Acute Myelogenous Leukemia, Lymphoma, Multiple Myeloma
Conditions
Keywords
Mobilization, Stem Cell, Parathyroid Hormone
Brief summary
The purpose of this study is to determine the safety of parathyroid hormone in combination with G-CSF when used as a stem cell mobilization regimen for patients who fail to mobilize sufficient progenitor stem cells after one or two attempts.
Detailed description
Patients will start treatment within 21 days of the determination of inadequate mobilization. PTH treatment will be given in 4 cohorts: 40 mcg, 60 mcg, 80 mcg, and 10 mcg. PTH will be given on day 1 and continue until stem cell collections are complete or a maximum of 20 days. G-CSF 10 mcg/kg will be given on days 10-14 and continue until stem cell collections are complete. Patients with inadequate CD34+ cells on Day 14 will meet off study criteria and not continue with PTH/G-CSF.
Interventions
Sponsors
Dana-Farber Cancer Institute
Beth Israel Deaconess Medical Center
Massachusetts General Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Disease status: NHL or HD refractory to chemotherapy, relapsed, o high risk first remission; multiple myeloma; AML in second or subsequent remission or in first remission with adverse cytogenetics or antecedent hematologic disorder. * Failed one or two mobilization attempts. * ECOG performance status of 0, 1, or 2.
Exclusion criteria
* Cardiac disease: symptomatic congestive heart failure, angina pectoris or uncontrolled hypertension * Pulmonary disease: severe chronic obstructive lung disease, or symptomatic restrictive lung disease. * Renal disease: serum creatinine \> 2 mg/dl * Hepatic disease: SGOT or SGPT \> 3x normal; serum bilirubin \> 2.0 mg/dl that is not due to Gilbert's syndrome or hemolysis * Calcium \> 10.5 * Phosphate \< 1.6 * Uncontrolled infection * Pregnancy or breast feeding mother
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess safety of parathyroid hormone in combination with G-CSF when used as a mobilization agent at four different dosing levels. | — |
Secondary
| Measure | Time frame |
|---|---|
| To evaluate CD34+ cells/kg from apheresis after second mobilization. | — |
| To evaluate the percent of patients for whom adequate numbers of CD34+ cells are obtained. | — |
| To evaluate the peripheral blood CD34+ count after second mobilization. | — |
| To evaluate the days to neutrophil engraftment (ANC >500) post autologous transplant. | — |
| To evaluate the days to platelet engraftment (platelet count > 20,000 unsupported). | — |
| To evaluate transfusion support. | — |
Countries
United States
Outcome results
None listed