Zevalin/BEAM/Rituximab vs BEAM/Rituximab With or Without Rituximab in Autologous Stem Cell Transplantation

Sponsor
M.D. Anderson Cancer Center (Other)
Overall Status
Completed
CT.gov ID
NCT00591630
Collaborator
(none)
30
1
4
147.7
0.2

Study Details

Study Description

Brief Summary

The goal of this clinical research study is to learn if the addition of 90Y Zevalin to BEAM chemotherapy (carmustine, etoposide, cytarabine, and melphalan) and rituximab is more effective than the combination of BEAM and rituximab alone in patients with lymphoma who receive a stem cell transplant.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

The Study Drugs:

90Y Zevalin is designed to attach to lymphoma cells, and destroy the cells using a radiation particle that is attached to it.

111In Zevalin is like 90Y Zevalin, but the radioactive particle that is attached to it does not kill lymphoma cells. The radioactive particle makes the drug able to be seen inside your body. It is being used in this study to predict how fast the study drug will travel in the body and how long the drug stays in the body.

Carmustine, etoposide, cytarabine, and melphalan (BEAM) are designed to kill lymphoma cells by damaging the cells DNA.

Rituximab is designed to attach to lymphoma cells, which may cause them to die.

Study Groups 1 and 2:

If you are found to be eligible to take part in this study, you will be randomly assigned (as in the toss of a coin) to 1 of 2 groups. You will have an equal chance of being assigned to each group. Group 1 will receive 90Y Zevalin along with rituximab and BEAM therapy. Group 2 will receive rituximab and BEAM therapy. You and the study staff will know which group you are in.

Study Drug Administration:

If you are in Group 1, you will receive rituximab through a needle in your vein (over 4-5 hours) followed by 111In Zevalin by vein (over 15 minutes). A nuclear scan will be done within the following 40 to 48 hours to see how the drug is traveling through your body.

If intolerable side effects are not shown by the scans, you will receive rituximab (over 4-5 hours) and 90Y Zevalin (over 15 minutes) through a needle in your vein 7 days after the 111In Zevalin infusion.

You will begin BEAM chemotherapy 7 days after the second 90Y Zevalin infusion.

BEAM Chemotherapy:

Both groups will have 7 days of BEAM combination chemotherapy.

  • On Day 1, you will receive carmustine through a needle in your vein over 1 hour.

  • On Days 2-5 you will receive cytarabine by vein (over 1 hour) followed by etoposide (over 3 hours). Both infusions will be repeated every 12 hours on Days 2-5.

  • On Day 6 you will be given melphalan by vein over 30 minutes.

  • On Day 7 the stem cells that were collected earlier from you will be given back ("transplanted") through a catheter over 30-45 minutes.

  • You will also receive rituximab by vein (over 5-7 hours) on Day 8.

You will receive rituximab (over 4-5 hours) 7 days after the stem cell transplant. You will receive G-CSF by injection once a day starting 7 days after the stem cell transplant until your blood counts return to a normal level. You should stay in the Houston area for about 2-4 weeks after the transplant.

Study Procedures:

At about 1 month after the transplant you will have x-rays, CT scans, and positron emission tomography (PET) scans. You will also have a bone marrow aspirate and biopsy to check the status of the disease.

Blood (about 1 tablespoon) will be drawn once a day while you are in the hospital to check your blood counts.

Blood tests (about 1-2 tablespoons), urine tests, bone marrow collections, and x-rays may be done as needed to track the effects of the transplant.

You will have transfusions of blood and platelets as needed.

Study Groups A and B:

About 1 month after the transplant, you will be randomly assigned (as in the toss of a coin) to 1 of 2 new groups (Group A and Group B). Group A will receive rituximab by vein over 5-7 hours, once every 3 months, starting 3 months after the stem cell transplant. You will receive rituximab for the first 18 months after the stem cell transplant. Group B will not receive rituximab. You will have an equal chance of being in each group.

Follow-up Visits:

You will return to the clinic every 6 months for 5 years to check the status of the disease.

The following tests and procedures will be performed:
  • Blood (about 1-2 tablespoons) and urine will be collected for routine tests.

  • You will have a bone marrow biopsy to check the status of the disease.

  • You will have a chest x-ray and a CT scan.

  • You will have a PET scan.

