Donor Stem Cell Transplant in Treating Older or Frail Patients With Hematologic Cancer
Chronic Myeloproliferative Disorders, Leukemia, Lymphoma
About this trial
This is an interventional treatment trial for Chronic Myeloproliferative Disorders focused on measuring stage III chronic lymphocytic leukemia, stage IV chronic lymphocytic leukemia, stage III adult diffuse small cleaved cell lymphoma, stage IV adult diffuse small cleaved cell lymphoma, noncontiguous stage II grade 1 follicular lymphoma, noncontiguous stage II grade 2 follicular lymphoma, noncontiguous stage II grade 3 follicular lymphoma, stage III grade 1 follicular lymphoma, stage III grade 2 follicular lymphoma, stage III grade 3 follicular lymphoma, stage IV grade 1 follicular lymphoma, stage IV grade 2 follicular lymphoma, stage IV grade 3 follicular lymphoma, noncontiguous stage II marginal zone lymphoma, stage III marginal zone lymphoma, stage IV marginal zone lymphoma, noncontiguous stage II small lymphocytic lymphoma, stage III small lymphocytic lymphoma, stage IV small lymphocytic lymphoma, noncontiguous stage II adult Burkitt lymphoma, stage III adult Burkitt lymphoma, stage IV adult Burkitt lymphoma, stage III adult diffuse large cell lymphoma, stage IV adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse mixed cell lymphoma, stage III adult diffuse mixed cell lymphoma, stage IV adult diffuse mixed cell lymphoma, noncontiguous stage II adult immunoblastic large cell lymphoma, stage III adult immunoblastic large cell lymphoma, stage IV adult immunoblastic large cell lymphoma, noncontiguous stage II adult lymphoblastic lymphoma, stage III adult lymphoblastic lymphoma, stage IV adult lymphoblastic lymphoma, noncontiguous stage II mantle cell lymphoma, stage III mantle cell lymphoma, stage IV mantle cell lymphoma, extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, nodal marginal zone B-cell lymphoma, splenic marginal zone lymphoma, stage II multiple myeloma, stage III multiple myeloma, chronic phase chronic myelogenous leukemia, primary myelofibrosis, polycythemia vera, prolymphocytic leukemia, stage II adult Hodgkin lymphoma, stage III adult Hodgkin lymphoma, stage IV adult Hodgkin lymphoma, de novo myelodysplastic syndromes, previously treated myelodysplastic syndromes, secondary myelodysplastic syndromes, refractory anemia with excess blasts in transformation, refractory anemia with excess blasts, chronic myelomonocytic leukemia, adult acute myeloid leukemia in remission, secondary acute myeloid leukemia, Waldenström macroglobulinemia, essential thrombocythemia, adult acute myeloid leukemia with 11q23 (MLL) abnormalities, adult acute myeloid leukemia with inv(16)(p13;q22), adult acute myeloid leukemia with t(15;17)(q22;q12), adult acute myeloid leukemia with t(16;16)(p13;q22), adult acute myeloid leukemia with t(8;21)(q22;q22), noncontiguous stage II adult diffuse large cell lymphoma, noncontiguous stage II adult diffuse small cleaved cell lymphoma, stage I multiple myeloma
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of a high-risk indolent hematologic malignancy meeting the following criteria: Chronic lymphocytic leukemia (CLL) meeting 1 of the following criteria: In second or subsequent remission Failed to achieve a complete remission (CR) after chemotherapy Non-Hodgkin's lymphoma (NHL) meeting 1 of the following criteria: Low-grade NHL meeting 1 of the following criteria: Standard-risk disease in second or subsequent remission Standard-risk disease and failed to achieve a CR after chemotherapy In first or subsequent remission with adverse International Prognostic Index (IPI) prognostic features, as defined by the presence of ≥ 3 of the following: Age > 60 years Tumor stage III or IV Extranodal disease at > 1 site ECOG performance status ≥ 2 Serum lactic dehydrogenase (LDH) > upper limit of normal (ULN) Intermediate- or high-grade NHL meeting 1 of the following criteria: In second or subsequent remission Failed to achieve a CR after initial chemotherapy Waldenstrom's macroglobulinemia meeting 1 of the following criteria: In second or subsequent remission Failed to achieve a CR after initial chemotherapy Multiple myeloma meeting 1 of the following criteria: In first or subsequent remission Failed to achieve a CR after initial chemotherapy Myeloproliferative disorders, including any of the following: Chronic myelogenous leukemia in first or subsequent chronic phase Myelofibrosis Essential thrombocytopenia that is poorly responsive to standard therapy Polycythemia vera that is poorly responsive to standard therapy or is in spent phase Prolymphocytic leukemia meeting 1 of the following criteria: In first or subsequent remission Failed to achieve a CR after initial chemotherapy Mantle cell lymphoma meeting 1 of the following criteria: In first or subsequent remission Failed to achieve a CR after initial chemotherapy Hodgkin's lymphoma meeting the following criteria: In second or subsequent remission Prior remission duration > 6 months No radiation therapy as the only prior primary therapy Myelodysplastic syndromes (MDS) meeting 1 of the following criteria: Refractory anemia with excess blasts (RAEB) RAEB in transformation Chronic myelomonocytic leukemia Any MDS with transfusion dependence Any MDS with ≥ 2 significant infections Acute myeloid leukemia in morphologic remission In CR or partial remission or stabilization of disease after standard chemotherapy No progressive or refractory disease Not eligible for standard allogeneic bone marrow transplantation Meets 1 of the following criteria: Age 60 to 75 years old AND no co-morbid illness Younger patients with any of the following comorbidities: Decreased cardiac ejection fraction Pulmonary dysfunction Elevated liver function tests Hepatitis C infection Poor performance status Sibling or related donor available Matched ≥ 5/6 HLA loci (A, B, and DR) NOTE: A new classification scheme for adult non-Hodgkin's lymphoma has been adopted by PDQ. The terminology of "indolent" or "aggressive" lymphoma will replace the former terminology of "low", "intermediate", or "high" grade lymphoma. However, this protocol uses the former terminology. PATIENT CHARACTERISTICS: See Disease Characteristics ECOG performance status 0-2 Creatinine < 2.0 mg/dL Creatinine clearance > 40 mL/min Ejection fraction > 30% by echocardiogram or MUGA Bilirubin < 3.0 mg/dL (if total bilirubin is elevated and Gilbert's disease is suspected, direct bilirubin must be normal) Alkaline phosphatase < 4 times ULN AST < 4 times ULN HIV negative Hepatitis B and/or C virus allowed if a liver biopsy (performed within the past 3 months) shows ≤ grade 2 inflammation No active infection PRIOR CONCURRENT THERAPY: See Disease Characteristics
Sites / Locations
- Alta Bates Comprehensive Cancer Center
- UCSF Comprehensive Cancer Center
Arms of the Study
Arm 1
Experimental
stem cell transplant