- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00425802
Chemotherapy, Total-Body Irradiation, Rituximab, and Donor Stem Cell Transplant in Treating Patients With B-Cell Non-Hodgkin's Lymphoma or Chronic Lymphocytic Leukemia
A Non-Myeloablative Conditioning Regimen With Peri-Transplant Rituximab and the Transplantation of Hematopoietic Stem Cells From HLA-Compatible Related or Unrelated Donors in Patients With B Cell Lymphoid Malignancies
RATIONALE: Giving low doses of chemotherapy and total-body irradiation before a donor stem cell transplant helps stop the growth of cancer cells. It also helps stop the patient's immune system from rejecting the donor's stem cells. Also, monoclonal antibodies, such as rituximab, can find cancer cells and either kill them or deliver cancer-killing substances to them without harming normal 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 rituximab before transplant and cyclosporine and mycophenolate mofetil after transplant may stop this from happening.
PURPOSE: This phase II trial is studying the side effects and how well giving chemotherapy and radiation therapy together with rituximab and donor stem cell transplant works in treating patients with B-cell non-Hodgkin's lymphoma or chronic lymphocytic leukemia.
Studieoversikt
Status
Intervensjon / Behandling
- Legemiddel: cyklofosfamid
- Biologisk: anti-tymocyttglobulin
- Legemiddel: fludarabin fosfat
- Stråling: bestråling av hele kroppen
- Biologisk: filgrastim
- Biologisk: rituximab
- Legemiddel: cyklosporin
- Biologisk: graft-versus-tumor induksjonsterapi
- Legemiddel: mykofenolatmofetil
- Fremgangsmåte: ikke-myeloablativ allogen hematopoetisk stamcelletransplantasjon
Studietype
Registrering (Faktiske)
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
-
-
New York
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New York, New York, Forente stater, 10065
- Memorial Sloan Kettering Cancer 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:
CD20-positive aggressive B-cell non-Hodgkin's lymphoma (NHL), including any of the following subtypes:
Diffuse large cell lymphoma*, meeting 1 of the following criteria:
- Relapsed disease after initial therapy, but failed to mobilize or had bone marrow involvement and therefore is not suitable for an autologous stem cell transplantation
- High-intermediate- or high-risk second-line, age-adjusted International Prognostic Index score and in second complete remission (CR) or partial remission (PR) after autologous stem cell transplantation
- Failed prior autologous stem cell transplantation and in PR or better after salvage chemotherapy
Large cell transformation of indolent NHL or chronic lymphocytic leukemia (CLL), meeting the following criteria:
- In CR or PR of the large cell component of disease after salvage chemotherapy or autologous stem cell transplantation
Mantle cell lymphoma*, meeting 1 of the following criteria:
- High-risk disease (e.g., p53 positivity) and in first CR or PR after initial therapy
- Relapsed disease after initial therapy and in second or third CR or PR after salvage chemotherapy NOTE: *No progressive disease at allograft work-up
CD20-positive indolent NHL (e.g., follicular lymphoma, small cell lymphoma, or marginal zone NHL) OR CLL
- Second or subsequent progression (pre-allograft cytoreduction necessary, but CR or PR not required)
- Relapsed disease must be biopsy-proven
Must have received pre-allograft salvage chemotherapy, including 1 of the following:
- Single autologous stem cell transplantation using high-dose chemotherapy conditioning within the past 120 days
- At least 2 courses of intensive combination chemotherapy (e.g., RICE [rituximab, ifosfamide, carboplatin, etoposide]), according to diagnosis, within the past 80 days
- CLL patients who have received CAMPATH do not have to receive pre-allograft salvage chemotherapy
HLA-compatible related or unrelated donor available
HLA-matched ≥ 9/10 of the A, B, C, DRB1, and DQB1 loci, as tested by high resolution typing
- One allele mismatch allowed
PATIENT CHARACTERISTICS:
- Karnofsky performance status 70-100%
- Creatinine < 1.2 mg/mL OR creatinine clearance ≥ 50 mL/min
- Bilirubin < 2.5 mg/dL
- AST and ALT ≤ 3 times upper limit of normal (unless benign congenital hyperbilirubinemia is present)
- Spirometry and corrected DLCO ≥ 50% of normal
- LVEF ≥ 40%
- Albumin ≥ 2.5 g/dL
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No active uncontrolled infection, including active infection with Aspergillus or other mold
- No HIV infection
- No hepatitis B antibody or antigen positivity
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior allogeneic transplantation
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: N/A
- Intervensjonsmodell: Enkeltgruppeoppdrag
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
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Annen: treatment
This is a phase 2 study of a treatment regimen consisting of a non-myeloablative (NMA) conditioning regimen incorporating low dose chemotherapy and low dose radiation as well as peri-transplant Rituximab and the transplantation of peripheral blood stem cells (PBSC) or bone marrow if PBSC collection not possible from an HLA compatible related or unrelated donor in patients with B cell lymphoid malignancies including diffuse large cell (DLC) and mantle cell non-Hodgkin's lymphoma (NHL), indolent B cell NHL, or chronic lymphocytic leukemia (CLL).
