150 Participants Needed

Auto Stem Cell Transplant for Lymphoma

TK
Overseen ByTimothy Krepski
Age: Any Age
Sex: Any
Trial Phase: Phase 2
Sponsor: Masonic Cancer Center, University of Minnesota
Must be taking: Anti-HIV therapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are HIV positive, you must be on a maximally active anti-HIV regimen as determined by your doctor.

What data supports the effectiveness of the treatment Auto Stem Cell Transplant for Lymphoma?

Research shows that high-dose chemotherapy followed by autologous stem cell transplantation is effective for treating relapsed or refractory Hodgkin and non-Hodgkin lymphoma, with studies reporting high survival rates and disease-free progression. The BEAM regimen, which includes carmustine and melphalan, is commonly used and has shown similar effectiveness to other regimens with potentially less toxicity.12345

Is the auto stem cell transplant for lymphoma generally safe for humans?

The safety of auto stem cell transplants for lymphoma has been studied, showing that while effective, high-dose chemotherapy regimens can lead to significant side effects. These include organ toxicity, such as liver and kidney issues, and other complications like mucositis (painful inflammation and ulceration of the mucous membranes lining the digestive tract). However, newer formulations like EVOMELA have shown an acceptable safety profile with reduced complications.36789

How is the Auto Stem Cell Transplant for Lymphoma treatment different from other treatments?

This treatment is unique because it combines high-dose chemotherapy with drugs like BCNU (carmustine), cyclophosphamide, and melphalan, along with total body irradiation and peripheral blood stem cell transplantation, which helps restore the patient's blood cells after intensive treatment. This approach is particularly used for patients with relapsed or refractory lymphoma, offering a comprehensive strategy to eliminate cancer cells and support recovery.35101112

What is the purpose of this trial?

This is a phase II study of autologous transplant for patients with Hodgkin (HL) and non-Hodgkin lymphomas (NHL) including those who are HIV positive.

Research Team

Veronika Bachanova | University of ...

Veronika Bachanova, MD

Principal Investigator

Masonic Cancer Center, University of Minnesota

Eligibility Criteria

This trial is for lymphoma patients, including those with HIV, who have not responded well to previous treatments. They must be in good physical condition (Karnofsky/Lansky score ≥80%), without severe liver disease or serious organ dysfunction. Eligible participants include those with various types of lymphoma such as Mature T-Cell and Mantle Cell Lymphoma after certain responses to therapy, and specific criteria are set for Hodgkin's Lymphoma stages and treatment responses.

Inclusion Criteria

My Lymphoblastic Lymphoma is in second or later complete remission or in first or later partial remission.
I have Mature T-Cell Lymphoma and have undergone initial therapy.
I have Hodgkin Lymphoma and my previous treatments didn't work.
See 6 more

Exclusion Criteria

Pregnant or breastfeeding females
Patients eligible for any higher priority transplant protocols
My cancer did not respond to chemotherapy.
See 1 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive autologous stem cell transplant with either BEAM, CBV, or CY/TBI regimens

4-6 weeks

Engraftment

Monitoring for platelet and neutrophil engraftment

Up to engraftment

Follow-up

Participants are monitored for progression-free survival, overall survival, and secondary malignancies

3 years

Treatment Details

Interventions

  • BCNU
  • Cyclophosphamide
  • Melphalan
  • Peripheral blood stem cell transplantation
  • Total Body Irradiation
Trial Overview The study tests autologous stem cell transplantation combined with chemotherapy drugs like Etoposide, AraC, G-CSF, Cyclophosphamide, BCNU, Melphalan and procedures like Total Body Irradiation on patients with Hodgkin's and non-Hodgkin's lymphomas. It aims to see how effective this approach is for those who haven't had success with other treatments.
Participant Groups
3Treatment groups
Experimental Treatment
Group I: CY/TBIExperimental Treatment4 Interventions
Cyclophosphamide/Total Body Irradiation (CY/TBI) for patients with recent history of CNS lymphoma or those with allergies/contra-indications to agents used in BEAM
Group II: CBV: HLExperimental Treatment3 Interventions
Cyclophosphamide, BCNU and VP-16 (CBV) for HL patients
Group III: BEAM: NHL & HLExperimental Treatment6 Interventions
BCNU, etoposide, Ara-C and melphalan (BEAM) for all NHL and those HL patients who are unable to receive CBV

BCNU is already approved in United States, European Union, Canada for the following indications:

🇺🇸
Approved in United States as Carmustine for:
  • Brain tumors
  • Hodgkin's disease
  • Non-Hodgkin's lymphoma
  • Multiple myeloma
🇪🇺
Approved in European Union as Carmustine for:
  • Brain tumors
  • Hodgkin's disease
  • Non-Hodgkin's lymphoma
  • Multiple myeloma
🇨🇦
Approved in Canada as Carmustine for:
  • Brain tumors
  • Hodgkin's disease
  • Non-Hodgkin's lymphoma
  • Multiple myeloma

Find a Clinic Near You

Who Is Running the Clinical Trial?

