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NCT00118352 · REGISTRY CONDITION SEARCH

Alemtuzumab, Fludarabine Phosphate, and Total-Body Irradiation Followed by Cyclosporine and Mycophenolate Mofetil in Treating Patients Who Are Undergoing Donor Stem Cell Transplant for Hematologic Cancer

Found through the registry condition index, not selected as a treatment recommendation. This discovery collection was restricted to studies with posted results.

Phase
PHASE2
Status at capture
COMPLETED
Registry last update
2017-05-30

This phase II trial is studying the side effects and best dose of alemtuzumab when given together with fludarabine phosphate and total-body irradiation followed by cyclosporine and mycophenolate mofetil in treating patients who are undergoing a donor stem cell transplant for hematologic cancer. Giving low doses of chemotherapy, such as fludarabine phosphate, a monoclonal antibody, such as alemtuzumab, and radiation therapy before a donor stem cell transplant helps stop the growth of cancer cells. Giving chemotherapy or radiation therapy before or after transplant also stops the patient's immune system from rejecting the donor's bone marrow stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving cyclosporine and mycophenolate mofetil after the transplant may stop this from happening.

Open the original ClinicalTrials.gov record → · Download preserved record

What did the study report?

Outcomes, safety and baseline populations are separate source sections. Quality-of-life measures appear under their original outcome titles.

Who could take part
eligibility Criteria
Inclusion Criteria: * The patient must be not eligible for conventional transplants and must have disease expected to be stable for at least 100 days without chemotherapy * Patients with hematologic malignancies treatable with HCT will be included: * Aggressive non-Hodgkin lymphomas (NHLs) and other histologies such as diffuse large B-cell NHL: not eligible for autologous HCT, not eligible for conventional myeloablative HCT, or after failed autologous HCT; * Low grade NHL: with \< 6 month duration of complete response (CR) between courses of conventional therapy; * Mantle cell NHL: may be treated in first CR; * Chronic lymphocytic leukemia (CLL): must have failed 2 lines of conventional therapy and must be refractory to fludarabine; this includes patients who fail to have a complete or partial response after therapy with a regimen containing fludarabine (or another nucleoside analog\] or experience disease relapse within 12 months after completing therapy with a regimen containing fludarabine \[or another nucleoside analog); * Hodgkin's disease (HD): must have received and failed frontline therapy and have failed or were not eligible for autologous transplant; * Multiple myeloma (MM): must have received prior chemotherapy or failed autografting; following a planned autologous transplant \[tandem\] is allowed; * Acute myeloid leukemia (AML): must have \< 5% marrow blasts at the time of transplant; * Acute lymphocytic leukemia (ALL): must have \< 5% marrow blasts at the time of transplant; * Chronic myelogenous leukemia (CML): patients will be accepted beyond first clinical progression (CP1) if they have received previous myelosuppressive chemotherapy or HCT, and have \< 5% marrow blasts at time of transplant; * Myelodysplastic syndrome/myeloproliferative disease (MDS/MPD): must have failed previous myelosuppressive chemotherapy or HCT, and have \< 5% marrow blasts at time of transplant; * Waldenstrom's macroglobulinemia: must have failed 2 courses of therapy * Patient refuses to be treated on a conventional transplant protocol; for this inclusion criteria, transplants must be approved by both the participating institution's patient review committee, such as the Patient Care Conference (PCC) at the Fred Hutchinson Cancer Research Center (FHCRC), and the FHCRC principal investigator * Patient with related or unrelated donors for whom: * There is a likelihood of disease progression while HLA typing and results of a preliminary search and the donor pool suggest that a 10/10 HLA-A, B, C, DRB1 and DQB1 matched unrelated donor will not be found; * Patient and donor must be matched for at least one DRB1 allele and one DQB1 allele; * Best available matches are HLA class I HLA-A, -B, -C allele matched donors allowing for any one