- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00233987
S0410 Tandem Stem Cell Transplantation in Treating Patients With Progressive or Recurrent Hodgkin's Lymphoma
Tandem Autologous Stem Cell Transplantation for Patients With Primary Progressive or Recurrent Hodgkin's Disease (A BMT Study), Phase II
RATIONALE: Radiation therapy uses high-energy x-rays to kill cancer cells. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving chemotherapy with a peripheral stem cell transplant may allow more chemotherapy to be given so that more cancer cells are killed. Tandem (two) autologous stem cell transplants may be an effective treatment for Hodgkin's lymphoma.
PURPOSE: This phase II trial is studying how well tandem stem cell transplantation works in treating patients with progressive or recurrent Hodgkin's lymphoma.
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
OBJECTIVES:
- Determine the 2-year progression-free survival of patients with progressive or recurrent Hodgkin's lymphoma treated with tandem autologous stem cell transplantation (2 courses of high-dose therapy with autologous stem cell rescue).
- Determine the response rate in patients treated with this regimen.
- Determine the toxic effects of this regimen in these patients.
OUTLINE: This is a multicenter study.
- Salvage therapy (for patients with relapsed disease after achieving a previous complete response): Patients receive at least 2 courses of salvage chemotherapy or radiotherapy. No more than 6 weeks later, patients proceed to autologous hematopoietic stem cell collection.
- Autologous hematopoietic stem cell collection: Patients undergo autologous hematopoietic stem cell collection. Patients with an inadequate number of collected stem cells are removed from the study.
- Pre-transplant salvage radiation: Patients with residual tumor greater than 5 cm after initial salvage therapy undergo involved-field radiotherapy. All patients then proceed to the first preparative regimen.
- First preparative regimen: Patients receive high-dose melphalan IV on day -1.
- First autologous stem cell transplantation (SCT): Patients undergo autologous SCT on day 0. At least 28 days later, patients proceed to second preparative regimen.
Second preparative regimen: Patients receive 1 of the following preparative regimens:
- Total-body irradiation (TBI)-based regimen: Patients undergo TBI twice daily on days -8 to -5. Patients also receive etoposide IV over 4 hours on day -4 and cyclophosphamide IV over 1 hour on day -2.
- Carmustine-based regimen: Patients receive carmustine IV over 2 hours on days -6 to -4, etoposide IV over 4 hours on day -4, and cyclophosphamide IV over 1 hour on day -2.
- Second autologous SCT: Patients undergo second autologous SCT on day 0. After completion of study treatment, patients are followed every 6 months for 2 years and then annually for up to 7 years.
PROJECTED ACCRUAL: A total of 85 patients will be accrued for this study over 2 years.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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California
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Sacramento, California, Vereinigte Staaten, 95817
- University of California Davis Cancer Center
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Idaho
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Boise, Idaho, Vereinigte Staaten, 83712
- Mountain States Tumor Institute at St. Luke's Regional Medical Center
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Illinois
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Maywood, Illinois, Vereinigte Staaten, 60153
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
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Kansas
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Chanute, Kansas, Vereinigte Staaten, 66720
- Cancer Center of Kansas, PA - Chanute
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Dodge City, Kansas, Vereinigte Staaten, 67801
- Cancer Center of Kansas, PA - Dodge City
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El Dorado, Kansas, Vereinigte Staaten, 67042
- Cancer Center of Kansas, PA - El Dorado
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Independence, Kansas, Vereinigte Staaten, 67301
- Cancer Center of Kansas-Independence
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Kingman, Kansas, Vereinigte Staaten, 67068
- Cancer Center of Kansas, PA - Kingman
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Liberal, Kansas, Vereinigte Staaten, 67901
- Southwest Medical Center
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Newton, Kansas, Vereinigte Staaten, 67114
- Cancer Center of Kansas, PA - Newton
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Parsons, Kansas, Vereinigte Staaten, 67357
- Cancer Center of Kansas, PA - Parsons
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Pratt, Kansas, Vereinigte Staaten, 67124
- Cancer Center of Kansas, PA - Pratt
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Salina, Kansas, Vereinigte Staaten, 67042
- Cancer Center of Kansas, PA - Salina
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Wellington, Kansas, Vereinigte Staaten, 67152
- Cancer Center of Kansas, PA - Wellington
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Wichita, Kansas, Vereinigte Staaten, 67208
- Cancer Center of Kansas, PA - Medical Arts Tower
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Wichita, Kansas, Vereinigte Staaten, 67214
- Cancer Center of Kansas, PA - Wichita
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Wichita, Kansas, Vereinigte Staaten, 67214
- CCOP - Wichita
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Wichita, Kansas, Vereinigte Staaten, 67214
- Via Christi Cancer Center at Via Christi Regional Medical Center
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Wichita, Kansas, Vereinigte Staaten, 67208
- Associates in Womens Health, PA - North Review
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Winfield, Kansas, Vereinigte Staaten, 67156
- Cancer Center of Kansas, PA - Winfield
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Louisiana
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Alexandria, Louisiana, Vereinigte Staaten, 71315-3198
- Tulane Cancer Center Office of Clinical Research
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Oregon
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Gresham, Oregon, Vereinigte Staaten, 97030
- Legacy Mount Hood Medical Center
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Milwaukie, Oregon, Vereinigte Staaten, 97222
- Providence Milwaukie Hospital
