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A Pilot Trial Of Reduced Intensity Allogeneic Stem Cell Transplantation With Fludarabine, Melphalan, And Low Dose Total Body Irradiation


N/A
3 Years
75 Years
Open (Enrolling)
Both
Accelerated Phase Chronic Myelogenous Leukemia, Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome, Adult Acute Lymphoblastic Leukemia in Remission, Adult Acute Myeloid Leukemia in Remission, Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities, Adult Acute Myeloid Leukemia With Del(5q), 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), Adult Nasal Type Extranodal NK/T-cell Lymphoma, Anaplastic Large Cell Lymphoma, Angioimmunoblastic T-cell Lymphoma, Aplastic Anemia, Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative, Childhood Acute Lymphoblastic Leukemia in Remission, Childhood Acute Myeloid Leukemia in Remission, Childhood Chronic Myelogenous Leukemia, Childhood Diffuse Large Cell Lymphoma, Childhood Immunoblastic Large Cell Lymphoma, Childhood Myelodysplastic Syndromes, Childhood Nasal Type Extranodal NK/T-cell Lymphoma, Chronic Eosinophilic Leukemia, Chronic Myelomonocytic Leukemia, Chronic Neutrophilic Leukemia, Chronic Phase Chronic Myelogenous Leukemia, de Novo Myelodysplastic Syndromes, Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue, Fanconi Anemia, Juvenile Myelomonocytic Leukemia, Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable, Nodal Marginal Zone B-cell Lymphoma, Noncontiguous Stage II Adult Burkitt Lymphoma, Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma, Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma, Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma, Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma, Noncontiguous Stage II Adult Lymphoblastic Lymphoma, Noncontiguous Stage II Grade 1 Follicular Lymphoma, Noncontiguous Stage II Grade 2 Follicular Lymphoma, Noncontiguous Stage II Grade 3 Follicular Lymphoma, Noncontiguous Stage II Mantle Cell Lymphoma, Noncontiguous Stage II Marginal Zone Lymphoma, Noncontiguous Stage II Small Lymphocytic Lymphoma, Paroxysmal Nocturnal Hemoglobinuria, Previously Treated Myelodysplastic Syndromes, Primary Myelofibrosis, Recurrent Adult Acute Lymphoblastic Leukemia, Recurrent Adult Acute Myeloid Leukemia, 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 Hodgkin Lymphoma, Recurrent Adult Immunoblastic Large Cell Lymphoma, Recurrent Adult Lymphoblastic Lymphoma, Recurrent Adult T-cell Leukemia/Lymphoma, Recurrent Childhood Acute Lymphoblastic Leukemia, Recurrent Childhood Acute Myeloid Leukemia, Recurrent Childhood Anaplastic Large Cell Lymphoma, Recurrent Childhood Grade III Lymphomatoid Granulomatosis, Recurrent Childhood Large Cell Lymphoma, Recurrent Childhood Lymphoblastic Lymphoma, Recurrent Childhood Small Noncleaved Cell Lymphoma, Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma, Recurrent Grade 1 Follicular Lymphoma, Recurrent Grade 2 Follicular Lymphoma, Recurrent Grade 3 Follicular Lymphoma, Recurrent Mantle Cell Lymphoma, Recurrent Marginal Zone Lymphoma, Recurrent Mycosis Fungoides/Sezary Syndrome, Recurrent Small Lymphocytic Lymphoma, Recurrent/Refractory Childhood Hodgkin Lymphoma, Refractory Chronic Lymphocytic Leukemia, Refractory Multiple Myeloma, Relapsing Chronic Myelogenous Leukemia, Secondary Acute Myeloid Leukemia, Secondary Myelodysplastic Syndromes, Splenic Marginal Zone Lymphoma, Stage III Adult Diffuse Small Cleaved Cell Lymphoma, Stage III Adult Immunoblastic Large Cell Lymphoma, Stage III Adult Lymphoblastic Lymphoma, Stage III Grade 1 Follicular Lymphoma, Stage III Grade 2 Follicular Lymphoma, Stage III Grade 3 Follicular Lymphoma, Stage III Mantle Cell Lymphoma, Stage III Marginal Zone Lymphoma, Stage III Small Lymphocytic Lymphoma, Stage IV Adult Burkitt Lymphoma, Stage IV Adult Diffuse Small Cleaved Cell Lymphoma, Stage IV Adult Immunoblastic Large Cell Lymphoma, Stage IV Adult Lymphoblastic Lymphoma, Stage IV Grade 1 Follicular Lymphoma, Stage IV Grade 2 Follicular Lymphoma, Stage IV Grade 3 Follicular Lymphoma, Stage IV Mantle Cell Lymphoma, Stage IV Marginal Zone Lymphoma, Stage IV Small Lymphocytic Lymphoma, Waldenström Macroglobulinemia

