Allogeneic Hematopoietic Stem Cell Transplantation for Hematologic Malignancies After a Non-Myeloablative Conditioning Regimen From HLA-Matched Sibling Donors
OBJECTIVES: I. Determine whether donor hematopoiesis can be safely established using a
nonmyeloablative conditioning regimen followed by HLA matched sibling donor peripheral blood
stem cell transplantation in patients with hematologic malignancies. II. Determine whether
mixed chimerism can be safely converted to full donor hematopoiesis with this treatment
regimen in these patients. III. Determine the toxicity and incidence of aplasia and graft
versus host disease in these patients treated with this regimen. IV. Determine the antitumor
potential of this treatment regimen in these patients. V. Determine the role of NFkB in the
modulation of the cytokine secretion profile of T lymphocytes during an alloimmune response
in these patients treated with this regimen.
OUTLINE: Patients receive immunosuppressive medications consisting of oral mycophenolate
mofetil and tacrolimus twice a day beginning on day -8 and continuing through day 45 (in the
absence of graft versus host disease). Patients also receive daclizumab IV over 30 minutes
on days -1, 3, and 8. Patients undergo allogeneic peripheral blood stem cell (PBSC)
transplantation with donor CD34+ cells IV on day 0. If there is 0-80% donor hematopoiesis,
patients receive donor lymphocyte infusions with CD3+ cells IV on days 75, 165, and 270.
PROJECTED ACCRUAL: A total of 10-45 patients will be accrued for this study.
Primary Purpose: Treatment
Bijoyesh Mookerjee, MD
Jefferson Medical College of Thomas Jefferson University
United States: Federal Government
|Marlene & Stewart Greenebaum Cancer Center, University of Maryland||Baltimore, Maryland 21201|