Neoplasms

Blood and Lymph Conditions

All Conditions

Immune System Diseases

Symptoms and General Pathology

Rare Diseases

Leukemia

Leukemia, Myeloid

Lymphoma

Hematologic Neoplasms

Leukemia, Myelogenous, Chronic, BCR-ABL Positive

Hematologic Diseases

Neoplasms by Histologic Type

Myeloproliferative Disorders

Bone Marrow Diseases

Chronic Disease

Disease Attributes

Myeloid Leukemia

Chronic Graft Versus Host Disease

Lymphosarcoma

Chronic Myeloid Leukemia

Chronic Myeloproliferative Disorders

Allogeneic bone marrow transplantation (BMT) is a curative treatment for patients with chronic myelogenous leukemia (CML) and other lymphoid/hematologic malignancies but is available as a treatment option to only a minority of patients. Autologous BMT, coupled with high dose chemotherapy, is a treatment open to more patients and is a promising strategy for the treatment of advanced solid malignancies. However, the development of potentially curative marrow transplant alternatives requires an ability to provide a nonmalignant hematopoietic stem cell population. In addition, the generation of hematopoietic stem cells (HSC), and the determination of whether or not such HSC repopulate all of the cell lineage subtypes following reinfusion are critical to understanding the biology and immunological consequences of stem cell transplantation. An increased understanding of the kinetics of HSC and lymphocyte repopulation post-BMT and the identification of donor cell populations that mediate a graft versus leukemia (GVL) effect or graft versus host (GVHD) is critical to therapeutic efficacy. In order to address these currently unmet objectives, normal volunteers and volunteers with malignancies will undergo venipuncture and bone marrow aspiration with or without prior \[6,6-(2)H(2)\] or \[U-(13)C(9)\]-glucose, infusion to provide cell populations which will then be utilized for specific pre-clinical studies aimed at developing new therapeutic alternatives for patients with CML and other lymphoid/hematologic malignancies. An infusion of \[6,6-(2)H(2)\] or \[U-(13)C(9)\]-glucose prior to bone marrow and/or leukocyte harvest, in some volunteers, will allow direct examination of the genesis and biology of stem cells and leukocyte subpopulations. \[6,6-(2)H(2)\] or \[U-(13)C(9)\]-glucose, are nonradioactive, stable isotopes of glucose which will label dividing cells during the time of administration and is chemically identical to glucose, with no adverse side effects other than those known for glucose.

Allogeneic bone marrow transplantation (BMT) is a curative treatment for patients with chronic myelogenous leukemia (CML) and other lymphoid/hematologic malignancies but is available as a treatment option to only a minority of patients. Autologous BMT, coupled with high dose chemotherapy, is a treatment open to more patients and is a promising strategy for the treatment of advanced solid malignancies. However, the development of potentially curative marrow transplant alternatives requires an ability to provide a nonmalignant hematopoietic stem cell population. In addition, the generation of hematopoietic stem cells (HSC), and the determination of whether or not such HSC repopulate all of the cell lineage subtypes following reinfusion are critical to understanding the biology and immunological consequences of stem cell transplantation. An increased understanding of the kinetics of HSC and lymphocyte repopulation post-BMT and the identification of donor cell populations that mediate a graft versus leukemia (GVL) effect or graft versus host (GVHD) is critical to therapeutic efficacy. In order to address these currently unmet objectives, normal volunteers and volunteers with malignancies will undergo venipuncture and bone marrow aspiration with or without prior \[6,6-(2)H2\] or \[U-(13)C9\]-glucose, infusion to provide cell populations which will then be utilized for specific pre-clinical studies aimed at developing new therapeutic alternatives for patients with CML and other lymphoid/hematologic malignancies. An infusion of \[6,6-(2)H2\] or \[U-(13)C9\]-glucose prior to bone marrow and/or leukocyte harvest, in some volunteers, will allow direct examination of the genesis and biology of stem cells and leukocyte subpopulations. \[6,6-(2)H2\] or \[U-(13)C9\]-glucose, are nonradioactive, stable isotopes of glucose which will label dividing cells during the time of administration and is chemically identical to glucose, with no adverse side effects other than those known for glucose.

The Collection of Peripheral Blood Lymphocytes and Marrow Progenitor Cells From Normal Volunteers and Volunteers With Lymphoid or Hematologic Malignancies

National Cancer Institute (NCI)

Heart and Blood Diseases

Multiple Myeloma

Neoplasms, Plasma Cell

Hemostatic Disorders

Blood Coagulation Disorders

Vascular Diseases

Paraproteinemias

Blood Protein Disorders

Hemorrhagic Disorders

Lymphoproliferative Disorders

Immunoproliferative Disorders

Anti-Infective Agents

All Drugs and Chemicals

Antineoplastic Agents

Plerixafor

Lenograstim

Bortezomib

Adjuvants, Immunologic

Immunologic Factors

Anti-HIV Agents

Anti-Retroviral Agents

Antiviral Agents

Standard of Care Stem cell collection without in-vivo purging with Bortezomib. Standard of Care drugs Granulocyte colony-stimulating factor (G-CSF) +/- Mozobil (the latter if needed).

NOTE: Multiparametric Flow Cytometry to be performed on samples for BOTH groups A and B

Bortezomib will be given subcutaneously (SQ) at 1.3 mg/m2 on day -11 and day -8 followed by Granulocyte colony-stimulating factor (G-CSF) given SQ on day -4 thru day -1 and continued until the collection is completed. Mozobil will be given if needed.

There must be at least 72 hours between each dose of bortezomib. NOTE: Multiparametric Flow Cytometry to be performed on samples for BOTH groups A and B

Bortezomib will be given to Group B participants by injection under the skin 11 days and 8 days before stem cell collection.

Granulocyte colony-stimulating factor (G-CSF) will be given to all participants by injection under the skin 4 days and 1 day before stem cell collection, and then continued until the stem cell collection is completed.

Granulocyte colony-stimulating factor (G-CSF)

Mozobil will be given to all participants by injection under the skin only if needed per Investigator.

Mozobil

Siddhartha Ganguly, MD

Explore stem cell collection with or without bortezomib with in-vivo purging in multiple myeloma.

High dose chemotherapy with autologous stem cell transplant has resulted in improved overall survival and is currently considered an effective first line therapy applicable to the majority of patients with multiple myeloma. However disease relapse is inevitable and remains the primary cause of mortality in this cohort.

The purpose of this study is to estimate the proportion of subjects with plasma cell contamination of harvested stem cell product in standard and treatment arms. The study will explore whether or not in-vivo purging of malignant tumor plasma cells will improve progression free survival (PFS) for patients.

The study will consist of two groups:

Group A: Standard of Care (SOC) stem cell collection without in-vivo purging with bortezomib. Granulocyte colony-stimulating factor (G-CSF) and Mozobil used if needed.

Group B: Bortezomib 1.3mg/m\^2 will be given subcutaneously (SQ) on days -11 and -8 followed by Granulocyte colony-stimulating factor (G-CSF) on days -4 through -1 prior to stem cell harvest (day 0).

Exploratory Trial to Estimate Proportion of Patients With Tumor Cell Contaminated Leukapheresis Products With and Without Bortezomib With In-vivo Purging - Multiple Myeloma (MM)

An Exploratory Trial to Estimate the Proportion of Patients With Tumor Cell Contaminated, Flow Positive Leukapheresis Products Collected With and Without Bortezomib as In-vivo Purging Prior to Autologous Stem Cell Harvest for Multiple Myeloma

Estimate the proportion of subjects with plasma cell contamination (defined as \>0.01% and at least 100 cellular events) of harvested stem cell product by multi parametric flow cytometry (MFC) from patients with myeloma undergoing autologous stem cell collection 1) by standard of care mobilization using Granulocyte colony-stimulating factor (G-CSF) with or without Mozobil and 2) after two doses of bortezomib as in vivo purging plus standard of care using G-CSF with or without Mozobil.

Estimate the proportion of subjects who have a successful collection of stem cells (\> 2 million Cluster of Differentiation 34 (CD34) cells/Kg of body weight) for autologous transplant in both treatment groups.

Estimate the percentage of Cluster of Differentiation 34 (CD34) positive cells in circulating peripheral blood as a measure of mobilization on the days of collection.

Siddhartha Ganguly

Medical Doctor

Standard of Care Stem cell collection without in-vivo purging with Bortezomib. Standard of Care drugs Granulocyte colony-stimulating factor (G-CSF) +/- Mozobil (the latter if needed).

NOTE: Multiparametric Flow Cytometry to be performed on samples for BOTH groups A and B

Granulocyte colony-stimulating factor (G-CSF): Granulocyte colony-stimulating factor (G-CSF) will be given to all participants by injection under the skin 4 days and 1 day before stem cell collection, and then continued until the stem cell collection is completed.

