Denne side blev automatisk oversat, og nøjagtigheden af ​​oversættelsen er ikke garanteret. Der henvises til engelsk version for en kildetekst.

Reduced Intensity Total Body Irradiation + Thymoglobulin Followed by Allogeneic PBSCT

7. november 2018 opdateret af: Virginia Commonwealth University

Reduced Intensity Myeloablative Total Body Irradiation and Thymoglobulin Followed by Allogeneic Peripheral Blood Stem Cell Transplantation

One of two different doses of thymoglobulin will allow bone marrow engraftment with minimal Graft-versus-Host Disease and allow adequate immune response to allow the transplanted stem cells to replace the tumor cells.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This randomized phase II trial studies how well giving low dose total-body irradiation (TBI) with anti-thymocyte globulin followed by donor peripheral blood stem cell transplant (PBSCT) works in treating patients with hematologic malignancies. Giving reduced intensity total-body irradiation and anti-thymocyte globulin before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Sometimes the transplanted cells from a donor can make an immune response against the body's normal cells. Giving total-body irradiation together with antithymocyte globulin before transplant may stop this from happening.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

42

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
    • Virginia
      • Richmond, Virginia, Forenede Stater, 23298-0037
        • Virginia Commonwealth University/Massey 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

40 år til 70 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Patients with hematological malignancies for which allogeneic stem cell transplantation indicated including non-Hodgkin lymphoma (NHL), multiple myeloma (MM), acute myeloid leukemia (AML), Hodgkin lymphoma (HD), chronic lymphocytic leukemia (CLL), chronic myelogenous leukemia (CML), and myelodysplastic syndrome (MDS)
  • Patients with HLA compatible related or unrelated stem cell donor, willing and able to serve as an allogenic HSC donor. Unrelated donors have to be matched at HLA-A, B, C and DRB1 loci. A single locus mismatch will be tolerated in the event a more closely matched donor is not available.
  • Patients age >/=40 to </=70 with an ECOG performance status < 2
  • Patients between 18 and 40 years of age will be eligible only if they have co-morbidities precluding conventional allogeneic transplantation with full intensity myeloablative conditioning
  • Adequate cardiac, pulmonary, renal and hepatic function for transplant
  • Negative serology for HIV
  • Negative serum pregnancy test
  • Patients who have received therapeutic radiation to a localized field will be eligible, provided critical structure tolerance doses have not been exceeded
  • Patients who have had prior myeloablative autologous transplant will be eligible

Exclusion Criteria:

  • Evidence of uncontrolled viral, fungal, bacterial infection
  • Evidence of active meningeal or CNS disease
  • Prior therapy with rabbit ATG, prior treatment with equine ATG is allowed if more than 3 months ago
  • Breast feeding mothers are excluded

