Trial Outcomes & Findings for Pentostatin and Lymphocyte Infusion in Preventing Graft Rejection in Patients Who Have Undergone Donor Stem Cell Transplant (NCT NCT00096161)

NCT ID: NCT00096161

Last Updated: 2020-01-31

Results Overview

A regimen will be considered successful if 20 patients are enrolled, at least 13 demonstrate improved chimerism. If fewer than 5 patients have shown improvement in chimerism then it can be at least 75% confident that the true rate of improvement is less than 0.53. Enrollment to the regimen will stop and the next regimen will be opened. Enrollment to a regimen may also be stopped at any time it becomes impossible to achieve 5 of 10 or 13 of 20 successful improvements. "Chimerism" in hematopoietic cell transplant derives from this idea of a "mixed" entity, referring to someone who has received a transplant of genetically different tissue. A test for chimerism after a hematopoietic cell transplant involves identifying the genetic profiles of the recipient and of the donor and then evaluating the extent of mixture in the recipient's blood cells or marrow cells.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

36 participants

Primary outcome timeframe

From the time of enrollment maintained to day 56 after the last DLI, up to Day 112

Results posted on

2020-01-31

Participant Flow

Participant milestones

Participant milestones
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Overall Study
STARTED
20
10
6
0
Overall Study
COMPLETED
20
10
6
0
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Pentostatin and Lymphocyte Infusion in Preventing Graft Rejection in Patients Who Have Undergone Donor Stem Cell Transplant

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Total
n=36 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
0 Participants
n=483 Participants
0 Participants
n=36 Participants
Age, Categorical
Between 18 and 65 years
17 Participants
n=93 Participants
7 Participants
n=4 Participants
4 Participants
n=27 Participants
0 Participants
n=483 Participants
28 Participants
n=36 Participants
Age, Categorical
>=65 years
3 Participants
n=93 Participants
3 Participants
n=4 Participants
2 Participants
n=27 Participants
0 Participants
n=483 Participants
8 Participants
n=36 Participants
Age, Continuous
55 years
n=93 Participants
59.3 years
n=4 Participants
60.3 years
n=27 Participants
56.9 years
n=36 Participants
Sex: Female, Male
Female
2 Participants
n=93 Participants
2 Participants
n=4 Participants
1 Participants
n=27 Participants
5 Participants
n=36 Participants
Sex: Female, Male
Male
18 Participants
n=93 Participants
8 Participants
n=4 Participants
5 Participants
n=27 Participants
31 Participants
n=36 Participants
Region of Enrollment
United States
20 participants
n=93 Participants
10 participants
n=4 Participants
6 participants
n=27 Participants
36 participants
n=36 Participants

PRIMARY outcome

Timeframe: From the time of enrollment maintained to day 56 after the last DLI, up to Day 112

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

A regimen will be considered successful if 20 patients are enrolled, at least 13 demonstrate improved chimerism. If fewer than 5 patients have shown improvement in chimerism then it can be at least 75% confident that the true rate of improvement is less than 0.53. Enrollment to the regimen will stop and the next regimen will be opened. Enrollment to a regimen may also be stopped at any time it becomes impossible to achieve 5 of 10 or 13 of 20 successful improvements. "Chimerism" in hematopoietic cell transplant derives from this idea of a "mixed" entity, referring to someone who has received a transplant of genetically different tissue. A test for chimerism after a hematopoietic cell transplant involves identifying the genetic profiles of the recipient and of the donor and then evaluating the extent of mixture in the recipient's blood cells or marrow cells.

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Percentage Patients With an Increase of at Least 10 Percentage Points in Donor T-cell Chimerism
60 percentage of participants
30 percentage of participants
33.3 percentage of participants

PRIMARY outcome

Timeframe: Within 100 days after the last DLI

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

Clinical Stage of acute GVHD according to Organ System Skin: 1. \- Maculopapular rash \<25% of body surface 2. \- Maculopapular rash 25-50% of body surface 3. \- Maculopapular rash \>50% body surface area or generalized erythroderma 4. \- Generalized erythroderma with bullous formation and desquamation Liver: 1. \- Bilirubin 2-3 mg/dl 2. \- Bilirubin 3.1-6 mg/dl 3. \- Bilirubin 6.1-15 mg/dl 4. \- Bilirubin \>15 mg/dl Gut: 1. \- \>500-1000 mL diarrhea per day or (nausea, anorexia or vomiting with biopsy (EGD) confirmation of upper GI GVHD 2. \- \>1000 -1500 mL diarrhea per day 3. \- \>1500 mL diarrhea per day 4. \- \>1500 mL diarrhea per day plus severe abdominal pain with or without ileus Overall Clinical Grading of Severity of acute GVHD Grade IV: 0-4 Skin, 2-4 Liver, and/or 2-4 GI

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Incidence of Grade IV Acute GVHD
5 percentage of participants
0 percentage of participants
0 percentage of participants

SECONDARY outcome

Timeframe: 1 year after DLI

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

Percentage patients with acute or chronic GVHD. The diagnosis of chronic GVHD requires at least one manifestation that is distinctive for chronic GVHD as opposed to acute GVHD. In all cases, infection and others causes must be ruled out in the differential diagnosis of chronic GVHD.

