Treatment of Patients With Hematological Malignancies Using Marrow Transplantation From Unrelated Donors Incompatible for One HLA Locus Antigen
- Compare the incidence of graft-versus-host disease (GVHD) grades III and IV in patients
with hematologic malignancies treated with bone marrow transplantation (BMT) using
donors with 1 HLA-A or B non-cross-reactive group mismatch vs control patients
previously treated with BMT using donors with 1 HLA-A or B cross-reactive group (CREG)
- Compare the incidence of GVHD grades III and IV in patients with hematologic
malignancies treated with BMT using donors with 1 HLA-A or B CREG mismatch vs control
patients previously treated with BMT using matched donors.
- Determine the relevance of HLA-DRB1 or DQB1 allele mismatching in BMT using donors
matched for HLA-A, B, and C.
OUTLINE: Beginning at least 3 weeks after completion of cytoreductive combination
chemotherapy, patients under age 18 undergo total body irradiation (TBI) twice a day on days
-7 to -4. Patients age 18 and over undergo TBI twice a day on days -6 to -4. All patients
then receive cyclophosphamide IV daily on days -3 and -2. Males with acute lymphocytic
leukemia, high-grade lymphoma, intermediate-grade lymphoma, or marrow or CNS involvement
receive radiotherapy boost to the testes. On day 0, patients receive infusion of bone marrow
from unrelated donors with 1 of the following: 1 HLA-A or B non-cross-reactive group
mismatch; 1 HLA-A or B cross-reactive group mismatch; or an HLA-A, B, and C match with an
HLA-DRB1 or DQB1 mismatch.
Patients are followed every 6 months for 2 years and then annually thereafter.
PROJECTED ACCRUAL: A total of 150 patients will be accrued for this study within 5 years.
Primary Purpose: Treatment
Claudio Anasetti, MD
Fred Hutchinson Cancer Research Center
United States: Federal Government
|Fred Hutchinson Cancer Research Center||Seattle, Washington 98109|