Completed

Phase 3
Age: 12Years +
All Genders
ID00000658

A Phase III Randomized Trial of Low-Dose Versus Standard-Dose mBACOD Chemotherapy With rGM-CSF for Treatment of AIDS-Associated Non-Hodgkin's Lymphoma

Led by National Institute of Allergy and Infectious Diseases (NIAID) · Updated on 2021-11-03

250

Participants Needed

22

Research Sites

N/A

Total Duration

On this page

Sponsors

N

National Institute of Allergy and Infectious Diseases (NIAID)

Lead Sponsor

S

Schering-Plough

Collaborating Sponsor

AI-Summary

What this Trial Is About

To determine the impact of dose intensity on tumor response and survival in patients with HIV-associated non-Hodgkin's lymphoma (NHL). HIV-infected patients are at increased risk for developing intermediate and high-grade NHL. While combination chemotherapy for aggressive B-cell NHL in the absence of immunodeficiency is highly effective, the outcome of therapy for patients with AIDS-associated NHL has been disappointing. Treatment is frequently complicated by the occurrence of multiple opportunistic infections, as well as the presence of poor bone marrow reserve, making the administration of standard doses of chemotherapy difficult. A recent study was completed using a low-dose modification of the standard mBACOD (cyclophosphamide, doxorubicin, vincristine, bleomycin, dexamethasone, methotrexate ) treatment. A 46 percent response rate was observed in patients treated with this combination of chemotherapeutic agents, with a number of durable remissions and reduced toxicity when compared to previous experience with more standard treatments. A subsequent study showed similar effectiveness using a lower dose of methotrexate administered on day 15. It is hoped that the use of sargramostim (granulocyte-macrophage colony-stimulating factor; GM-CSF) will improve bone marrow function and allow for administration of a higher dose of chemotherapy.

CONDITIONS

Official Title

A Phase III Randomized Trial of Low-Dose Versus Standard-Dose mBACOD Chemotherapy With rGM-CSF for Treatment of AIDS-Associated Non-Hodgkin's Lymphoma

Who Can Participate

Age: 12Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

Inclusion Criteria

Concurrent Medication:

Required:

  • PCP prophylaxis with Bactrim, aerosolized pentamidine, or dapsone.

Allowed:

ddI, except when patient is also taking allopurinol.

Patients must have the following:

  • Diagnosis of HIV seropositivity and non-Hodgkin's lymphoma.
  • Ability to give informed consent and willingness to comply with all procedures and visit schedule.
  • If between ages of 12 and 18 must receive care under direct supervision of a pediatric oncologist, and have consent of parent, guardian, or person with power of attorney.
  • Participation in clinical trials of other antiretroviral agents is at the discretion of the investigator and individual patient.

Exclusion Criteria

Co-existing Condition:

Patients with the following conditions or symptoms are excluded:

  • Active opportunistic infection, excluding Mycobacterium avium complex, requiring antibiotic therapy.
  • Another prior or current malignancy, excepting curatively treated cervical or basal cell carcinoma.
  • Kaposi's sarcoma if rapidly progressive, with visceral involvement, or causing peripheral edema.
  • Primary central nervous system lymphoma.

Concurrent Medication:

Excluded:

  • Zidovudine (AZT) or any antiretroviral agent unless allowed by investigator. ddI is allowed except when also taking allopurinol.

Systemic myelosuppressive drugs, including trimethoprim/sulfamethoxazole (T/S), pyrimethamine/sulfa, or ganciclovir.

-

Patients with the following are excluded:

  • Active opportunistic infection, excluding Mycobacterium avium complex, requiring antibiotic therapy.
  • Another prior or current malignancy, excepting curatively treated cervical or basal cell carcinoma.
  • Kaposi's sarcoma if rapidly progressive, with visceral involvement, or causing peripheral edema.
  • Primary central nervous system lymphoma.

Prior Medication:

Excluded:

  • Immunomodulating agents within 2 weeks of study entry.

Prior Treatment:

Excluded:

  • Chemotherapy.

Radiation therapy as outlined in protocol.

Not Eligible

You will not qualify if you...

History of severe allergic reactions to study medication Currently pregnant or breastfeeding Recent participation in another clinical trial within the last 30 days Presence of uncontrolled medical conditions that could affect safety

Trial Site Locations

Total: 22 locations

1

USC CRS

Los Angeles, California, United States, 900331079

Status Unknown

2

UCLA CARE Center CRS

Los Angeles, California, United States, 90095

Status Unknown

3

Ucsf Aids Crs

San Francisco, California, United States, 941102859

Status Unknown

4

University of Colorado Hospital CRS

Aurora, Colorado, United States, 80262

Status Unknown

5

Northwestern University CRS

Chicago, Illinois, United States, 60611

Status Unknown

6

Rush Univ. Med. Ctr. ACTG CRS

Chicago, Illinois, United States, 60612

Status Unknown

7

Indiana Univ. School of Medicine, Infectious Disease Research Clinic

Indianapolis, Indiana, United States, 462025250

Status Unknown

8

Johns Hopkins Adult AIDS CRS

Baltimore, Maryland, United States

Status Unknown

9

Beth Israel Deaconess Med. Ctr., ACTG CRS

Boston, Massachusetts, United States, 02118

Status Unknown

10

Beth Israel Deaconess - East Campus A0102 CRS

Boston, Massachusetts, United States, 02215

Status Unknown

11

Bmc Actg Crs

Boston, Massachusetts, United States

Status Unknown

12

Washington U CRS

St Louis, Missouri, United States

Status Unknown

13

SUNY - Buffalo, Erie County Medical Ctr.

Buffalo, New York, United States, 14215

Status Unknown

14

Beth Israel Med. Ctr. (Mt. Sinai)

New York, New York, United States, 02215

Status Unknown

15

NY Univ. HIV/AIDS CRS

New York, New York, United States, 10016

Status Unknown

16

Memorial Sloan-Kettering Cancer Ctr.

New York, New York, United States, 10021

Status Unknown

17

Univ. of Rochester ACTG CRS

Rochester, New York, United States, 14642

Status Unknown

18

Unc Aids Crs

Chapel Hill, North Carolina, United States, 275997215

Status Unknown

19

Case CRS

Cleveland, Ohio, United States

Status Unknown

20

The Ohio State Univ. AIDS CRS

Columbus, Ohio, United States, 432101228

Status Unknown

21

Hosp. of the Univ. of Pennsylvania CRS

Philadelphia, Pennsylvania, United States, 19104

Status Unknown

22

Pitt CRS

Pittsburgh, Pennsylvania, United States, 15213

Status Unknown

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How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

N/A

Model

N/A

Primary Purpose

TREATMENT

Number of Arms

0

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Published Research Related To This Trial

Low-dose compared with standard-dose m-BACOD chemotherapy for non-Hodgkin's lymphoma associated with human immunodeficiency virus infection. National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group.

L D Kaplan, D J Straus, M A Testa...

https://pubmed.ncbi.nlm.nih.gov/9171066

Prognostic factors in the treatment of human immunodeficiency virus-associated non-Hodgkin's lymphoma: analysis of AIDS Clinical Trials Group protocol 142--low-dose versus standard-dose m-BACOD plus granulocyte-macrophage colony-stimulating factor. National Institute of Allergy and Infectious Diseases.

D J Straus, J Huang, M A Testa...

https://pubmed.ncbi.nlm.nih.gov/9817281