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Portland, Oregon, Vereinigte Staaten, 97216
- Adventist Medical Center
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Portland, Oregon, Vereinigte Staaten, 97210
- Legacy Good Samaritan Hospital & Comprehensive Cancer Center
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Portland, Oregon, Vereinigte Staaten, 97213-2967
- Providence Cancer Center at Providence Portland Medical Center
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Portland, Oregon, Vereinigte Staaten, 97225
- CCOP - Columbia River Oncology Program
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Portland, Oregon, Vereinigte Staaten, 97225
- Providence St. Vincent Medical Center
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Portland, Oregon, Vereinigte Staaten, 97227
- Legacy Emanuel Hospital and Health Center and Children's Hospital
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Tualatin, Oregon, Vereinigte Staaten, 97062
- Legacy Meridian Park Hospital
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Tennessee
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Knoxville, Tennessee, Vereinigte Staaten, 37916
- Thompson Cancer Survival Center
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Washington
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Auburn, Washington, Vereinigte Staaten, 98002
- Auburn Regional Center for Cancer Care
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Bellingham, Washington, Vereinigte Staaten, 98225
- St. Joseph Cancer Center
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Bremerton, Washington, Vereinigte Staaten, 98310
- Olympic Hematology and Oncology
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Centralia, Washington, Vereinigte Staaten, 98531-9027
- Providence Centralia Hospital
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Federal Way, Washington, Vereinigte Staaten, 98003
- St. Francis Hospital
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Kennewick, Washington, Vereinigte Staaten, 99336
- Columbia Basin Hematology
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Olympia, Washington, Vereinigte Staaten, 98506-5166
- Providence St. Peter Hospital Regional Cancer Center
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Puyallup, Washington, Vereinigte Staaten, 98372
- Good Samaritan Cancer Center
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Seattle, Washington, Vereinigte Staaten, 98104
- Harborview Medical Center
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Seattle, Washington, Vereinigte Staaten, 98104
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, Vereinigte Staaten, 98104
- Minor and James Medical, PLLC
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Seattle, Washington, Vereinigte Staaten, 98112
- Group Health Central Hospital
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Seattle, Washington, Vereinigte Staaten, 98122-4307
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
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Seattle, Washington, Vereinigte Staaten, 98122
- Polyclinic First Hill
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Seattle, Washington, Vereinigte Staaten, 98195-6043
- University Cancer Center at University of Washington Medical Center
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Spokane, Washington, Vereinigte Staaten, 99202
- Cancer Care Northwest - Spokane South
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Tacoma, Washington, Vereinigte Staaten, 98405-3004
- Franciscan Cancer Center at St. Joseph Medical Center
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Tacoma, Washington, Vereinigte Staaten, 98405
- Allenmore Hospital
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Tacoma, Washington, Vereinigte Staaten, 98405
- CCOP - Northwest
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Tacoma, Washington, Vereinigte Staaten, 98405
- MultiCare Regional Cancer Center at Tacoma General Hospital
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Tacoma, Washington, Vereinigte Staaten, 98499
- St. Clare Hospital
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Vancouver, Washington, Vereinigte Staaten, 98668
- Southwest Washington Medical Center Cancer Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
DISEASE CHARACTERISTICS:
Histologically or cytologically confirmed Hodgkin's lymphoma
- Relapsed or refractory disease
- Biopsy or radiological evidence of disease at time of recurrence/progression required
- Has received ≥ 1 prior systemic chemotherapy regimen
- No clonal abnormalities in marrow collection
- Must undergo involved-field radiotherapy if bulky disease > 5 cm
Must have adequate sections of original diagnostic specimen available for review
- Needle aspirations or cytologies are not adequate
- No prior lymphoma, myelodysplastic syndromes, or leukemia (even if disease free > 5 years)
- Patients who relapse after achieving a complete remission must complete a minimum of 2 courses of salvage chemotherapy or radiation therapy to determine if sensitive or resistant recurrent disease is present
- No central nervous system (CNS) involvement
PATIENT CHARACTERISTICS:
Age
- 15 to 70
Performance status
- Zubrod 0-2
Life expectancy
- Not specified
Hematopoietic
- Absolute neutrophil count ≥ 1,500/mm^3
Hepatic
- Bilirubin ≤ 1.5 times upper limit of normal (ULN) (unless due to Hodgkin's disease)
Renal
- Creatinine clearance ≥ 60 mL/min
- Creatinine ≤ 2 times upper limit of normal
Cardiovascular
None of the following conditions requiring therapy:
- Coronary artery disease
- Cardiomyopathy
- Congestive heart failure
- Arrhythmias
- Ejection fraction ≥ 45% by Multi Gated Acquisition Scan (MUGA) or 2-D echocardiogram
Pulmonary
- Adequate pulmonary function
- Corrected diffusing capacity of lung for carbon monoxide (DLCO) ≥ 60% OR
- Forced Expiratory Volume in One Side (FEV_1) ≥ 60% of predicted
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No other malignancy within the past 5 years except adequately treated basal cell or squamous cell skin cancer
- No known HIV or AIDS infection
- No active bacterial, fungal, or viral infection
- No medical condition that would preclude study treatment
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
Endocrine therapy
- Not specified
Radiotherapy
- See Disease Characteristics
Surgery
- Not specified
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
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Experimental: High-dose therapy plus tandem transplant
Regimen consists of 2 cycles of high-dose therapy, each followed by stem cell infusion.
