Radiation Therapy in Relapsed or Refractory Non-Hodgkin's Lymphoma Who Have Undergone Stem Cell Transplantation
Lymphoma
About this trial
This is an interventional treatment trial for Lymphoma focused on measuring Waldenstrom macroglobulinemia, recurrent adult diffuse large cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult T-cell leukemia/lymphoma, anaplastic large cell lymphoma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed non-Hodgkin's lymphoma Diffuse large cell lymphoma, B-cell (includes primary mediastinal B-cell lymphoma and T-cell rich B-cell lymphoma) Previous indolent lymphoma (follicular center cell lymphoma, marginal zone lymphoma, including extranodal MALT lymphoma and lymphoplasmacytoid lymphoma) with transformation to diffuse large B-cell lymphoma at relapse Peripheral T-cell lymphoma Anaplastic large cell lymphoma (T cell or null cell) Small non-cleaved Burkitt-like lymphoma Relapsed or refractory disease after first-line anthracycline-based chemotherapy Bulky disease, nodal or extranodal Clinically or radiographically measurable mass at least 5 cm in diameter OR Non-bulky disease, nodal or extranodal, excluding diffuse organ (lung, liver, kidney, or bone marrow) involvement Clinically or radiographically measurable disease more than 1.5 cm in greatest transverse diameter Biopsy at relapse not required except for transformed lymphomas Patients with transformed lymphoma at diagnosis, but with indolent histology without transformation at relapse, are not eligible No patients with stage IA or IIA disease at initial diagnosis who, at time of relapse or diagnosis of refractory disease prior to salvage therapy, remained in stage IA or IIA, with no new disease sites, without having received radiotherapy Received up to 2 regimens and 4 courses of salvage chemotherapy Monoclonal antibodies (e.g., rituximab) are not considered salvage chemotherapy Achieved complete response (CR), unconfirmed CR, or partial response (PR) if bulky disease OR Achieved PR (but not CR) if non-bulky disease No residual disease involving extranodal organs diffusely (e.g., liver, lung, bone, kidney, or leptomeningeal) after salvage chemotherapy Planned autologous hematopoietic stem cell transplantation (ASCT) ASCT conditioning must be with high-dose BEAM (carmustine, etoposide, cytarabine, and melphalan) chemotherapy No disease progression after ASCT No major organ complication or poor hematologic recovery from ASCT that would preclude initiation of study radiotherapy within 14 weeks after ASCT No more than 2 non-contiguous nodal or extranodal areas of bulky/residual disease requiring more than 2 separate involved-field radiotherapy volume arrangements (e.g., field arrangement covering up to 2 involved lymph node regions or extranodal sites, with or without 1 adjacent nodal/region or extranodal site) No active CNS lymphoma (parenchymal brain and/or leptomeningeal) PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0-2 Life expectancy: Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Other: Not pregnant or nursing Fertile patients must use effective contraception No other malignancy within the past 5 years except basal cell carcinoma of the skin PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics No prior radioimmunotherapy Chemotherapy: See Disease Characteristics Endocrine therapy: Not specified Radiotherapy: See Disease Characteristics No prior total body irradiation No prior radiotherapy to the site of bulky disease or residual tumor Surgery: Not specified Other: No other concurrent anti-cancer therapy unless documentation of disease progression
Sites / Locations
- Tom Baker Cancer Center - Calgary
- Cross Cancer Institute
- Newfoundland Cancer Treatment and Research Foundation
- Cancer Care Ontario-Hamilton Regional Cancer Centre
- Cancer Care Ontario-London Regional Cancer Centre
- Toronto Sunnybrook Regional Cancer Centre
- Princess Margaret Hospital
- Maisonneuve-Rosemont Hospital
- McGill University