Status:

COMPLETED

Cyclophosphamide and/or Mycophenolate Mofetil With or Without Tacrolimus in Treating Patients Who Are Undergoing a Donor Bone Marrow or Peripheral Stem Cell Transplant for Hematologic Cancer

Lead Sponsor:

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Collaborating Sponsors:

National Cancer Institute (NCI)

Conditions:

Chronic Myeloproliferative Disorders

Graft Versus Host Disease

Eligibility:

All Genders

18-75 years

Phase:

PHASE1

Brief Summary

RATIONALE: Giving low doses of chemotherapy, such as fludarabine, and radiation therapy before a donor bone marrow or stem cell transplant helps stop the growth of cancer cells. It also stops the pati...

Detailed Description

OBJECTIVES: * Determine a minimal (short-duration) post-transplant immunosuppression regimen comprising cyclophosphamide and/or mycophenolate mofetil with or without tacrolimus that results in ≤ 20% ...

Eligibility Criteria

Inclusion

  • DISEASE CHARACTERISTICS:
  • Diagnosis of 1 of the following hematologic malignancies:
  • Stage II or III multiple myeloma
  • Amyloidosis
  • Myelofibrosis with ≥ 2 of the following high-risk features:
  • Over 55 years of age
  • Hemoglobin \< 10 g/dL
  • WBC \< 3,000/mm\^3 OR \> 10,000/mm\^3
  • Platelet count \< 100,000/mm\^3
  • Cytogenetic abnormalities
  • Mycosis fungoides, meeting 1 of the following criteria:
  • Stage IIB or III disease with evidence of histologic conversion to an aggressive lymphoma
  • Must demonstrate chemosensitivity
  • Stage IV disease
  • Paroxysmal nocturnal hemoglobinuria
  • Not meeting criteria for other bone marrow transplantation (BMT) or treatment studies
  • Diagnosis of 1 of the following hematologic malignancies, for which patient is not eligible for potentially curative allogeneic BMT due to end-organ dysfunction, age 65 to 75, or the amount of prior chemotherapy:
  • Acute myeloid or acute lymphoblastic leukemia
  • High-risk disease in first or second (or further) complete remission
  • Relapsed aggressive non-Hodgkin's lymphoma
  • Not eligible for autologous or standard allogeneic BMT
  • Hodgkin's lymphoma in second or further complete or partial remission
  • Not eligible for autologous or standard allogeneic BMT
  • Myelodysplastic syndromes or myelodysplastic/myeloproliferative diseases
  • Any of the following subtypes:
  • Refractory anemia with excess blasts (RAEB)
  • RAEB in transformation
  • Chronic myelomonocytic leukemia
  • Any morphologic subtype with multiple chromosomal abnormalities
  • Any subset with life-threatening cytopenias in all 3 cell lines, defined as platelet count ≤ 20,000/mm\^3, absolute neutrophil count ≤ 500/mm\^3, and reticulocyte count ≤ 50,000/mm\^3
  • Meets both of the following criteria:
  • Less than 20% blasts by bone marrow biopsy
  • Not eligible for standard allogeneic BMT
  • No refractory anemia with ringed sideroblasts
  • No 5q syndrome
  • Stage III or IV chronic lymphocytic leukemia
  • Not meeting criteria for other BMT studies
  • Chronic myelogenous leukemia in first or second chronic phase
  • Not meeting criteria for other BMT studies or treatment
  • Stage III or IV indolent small lymphocytic or follicular lymphoma
  • Not eligible for autologous or standard allogeneic BMT or other active protocols at Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Must have an HLA-identical related donor available
  • PATIENT CHARACTERISTICS:
  • Performance status
  • ECOG 0-2
  • Life expectancy
  • Not specified
  • Hematopoietic
  • See Disease Characteristics
  • Hepatic
  • Bilirubin ≤ 3.0 mg/dL
  • AST ≤ 175 U/L
  • ALT ≤ 200 U/L
  • Renal
  • Creatinine ≤ 3.0 mg/dL
  • Cardiovascular
  • LVEF ≥ 30%
  • Pulmonary
  • FEV\_1 ≥ 40% predicted
  • Forced vital capacity ≥ 40% predicted
  • Other
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • HIV negative
  • PRIOR CONCURRENT THERAPY:
  • Chemotherapy
  • See Disease Characteristics

Exclusion

    Key Trial Info

    Start Date :

    July 1 2002

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    Estimated Enrollment :

    60 Patients enrolled

    Trial Details

    Trial ID

    NCT00255710

    Start Date

    July 1 2002

    Last Update

    March 17 2010

    Active Locations (1)

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    1

    Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

    Baltimore, Maryland, United States, 21231-2410