or two DRB1 and/or DQB1 antigen/allele mismatch; * There is no indication for an autologous transplantation as a treatment option * DONOR: For HLA matching inclusion criteria, see patient inclusion criteria * DONOR: Only peripheral blood stem cells (PBSC) will be permitted as a HSC source on this protocol Exclusion Criteria: * Positive crossmatch between donor and recipients * Patient's life expectancy is severely limited by diseases other than malignancy * Patient has central nervous system (CNS) involvement with disease refractory to intrathecal chemotherapy * Presence of circulating leukemic blasts (in the peripheral blood) detected by standard pathology for patients with AML, ALL or CML * Patient is a fertile man or woman unwilling to use contraceptives during and for up to 12 months post treatment * Patient is a female who is pregnant or breastfeeding * Patient is human immunodeficiency virus (HIV) positive * Patients with active non-hematologic malignancies (except non-melanoma skin cancers) * Patients with a history of non-hematologic malignancies (except non-melanoma skin cancers) currently in a complete remission, who are less than 5 years from the time of complete remission, and have a \> 20% risk of disease recurrence * Patient has a fungal infection with radiological progression after receipt of amphotericin B or active triazole for greater than 1 month * Patient has the following organ dysfunction: * Symptomatic coronary artery disease or ejection fraction \< 35% or other cardiac failure requiring therapy; ejection fraction is required if age \> 50 years or if the patient has a history of anthracyclines or history of cardiac disease; * Diffusion capacity of the lung for carbon monoxide (DLCO) \< 35% total lung capacity (TLC) \< 35%, forced expiratory volume of the lung in one second (FEV1) \< 35% and/or receiving supplementary continuous oxygen; the FHCRC study principal investigator (PI) must approve enrollment of all patients with pulmonary nodules; * Liver function abnormalities: patient with clinical or laboratory evidence of liver disease will be evaluated for the cause of liver disease, its clinical severity in terms of liver function, bridging fibrosis, and the degree of portal hypertension; the patient will be excluded if he/she is found to have fulminant liver failure, cirrhosis of the liver with evidence of portal hypertension, alcoholic hepatitis, esophageal varices, a history of bleeding esophageal varices, hepatic encephalopathy, uncorrectable hepatic synthetic dysfunction evinced by prolongation of the prothrombin time, ascites related to portal hypertension, bacterial or fungal liver abscess, biliary obstruction, chronic viral hepatitis with total serum bilirubin \> 3mg/dL, or symptomatic biliary disease * Patient has poorly controlled hypertension and on multiple antihypertensives * Karnofsky performance score \< 70 for adult patients * Lansky play-performance score \< 70 for pediatric patients * Patient received cytotoxic agents for "cytoreduction" within three weeks (or the interval in which a cycle of standard chemotherapy would be administered in a non-transplant setting) prior to initiating the nonmyeloablative transplant conditioning; (exceptions are hydroxyurea and imatinib mesylate) * DONOR: Marrow donors * DONOR: Positive crossmatch between donor and recipient * DONOR: Donor is HIV-positive and/or has a medical condition that would result in increased risk for filgrastim (G-CSF) mobilization and harvest of PBSC * DONOR: Donor age \< 12 years
healthy Volunteers
false
maximum Age
74 Years
sex
ALL
std Ages
  1. CHILD
  2. ADULT
  3. OLDER_ADULT
Treatment arms and interventions
arm Groups
  1. description
    NONMYELOABLATIVE CONDITIONING REGIMEN: Patients receive alemtuzumab IV over 6 hours once daily on days -6, -5, and -4 OR days -5 and -4 and fludarabine phosphate IV over 30 minutes on days -4, -3, and -2. Patients also undergo low-dose TBI on day 0. ALLOGENEIC PBSCT: After completion of TBI, patients undergo allogeneic PBSCT on day 0. IMMUNOSUPPRESSION: Patients receive cyclosporine PO or IV every 12 hours on days -3 to 180 followed by a taper until day 365 in the absence of GVHD. Beginning 4-6 hours after completion of allogeneic PBSCT, patients receive mycophenolate mofetil PO every 8 hours on days 0 to 100 followed by a taper until day 156 in the absence of GVHD.