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Trial Information

A Pilot Trial Of Reduced Intensity Allogeneic Stem Cell Transplantation With Fludarabine, Melphalan, And Low Dose Total Body Irradiation


PRIMARY OBJECTIVES:

I. To determine the transplant related mortality (TRM) of this reduced intensity
transplantation (RIT) combination in a patient population that is usually not eligible for a
full myeloablative allogeneic transplant.

SECONDARY OBJECTIVES:

I. To evaluate engraftment, safety, clinical response, evidence of graft-versus-malignancy
effect/graft-versus-host disease (GVHD) and overall outcomes of treatment with our RIT
regimen across a variety of hematological conditions.

OUTLINE: Patients receive fludarabine phosphate intravenously (IV) over 30 minutes on days
-5 to -2 and melphalan* IV over 30 minutes on day -2. Patients then undergo total-body
irradiation on day -1 and allogeneic stem cell transplantation on day 0.

Note: *Patients with chromosomal breakage syndromes, such as Fanconi anemia or dyskeratosis
congenita, receive anti-thymocyte globulin IV over 4 hours on day -4 to -2 instead of
melphalan.

After completion of study treatment, patients are followed up periodically.


Inclusion Criteria:



- Diagnosis of a histology documented hematologic malignancy or marrow disorder

- Bone marrow failure disorders and other non-malignant hematologic or immunologic
disorders:

- Acquired bone marrow failure disorders include aplastic anemia, paroxysmal
nocturnal hemoglobinuria (PNH):

- Primary allogeneic hematopoietic stem cell transplantation (HSCT) is
appropriate for selected patients with severe aplastic anemia; however,
patients with aplastic anemia must have failed at least one cycle of
standard immunosuppressive therapy with calcineurin inhibitor plus
anti-thymocyte globulin (ATG) if a fully-matched donor is not available

- Patients with PNH must have a history of thrombosis related to PNH

- Hereditary bone marrow failure disorders include Fanconi anemia or related
chromosomal breakage syndrome dyskeratosis congenita, Diamond-Blackfan anemia,
Shwachman-Diamond syndrome, Kostmann syndrome, congenital amegakaryocytic
thrombocytopenia:

- Fanconi anemia or related chromosomal breakage syndrome: positive
chromosome breakage analysis using diepoxybutane (DEB) or mitomycin C if
applicable

- Dyskeratosis: diagnosis is supported by using either telomerase reverse
transcriptase (TERC) gene mutation in autosomal dominant Dyskeratosis
Congenita or Xlinked DKC1 gene mutation

- Other non-malignant hematologic or immunologic disorders that require
transplantation

- Quantitative or qualitative congenital platelet disorders (including but
not limited to congenital amegakaryocytopenia, absent-radii syndrome,
Glanzmann's thrombasthenia)

- Quantitative or qualitative congenital neutrophil disorders (including but
not limited to chronic granulomatous disease, congenital neutropenia)

- Congenital primary immunodeficiencies (including but not limited to Severe
Combined Immunodeficiency Syndrome, Wiskott-Aldrick syndrome, CD40 ligand
deficiency, T-cell deficiencies)

- Acute leukemias:

- Subjects must be ineligible for conventional myeloablative transplantation;

- Resistant or recurrent disease after at least one standard combination
chemotherapy regime or first remission patients at high risk of relapse OR First
remission patients at high risk of relapse:

