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Rituxan + BEAM and Auto Stem Cell Transplant for High Risk Lymphoma or Hodgkin's Disease (Rituxan+BEAM)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01702961
Recruitment Status : Completed
First Posted : October 10, 2012
Results First Posted : September 28, 2015
Last Update Posted : December 19, 2018
The Methodist Hospital System
Center for Cell and Gene Therapy, Baylor College of Medicine
Information provided by (Responsible Party):
George Carrum, Baylor College of Medicine

Brief Summary:

High-dose chemotherapy followed by autologous (the patient's own) peripheral blood (circulating blood) stem cell (cells that divide to form white cells, red cells and cells that help clot) transplantation is a conventional treatment for patients with lymphoma (cancer of lymph glands) and Hodgkin's disease (cancer of lymph glands) after first relapse (recurrence of disease). For patients who did not have a complete response after traditional chemotherapy, the chance is high that the tumor will return even after high-dose chemotherapy. To improve the response and decrease the chance of relapse, doctors have used rituximab, an antibody that kills lymphoma cells, both before and after transplantation. These doctors have reported that more patients had control of the tumor for an extended period of time using rituximab with high-dose chemotherapy with autologous stem cell transplantation. How widely this is applicable is not known.

The purpose of this clinical research trial is to confirm that there is a good control of tumor in patients with lymphoma or Hodgkin's disease treated with rituximab and conventional stem cell transplantation.

Condition or disease Intervention/treatment Phase
Lymphoma Hodgkin's Disease Drug: Melphalan Drug: Ara-C Drug: VP-16 Drug: BCNU Drug: Rituxan Drug: Stem Cells Not Applicable

Detailed Description:

Subjects will receive the chemotherapy through a plastic tube (catheter) placed into a vein under the collarbone. The antibody rituximab is given on the day of admission. The subject will also start a six-day course of chemotherapy at that time. The chemotherapy will consist of the following drugs: BCNU, etoposide also called VP-16, Ara-C also called cytosine arabinoside, and melphalan. BCNU is given on the first day, Ara-C and VP-16 on the second, third, fourth and fifth days, and melphalan on the sixth day. The infusion of blood stem cells is given through the catheter the day after the last dose of chemotherapy. This is called Day 0. A week later the subject will receive shots under the skin of Neupogen to help the stem cells grow quickly. Three additional doses of rituximab are given weekly starting 2 weeks later. If the subject recovers and is discharged from the hospital before getting all the doses of rituximab, they can receive the remainder in clinic.

Patients will remain in the hospital for approximately 3-4 weeks, and in the Houston area for about 30 days from the infusion of the donor cells. The patient will have blood, urine, bone marrow, and x-ray examinations performed as necessary to monitor the results of treatment. They will have blood tests daily while hospitalized.

As an outpatient, the patient will be monitored to make sure their immune system (system in the body that helps protect the body and fights bacterial, viral and fungal infections) is recovering, and the patient may require additional infusions of immunoglobulins (infection-fighting blood proteins) until the blood protein levels are safe. The patient will also be taking antibiotic pills for about 6 months to prevent infections. They will have x-rays and other diagnostic tests (PET scans) every 6-12 months during the next 5 years to make sure the tumor stays under control.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 75 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Current Practice Study of Rituxan in Patient Receiving BEAM Chemotherapy and Autologous Blood Stem Cell Transplantation for High Risk Lymphoma or Hodgkin's Disease
Study Start Date : June 2002
Actual Primary Completion Date : August 2014
Actual Study Completion Date : January 2017

Resource links provided by the National Library of Medicine

Drug Information available for: Rituximab

Arm Intervention/treatment
BEAM+R: Autologous Stem Cell Transplant
Ara-C, VP-16, BCNU, Melphalan, Rituxan and Stem Cells
Drug: Melphalan

Given on Day -1

Melphalan is administered according to the current SOP.