Length of Study:

You may stay on study as long as you are benefitting. You will be taken off-study if the disease gets worse or intolerable side effects occur.

This is an investigational study. 90Y-Zevalin is approved by the FDA for relapsed and refractory lymphoma. Its use in this study is investigational. 111In Zevalin, Carmustine, etoposide, cytarabine, melphalan, and Rituximab are all FDA approved and commercially available. However, their use together in this study is also investigational. Up to 50 patients will be take part in this study. All will be enrolled at MD Anderson.

Study Design

Study Type:
Interventional
Actual Enrollment :
30 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Zevalin/BEAM/Rituximab vs BEAM/Rituximab With or Without Rituximab Maintenance in Autologous Stem Cell Transplantation for Diffuse Large B-Cell Lymphomas
Actual Study Start Date :
Nov 14, 2007
Actual Primary Completion Date :
Mar 5, 2020
Actual Study Completion Date :
Mar 5, 2020

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: Zevalin + BEAM + Rituximab +Stem Cell Transplant + Rituximab

Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab

Drug: Zevalin
(111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein.
Other Names:
  • Ibritumomab
  • IDEC-Y2B8
  • Drug: Carmustine
    300 mg/m^2 by vein.
    Other Names:
  • BCNU
  • BiCNU
  • Drug: Etoposide
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • VePesid
  • Drug: Cytarabine
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • Ara-C
  • Cytosar
  • DepoCyt
  • Cytosine arabinosine hydrocholoride
  • Drug: Melphalan
    140 mg/m^2 by vein.

    Drug: Rituximab
    Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy.
    Other Names:
  • Rituxan
  • Procedure: Stem Cell Transplant
    Injection of stem cells (Autologous SCT)
    Other Names:
  • Stem Cell Transplantation
  • SCT
  • Active Comparator: Zevalin + BEAM + Rituximab +Stem Cell Transplant

    Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant

    Drug: Zevalin
    (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein.
    Other Names:
  • Ibritumomab
  • IDEC-Y2B8
  • Drug: Carmustine
    300 mg/m^2 by vein.
    Other Names:
  • BCNU
  • BiCNU
  • Drug: Etoposide
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • VePesid
  • Drug: Cytarabine
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • Ara-C
  • Cytosar
  • DepoCyt
  • Cytosine arabinosine hydrocholoride
  • Drug: Melphalan
    140 mg/m^2 by vein.

    Drug: Rituximab
    Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy.
    Other Names:
  • Rituxan
  • Procedure: Stem Cell Transplant
    Injection of stem cells (Autologous SCT)
    Other Names:
  • Stem Cell Transplantation
  • SCT
  • Active Comparator: BEAM + Rituximab + Stem Cell Transplant + Rituximab

    BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab

    Drug: Carmustine
    300 mg/m^2 by vein.
    Other Names:
  • BCNU
  • BiCNU
  • Drug: Etoposide
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • VePesid
  • Drug: Cytarabine
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • Ara-C
  • Cytosar
  • DepoCyt
  • Cytosine arabinosine hydrocholoride
  • Drug: Melphalan
    140 mg/m^2 by vein.

    Drug: Rituximab
    Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy.
    Other Names:
  • Rituxan
  • Procedure: Stem Cell Transplant
    Injection of stem cells (Autologous SCT)
    Other Names:
  • Stem Cell Transplantation
  • SCT
  • Active Comparator: BEAM + Rituximab + Stem Cell Transplant

    BEAM + Rituximab Followed by Stem Cell Transplant

    Drug: Carmustine
    300 mg/m^2 by vein.
    Other Names:
  • BCNU
  • BiCNU
  • Drug: Etoposide
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • VePesid
  • Drug: Cytarabine
    200 mg/m^2 by vein every 12 hours.
    Other Names:
  • Ara-C
  • Cytosar
  • DepoCyt
  • Cytosine arabinosine hydrocholoride
  • Drug: Melphalan
    140 mg/m^2 by vein.

    Drug: Rituximab
    Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy.
    Other Names:
  • Rituxan
  • Procedure: Stem Cell Transplant
    Injection of stem cells (Autologous SCT)
    Other Names:
  • Stem Cell Transplantation
  • SCT
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Participants With a 2-Year Progression-Free Survival (PFS) [2 years (beginning day 30 after treatment)]

      Response evaluated using the standard criteria response for lymphoma through CT scan.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 70 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Relapsed CD20-positive B-cell diffuse large cell lymphoma (demonstrated in lymph nodes or bone marrow), chemosensitive (at least PR).

