Status:

COMPLETED

Lenalidomide After Donor Bone Marrow Transplant in Treating Patients With High-Risk Hematologic Cancers

Lead Sponsor:

National Cancer Institute (NCI)

Conditions:

Adult Acute Myeloid Leukemia in Remission

Adult Acute Myeloid Leukemia With Inv(16)(p13.1q22); CBFB-MYH11

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

This phase I clinical trial is studying the side effects and the best dose of lenalidomide after donor bone marrow transplant in treating patients with high-risk hematologic cancer. Biological therapi...

Detailed Description

PRIMARY OBJECTIVES: I. Determine the maximal-tolerable dose (MTD) of lenalidomide after allogeneic hematopoietic stem cell transplantation (AHSCT) in patients with advanced acute myeloid leukemia (AM...

Eligibility Criteria

Inclusion

  • Inclusion Criteria:
  • Histologically confirmed hematologic malignancy meeting 1 of the following criteria:
  • High-risk acute myeloid leukemia meeting 1 the following criteria:
  • First complete response (CR) and ≥ 60 years of age OR \< 60 years of age with high-risk cytogenetics as defined by CALGB OR high-molecular risk and not eligible or willing to undergo myeloablative conditioning
  • Second or later complete remission
  • Not in remission but with \< 5% blasts within 3 weeks of start of conditioning chemotherapy for allogeneic transplantation
  • Patients with a history of CNS involvement allowed provided disease is in remission at the time of transplantation
  • Patients with non-Hodgkin lymphoma who are candidates for allogeneic stem cell transplantation will be eligible; patients who have relapsed status post autologous transplantation are eligible as long as they demonstrate chemotherapy sensitive disease; patients with a history of CNS involvement are eligible if this aspect of the disease is in remission at the time of transplantation
  • High-risk chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), or primary and secondary B-prolymphocytic leukemia (PLL) meeting 1 of the following criteria:
  • del(17p13.1) disease that has been treated (may have been given as consolidation therapy)
  • Less than PR to chemoimmunotherapy or relapsed within 2 years of treatment
  • Nucleoside analog refractory disease or disease that relapsed after two prior regimens
  • Patients with Richter (large cell) transformation allowed provided the large cell component of the disease is in remission (\< 10% large cells in the bone marrow allowed)
  • Patient has undergone an allogeneic stem cell transplantation using a reduced-intensity or non-myeloablative conditioning regimen within the past 60 days
  • At least 40% T-cell donor chimerism at day 30
  • ECOG performance status 0-2 (Karnofsky 60-100%)
  • Life expectancy \> 3 months
  • Myeloid engraftment with absolute neutrophil count \> 1,000/μL and platelet count \> 50,000/μL (after allogeneic hematopoietic stem cell transplantation \[AHSCT\])
  • Total bilirubin normal
  • AST and ALT ≤ 2.5 times upper limit of normal (ULN)
  • AST \< 3 times ULN after AHSCT
  • Creatinine clearance ≥ 50 mL/min in stratum 1 or ≥ 30 mL/min in stratum 2
  • DLCO \> 40% with no symptomatic pulmonary disease
  • LVEF ≥ 30% by echocardiogram or MUGA
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must agree to use two acceptable methods of contraception (one highly effective method and one additional effective method) or practice abstinence for ≥ 28 days before, during, and ≥ 28 days after completing lenalidomide
  • HIV negative
  • No uncontrolled infection requiring intravenous therapy or poorly controlled diabetes mellitus
  • No history of allergic reactions attributed to compounds of similar chemical or biologic composition to lenalidomide
  • No uncontrolled intercurrent illness including, but not limited to, any of the following:
  • Ongoing or active infection
  • Symptomatic congestive heart failure
  • Unstable angina pectoris
  • Cardiac arrhythmia
  • Psychiatric illness and/or social situations that would limit compliance with study requirements
  • No history of grade 3 or 4 graft-vs-host disease (GVHD)
  • If patient has acute GVHD grade 1 or 2, GVHD must be controlled and dose of oral prednisone or equivalent ≤ 20 mg per day (after AHSCT)
  • More than 4 weeks since prior chemotherapy (excluding steroids), radiotherapy, or radioimmunoconjugate therapy (6 weeks for nitrosoureas or mitomycin C) and recovered
  • No other concurrent investigational agents

Exclusion

    Key Trial Info

    Start Date :

    November 24 2010

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    November 9 2012

    Estimated Enrollment :

    17 Patients enrolled

    Trial Details

    Trial ID

    NCT01254578

    Start Date

    November 24 2010

    End Date

    November 9 2012

    Last Update

    September 25 2017

    Active Locations (1)

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    Ohio State University Comprehensive Cancer Center

    Columbus, Ohio, United States, 43210