AUTOGRAFTING FOR LYMPHOMA

自体移植治疗淋巴瘤

• 批准号: 6395686
• 负责人: SANDRA J. HORNING
• 金额: $ 22.14万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-03-13 至 2001-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6395686
• 关键词: Hodgkin's disease; autologous transplantation; bone marrow transplantation; clinical research; cyclophosphamide; cytokine; dosage; hematopoietic tissue transplantation; human subject; human therapy evaluation; lomustine; lymphokine activated killer cell; neoplasm /cancer chemotherapy; neoplasm /cancer immunotherapy; neoplasm /cancer relapse /recurrence; nonHodgkin's lymphoma

It is the objective of our studies to improve the results of treatment with high dose therapy and autografting in Hodgkin's disease and the non-Hodgkin's lymphomas. We intend to accomplish this goal through the study of novel preparatory regimens and post-transplant immunotherapy. Complementary pathology studies are planned to better define biologic correlates of the clinical results. The proposed clinical studies build on our previous research in these diseases. A new preparatory regimen (CCNU, VP16, cyclophosphamide) developed at Stanford University will be evaluated in patients with low risk Hodgkin's disease. Multiple cycle high dose therapy has been developed to reduce relapse in high risk Hodgkin's disease patients. We will compare the efficacy and toxicity of high dose sequential chemotherapy with our standard preparatory regimen in a Phase III trial in non-Hodgkin's lymphoma. Correlations will be made with a number of biologic parameters assessed in lymphoma tissues in order to further elucidate factors that may predict the treatment outcome after high dose therapy and autografting. All autografted patients will be studied by sensitive molecular and cytogenetic techniques designed to predict genomic instability and the risk for treatment- related myelodysplasia or acute leukemia. In collaboration with investigators in Project III, we will study the feasibility and toxicity of infusing cytokine-induced killer cells into patients with refractory non-Hodgkin's lymphoma. These CIK cells represent a novel therapeutic which, when used as an adjunct to high dose therapy and autografting, may reduce the major problem of relapse after autografting. The studies in Project II are based on past accomplishments in the research laboratory and the clinic. Analysis of previous experience allows us to define risk groups in Hodgkin's disease and structure preparatory regimens accordingly. We plan a comprehensive approach to the study of non-Hodgkin's lymphoma by characterizing lymphoma tissues, purging lymphoma from the apheresis product, comparing two preparatory regimens, and introducing a novel post-transplant immunotherapy to the clinic. The potential for myelodysplasia or acute leukemia as a late effect of high dose therapy will be studied prospectively in all patients. Project II will serve as a clinical resource for other subprojects.

我们研究的目的是改善治疗结果 高剂量治疗和自体移植治疗霍奇金病和 非霍奇金淋巴瘤。 我们打算通过以下方式实现这一目标 新的准备方案和移植后的研究 免疫疗法。 计划进行补充病理学研究以更好地 定义临床结果的生物学相关性。 拟议的临床研究建立在我们之前的这些研究的基础上 疾病。 新的准备方案（CCNU、VP16、环磷酰胺） 斯坦福大学开发的产品将在患有以下疾病的患者中进行评估 低风险霍奇金病。 多周期大剂量治疗 开发用于减少高危霍奇金病患者的复发。 我们将比较高剂量序贯治疗的疗效和毒性 使用我们的 III 期标准准备方案进行化疗 非霍奇金淋巴瘤试验。 相关性将通过 淋巴瘤组织中评估的生物学参数的数量，按顺序 进一步阐明可能预测治疗结果的因素 高剂量治疗和自体移植后。 所有自体移植患者 将通过敏感的分子和细胞遗传学技术进行研究 旨在预测基因组不稳定性和治疗风险- 相关的骨髓增生异常或急性白血病。 与合作 项目III的研究人员，我们将研究可行性和 将细胞因子诱导的杀伤细胞注入患者体内的毒性 难治性非霍奇金淋巴瘤。 这些 CIK 细胞代表了一种新颖的 治疗剂，当用作高剂量治疗的辅助剂时， 自体移植，可能会减少术后复发的主要问题 自体嫁接。 项目 II 中的研究基于过去的成就 研究实验室和诊所。 以往经验分析 允许我们定义霍奇金病和结构的风险组 相应的准备方案。 我们计划采取全面的方法 通过表征淋巴瘤来研究非霍奇金淋巴瘤 组织，从单采血液成分中清除淋巴瘤，比较两种 准备方案，并引入新的移植后 免疫疗法走向临床。 骨髓增生异常的可能性或 将研究急性白血病作为高剂量治疗的迟发效应 前瞻性地对所有患者进行治疗。 项目II将作为临床 其他子项目的资源。