Cycle 1 consists of high-dose melphalan followed by infusion of approximately 1.5 million cluster of differentiation 34 positive (CD34+) cells.
Cycle 2 consists of either TBI-based or 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU)-based high-dose therapy followed by infusion of at least 2 million CD34+ cells.
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150 mg/m^2 IV over 2 hours 4, 5, and 6 days before transplant.
Andere Namen:
100 mg/kg IV 2 days before transplant.
60 mg/kg IV over 4 hours 4 days before transplant.
150 mg/m^2 IV 1 day before transplant.
2.0 x 10^6 CD34+ cells, beginning at least 24 hours after melphalan infusion.
150 centigray (cGy) total body irradiation given b.i.d on days 5-8 before transplant.
Andere Namen:
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
2-year Progression-free Survival
Zeitfenster: At day 60, then every 6 months for 2 years
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Measured from date of randomization to date of first observation of progressive disease, or death due to any cause
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At day 60, then every 6 months for 2 years
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Response Rate
Zeitfenster: At day 60, then every 6 months for 2 years
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Complete Response(CR) is a complete disappearance of all disease with the exception of nodes.
No new lesions.
previously enlarged organs must have regressed and not be palpable.
Bone marrow(BM) must be negative if positive at baseline.
Normalization of markers.
CR Unconfirmed (CRU) does not qualify for CR above, due to a residual nodal mass or an indeterminate BM.
Partial Response(PR) is a 50% decrease in the sum of products of greatest diameters (SPD) for up to 6 identified dominant lesions, including spleenic and hepatic nodules from baseline.
No new lesions and no increase in the size of liver, spleen or other nodes.
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At day 60, then every 6 months for 2 years
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Overall Survival
Zeitfenster: At day 60, then every 6 months for 2 years, then annually for a total of 7 years
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Measured from date of registration to date of death due to any cause or last contact
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At day 60, then every 6 months for 2 years, then annually for a total of 7 years
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Number of Patients With Grade 3 Through Grade 5 Adverse Events That Are Related to Study Drug
Zeitfenster: Assessed after cycle 1 high dose therapy, after cycle 2 high dose therapy, and at 1 month and 2 months after the second stem cell infusion
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Adverse Events (AEs) are reported by the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 3.0.
For each patient, worst grade of each event type is reported.
Grade 3 = Severe, Grade 4 = Life-threatening, Grade 5 = Fatal.
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Assessed after cycle 1 high dose therapy, after cycle 2 high dose therapy, and at 1 month and 2 months after the second stem cell infusion
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Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Studienstuhl: Patrick J. Stiff, MD, Loyola University
- Studienstuhl: Louis S. Constine, MD, James P. Wilmot Cancer Center
- Studienstuhl: Eileen P. Smith, MD, City of Hope Comprehensive Cancer Center
Publikationen und hilfreiche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Immunsystems
- Neubildungen nach histologischem Typ
- Neubildungen
- Lymphoproliferative Erkrankungen
- Lymphatische Erkrankungen
- Immunproliferative Erkrankungen
- Lymphom
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Enzym-Inhibitoren
- Antirheumatika
- Antineoplastische Mittel
- Immunsuppressive Mittel
- Immunologische Faktoren
- Antineoplastische Mittel, alkylierend
- Alkylierungsmittel
- Myeloablative Agonisten
- Antineoplastische Mittel, Phytogen
- Topoisomerase-II-Inhibitoren
- Topoisomerase-Inhibitoren
- Cyclophosphamid
- Etoposid
- Melphalan
- Carmustin
Andere Studien-ID-Nummern
- CDR0000442392
- U10CA032102 (US NIH Stipendium/Vertrag)
- S0410 (Andere Kennung: SWOG)
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