Trials / Completed
CompletedNCT01231412
Graft-Versus-Host Disease Prophylaxis in Treating Patients With Hematologic Malignancies Undergoing Unrelated Donor Peripheral Blood Stem Cell Transplant
A Randomized Phase III Study to Determine the Most Promising Postgrafting Immunosuppression for Prevention of Acute GVHD After Unrelated Donor Hematopoietic Cell Transplantation Using Nonmyeloablative Conditioning for Patients With Hematologic Malignancies: A Multi-center Trial
- Status
- Completed
- Phase
- Phase 3
- Study type
- Interventional
- Enrollment
- 174 (actual)
- Sponsor
- Fred Hutchinson Cancer Center · Academic / Other
- Sex
- All
- Age
- —
- Healthy volunteers
- Not accepted
Summary
This randomized phase III trial studies how well graft-vs-host disease (GVHD) prophylaxis works in treating patients with hematologic malignancies undergoing unrelated donor peripheral blood stem cell transplant. Giving chemotherapy and total-body irradiation before a donor peripheral blood stem cell transplant (PBSCT) helps stop the growth of cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Sometimes the transplanted cells from a donor can make an immune response against the body's normal cells. Giving total-body irradiation (TBI) together with fludarabine phosphate (FLU), cyclosporine (CSP), mycophenolate mofetil (MMF), or sirolimus before transplant may stop this from happening.
Detailed description
PRIMARY OBJECTIVES: I. To compare the effectiveness of 2 GVHD prophylaxis regimens in preventing acute grades II-IV GVHD. SECONDARY OBJECTIVES: I. Compare non-relapse mortality in the 2 arms. II. Compare survival and progression-free survivals in the 2 arms. OUTLINE: Patients are randomized to 1 of 2 treatment arms. All patients receive FLU intravenously (IV) over 30 minutes on days -4 to -2 followed by 2-3 Gy TBI on day 0. ARM 0: Patients receive CSP orally (PO) twice daily (BID) on days -3 to 96 with taper to day 150 and and sirolimus PO once daily (QD) on days -3 to 150 with taper to day 180. Arm removed as of 14-Sep-2011 ARM I: Patients receive CSP orally (PO) twice daily (BID) on days -3 to 96 with taper to day 150 and MMF PO three times daily (TID) on days 0-29 and then BID on days 30-150 with taper to day 180. ARM II: Patients receive CSP as in Arm I and sirolimus PO once daily (QD) on days -3 to 150 with taper to day 180. Patients also receive MMF PO TID on days 0-29 and then BID on days 30-40. MMF will then be discontinued without taper unless GVHD or disease relapse/progression occurs. TRANSPLANTATION: Patients undergo allogeneic PBSCT on day 0 following the TBI. After completion of study treatment, patients are followed up periodically.
Conditions
- Acute Lymphoblastic Leukemia
- Acute Myeloid Leukemia
- Aggressive Non-Hodgkin Lymphoma
- Chronic Lymphocytic Leukemia
- Diffuse Large B-Cell Lymphoma
- Hematopoietic and Lymphoid Cell Neoplasm
- Indolent Non-Hodgkin Lymphoma
- Mantle Cell Lymphoma
- Myelodysplastic Syndrome
- Myeloproliferative Neoplasm
- Prolymphocytic Leukemia
- Recurrent Chronic Lymphocytic Leukemia
- Recurrent Plasma Cell Myeloma
- Refractory Chronic Lymphocytic Leukemia
- Refractory Chronic Myelogenous Leukemia, BCR-ABL1 Positive
- Refractory Hodgkin Lymphoma
- Small Lymphocytic Lymphoma
- T-Cell Chronic Lymphocytic Leukemia
- Waldenstrom Macroglobulinemia
Interventions
| Type | Name | Description |
|---|---|---|
| PROCEDURE | Allogeneic Hematopoietic Stem Cell Transplantation | Undergo allogeneic PBSCT |
| DRUG | Cyclosporine | Given PO or IV |
| DRUG | Fludarabine Phosphate | Given IV |
| DRUG | Mycophenolate Mofetil | Given PO |
| PROCEDURE | Peripheral Blood Stem Cell Transplantation | Undergo allogeneic PBSCT |
| DRUG | Sirolimus | Given PO |
| RADIATION | Total-Body Irradiation | Undergo TBI |
Timeline
- Start date
- 2010-11-01
- Primary completion
- 2016-10-08
- Completion
- 2017-06-30
- First posted
- 2010-11-01
- Last updated
- 2019-10-24
- Results posted
- 2017-12-04
Locations
11 sites across 3 countries: United States, Denmark, Germany
Source: ClinicalTrials.gov record NCT01231412. Inclusion in this directory is not an endorsement.