Biological Therapy After Chemotherapy in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma
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ClinicalTrials.gov Identifier: NCT00012207 |
Recruitment Status :
Completed
First Posted : January 27, 2003
Last Update Posted : August 24, 2010
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RATIONALE: Biological therapies use different ways to stimulate the immune system and stop cancer cells from growing. Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining biological therapy with chemotherapy may kill more cancer cells.
PURPOSE: Phase I trial to study the effectiveness of biological therapy after chemotherapy in treating patients who have relapsed or refractory non-Hodgkin's lymphoma.
Condition or disease | Intervention/treatment | Phase |
---|---|---|
Leukemia Lymphoma | Biological: aldesleukin Biological: therapeutic autologous lymphocytes Drug: cyclophosphamide Drug: prednisone Drug: vincristine sulfate Procedure: adjuvant therapy | Phase 1 |
OBJECTIVES:
Primary
- Determine the safety and toxicity of cellular immunotherapy with autologous CD8+ cytotoxic T-lymphocyte clones after chemotherapy comprising cyclophosphamide, vincristine, and prednisone in patients with relapsed or refractory CD20+ indolent lymphomas or mantle cell lymphoma.
Secondary
- Determine the duration of in vivo persistence of adoptively transferred CD20-specific CD8+ cytotoxic T-lymphocyte clones in the absence and presence of subcutaneous interleukin-2 in these patients.
- Assess the trafficking of CD8+ cytotoxic T-lymphocyte clones to lymph nodes in these patients treated with this regimen.
- Determine immune response and tumor response in patients treated with this regimen.
OUTLINE: This is an open-label, pilot study.
- Leukapheresis: Patients undergo leukapheresis. Selected CD20-specific CD8+ cells are cultured to expand the cytotoxic T lymphocytes (CTL), which are then cloned.
- Chemotherapy:
Patients receive oral cyclophosphamide and oral prednisone on days 1-5 and vincristine IV on day 1. Courses repeat every 3-4 weeks for a total of 6 courses.
- Immune cell infusion:
Beginning 4 weeks after the last course of chemotherapy (and lymph nodes ≤ 5 cm diameter or ≤ 5,000 circulating CD20+ lymphocytes/mm^3), patients receive autologous CD8+ CTL clones IV over 30 minutes. Courses repeat every 2-5 days for a total of 3 courses in the absence of disease progression or unacceptable toxicity. The last 6 patients receive interleukin-2 subcutaneously every 12 hours for 14 days, beginning 2 hours after the last infusion of CD8+ CTL clones.
After course 2 or 3 of immune cells, all patients undergo surgical lymph node biopsy to determine if immune cells are moving to the lymph nodes.
Patients are followed monthly for 1 year and then annually for 2 years.
PROJECTED ACCRUAL: A total of 12 patients will be accrued for this study within 4 years.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 12 participants |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | A Phase I Study To Evaluate The Safety Of Cellular Immunotherapy Using Genetically Modified Autologous Cd20-Specific Cd8+ T Cell Clones For Patients With Relapsed Cd20+ Indolent Lymphomas |
Study Start Date : | September 2000 |
Actual Study Completion Date : | July 2010 |

- Safety and toxicity by NCI CTC toxicity scale in patients w/ recurr. or refract. CD20+ follicular lymphoma who are not candidates for high dose chemoradiotx and stem cell transplant during each infusion, weekly for 4 wks and then monthly for a yr
- Duration of in vivo persistence of adoptively transferred CD20-specific CD8+ T cell clones by flow cytometry and quantitative polymerase chain reaction (qPCR) during each infusion, weekly for 4 weeks, and then monthly for a year
- Trafficking of CD8+ CD20-specific T cell clones to lymph nodes by Gamma camera imaging during each infusion, weekly for 4 weeks, and then monthly for a year
- Development of host anti-scFvFc:zeta (and anti-NeoR) immune responses by ELISA and chromium release assays during each infusion, weekly for 4 weeks, and then monthly for a year
- Tumor responses to cyclophosphamide, vincristine, and prednisone (CVP) and to cytotoxic T-lymphocyte (CTL) infusions by Cheson criteria during each infusion, weekly for 4 weeks, and then monthly for a year

