Sirolimus, Tacrolimus, and Antithymocyte Globulin in Preventing Graft-Versus-Host Disease in Patients Undergoing a Donor Stem Cell Transplant For Hematological Cancer
3. september 2014 opdateret af: City of Hope Medical Center
A Phase II Study of Sirolimus, Tacrolimus and Thymoglobulin, as Graft-versus-Host Prophylaxis in Patients Undergoing Unrelated Donor Hematopoietic Cell Transplantation
RATIONALE: Giving chemotherapy and total-body irradiation before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving tacrolimus, sirolimus, antithymocyte globulin, and methotrexate before and after transplant may stop this from happening.
PURPOSE: This phase II trial is studying how well sirolimus, tacrolimus, and antithymocyte globulin work in preventing graft-versus-host disease in patients undergoing a donor stem cell transplant for hematological cancer .
Studieoversigt
Status
Afsluttet
Betingelser
Intervention / Behandling
- Biologisk: anti-thymocyte globulin
- Medicin: fludarabine phosphate
- Medicin: melphalan
- Medicin: methotrexate
- Medicin: sirolimus
- Medicin: tacrolimus
- Procedure: allogeneic hematopoietic stem cell transplantation
- Procedure: hematopoietic stem cell transplantation
- Procedure: nonmyeloablative allogeneic hematopoietic stem cell transplantation
- Procedure: peripheral blood stem cell transplantation
- Stråling: total-body irradiation
- Medicin: cyclophosphamide
- Medicin: etoposide
Detaljeret beskrivelse
OBJECTIVES:
Primary
- To determine the incidence and severity of acute- and chronic-graft-versus-host disease (GVHD) after HLA-matched or -mismatched unrelated donor hematopoietic peripheral blood transplantation in patients with hematologic malignancies scheduled to receive immunosuppressive combination of sirolimus, tacrolimus, and anti-thymocyte globulin as GVHD prophylaxis.
- To determine the safety of this combination in the first six months post-transplant.
Secondary
- To determine the time-to-engraftment, non-relapse mortality rate, overall and disease-free survival, incidence of disease relapse, and incidence of opportunistic infections with this GVHD prophylaxis.
OUTLINE: Patients are stratified according to conditioning regimen (fludarabine phosphate and melphalan vs fractionated total-body irradiation [FTBI] and etoposide vs FTBI and cyclophosphamide) and degree of donor/recipient HLA mismatch (high-risk vs low-risk).
- Conditioning regimen: Patients receive 1 of 3 standard conditioning regimens beginning on day -9 or -8 and continuing to day -1 or 0.
- Peripheral blood stem cell transplantation: Patients receive HLA-matched or mismatched unrelated donor peripheral blood stem cells on day 0.
- Graft-versus-host disease prophylaxis: Patients receive tacrolimus IV continuously beginning on day -3 and then orally when tolerated, oral sirolimus on days -3 and -2, anti-thymocyte globulin IV over 4-8 hours on days -3 to 0, and methotrexate* IV on days 1, 3, and 6. Tacrolimus and sirolimus continue for 3-6 months (with taper).
NOTE: *Only patients with high-risk HLA mismatch receive treatment with methotrexate.
After completion of study therapy, patients are followed periodically for up to 2 years.
