Clinical Trials /

Chemotherapy Plus Ofatumumab Followed by G-CSF for Mobilization of Peripheral Blood Stem Cells in Patients With Non-Hodgkin's Lymphomas

NCT01329900

Description:

The goal of this clinical research study is to learn if it is possible to collect stem cells after ofatumumab and chemotherapy treatment. This study will also evaluate side-effects, number of stem cells collected, and the number of procedures that are needed to collect enough stem cells.

Related Conditions:
  • Mature B-Cell Lymphoma/Leukemia
Recruiting Status:

Active, not recruiting

Phase:

Phase 2

Trial Eligibility

Document

<span class="go-doc-concept go-doc-intervention">Stem Cell</span> Collection With <span class="go-doc-concept go-doc-intervention">Ofatumumab</span>

Title

  • Brief Title: Stem Cell Collection With Ofatumumab
  • Official Title: Chemotherapy Plus Ofatumumab Followed by G-CSF for Mobilization of Peripheral Blood Stem Cells in Patients With Non-Hodgkin's Lymphomas
  • Clinical Trial IDs

    NCT ID: NCT01329900

    ORG ID: 2009-0796

    NCI ID: NCI-2011-01068

    Trial Conditions

    Lymphoma

    Trial Interventions

    Drug Synonyms Arms
    Ofatumumab Arzera Ofatumumab + Stem Cell Collection
    Ifosfamide Ifex Ofatumumab + Stem Cell Collection
    Etoposide VePesid Ofatumumab + Stem Cell Collection
    Mesna Mesnex Ofatumumab + Stem Cell Collection
    G-CSF Filgrastim, Neupogen, Granulocyte colony-stimulating factor, GCSF Ofatumumab + Stem Cell Collection

    Trial Purpose

    The goal of this clinical research study is to learn if it is possible to collect stem cells
    after ofatumumab and chemotherapy treatment. This study will also evaluate side-effects,
    number of stem cells collected, and the number of procedures that are needed to collect
    enough stem cells.

    Detailed Description

    The Study Drugs:

    Ofatumumab is a human monoclonal antibody for the CD20 protein designed to bind to the
    surface of some of the white blood cells (B-cells). It can destroy cancer cells that come
    from B-cells, and can be used to treat cancers of B-cells such as resistant CLL (chronic
    lymphocytic leukemia).

    Etoposide is designed to slow or stop the growth of cancer cells.

    Filgrastim promotes the growth of white blood cells, which help to fight infections.

    Ifosfamide is designed to slow or stop the growth of cancer cells.

    Mesna is a drug that protects bladder cells from damage by the chemotherapy drug ifosfamide.
    It is used to decrease the risk of bleeding in the bladder.

    Treatment Administration:

    You will be admitted to the hospital. You will have to stay in the hospital for 4-6 days for
    this part of the treatment.

    On Day 1, you will receive ofatumumab through the CVL over 6-8 hours.

    On Days 2, 3, and 4, you will receive ifosfamide and mesna continuously and etoposide every
    12 hours. Mesna is given to help decrease the risk of developing side effects.

    As an outpatient, you will receive a higher dose of ofatumumab (about 1 week after the first
    one) through the CVL over 10-12 hours.

    Beginning on Day 6, you will get G-CSF (filgrastim) injections (given under the skin) and
    will continue to be given until enough stem cells have been collected.

    Tests and Procedures:

    Every day while you are in the hospital, you will have a physical exam and you will be asked
    about any side effects you may be having. After you are no longer in the hospital, you will
    have a physical exam and you will be asked about any side effects you may be having when the
    doctor thinks it is needed.

    While you are waiting for enough stem cells to be collected, you will have blood drawn
    (about 1 tablespoon) for routine tests at least 3 times a week. If your doctor thinks it is
    needed, you may have blood drawn more often.

    Stem Cell Collection:

    Blood stem cells will be collected when your blood counts have returned to normal (about
    10-16 days after chemotherapy). The process of stem cell collection takes about 4 hours each
    time. You will have stem cells collected each day until enough are collected (between 1-6
    sessions). A machine is attached to the CVL and blood is withdrawn. The blood then flows
    through the machine, which removes stem cells from the blood. The blood is then returned
    back to you through the CVL. The stem cells are then frozen and stored. These stem cells
    will be given back to you after the next phase of treatment to help your blood counts
    recover after high dose chemotherapy. After enough stem cells have been collected, you will
    be admitted to the hospital for high dose chemotherapy. You will sign a separate consent
    before you receive high dose chemotherapy.