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Incidence of GVHD
cGVHD
50 percentage of participants
20 percentage of participants
16.7 percentage of participants
Incidence of GVHD
aGVHD
20 percentage of participants
0 percentage of participants
0 percentage of participants

SECONDARY outcome

Timeframe: 100 days after DLI

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Incidence of Infections
80 percentage of participants
70 percentage of participants
33.3 percentage of participants

SECONDARY outcome

Timeframe: 1 year after DLI

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

CML Acquisition of a new cytogenetic abnormality and/or development of accelerated phase or blast crisis. Criteria for accelerated phase: unexplained fever \>38.3° C, new clonal cytogenetic abnormalities in addition to a single Ph-positive chromosome, BM blasts and promyelocytes \>20%. AML, ALL, CMML \>30% BM blasts w/ deteriorating performance status, or worsening of anemia, neutropenia, or thrombocytopenia. CLL Progressive disease: ≥1 of: physical exam/imaging studies (nodes, liver, and/or spleen) ≥50% increase or new, circulating lymphocytes by morphology and/or flow cytometry ≥50% increase, and lymph node biopsy w/ Richter's transformation. NHL \>25% increase in the sum of the products of the perpendicular diameters of marker lesions, or the appearance of new lesions. MM ≥100% increase of the serum myeloma protein from its lowest level, or reappearance of myeloma peaks that had disappeared w/ tx; or definite increase in the size/number of plasmacytomas or lytic bone lesions.

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Incidence of Relapse/Progression
45 percentage of participants
20 percentage of participants
33.3 percentage of participants

SECONDARY outcome

Timeframe: 1 year after DLI

Population: No subjects were enrolled onto Group 2D because the dose escalation was not triggered before the study closed to accrual.

Percentage patients surviving.

Outcome measures

Outcome measures
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 Participants
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 Participants
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Survival
60 percentage of participants
90 percentage of participants
66.7 percentage of participants

Adverse Events

Group 1A (Pentostatin, DLI Dose Level 1)

Serious events: 6 serious events
Other events: 10 other events
Deaths: 0 deaths

Group 1B (Pentostatin, DLI Dose Level 2)

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 participants at risk
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 participants at risk
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 participants at risk
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Blood and lymphatic system disorders
Anemia
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Immune system disorders
GVHD
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Respiratory, thoracic and mediastinal disorders
Hypoxia
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Nervous system disorders
Peripheral motor neuropathy
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Cardiac disorders
Atrial fibrillation
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Blood and lymphatic system disorders
Hemolytic uremic syndrome
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.

Other adverse events

Other adverse events
Measure
Group 1A (Pentostatin, DLI Dose Level 1)
n=20 participants at risk
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (1x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 1B (Pentostatin, DLI Dose Level 2)
n=10 participants at risk
Patients receive pentostatin IV over 20-30 minutes on day -2 and DLI (3x10\^7 CD3+ cells/kg) over 15-30 minutes on day 0. Treatment may repeat once beginning with an escalated or same CD3-dose at least 4 weeks if persistent donor T-cells are documented, no GvHD has developed, and the chimerism status worsens or, if chimerism status is unchanged after at least 8 weeks with two subsequent tests of chimerism 4 weeks apart. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2C (Pentostatin, DLI Dose Level 1, Add'l IS)
n=6 participants at risk
Patients receive treatment as in group 1A. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Group 2D (Pentostatin, DLI Dose Level 2, Add'l IS)
Patients receive treatment as in group 1B. Patients also receive cyclosporine PO BID on days -3 to 56 and mycophenolate mofetil PO QD on days 0 to 27. Treatment continues in the absence of GvHD. Pentostatin: Given IV Therapeutic Allogeneic Lymphocytes: Given IV
Renal and urinary disorders
Acute kidney injury
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Blood and lymphatic system disorders
Anemia
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Investigations
Blood bilirubin increased
10.0%
2/20 • Number of events 2 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
16.7%
1/6 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Cardiac disorders
Cardiac troponin I increased
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Investigations
Creatinine increased
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Blood and lymphatic system disorders
Febrile neutropenia
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Investigations
Forced expiratory volume decreased
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Gastrointestinal disorders
Gastric hemorrhage
10.0%
2/20 • Number of events 3 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Blood and lymphatic system disorders
Hemolysis
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
16.7%
1/6 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Vascular disorders
Hypotension
10.0%
2/20 • Number of events 2 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Respiratory, thoracic and mediastinal disorders
Hypoxia
15.0%
3/20 • Number of events 3 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
10.0%
1/10 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Gastrointestinal disorders
Ileal obstruction
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Investigations
Investigations - Other, (Pancytopenia)
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Infections and infestations
Small intestine infection
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
Blood and lymphatic system disorders
Thrombotic thrombocytopenic purpura
5.0%
1/20 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/10 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
General disorders
Fever
0.00%
0/20 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
10.0%
1/10 • Number of events 1 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0.00%
0/6 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.
0/0 • AEs: Conditioning through Day 100; SAEs: Conditioning through Day 200
One incident of GVHD was incorrectly reported as an SAE, as it is an expected complication of DLI. This patient outcome is recorded under deaths.

Additional Information

Dr. Brenda M. Sandmaier

Fred Hutchinson Cancer Research Center

Phone: (206) 667-4961

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place