TMI With HD Mel in ASCT for R/R Multiple Myeloma (BMT-03)

NCT ID: NCT02043847

Last Updated: 2024-11-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-14

Study Completion Date

2016-09-14

Brief Summary

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In this phase I trial, patients with relapsed or refractory multiple myeloma will receive standard autologous stem cell transplant conditioned with high dose melphalan. In addition to Melphalan, the conditioning will include targeted total marrow irradiation (TMI). This is a conventional 3+3 phase I trial with increasing doses of TMI from minimum 3Gy to Maximum 9Gy.

Detailed Description

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In this phase I trial, patients with relapsed or refractory multiple myeloma will receive standard high dose melphalan with autologous stem cell rescue. In addition the pre-transplant conditioning will include targeted total marrow irradiation (TMI). This conventional 3+3 phase I trial will increase the dose of TMI until the maximum tolerated dose (MTD) is reached. Initial patients enrolled will receive the lowest possible dose of 3Gy. Maximum dose will be 9Gy.

Conditions

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Multiple Myeloma, Relapsed Multiple Myeloma, Refractory to Standard Treatment

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Increasing doses of Total Marrow Irradiation (TMI), 3 Gy, 6 Gy, and 9 Gy.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cohort 1Total Marrow Irradiation (TMI) 3Gy

3Gy with standard high dose melphalan prior to autologous stem cell rescue

Group Type EXPERIMENTAL

Total Marrow Irradiation

Intervention Type RADIATION

Subjects in this trial will receive total marrow irradiation 3Gy per day for up to four days and as little as one day

Melphalan

Intervention Type DRUG

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Filgrastim (G-CSF)

Intervention Type DRUG

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days.

Autologous transplant

Intervention Type PROCEDURE

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Cohort 2 Total Marrow Irradiation (TMI) 6Gy

6Gy with standard high dose melphalan prior to autologous stem cell rescue

Group Type EXPERIMENTAL

Total Marrow Irradiation

Intervention Type RADIATION

Subjects in this trial will receive total marrow irradiation 6Gy per day for up to four days and as little as one day

Melphalan

Intervention Type DRUG

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Filgrastim (G-CSF)

Intervention Type DRUG

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days

Autologous transplant

Intervention Type PROCEDURE

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Cohort 3 Total Marrow Irradiation (TMI) 9Gy

9Gy with standard high dose melphalan prior to autologous stem cell rescue

Group Type EXPERIMENTAL

Total Marrow Irradiation

Intervention Type RADIATION

Subjects in this trial will receive total marrow irradiation 9Gy per day for up to four days and as little as one day

Melphalan

Intervention Type DRUG

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Filgrastim (G-CSF)

Intervention Type DRUG

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days

Autologous transplant

Intervention Type PROCEDURE

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Interventions

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Total Marrow Irradiation

Subjects in this trial will receive total marrow irradiation 3Gy per day for up to four days and as little as one day

Intervention Type RADIATION

Melphalan

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Intervention Type DRUG

Filgrastim (G-CSF)

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days.

Intervention Type DRUG

Autologous transplant

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Intervention Type PROCEDURE

Total Marrow Irradiation

Subjects in this trial will receive total marrow irradiation 6Gy per day for up to four days and as little as one day

Intervention Type RADIATION

Melphalan

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Intervention Type DRUG

Filgrastim (G-CSF)

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days

Intervention Type DRUG

Autologous transplant

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Intervention Type PROCEDURE

Total Marrow Irradiation

Subjects in this trial will receive total marrow irradiation 9Gy per day for up to four days and as little as one day

Intervention Type RADIATION

Melphalan

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning therapy prior to transplant

Intervention Type DRUG

Filgrastim (G-CSF)

Subjects to begin GCSF 5 μg/kg/d SC or IV on Day 5 and continue until ANC \> 1000/mm\^3 over period of 3 days

Intervention Type DRUG

Autologous transplant

Subjects will receive standard melphalan 200mg/m\^2 (100mg/m\^2 day-2 and day-1) conditioning with autologous stem cell rescue

Intervention Type PROCEDURE

Other Intervention Names

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Alkeran ® Neupogen® Alkeran ® Neupogen® Alkeran ® Neupogen®

Eligibility Criteria

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Inclusion Criteria

1. Patients meeting criteria for symptomatic myeloma
2. Patients who have progressive myeloma following initial induction (patients may have received any number of treatment regimens including prior autologous transplant)
3. Patient age 18-75 years at time of enrollment
4. Karnofsky performance status of ≥70
5. Cardiac function: LVEF \>40%
6. Hepatic: Bilirubin \<2x upper limit of normal and ALT and AST \< 2.5x the upper limit of normal
7. Renal: Creatinine clearance of \>30mL/min, estimated or calculated
8. Pulmonary: DLCO, FEV1, FVC \>50% of predicted (after correction for hemoglobin)

Exclusion Criteria

1. Patients with diagnosis of plasma cell leukemia
2. Patients with truly non secretory myeloma (patients with light chain disease are eligible)
3. Pregnant or breast-feeding
4. Uncontrolled viral, fungal or bacterial infection Note: Infection is permitted if there is evidence of response to medication. Eligibility of HIV infected patients will be determined on a case-by-case basis.
5. Patients who have undergone prior allogeneic stem cell transplant
6. Prior solid organ transplant
7. Patients receiving prior radiation to more than 20% of bone marrow containing areas
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Illinois at Chicago

OTHER

Sponsor Role lead

Responsible Party

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Damiano Rondelli, MD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Damiano Rondelli, MD

Role: PRINCIPAL_INVESTIGATOR

University of Illinois at Chicago

Locations

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University of Illinois Cancer Center

Chicago, Illinois, United States

Site Status

Countries

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United States

References

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Patel P, Oh AL, Koshy M, Sweiss K, Saraf SL, Quigley JG, Khan I, Mahmud N, Hacker E, Ozer H, Peace DJ, Weichselbaum RR, Aydogan B, Rondelli D. A phase 1 trial of autologous stem cell transplantation conditioned with melphalan 200 mg/m2 and total marrow irradiation (TMI) in patients with relapsed/refractory multiple myeloma. Leuk Lymphoma. 2018 Jul;59(7):1666-1671. doi: 10.1080/10428194.2017.1390231. Epub 2017 Oct 25.

Reference Type DERIVED
PMID: 29065747 (View on PubMed)

Other Identifiers

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2013-0201

Identifier Type: OTHER

Identifier Source: secondary_id

2013-0201

Identifier Type: -

Identifier Source: org_study_id

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