Bone Marrow Transplant Plus Cyclophosphamide and Total-Body Irradiation in Treating Patients With Hematologic Cancer

This study has been completed.
Sponsor:
Information provided by:
Temple University
ClinicalTrials.gov Identifier:
NCT00002809
First received: November 1, 1999
Last updated: September 30, 2010
Last verified: September 2010

November 1, 1999
September 30, 2010
August 1996
December 2003   (final data collection date for primary outcome measure)
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Not Provided
Complete list of historical versions of study NCT00002809 on ClinicalTrials.gov Archive Site
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Bone Marrow Transplant Plus Cyclophosphamide and Total-Body Irradiation in Treating Patients With Hematologic Cancer
Unrelated Bone Marrow Transplantation With Cyclophosphamide and Total Body Irradiation For Hematologic Malignancies and Bone Marrow Failure States

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Combining chemotherapy and radiation therapy together with bone marrow transplant may allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells.

PURPOSE: This phase II trial is studying how well giving bone marrow transplant from an unrelated donor together with cyclophosphamide and total-body irradiation works in treating patients with hematologic cancer.

OBJECTIVES:

  • Study the curative potential of high-dose cyclophosphamide and total-body irradiation followed by rescue with bone marrow from volunteer HLA-matched donors in patients with a variety of hematologic malignancies and bone marrow failure states.
  • Study the toxic effects associated with matched unrelated bone marrow transplantation in this patient population.
  • Participate in collaborative research studies with the National Marrow Donor Program.

OUTLINE: All patients receive myeloablative therapy with high-dose cyclophosphamide and total body irradiation over 4 days; patients with severe aplastic anemia also receive antithymocyte globulin. Patients then undergo allogeneic bone marrow transplantation. Filgrastim (G-CSF) is given after transplant to accelerate engraftment. Sargramostim (GM-CSF) may be given in case of graft failure.

All patients receive graft-versus-host-disease (GVHD) prophylaxis with tacrolimus, methotrexate, and gamma globulin. Established GVHD is treated with corticosteroids and, as necessary, antithymocyte globulin.

Patients are followed at 100 days, 6 months, and 1 year after transplant, then annually thereafter.

PROJECTED ACCRUAL: A total of 10 patients per year will be accrued for this study over 5 years.

Interventional
Phase 2
Masking: Open Label
Primary Purpose: Treatment
  • Leukemia
  • Myelodysplastic Syndromes
  • Myelodysplastic/Myeloproliferative Diseases
  • Biological: anti-thymocyte globulin
  • Biological: filgrastim
  • Biological: sargramostim
  • Biological: therapeutic immune globulin
  • Drug: cyclophosphamide
  • Drug: methotrexate
  • Drug: tacrolimus
  • Procedure: allogeneic bone marrow transplantation
  • Radiation: radiation therapy
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
10
December 2003
December 2003   (final data collection date for primary outcome measure)

DISEASE CHARACTERISTICS:

  • One of the following hematologic malignancies/disorders:

    • Acute lymphoblastic leukemia

      • In second or subsequent complete remission (CR)
      • In first CR with high-risk features (e.g., Philadelphia chromosome-positive)
      • In first relapse and failed conventional salvage therapy
    • Acute myelogenous leukemia (AML)

      • In second or subsequent CR
      • In early first relapse
      • In full first relapse and failed conventional salvage therapy
      • In first CR with high-risk features, e.g., trisomy 8 or FAB 6/7

        • Standard-risk AML offered conventional-dose consolidation chemotherapy or autologous bone marrow transplantation
    • Chronic myelogenous leukemia in chronic, accelerated, or second chronic phase

      • No blast crisis
    • Severe aplastic anemia that has failed at least 1 course of immunosuppressive therapy
    • Paroxysmal nocturnal hemoglobinuria with high-risk features (e.g., disseminated intravascular coagulation, thrombotic events)
    • Myelodysplastic syndrome, i.e.:

      • Symptomatic, transfusion-dependent refractory anemia with excess blasts
      • (RAEB) or RAEB in transformation
    • Secondary leukemia in CR following conventional-dose induction chemotherapy
  • Unrelated marrow donor available who is 8 out of 10-, 9 out of 10-, or 10 out of 10-antigen serologically HLA-matched at A, B, C, DRb, and DQB loci by molecular typing
  • No CNS malignancy

PATIENT CHARACTERISTICS:

Age:

  • 17 to 60

Performance status:

  • Karnofsky 70-100%

Life expectancy:

  • No reduction due to other serious illness

Hematopoietic:

  • Not specified

Hepatic:

  • Bilirubin less than 3 mg/dL
  • AST/ALT no greater than twice normal

Renal:

  • Creatinine no greater than 2.0 mg/dL
  • Creatinine clearance greater than 60 mL/min

Cardiovascular:

  • Left ventricular ejection fraction at least 45%
  • No severe hypertension

Pulmonary:

  • DLCO, FEV_1, and FVC at least 50%

Other:

  • HIV negative
  • No active infection at time of transplant
  • No advanced diabetes
  • No significant neurologic deficit
  • No active drug or substance abuse
  • No emotional disorders
  • Able to participate in frequent medical care for at least 1-2 years
  • Willing to comply with National Marrow Donor Program policies

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • See Disease Characteristics

Chemotherapy

  • See Disease Characteristics

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified
Both
17 Years to 60 Years
No
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00002809
CDR0000064937, TUHSC-2803, NCI-V96-0950
Not Provided
Temple University Bone Marrow Transplant Program, Temple University Health Systems
Temple University
Not Provided
Study Chair: Kenneth F. Mangan, MD, FACP Fox Chase Cancer Center
Temple University
September 2010

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP