Prior Therapy

    1. Patients who have failed initial therapy are eligible (without any of the poor prognostic characteristics listed in the protocol). Failure to initial treatment is defined as one of the following:

      • Failure to achieve clinical complete remission after treatment with an anthracycline-containing regimen
      • Disease recurrence after initial treatment (with an anthracycline-containing regimen)

    2. Patients in first remission must have one of the following poor prognostic characteristics:

      • International Prognostic Index (IPI) score > 1. IPI risk factors include the following: age > 60 (not eligible for this protocol); performance status > 1; LDH > normal; presence of > 1 extranodal sites; and stage III/IV disease
      • Blastic variant of mantle cell lymphoma (regardless of IPI score)
      • Complex karyotypes (i.e., cytogenetic abnormalities different from or in addition to t(11;14) (regardless of IPI score)
      • Proliferative index > 10% (regardless of IPI score)
      • Presence of p53 mutations
    3. Patients who have received more than two chemotherapy regimens are ineligible. Patients who have undergone a prior bone marrow transplant are not eligible.
  4. Age < 60 years
  5. No active CNS lymphoma
  6. DLCO ≥ 40% and no symptomatic pulmonary disease
  7. No HIV infection
  8. Non-pregnant and non-nursing. Treatment under this protocol would expose an unborn child to significant risks. Women and men of reproductive potential should agree to use an effective means of birth control.

  9. Initial required laboratory values

    • bilirubin < 2 mg/dl
    • AST ≤ 3 x upper limit of normal (ULN)
    • ALT ≤ 3 x ULN
    • serum creatinine < 2 mg/dl
    • u-HCG or serum HCG negative (if patient of childbearing potential)

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: chemotherapy + stem cell transplantation

Patients receive carmustine, etoposide, cytarabine and melphalan on day -1. Patients undergo allogeneic peripheral blood stem cell (PBSC) transplantation on day 0. Patients also receive tacrolimus on day -2 and then orally twice daily until day 120 and methotrexate on days 1, 3, and 6 as graft-versus-host disease (GVHD) prophylaxis. Patients receive sargramostim daily beginning on day 7 and continuing until blood counts recover.

Patients with no active GVHD who have persistent disease on day 150 or progressive disease at any time after PBSC transplantation receive donor lymphocytes IV over 2 hours. Patients may receive additional donor lymphocytes at least 8 weeks later if disease persists.

Patients are followed at 6 and 12 months post-transplantation and then annually for 4 years.
Medicin: etoposid
IV
Medicin: cytarabin
IV
Medicin: melphalan
IV
Medicin: karmustin
IV
Medicin: tacrolimus
IV
Medicin: methotrexate
IV
Medicin: sargramostim
IV
Procedure: transplant

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
disease free survival
Tidsramme: up to 5 years post-transplant
up to 5 years post-transplant

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Alliance for Clinical Trials in Oncology

Samarbejdspartnere

National Cancer Institute (NCI)

Efterforskere

  • Studiestol: Koen Van Besien, MD, University of Chicago

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. november 2000

Primær færdiggørelse (Faktiske)

1. februar 2003

Studieafslutning (Faktiske)

1. februar 2003

Datoer for studieregistrering

Først indsendt

6. december 2000

Først indsendt, der opfyldte QC-kriterier

26. januar 2003

Først opslået (Skøn)

27. januar 2003

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

19. juli 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

15. juli 2016

Sidst verificeret

1. juli 2016

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • CALGB-59908
  • U10CA031946 (U.S. NIH-bevilling/kontrakt)
  • CLB-59908
  • CDR0000068324 (Registry Identifier: NCI Physician Data Query)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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