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Combination Chemotherapy Followed by Peripheral Stem Cell Transplantation in Treating Patients With Mantle Cell Lymphoma

15 juli 2016 uppdaterad av: Alliance for Clinical Trials in Oncology

Allogeneic Stem Cell Transplantation for Mantle Cell Lymphoma

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells. Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy used to kill cancer cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by donor peripheral stem cell transplantation in treating patients who have mantle cell lymphoma.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

OBJECTIVES:

  • Determine the long term disease-free survival of patients with mantle cell lymphoma treated with etoposide, carmustine, melphalan, and cytarabine followed by allogeneic peripheral blood stem cell transplantation.
  • Determine the incidence of molecular remissions in these patients treated with this regimen.
  • Correlate the persistence of minimal residual disease with clinical outcome in these patients treated with this regimen.
  • Determine the effect of donor lymphocytes in patients with progressive disease after treatment with this regimen.

OUTLINE: This is a multicenter study.

Patients receive carmustine IV over 2 hours on day -6; etoposide IV over 3 hours and cytarabine IV over 1 hour every 12 hours on days -5 to -2 for a total of 8 doses; and melphalan IV over 20-30 minutes on day -1. Patients undergo allogeneic peripheral blood stem cell (PBSC) transplantation on day 0. Patients also receive tacrolimus IV continuously over 24 hours beginning on day -2 and then orally twice daily until day 120 and methotrexate IV over 30 minutes on days 1, 3, and 6 as graft-versus-host disease (GVHD) prophylaxis. Patients receive sargramostim (GM-CSF) IV or subcutaneously daily beginning on day 7 and continuing until blood counts recover.

Patients with no active GVHD who have persistent disease on day 150 or progressive disease at any time after PBSC transplantation receive donor lymphocytes IV over 2 hours. Patients may receive additional donor lymphocytes at least 8 weeks later if disease persists.

Patients are followed at 6 and 12 months posttransplantation and then annually for 4 years.

Studietyp

Interventionell

Inskrivning (Faktisk)

