GRANULOCYTE-MACROPHAGE COLONY STIMULATING FACTOR (Rhu-GM-CSF) FOR REDUCTION OF LEUKEMIC RELAPSE AFTER T-LYMPHOCYTE DEPLETED ALLOGENEIC BMT FOR CHRONIC MYELOID LEUKEMIA
sargramostim
+ therapeutic allogeneic lymphocytes
+ allogeneic bone marrow transplantation
Bone Marrow Diseases+14
+ Chronic Disease
+ Hematologic Diseases
Treatment Study
Summary
Study start date: February 1, 1995
Actual date on which the first participant was enrolled.OBJECTIVES: Determine whether the use of sargramostim (GM-CSF) after T-cell depleted, CD34-positive cell-supplemented allogeneic bone marrow transplantation can reduce leukemic relapse in patients with chronic myelogenous leukemia. OUTLINE: Patients receive myeloablation with busulfan and cyclophosphamide on an approved protocol. Allogeneic bone marrow is harvested and treated in vitro with anti-CD34 antibody. T-cell depleted, CD34-positive cell-supplemented bone marrow is infused on day 0. Patients receive high-dose sargramostim (GM-CSF) subcutaneously (SC) beginning on day 5 and continuing until blood counts recover and then low-dose GM-CSF SC continuing until day 60. Donor lymphocyte infusions or second unmodified allogeneic bone marrow transplantation without GM-CSF is considered in case of primary or secondary engraftment failure. Patients are followed every month for 3 months, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter. PROJECTED ACCRUAL: A total of 40 patients will be accrued for this study within approximately 6-10 years.
Protocol
This section provides details of the study plan, including how the study is designed and what the study is measuring.40 patients to be enrolled
Total number of participants that the clinical trial aims to recruit.Treatment Study
Eligibility
Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.Any sex
Biological sex of participants that are eligible to enroll.From 18 to 65 Years
Range of ages for which participants are eligible to join.Healthy volunteers not allowed
If individuals who are healthy and do not have the condition being studied can participate.Conditions
Pathology
Criteria
DISEASE CHARACTERISTICS: Diagnosis of chronic myelogenous leukemia (CML) documented by cytogenetic and molecular analyses at Johns Hopkins Philadelphia chromosome (Ph)-positive or -negative CML Ph-negative CML allowed with presence of either: BCR-ABL rearrangement (on molecular, fluorescent in situ hybridization, or polymerase chain reaction analyses) p210 protein One of the following: Patient age 18 to 65 Disease duration longer than 3 years Accelerated phase CML Accelerated phase diagnosis based on any of the following: More than 10% to less than 30% blasts in blood or bone marrow No hematologic response to prior conventional therapy (hydroxyurea or interferon) Extramedullary disease (e.g., progressive splenomegaly or lymphadenopathy) Basophilia greater than 10% in blood or bone marrow Other cytogenetic abnormalities in addition to a single Ph chromosome Second chronic phase Failure on interferon suggested of patients over age 18 with chronic phase CML, with failure defined as: No detectable Ph-negative metaphases in marrow after 6 months No progressive increase in Ph-negative metaphases in marrow after 6-12 months Less than 50% Ph-negative metaphases after 1 year No complete cytogenetic remission after 2 years Intolerance to interferon therapy No blast crisis CML, chronic myelomonocytic leukemia, or juvenile CML The following conditions are allowed: Leukocyte count abnormalities Fibrosis Anemia Fever or bone pain Thrombocytopenia Bone marrow reticulin Availability of an HLA-identical sibling donor At least 3 years of age (priority given to donors over age 10) Priority given to CMV-negative donor if patient CMV-negative No medical or psychiatric condition that precludes transplant procedure PATIENT CHARACTERISTICS: Age 18 to 65 Performance status ECOG 0-1 Life expectancy Not specified Hematopoietic See Disease Characteristics Hepatic Not specified Renal Not specified Other No history of intolerance to sargramostim (GM-CSF) PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics Chemotherapy See Disease Characteristics Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified
Study Centers
These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.This study has 1 location
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Baltimore, United StatesOpen Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Google Maps