Investigator-Initiated Trial: Sequential Regimen of Intensive Chemotherapy Followed by Stem Cell Transplant for Refractory Lymphoma

Update: this study is closed to enrollment. 

The Weill Cornell Hematologic Malignancies & Bone Marrow Transplant Program is now enrolling men and women with relapsed or refractory lymphoma (non-Hodgkin or Hodgkin) and who are in need of a stem cell transplant for an investigator-initiated clinical trial. The principal investigator is Tsiporah B. Shore, M.D. For more information about the study, please call June Greenberg, RN at (212) 746-2651, e-mail June at jdg2002@med.cornell.edu, or call the Bone Marrow Transplant Program at (212) 746-2119.

Study Details

This clinical trial is for men and women whose lymphoma (non-Hodgkin or Hodgkin) did not respond to treatment or has returned after responding to previous therapy, and who are in need of a stem cell transplant.

The purpose of the study is to test the safety and effectiveness of giving the drug Bendamustine, followed by high dose chemotherapy, within two weeks prior to a stem cell transplant for lymphoma that has not achieved a complete response to salvage chemotherapy (treatment used for relapsed disease).

Bendamustine is FDA-approved for the treatment of Chronic Lymphocytic Leukemia. Although Bendamustine has been used in stem cell research studies, the timing and combination of Bendamustine and the conditioning regimen BEAM (carmustine, etoposide, cytarabine arabinoside, and melphalan) prior to transplant is not approved by the FDA, thus the combination therapy used in this research study is considered experimental.

Autologous stem cell transplants refer to stem cells that are collected from an individual and given back to that same individual after high dose chemotherapy. With this type of transplant, the person’s stem cells are obtained prior to high-dose chemotherapy, frozen, stored-if necessary, and then given back afterward. Allogeneic stem cell transplantation refers to stem cells that are collected from a donor.

Treatment Plan

Study participants will receive Continue reading “Investigator-Initiated Trial: Sequential Regimen of Intensive Chemotherapy Followed by Stem Cell Transplant for Refractory Lymphoma”

ASH 2011: Major Advances in Allogeneic Stem Cell Transplant Offer New Hope For Patients with Hematologic Malignancies

By Koen van Besien, MD, PhD

Allogeneic transplant can be curative for patients with lymphoma and is often effective in difficult situations where other treatments have failed. Unfortunately very few of us have suitable sibling donors and in a multi-ethnic society such as the US, finding HLA-identical donors in the transplant registry can also represent a challenge.  Several studies presented at the Annual Society of Hematology meeting offer evidence of rapid progress and increased success in the field of mismatched transplantation.  Dr. Symons from John’s Hopkins used mismatched related donors  ( also called haplo-identical donors i.e relatives who are partially HLA-identical) and with a novel chemotherapy regimen and  GVHD prophylaxis reported a low risk for graft vs host disease and excellent outcomes in patients with very high risk disease. Using similar technology even better results were reported by Dr. Bashey from Atlanta. He reported that the outcomes of such haplo-transplant were similar to those of transplants from HLA-identical siblings.  We used a slightly different approach and combined a haplo-identical transplant with an umbilical cord blood graft. In this procedure, the umbilical cord blood graft tends to assure long term hematopoiesis and may provide a more robust immune system with very little chronic graft vs host disease. We presented data on 51 patients with hematologic malignancies and the group from NIH used a similar approach to treat 10 pts with aplastic anemia. Both groups showed excellent rates of recovery and a high percentage of patients achieving prolonged remissions.  Dr. van Rood showed that the choice of umbilical cord graft may minimize the risk for disease recurrence.  It is too early to know which of these approaches, haplo or haplo-cord transplantation will ultimately become widely accepted, but the field is moving rapidly and options for patients who lack a sibling donor are rapidly improving.

Allogeneic transplantation for Hodgkin’s lymphoma

Though most patients with Hodgkin’s Lymphoma (HL) are cured with their initial treatment, a small percentage of them fail to achieve remission or relapse after initial treatment. Such patients usually receive a salvage chemotherapy regimen followed by autologous stem cell transplantation. However, only half of those undergoing autologous transplant are cured, and that percentage is even lower for those with incomplete responses to salvage. Using an innovative approach, Continue reading “ASH 2011: Major Advances in Allogeneic Stem Cell Transplant Offer New Hope For Patients with Hematologic Malignancies”