Clinical Trials Directory

Trials / Terminated

TerminatedNCT00800150

Total Marrow and Total Lymph Node Irradiation, Fludarabine, and Melphalan Followed By Donor Stem Cell Transplant in Treating Patients With Advanced Hematological Cancer That Has Not Responded to Treatment

Phase I Study of Escalating Doses of Radiation Therapy Using Helical Tomotherapy in Combination With Fludarabine (FLU) and Melphalan (MEL) as a Preparative Regimen for Allogeneic Hematopoietic Stem Cell (HSC) Transplantation in Patients With Advanced and Hematological Malignancies Who Are Not Eligible for Fully Myeloablative Regimen

Status
Terminated
Phase
Phase 1
Study type
Interventional
Enrollment
6 (actual)
Sponsor
City of Hope Medical Center · Academic / Other
Sex
All
Age
16 Years
Healthy volunteers
Not accepted

Summary

RATIONALE: Giving total marrow and total lymph node irradiation together with low doses of chemotherapy before a donor stem cell transplant helps stop the growth of cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect). PURPOSE: This phase I trial is studying the side effects and best dose of total marrow and total lymph node irradiation when given together with fludarabine and melphalan followed by donor stem cell transplant in treating patients with advanced hematological cancer that has not responded to treatment.

Detailed description

OBJECTIVES: Primary * To determine the maximum tolerated dose of intensity-modulated total marrow and lymph node irradiation (TMLI) using helical tomotherapy in combination with a reduced-intensity preparative regimen comprising fludarabine phosphate and melphalan in patients undergoing allogeneic hematopoietic stem cell transplantation for advanced, relapsed or refractory hematological malignancies. * To describe the toxicities of escalating doses of TMLI in these patients. Secondary * To describe the frequency of clinical response in patients treated with this regimen. * To describe the frequency of primary and secondary engraftment failure in patients treated with this regimen. * To describe the time to neutrophil and platelet engraftment in patients treated with this regimen. * To describe the incidence of acute and chronic graft-versus-host disease in patients treated with this regimen. * To describe the overall survival of patients treated with this regimen. * To describe the progression-free survival of patients treated with this regimen. OUTLINE: This is a dose-escalation study of intensity-modulated total marrow and lymph node irradiation (TMLI). * Intensity-modulated radiation therapy: Patients undergo TMLI to skeletal bone/marrow, major lymph node chains, spleen, and liver using helical tomotherapy twice daily on days -6 to -3. * Reduced-intensity preparative regimen: Patients receive fludarabine phosphate IV on days -6 to -2 and melphalan IV on day -1. * Hematopoietic stem cell transplantation (HSCT): Patients undergo allogeneic HSCT on day 0. After completion of study treatment, patients are followed periodically.

Conditions

Interventions

TypeNameDescription
DRUGfludarabine phosphate
DRUGmelphalan
PROCEDUREnonmyeloablative allogeneic hematopoietic stem cell transplantation
RADIATIONintensity-modulated radiation therapy
RADIATIONtomotherapy
RADIATIONtotal marrow irradiation
RADIATIONtotal nodal irradiation

Timeline

Start date
2008-11-01
Primary completion
2010-10-01
Completion
2010-10-01
First posted
2008-12-01
Last updated
2015-06-08

Locations

1 site across 1 country: United States

Source: ClinicalTrials.gov record NCT00800150. Inclusion in this directory is not an endorsement.