Other Name: Alkeran

Drug: Ara-C
200 mg/m2 IB BID given on Days -5, -4, -3, -2
Other Names:
  • Cytarabine
  • Cytosar-u

Drug: VP-16
200 mg/m2 IV BID given on Days -5, -4, -3, -2
Other Name: Etoposide

Drug: BCNU
BCNU 300 mg/m2 IV given on Day -6
Other Name: Carmustine

Drug: Rituxan
375 mg/m2 IB given on Days -6, +14, +21, +28
Other Name: Rituxamib

Drug: Stem Cells
Stem cells given on Day 0
Other Name: Autologous Blood Stem Cells

Primary Outcome Measures :
  1. Disease-free Survival [ Time Frame: 12 months post-transplant ]
    Disease-free survival at 12 months post-transplant in patients with Hodgkin's disease or non-Hodgkin's lymphomas

Secondary Outcome Measures :
  1. Median Days to Neutrophil Engraftment [ Time Frame: 30 days post-transplant ]
    Neutrophil engraftment was recorded as the first day that absolute neutrophil counts (ANC) exceeds 0.5 X 10^9/L for three consecutive readings.

  2. Number of Participants With Overall Best Response Achieved After Transplantation [ Time Frame: 3 months post-transplant ]
    Response was summarized as complete remission (CR): disappearance of all evidence of disease; partial remission (PR): regression of measurable disease (>=50% decrease in sum of the product of the diameters (SPD) of up to six of the largest dominant nodes or nodal masses) and no new sites; stable disease (SD): failure to attain CR/PR/PD; relapsed disease or progressive disease (PD): any new lesion or increase by >= 50% of previously involved sites from nadir.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients with biopsy-proven, relapsed, or refractory CD20+ lymphoma, or HD.
  • At least 2e6 CD34+/kg autologous PBSC stored. If patients are non-mobilizers, then at least 2e8 TNC/kg autologous marrow should be stored.
  • Patient is not pregnant.
  • Zubrod performance status less than or equal to 2.
  • Life expectancy is not severely limited by concomitant illness.
  • Left ventricular ejection fraction greater than or equal to 50%.
  • No uncontrolled arrhythmias or symptomatic cardiac disease.
  • FEV1, FVC and DLCO greater than or equal to 50%.
  • No symptomatic pulmonary disease.
  • Serum creatinine less than or equal to 1.5 mg/dL.
  • Serum bilirubin less than or equal to 2X upper limit of normal, SGPT less than or equal to 3X upper limit of normal.
  • No evidence of chronic active hepatitis or cirrhosis.
  • No effusion or ascites greater than or equal to 1L prior to drainage.
  • HIV negative.
  • Patient or guardian able to sign informed consent.
  • Patients of any age may be enrolled on this protocol.

Exclusion Criteria:

  • Anyone not meeting the above criteria.

Information from the National Library of Medicine

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 identifier (NCT number): NCT01702961

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United States, Texas
Texas Children's Hospital
Houston, Texas, United States, 77030
The Methodist Hospital
Houston, Texas, United States, 77030
Sponsors and Collaborators
Baylor College of Medicine
The Methodist Hospital System
Center for Cell and Gene Therapy, Baylor College of Medicine
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Principal Investigator: George Carrum, MD Associate Professor; Director-Adult Outpatient Clinic

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Responsible Party: George Carrum, Associate Professor; Director-Adult Outpatient Clinic, Baylor College of Medicine Identifier: NCT01702961    
Other Study ID Numbers: H-11892
Rituxan+BEAM ( Other Identifier: BCM Center for Cell and Gene Therapy )
First Posted: October 10, 2012    Key Record Dates
Results First Posted: September 28, 2015
Last Update Posted: December 19, 2018
Last Verified: November 2018
Keywords provided by George Carrum, Baylor College of Medicine:
Hodgkin's Disease
Additional relevant MeSH terms:
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Hodgkin Disease
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Antineoplastic Agents
Molecular Mechanisms of Pharmacological Action
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antineoplastic Agents, Alkylating
Alkylating Agents
Myeloablative Agonists
Antineoplastic Agents, Immunological
Antirheumatic Agents