Masonic Cancer Center, University of Minnesota

Lead Sponsor

Trials
285
Recruited
15,700+

Findings from Research

In a study involving 77 patients with Hodgkin's disease and non-Hodgkin's lymphoma, high-dose etoposide combined with either fractionated total body irradiation (TBI) or carmustine before autologous bone marrow transplantation showed promising results, with a 1-year survival rate of 85% for TBI patients and 79% for carmustine patients.
Despite the effectiveness, there was an 8% rate of toxic deaths, all occurring in the carmustine group, highlighting a safety concern associated with this treatment regimen.
The Stanford experience with high-dose etoposide cytoreductive regimens and autologous bone marrow transplantation in Hodgkin's disease and non-Hodgkin's lymphoma: preliminary data.Horning, SJ., Chao, NJ., Negrin, RS., et al.[2020]
Patients with hematological malignancies experienced slower recovery of neutrophils and platelets after autologous peripheral blood stem cell transplantation compared to those with solid tumors, indicating a higher risk of complications.
Hematological malignancy patients required more red blood cell and platelet transfusions, had longer hospital stays, and experienced more severe mucositis, highlighting the increased transplant-related complications in this group.
Differences in transplant-related complications between hematologic malignancies and solid tumors receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation.Martino, M., Morabito, F., Console, G., et al.[2022]
In a study of 101 lymphoma patients undergoing autologous stem cell transplantation, the mitoxantrone-melphalan (Mx-Mel) regimen showed similar efficacy to the BEAM regimen while being less toxic, making it a promising alternative for patients who cannot tolerate high cytotoxic treatments.
Although the BEAM regimen resulted in a statistically shorter time to neutrophil engraftment (10 days) compared to Mx-Mel (12 days), both regimens did not lead to significant differences in transplant-related complications, indicating that Mx-Mel is a safe option with effective outcomes.
Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens in Patients with Lymphoma.Gunes, AK., Serin, I., Demir, I., et al.[2023]

References

The Stanford experience with high-dose etoposide cytoreductive regimens and autologous bone marrow transplantation in Hodgkin's disease and non-Hodgkin's lymphoma: preliminary data. [2020]
Differences in transplant-related complications between hematologic malignancies and solid tumors receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation. [2022]
Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens in Patients with Lymphoma. [2023]
Cyclophosphamide, carmustine, and etoposide with autologous bone marrow transplantation in refractory Hodgkin's disease and non-Hodgkin's lymphoma: a dose-finding study. [2017]
BEAM-Modified Conditioning Therapy with Cisplatin+Dexamethasone Instead of Carmustine Prior to Autologous Hematopoietic Stem Cell Transplantation (HSCT) in Patients with Hodgkin and Non-Hodgkin Lymphoma. [2020]
A Retrospective Comparison of Mitoxantrone-Melphalan and BEAM Conditioning Regimens Before Autologous Hematopoietic Stem Cell Transplantation in Relapsed/Refractory Lymphoma Patients. [2023]
A Phase IIb, Multicenter, Open-Label, Safety, and Efficacy Study of High-Dose, Propylene Glycol-Free Melphalan Hydrochloride for Injection (EVOMELA) for Myeloablative Conditioning in Multiple Myeloma Patients Undergoing Autologous Transplantation. [2017]
High-dose combination alkylating agents with autologous bone marrow support: a Phase 1 trial. [2017]
Carmustine, Ara C, cyclophosphamide and etoposide with autologous bone marrow transplantation in relapsed or refractory lymphoma: a dose-finding study. [2013]
10.United Statespubmed.ncbi.nlm.nih.gov
Comparison of autologous bone marrow transplantation with sequential chemotherapy for intermediate-grade and high-grade non-Hodgkin's lymphoma in first complete remission: a study of 464 patients. Groupe d'Etude des Lymphomes de l'Adulte. [2017]
Multiple myeloma preparative regimens for high-dose therapy and autologous transplantation: what's new? [2013]
A Retrospective Comparison of TECAM and BEAM Conditioning Regimens Before Autologous Hematopoietic Stem Cell Transplant in Lymphoma Patients: Efficacy and Toxicity. [2019]
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