- Acute myeloid leukemia (AML)- antecedent myelodysplastic syndrome, secondary
AML, high risk cytogenetic abnormalities or normal cytogenetics with high-risk
molecular features (e.g. Flt3-ITD mutation, mixed-lineage leukemia [MLL],
wildtype NPM1);

- Acute lymphocytic leukemia (ALL)- high or standard risk ALL

- Chronic Myeloid Leukemia (CML):

- Chronic phase (intolerant or unresponsive to imatinib and/or other tyrosine
kinase inhibitors), second chronic phase or accelerated phase who are ineligible
for conventional myeloablative transplantation

- Myeloproliferative and myelodysplastic syndromes (MDS):

- Myelofibrosis (with/without splenectomy) with intermediate to high risk features

- Advanced polycythemia vera not responding to standard therapy

- MDS with an international prostate symptom score (IPSS) score of Int-2 or higher

- MDS with lower IPSS scores Int-1 or less with severe clinical features such as
severe neutropenia or thrombocytopenia or high risk chromosome abnormalities
such as monosomy 7

- Secondary massively parallel signature sequencing (MPSS) with any IPSS scores

- Chronic myelomoncytic leukemia

- Lymphoproliferative disease:

- Chronic lymphocytic leukemia (CLL), low-grade non-Hodgkin lymphoma (NHL)
(recurrent or persistent) fludarabine refractory or with less than 6 months
duration of complete response (CR) between courses of conventional therapy

- Multiple myeloma, progressive disease after autologous stem cell transplant or
as planned tandem (allogeneic transplant after prior autologous stem cell
transplant)

- Waldenstroms macroglobulinemia (failed one standard regimen)

- High grade NHL and diffuse large B-cell lymphoma (DLBCL)

- Not eligible for conventional myeloablative HSCT OR failed autologous HSCT

- First remission lymphoblastic lymphoma, or small, non-cleaved cell lymphoma or
mantle cell lymphoma

- Hodgkin disease:

- Relapsed or refractory after front-line therapy

- Failed or were not eligible for autologous transplantation

- Failed prior autotransplant

- Age >= 3 and =< 75 years for blood and bone marrow transplants and age >= 3, < 60 for
cord blood transplants

- No serious uncontrolled psychiatric illness

- No concomitant active malignancy other than non-melanoma skin cancer

- Non-pregnant and non-nursing women (women or men with reproductive potential should
agree to use an effective means of birth control)

- Patients may have received prior autologous bone marrow transplant (BMT) or prior
myeloablative allogeneic BMT (at least 60 days have elapsed)

- At least 2 weeks since prior chemotherapy, radiation treatment and/or surgery

- Informed consent

- DONOR: Permissible HLA matching: Related donors- single antigen mismatch at HLA A, B
or DRB 1; unrelated donors- a single antigen mismatch at HLA A, B, or C, +/-
additional single allele level mismatch at A, B, C or DRB1; cord blood >= 4 out of 6
antigen match at HLA A, B, DRB1)

- DONOR: Compatibility at the four most informative HLA loci: A, B, C and DRB1 are
important for reducing the risk of GVHD and successful transplant outcomes; the A, B,
C and DRB1 loci comprise 8 possible alleles (a haplotype being inherited from each
parent); one additional locus, HLA-DQ, is also typed to ascertain haplotypes and
assist in the search for a compatible donor; however mismatching at DQ has not been
shown to be associated with adverse outcomes; high resolution molecular typing (at
the allele level) is now the standard of care for unrelated donor searches and allows
greater refinement of the search strategy

- DONOR: Matched related donor: a single antigen mismatch at A, B, or the DR transplant
from a family member is associated with a higher risk of GVHD but similar overall
survival when compared to full identity at these 3 regions; related donor/recipient
pairs must be matched at 5 of 6 HLA antigens (A, B, DRBl)

