Ultraviolet-B Light Therapy and Allogeneic Stem Cell Transplantation in Treating Patients With Hematologic Malignancies

• Status: Completed
• Trial end date: 1969-12-31
• Target enrollment: 0
• Participant gender: All

Summary

RATIONALE: Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy. Sometimes the transplanted cells from a donor are rejected by the body's normal cells. Ultraviolet-B light therapy given before and after allogeneic stem cell transplantation may help prevent this from happening.

PURPOSE: Clinical trial to study the effectiveness of combining ultraviolet-B light therapy with allogeneic stem cell transplantation in treating patients who have hematologic malignancies.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Case Comprehensive Cancer Center
• Collaborator: National Cancer Institute (NCI)
• Treatments: Antilymphocyte Serum; Cyclophosphamide; Cyclosporine; Cyclosporins; Fludarabine; Fludarabine phosphate; Methylprednisolone; Methylprednisolone acetate; Methylprednisolone Hemisuccinate; Prednisolone; Prednisolone acetate; Prednisolone hemisuccinate; Prednisolone phosphate

Criteria

DISEASE CHARACTERISTICS:

• Histologically confirmed diagnosis of any of the following hematologic malignancies:

• Acute myeloid leukemia (AML) meeting any of the following criteria:

• First complete remission with high-risk karyotype

• Translocations t(15;17) allowed only if failed first-line induction therapy OR molecular evidence of persistent disease exists

• Translocations t(8;21) and inv(16) allowed only if failed first-line induction therapy

• Second or subsequent complete remission

• Minimal residual disease*

• Acute lymphoblastic leukemia meeting any of the following criteria:

• Failed induction therapy and has minimal residual disease* by salvage therapy

• First complete remission with high-risk karyotype (e.g., t[4;11] or t[9;22])

• Relapsed disease allowed provided a second or subsequent complete remission or minimal residual disease* is achieved

• Chronic myelogenous leukemia meeting any of the following criteria:

• Persistent or relapsed disease after 1 year of imatinib mesylate therapy

• Accelerated phase or blast crisis

• Blast crisis allowed after reinduction chemotherapy places disease in chronic phase

• Myelodysplastic syndromes meeting any of the following criteria:

• Refractory to medical management

• Cytogenetic abnormalities predictive of transformation into acute leukemia, including 5q-, 7q-, monosomy 7 and trisomy 8, or evidence of evolution to AML (e.g., refractory anemia with excess blasts (RAEB) or RAEB in transformation)

• Non-Hodgkin's lymphoma or Hodgkin's lymphoma meeting any of the following criteria:

• Beyond first complete remission or failed primary induction therapy and demonstrated sensitivity to therapy during the 6 months before transplantation

• Recurrent disease after autologous stem cell transplantation

• Must be at least 3 months posttransplantation

• Cyclin D1+ mantle cell lymphoma allowed after induction therapy and in first remission

• Multiple myeloma meeting either of the following criteria:

• Refractory or relapsed disease

• Residual disease after autologous transplantation

• Chronic lymphocytic leukemia (CLL) meeting all of the following criteria:

• Peripheral blood absolute lymphocyte count greater than 5,000/mm^3

• Small to moderate size lymphocytes and less than 55% pro-lymphocytes, atypical lymphocytes, or lymphoblasts morphologically

• B-cell or T-cell

• Myeloproliferative disorders, including myelofibrosis

• Philadelphia negative

• Availability of a HLA-A, B, and DR identical family donor OR HLA-A, B, and DR genetically matched unrelated donor

• Must meet 1 of the following criteria:

• At least 55 years of age at time of transplantation

• Received extensive prior therapy (i.e., more than 1 year of alkylator therapy or more than 2 different prior salvage regimens) or stem cell transplantation with myeloablative conditioning (either autologous or allogeneic)

• Presenting with comorbid condition (e.g., abnormal cardiac, pulmonary, or renal function and/or prior life-threatening infection) that precludes eligibility for enrollment in allogeneic transplantation protocols with full ablation conditioning

• No active CNS disease NOTE: *Defined as having no circulating blasts, absolute neutrophil count greater than 1,000/mm3 and less than 10% blasts in bone marrow at least 3 weeks after last systemic chemotherapy

PATIENT CHARACTERISTICS:

Age

• See Disease Characteristics

• Over 18

Performance status

• ECOG 0-2

Life expectancy

• At least 3 months

Hematopoietic

• See Disease Characteristics

Hepatic

• Bilirubin no greater than 2.0 mg/dL

• ALT/AST no greater than 4 times normal

Renal

• See Disease Characteristics

• Creatinine less than 2.0 mg/dL OR

• Creatinine clearance at least 50 mL/min

Cardiovascular

• See Disease Characteristics

• Normal cardiac function by echocardiogram or radionuclide scan

• Shortening fraction or ejection fraction at least 40% of normal

Pulmonary

• See Disease Characteristics

• DLCO at least 60%

• FEV_1 greater than 50% of predicted

• Pulse oximetry greater than 85%

Other

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective contraception

• HIV negative

• No uncontrolled active infection

PRIOR CONCURRENT THERAPY:

Biologic therapy

• See Disease Characteristics

• At least 2 weeks since prior biologic response modifiers, signal transduction inhibitors, or monoclonal antibodies

Chemotherapy

• See Disease Characteristics

• At least 4 weeks since prior systemic conventional chemotherapy

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• Not specified

Other

• Recovered from prior therapy

• No concurrent sun block/sunscreen or any cosmetic that may act as a sunscreen (e.g., lotion with SPF) on the days of scheduled ultraviolet-B light therapy