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
32
Fase
- Fase 2
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
-
Arizona
-
Phoenix, Arizona, Forenede Stater, 85006
- Banner Good Samaritan Medical Center
-
-
California
-
Duarte, California, Forenede Stater, 91010-3000
- City of Hope Comprehensive Cancer Center
-
-
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
2 år og ældre (Barn, Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
DISEASE CHARACTERISTICS:
Diagnosis of hematological malignancy including any of the following:
- Non-Hodgkin lymphoma (NHL) in any complete remission (CR) or partial response (PR)
- Hodgkin lymphoma in any CR or PR
Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) in any CR
- Bone marrow blasts < 20% within 4 weeks of transplant and peripheral blood absolute blast count < 500/µL on the day of initiation of conditioning for patients with non-CR AML or ALL
- Myelodysplastic syndromes (MDS) treated or untreated
- Chronic myelogenous leukemia (CML) in chronic or accelerated phase
- Multiple myeloma in any CR or PR
- Chronic lymphocytic leukemia in CR or PR 2 or greater
Myelofibrosis and other myeloproliferative disorders
- Bone marrow blasts < 20% within 4 weeks of transplant and peripheral blood absolute blast count < 500/µL on the day of initiation
- High-risk disease defined as AML or ALL > CR1, accelerated phase CML, recurrent aggressive lymphoma, or active lymphoproliferative disease at transplant
- Low-risk disease defined as AML or ALL in CR1, chronic phase CML, or low-grade lymphoproliferative disorder with controlled disease at transplant
Must be planning to receive 1 of the following conditioning regimens at City of Hope:
- Fludarabine phosphate and melphalan for patients with hematological malignancies and contraindications for conventional myeloablative regimens due to age, co-morbidity, or previous transplant
- Fractionated total-body irradiation (FTBI) and etoposide for patients with AML and ALL or CML in accelerated phase
- FTBI and cyclophosphamide for patients with NHL, AML, CML, and MDS
Suitable unrelated donor available
- HLA-matched or mismatched
- Peripheral blood stem cells available
- No bone marrow or ex vivo-engineered or processed graft (e.g., CD34-positive, T-cell depletion)
- No uncontrolled CNS disease
PATIENT CHARACTERISTICS:
- Karnofsky performance status (PS) 70-100% or ECOG PS 0-2
- Creatinine < 1.3 mg/dL or creatinine clearance ≥ 70 mL/min
- Ejection fraction > 45%
- Direct bilirubin < 3 times upper limit of normal (ULN)
- ALT and AST < 3 times ULN
- Forced vital capacity, FEV1, and DLCO > 45% of predicted
- Able to cooperate with oral medication intake
- No active donor or recipient serology positive for HIV
- No known contraindication to administration of sirolimus, tacrolimus, or anti-thymocyte globulin
- No active hepatitis B or C
- Negative pregnancy test
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- Concurrent participation in other clinical trials for prevention or treatment of viral, bacterial, or fungal disease allowed provided agents do not interact with agents used in the current study
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Støttende pleje
- Tildeling: Ikke-randomiseret
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Eksperimentel: Fludarabine/Melphalan Conditioning
Fludarabine/Melphalan Conditioning with Sirolimus, Tacrolimus and rabbit anti-thymocyte globulin (+/- methotrexate) for GvHD Prophylaxis |
0.5 mg/kg on day -3, 1.5 mg/kg on day -2 and 2.5 mg/kg on day -1 or day 0 from stem cell transplant
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant
Melphalan 140 mg/m2 on day -4 from stem cell transplant
For high risk HLA-mismatch transplant only: 5 mg/m2 on days +1, +3 and +6 from stem cell transplant
Adults: 12 mg loading dose on day -3 from stem cell transplant followed by 4 mg orally single morning daily dose. Pediatric Patients <40kg: 3 mg/m2 orally on day -3 from stem cell transplant followed by 1 mg/m2 orally single morning daily dose
0.02 mg/kd/d CIV beginning on day -3 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant, Melphalan 140 mg/m2 on day -4 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
1320 cGy in 11 fractions from day -8 to day -5 or day -9 to day -6 prior to stem cell transplant
|
|
Eksperimentel: FTBI/Cytoxan Conditioning
FTBI/Cytoxan Conditioning with Sirolimus, Tacrolimus and rabbit anti-thymocyte globulin (+/- methotrexate) for GvHD Prophylaxis
|
0.5 mg/kg on day -3, 1.5 mg/kg on day -2 and 2.5 mg/kg on day -1 or day 0 from stem cell transplant
For high risk HLA-mismatch transplant only: 5 mg/m2 on days +1, +3 and +6 from stem cell transplant
Adults: 12 mg loading dose on day -3 from stem cell transplant followed by 4 mg orally single morning daily dose. Pediatric Patients <40kg: 3 mg/m2 orally on day -3 from stem cell transplant followed by 1 mg/m2 orally single morning daily dose
0.02 mg/kd/d CIV beginning on day -3 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant, Melphalan 140 mg/m2 on day -4 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
1320 cGy in 11 fractions from day -8 to day -5 or day -9 to day -6 prior to stem cell transplant
