Post Transplant Donor Lymphocyte Infusion
Stopped early · Phase 2
Conditions studied: Leukemia, Myeloid, Chronic, Lymphomas, Multiple Myeloma, Myelodysplastic Syndrome, Leukemia, Lymphocytic, Acute, Leukemia, Lymphocytic, Chronic, AML
In brief
The purpose of this study is to test the hypothesis that a pre-infusion preparative regimen of cyclophosphamide and fludarabine will improve the effectiveness of DLI in patients with blood cancers.
Key facts
- Study ID
- NCT00167180
- Run by
- Masonic Cancer Center, University of Minnesota
- People needed
- 57
- Starts
- 2004-01-01
- Expected to finish
- 2018-12-24
- Last updated by the study team
- 2019-07-30
Who can join
Age: 1 and older, up to 70. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Patients (age > or = 1 years) with a diagnosis of relapse after related or unrelated allogeneic stem cell transplantation for a hematological malignancy.
- For CML, relapse will be defined as any cytogenetic evidence of a Philadelphia chromosome or persistence of BCR/ABL rearrangements by molecular testing on at least two measurements over a 6 month interval. If cytogenetics are normal and there is PCR evidence of a BCR/ABL fusion, patients will be eligible if they have evidence of a quantitative increase in CML measured either by quantitative PCR or by fluorescent in situ hybridization (FISH).
- For non-CML, relapse will be defined based on disease specific morphologic criteria from a bone marrow biopsy and aspirate or recurrence of disease specific cytogenetics. For disease specific definition of relapse, see appendix 3. Relapse can be determined morphologically with less than 5 percent blasts if definitive relapse can be determined. Equivocal results for relapse should result in a repeated test after an appropriate time interval (suggested 1 month) to determine eligibility.
- Post-transplant lymphoproliferative diseases (often referred to as EBV-associated lymphomas) are NOT eligible for this protocol.
- For Chronic Phase CML patients only
- - must have failed (no response in 3 months or incomplete response at 6 months) or refused treatment with Gleevec
- - if no prior DLI, CML patients will first have DLI- if relapse occurs after DLI, DLI with chemotherapy per this protocol will be offered
- Patients must be within one year of identification of relapse or if beyond that time period, must have at least 10% donor DNA by RFLP or cytogenetics.
- Same allogeneic donor (sibling or URD) used for transplantation is available for lymphocyte donation.
- No severe organ damage (by laboratory or clinical assessment) as measured by:
- - blood creatinine ≤ 2.0 mg/dL
- - liver function tests < 5 x normal
- - left ventricular ejection fraction > 40% (testing required only if symptomatic or prior known impairment).
- - pulmonary functions > 50% (testing required only if symptomatic or prior known impairment). Oxygen saturation (>92%) can be used in child where PFT's cannot be obtained.
- - chest x-ray without evidence of active infection
- Off prednisone and other immunosuppressive agents (given for any reason) for at least 3 days prior to DLI infusions.
- Performance status ≥ 60%
- Women must not be pregnant or lactating. The agents used in this study may be teratogenic to a fetus and there is no information on the excretion of agents into breast milk All females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy
- Women of childbearing potential and sexually active males are strongly advised to use an accepted and effective method of contraception
- Patient must given written informed consent indicating understanding of the nature of the treatment and its potential risks
You may not qualify if…
- Concurrent signs of acute or chronic graft-versus-host disease requiring ongoing treatment at the time of relapse will be ineligible.
- Patients being treated for GVHD with prednisone, cyclosporine, Imuran or other immunosuppressive medications are not eligible until these medications are discontinued for at least 2 weeks without a flare of GVHD.
- Active CNS leukemia
- Active fungal infection or pulmonary infiltrates (stable prior treated disease is allowable)
- HIV positive
Where it is running
- Masonic Cancer Center, University of Minnesota — Minneapolis, Minnesota, United States
Full record on ClinicalTrials.gov
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