Alemtuzumab and Combination Chemotherapy Followed By Donor Lymphocytes in Treating Patients Who Are Undergoing Donor Stem Cell Transplant for Hematologic Cancer

• Status: Completed
• Trial end date: 2008-05-01
• Target enrollment: 0
• Participant gender: All

Summary

RATIONALE: Giving low doses of chemotherapy before a donor peripheral blood stem cell transplant helps stop the growth of cancer cells. It also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune system and help destroy any remaining cancer cells (graft-versus-tumor effect). Giving an infusion of the donor's T cells that have been treated in the laboratory after the transplant may help increase this effect. Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving tacrolimus before and after transplant may stop this from happening.

PURPOSE: This phase I trial is studying the side effects and best dose of donor lymphocytes when given after alemtuzumab and combination chemotherapy in treating patients who are undergoing donor stem cell transplant for hematologic cancer.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Yale University
• Collaborator: National Cancer Institute (NCI)
• Treatments: Alemtuzumab; Fludarabine; Fludarabine phosphate; Melphalan; Tacrolimus; Thiotepa

Criteria

DISEASE CHARACTERISTICS:

• Diagnosis of 1 of the following hematologic malignancies:

• Chronic myelogenous leukemia

• Accelerated phase or blast phase

• Acute myeloid leukemia, meeting any of the following criteria:

• In second or subsequent remission

• In primary induction failure

• In partial remission

• In resistant relapse

• Chronic lymphocytic leukemia

• In Richter's transformation

• High-grade non-Hodgkin's lymphoma

• Refractory to standard treatment

• Myeloproliferative disorders

• Undergoing transformation to terminal stages

• Myelodysplastic syndromes (MDS), including any of the following:

• Refractory anemia with excess blasts

• Transformation to acute leukemia

• MDS secondary to chemotherapy

• Partially-matched related family donor available

• One HLA haplotype match

• No HLA-matched (10/10 or 9/10) sibling donor or unrelated donor available NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology.

PATIENT CHARACTERISTICS:

Age

• 18 to 55

Performance status

• ECOG 0-1

Life expectancy

• Not specified

Hematopoietic

• Not specified

Hepatic

• SGOT and SGPT < 3 times upper limit of normal (ULN)

• No active or persistent viral hepatitis

Renal

• Creatinine < 2.0 mg/dL* OR

• Creatinine clearance > 60 mL/min* NOTE: *Unless due to malignancy

Cardiovascular

• LVEF ≥ 45%

Pulmonary

• DLCO ≥ 60% of predicted* (corrected for hemoglobin) NOTE: *Unless patient is given clearance by a pulmonary consultation

Other

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective contraception during and for up to 2 years after completion of study treatment

• HIV negative

• Human T cell lymphotrophic virus type 1 negative

• No serious co-morbid medical condition

• No other medical condition that would preclude study compliance

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• Not specified

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• Not specified