    intervention Names
    1. Biological: alemtuzumab
    2. Radiation: total-body irradiation
    3. Drug: fludarabine phosphate
    4. Drug: cyclosporine
    5. Drug: mycophenolate mofetil
    6. Procedure: allogeneic hematopoietic stem cell transplantation
    7. Procedure: peripheral blood stem cell transplantation
    8. Biological: graft versus host disease prophylaxis/therapy
    9. Other: laboratory biomarker analysis
    label
    Treatment (chemotherapy, TBI, transplant)
    type
    EXPERIMENTAL
interventions
  1. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Given IV
    name
    alemtuzumab
    other Names
    1. anti-CD52 monoclonal antibody
    2. Campath-1H
    3. MoAb CD52
    4. Monoclonal Antibody Campath-1H
    5. Monoclonal Antibody CD52
    type
    BIOLOGICAL
  2. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Undergo low-dose TBI
    name
    total-body irradiation
    other Names
    1. TBI
    type
    RADIATION
  3. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Given IV
    name
    fludarabine phosphate
    other Names
    1. 2-F-ara-AMP
    2. Beneflur
    3. Fludara
    type
    DRUG
  4. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Given PO or IV
    name
    cyclosporine
    other Names
    1. ciclosporin
    2. cyclosporin
    3. cyclosporin A
    4. CYSP
    5. Sandimmune
    type
    DRUG
  5. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Given PO
    name
    mycophenolate mofetil
    other Names
    1. Cellcept
    2. MMF
    type
    DRUG
  6. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Undergo allogeneic stem cell transplantation
    name
    allogeneic hematopoietic stem cell transplantation
    type
    PROCEDURE
  7. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Undergo PBSCT
    name
    peripheral blood stem cell transplantation
    other Names
    1. PBPC transplantation
    2. PBSC transplantation
    3. peripheral blood progenitor cell transplantation
    4. transplantation, peripheral blood stem cell
    type
    PROCEDURE
  8. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Undergo GVHD prophylaxis/therapy
    name
    graft versus host disease prophylaxis/therapy
    other Names
    1. prophylaxis/therapy, graft versus host disease
    2. prophylaxis/therapy, GVHD
    type
    BIOLOGICAL
  9. arm Group Labels
    1. Treatment (chemotherapy, TBI, transplant)
    description
    Correlative studies
    name
    laboratory biomarker analysis
    type
    OTHER
Study design
allocation
NA
intervention Model
SINGLE_GROUP
masking Info
masking
NONE
primary Purpose
TREATMENT
Enrollment
count
12
type
ACTUAL
Registered outcome plans (not posted results)
primary Outcomes
  1. description
    Severity of Individual Organ Involvement Liver: Stage 2 - bilirubin (3-5.9mg/100ml) Stage 3 - bilirubin (6-14.9mg/100ml) Stage 4 - bilirubin \> 15mg/100ml Gut: Diarrhea is graded stage 1 to stage 4 in severity. Nausea and vomiting and/or anorexia caused by GVHD is assigned as stage 1 in severity. The severity of gut involvement is assigned to the most severe involvement noted. Patients with visible bloody diarrhea are at least stage 2 gut and grade 3 overall Severity of GVHD Grade III - Stage 2 to 4 gastrointestinal involvement and/or Stage 2 to 4 liver involvement with or without a rash Grade IV - Pattern and severity of GVHD similar to grade 3 with extreme constitutional symptoms or death
    measure
    Incidence of Grade III-IV Acute GVHD
    time Frame
    100 days after transplant
secondary Outcomes
  1. description
    Percentage patients that experienced graft rejection.
