Status:
TERMINATED
Antithymocyte Globulin, Clofarabine, and Rituximab in Treating Patients After an Unsuccessful Stem Cell Transplant
Lead Sponsor:
Masonic Cancer Center, University of Minnesota
Conditions:
Cancer
Eligibility:
All Genders
Phase:
PHASE2
Brief Summary
RATIONALE: Antithymocyte globulin, clofarabine, and rituximab may stop the patient's immune system from rejecting the donor's stem cells when they do not exactly match the patient's blood. The donated...
Detailed Description
OBJECTIVES: Primary * To determine the rate of sustained donor engraftment at 42 days and survival at 100 days post transplantation in patients treated with anti-thymocyte globulin, clofarabine, and...
Eligibility Criteria
Inclusion
- Patient
- Timing of relevant evaluations: Taking in account the need for rapid intervention, if white blood count is less than 200 on day +20, bone marrow aspirate should be performed on day +21. Unless there is an increase in absolute neutrophil count (ANC) to \> 500 in the following 7 days, bone marrow aspirate should be repeated on day +28. If the white blood count is still less than 200 and bone marrow is acellular, bone marrow (BM) or peripheral blood stem cell (PBSC) donor should be reactivated and availability of cord blood (CB) units assessed. If the BM or PBSC donor is not confirmed within 14 days of the request for the donation (typically second donation from the same donor), CB unit should be used instead.
- Primary or secondary graft failure after hematopoietic stem cell transplantation defined as a \> 50% loss of donor chimerism from previous maximum or less than 25% donor beyond day +42 with pancytopenia and no evidence of relapse. Patients with any diagnosis, type of donor, hematopoietic cell graft or conditioning regimen should be considered for this study.
- primary graft failure is defined as:
- ANC \< 500
- BM \< 10% on two occasions (Day +21 and Day +28)
- Donor chimerism need not to be considered, provided there is no evidence of malignancy
- secondary graft failure is defined as \< 5% cellularity and ANC \< 500 for more than 7 days any time after primary engraftment).
- Women of childbearing potential must agree to use adequate contraception (diaphragm, birth control pills, injections, intrauterine device \[IUD\], surgical sterilization, subcutaneous implants, or abstinence, etc.) for the duration of treatment.
- Patients or their guardian are able and willing to provide written informed consent.
- Patient
Exclusion
- The presence of any of the following excludes a patient from study enrollment:
- Uncontrolled active infection defined as more than one week with no response to appropriately chosen antibiotics
- Evidence of recurrence of primary malignancy.
- Pregnant or lactating. The agents used in this study may be teratogenic to a fetus and there is no information on the excretion of agents into breast milk. All females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy. Women of childbearing age must use appropriate methods as described.
- Allergy to rituximab.
- Evidence of HIV infection or positive HIV serology.
- Autologous recovery defined as defined as greater than 90% recipient PCR product in the competitive VNTR PCR performed on gradually increasing white blood cell count.
- Donor Inclusion Criteria:
- Related donors must be 2-75 years of age and in good health.
- Meets match criteria
- Able and willing to undergo cell collection procedures (bone marrow cell collection or leukapheresis)
- Not pregnant or lactating.
- HIV-1, HIV-2 negative; HTLV-1, HTLV-2 negative, Hepatitis B and C negative.
- Patients or their guardian are able and willing to provide informed consent
Key Trial Info
Start Date :
January 1 2008
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
October 1 2015
Estimated Enrollment :
12 Patients enrolled
Trial Details
Trial ID
NCT00617929
Start Date
January 1 2008
End Date
October 1 2015
Last Update
December 28 2017
Active Locations (1)
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1
Masonic Cancer Center at University of Minnesota
Minneapolis, Minnesota, United States, 55455