Malignant Lymphoma
Conditions
Keywords
TEAM (Thiotepa, Etoposide, Cytosar, Melphalan ), autologous stem-cell transplantation (ASCT), malignant lymphoma
Brief summary
Study is designed to explore whether the introduction of Thiotepa, to the pre autologous stem-cell transplantation (ASCT) conditioning will reduce toxicity and thus improve outcome following transplantation in up to 24 patients with malignant lymphoma including both non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma ( HL) improving toxicity profile , reducing side effects while potentially improving the antitumor response. Specifically,we speculate that using the novel Thiotepa based TEAM consisted of THIOTEPA 5mg/kg on days -7-6, etoposide 200 mg/m2 , Cytosar (ARA-C) 200 mg/m2 on days -5,-4, -3, -2 and melphalan 140 mg/m2 on day -1, pre transplantation conditioning regimen may allow transplantation with lower transplant related toxicity and thus improve outcome in this setting. Toward this aim the impact on toxicity profile ,engraftment and disease control will be assessed.
Interventions
DRUGThiotepa
fixed dose 5mg/kg on days -7-6
Sponsors
Sheba Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
TEAM conditioning consisted of THIOTEPA 5mg/kg on days -7-6, etoposide 200 mg/m2 , Cytosar (ARA-C) 200 mg/m2 on days -5,-4, -3, -2 and melphalan 140 mg/m2 on day -1 followed by autologous hematopoietic stem-cell transplantation as per standard institutional protocols.
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Patients with non-Hodgkin's and Hodgkin's lymphoma as confirmed by a pathological biopsy report. 2. Patients who are candidates for Autologous stem-cell transplantation due to refractory or relapsing disease by standard institutional indications and comply with standard transplant eligibility criteria. 3. Age less than physiologic 70 years. 4. Patients with an adequate autologous stem cell collection for transplantation and backup (\>5 x 106 CD34(cluster of differentiation 34)+ cells/kg) .Patients must sign written informed consent. 5. No limitation on bulky disease or bone marrow involvement. No limitation on the number and response to prior therapy. Prior autologous transplantation and/or treatment with rituximab allowed. All prior chemotherapy completed at least three weeks before study treatment
Exclusion criteria
1. Bilirubin \> 3.0 mg/dl, transaminases \> 3 times upper normal limit 2. Creatinine \> 2.0 mg/dl 3. Eastern Cooperative Oncology Group (ECOG) Performance status \> 2 4. Uncontrolled infection 5. Pregnancy or lactation 6. Abnormal lung diffusion capacity (DLCO \< 40% predicted) 7. Severe cardiovascular disease 8. CNS (central nervous system) disease involvement 9. Pleural effusion or ascites \> 1 liter 10. Psychiatric conditions/disease that impair the ability to give informed consent or to adequately co-operate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Toxicities graded by Bearman's criteria and infectious complications | 15 month | To determine the relative toxicity and response rate of TEAM preparative regimen pre- Autologous stem cell transplantation in patients with non-Hodgkin's and Hodgkin's Lymphoma |
Countries
Israel
Outcome results
None listed