60mg/kg on days -5 and -4 from stem cell transplant
|
|
Eksperimentel: FTBI/Etoposide Conditioning
FTBI/Etoposide Conditioning with Sirolimus, Tacrolimus and rabbit anti-thymocyte globulin (+/- methotrexate) for GvHD Prophylaxis |
0.5 mg/kg on day -3, 1.5 mg/kg on day -2 and 2.5 mg/kg on day -1 or day 0 from stem cell transplant
For high risk HLA-mismatch transplant only: 5 mg/m2 on days +1, +3 and +6 from stem cell transplant
Adults: 12 mg loading dose on day -3 from stem cell transplant followed by 4 mg orally single morning daily dose. Pediatric Patients <40kg: 3 mg/m2 orally on day -3 from stem cell transplant followed by 1 mg/m2 orally single morning daily dose
0.02 mg/kd/d CIV beginning on day -3 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
Fludarabine 25 mg/m2/d from days -9 to -5 from stem cell transplant, Melphalan 140 mg/m2 on day -4 from stem cell transplant
The target peripheral blood stem cell dose will be 5-10 x 106/kg actual body weight
1320 cGy in 11 fractions from day -8 to day -5 or day -9 to day -6 prior to stem cell transplant
60mg/kg on day -4 from stem cell transplant
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Cumulative Incidence of Grade II-IV Acute Graft-Versus-Host Disease (GVHD) at Day 100
Tidsramme: 100 Days Post Hematopoietic Stem Cell Transplant (HSCT)
|
Patients were evaluated for the development of acute GVHD within the first 100 days post HSCT.
The cumulative incidence of grade II-IV acute GVHD was determined using competing risk analysis.
Competing risks for acute GVHD were death and nonengraftment.
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100 Days Post Hematopoietic Stem Cell Transplant (HSCT)
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Severity of Acute GVHD
Tidsramme: 100 Days Post HSCT
|
All patients were considered for the evaluation of the severity of acute GVHD.
|
100 Days Post HSCT
|
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Cumulative Incidence of Chronic GVHD
Tidsramme: 2 year point estimate was provided.
|
Patients were evaluated for the development of chronic GVHD from 101 days post HSCT to last contact or documented evidence of the disease.
The cumulative incidence of chronic GVHD was determined using competing risk analysis.
Competing risks for GVHD were death and nonengraftment.
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2 year point estimate was provided.
|
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Severity of Chronic GVHD
Tidsramme: Patients were evaluated until they developed chronic GVHD, a median of 130 days post HSCT
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All Patients were considered for the evaluation of chronic GVHD severity.
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Patients were evaluated until they developed chronic GVHD, a median of 130 days post HSCT
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Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Time to Absolute Neutrophil Count Recovery (Engraftment)
Tidsramme: Patients were evaluated until neutrophil recovery, a median of 15 days post HSCT
|
Absolute neutrophil count (ANC) recovery is defined as an ANC of ≥ 0.5 x 10^9/L (500/mm3) for three consecutive laboratory values obtained on different days
|
Patients were evaluated until neutrophil recovery, a median of 15 days post HSCT
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Time to Platelet Count Recovery (Engraftment)
Tidsramme: Patients were evaluated until platelet recovery, a median of 14 days
|
Platelet recovery is defined as the first date of three consecutive laboratory values ≥ 25 x 10^9 L obtained on different days.
|
Patients were evaluated until platelet recovery, a median of 14 days
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Occurence of Infections Including Cytomegalovirus and Epstein-Barr Virus Reactivation
Tidsramme: Median Follow Up: 28 months (Range: 1-49 months)
|
Participants were monitored throughout the trial (median of 28 months) for various infections/complications.
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Median Follow Up: 28 months (Range: 1-49 months)
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Occurrence of Thrombotic Microangiopathy
Tidsramme: Median Follow Up: 28 Months (Range: 1-49 months)
|
Participants were monitored throughout the trial (median of 28 months) for various infections/complications.
This is the number of participants who developed TMA.
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Median Follow Up: 28 Months (Range: 1-49 months)
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Occurence of Sinusoidal Obstructive Syndrome (SOS)
Tidsramme: Median Follow Up: 28 Months (Range: 1-49 Months)
|
Participants were monitored throughout the trial (median of 28 months) for various infections/complications.
This is the number of participants who developed SOS.
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Median Follow Up: 28 Months (Range: 1-49 Months)
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Non-relapse Mortality at 100 Days Post HSCT
Tidsramme: 100 day point estimate was provided
|
Patients were evaluated for non-relapse mortality (NRM) throughout the study.