- DONOR: Unrelated donor: when evaluating patients for unrelated donor transplant, a
higher degree of matching is preferred due to minimize the risk of GVHD; the A, B, C,
DRB1 and DQ loci, comprising 10 possible alleles, will be typed routinely for all
unrelated transplants; given the higher risk of TRM in mismatched transplants, RIT is
often the best way to mitigate the risk; evolving data from the National Marrow Donor
Program now makes it possible to estimate the risks of donor-recipient HLA mismatch
at the allele or antigen level; the higher risk from HLA-mismatching must be
carefully assessed with respect to the clinical urgency and the patient's risk by the
transplant physician; antigen level mismatches at DQ are inconsequential to
transplant outcomes and are ignored with respect to donor selection for the purposes
of this protocol, with matching requirements confined to the 8 loci involving HLA A,
B, C and DRB1; for the purpose of this protocol, a single antigen mismatch at HLA A,
B, or C, with or without additional single allele level mismatch may participate in
this protocol for voluntary unrelated donors (blood or marrow); patients must be at
least antigen-level matched at DRB1

- DONOR: If a patient has no suitable family donor matched for 5 of 6 HLA antigens (A,
B, DRB1) and no suitable unrelated donor is identified or for reasons of urgency, the
patient can be considered a candidate for cord blood transplant, provided a cord
blood donor is identified with a >= 4 out of 6 antigen match at HLA A, B, DRB1
antigens; the cord blood product must provide a minimum of 2 x 10^7 nucleated
cells/kg, test negative for HIV and Hepatitis A, Band C, and sterility assays have no
growth; the cord blood products are located through the National Marrow Donor
Program, the American Registry, or the Bone Marrow Donor Worldwide or other
established registries, and may be stored in the N.Y Placental Cord Blood Bank, the
St. Louis Cord Blood Bank, or any of the established, registered International blood
and marrow banks

- DONOR: Donor must be healthy and have nonreactive test results for all infectious
disease assays as required by state and federal regulations; donors who screen
seropositive for hepatitis and/or syphilis must be cleared by infectious disease
consultation

- DONOR: The donor must have no uncontrolled cardiopulmonary, renal, endocrine, hepatic
or psychiatric disease to render donation unsafe

- DONOR: The donor must be able to give informed consent for peripheral blood stem cell
collection or bone marrow collection

- DONOR: Syngeneic donors are not eligible

- DONOR: Donors who have poor peripheral venous access, may require central venous line
placement for stem cell apheresis

Exclusion Criteria:

- Uncontrolled central nervous system (CNS) disease (for hematologic malignancies)

- Karnofsky (adult) or Lansky (for =< 16 years) performance status =< 50%

- Diffusing capacity of the lung for carbon monoxide (DLCO) less than 40% predicted,
corrected for hemoglobin (Hb) and/or alveolar ventilation

- Cardiac: left ventricular ejection fraction less than 40%

- Bilirubin >= 3 x upper limit of normal

- Liver alkaline phosphatase >= 3 x upper limit of normal

- Serum glutamic oxaloacetic transaminase (SGOT) or serum glutamic pyruvate
transaminase (SGPT) >= 3 x upper limit of normal

- Child's class B and C liver failure

- Calculated creatinine clearance < 40 cc/min by the modified Cockcroft-Gault formula
for adults or the Schwartz formula for pediatrics

- Patients who have received maximally allowed doses (given in 2 Gy fractions, or
equivalent) of previous radiation therapy to various organs as follows:

- Mediastinum 40 Gy

- Heart (any volume) 36 Gy

- Whole lungs 12 Gy

- Small bowel (any volume) 46 Gy

- Kidneys 12 Gy

- Whole liver 20 Gy

- Spinal cord (any volume) 36 Gy

- Whole brain 30 Gy Enrollment of patients who previously receive higher than
allowed dose of radiation to a small volume of lungs, liver, and brain will be
determine by the discretion of the radiation oncologist on the study

- Uncontrolled diabetes mellitus, cardiovascular disease, active serious infection or
other condition which, in the opinion of treating physician, would make this protocol
unreasonably hazardous for the patient

- Human immunodeficiency virus (HIV) positive

- Patients who in the opinion of the treating physician are unlikely to comply with the
restrictions of allogeneic stem cell transplantation based on formal psychosocial
screening

- Females of childbearing potential with a positive pregnancy test

Type of Study:

Interventional

Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

TRM

Outcome Description:

An exact 95% confidence interval will be provided.