4

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Förenta staterna
    • Alabama
      • Birmingham, Alabama, Förenta staterna, 35233-1996
        • Veterans Affairs Medical Center - Birmingham
    • California
      • La Jolla, California, Förenta staterna, 92093-0658
        • University of California San Diego Cancer Center
      • San Francisco, California, Förenta staterna, 94121
        • Veterans Affairs Medical Center - San Francisco
      • San Francisco, California, Förenta staterna, 94143-0128
        • UCSF Cancer Center and Cancer Research Institute
    • Delaware
      • Wilmington, Delaware, Förenta staterna, 19899
        • CCOP - Christiana Care Health Services
    • District of Columbia
      • Washington, District of Columbia, Förenta staterna, 20307-5000
        • Walter Reed Army Medical Center
      • Washington, District of Columbia, Förenta staterna, 20007
        • Lombardi Cancer Center
    • Florida
      • Miami Beach, Florida, Förenta staterna, 33140
        • CCOP - Mount Sinai Medical Center
    • Illinois
      • Chicago, Illinois, Förenta staterna, 60612
        • University of Illinois at Chicago
      • Chicago, Illinois, Förenta staterna, 60612
        • Veterans Affairs Medical Center - Chicago (Westside Hospital)
      • Chicago, Illinois, Förenta staterna, 60637-1470
        • University of Chicago Cancer Research Center
    • Iowa
      • Iowa City, Iowa, Förenta staterna, 52242-1009
        • Holden Comprehensive Cancer Center
    • Maine
      • Togus, Maine, Förenta staterna, 04330
        • Veterans Affairs Medical Center - Togus
    • Maryland
      • Baltimore, Maryland, Förenta staterna, 21201
        • Marlene and Stewart Greenebaum Cancer Center, University of Maryland
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna, 02115
        • Dana-Farber Cancer Institute
      • Worcester, Massachusetts, Förenta staterna, 01655
        • University of Massachusetts Memorial Medical Center - University Campus
    • Minnesota
      • Minneapolis, Minnesota, Förenta staterna, 55417
        • Veterans Affairs Medical Center - Minneapolis
      • Minneapolis, Minnesota, Förenta staterna, 55455
        • University of Minnesota Cancer Center
    • Missouri
      • Columbia, Missouri, Förenta staterna, 65201
        • Veterans Affairs Medical Center - Columbia (Truman Memorial)
      • Columbia, Missouri, Förenta staterna, 65203
        • Ellis Fischel Cancer Center - Columbia
      • Saint Louis, Missouri, Förenta staterna, 63110
        • Barnes-Jewish Hospital
    • Nebraska
      • Omaha, Nebraska, Förenta staterna, 68198-7680
        • University of Nebraska Medical Center
    • Nevada
      • Las Vegas, Nevada, Förenta staterna, 89106
        • CCOP - Southern Nevada Cancer Research Foundation
    • New Hampshire
      • Lebanon, New Hampshire, Förenta staterna, 03756-0002
        • Norris Cotton Cancer Center
    • New York
      • Buffalo, New York, Förenta staterna, 14263-0001
        • Roswell Park Cancer Institute
      • Buffalo, New York, Förenta staterna, 14215
        • Veterans Affairs Medical Center - Buffalo
      • Manhasset, New York, Förenta staterna, 11030
        • CCOP - North Shore University Hospital
      • Manhasset, New York, Förenta staterna, 11030
        • North Shore University Hospital
      • New York, New York, Förenta staterna, 10021
        • Memorial Sloan-Kettering Cancer Center
      • New York, New York, Förenta staterna, 10021
        • New York Presbyterian Hospital - Cornell Campus
      • New York, New York, Förenta staterna, 10029
        • Mount Sinai Medical Center, NY
      • Syracuse, New York, Förenta staterna, 13210
        • State University of New York - Upstate Medical University
      • Syracuse, New York, Förenta staterna, 13210
        • Veterans Affairs Medical Center - Syracuse
      • Syracuse, New York, Förenta staterna, 13217
        • CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
    • North Carolina
      • Chapel Hill, North Carolina, Förenta staterna, 27599-7295
        • Lineberger Comprehensive Cancer Center, UNC
      • Durham, North Carolina, Förenta staterna, 27705
        • Veterans Affairs Medical Center - Durham
      • Durham, North Carolina, Förenta staterna, 27710
        • Duke Comprehensive Cancer Center
      • Winston-Salem, North Carolina, Förenta staterna, 27104-4241
        • CCOP - Southeast Cancer Control Consortium
      • Winston-Salem, North Carolina, Förenta staterna, 27157-1082
        • Comprehensive Cancer Center at Wake Forest University
    • Ohio
      • Columbus, Ohio, Förenta staterna, 43210-1240
        • Arthur G. James Cancer Hospital - Ohio State University
    • Rhode Island
      • Providence, Rhode Island, Förenta staterna, 02903
        • Rhode Island Hospital
    • Tennessee
      • Memphis, Tennessee, Förenta staterna, 38104
        • Veterans Affairs Medical Center - Memphis
      • Memphis, Tennessee, Förenta staterna, 38103
        • University of Tennessee Cancer Institute
    • Vermont
      • Bennington, Vermont, Förenta staterna, 05201
        • Green Mountain Oncology Group
      • Burlington, Vermont, Förenta staterna, 05401-3498
        • Vermont Cancer Center
      • White River Junction, Vermont, Förenta staterna, 05009
        • Veterans Affairs Medical Center - White River Junction
    • Virginia
      • Richmond, Virginia, Förenta staterna, 23298-0037
        • MBCCOP - Massey Cancer Center
      • Richmond, Virginia, Förenta staterna, 23249
        • Veterans Affairs Medical Center - Richmond

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

Inte äldre än 59 år (Barn, Vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

  1. Documentation of Disease

    1. Histologically documented mantle cell lymphoma of any stage (needle or core biopsy is not acceptable as the sole means of diagnosis) with at least one of the following confirmatory tests indicative of diagnosis:

      • Immunophenotype with expression of CD5 and CD19 and absence of CD23
      • Cytogenetic analysis with presence of t(11;14)
      • Overexpression of cyclin D1
      • Rearrangement of BCL1 gene
    2. Rebiopsy of a node at relapse is recommended but not required.
    3. Bone marrow biopsy required for pretreatment evaluation. Bilateral biopsies are not required.
  2. Identification of HLA-Matched sibling donor - The sibling donor must meet eligibility criteria outlined in section 5.0

  3. Prior Therapy

    1. Patients who have failed initial therapy are eligible (without any of the poor prognostic characteristics listed in the protocol). Failure to initial treatment is defined as one of the following:

      • Failure to achieve clinical complete remission after treatment with an anthracycline-containing regimen
      • Disease recurrence after initial treatment (with an anthracycline-containing regimen)

    2. Patients in first remission must have one of the following poor prognostic characteristics:

      • International Prognostic Index (IPI) score > 1. IPI risk factors include the following: age > 60 (not eligible for this protocol); performance status > 1; LDH > normal; presence of > 1 extranodal sites; and stage III/IV disease
      • Blastic variant of mantle cell lymphoma (regardless of IPI score)
      • Complex karyotypes (i.e., cytogenetic abnormalities different from or in addition to t(11;14) (regardless of IPI score)
      • Proliferative index > 10% (regardless of IPI score)
      • Presence of p53 mutations
    3. Patients who have received more than two chemotherapy regimens are ineligible. Patients who have undergone a prior bone marrow transplant are not eligible.
  4. Age < 60 years
  5. No active CNS lymphoma
  6. DLCO ≥ 40% and no symptomatic pulmonary disease
  7. No HIV infection
  8. Non-pregnant and non-nursing. Treatment under this protocol would expose an unborn child to significant risks. Women and men of reproductive potential should agree to use an effective means of birth control.

  9. Initial required laboratory values

    • bilirubin < 2 mg/dl
    • AST ≤ 3 x upper limit of normal (ULN)
    • ALT ≤ 3 x ULN
    • serum creatinine < 2 mg/dl
    • u-HCG or serum HCG negative (if patient of childbearing potential)

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: chemotherapy + stem cell transplantation

Patients receive carmustine, etoposide, cytarabine and melphalan on day -1. Patients undergo allogeneic peripheral blood stem cell (PBSC) transplantation on day 0. Patients also receive tacrolimus on day -2 and then orally twice daily until day 120 and methotrexate on days 1, 3, and 6 as graft-versus-host disease (GVHD) prophylaxis. Patients receive sargramostim daily beginning on day 7 and continuing until blood counts recover.

Patients with no active GVHD who have persistent disease on day 150 or progressive disease at any time after PBSC transplantation receive donor lymphocytes IV over 2 hours. Patients may receive additional donor lymphocytes at least 8 weeks later if disease persists.

Patients are followed at 6 and 12 months post-transplantation and then annually for 4 years.
Läkemedel: etoposid
IV
Läkemedel: cytarabin
IV
Läkemedel: melfalan
IV
Läkemedel: karmustin
IV
Läkemedel: tacrolimus
IV
Läkemedel: methotrexate
IV
Läkemedel: sargramostim
IV
Procedur: transplant

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
disease free survival
Tidsram: up to 5 years post-transplant
up to 5 years post-transplant

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Alliance for Clinical Trials in Oncology

Samarbetspartners

National Cancer Institute (NCI)

Utredare

  • Studiestol: Koen Van Besien, MD, University of Chicago

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 november 2000

Primärt slutförande (Faktisk)

1 februari 2003

Avslutad studie (Faktisk)

1 februari 2003

Studieregistreringsdatum

Först inskickad

6 december 2000

Först inskickad som uppfyllde QC-kriterierna

26 januari 2003

Första postat (Uppskatta)

27 januari 2003

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

19 juli 2016

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 juli 2016

Senast verifierad

1 juli 2016

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • CALGB-59908
  • U10CA031946 (U.S.S. NIH-anslag/kontrakt)
  • CLB-59908
  • CDR0000068324 (Registeridentifierare: NCI Physician Data Query)

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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