Non-relapse mortality was considered any death not attributable to relapse or disease progression.
The cumulative incidence of NRM was determined using competing risk analysis.
Competing risks for NRM were death due to disease progression, relapse and nonengraftment.
|
100 day point estimate was provided
|
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Non-relapse Mortality at Two Years Post HSCT
Tidsramme: 2 year point estimate was provided.
|
Patients were evaluated for non-relapse mortality (NRM) throughout the study.
Non-relapse mortality was considered any death not attributable to relapse or disease progression.
The cumulative incidence of NRM was determined using competing risk analysis.
Competing risks for NRM were death due to disease progression, relapse and nonengraftment.
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2 year point estimate was provided.
|
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Overall Survival at Two Years Post HSCT
Tidsramme: 2 year point estimate was provided.
|
Patients were evaluated for survival (OS) throughout the study.
Kaplan Meier estiamtes were calculated for overall survival using time from HSCT to death of any cause or for surviving patients last contact date.
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2 year point estimate was provided.
|
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Event Free Survival at Two Years Post HSCT
Tidsramme: 2 year point estimate was provided.
|
Patients were evaluated for event free survival (EFS) throughout the study.
Events were defined as death, relapse, progression, or nonengraftment.
Kaplan Meier estimates were calculated as time from HSCT to event.
|
2 year point estimate was provided.
|
|
Incidence of Disease Relapse/Progression at 2 Years Post HSCT
Tidsramme: 2 year point estimate was provided.
|
Patients were evaluated for relapse/progression post transplant throughout the study.
The cumulative incidence of relapse/progression was determined using competing risk analysis.
Competing risks for relapse were non-relapse mortality and nonengraftment.
|
2 year point estimate was provided.
|
Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Samarbejdspartnere
Efterforskere
- Studiestol: Ryotaro Nakamura, MD, City of Hope Comprehensive Cancer Center
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. maj 2007
Primær færdiggørelse (Faktiske)
1. februar 2012
Studieafslutning (Faktiske)
1. februar 2012
Datoer for studieregistrering
Først indsendt
21. december 2007
Først indsendt, der opfyldte QC-kriterier
25. december 2007
Først opslået (Skøn)
9. januar 2008
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
10. september 2014
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
3. september 2014
Sidst verificeret
1. september 2014
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
- primær myelofibrose
- stadium I kutan T-celle non-Hodgkin lymfom
- stadium I kronisk lymfatisk leukæmi
- infektion
- stadium III voksent diffust storcellet lymfom
- stadium III voksen immunoblastisk storcellet lymfom
- stadium III voksen Burkitt lymfom
- stadium IV grad 3 follikulært lymfom
- stadium IV voksent diffust storcellet lymfom
- stadium IV voksen immunoblastisk storcellet lymfom
- stadium IV voksen Burkitt lymfom
- tilbagevendende grad 3 follikulært lymfom
- tilbagevendende voksent diffust storcellet lymfom
- tilbagevendende voksen immunoblastisk storcellet lymfom
- recidiverende voksen Burkitt lymfom
- stadium III barndoms små ikke-spaltede celle lymfom
- stadium IV barndom små non-cleaved cell lymfom
- tilbagevendende små ikke-spaltede celle lymfomer i barndommen
- kronisk myelomonocytisk leukæmi
- de novo myelodysplastiske syndromer
- tidligere behandlede myelodysplastiske syndromer
- sekundære myelodysplastiske syndromer
