Ultraviolet-B Light Therapy and Allogeneic Stem Cell Transplantation in Treating Patients With Hematologic Malignancies
Chronic Myeloproliferative Disorders, Leukemia, Lymphoma
About this trial
This is an interventional treatment trial for Chronic Myeloproliferative Disorders focused on measuring refractory multiple myeloma, accelerated phase chronic myelogenous leukemia, adult acute lymphoblastic leukemia in remission, adult acute myeloid leukemia in remission, blastic phase chronic myelogenous leukemia, recurrent adult acute lymphoblastic leukemia, recurrent adult acute myeloid leukemia, refractory chronic lymphocytic leukemia, relapsing chronic myelogenous leukemia, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, recurrent adult diffuse large cell lymphoma, recurrent adult diffuse mixed cell lymphoma, recurrent adult diffuse small cleaved cell lymphoma, recurrent adult Burkitt lymphoma, recurrent adult immunoblastic large cell lymphoma, recurrent adult lymphoblastic lymphoma, recurrent grade 1 follicular lymphoma, recurrent grade 2 follicular lymphoma, recurrent grade 3 follicular lymphoma, recurrent mantle cell lymphoma, refractory anemia with excess blasts in transformation, refractory anemia with excess blasts, secondary myelodysplastic syndromes, Philadelphia chromosome negative chronic myelogenous leukemia, chronic idiopathic myelofibrosis, B-cell chronic lymphocytic leukemia, T-cell large granular lymphocyte leukemia, chronic phase chronic myelogenous leukemia, recurrent adult Hodgkin lymphoma, recurrent adult T-cell leukemia/lymphoma, stage III chronic lymphocytic leukemia, stage IV chronic lymphocytic leukemia, recurrent cutaneous T-cell non-Hodgkin lymphoma, recurrent mycosis fungoides/Sezary syndrome, secondary acute myeloid leukemia, atypical chronic myeloid leukemia, myelodysplastic/myeloproliferative disease, unclassifiable, recurrent marginal zone lymphoma, recurrent small lymphocytic lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, splenic marginal zone lymphoma, adult acute myeloid leukemia with t(8;21)(q22;q22), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with t(15;17)(q22;q12)
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed diagnosis of any of the following hematologic malignancies: Acute myeloid leukemia (AML) meeting any of the following criteria: First complete remission with high-risk karyotype Translocations t(15;17) allowed only if failed first-line induction therapy OR molecular evidence of persistent disease exists Translocations t(8;21) and inv(16) allowed only if failed first-line induction therapy Second or subsequent complete remission Minimal residual disease* Acute lymphoblastic leukemia meeting any of the following criteria: Failed induction therapy and has minimal residual disease* by salvage therapy First complete remission with high-risk karyotype (e.g., t[4;11] or t[9;22]) Relapsed disease allowed provided a second or subsequent complete remission or minimal residual disease* is achieved Chronic myelogenous leukemia meeting any of the following criteria: Persistent or relapsed disease after 1 year of imatinib mesylate therapy Accelerated phase or blast crisis Blast crisis allowed after reinduction chemotherapy places disease in chronic phase Myelodysplastic syndromes meeting any of the following criteria: Refractory to medical management Cytogenetic abnormalities predictive of transformation into acute leukemia, including 5q-, 7q-, monosomy 7 and trisomy 8, or evidence of evolution to AML (e.g., refractory anemia with excess blasts (RAEB) or RAEB in transformation) Non-Hodgkin's lymphoma or Hodgkin's lymphoma meeting any of the following criteria: Beyond first complete remission or failed primary induction therapy and demonstrated sensitivity to therapy during the 6 months before transplantation Recurrent disease after autologous stem cell transplantation Must be at least 3 months posttransplantation Cyclin D1+ mantle cell lymphoma allowed after induction therapy and in first remission Multiple myeloma meeting either of the following criteria: Refractory or relapsed disease Residual disease after autologous transplantation Chronic lymphocytic leukemia (CLL) meeting all of the following criteria: Peripheral blood absolute lymphocyte count greater than 5,000/mm^3 Small to moderate size lymphocytes and less than 55% pro-lymphocytes, atypical lymphocytes, or lymphoblasts morphologically B-cell or T-cell Myeloproliferative disorders, including myelofibrosis Philadelphia negative Availability of a HLA-A, B, and DR identical family donor OR HLA-A, B, and DR genetically matched unrelated donor Must meet 1 of the following criteria: At least 55 years of age at time of transplantation Received extensive prior therapy (i.e., more than 1 year of alkylator therapy or more than 2 different prior salvage regimens) or stem cell transplantation with myeloablative conditioning (either autologous or allogeneic) Presenting with comorbid condition (e.g., abnormal cardiac, pulmonary, or renal function and/or prior life-threatening infection) that precludes eligibility for enrollment in allogeneic transplantation protocols with full ablation conditioning No active CNS disease NOTE: *Defined as having no circulating blasts, absolute neutrophil count greater than 1,000/mm3 and less than 10% blasts in bone marrow at least 3 weeks after last systemic chemotherapy PATIENT CHARACTERISTICS: Age See Disease Characteristics Over 18 Performance status ECOG 0-2 Life expectancy At least 3 months Hematopoietic See Disease Characteristics Hepatic Bilirubin no greater than 2.0 mg/dL ALT/AST no greater than 4 times normal Renal See Disease Characteristics Creatinine less than 2.0 mg/dL OR Creatinine clearance at least 50 mL/min Cardiovascular See Disease Characteristics Normal cardiac function by echocardiogram or radionuclide scan Shortening fraction or ejection fraction at least 40% of normal Pulmonary See Disease Characteristics DLCO at least 60% FEV_1 greater than 50% of predicted Pulse oximetry greater than 85% Other Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception HIV negative No uncontrolled active infection PRIOR CONCURRENT THERAPY: Biologic therapy See Disease Characteristics At least 2 weeks since prior biologic response modifiers, signal transduction inhibitors, or monoclonal antibodies Chemotherapy See Disease Characteristics At least 4 weeks since prior systemic conventional chemotherapy Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified Other Recovered from prior therapy No concurrent sun block/sunscreen or any cosmetic that may act as a sunscreen (e.g., lotion with SPF) on the days of scheduled ultraviolet-B light therapy
Sites / Locations
- Ireland Cancer Center at University Hospitals Case Medical Center, Case Comprehensive Cancer Center