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Peripheral Stem Cell Transplantation With Specially Treated Stem Cells in Treating Patients With Non-Hodgkin's Lymphoma or Hodgkin's Disease
Autologous Transplantation for Non-Hodgkin's Lymphoma and Hodgkin's Disease Using Retrovirally Marked Peripheral Blood Progenitor Cells Obtained After In Vivo Mobilization Using Hematopoietic Cytokines Plus Chemotherapy
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining chemotherapy and radiation therapy with peripheral stem cell transplantation using specially treated stem cells may allow the doctor to give higher doses of chemotherapy drugs and radiation therapy and kill more cancer cells.
PURPOSE: Phase II trial to study the effectiveness of peripheral stem cell transplantation using specially treated stem cells in treating patients who have non-Hodgkin's lymphoma or Hodgkin's disease.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
- Geneesmiddel: cyclofosfamide
- Geneesmiddel: mitoxantron hydrochloride
- Geneesmiddel: cytarabine
- Geneesmiddel: dexamethason
- Geneesmiddel: etoposide
- Procedure: in vitro behandelde perifere bloedstamceltransplantatie
- Geneesmiddel: filgrastim
- Procedure: stamceltransplantatie uit perifeer bloed
- Geneesmiddel: carmustine
- Procedure: bestralingstherapie
- Geneesmiddel: retrovirus vector LN
Gedetailleerde beschrijving
OBJECTIVES:
- Determine whether priming with hematopoietic cytokines and chemotherapy increases the yield of hematopoietic progenitors in peripheral blood stem cells (PBSC) in patients with non-Hodgkin's lymphoma or Hodgkin's disease undergoing autologous PBSC transplantation.
- Determine whether in vitro studies can predict the transduction efficiency of early and late engrafting hematopoietic stem cells in this patient population undergoing this treatment.
- Determine whether in vitro transduction of a graft product stable long term transduction of marrow cells in these patients after autologous transplantation.
OUTLINE: Patients receive filgrastim (G-CSF) subcutaneously (SC) twice daily on days 1-7. Peripheral blood stem cells (PBSC) are collected on days 5-7. Patients receive cyclophosphamide IV over 2 hours, mitoxantrone IV, and cytarabine IV every 12 hours for 2 doses on day 10, and dexamethasone every 12 hours for 4 doses on days 10 and 11. Patients receive G-CSF SC for the next 10-20 days. Additional PBSC are collected on days 25-28 or 29. Beginning 7 days before PBSC transplantation, patients receive cyclophosphamide IV over 2 hours on days -7 and -6 and total body irradiation (TBI) twice daily on days -4 to -1. Patients unable to tolerate TBI receive cyclophosphamide IV over 2 hours on days -6 to -3, carmustine IV over 1 hour on days -6, and etoposide IV over 1 hour every 12 hours on days -6 to -4. Retrovirally transduced PBSC are reinfused on day 0 followed by another course of G-CSF SC until hematopoietic recovery.
Patients are followed at 1, 3, 6, 9, 12, 18, and 24 months and then annually thereafter.
PROJECTED ACCRUAL: A total of 15-20 patients will be accrued for this study within 12-15 months.
Studietype
Fase
- Fase 2
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
DISEASE CHARACTERISTICS:
Intermediate or high grade non-Hodgkin's lymphoma (NHL) or Hodgkin's disease (HD)
- Chemotherapy sensitive, initial partial remission OR
- Relapse after initial complete or partial remission
- Low grade NHL eligible provided progression following initial partial or complete remission
- Ineligible for ongoing allogeneic marrow donor transplant protocols or elected not to participate in such protocols
- No chemotherapy resistant NHL or HD NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.
PATIENT CHARACTERISTICS:
Age:
- 18 to 70
Performance status:
- Karnofsky 90-100%
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- AST less than 2.5 times upper limit of normal (ULN)
- Bilirubin less than 2.5 times ULN
Renal:
- Creatinine less than 2.0 mg/dL
Cardiovascular:
- Resting LVEF at least 40%
- No unstable ischemic heart disease
Pulmonary:
- Spirometry and DLCO greater than 50% predicted
Other:
- No active uncontrolled infection
- HIV negative
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- See Disease Characteristics
Chemotherapy:
- See Disease Characteristics
- At least 4 weeks since prior chemotherapy (6 weeks for nitrosoureas)
Endocrine therapy:
- Not specified
Radiotherapy:
- Not specified
Surgery:
- Not specified
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Studie stoel: Daniel J. Weisdorf, MD, Masonic Cancer Center, University of Minnesota
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
- recidiverend graad 3 folliculair lymfoom
- recidiverend diffuus grootcellig lymfoom bij volwassenen
- recidiverend volwassen immunoblastisch grootcellig lymfoom
- recidiverend volwassen Burkitt-lymfoom
- recidiverend volwassen Hodgkin-lymfoom
- recidiverend diffuus kleincellig lymfoom bij volwassenen
- recidiverend diffuus gemengd cellymfoom bij volwassenen
- recidiverend graad 1 folliculair lymfoom
- recidiverend graad 2 folliculair lymfoom
- recidiverend marginale zone-lymfoom
- terugkerend klein lymfocytisch lymfoom
- extranodale marginale zone B-cellymfoom van mucosa-geassocieerd lymfoïde weefsel
- nodale marginale zone B-cellymfoom
- milt marginale zone lymfoom
- recidiverend volwassen lymfoblastisch lymfoom
- terugkerend mantelcellymfoom
Aanvullende relevante MeSH-voorwaarden
- Ziekten van het immuunsysteem
- Neoplasmata per histologisch type
- Neoplasmata
- Lymfoproliferatieve aandoeningen
- Lymfatische ziekten
- Immunoproliferatieve aandoeningen
- Lymfoom
- Ziekte van Hodgkin
- Lymfoom, non-Hodgkin
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Autonome agenten
- Agenten van het perifere zenuwstelsel
- Antivirale middelen
- Enzymremmers
- Pijnstillers
- Sensorische systeemagenten
- Ontstekingsremmende middelen
- Antireumatische middelen
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Anti-emetica
- Gastro-intestinale middelen
- Glucocorticoïden
- Hormonen
- Hormonen, hormoonvervangers en hormoonantagonisten
- Antineoplastische middelen, hormonaal
- Antineoplastische middelen, alkylering
- Alkyleringsmiddelen
- Myeloablatieve agonisten
- Antineoplastische middelen, fytogeen
- Topoisomerase II-remmers
- Topoisomeraseremmers
- Dexamethason
- Cyclofosfamide
- Etoposide
- Cytarabine
- Mitoxantron
- Carmustine
Andere studie-ID-nummers
- 1999LS080
- MT1999-19 (Andere identificatie: Blood and Marrow Transplantation Program)
- NCI-G00-1807
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