MARROW GRAFTING FOR THE LYMPHOMAS

淋巴瘤骨髓移植

• 批准号: 5207559
• 负责人: SANDRA J HORNING
• 金额: --
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/5207559
• 关键词: Hodgkin's disease; autologous transplantation; bone marrow transplantation; clinical trials; dosage; etoposide; hematopoietic tissue transplantation; human subject; human therapy evaluation; longitudinal human study; lymphoma; neoplasm /cancer chemotherapy; neoplasm /cancer immunotherapy; neoplasm /cancer relapse /recurrence

The goal of our studies is to improve disease-free and overall survival in subsets of patients with malignant lymphoma and Hodgkin's disease through the use of high dose therapy and stem cell grafting. The clinical studies proposed for years 04-08 will test 1) the relative efficacy and toxicity of high dose etoposide-containing preparative regimens in poor risk Hodgkin's disease, 2) the curative potential of high dose etoposide preparative regimens in recurrent intermediate and high grade lymphoma and the ability of post-transplant active immunotherapy to further decrease the rate of lymphoma relapse as assessed in a prospective randomized trial, and 3) the ability of consolidative high dose radiochemotherapy to prolong remission duration in advanced stage low grade lymphoma. In order to confirm the validity of our results in the phase II studies, we will employ a case- control statistical analysis in which therapeutic outcome will be compared to individually matched clusters of historical controls obtained from the Stanford Lymphoma Databank. Our studies incorporate novel methods to approach the problem of post- transplant relapse, which is the greatest obstacle to the successful use of ablative therapy and stem cell transplant in malignant lymphomas. Idiotype vaccination, which has been developed and studied by investigators in this Program Project, will be employed in a minimal disease state post- transplant in B-cell lymphoma patients. A novel method of fractionation of allogeneic bone marrow which results in a graft-versus-lymphoma effect, without graft-versus-host disease, has been developed by investigators in Project IV, and this approach will be studied in a clinical trial during the years 05-08. A clinical trial using highly purified stem cell preparations obtained through positive stem cell selection represents an approach to reduce relapse related to contamination of the marrow graft (see: Project IV). In addition, we will evaluate methods of detection of minimal residual disease, developed by investigators in the Program Project (see: Project III).

我们研究的目标是提高中国的无病生存率和总体生存率 恶性淋巴瘤和霍奇金氏病患者的亚群 使用大剂量治疗和干细胞移植。临床研究 为04-08年度提出的建议将测试1)相对疗效和毒性 大剂量含依托泊苷制备方案治疗低危霍奇金病 疾病，2)大剂量依托泊苷制剂的治疗潜力 复发性中高度恶性淋巴瘤的化疗方案及疗效观察 移植后主动免疫治疗可进一步降低 在一项前瞻性随机试验中评估淋巴瘤复发，以及3) 巩固大剂量放化疗延长缓解期的能力 晚期低度恶性淋巴瘤病程。为了确认 我们在第二阶段研究中的结果的有效性，我们将采用一个案例- 对照统计分析，其中将比较治疗结果 获取的历史控件的单个匹配群集。 斯坦福淋巴瘤数据库。 我们的研究采用了新的方法来处理后 移植复发，这是成功使用的最大障碍 恶性淋巴瘤的消融治疗和干细胞移植。独特型 疫苗接种，这是由研究人员在这方面开发和研究的 计划项目，将在最低疾病状态下受雇- B细胞淋巴瘤患者的移植。一种新的精馏方法 导致移植物抗淋巴瘤效应的异基因骨髓， 没有移植物抗宿主疾病，已经由研究人员在 项目IV，这一方法将在#年进行临床试验研究 05-08年。使用高纯度干细胞的临床试验 通过阳性干细胞选择获得的准备代表着一种 减少与骨髓移植污染相关的复发的方法 (见项目四)。此外，我们还将对检测方法进行评估 最小残留疾病，由计划项目中的研究人员开发 (见项目三)。