Autologous Followed By Non-Myeloablative Allogeneic Transplant For Multiple Myeloma
OBJECTIVES:
- Determine whether autologous peripheral blood stem cell transplantation (PBSCT)
followed by non-myeloablative allogeneic PBSCT is associated with no more than 20%
treatment-related mortality rates at 6 months in patients with multiple myeloma.
- Determine the response rate of patients treated with this regimen.
- Determine the percent donor chimerism in patients treated with this regimen.
- Determine the rate of graft-vs-host disease in patients treated with this regimen.
- Determine the toxic effects of this regimen in these patients.
- Determine the disease-free and overall survival of patients treated with this regimen.
- Determine whether abnormal cytogenetics at presentation correlate with poor response in
patients treated with this regimen.
OUTLINE: This is a multicenter study.
Patients receive cyclophosphamide IV over 1-2 hours on day 1 and filgrastim (G-CSF)
subcutaneously (SC) beginning on day 5 and continuing until peripheral blood stem cell
(PBSC) collection is complete.
Approximately 2-4 weeks after PBSC collection, patients receive melphalan IV over 15-30
minutes on day -2. Patients then undergo autologous PBSC transplantation (PBSCT) on day 0.
Patients receive G-CSF SC beginning on day 5 and continuing until blood counts recover.
Approximately 2-4 months after autologous PBSCT, patients receive fludarabine IV over 30
minutes on days -7 to -3 and cyclophosphamide IV over 1 hour on days -4 to -3. Patients
undergo allogeneic PBSCT on day 0. Patients receive G-CSF SC beginning on day 7 and
continuing until blood counts recover.
Patients receive graft-vs-host disease (GVHD) prophylaxis comprising oral tacrolimus twice
daily on days -1 to 90 followed by a taper on days 91-150 and methotrexate IV on days 1, 3,
and 6.
After day 120, patients with stable or progressive disease and no evidence of active GVHD
may receive donor lymphocyte infusion (DLI) over 2 hours. Patients may receive up to 3 DLIs
every 8 weeks.
Patients are followed every 3 months for 3 years, every 6 months for 5 years, and then
annually for 15 years.
PROJECTED ACCRUAL: A maximum of 63 patients will be accrued for this study.
Interventional
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Treatment-related mortality
6 months
Yes
Kenneth C. Anderson, MD
Study Chair
Dana-Farber Cancer Institute
United States: Federal Government
CDR0000069109
NCT00028600
November 2001
March 2023
Name | Location |
---|---|
Roswell Park Cancer Institute | Buffalo, New York 14263 |
University of Chicago Cancer Research Center | Chicago, Illinois 60637 |
CCOP - Christiana Care Health Services | Wilmington, Delaware 19899 |
Holden Comprehensive Cancer Center at University of Iowa | Iowa City, Iowa 52242-1002 |
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill | Chapel Hill, North Carolina 27599-7570 |
Mount Sinai Medical Center | New York, New York 10029 |
Wake Forest University Comprehensive Cancer Center | Winston-Salem, North Carolina 27157-1096 |
UCSF Helen Diller Family Comprehensive Cancer Center | San Francisco, California 94115 |
Lombardi Comprehensive Cancer Center at Georgetown University Medical Center | Washington, District of Columbia 20007 |
Arthur G. James Cancer Hospital and Solove Research Institute at Ohio State University Medical Center | Columbus, Ohio 43210-1240 |
Cancer Institute of New Jersey at Cooper - Voorhees | Voorhees, New Jersey 08043 |
Western Pennsylvania Cancer Institute at Western Pennsylvania Hospital | Pittsburgh, Pennsylvania 15224-1791 |
Tunnell Cancer Center at Beebe Medical Center | Lewes, Delaware 19958 |
Union Hospital Cancer Program at Union Hospital | Elkton MD, Maryland 21921 |
Siteman Cancer Center at Barnes-Jewish St. Peters Hospital - Saint Louis | St Louis, Missouri 63110 |