Mozobil: Mozobil will be given to all participants by injection under the skin only if needed per Investigator.

Stem Cell Collection Without In-vivo Purging With Bortezomib

Bortezomib will be given subcutaneously (SQ) at 1.3 mg/m2 on day -11 and day -8 followed by Granulocyte colony-stimulating factor (G-CSF) given SQ on day -4 thru day -1 and continued until the collection is completed. Mozobil will be given if needed.

There must be at least 72 hours between each dose of bortezomib. NOTE: Multiparametric Flow Cytometry to be performed on samples for BOTH groups A and B

Bortezomib: Bortezomib will be given to Group B participants by injection under the skin 11 days and 8 days before stem cell collection.

Granulocyte colony-stimulating factor (G-CSF): Granulocyte colony-stimulating factor (G-CSF) will be given to all participants by injection under the skin 4 days and 1 day before stem cell collection, and then continued until the stem cell collection is completed.

Mozobil: Mozobil will be given to all participants by injection under the skin only if needed per Investigator.

Stem Cell Collection With In-vivo Purging With Bortezomib

Total

Age, Categorical

Sex: Female, Male

Ethnicity (NIH/OMB)

Dr. Sid Ganguly

Multiparametric Flow Cytometry - Minimum Residual Disease

Multiparametric Flow Cytometry - Cluster of Differentiation 34 (CD34)Assessment

Cluster of Differentiation 34 (CD34) Enumeration

Overall Study

Syndrome

Leukemia, Myeloid, Acute

Preleukemia

Myelodysplastic Syndromes

Acute Myeloid Leukemia

Acute Non Lymphoblastic Leukemia

Acute Graft Versus Host Disease

Fludarabine

Fludarabine phosphate

Busulfan

GEL protein, Gelonium multiflorum

Antimetabolites

Immunosuppressive Agents

Alkylating Agents

Antineoplastic Agents, Alkylating

Enzyme Inhibitors

Gelonin Purging of Autologous Stem Cells for Transplantation (ASCT) + Fludara/Busulfan

Gelonin-AntiCD33 purging, 3 purging concentrations (fixed dose of 5 x 10\^6 CD34+ cells/kg to be infused) with 3 dose levels of 1 nanomolar, 5.0 nanomolar and 10.0 nanomolar.

Gelonin

130 mg/m2 in normal saline over three (3) hours IV every twenty-four (24) hours for four (4) consecutive days (days -6 to -3).

40 mg/m2 in 100 ml of saline over one (1) hour on each of four (4) consecutive days (days - 6 to -3).

Sergio A. Giralt, MD

Patients with Acute Myelogenous Leukemia or Myelodysplastic are able to achieve a complete remission but fail to achieve a prolonged disease-free survival. High dose chemotherapy and autologous bone marrow transplantation has been shown to be effective in this group of patients but hematopoietic recovery is slow, and infectious or bleeding complications are common. The delay in hematopoietic recover is accentuated by the use of purging techniques. This is a novel purging approach for autologous stem cell transplantation in patients with Acute Myelogenous Leukemia or Myelodysplastic syndrome to allow for rapid engraftment with a lower relapse rate therefore improving the therapeutic outcomes

Treatment:

The HuM195-Gelonin conjugate has been designed to target leukemia cells and destroy them.

This treatment is divided into 3 parts.

Part I:

MOBILIZATION and STEM CELL COLLECTION:

This is the process that allows for collection of the autologous stem cells (the cells that will be used to do the transplant). All participants will receive the drug idarubicin by vein for 3 days together with cytarabine by vein for 3 days. This will be followed by injections of filgrastim (Neupogen) under the skin twice a day until the white count has recovered and the stem cells are collected. During the process, the number of stem cells in the blood will be measured. When the number of cells reach a certain level, participants will go through a collection procedure known as apheresis.

The apheresis procedure includes collecting blood through a large catheter placed under the collarbone or in the arm with the assistance of a device known as a cell separator. This device separates the stem cells from the rest of the blood and returns the rest of the blood to the participant. The procedure is usually done as an outpatient and takes between 4-5 hours to perform. Most patients collect enough cells for a transplant after 1 or 2 procedures. In this study, a maximum of 5 procedures are allowed.

