Nervous System Diseases

Immune System Diseases

All Conditions

Symptoms and General Pathology

Neoplasms

Heart and Blood Diseases

Eye Diseases

Musculoskeletal Diseases

Infections

Rare Diseases

Multiple Sclerosis

Sclerosis

Autoimmune Diseases

Syndrome

Myasthenia Gravis

Encephalitis

Autoimmune Diseases of the Nervous System

Vasculitis

Polyneuropathies

Neuromyelitis Optica

Polyradiculoneuropathy, Chronic Inflammatory Demyelinating

Stiff-Person Syndrome

Lambert-Eaton Myasthenic Syndrome

Myoclonus

Vasculitis, Central Nervous System

Opsoclonus-Myoclonus Syndrome

Muscle Weakness

Paresis

Asthenia

Polyradiculoneuropathy

Ocular Motility Disorders

Demyelinating Autoimmune Diseases, CNS

Demyelinating Diseases

Brain Diseases

Central Nervous System Diseases

Neuroinflammatory Diseases

Vascular Diseases

Peripheral Nervous System Diseases

Neuromuscular Diseases

Muscular Diseases

Neuromuscular Manifestations

Neurologic Manifestations

Paraneoplastic Syndromes

Paraneoplastic Syndromes, Nervous System

Nervous System Neoplasms

Neurodegenerative Diseases

Neuromuscular Junction Diseases

Myelitis

Myelitis, Transverse

Neuritis

Optic Neuritis

Optic Nerve Diseases

Cranial Nerve Diseases

Chronic Disease

Disease Attributes

Dyskinesias

Spinal Cord Diseases

Strabismus

Cerebrovascular Disorders

Chronic Graft Versus Host Disease

Neuromyelitis Optica Spectrum Disorder

Chronic Inflammatory Demyelinating Polyneuropathy

Stiff Person Syndrome

Lambert Eaton Myasthenic Syndrome

Cerebellar Degeneration

Rasmussen Encephalitis

Opsoclonus-myoclonus Syndrome

Antineoplastic Agents

All Drugs and Chemicals

Anti-Infective Agents

Anti-Inflammatory Agents

Dermatologic Agents

Amino Acids

Etoposide

Cytarabine

Prednisone

Melphalan

Thymoglobulin

Etoposide phosphate

Podophyllotoxin

Cortisone

Carmustine

Immunosuppressive Agents

Mechlorethamine

Nitrogen Mustard Compounds

Antilymphocyte Serum

Glucocorticoids

Hormones

Hormone Antagonists

Antineoplastic Agents, Hormonal

Enzyme Inhibitors

Antimetabolites

Antiviral Agents

Immunologic Factors

Antineoplastic Agents, Alkylating

Alkylating Agents

Keratolytic Agents

Tubulin Modulators

Antimitotic Agents

Phenylalanine

Alanine

Patients receive carmustine IV on day -6, etoposide IV and cytarabine IV BID on days -5 to -2, melphalan IV on day -1 and antithymocyte globulin IV on days -2 and -1. Patients then undergo autologous or syngeneic stem cell transplant on day 0. Patients also receive prednisone PO QD on days 7-21, followed by 2 week taper.

Anti-Thymocyte Globulin

Undergo autologous or syngeneic stem cell transplantation

Autologous Hematopoietic Stem Cell Transplantation

Laboratory Biomarker Analysis

Peripheral Blood Stem Cell Transplantation

Undergo syngeneic bone marrow transplantation

Syngeneic Bone Marrow Transplantation

Leona Holmberg

This phase II trial studies the side effects and how well carmustine, etoposide, cytarabine and melphalan together with antithymocyte globulin before a stem cell transplant works in treating patients with autoimmune neurologic disease that did not respond to previous therapy. In autoimmune neurological diseases, the patient's own immune system 'attacks' the nervous system which might include the brain/spinal cord and/or the peripheral nerves. Giving high-dose chemotherapy, including carmustine, etoposide, cytarabine, melphalan, and antithymocyte globulin, before a stem cell transplant weakens the immune system and may help stop the immune system from 'attacking' a patient's nervous system. When the patient's own (autologous) stem cells are infused into the patient they help the bone marrow make red blood cells, white blood cells, and platelets so the blood counts can improve.

OUTLINE:

Patients receive carmustine intravenously (IV) on day -6, etoposide IV and cytarabine IV twice daily (BID) on days -5 to -2, melphalan IV on day -1, and antithymocyte globulin IV on days -2 and -1. Patients then undergo autologous or syngeneic stem cell transplant on day 0. Patients also receive prednisone orally (PO) once daily (QD) on days 7-21, followed by 2 week taper.

After completion of study treatment, patients are followed up at 3 months, 1 year, and then annually thereafter for up to 5 years.

Autologous Stem Cell Transplant for Neurologic Autoimmune Diseases

High-Dose Immunosuppressive Therapy Using Carmustine, Etoposide, Cytarabine, and Melphalan (BEAM) + Thymoglobulin Followed by Syngeneic or Autologous Hematopoietic Cell Transplantation for Patients With Autoimmune Neurologic Diseases

Assessed by the Regimen Related Toxicity Scale. Using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0. The development of a grade 4 to 5 toxicity of any of the included major organ systems within the first 365 days after transplant will be defined as regimen-related toxicity.

Defined as death within the first 100 days of transplant due to transplant-related complications.

Assessed by clinical, laboratory and radiologic evaluation

Monitored for engraftment kinetics of granulocytes, platelets and red cells post-transplant.

Efficacy of peripheral blood stem cell mobilization as evaluated by total number of harvested CD34+cells/kg, for autologous transplant.

Subjects are evaluated by standardized clinical neurologic tests specific to autoimmune disease type.

Fred Hutchinson Cancer Center

Spots Global Cancer Trial Database for autoimmune nervous system disorder