    measure
    Incidence of Graft Rejection
    time Frame
    84 days after transplant
  2. description
    Percentage patients requiring steroids greater than 1 mg/kg.
    measure
    Incidence of High-dose Corticosteroid Utilization.
    time Frame
    100 days after transplant
  3. description
    Percentage patient deaths due to non-relapse mortality
    measure
    Incidence of Non-relapse Mortality
    time Frame
    100 days after transplant
  4. description
    Percentage patients that experienced infection(s).
    measure
    Incidence of Infection
    time Frame
    Up to 5 years post-transplant
  5. description
    The outcome of immune reconstitution was not analyzed by the collaborating laboratory because only a small number of patients were only enrolled in Dose Level 1 (no alemtuzumab). The Dose Level 1 patients were going to be the baseline for which to compare the other patients on Dose Level 2 (and 3) who would have received alemtuzumab. The collaborating investigator determined that the study was not worthwhile performing based on this information.
    measure
    Immune Reconstitution
    time Frame
    Up to 1 year post-transplant
  6. description
    CML New cytogenetic abnormality and/or development of accelerated phase or blast crisis. The criteria for accelerated phase will be defined as unexplained fever greater than 38.3°C, new clonal cytogenetic abnormalities in addition to a single Ph-positive chromosome, marrow blasts and promyelocytes \>20%. AML, ALL \>5% marrow blasts by morphologic or flow cytometric, or appearance of extramedullary disease. CLL ≥1 of: Physical exam/Imaging studies (nodes, liver, and/or spleen) ≥50% increase or new, circulating lymphocytes by morphology and/or flow cytometry ≥50% increase, and lymph node biopsy w/ Richter's transformation. NHL \>25% increase in the sum of the products of the perpendicular diameters of marker lesions, or the appearance of new lesions. MM ≥100% increase of the serum myeloma protein from its lowest level, or reappearance of myeloma peaks that had disappeared w/ treatment; or definite increase in the size or number of plasmacytomas or lytic bone lesions.
    measure
    Disease Progression/Relapse
    time Frame
    Up to 5 years
Full study description
brief Summary
This phase II trial is studying the side effects and best dose of alemtuzumab when given together with fludarabine phosphate and total-body irradiation followed by cyclosporine and mycophenolate mofetil in treating patients who are undergoing a donor stem cell transplant for hematologic cancer. Giving low doses of chemotherapy, such as fludarabine phosphate, a monoclonal antibody, such as alemtuzumab, and radiation therapy before a donor stem cell transplant helps stop the growth of cancer cells. Giving chemotherapy or radiation therapy before or after transplant also stops the patient's immune system from rejecting the donor's bone marrow stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect). Sometimes the transplanted cells from a donor can also make an immune response against the body's normal cells. Giving cyclosporine and mycophenolate mofetil after the transplant may stop this from happening.
detailed Description
PRIMARY OBJECTIVES: I. To determine which dose of Campath (alemtuzumab) allows related and unrelated human leukocyte antigen (HLA) class-II mismatched hematopoietic cell transplantation (HCT) with an incidence of grade III-IV acute graft-versus-host disease (GVHD) less than 40%. SECONDARY OBJECTIVES: I. Incidence of graft rejection. II. Number of days of steroids \>= 1mg/kg required before day 100 in each patient. III. Incidence of non-relapse mortality. IV. Risk/incidence of infections. V. Immune reconstitution. VI. Risk for disease progression and relapse. OUTLINE: This is a dose-escalation study of alemtuzumab. NONMYELOABLATIVE CONDITIONING REGIMEN: Patients receive alemtuzumab intravenously (IV) over 6 hours once daily on days -6, -5, and -4 OR days -5 and -4 and fludarabine phosphate IV over 30 minutes on days -4, -3, and -2. Patients also undergo low-dose total-body irradiation (TBI) on day 0. ALLOGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION (PBSCT): After completion of TBI, patients undergo allogeneic PBSCT on day 0. IMMUNOSUPPRESSION: Patients receive cyclosporine orally (PO) or IV every 12 hours on days -3 to 180 followed by a taper until day 365 in the absence of GVHD. Beginning 4-6 hours after completion of allogeneic PBSCT, patients receive mycophenolate mofetil PO every 8 hours on days 0 to 100 followed by a taper until day 156 in the absence of GVHD. After completion of study treatment, patients are followed up periodically for 12 months, at 18 months, and then annually for 5 years.