    During the stem cell collection, blood (about 2 teaspoons) will be drawn through the CVL to
    check for cell markers that can affect the response of the cell counts and to check the
    status of the disease.

    Length of Study:

    Patients will be followed for up to 12 months after the transplant. You will be taken off
    study early if the stem cell collection does not work.

    This is an investigational study. Etoposide and ifosfamide are FDA approved and are
    commercially available for lymphomas. Ofatumumab has been approved by the FDA for treatment
    of recurrent refractory chronic lymphocytic leukemias. G-CSF and Mesna are FDA approved and
    commercially available. The use of Ofatumumab for the collection of stem cells is
    investigational.

    Up to 50 patients will take part in this study. All will be enrolled at MD Anderson.

    Trial Arms

    Name Type Description Interventions
    Ofatumumab + Stem Cell Collection Experimental Ofatumumab 1000 mg by vein on Day 1 and 2000 mg by vein on Day 8. Ifosfamide 3.33 gm/m2 by vein on Days 2, 3, and 4 continuously. Etoposide 150 mg/m2 by vein over 2 hours every 12 hours for 6 doses. Mesna 2 gm/m2 by vein over 1 hour on Day 2 (given before Ifosfamide starts). Mesna 2.66 gm/m2/day by vein continuous infusion given over 24 hours daily for 3 days starting on Day 2 (together with Ifosfamide). After Ifosfamide/Mesna, 2 gm/m2 by vein given over 12 hours for one dose. G-CSF 6 mcg/kg subcutaneously twice a day on day 6 (rounded off to the nearest vial) until completion of apheresis. Blood stem cells will be collected when blood counts have returned to normal (about 10-16 days after chemotherapy). Stem cell collection takes about 4 hours each time. Ofatumumab, Ifosfamide, Etoposide, Mesna, G-CSF

    Eligibility Criteria

    Inclusion Criteria:

    1. Patients with histologically confirmed CD20 positive B-cell NHL who are candidates
    for autologous SCT.

    2. Patients must have PR to salvage chemotherapy.

    3. Age 18-70 years.

    4. Platelet count >/= 100,00 mm independent of transfusion support.

    5. Absolute neutrophil count >/= 1500/mm.

    6. Zubrod performance status (PS) 2 or less.

    7. Negative serum pregnancy test in women of childbearing potential. This is a female
    who has not been postmenopausal for at least 12 consecutive months or who has not
    undergone previous surgical sterilization.

    8. Less than 5% marrow involvement with NHL within 4 weeks of study as defined by
    unilateral bone marrow aspiration and biopsy.

    9. Seronegativity for HIV, HTLV1, Hepatitis .

    Exclusion Criteria:

    1. Subjects who have current active hepatic ( (HbsAg, HbcAb, and positive viral load by
    PCR) or biliary disease (with exception of patients with Gilbert's syndrome,
    asymptomatic gallstones, liver metastases or stable chronic liver disease per
    investigator assessment) with ALT > 2x upper limit of normal or bilirubin > 1.5.
    (Consult with a physician experienced in care and management of subjects with
    hepatitis B to manage/treat subjects who are anti-HBc positive.)

    2. Active CNS disease.

    3. Severe concomitant medical or psychiatric illness.

    4. Lactating or breast feeding females.

    5. Serum creatinine >1.6 mg/dl.

    6. History of pelvic radiation.

    7. Fludarabine-based chemotherapy within 6 months.

    Minimum Eligible Age: 18 Years

    Maximum Eligible Age: 70 Years

    Eligible Gender: Both

    Primary Outcome Measures

    Mobilization Rate

    Secondary Outcome Measures

    Trial Keywords

    Chemotherapy

    Stem Cell Collection

    Ofatumumab

    Arzerra

    Ifosfamide

    Ifex

    Etoposide

    VePesid

    Mesna

    Mesnex

    G-CSF

    Filgrastim

    Neupogen

    Apheresis