Immune Reconstitution After Autologous Hematopoietic Stem Cell Transplantation for High-Risk Lymphoma and Myeloma
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Number of Participants Experiencing Immune Reconstitution
研究概览
简要总结
RATIONALE: Vaccines may help the body build an effective immune response to kill cancer cells. Giving vaccine therapy after an autologous stem cell transplant may kill any cancer cells that remain after transplant.
PURPOSE: This clinical trial is studying how well vaccine therapy works in treating patients who have undergone autologous stem cell transplant for high-risk lymphoma or multiple myeloma.
详细描述
OBJECTIVES:
Primary
- Assess immune reconstitution as measured by response to pneumococcal polyvalent vaccine, NK-cell activity against autologous lymphoblastoid cell lines, and cytomegalovirus and Epstein-Barr virus tetramer responses in patients who have undergone autologous hematopoietic stem cell transplantation for high-risk lymphoma or multiple myeloma.
Secondary
- Assess the absolute number of circulating regulatory T-cells and the function of these cells as measured by their expression of TGFβ and interleukin-10 (IL-10).
- Evaluate the effect of conditioning therapy on quality of life, including functional status, fatigue, and depression, in these patients.
- Correlate quality of life with inflammatory cytokine production of peripheral blood monocytes at specified time points.
- Provide baseline immune reconstitution and quality of life pilot data for comparison in future post-transplant immunotherapy trials.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •DISEASE CHARACTERISTICS:
- •Diagnosis of multiple myeloma OR any of the following high-risk lymphomas:
- •Diffuse large B-cell lymphoma meeting any of the following criteria:
- •Failed induction therapy but responded to salvage therapy
- •Relapsed < 1 year after completion of induction therapy
- •Elevated lactic dehydrogenase (LDH) at relapse
- •Stage III or IV disease at relapse
- •Positive PET scan after induction or salvage therapy
- •Age 60 to 75 years
- •Follicular lymphoma meeting any of the following criteria:
- •Progressive disease after two or more prior regimens
- •Transformed to aggressive diffuse large B-cell lymphoma but is still chemotherapy sensitive
- •Not considered to be a good candidate for allogeneic stem cell transplantation
- •Hodgkin lymphoma meeting any of the following criteria:
- •Primary refractory disease
- •Relapsed < 1 year after completion of induction therapy
- •Relapsed with PET positive disease after salvage therapy
- •Relapsed refractory disease and is not considered to be a good candidate for allogeneic stem cell transplantation
- •Mantle cell lymphoma meeting any of the following criteria:
- •Chemotherapy sensitive disease after induction therapy
- •Chemotherapy sensitive relapsed disease and is not considered to be a good candidate for allogeneic stem cell transplantation
- •T-cell non-Hodgkin lymphoma (NHL) meeting any of the following criteria:
- •Peripheral T-cell lymphoma, not otherwise specified meeting at least one of the following criteria:
- •High LDH at diagnosis
- •Marrow involvement at diagnosis
- •Age > 60 years at diagnosis
- •Low platelet count at diagnosis
- •Chemotherapy sensitive relapsed disease
- •Angioimmunoblastic lymphadenopathy with dysproteinemia
- •ALK-negative anaplastic NHL
- •Enteropathy-associated T-cell NHL
- •Stage III or IV NK-/T-cell NHL at diagnosis
- •NK-blastic NHL
- •Has undergone autologous hematopoietic stem cell transplantation and received 200 mg/m² of melphalan (for multiple myeloma) OR BEAM chemotherapy comprising carmustine, etoposide, cytarabine, and methotrexate (for high-risk lymphoma) as conditioning therapy
- •PATIENT CHARACTERISTICS:
- •ECOG or WHO performance status 0-2
- •ANC ≥ 1,000/μL
- •Platelet count ≥ 75,000/μL
- •Total bilirubin ≤ 1.5 mg/dL
- •Alkaline phosphatase ≤ 2 times upper limit of normal (ULN)
- •AST and ALT ≤ 2 times the ULN
- •Not pregnant or nursing
- •No severe or uncontrolled systemic illness
- •No "currently active" second malignancy, other than nonmelanoma skin cancer or carcinoma in situ of the cervix
- •Patients are not considered to have a "currently active" malignancy if they completed therapy for the malignancy, are disease free from the malignancy for > 5 years, and are considered by their physician to be at < 30% risk of relapse
- •No significant history of uncontrolled cardiac disease including, but not limited to, any of the following:
- •Uncontrolled hypertension
- •Unstable angina
- •Recent myocardial infarction (within the past 6 months)
- •Uncontrolled congestive heart failure
- 另有 5 项未显示
排除标准
- 未提供
研究组 & 干预措施
Prevnar
The conjugate vaccine for Streptococcus pneumoniae will be administered during weeks 9, 17, and 25 after autologous HSCT - the study nurse will arrange for the vaccine to be administered at the specified time and the patient will be instructed to notify an investigator or study nurse of any side effects of vaccine administration. At the specified times, patients will fill out the quality-of-life assessment. All patients enrolled on this trial will have samples procured for all proposed laboratory correlative studies.
干预措施: laboratory correlative studies (Other)
Prevnar
The conjugate vaccine for Streptococcus pneumoniae will be administered during weeks 9, 17, and 25 after autologous HSCT - the study nurse will arrange for the vaccine to be administered at the specified time and the patient will be instructed to notify an investigator or study nurse of any side effects of vaccine administration. At the specified times, patients will fill out the quality-of-life assessment. All patients enrolled on this trial will have samples procured for all proposed laboratory correlative studies.
干预措施: quality-of-life assessment (Other)
Prevnar
The conjugate vaccine for Streptococcus pneumoniae will be administered during weeks 9, 17, and 25 after autologous HSCT - the study nurse will arrange for the vaccine to be administered at the specified time and the patient will be instructed to notify an investigator or study nurse of any side effects of vaccine administration. At the specified times, patients will fill out the quality-of-life assessment. All patients enrolled on this trial will have samples procured for all proposed laboratory correlative studies.
干预措施: Streptococcus pneumoniae (Biological)
结局指标
主要结局
Number of Participants Experiencing Immune Reconstitution
时间窗: Up to 2 years
Immune reconstitution as measured by response to conjugate vaccine to Streptococcus pneumoniae (Prevnar, PCV7), NK cell activity against autologous lymphoblastoid cell lines, and CMV \& EBV tetramer responses after autologous transplant for myeloma
次要结局
- Quality of Life, Including Brief Pain Inventory(Up to 3 years)
- Serial Assessment of the Absolute Number of Circulating Regulatory T-cells and the Function of These Cells as Measured by Their Expression of TGFβ and Interleukin-10 (IL-10)(Up to 3 years)
- Correlation of Quality of Life With Inflammatory Cytokine Production of Peripheral Blood Monocytes(Up to 3 years)
- Quality of Life, Including Fatigue(Up to 3 years)
- Collection of Baseline Immune Reconstitution and Quality of Life Pilot Data for Comparison in Future Post-transplant Immunotherapy Trials(Up to 3 years)