Peripheral Blood Mobilized Hematopoietic Precursor Cell Transplantation Followed by T Cell Add-Back for Hematological Malignancies - Effect of Peri-transplant Cyclosporine on Chimerism

Date de début de l'étude : 1 janvier 2004

INCLUSION CRITERIA: RECIPIENT: * 1. Ages 10-55 years inclusive (but less than 56) * 2. Chronic myelogenous leukemia (CML) in chronic phase * 3. Acute lymphoblastic leukemia (ALL) categories 1. Adults in first remission with high-risk features 2. All second or subsequent remissions, primary induction failure, partially responding or untreated relapse * 4. Acute myelogenous leukemia (AML) 1. AML in first remission Except AML with good risk karyotypes 2. All AML in second or subsequent remission, primary induction failure and resistant relapse * 5. Myelodysplastic syndromes categories 1. refractory anemia with transfusion dependence 2. refractory anemia with excess of blasts 3. transformation to acute leukemia, chronic myelomonocytic leukemia * 6. Myeloproliferative disorders in transformation to acute leukemia * 7. Chronic lymphocytic leukemia refractory to fludarabine treatment and with bulky progressive disease or with thrombocytopenia (less than or equal to 100,000 /micro L) or anemia (less than or equal to 10g/dl) not due to recent chemotherapy * 8. Non-Hodgkin's lymphoma including Mantle cell lymphoma relapsing or refractory to current chemotherapy and monoclonal antibody treatment and unsuitable for autologous stem cell transplantation * 9. No major organ dysfunction precluding transplantation * 10. Diffusion capacity of lung for carbon monoxide (DLCO) greater than or equal to 60% predicted * 11. Left ventricular ejection fraction: greater than or equal to 40% * 12. Eastern Cooperative Oncology Group(ECOG) performance status of 0 or 1 * 13. Able to give informed consent * 14. Negative pregnancy test for women of childbearing age INCLUSION CRITERIA: DONOR * 1. Human leukocyte antigen (HLA) 6/6 identical family donor * 2. Weight greater than or equal to 18 kg * 3. Age greater than or equal to 2 or less than or equal to 80 years old * 4. Fit to receive granulocyte colony -stimulating factor(G-CSF) and give peripheral blood stem cells (normal blood count, normotensive, no history of stroke) EXCLUSION CRITERIA: RECIPIENT * 1. Patient pregnant * 2. Age less than 10 years and 56 years or more * 3. Patients with CML in chronic phase who are 41 years or over in whom imatinib mesylate (STI-571)is the treatment of choice * 4. ECOG performance status of 2 or more * 5. Severe psychiatric illness * 6. Major anticipated illness or organ failure incompatible with survival from BMT * 7. DLCO less than 60% predicted * 8. Left ventricular ejection fraction: less than 40% * 9. Serum creatinine greater than 3mg/dl * 10. Serum bilirubin greater than 4 mg/dl * 11. HIV positive 12. Debilitation or age making the risk of intensive myeloablative therapy unacceptable EXCLUSION CRITERIA: DONOR * 1. Pregnant or lactating * 2. Donor unfit to receive G-CSF and undergo apheresis * 3. HIV positive * 4. Weight less than 18 kg * 5. Age less than 2 or greater than 80 years * 6. Severe psychiatric illness