Participants who are unable to have enough cells collected to take part in the study procedures, will be taken off study and offered alternative standard or investigational therapy. Participants will be able to leave the hospital with physician approval. They will then be monitored on a daily basis until the white blood cell count has recovered (usually 4-5 weeks). The stem cell collection can be done as either an inpatient or outpatient procedure depending on the participant's condition.

Part II:

PURGING PROCEDURE:

The stem cells that are collected through the apheresis procedure are treated in the laboratory with the Hum195/Gelonin conjugate. This procedure is known as purging and it is being studied to learn if the treatment of the stem cells with the HuM195/Gelonin conjugate can eliminate leukemia cells without damaging the normal stem cells. Since the best dose of HuM195/Gelonin conjugate for purging is not known, the cells of the participants in this study will receive 1 of 3 different doses of HuM195/Gelonin. The dose of HuM195/Gelonin that the cells will receive will be decided randomly according to the experience of the participants treated earlier in the study.

The first 3 participants in this study will receive cells that have not been treated with HuM195/Gelonin

After the cells have been treated, they are frozen for future use after the high dose busulfan treatment is given. As a safety measure, all participants will need to have a proportion of untreated stem cells as a back up. These can come from the original stem cell harvest or from a bone marrow harvest.

Part III:

HIGH DOSE FLUDARABINE/BUSULFAN WITH AUTOLOGOUS STEM CELL TRANSPLANT:

All participants who had enough cells treated with HuM195-Gelonin conjugate will then receive busulfan. Busulfan will be given by vein once a day for four days. It will be given together with fludarabine by vein once a day for 4 days. Three days after participants receive the last dose of busulfan, they will receive their previously stored stem cells through a blood transfusion. All participants will receive supportive care. This will include antibiotics, transfusions of blood products, extra nutrients, pain medication, and medications that will quicken the recovery of white blood cells. Participants will be on study for at least 12 months after the stem cell transplant coming for regular check ups.

All participants will have busulfan blood levels checked at specific times before, during and after busulfan infusion. On occasion more blood levels may be drawn. Levels are drawn through a small needle placed in the hands or arms of the patients and removed after the last busulfan blood draw. The busulfan dose administered MAY be modified according to the levels to prevent side effects. Two teaspoons of blood will be drawn for these measurements each time.

Participants will remain in the hospital for about 4-6 weeks and as an outpatient for 1 to 3 months. After participants leave the Medical Center Area, they will be seen in the transplant center every 3 to 6 months for 2 years.

This is an investigational study. The FDA has authorized the use of the HuM195-Gelonin conjugate in research only. Fludarabine has been previously approved for treatment of chronic lymphocytic leukemia by the FDA. The injectable solution of busulfan is a new preparation that has been approved by the FDA for allogeneic transplantation for chronic myelogenous leukemia (CML). The use of these drugs in this study is investigational. Up to 24 patients will be enrolled on this study. All will be enrolled at UTMDACC.

Study of Gelonin Purging of Autologous Stem Cells for Transplantation

Dose Finding Study of Gelonin Purging of Autologous Stem Cells for Transplantation of Patients With AML/MDS in First or Subsequent Remission

Dose-finding success, defined as patient alive and engrafted at day 28 post transplant, represented as number of patient successes with 3 differing doses (5, 10, or 15 nanomolar (nm) gelonin-antiCD33 purged autologous stem cells after a high dose fludarabine/busulfan conditioning regimen).

M.D. Anderson Cancer Center

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
The Collection of Peripheral Blood Lymphocytes and Marrow Progenitor Cells From Normal Volunteers and Volunteers With Lymphoid or Hematologic Malignancies	NCT00001432	Chronic Myeloid... Healthy Hematologic Neo... Lymphoma		-	National Institutes of Health Clinical Center (CC)
Exploratory Trial to Estimate Proportion of Patients With Tumor Cell Contaminated Leukapheresis Products With and Without Bortezomib With In-vivo Purging - Multiple Myeloma (MM)	NCT02703779	Multiple Myelom...	Bortezomib Granulocyte col... Mozobil	18 Years -	University of Kansas Medical Center
Study of Gelonin Purging of Autologous Stem Cells for Transplantation	NCT00043810	Acute Myelogeno... Myelodysplastic...	Gelonin Busulfan Fludarabine	-	M.D. Anderson Cancer Center

Spots Global Cancer Trial Database for purging

Every month we try and update this database with for purging cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for purging

Every month we try and update this database with for purging cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for purging cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.