This phase II trial studies the how well donor stem cell transplant works in treating patients with high risk hematologic malignancies. Giving total-body irradiation and chemotherapy before a donor stem cell transplant helps stop the growth of cells in the bone marrow, including normal blood-forming cells (stem cells) and cancer cells. It may also stop the patient's immune system from rejecting the donor's stem cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. The donated stem cells may also replace the patient's immune cells and help destroy any remaining cancer cells.
Primary Objective: 1\. To assess 2 year probability of OS in high risk patients undergoing a myeloablative 2 step HSCT utilizing strategies to decrease relapse. Secondary Objective: 1. To assess relapse incidence at 2 years post-HSCT of patients undergoing treatment on this protocol. 2. To assess regimen related toxicity and GVHD incidence at 2 years post-HSCT and severity in patients undergoing treatment on this protocol. 3. To assess the consistency and pace of engraftment. 4. To assess the pace of T cell and B cell immune recovery.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
51
Undergo Total Body Irradiation
Undergo Donor Lymphocyte Infusion
Given IV
Given IV
Given IV
Undergo Hematopoietic Stem Cell Transplantation
Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University
Philadephia, Pennsylvania, United States
Overall Survival (OS)
Will be tested using an exact one-sided binomial test with alpha 0.05. The trial will be considered successful if the null hypothesis of 45% 2-year OS is rejected. In addition, the exact binomial 95% confidence interval for 2-year OS will be computed.
Time frame: At two years
Incidence of graft failure
Should be less than 10%
Time frame: Up to 2 years
Incidence of non-relapse mortality
Should be less than 20% at 100 days
Time frame: Up to 2 years
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