Peripheral Stem Cell Transplant in Treating Patients With High-Risk Leukemia
RATIONALE: Giving chemotherapy and total-body irradiation before a donor peripheral stem cell transplant helps stop the growth of cancer and abnormal cells and helps stop the patient's immune system from rejecting the donor's stem cells. When the stem cells from a related donor, that do not exactly match the patient's blood, are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets.
PURPOSE: This phase II trial is studying how well peripheral stem cell transplant works in treating patients with high-risk leukemia.
Chronic Myeloproliferative Disorders
Drug: fludarabine phosphate
Drug: therapeutic allogeneic lymphocytes
Procedure: allogeneic bone marrow transplantation
Procedure: biological therapy
Procedure: bone marrow ablation with stem cell support
Procedure: bone marrow transplantation
Procedure: leukocyte therapy
Procedure: non-specific immune-modulator therapy
Procedure: peripheral blood lymphocyte therapy
Procedure: peripheral blood stem cell transplantation
Procedure: radiation therapy
|Study Design:||Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Pilot Study Of T-Cell-Depleted Peripheral Blood Stem Cell Transplantation From Partially Matched Related Donors For Patients With High-Risk Leukemia|
- Incidence of graft failure 100 days post-transplant
- Incidence of acute and chronic graft-vs-host disease100 days post-transplant
- Transplant-related mortality 100 days post-transplant
- Disease-free survival 100 days post-transplant
- Overall survival 100 days post-transplant
|Study Completion Date:||January 2007|
- Determine the safety of a preparative regimen comprising total body irradiation, cyclophosphamide, thiotepa, and fludarabine, but without anti-thymocyte globulin, in patients with high-risk leukemia treated with peripheral blood stem cell transplantation from partially matched related donors.
- Determine the incidence of graft failure, acute graft-versus-host disease (GVHD), and treatment-related mortality in patients treated with this regimen.
- Determine rates of chronic GVHD and relapse in patients treated with this regimen.
- Determine disease-free and overall survival in patients treated with this regimen.
OUTLINE: This is a pilot study.
Patients receive a preparative regimen comprising total lymphoid irradiation once daily on days -13 to -11; cyclophosphamide IV over 1 hour on days -8 and -7; thiotepa IV over 4 hours every 12 hours on day -6; fludarabine IV over 30 minutes on days -5 to -1; and total body irradiation once on day -1. Patients also receive cyclosporine IV over 12 hours on days -8 to -1 and methylprednisolone IV twice daily on days -3 and -2. Patients receive CD34-enriched T-cell-depleted allogeneic stem cell infusion on day 0.
Patients with disease progression or uncontrolled infection but without grade II or greater graft-versus-host disease may receive up to 3 donor lymphocyte infusions at least 4 weeks apart until disease regression.
Patients are followed at least weekly until day 100 and then at 6, 12, 18, 24, 36, and 48 months.
PROJECTED ACCRUAL: A total of 20-51 patients will be accrued for this study.
|United States, Maryland|
|NIH - Warren Grant Magnuson Clinical Center|
|Bethesda, Maryland, United States, 20892-1182|
|Study Chair:||Bipin N. Savani, MD||National Heart, Lung, and Blood Institute (NHLBI)|