G-CSF-Treated Donor Bone Marrow Transplant in Treating Patients With Hematologic Disorders

OBJECTIVES:

Primary

• Determine whether granulocyte engraftment can be achieved by day 30 in patients with hematologic disorders undergoing HLA-matched, related-donor, allogeneic bone marrow transplantation using filgrastim (G-CSF)-primed bone marrow.
• Determine the incidence of grade II or greater acute graft-versus-host disease (GVHD) in patients treated with this regimen and post-transplantation immunosuppression with cyclosporine and methotrexate.

Secondary

• Determine whether platelet and red blood cell engraftment can be achieved in patients treated with this regimen.
• Determine the incidence of limited and extensive chronic GVHD in patients treated with this regimen.
• Determine the event-free survival of patients treated with this regimen.
• Determine the post-transplant immune reconstitution in patients treated with this regimen.

OUTLINE: This is a pilot study.

• Mobilization: Donors receive filgrastim (G-CSF) subcutaneously (SC) daily on days -3 to -1 followed by bone marrow collection.

• Conditioning regimen: Patients receive 1 of the following conditioning regimens according to their primary disease:

  • Total-body irradiation and high-dose chemotherapy comprising etoposide and cyclophosphamide
  • High-dose chemotherapy comprising busulfan and cyclophosphamide
• Bone marrow transplantation: Patients receive G-CSF-primed allogeneic bone marrow on day 0. Patients then receive G-CSF SC beginning on day 5.
• Graft-versus-host disease prophylaxis: Patients receive cyclosporine beginning on day -1 and methotrexate on days 1, 3, and 6.

PROJECTED ACCRUAL: A total of 15 patients will be accrued for this study.