- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00248430
Donor White Blood Cell Infusions and Interleukin-2 in Treating Patients Who Are Undergoing an Autologous Stem Cell Transplant for Relapsed Advanced Lymphoid Cancer
A Phase I-II Trial of Adoptive Immunotherapy Using Haploidentical, Related Donor-Lymphocyte Infusions and IL-2 After Autologous Stem Cell Transplantation for Advanced Lymphoid Malignancies
RATIONALE: Drugs used in chemotherapy, such as melphalan, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. An autologous stem cell transplant using the patient's stem cells may be able to replace blood-forming cells that were destroyed by chemotherapy. Giving white blood cells from a donor may help the patient's body destroy any remaining cancer cells. Interleukin-2 may stimulate the white blood cells to kill cancer cells.
PURPOSE: This phase I/II trial is studying the side effects of donor white blood cell infusions and interleukin-2 and to see how well they work in treating patients who are undergoing an autologous stem cell transplant for relapsed advanced lymphoid cancer.
Studieoversikt
Status
Detaljert beskrivelse
OBJECTIVES:
Primary
- Determine the feasibility and toxicity of haploidentical related donor lymphocyte infusions (DLI) and interleukin-2, in terms of acute graft-versus-host-disease, graft failure, and transplant-related mortality, in patients with relapsed advanced lymphoid malignancies undergoing autologous stem cell transplantation.
Secondary
- Determine the extent, degree, and duration of donor chimerism in patients treated with this regimen.
- Determine, preliminarily, activity of haploidentical DLI, as measured by complete response rate, in these patients.
OUTLINE: This is a pilot study.
Patients receive high-dose melphalan IV over 15-60 minutes on day -2 and undergo autologous stem cell transplantation on day 0. Patients receive haploidentical related donor lymphocyte infusions (DLI) IV on days 1, 5*, and 10* and interleukin-2 (IL-2) IV continuously on days 1-12.
NOTE: *DLI are not administered on days 5 or 10 if grade 3 or 4 graft-versus-host disease is present
After completion of study treatment, patients are followed monthly for 3 months and then every 3-12 months thereafter.
PROJECTED ACCRUAL: A total of 20 patients will be accrued for this study.
Studietype
Registrering (Forventet)
Fase
- Fase 2
- Fase 1
Kontakter og plasseringer
Studiesteder
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-
Washington
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Seattle, Washington, Forente stater, 98109-1023
- Seattle Cancer Care Alliance
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Seattle, Washington, Forente stater, 98109-1024
- Fred Hutchinson Cancer Research Center
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-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
DISEASE CHARACTERISTICS:
Diagnosis of 1 of the following advanced lymphoid malignancies:
Multiple myeloma, meeting both of the following criteria:
- Deletion of chromosome 13
- Elevated pre-transplant lactic dehydrogenase
Chronic lymphocytic leukemia (CLL)
- Failed ≥ 2 prior conventional chemotherapy regimens, including fludarabine
- Small lymphocytic lymphoma
Follicular non-Hodgkin's lymphoma
- Received ≥ 3 prior conventional chemotherapy regimens
Mantle cell lymphoma
- Received ≥ 3 prior conventional chemotherapy regimens
- Predicted poor outcome and relapsed disease after undergoing autologous stem cell transplantation ≥ 6 months ago
- Measurable disease, defined as any evidence of disease by scans or blood or urine analysis
At least 8 x 10^6 autologous CD34-positive cells/kg available for transplantation
- Stem cell mobilization allowed
Haploidentical related donor available
- Sex-mismatched
- Identical for 1 HLA haplotype AND mismatched for ≥ 1 HLA-A, -B, -C, or DRB1 locus of the unshared haplotype
- No HLA-identical related or unrelated donor available
- Not eligible for first-line autologous stem cell transplantation on protocol FHCRC-1368.00, FHCRC-1366.00, FHCRC-1461.00, or FHCRC-1595.00
- No bulky disease, defined as total volume of all measurable tumor > 500 cc
- No CNS disease resistant to therapy
PATIENT CHARACTERISTICS:
Age
- 18 to 69
Performance status
- Karnofsky 70-100%
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Liver function tests or liver enzymes ≤ 2 times upper limit of normal
Renal
- Not specified
Cardiovascular
- Ejection fraction ≥ 45%
- No symptomatic cardiac disease
Pulmonary
- DLCO ≥ 50%
Other
- Not pregnant or nursing
- Fertile patients must use effective contraception
- HIV Negative
- No active infection
PRIOR CONCURRENT THERAPY:
Biologic therapy
- See Disease Characteristics
- No prior allogeneic stem cell transplantation
Chemotherapy
- See Disease Characteristics
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- No concurrent contrast dye during and for 3 weeks after completion of interleukin-2 administration
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
Hva måler studien?
Primære resultatmål
Resultatmål |
---|
Giftighet
|
Gjennomførbarhet
|
Sekundære resultatmål
Resultatmål |
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Fullstendig svarprosent
|
Extent, degree, and duration of donor chimerism
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Hovedetterforsker: William I. Bensinger, MD, Fred Hutchinson Cancer Center
Studierekorddatoer
Studer hoveddatoer
Studiestart
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Anslag)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
- stadium IV grad 3 follikulært lymfom
- tilbakevendende grad 3 follikulær lymfom
- stadium III grad 1 follikulært lymfom
- stadium III grad 2 follikulært lymfom
- stadium III grad 3 follikulær lymfom
- stadium IV grad 1 follikulær lymfom
- stadium IV grad 2 follikulært lymfom
- stadium III mantelcellelymfom
- stadium IV mantelcellelymfom
- stadium II multippelt myelom
- stadium III multippelt myelom
- tilbakevendende grad 1 follikulær lymfom
- tilbakevendende grad 2 follikulær lymfom
- tilbakevendende små lymfatiske lymfomer
- stadium III små lymfatiske lymfomer
- stadium IV små lymfatiske lymfomer
- tilbakevendende mantelcellelymfom
- refraktær kronisk lymfatisk leukemi
- stadium III kronisk lymfatisk leukemi
- stadium IV kronisk lymfatisk leukemi
- refraktært myelomatose
- graft versus host sykdom
Ytterligere relevante MeSH-vilkår
- Kardiovaskulære sykdommer
- Vaskulære sykdommer
- Sykdommer i immunsystemet
- Neoplasmer etter histologisk type
- Neoplasmer
- Lymfoproliferative lidelser
- Lymfesykdommer
- Immunproliferative lidelser
- Hematologiske sykdommer
- Hemoragiske lidelser
- Hemostatiske lidelser
- Paraproteinemier
- Blodproteinforstyrrelser
- Lymfom
- Multippelt myelom
- Neoplasmer, plasmacelle
- Leukemi
- Plasmacytom
- Graft vs vertssykdom
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Antivirale midler
- Anti-HIV-midler
- Antiretrovirale midler
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Aldesleukin
- Melphalan
Andre studie-ID-numre
- 1838.00
- FHCRC-1838.00
- CDR0000430694 (Registeridentifikator: PDQ)
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