Outcome Time Frame:

First 100 days

Safety Issue:

No

Principal Investigator

Hong Liu

Investigator Role:

Principal Investigator

Investigator Affiliation:

Roswell Park Cancer Institute

Authority:

United States: Institutional Review Board

Study ID:

I 118807

NCT ID:

NCT00856388

Start Date:

January 2009

Completion Date:

Related Keywords:

  • Accelerated Phase Chronic Myelogenous Leukemia
  • Acute Myeloid Leukemia With Multilineage Dysplasia Following Myelodysplastic Syndrome
  • Adult Acute Lymphoblastic Leukemia in Remission
  • Adult Acute Myeloid Leukemia in Remission
  • Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities
  • Adult Acute Myeloid Leukemia With Del(5q)
  • 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)
  • Adult Nasal Type Extranodal NK/T-cell Lymphoma
  • Anaplastic Large Cell Lymphoma
  • Angioimmunoblastic T-cell Lymphoma
  • Aplastic Anemia
  • Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative
  • Childhood Acute Lymphoblastic Leukemia in Remission
  • Childhood Acute Myeloid Leukemia in Remission
  • Childhood Chronic Myelogenous Leukemia
  • Childhood Diffuse Large Cell Lymphoma
  • Childhood Immunoblastic Large Cell Lymphoma
  • Childhood Myelodysplastic Syndromes
  • Childhood Nasal Type Extranodal NK/T-cell Lymphoma
  • Chronic Eosinophilic Leukemia
  • Chronic Myelomonocytic Leukemia
  • Chronic Neutrophilic Leukemia
  • Chronic Phase Chronic Myelogenous Leukemia
  • de Novo Myelodysplastic Syndromes
  • Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue
  • Fanconi Anemia
  • Juvenile Myelomonocytic Leukemia
  • Myelodysplastic/Myeloproliferative Neoplasm, Unclassifiable
  • Nodal Marginal Zone B-cell Lymphoma
  • Noncontiguous Stage II Adult Burkitt Lymphoma
  • Noncontiguous Stage II Adult Diffuse Large Cell Lymphoma
  • Noncontiguous Stage II Adult Diffuse Mixed Cell Lymphoma
  • Noncontiguous Stage II Adult Diffuse Small Cleaved Cell Lymphoma
  • Noncontiguous Stage II Adult Immunoblastic Large Cell Lymphoma
  • Noncontiguous Stage II Adult Lymphoblastic Lymphoma
  • Noncontiguous Stage II Grade 1 Follicular Lymphoma
  • Noncontiguous Stage II Grade 2 Follicular Lymphoma
  • Noncontiguous Stage II Grade 3 Follicular Lymphoma
  • Noncontiguous Stage II Mantle Cell Lymphoma
  • Noncontiguous Stage II Marginal Zone Lymphoma
  • Noncontiguous Stage II Small Lymphocytic Lymphoma
  • Paroxysmal Nocturnal Hemoglobinuria
  • Previously Treated Myelodysplastic Syndromes
  • Primary Myelofibrosis
  • Recurrent Adult Acute Lymphoblastic Leukemia
  • Recurrent Adult Acute Myeloid Leukemia
  • 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 Hodgkin Lymphoma
  • Recurrent Adult Immunoblastic Large Cell Lymphoma
  • Recurrent Adult Lymphoblastic Lymphoma
  • Recurrent Adult T-cell Leukemia/Lymphoma
  • Recurrent Childhood Acute Lymphoblastic Leukemia
  • Recurrent Childhood Acute Myeloid Leukemia
  • Recurrent Childhood Anaplastic Large Cell Lymphoma
  • Recurrent Childhood Grade III Lymphomatoid Granulomatosis
  • Recurrent Childhood Large Cell Lymphoma
  • Recurrent Childhood Lymphoblastic Lymphoma