- akut myeloid leukæmi hos voksne med 11q23 (MLL) abnormiteter
- akut myeloid leukæmi hos voksne med inv(16)(p13;q22)
- akut myeloid leukæmi hos voksne med t(15;17)(q22;q12)
- akut myeloid leukæmi hos voksne med t(16;16)(p13;q22)
- akut myeloid leukæmi hos voksne med t(8;21)(q22;q22)
- sekundær akut myeloid leukæmi
- akut lymfatisk leukæmi i barndommen i remission
- akut myeloid leukæmi i barndommen i remission
- juvenil myelomonocytisk leukæmi
- kronisk fase kronisk myelogen leukæmi
- barndoms myelodysplastiske syndromer
- tilbagevendende akut myeloid leukæmi hos voksne
- akut myeloid leukæmi hos voksne i remission
- recidiverende voksen Hodgkin lymfom
- tilbagevendende/refraktær Hodgkin-lymfom i barndommen
- recidiverende voksent diffust små spaltet celle lymfom
- recidiverende voksent diffust blandet celle lymfom
- recidiverende kronisk myelogen leukæmi
- stadium III grad 1 follikulært lymfom
- stadium III grad 2 follikulært lymfom
- stadium III grad 3 follikulært lymfom
- stadium III voksent diffust små spaltet celle lymfom
- stadium III voksent diffust blandet celle lymfom
- stadium IV grad 1 follikulært lymfom
- stadium IV grad 2 follikulært lymfom
- stadium IV voksent diffust små spaltet celle lymfom
- stadium IV voksent diffust blandet celle lymfom
- stadium III mantelcellelymfom
- stadium IV mantelcellelymfom
- stadium II myelomatose
- stadium III myelomatose
- stadium I voksent diffust små spaltet celle lymfom
- tilbagevendende grad 1 follikulært lymfom
- tilbagevendende grad 2 follikulært lymfom
- sammenhængende fase II grad 1 follikulært lymfom
- sammenhængende stadium II grad 2 follikulært lymfom
- sammenhængende stadium II voksent diffust små spaltet celle lymfom
- ikke-sammenhængende stadium II grad 1 follikulært lymfom
- ikke-sammenhængende stadium II grad 2 follikulært lymfom
- ikke-sammenhængende stadium II voksent diffust små spaltet celle lymfom
- ikke-sammenhængende trin II lille lymfocytisk lymfom
- noncontiguous stadium II marginal zone lymfom
- tilbagevendende marginal zone lymfom
- tilbagevendende lille lymfocytisk lymfom
- stadium III lille lymfatisk lymfom
- stadium III marginal zone lymfom
- stadium IV lille lymfocytisk lymfom
- stadium IV marginal zone lymfom
- sammenhængende stadium II marginal zone lymfom
- sammenhængende fase II lille lymfocytisk lymfom
- ekstranodal marginal zone B-celle lymfom af slimhinde-associeret lymfoid væv
- nodal marginal zone B-celle lymfom
- milt marginal zone lymfom
- stadium I myelomatose
- tilbagevendende lymfoblastisk lymfom hos voksne
- tilbagevendende kappecellelymfom
- refraktær kronisk lymfatisk leukæmi
- stadium II kronisk lymfatisk leukæmi
- stadium III kronisk lymfatisk leukæmi
- stadium IV kronisk lymfatisk leukæmi
- stadium III voksen Hodgkin lymfom
- stadium IV voksen Hodgkin lymfom
- stadium III kutant T-celle non-Hodgkin lymfom
- stadium IV kutant T-celle non-Hodgkin lymfom
- tilbagevendende kutant T-celle non-Hodgkin lymfom
- tyndtarms lymfom
- stadium III voksen lymfoblastisk lymfom
- stadium IV voksen lymfoblastisk lymfom
- stadium III voksen T-celle leukæmi/lymfom
- stadium IV voksen T-celle leukæmi/lymfom
- tilbagevendende voksen T-celle leukæmi/lymfom
- angioimmunoblastisk T-celle lymfom
- anaplastisk storcellet lymfom
- tilbagevendende voksen grad III lymfomatoid granulomatose
- kutant B-celle non-Hodgkin lymfom
- tilbagevendende akut lymfatisk leukæmi hos voksne
- tilbagevendende akut lymfatisk leukæmi hos børn
- stadium III barndoms lymfoblastisk lymfom
- stadium IV barndoms lymfoblastisk lymfom
- sammenhængende fase II mantelcellelymfom
- ikke-sammenhængende stadium II mantelcellelymfom
- stadium II kutant T-celle non-Hodgkin lymfom
- ikke-sammenhængende stadium II voksent diffust storcellet lymfom
- ikke-sammenhængende stadium II voksent diffust blandet celle lymfom
- ikke-sammenhængende stadium II voksen lymfoblastisk lymfom
- ikke-sammenhængende stadium II grad 3 follikulært lymfom
- accelereret fase kronisk myelogen leukæmi
- akut lymfatisk leukæmi hos voksne i remission
- stadium IV barndom Hodgkin lymfom
- tilbagevendende akut myeloid leukæmi i barndommen
- myelodysplastisk/myeloproliferativ neoplasma, uklassificerbar
- atypisk kronisk myeloid leukæmi, BCR-ABL negativ
- ikke-sammenhængende stadium II voksen Burkitt lymfom
- ikke-sammenhængende stadium II voksent immunoblastisk storcellet lymfom
- tilbagevendende lymfoblastisk lymfom i barndommen
- stadium III barndoms Hodgkin lymfom
- stadium I voksen Hodgkin lymfom
- stadium II voksen Hodgkin lymfom
- stadium I voksen Burkitt lymfom
- sammenhængende stadium II voksen Burkitt lymfom
- sammenhængende stadium II voksent immunoblastisk storcellet lymfom
- stadium I voksen immunoblastisk storcellet lymfom
- stadium I barndoms Hodgkin lymfom
- stadium II barndoms Hodgkin lymfom
- tilbagevendende barndomsgrad III lymfomatoid granulomatose
- tilbagevendende anaplastisk storcellet lymfom i barndommen
- stadium III anaplastisk storcellet lymfom i barndommen
- stadium IV anaplastisk storcellet lymfom i barndommen
- sammenhængende stadium II grad 3 follikulært lymfom
- sammenhængende stadium II voksent diffust storcellet lymfom
- sammenhængende stadium II voksent diffust blandet celle lymfom
- stadium I voksent diffust storcellet lymfom
- stadium I voksent diffust blandet celle lymfom
- stadium I voksen T-celle leukæmi/lymfom
- sammenhængende stadium II voksen lymfoblastisk lymfom
- stadium I voksen lymfoblastisk lymfom
- Burkitt lymfom
- graft versus host sygdom
- gunstig prognose for voksne Hodgkin lymfom
- voksen ugunstig prognose Hodgkin lymfom
- sekundær myelofibrose
- barndom ugunstig prognose Hodgkin lymfom
- childhood favorable prognosis Hodgkin lymphoma
- tilbagevendende grad I lymfomatoid granulomatose
- recidiverende grad II lymfomatoid granulomatose
Yderligere relevante MeSH-vilkår
- Sygdomme i fordøjelsessystemet
- Patologiske processer
- Hjerte-kar-sygdomme
- Karsygdomme
- Sygdomme i immunsystemet
- Neoplasmer efter histologisk type
- Lymfoproliferative lidelser
- Lymfesygdomme
- Immunproliferative lidelser
- Neoplasmer efter sted
- Sygdom
- Knoglemarvssygdomme
- Hæmatologiske sygdomme
- Gastrointestinale neoplasmer
- Neoplasmer i fordøjelsessystemet
- Gastrointestinale sygdomme
- Hæmoragiske lidelser
- Tarmsygdomme
- Hæmostatiske lidelser
- Paraproteinæmier
- Blodproteinforstyrrelser
- Neoplastiske processer
- Neoplasmer
- Lymfom
- Syndrom
- Myelodysplastiske syndromer
- Primær myelofibrose
- Myelomatose
- Neoplasmer, Plasmacelle
- Leukæmi
- Neoplasma Metastase
- Præleukæmi
- Plasmacytom
- Intestinale neoplasmer
- Myeloproliferative lidelser
- Myelodysplastisk-myeloproliferative sygdomme
- Graft vs værtssygdom
- Forstadier til kræft
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Anti-infektionsmidler
- Nukleinsyresyntesehæmmere
- Enzymhæmmere
- Antirheumatiske midler
- Antimetabolitter, Antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Antineoplastiske midler, fytogene
- Topoisomerase II-hæmmere
- Topoisomerasehæmmere
- Dermatologiske midler
- Antibakterielle midler
- Antibiotika, antineoplastisk
- Antifungale midler
- Reproduktive kontrolmidler
- Abortfremkaldende midler, ikke-steroide
- Aborterende midler
- Folinsyreantagonister
- Calcineurin-hæmmere
- Cyclofosfamid
- Etoposid
- Melphalan
- Fludarabin
- Fludarabin phosphat
- Methotrexat
- Tacrolimus
- Sirolimus
- Antimfocyt serum
Andre undersøgelses-id-numre
- 06141
- P30CA033572 (U.S. NIH-bevilling/kontrakt)
- CHNMC-06141
- CDR0000579340 (Registry Identifier: NCI PDQ)
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