Stem Cell Transplant in Treating Patients With Hematological Cancer or Other Disorders

The recruitment status of this study is unknown because the information has not been verified recently.
Verified July 2009 by National Cancer Institute (NCI).
Recruitment status was  Recruiting
Sponsor:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00740467
First received: August 22, 2008
Last updated: January 27, 2010
Last verified: July 2009
  Purpose

RATIONALE: Giving chemotherapy, such as fludarabine, busulfan, and cyclophosphamide, together with antithymocyte globulin before a donor stem cell transplant helps stop the growth of cancer and abnormal cells. Giving chemotherapy before or after transplant also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer and abnormal 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 cyclosporine and mycophenolate mofetil after the transplant may stop this from happening.

PURPOSE: This phase II trial is studying how well stem cell transplant works in treating patients with hematological cancer or other disorders.


Condition Intervention Phase
Graft Versus Host Disease
Leukemia
Lymphoma
Multiple Myeloma and Plasma Cell Neoplasm
Precancerous Condition
Biological: anti-thymocyte globulin
Drug: busulfan
Drug: cyclophosphamide
Drug: cyclosporine
Drug: fludarabine phosphate
Drug: mycophenolate mofetil
Procedure: nonmyeloablative allogeneic hematopoietic stem cell transplantation
Phase 2

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Masking: Open Label
Primary Purpose: Treatment
Official Title: Allograft of Hematopoietic Stem Cells With Reduced-intensity Conditioning From a HLA-haploidentical Family Donor: Phase II Study of Combined Immunosuppression Before and After Transplantation

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Incidence of graft acceptance [ Designated as safety issue: No ]

Estimated Enrollment: 50
Study Start Date: January 2008
Estimated Primary Completion Date: January 2010 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Evaluate the incidence of graft acceptance in patients with hematological disorders treated with combined immunosuppression before and after HLA-haploidentical hematopoietic stem cell transplantation.

Secondary

  • Evaluate efficacy of this regimen in these patients.
  • Evaluate toxicity of this regimen in these patients.
  • Assess survival of patients treated with this regimen.

OUTLINE: This is a multicenter study.

  • Reduced-intensity conditioning: Patients receive fludarabine phosphate IV on days -6 to -1, busulfan IV on days -6 to -5, and anti-thymocyte globulin IV on days -4 to -1.
  • Transplantation: Patients undergo transplantation of donor hematopoietic stem cells on day 0. Patients also receive cyclophosphamide IV on day 3 and filgrastim (G-CSF) beginning on day 4 and continuing until blood counts recover.
  • Immunosuppression: Patients receive cyclosporine IV beginning on day -2 and continuing for 6 months and mycophenolate mofetil 4 times a day on days 4-84.
  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of any of the following hematological cancers with a poor prognosis:

    • Acute myeloid leukemia meeting 1 of the following criteria:

      • Third complete remission (CR3) or beyond
      • CR2 after an early bone marrow relapse (< 24 months)
      • Refractory disease after ≥ 2 chemotherapy courses of induction therapy
    • Acute lymphoblastic leukemia meeting 1 of the following criteria:

      • CR3 after ≥ 1 bone marrow relapse
      • CR2 after early bone marrow relapse (currently or within 6 months after stopping maintenance therapy)
    • Chronic myelogenous leukemia meeting the following criteria:

      • Accelerated phase
      • Second chronic phase
      • No other treatment options
    • Multiple myeloma meeting the following criteria:

      • Failed conventional therapy (including autologous hematopoietic stem cell transplantation)
      • No other treatment alternatives
    • Chronic lymphocytic leukemia meeting the following criteria:

      • Failed conventional therapy
      • No other treatment alternatives
    • Hodgkin lymphoma meeting the following criteria:

      • Failed conventional therapy
      • No other treatment alternatives
    • Non-Hodgkin lymphoma meeting the following criteria:

      • Failed conventional therapy
      • No other treatment alternatives
  • Not eligible for standard myeloablative allograft due to increased toxicity
  • Healthy related donor available and meeting the following criteria:

    • Brother, sister, father, mother, cousin, uncle, or aunt
    • At least an identical HLA haplotype

      • Identical genotype on 1 haplotype (in terms of HLA-A, B, C, and DR)
      • Different on ≤ 4 alleles on the other haplotype
  • No HLA-identical intra- or extra-familial donor cord blood available within the next 3 months

PATIENT CHARACTERISTICS:

  • Karnofsky performance status 70-100%
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • No contraindication to allogeneic transplantation, including any of the following:

    • Cardiac systolic ejection fraction < 40%
    • DLCO level limiting use of fludarabine
    • Creatinine clearance < 30 mL/min
    • Transaminases and/or bilirubin > 3 times upper limit of normal (unless due to Gilbert disease or cancer)
    • HIV seropositivity
    • Human T-cell lymphotrophic virus type 1 seropositivity
    • Uncontrolled bacterial, viral, or fungal infection
  • No contraindication to any of the study drugs
  • No prior or concurrent psychiatric illness
  • No other cancer in the past 5 years except for basal cell skin cancer or carcinoma in situ of the cervix
  • No concurrent serious, uncontrolled condition
  • No patients deprived of liberty or subject to legal protection

PRIOR CONCURRENT THERAPY:

  • No participation in a study of allografts in the past month
  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: NCT00740467

Locations
France
Marseille Institute of Cancer - Institut J. Paoli and I. Calmettes Recruiting
Marseille, France, 13273
Contact: Contact Person    33-4-91-22-37-54      
Sponsors and Collaborators
Institut Paoli-Calmettes
Investigators
Study Chair: Didier Blaise, MD Institut Paoli-Calmettes
  More Information

Additional Information:
No publications provided

ClinicalTrials.gov Identifier: NCT00740467     History of Changes
Other Study ID Numbers: CDR0000592923, IPC-ITT-06-01, INCA-RECF0627, EUDRACT-2006-001369-14
Study First Received: August 22, 2008
Last Updated: January 27, 2010
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
graft versus host disease
adult acute myeloid leukemia in remission
adult acute myeloid leukemia with 11q23 (MLL) abnormalities
adult acute myeloid leukemia with inv(16)(p13;q22)
adult acute myeloid leukemia with t(15;17)(q22;q12)
adult acute myeloid leukemia with t(16;16)(p13;q22)
adult acute myeloid leukemia with t(8;21)(q22;q22)
recurrent adult acute myeloid leukemia
adult acute lymphoblastic leukemia in remission
recurrent adult acute lymphoblastic leukemia
accelerated phase chronic myelogenous leukemia
chronic phase chronic myelogenous leukemia
refractory multiple myeloma
relapsing chronic myelogenous leukemia
recurrent adult Hodgkin lymphoma
adult nasal type extranodal NK/T-cell lymphoma
anaplastic large cell lymphoma
angioimmunoblastic T-cell lymphoma
extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
nodal marginal zone B-cell lymphoma
recurrent adult Burkitt lymphoma
recurrent adult diffuse large cell lymphoma
recurrent adult diffuse mixed cell lymphoma
recurrent adult diffuse small cleaved cell lymphoma
recurrent adult grade III lymphomatoid granulomatosis
recurrent adult immunoblastic large cell lymphoma
recurrent adult lymphoblastic lymphoma
recurrent adult T-cell leukemia/lymphoma
recurrent cutaneous T-cell non-Hodgkin lymphoma
recurrent grade 1 follicular lymphoma

Additional relevant MeSH terms:
Neoplasms
Graft vs Host Disease
Leukemia
Lymphoma
Multiple Myeloma
Neoplasms, Plasma Cell
Plasmacytoma
Precancerous Conditions
Immune System Diseases
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Paraproteinemias
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Antilymphocyte Serum
Busulfan
Cyclophosphamide
Cyclosporins
Cyclosporine
Mycophenolate mofetil
Fludarabine monophosphate
Fludarabine
Mycophenolic Acid
Vidarabine

ClinicalTrials.gov processed this record on July 20, 2014