  • Recurrent Childhood Small Noncleaved Cell Lymphoma
  • Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma
  • Recurrent Grade 1 Follicular Lymphoma
  • Recurrent Grade 2 Follicular Lymphoma
  • Recurrent Grade 3 Follicular Lymphoma
  • Recurrent Mantle Cell Lymphoma
  • Recurrent Marginal Zone Lymphoma
  • Recurrent Mycosis Fungoides/Sezary Syndrome
  • Recurrent Small Lymphocytic Lymphoma
  • Recurrent/Refractory Childhood Hodgkin Lymphoma
  • Refractory Chronic Lymphocytic Leukemia
  • Refractory Multiple Myeloma
  • Relapsing Chronic Myelogenous Leukemia
  • Secondary Acute Myeloid Leukemia
  • Secondary Myelodysplastic Syndromes
  • Splenic Marginal Zone Lymphoma
  • Stage III Adult Diffuse Small Cleaved Cell Lymphoma
  • Stage III Adult Immunoblastic Large Cell Lymphoma
  • Stage III Adult Lymphoblastic Lymphoma
  • Stage III Grade 1 Follicular Lymphoma
  • Stage III Grade 2 Follicular Lymphoma
  • Stage III Grade 3 Follicular Lymphoma
  • Stage III Mantle Cell Lymphoma
  • Stage III Marginal Zone Lymphoma
  • Stage III Small Lymphocytic Lymphoma
  • Stage IV Adult Burkitt Lymphoma
  • Stage IV Adult Diffuse Small Cleaved Cell Lymphoma
  • Stage IV Adult Immunoblastic Large Cell Lymphoma
  • Stage IV Adult Lymphoblastic Lymphoma
  • Stage IV Grade 1 Follicular Lymphoma
  • Stage IV Grade 2 Follicular Lymphoma
  • Stage IV Grade 3 Follicular Lymphoma
  • Stage IV Mantle Cell Lymphoma
  • Stage IV Marginal Zone Lymphoma
  • Stage IV Small Lymphocytic Lymphoma
  • Waldenström Macroglobulinemia
  • Congenital Abnormalities
  • Primary Myelofibrosis
  • Anemia
  • Anemia, Aplastic
  • Burkitt Lymphoma
  • Neoplasms
  • Fanconi Anemia
  • Fanconi Syndrome
  • Hemoglobinuria
  • Hodgkin Disease
  • Immunoblastic Lymphadenopathy
  • Leukemia
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Leukemia, Lymphoid
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • Leukemia, Myeloid, Acute
  • Leukemia, Myeloid
  • Leukemia, Myeloid, Accelerated Phase
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive
  • Leukemia, Myeloid, Chronic-Phase
  • Leukemia, Myelomonocytic, Chronic
  • Leukemia, Neutrophilic, Chronic
  • Leukemia, T-Cell
  • Leukemia-Lymphoma, Adult T-Cell
  • Lymphoma
  • Lymphoma, Follicular
  • Lymphoma, Large B-Cell, Diffuse
  • Lymphoma, Non-Hodgkin
  • Lymphomatoid Granulomatosis
  • Waldenstrom Macroglobulinemia
  • Hemoglobinuria, Paroxysmal
  • Multiple Myeloma
  • Neoplasms, Plasma Cell
  • Mycoses
  • Mycosis Fungoides
  • Myelodysplastic Syndromes
  • Preleukemia
  • Leukemia, Myelomonocytic, Acute
  • Myeloproliferative Disorders
  • Sezary Syndrome
  • Lymphoma, B-Cell
  • Lymphoma, Large-Cell, Immunoblastic
  • Lymphoma, T-Cell
  • Lymphoma, T-Cell, Cutaneous
  • Hypereosinophilic Syndrome
  • Lymphoma, Large-Cell, Anaplastic
  • Lymphoma, B-Cell, Marginal Zone
  • Lymphoma, Extranodal NK-T-Cell
  • Lymphoma, Mantle-Cell
  • Leukemia, Myelomonocytic, Juvenile
  • Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative
  • Myelodysplastic-Myeloproliferative Diseases

Name

Location

Roswell Park Cancer Institute Buffalo, New York  14263