- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning 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.
Studieöversikt
Status
Intervention / Behandling
- Läkemedel: cyklofosfamid
- Biologisk: anti-tymocytglobulin
- Läkemedel: fludarabinfosfat
- Strålning: bestrålning av hela kroppen
- Biologisk: filgrastim
- Biologisk: rituximab
- Läkemedel: cyklosporin
- Biologisk: transplantat-mot-tumörinduktionsterapi
- Läkemedel: mykofenolatmofetil
- Procedur: icke-myeloablativ allogen hematopoetisk stamcellstransplantation
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
Kontakter och platser
Studieorter
-
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New York
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New York, New York, Förenta staterna, 10065
- Memorial Sloan Kettering Cancer Center
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-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
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
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 |
|---|---|
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Övrig: 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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Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Overall Survival at 1 Year
Tidsram: 1 year
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1 year
|
Sekundära resultatmått
Resultatmått |
Tidsram |
|---|---|
|
Time to Neutrophil Engraftment
Tidsram: 2 years
|
2 years
|
|
Time to Platelet Engraftment
Tidsram: 1 year
|
1 year
|
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Incidence of Moderate to Severe Grades II to IV Graft Versus Host Disease (GVHD) at 100 Days
Tidsram: 100 days
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100 days
|
|
Incidence of Chronic GVHD at 1 Year
Tidsram: 1 year
|
1 year
|
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Immune Reconstruction/CD4+ Count at 3 Months
Tidsram: 3 months
|
3 months
|
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Response to Treatment
Tidsram: 2 years
|
2 years
|
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Immune Reconstruction/CD4+ Count at 6 Months
Tidsram: 6 months
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6 months
|
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Immune Reconstruction/CD4+ Count at 1 Year
Tidsram: 1 year
|
1 year
|
Samarbetspartners och utredare
Samarbetspartners
Utredare
- Huvudutredare: Juliet Barker, MBBS, Memorial Sloan Kettering Cancer Center
- Huvudutredare: Craig Moskowitz, MD, Memorial Sloan Kettering Cancer Center
- Huvudutredare: Hugo R. Castro-Malaspina, MD, Memorial Sloan Kettering Cancer Center
Publikationer och användbara länkar
Användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart (Faktisk)
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
- B-cells kronisk lymfatisk leukemi
- stadium III vuxen diffust storcelligt lymfom
- stadium III vuxen immunoblastiskt storcelligt lymfom
- stadium IV vuxen diffust storcelligt lymfom
- stadium IV vuxen immunoblastiskt storcelligt lymfom
- återkommande vuxen diffust storcelligt lymfom
- återkommande vuxen immunoblastiskt storcelligt lymfom
- stadium III grad 1 follikulärt lymfom
- stadium III grad 2 follikulärt lymfom
- stadium IV grad 1 follikulärt lymfom
- stadium IV grad 2 follikulärt lymfom
- stadium III mantelcellslymfom
- stadium IV mantelcellslymfom
- återkommande follikulärt lymfom grad 1
- återkommande follikulärt lymfom grad 2
- icke-sammanhängande stadium II grad 1 follikulärt lymfom
- icke sammanhängande stadium II grad 2 follikulärt lymfom
- icke sammanhängande små lymfocytiska lymfom i stadium II
- noncontiguous stadium II marginell zon lymfom
- återkommande lymfom i marginalzonen
- återkommande små lymfocytiska lymfom
- stadium III små lymfocytiska lymfom
- stadium III marginalzon lymfom
- stadium IV små lymfocytiska lymfom
- stadium IV marginalzon lymfom
- extranodal marginalzon B-cellslymfom i slemhinneassocierad lymfoid vävnad
- nodal marginalzon B-cells lymfom
- marginalzonens lymfom i mjälten
- återkommande mantelcellslymfom
- refraktär kronisk lymfatisk leukemi
- stadium III kronisk lymfatisk leukemi
- stadium IV kronisk lymfatisk leukemi
- icke sammanhängande stadium II mantelcellslymfom
- icke sammanhängande stadium II vuxen diffust storcelligt lymfom
- icke sammanhängande stadium II vuxen immunoblastiskt storcelligt lymfom
Ytterligare relevanta MeSH-villkor
- Immunsystemets sjukdomar
- Neoplasmer efter histologisk typ
- Neoplasmer
- Lymfoproliferativa störningar
- Lymfatiska sjukdomar
- Immunproliferativa störningar
- Leukemi, lymfoid
- Leukemi, B-cell
- Lymfom
- Leukemi
- Leukemi, lymfocytisk, kronisk, B-cell
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Enzyminhibitorer
- Antireumatiska medel
- Antimetaboliter, antineoplastiska
- Antimetaboliter
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Antineoplastiska medel, Alkylering
- Alkyleringsmedel
- Myeloablativa agonister
- Antineoplastiska medel, immunologiska
- Dermatologiska medel
- Antibakteriella medel
- Antibiotika, antineoplastiska
- Antifungala medel
- Antituberkulära medel
- Antibiotika, Antituberkulära
- Calcineurin-hämmare
- Cyklofosfamid
- Rituximab
- Fludarabin
- Fludarabinfosfat
- Mykofenolsyra
- Antimfocytserum
- Cyklosporin
- Cyklosporiner
Andra studie-ID-nummer
- 06-150
- MSKCC-06150
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