Allogeneic Transplantation Using Total Lymphoid Irradiation (TLI) and Anti-Thymocyte Globulin (ATG) for Older Patients With Hematologic Malignancies
Trial ID or NCT#
Status
Purpose
To measure how frequently and to what degree a complication of transplant cell acute graft versus host disease (GvHD) occurs.
Official Title
Allogeneic Hematopoietic Cell Transplantation Using a Non-Myeloablative Preparative Regimen of Total Lymphoid Irradiation and Anti-Thymocyte Globulin for Older Patients With Hematologic Malignancies
Eligibility Criteria
- * Any patient with one of the following hematolymphoid malignancies or syndromes in whom allogeneic hematopoietic stem cell transplant (HST) is warranted. Specific disease categories include:
- * Indolent advanced stage non-Hodgkin lymphomas * Mantle cell lymphoma * Chronic lymphocytic leukemia * Hodgkin disease (Hodgkin's lymphoma) * Acute leukemias in complete remission * Aplastic anemia * Paroxysmal nocturnal hemoglobinuria * Myelodysplastic or myeloproliferative syndromes. * Other selected malignancies/disorders may also be considered but must be approved by the transplant team and the Principal Investigator.* Age \> 50 years, or if \< 50 years of age, considered to be at high risk for regimen-related toxicity associated with conventional myeloablative transplants due to pre-existing medical conditions or prior therapy.* A fully human leukocyte antigen (HLA)-identical sibling or matched unrelated donor is available. Potential participants with one antigen mismatched donors can be considered but only after discussion with the transplant team and the Principal Investigator.* Participant must be competent to give consent.
- EXCLUSION CRITERIA:
- * Progressive hematolymphoid malignancies despite conventional therapies, or acute leukemias not in complete remission.* Uncontrolled central nervous system (CNS) involvement with disease* Fertile men or women unwilling to use contraceptive techniques during and for 12 months following treatment* Pregnant* Cardiac ejection fraction \< 30%* Uncontrolled cardiac failure* Pulmonary diffusing capacity (DLCO) \< 40% predicted* Elevation of bilirubin to \> 3 mg/dL* Transaminases \> 4 x the upper limit of normal* Creatinine clearance \< 50 cc/min (24-hour urine collection)* Karnofsky performance score \< 60%* Poorly controlled hypertension on multiple antihypertensives* Documented fungal disease that is progressive despite treatment* HIV-positive. Other viral infections, ie, Hepatitis B- and C- positive, evaluated on a case-by-case basis* Psychiatric disorders or psychosocial problems which in the opinion of the primary physician or Principal Investigator would place the patient at unacceptable risk from this regimen.
- * Progressive hematolymphoid malignancies despite conventional therapies, or acute leukemias not in complete remission.* Uncontrolled central nervous system (CNS) involvement with disease* Fertile men or women unwilling to use contraceptive techniques during and for 12 months following treatment* Pregnant* Cardiac ejection fraction \< 30%* Uncontrolled cardiac failure* Pulmonary diffusing capacity (DLCO) \< 40% predicted* Elevation of bilirubin to \> 3 mg/dL* Transaminases \> 4 x the upper limit of normal* Creatinine clearance \< 50 cc/min (24-hour urine collection)* Karnofsky performance score \< 60%* Poorly controlled hypertension on multiple antihypertensives* Documented fungal disease that is progressive despite treatment* HIV-positive. Other viral infections, ie, Hepatitis B- and C- positive, evaluated on a case-by-case basis* Psychiatric disorders or psychosocial problems which in the opinion of the primary physician or Principal Investigator would place the patient at unacceptable risk from this regimen.
Investigator(s)
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Contact
Physician Referrals
650-723-0822
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