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: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: ATG 1.7 mg/kg, TBI, transplant
(Rabbit-ATG;Thymoglobulin,Genzyme) ATG 5.1 mg/kg in three divided doses (1.7 mg/kg/d) given over three days (day -9 to -7) followed by 450 cGy TBI and tacrolimus plus MMF GVHD prophylaxis. Patients receive lower dose anti-thymocyte globulin IV on days -9 to -7. Patients undergo total-body radiation (TBI) twice daily (BID) on day -1 and once daily (QD) on day 0. Patients then undergo peripheral blood stem cells or bone marrow transplant on day 0. GRAFT-VERSUS-HOST DISEASE PROPHYLAXIS: patients receive tacrolimus orally (PO) on days -2 to 90-120 with taper for 2 months, and mycophenolate mofetil (MMF) PO BID on days 0-30.
Medicin: Mycophenolatmofetil
Givet PO
Andre navne:
  • CellCept
  • MMF
Stråling: Bestråling af hele kroppen
Gennemgå TBI
Andre navne:
  • Helkropsbestråling
  • Total kropsbestråling [TBI]
Medicin: Tacrolimus
Givet PO
Andre navne:
  • Prograf
  • Hecoria
  • Fujimycin
  • Protopic
Biologisk: Thymoglobulin
Patients eligible for participation in this study will be randomized between receiving rabbit ATG for 3 days. Thymoglobulin will be administered according to VCU BMT standard of care starting day -9 and continued daily through day -7.
Andre navne:
  • ATG
  • Genzyme
  • anti-thymocyt globulin
  • anti-thymocyte globulin (rabbit)
  • Rabbit
  • Rabbit-ATG
Procedure: Allogeneic PBSCT or BMT
Undergo allogeneic PBSCT or BMT
Andre navne:
  • PBPC transplantation
  • Perifer blodprogenitorcelletransplantation
  • HSCT
  • Allogen BMT
  • Allogen hæmatopoietisk stamcelletransplantation
  • Peripheral Blood Stem Cell Transplantation [Allogenic PBSCT]
  • Allogeneic Bone Marrow Transplantation [BMT]
Eksperimentel: ATG 2.5 mg/kg/d, TBI, transplant
(Rabbit-ATG;Thymoglobulin,Genzyme) ATG 7.5 mg/kg in three divided doses (2.5 mg/kg/d) given over three days (day -9 to -7) followed by 450 cGy TBI and tacrolimus plus MMF GVHD prophylaxis. Patients receive higher dose anti-thymocyte globulin intravenously (IV) on days -9 to -7. Patients undergo total-body radiation (TBI) twice daily (BID) on day -1 and once daily (QD) on day 0. Patients then undergo peripheral blood stem cells or bone marrow transplant on day 0. GRAFT-VERSUS-HOST DISEASE PROPHYLAXIS: patients receive tacrolimus orally (PO) on days -2 to 90-120 with taper for 2 months, and mycophenolate mofetil (MMF) PO BID on days 0-30.
Medicin: Mycophenolatmofetil
Givet PO
Andre navne:
  • CellCept
  • MMF
Stråling: Bestråling af hele kroppen
Gennemgå TBI
Andre navne:
  • Helkropsbestråling
  • Total kropsbestråling [TBI]
Medicin: Tacrolimus
Givet PO
Andre navne:
  • Prograf
  • Hecoria
  • Fujimycin
  • Protopic
Biologisk: Thymoglobulin
Patients eligible for participation in this study will be randomized between receiving rabbit ATG for 3 days. Thymoglobulin will be administered according to VCU BMT standard of care starting day -9 and continued daily through day -7.
Andre navne:
  • ATG
  • Genzyme
  • anti-thymocyt globulin
  • anti-thymocyte globulin (rabbit)
  • Rabbit
  • Rabbit-ATG
Procedure: Allogeneic PBSCT or BMT
Undergo allogeneic PBSCT or BMT
Andre navne:
  • PBPC transplantation
  • Perifer blodprogenitorcelletransplantation
  • HSCT
  • Allogen BMT
  • Allogen hæmatopoietisk stamcelletransplantation
  • Peripheral Blood Stem Cell Transplantation [Allogenic PBSCT]
  • Allogeneic Bone Marrow Transplantation [BMT]

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The Comparison of Functional Immune Reconstitution at 6-9 Months Following Transplant as Measured by Antibody Response to Vaccination With Inactivated Hepatitis A or B Vaccine.
Tidsramme: Up to 9 months following transplant
A positive test result will indicate immune reconstitution, while a negative test results will indicate lack of immune reconstitution. Participants not done (ND) will be counted with the negative (Neg).
Up to 9 months following transplant

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Begivenhedsfri overlevelse
Tidsramme: 2 år
2 år
Engraftment of Donor Hematopoietic Stem Cells, as Measured by Time in Days to Neutrophil and Platelet Count Recovery Following Allogeneic PBSCT.
Tidsramme: Up to 52 weeks post transplant.
Up to 52 weeks post transplant.
Survival
Tidsramme: 2-year survival rate (%)
2-year survival rate (%)
Treatment Related Mortality
Tidsramme: Day 100
Day 100
Relapse
Tidsramme: 2 year relapse rate (%)
Patients with different disease relapses was determined according to current clinical standards based on the disease. For example, AML or MDS relapse is determined by a bone marrow biopsy. Multiple myeloma relapse requires a number of labs and/or biopsy to diagnose such as SPEP, UPEP, immunofixation, serum and urine light chains. In lymphoma disease is followed using CT and/or PET scans.
2 year relapse rate (%)
Donor Lymphocyte Infusion
Tidsramme: 2 year rate of DLI
2 year rate of DLI
Acute Graft-Versus-Host Disease (GVHD)
Tidsramme: 2 year rate (%)
2 year rate (%)
Chronic Graft-Versus-Host Disease (GVHD)
Tidsramme: 2 year GVHD rate
2 year GVHD rate

Samarbejdspartnere og efterforskere

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

Sponsor

Virginia Commonwealth University

Samarbejdspartnere

Genzyme, a Sanofi Company

Efterforskere

  • Ledende efterforsker: Amir Toor, MD, Massey Cancer Center

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Hjælpsomme links

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 (Faktiske)

21. juli 2008

Primær færdiggørelse (Faktiske)

15. februar 2014

Studieafslutning (Faktiske)

28. juni 2017

Datoer for studieregistrering

Først indsendt

1. juli 2008

Først indsendt, der opfyldte QC-kriterier

2. juli 2008

Først opslået (Skøn)

3. juli 2008

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

9. november 2018

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. november 2018

Sidst verificeret

1. november 2018

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • MCC-11561
  • NCI-2011-01698 (Anden identifikator: CTRP (Clinical Trial Reporting Program))

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ja

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 .

Abonner