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Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
|---|---|
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Overall Survival at 1 Year
Tidsramme: 1 year
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1 year
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
|---|---|
|
Time to Neutrophil Engraftment
Tidsramme: 2 years
|
2 years
|
|
Time to Platelet Engraftment
Tidsramme: 1 year
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1 year
|
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Incidence of Moderate to Severe Grades II to IV Graft Versus Host Disease (GVHD) at 100 Days
Tidsramme: 100 days
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100 days
|
|
Incidence of Chronic GVHD at 1 Year
Tidsramme: 1 year
|
1 year
|
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Immune Reconstruction/CD4+ Count at 3 Months
Tidsramme: 3 months
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3 months
|
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Response to Treatment
Tidsramme: 2 years
|
2 years
|
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Immune Reconstruction/CD4+ Count at 6 Months
Tidsramme: 6 months
|
6 months
|
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Immune Reconstruction/CD4+ Count at 1 Year
Tidsramme: 1 year
|
1 year
|
Samarbeidspartnere og etterforskere
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Juliet Barker, MBBS, Memorial Sloan Kettering Cancer Center
- Hovedetterforsker: Craig Moskowitz, MD, Memorial Sloan Kettering Cancer Center
- Hovedetterforsker: Hugo R. Castro-Malaspina, MD, Memorial Sloan Kettering Cancer Center
Publikasjoner og nyttige lenker
Hjelpsomme linker
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Faktiske)
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 (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
- B-celle kronisk lymfatisk leukemi
- stadium III voksent diffust storcellet lymfom
- stadium III voksent immunoblastisk storcellet lymfom
- stadium IV voksent diffust storcellet lymfom
- stadium IV voksent immunoblastisk storcellet lymfom
- tilbakevendende voksent diffust storcellet lymfom
- tilbakevendende immunoblastisk storcellet lymfom hos voksne
- stadium III grad 1 follikulært lymfom
- stadium III grad 2 follikulært lymfom
- stadium IV grad 1 follikulær lymfom
- stadium IV grad 2 follikulært lymfom
- stadium III mantelcellelymfom
- stadium IV mantelcellelymfom
- tilbakevendende grad 1 follikulær lymfom
- tilbakevendende grad 2 follikulær lymfom
- ikke-sammenhengende stadium II grad 1 follikulær lymfom
- ikke-sammenhengende stadium II grad 2 follikulært lymfom
- ikke-sammenhengende stadium II små lymfatiske lymfomer
- ikke-sammenhengende stadium II marginalsone lymfom
- tilbakevendende marginalsone lymfom
- tilbakevendende små lymfatiske lymfomer
- stadium III små lymfatiske lymfomer
- stadium III marginalsone lymfom
- stadium IV små lymfatiske lymfomer
- stadium IV marginal sone lymfom
- ekstranodal marginalsone B-celle lymfom av slimhinneassosiert lymfoidvev
- nodal marginal sone B-celle lymfom
- milt marginal sone lymfom
- tilbakevendende mantelcellelymfom
- refraktær kronisk lymfatisk leukemi
- stadium III kronisk lymfatisk leukemi
- stadium IV kronisk lymfatisk leukemi
- ikke-sammenhengende stadium II mantelcellelymfom
- ikke-sammenhengende stadium II voksent diffust storcellet lymfom
- ikke-sammenhengende stadium II voksent immunoblastisk storcellet lymfom
Ytterligere relevante MeSH-vilkår
- Sykdommer i immunsystemet
- Neoplasmer etter histologisk type
- Neoplasmer
- Lymfoproliferative lidelser
- Lymfesykdommer
- Immunproliferative lidelser
- Leukemi, lymfoid
- Leukemi, B-celle
- Lymfom
- Leukemi
- Leukemi, lymfatisk, kronisk, B-celle
- Fysiologiske effekter av legemidler
- Molekylære mekanismer for farmakologisk virkning
- Anti-infeksjonsmidler
- Enzymhemmere
- Antirevmatiske midler
- Antimetabolitter, antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Antineoplastiske midler, immunologiske
- Dermatologiske midler
- Antibakterielle midler
- Antibiotika, antineoplastisk
- Antifungale midler
- Antituberkulære midler
- Antibiotika, Antituberkulær
- Calcineurin-hemmere
- Cyklofosfamid
- Rituximab
- Fludarabin
- Fludarabinfosfat
- Mykofenolsyre
- Antilymfocyttserum
- Syklosporin
- Syklosporiner
Andre studie-ID-numre
- 06-150
- MSKCC-06150
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