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      8ae28aa1a022b179ff4a29ad796d3dab7d6154066774cbe300b7755ff32fbf36
    7. release id
      ctgov-registry-1336d216cbd1bbff780dac70
      edge id
      nct-edge-d05c8319bb9b10bfa95b
      requested nct id
      NCT00118352
      primary nct id
      NCT00118352
      source kind
      ctgov_condition_query
      source record id
      Source null
      source file sha256
      8b9a346048372591e3ee0de631ceead25528dc1d384a69971d454af93b26921d
      payload sha256
      2e9ce138cbbaadbcd4e3c847017b55d7843ad55afdc110005969f25147384c80
      payload
      clinical indication matching status
      condition_index_match_asserted_by_registry_not_reviewed
      end exclusive
      true
      id
      nct-edge-d05c8319bb9b10bfa95b
      link basis
      returned_by_explicit_condition_and_posted_results_filter_query
      nct id
      NCT00118352
      occurrences
      1. context exact
        NCT00118352
        end
        11
        exact text
        NCT00118352
        start
        0
      offset unit
      unicode_code_points
      query cond
      Hairy Cell Leukemia
      query disease state id
      ds-hairy-cell-leukemia
      source file
      /Users/arunverma/Documents/ChatGPT/Cancer Statistics Website/research-data/2026-09-10/clinicaltrials-condition/round-0000/raw/cond-hairy-cell-leukemia-000.json
      source file sha256
      8b9a346048372591e3ee0de631ceead25528dc1d384a69971d454af93b26921d
      source json pointer
      /studies/25/protocolSection/identificationModule/nctId
      source kind
      ctgov_condition_query
      source record id
      Source null
      source string basis
      parsed_JSON_string_unmodified
      source string sha256
      8ae28aa1a022b179ff4a29ad796d3dab7d6154066774cbe300b7755ff32fbf36
    8. release id
      ctgov-registry-1336d216cbd1bbff780dac70
      edge id
      nct-edge-e321845ae17d7534d333
      requested nct id
      NCT00118352
      primary nct id
      NCT00118352
      source kind
      ctgov_condition_query
      source record id
      Source null
      source file sha256
      2314ce01316b2d7044d298c6d25eda12e99cc5f44273bc75efed6cd5e03a8c14
      payload sha256
      117251c92a0711d5bf9328706d69e05f9315629052fb9cdff8a27f040c8c378a
      payload
      clinical indication matching status
      condition_index_match_asserted_by_registry_not_reviewed
      end exclusive
      true
      id
      nct-edge-e321845ae17d7534d333
      link basis
      returned_by_explicit_condition_and_posted_results_filter_query
      nct id
      NCT00118352
      occurrences
      1. context exact
        NCT00118352
        end
        11
        exact text
        NCT00118352
        start
        0
      offset unit
      unicode_code_points
      query cond
      Plasma Cell Neoplasms
      query disease state id
      ds-plasma-cell-neoplasms
      source file
      /Users/arunverma/Documents/ChatGPT/Cancer Statistics Website/research-data/2026-09-10/clinicaltrials-condition/round-0000/raw/cond-plasma-cell-neoplasms-000.json
      source file sha256
      2314ce01316b2d7044d298c6d25eda12e99cc5f44273bc75efed6cd5e03a8c14
      source json pointer
      /studies/566/protocolSection/identificationModule/nctId
      source kind
      ctgov_condition_query
      source record id
      Source null
      source string basis
      parsed_JSON_string_unmodified
      source string sha256
      8ae28aa1a022b179ff4a29ad796d3dab7d6154066774cbe300b7755ff32fbf36