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Ages Eligible for Study: | Child, Adult, Older Adult |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
-
Immunohistopathologically documented relapsed or refractory CD20+ indolent lymphomas or mantle cell lymphoma
-
Indolent B-cell lymphomas including any of the following subtypes:
- Follicular lymphoma (grade I, II, or III)
- Small lymphocytic lymphoma or chronic lymphocytic leukemia
- Marginal zone lymphoma (splenic, nodal, and extra-nodal)
- Lymphoplasmacytoid lymphoma
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- Ineligible for or unwilling to participate in other FHCRC/UWMC protocols
- Serological evidence of prior exposure to Epstein-Barr virus
- Must agree to undergo peripheral blood drawing, bone marrow biopsy, lymph node biopsy, and nuclear medicine imaging
- Must agree to cytoreductive chemotherapy if necessary to reduce lymph nodes to < 5 cm in diameter or circulating B lymphocyte counts to < 5,000/mm^3
- No pulmonary involvement
- No CNS involvement
PATIENT CHARACTERISTICS:
Age:
- Any age
Performance status:
- Not specified
Life expectancy:
- At least 90 days
Hematopoietic:
- Not specified
Hepatic:
- No active hepatitis B infection
Renal:
- Not specified
Other:
- No HIV positivity
- Not pregnant or nursing
- Fertile patients must use effective contraception
- No history of hypersensitivity reactions to murine proteins
PRIOR CONCURRENT THERAPY:
Biologic therapy:
- At least 4 months since prior rituximab, tositumomab, or ibritumomab
- No prior allogeneic stem cell transplantation
- No other concurrent immunotherapy (e.g., interferons, vaccines, or other cellular products)
Chemotherapy:
- At least 2 years since prior fludarabine or cladribine
- At least 4 weeks since prior chemotherapy and recovered
Endocrine therapy:
- No concurrent systemic corticosteroids except to treat toxicity from chemotherapy or cellular immunotherapy
Radiotherapy:
- Not specified
Surgery:
- Not specified
Other:
- At least 4 weeks since prior immunosuppressive therapy and recovered
- No concurrent pentoxifylline
- No other concurrent investigational agents

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00012207
United States, California | |
City of Hope Comprehensive Cancer Center | |
Duarte, California, United States, 91010-3000 | |
United States, Washington | |
Fred Hutchinson Cancer Research Center | |
Seattle, Washington, United States, 98109-1024 | |
University of Washington School of Medicine | |
Seattle, Washington, United States, 98195 |
Study Chair: | Oliver W. Press, MD, PhD | Fred Hutchinson Cancer Research Center |
Publications of Results:
ClinicalTrials.gov Identifier: | NCT00012207 History of Changes |
Other Study ID Numbers: |
1503.00 FHCRC-1503.00 NCI-G01-1921 CDR0000068494 ( Registry Identifier: PDQ ) |
First Posted: | January 27, 2003 Key Record Dates |
Last Update Posted: | August 24, 2010 |
Last Verified: | August 2010 |
recurrent grade 1 follicular lymphoma recurrent grade 2 follicular lymphoma recurrent grade 3 follicular lymphoma recurrent mantle cell lymphoma |
recurrent marginal zone lymphoma recurrent small lymphocytic lymphoma refractory chronic lymphocytic leukemia |
Lymphoma Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Aldesleukin Prednisone Cyclophosphamide Vincristine Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents |
Antineoplastic Agents, Alkylating Alkylating Agents Molecular Mechanisms of Pharmacological Action Antineoplastic Agents Myeloablative Agonists Anti-Inflammatory Agents Glucocorticoids Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Antineoplastic Agents, Hormonal Antineoplastic Agents, Phytogenic Tubulin Modulators Antimitotic Agents Mitosis Modulators Anti-HIV Agents |