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Brief Title: BENdamustine at Elevated Dose for Relapsed Follicular Lymphoma in Intensification Therapy and Transplantation (BENEFIT)
Official Title: A Multicenter Phase II Study Evaluating BeEAM (Bendamustine, Etoposide, Cytarabine, Melphalan) Prior to Autologous Stem Cell Transplant for First and Second Chemosensitive Relapses in Patients With Follicular Lymphoma
Study ID: NCT02008006
Brief Summary: The purpose of this study is to evaluate the efficacy and safety of BeEAM (bendamustine, etoposide, cytarabine and melphalan) regimen prior to autologous stem cell transplant for first and second chemosensitive relapses in patients with follicular lymphoma (World Health Organisation (WHO) grade 1, 2, 3a).
Detailed Description: The natural history of this follicular lymphoma (FL) is marked by multiple relapses. The prognosis of FL has improved with the use of effective sequential chemotherapy and the introduction of anti-cluster of differentiation antigen 20 (anti-CD20) monoclonal antibody. Based on the multiple phases II, high dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) appear to be an effective treatment in relapsed FL. At rituximab era, the 3-years EFS rate was 75% for relapsed transplanted patients treated in first line therapy in FL2000 protocol. Bendamustine that combines alkylating and antimetabolite activities had proven clinical activity in relapse and in first line therapy of FL. Carmustine (BCNU), etoposide, cytarabine, and melphalan (BEAM regimen) is one of the most used schedule of HDT in non hodgkin lymphoma. Regarding the good safety profile of Bendamustine, Visani et al. proposed a phase I/II of bendamustine at day -7 and -6, followed by etoposide, cytarabine and melphalan with similar dose than BEAM regimen. The bendamustine maximal dose is 200 mg/m² day -7, -6. Data from engraftment showed closed results than those observed after BEAM. None of patients experienced a dose limiting toxicity. In this context, the investigators proposed to perform a multicentric phase II of this regimen with 200 mg/m² day-7 and -6 of bendamustine for first and second relapsed FL with a chemosensitive disease after salvage therapy. No FL was evaluated in Visani et al. study. In addition, the investigators can observe a shortage of the BCNU these last years that incline to evaluate new schedule of HDT.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
CHU de Dijon - Hôpital Le Bocage, Dijon, Côte d'Or, France
Centre Henri Becquerel, Rouen, Haute Normandie, France
CHRU de Montpellier, Hôpital Saint-Eloi, Montpellier, Hérault, France
APHP Hôpital Necker, Paris, Ile De France, France
AP-HP Hôpital Saint-Louis, Paris, Ile-de-France, France
CHU de Rennes - Hôpital Pontchaillou, Rennes, Ille Et Vilaine, France
CHU Grenoble - Hôpital Michallon, Grenoble, Isère, France
CHU de Nantes Hôtel Dieu, Nantes, Loire Atlantique, France
CHU de Nancy, Vandoeuvre Lès Nancy, Meurthe Et Moselle, France
CHRU de Lille Hôpital Claude Huriez, Lille, Nord Pas De Calais, France
Centre Léon Bérard, Lyon, Rhône, France
CHU Lyon Sud, Pierre Bénite, Rhône, France
CHU Henri Mondor, Créteil, Val De Marne, France
Name: Hervé Ghesquières, Dr
Affiliation: Centre Léon Bérard, Lyon
Role: PRINCIPAL_INVESTIGATOR