    9. release id
      ctgov-registry-1336d216cbd1bbff780dac70
      edge id
      nct-edge-e746397a0c626d77c167
      requested nct id
      NCT00118352
      primary nct id
      NCT00118352
      source kind
      ctgov_condition_query
      source record id
      Source null
      source file sha256
      69c40ed34b17434f684079ec5635264bc5ad292871a86b835704fc99fa9d8157
      payload sha256
      4b739a0c6dfeb473556687644de542b7247e6c0212dabc59c41f1d2753b67827
      payload
      clinical indication matching status
      condition_index_match_asserted_by_registry_not_reviewed
      end exclusive
      true
      id
      nct-edge-e746397a0c626d77c167
      link basis
      returned_by_explicit_condition_and_posted_results_filter_query
      nct id
      NCT00118352
      occurrences
      1. context exact
        NCT00118352
        end
        11
        exact text
        NCT00118352
        start
        0
      offset unit
      unicode_code_points
      query cond
      Small Intestine Cancer
      query disease state id
      ds-small-intestine-cancer
      source file
      /Users/arunverma/Documents/ChatGPT/Cancer Statistics Website/research-data/2026-09-10/clinicaltrials-condition/round-0000/raw/cond-small-intestine-cancer-000.json
      source file sha256
      69c40ed34b17434f684079ec5635264bc5ad292871a86b835704fc99fa9d8157
      source json pointer
      /studies/56/protocolSection/identificationModule/nctId
      source kind
      ctgov_condition_query
      source record id
      Source null
      source string basis
      parsed_JSON_string_unmodified
      source string sha256
      8ae28aa1a022b179ff4a29ad796d3dab7d6154066774cbe300b7755ff32fbf36
    10. release id
      ctgov-registry-1336d216cbd1bbff780dac70
      edge id
      nct-edge-f2d1895f308124ce7dae
      requested nct id
      NCT00118352
      primary nct id
      NCT00118352
      source kind
      ctgov_condition_query
      source record id
      Source null
      source file sha256
      cddcd4e3a59550bc78924062a298c359d8f811413f73f4a4461963aecf3790d6
      payload sha256
      769ba273f74f33b2ef9e90961f0c3b2eb6ba062b9a13080426b75a4373c3baf1
      payload
      clinical indication matching status
      condition_index_match_asserted_by_registry_not_reviewed
      end exclusive
      true
      id
      nct-edge-f2d1895f308124ce7dae
      link basis
      returned_by_explicit_condition_and_posted_results_filter_query
      nct id
      NCT00118352
      occurrences
      1. context exact
        NCT00118352
        end
        11
        exact text
        NCT00118352
        start
        0
      offset unit
      unicode_code_points
      query cond
      Juvenile Myelomonocytic Leukemia
      query disease state id
      ds-juvenile-myelomonocytic-leukemia
      source file
      /Users/arunverma/Documents/ChatGPT/Cancer Statistics Website/research-data/2026-09-10/clinicaltrials-condition/round-0000/raw/cond-juvenile-myelomonocytic-leukemia-000.json
      source file sha256
      cddcd4e3a59550bc78924062a298c359d8f811413f73f4a4461963aecf3790d6
      source json pointer
      /studies/78/protocolSection/identificationModule/nctId
      source kind
      ctgov_condition_query
      source record id
      Source null
      source string basis
      parsed_JSON_string_unmodified
      source string sha256
      8ae28aa1a022b179ff4a29ad796d3dab7d6154066774cbe300b7755ff32fbf36

    Preserved source evidence · Not medical advice