Status:

TERMINATED

2nd Autologous Stem Cell Transplant in Patients With Persistent/Recurrent (AL) Amyloidosis

Lead Sponsor:

Boston Medical Center

Conditions:

Multiple Myeloma

Plasma Cell Neoplasm

Eligibility:

All Genders

18-65 years

Phase:

PHASE2

Brief Summary

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of plasma cells, either by killing the cells or by stopping them from dividing. Having a stem cell transplant to replace...

Detailed Description

OBJECTIVES: * Determine the feasibility and tolerability of second autologous stem cell transplantation in patients with persistent or recurrent AL amyloidosis. * Determine the response rate and dura...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • DISEASE CHARACTERISTICS:
  • Histologically confirmed AL amyloidosis
  • Persistent or recurrent disease after 1 course of prior high-dose chemotherapy
  • Previously treated with autologous stem cell transplantation
  • Significant initial improvement in organ function after prior high-dose melphalan, defined by at least 1 of the following:
  • Complete hematologic remission (e.g., absence of monoclonal spike by immunofixation in serum and urine AND less then 5% plasma cells in bone marrow with no clonal predominance) OR partial hematologic response (e.g., any decrease in serum or urine monoclonal protein OR decrease in bone marrow plasmacytosis)
  • Greater than 50% reduction in proteinuria with preservation of creatinine clearance
  • Greater than 50% reduction in alkaline phosphatase OR at least 2 cm decrease in liver size by physical exam
  • Subjective neurologic improvement, as confirmed by neurologist
  • Cardiac stabilization of disease confirmed by echocardiography defined as less than 2 mm increase in mean wall thickness and/or less than 20 g increase in left ventricular mass
  • Improvement in performance status\* NOTE: \*This criteria alone does not constitute significant improvement in organ function
  • Prior stem cell yield must have been ≥ 2 x 10\^6 CD34+ cells/kg
  • PRIOR CONCURRENT THERAPY:
  • Biologic therapy
  • See Disease Characteristics
  • Chemotherapy
  • See Disease Characteristics
  • No chemotherapy after first transplantation
  • Endocrine therapy
  • Not specified
  • Radiotherapy
  • Not specified
  • Surgery
  • Not specified
  • PATIENT CHARACTERISTICS:
  • Age
  • 18 to 65
  • Performance status
  • Southwest Oncology Group- 0-2
  • Life expectancy
  • More than 6 months
  • Hematopoietic
  • See Disease Characteristics
  • Hepatic
  • See Disease Characteristics
  • Renal
  • See Disease Characteristics
  • Cardiovascular
  • See Disease Characteristics
  • Left ventricular ejection fraction ≥ 45% by multiple gated acquisition scan or echocardiogram
  • Pulmonary
  • diffusing capacity of lung for carbon monoxide ≥ 50%
  • Exclusion Criteria:
  • No myelodysplastic syndromes
  • No abnormal bone marrow cytogenetics
  • Other
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • Acceptable toxicity from first transplantation, confirmed by the transplant team
  • HIV negative
  • No other concurrent malignancy except treated skin cancer

Exclusion

    Key Trial Info

    Start Date :

    August 1 2001

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    October 1 2011

    Estimated Enrollment :

    12 Patients enrolled

    Trial Details

    Trial ID

    NCT00075608

    Start Date

    August 1 2001

    End Date

    October 1 2011

    Last Update

    January 27 2017

    Active Locations (1)

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    Boston University Cancer Research Center

    Boston, Massachusetts, United States, 02118