Sargramostim Following Allogeneic Bone Marrow Transplantation in Treating Patients With Chronic Myelogenous Leukemia

This study has been terminated.
(subject accrual and data analysis is completed.)
Sponsor:
Collaborator:
Information provided by:
Sidney Kimmel Comprehensive Cancer Center
ClinicalTrials.gov Identifier:
NCT00002778
First received: November 1, 1999
Last updated: July 19, 2011
Last verified: April 2011
  Purpose

RATIONALE: Drugs used in chemotherapy work in different ways to stop cancer cells from dividing so they stop growing or die. Combining chemotherapy with allogeneic bone marrow transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells. Colony-stimulating factors such as sargramostim may increase the number of immune cells found in bone marrow or peripheral blood, and may help a person's immune system recover from the side effects of chemotherapy.

PURPOSE: Phase II trial to study the effectiveness of allogeneic bone marrow transplantation followed by sargramostim in treating patients who have chronic myelogenous leukemia.


Condition Intervention Phase
Leukemia
Biological: sargramostim
Biological: therapeutic allogeneic lymphocytes
Procedure: allogeneic bone marrow transplantation
Procedure: in vitro-treated bone marrow transplantation
Phase 2

Study Type: Interventional
Study Design: Masking: Open Label
Primary Purpose: Treatment
Official Title: GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR (Rhu-GM-CSF) FOR REDUCTION OF LEUKEMIC RELAPSE AFTER T-LYMPHOCYTE DEPLETED ALLOGENEIC BMT FOR CHRONIC MYELOID LEUKEMIA

Resource links provided by NLM:


Further study details as provided by Sidney Kimmel Comprehensive Cancer Center:

Estimated Enrollment: 40
Study Start Date: February 1995
Study Completion Date: July 2010
Primary Completion Date: February 2005 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Determine whether the use of sargramostim (GM-CSF) after T-cell depleted, CD34-positive cell-supplemented allogeneic bone marrow transplantation can reduce leukemic relapse in patients with chronic myelogenous leukemia.

OUTLINE: Patients receive myeloablation with busulfan and cyclophosphamide on an approved protocol. Allogeneic bone marrow is harvested and treated in vitro with anti-CD34 antibody. T-cell depleted, CD34-positive cell-supplemented bone marrow is infused on day 0. Patients receive high-dose sargramostim (GM-CSF) subcutaneously (SC) beginning on day 5 and continuing until blood counts recover and then low-dose GM-CSF SC continuing until day 60.

Donor lymphocyte infusions or second unmodified allogeneic bone marrow transplantation without GM-CSF is considered in case of primary or secondary engraftment failure.

Patients are followed every month for 3 months, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.

PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study within approximately 6-10 years.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of chronic myelogenous leukemia (CML) documented by cytogenetic and molecular analyses at Johns Hopkins

    • Philadelphia chromosome (Ph)-positive or -negative CML

      • Ph-negative CML allowed with presence of either:

        • BCR-ABL rearrangement (on molecular, fluorescent in situ hybridization, or polymerase chain reaction analyses)
        • p210 protein
  • One of the following:

    • Patient age 18 to 65
    • Disease duration longer than 3 years
    • Accelerated phase CML
  • Accelerated phase diagnosis based on any of the following:

    • More than 10% to less than 30% blasts in blood or bone marrow
    • No hematologic response to prior conventional therapy (hydroxyurea or interferon)
    • Extramedullary disease (e.g., progressive splenomegaly or lymphadenopathy)
    • Basophilia greater than 10% in blood or bone marrow
    • Other cytogenetic abnormalities in addition to a single Ph chromosome
    • Second chronic phase
  • Failure on interferon suggested of patients over age 18 with chronic phase CML, with failure defined as:

    • No detectable Ph-negative metaphases in marrow after 6 months
    • No progressive increase in Ph-negative metaphases in marrow after 6-12 months
    • Less than 50% Ph-negative metaphases after 1 year
    • No complete cytogenetic remission after 2 years
    • Intolerance to interferon therapy
  • No blast crisis CML, chronic myelomonocytic leukemia, or juvenile CML
  • The following conditions are allowed:

    • Leukocyte count abnormalities
    • Fibrosis
    • Anemia
    • Fever or bone pain
    • Thrombocytopenia
    • Bone marrow reticulin
  • Availability of an HLA-identical sibling donor

    • At least 3 years of age (priority given to donors over age 10)
    • Priority given to CMV-negative donor if patient CMV-negative
    • No medical or psychiatric condition that precludes transplant procedure

PATIENT CHARACTERISTICS:

Age

  • 18 to 65

Performance status

  • ECOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • See Disease Characteristics

Hepatic

  • Not specified

Renal

  • Not specified

Other

  • No history of intolerance to sargramostim (GM-CSF)

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Disease Characteristics

Chemotherapy

  • See Disease Characteristics

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00002778

Locations
United States, Maryland
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, Maryland, United States, 21231
Sponsors and Collaborators
Sidney Kimmel Comprehensive Cancer Center
Investigators
Principal Investigator: B. Douglas Smith, MD Sidney Kimmel Comprehensive Cancer Center
  More Information

No publications provided

ClinicalTrials.gov Identifier: NCT00002778     History of Changes
Other Study ID Numbers: CDR0000064783, P01CA015396, P30CA006973, JHOC-J9449, BRLX-001.0649, JHOC-94110404, NCI-V96-0900
Study First Received: November 1, 1999
Last Updated: July 19, 2011
Health Authority: United States: Federal Government

Keywords provided by Sidney Kimmel Comprehensive Cancer Center:
relapsing chronic myelogenous leukemia
chronic phase chronic myelogenous leukemia
accelerated phase chronic myelogenous leukemia
Philadelphia chromosome positive chronic myelogenous leukemia
Philadelphia chromosome negative chronic myelogenous leukemia
atypical chronic myeloid leukemia

Additional relevant MeSH terms:
Leukemia
Leukemia, Myeloid
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Neoplasms by Histologic Type
Neoplasms
Myeloproliferative Disorders
Bone Marrow Diseases
Hematologic Diseases

ClinicalTrials.gov processed this record on September 14, 2014