Sequential Autologous HCT / Nonmyeloablative Allogeneic HCT Using Related, HLA-Haploidentical Donors for Patients With High-Risk Lymphoma, Multiple Myeloma, or Chronic Lymphocytic Leukemia
PRIMARY OBJECTIVES:
I. Event-free survival (EFS) at 1-year after autograft.
SECONDARY OBJECTIVES:
I. Relapse rates at 1-year after autograft.
II. Overall survival (OS) at 1-year after autograft.
III. Incidence of grades II-IV acute GVHD and chronic extensive GVHD.
IV. Non-relapse mortality (NRM) at 200 days and 1 year after allograft.
V. Donor engraftment at day +84.
VI. Incidence of infections.
OUTLINE:
CONDITIONING REGIMEN 1 (lymphoma, Waldenstrom Macroglobulinemia, or chronic lymphocytic
leukemia [CLL] with no dose limiting radiation or significant comorbidities: Patients
receive cyclophosphamide intravenously (IV) on days -6 and -5. Patients undergo high-dose
TBI twice daily (BID) on days -3 to -1.
CONDITIONING REGIMEN 2 (lymphoma, Waldenstrom Macroglobulinemia, CLL, with prior
dose-limiting radiation, or significant comorbidities): Patients receive carmustine IV on
day -7, etoposide IV BID on days -6 to -3, cytarabine IV BID on days -6 to -3, and melphalan
IV on day -2.
CONDITIONING REGIMEN 3 (multiple myeloma or plasma cell leukemia, with no significant renal
insufficiency or other significant comorbidities): Patients receive high-dose melphalan IV
on day -2.
CONDITIONING REGIMEN 4 (multiple myeloma or plasma cell leukemia, with significant renal
insufficiency or other significant comorbidities): Patients receive lessened dose of
melphalan IV on day -2.
PBSC TRANSPLANTATION: All patients undergo autologous PBSC transplantation on day 0.
WAITING INTERVAL: Between 40 and 120 days.
NONMYELOABLATIVE CONDITIONING REGIMEN: Patients receive fludarabine phosphate IV once daily
(QD) on days -6 to -2 and cyclophosphamide IV QD on days -6 to -5 and day 3. Patients
infused with donor's peripheral blood stem cells will additionally receive cyclophosphamide
IV on day 4. Patients undergo low-dose TBI on day -1.
ALLOGENEIC BONE MARROW TRANSPLANTATION: Patients undergo donor bone marrow transplantation
on day 0.
- GRAFT-VERSUS-HOST DISEASE PROPHYLAXIS: Beginning on day 4, patients receive tacrolimus
orally (PO) or IV and taper beginning on day 86 if no graft-versus-host disease.
Patients also receive mycophenolate mofetil PO thrice daily (TID) on days 4 - 35.
- PERIPHERAL BLOOD COUNT SUPPORT: Patients receive filgrastim (G-CSF) IV or
subcutaneously (SC) beginning from day 4 and continue till blood counts recover.
ALLOGENEIC PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC) TRANSPLANTATION: Patients undergo donor
PBMC transplantation on day 0.
- GRAFT-VERSUS-HOST DISEASE PROPHYLAXIS: Beginning on day 5, patients receive tacrolimus
orally (PO) or IV and taper beginning on day 86 if no graft-versus-host disease.
Patients also receive mycophenolate mofetil PO thrice daily (TID) on days 5 - 35.
- PERIPHERAL BLOOD COUNT SUPPORT: Patients receive filgrastim (G-CSF) IV or
subcutaneously (SC) beginning from day 5 and continue till blood counts recover.
After completion of study treatment, patients are followed periodically for 5 years.
Interventional
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Progression-free survival (PFS)
An observed 1-year PFS of >= 50% would be considered efficacious and worthy of further study.
Calculated for all patients from the date of autologous transplant until the time of death, assessed up to 1 year
No
Mohamed Sorror
Principal Investigator
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
United States: Institutional Review Board
2241.00
NCT01008462
March 2010
Name | Location |
---|---|
Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium | Seattle, Washington 98109 |
Froedtert and the Medical College of Wisconsin | Milwaukee, Wisconsin 53226 |