Combination Chemotherapy Followed by Bone Marrow or Peripheral Stem Cell Transplantation in Treating Patients With Relapsed or Refractory Hodgkin's Lymphoma

NCT ID: NCT00002522

Last Updated: 2010-10-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Study Classification

INTERVENTIONAL

Study Start Date

1993-02-28

Study Completion Date

2002-02-28

Brief Summary

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RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining chemotherapy with bone marrow or peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more tumor cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy followed by bone marrow or peripheral stem cell transplantation in treating patients with relapsed or refractory Hodgkin's lymphoma.

Detailed Description

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OBJECTIVES:

* Determine the curative potential of high-dose cyclophosphamide, etoposide, and cisplatin (CEP) followed by syngeneic or autologous bone marrow and/or autologous peripheral blood stem cell (PBSC) rescue in patients with relapsed or refractory stage I-IV Hodgkin's lymphoma.
* Determine the overall response rate and survival of patients treated with this regimen.
* Determine the toxicity of this regimen in these patients.
* Determine the differences in the rate of engraftment, response, and survival of patients treated with bone marrow vs PBSC transplantation.
* Determine the response rate and survival of patients treated with late consolidative radiotherapy after recovery from transplantation.
* Determine the toxicity of late consolidative radiotherapy after recovery from transplantation in these patients.

OUTLINE: Syngeneic or autologous bone marrow and/or autologous peripheral blood stem cells (PBSC) are harvested. Syngeneic bone marrow transplantation is preferred for patients with a qualifying identical twin donor. Patients without a syngeneic donor who have a history of lymphomatous involvement of the bone marrow or are profoundly hypocellular undergo harvest of PBSC alone. Patients without a syngeneic donor who have no history of lymphomatous involvement of the bone marrow undergo harvest of autologous bone marrow or PBSC.

Patients receive conditioning comprising cyclophosphamide IV over 1 hour on days -6 to -3 and etoposide IV over 1 hour every 12 hours and cisplatin IV continuously on days -6 to -4. Bone marrow and/or PBSC are infused on day 0. (Patients requiring more than 25 bags of stem cells receive bone marrow transplantation on day 0 and PBSC transplantation on day 1.)

After recovery from transplantation, eligible patients receive consolidative radiotherapy to any site of prior bulk disease (greater than 5 cm) present at any time before transplantation and any site of disease present at the time of transplantation.

Patients are followed at 3, 6, and 12 months and then annually thereafter.

PROJECTED ACCRUAL: A maximum of 30 patients will be accrued for this study.

Conditions

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Lymphoma

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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cisplatin

Intervention Type DRUG

cyclophosphamide

Intervention Type DRUG

etoposide

Intervention Type DRUG

autologous bone marrow transplantation

Intervention Type PROCEDURE

bone marrow ablation with stem cell support

Intervention Type PROCEDURE

peripheral blood stem cell transplantation

Intervention Type PROCEDURE

syngeneic bone marrow transplantation

Intervention Type PROCEDURE

radiation therapy

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Stable residual masses after conventional-dose chemotherapy not considered treatment failures

* Active (refractory or relapsed) disease must be proven histologically or documented by gallium nitrate uptake
* Syngeneic marrow transplantation offered to patients with consenting identical twin donor
* No CNS involvement by lymphoma

PATIENT CHARACTERISTICS:

Age:

* 15 to 60 (selected patients up to age 70 may be eligible)

Performance status:

* ECOG 0-2

Life expectancy:

* Not specified

Hematopoietic:

* WBC greater than 4,000/mm\^3
* Absolute neutrophil count greater than 2,000/mm\^3
* Platelet count greater than 100,000/mm\^3

Hepatic:

* Bilirubin less than 2.0 mg/dL
* SGOT and SGPT less than 2 times upper limit of normal
* Albumin greater than 3.0 g/dL

Renal:

* Must meet 1 of the following criteria:

* Creatinine less than 1.8 mg/dL
* Creatinine clearance greater than 60 mL/min
* BUN less than 20 mg/dL

Cardiovascular:

* Left ventricular ejection fraction at least 50%

Pulmonary:

* DLCO, FEV\_1, and FVC greater than 50% of predicted OR
* Resting pO\_2 greater than 70 mm Hg on room air

Other:

* HIV negative
* No severe neurologic or emotional disorders
* No active infection
* No other disease that would limit life expectancy
* Not pregnant
* Fertile patients must use effective contraception
* Adequate psychosocial support required

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* See Disease Characteristics

Endocrine therapy

* Not specified

Radiotherapy

* Not specified

Surgery

* Not specified
Minimum Eligible Age

15 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Temple University

OTHER

Sponsor Role lead

Responsible Party

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Temple University Health Systems

Principal Investigators

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Kenneth F. Mangan, MD, FACP

Role: STUDY_CHAIR

Fox Chase Cancer Center

Locations

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Fox Chase - Temple Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Other Identifiers

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TUHSC-2162

Identifier Type: -

Identifier Source: secondary_id

NCI-V93-0249

Identifier Type: -

Identifier Source: secondary_id

CDR0000078283

Identifier Type: -

Identifier Source: org_study_id