    2. Age: up to 18-70 years of age.

    3. Prestudy performance status of 0, 1, or 2 according to the WHO.

    4. No anti-cancer therapy started within three weeks, prior to study initiation, and fully recovered from all toxicities associated with prior surgery, radiation treatments, chemotherapy, or immunotherapy. No prior rituximab within three weeks of starting therapy.

    5. If patients had prior radiation, this should have not involved more than 25% of the bone marrow.

    6. Acceptable hematologic status within two weeks prior to patient registration, including: Absolute neutrophil count ({segmented neutrophils + bands} x total WBC) > 1,500/mm³ and platelet counts > 80,000/mm³

    7. IRB -approved signed informed consent.

    8. Patients determined to have <10% bone marrow involvement with lymphoma within 60 days before study entry as defined by bone marrow aspirates and biopsies.

    9. Female patients included must not be pregnant or lactating.

    10. Patients should have at least 4-6 x 10^6 CD34+/kg peripheral stem cells collected. Around 1-2 million cells will beheld as back up.

    11. Voluntary signed, written IRB-approved informed consent before performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.

    12. Men and women of reproductive potential must agree to follow accepted birth control methods for the duration of the study. Female subject is either post-menopausal or surgically sterilized or willing to use an acceptable method of birth control (i.e., a hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence) for the duration of the study. Male subject agrees to use an acceptable method for contraception for the duration of the study.

    Exclusion Criteria:
    1. Failed stem cell collection of >/= 4x10^6CD34+/kg.

    2. Prior radioimmunotherapy.

    3. Presence of active CNS lymphoma.

    4. Patients with abnormal liver function: total bilirubin > 1.5 mg/dl.

    5. Patients with abnormal renal function: serum creatinine > 1.6 mg/dl.

    6. Serious nonmalignant disease or infection which, in the opinion of the investigator and/or the sponsor, would compromise other protocol objectives.

    7. Corrected DLCO < 50% and FEV subscript 1 or FVC < 50% predicted.

    8. Cardiac EF < 50% by 2-D Echogram.

    9. Prior radiation to lungs.

    10. Abnormal cytogenetics predictive of secondary cancers, such as -5,-7.

    11. Pregnant (Positive Beta HCG test in a woman with child bearing potential defined as not post-menopausal for 12 months or no previous surgical sterilization) or currently breast-feeding. Pregnancy testing is not required for post-menopausal or surgically sterilized women.

    12. Patients with other malignancies diagnosed within 2 years prior to Study entry (except skin squamous or basal cell carcinoma).

    13. Active uncontrolled bacterial, viral fungal infections.

    14. Major surgical procedure or significant traumatic injury within 4 weeks prior to Study entry.

    15. Serious, non-healing wound, ulcer, or bone fracture.

    16. History of abdominal fistula, gastrointestinal perforation or intra-abdominal abscess within 3 months prior to Study entry.

    17. History of Stroke within 6 months.

    18. Myocardial infarction within the past 6 months prior to Study Day 1, or has New York Heart Association (NYHA) Class III or IV heart failure or arrythmias, unstable angina, uncontrolled congestive heart failure or arrythmias, or electrocardiographic evidence of acute ischemia or active conduction system abnormalities. Prior to study entry, any ECG abnormality at screening must be documented by investigator as not medically relevant.

    19. Uncontrolled chronic diarrhea.

    20. Serious medical or psychiatric illness likely to interfere with participation in this clinical study.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Texas MD Anderson Cancer Center Houston Texas United States 77030

    Sponsors and Collaborators

    • M.D. Anderson Cancer Center

    Investigators

    • Principal Investigator: Issa F. Khouri, MD, M.D. Anderson Cancer Center

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT00591630
    Other Study ID Numbers:
    • 2006-1018
    • NCI-2012-01753
    First Posted:
    Jan 11, 2008
    Last Update Posted:
    Feb 2, 2021
    Last Verified:
    Jan 1, 2021
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by M.D. Anderson Cancer Center
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Arm/Group Description Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT)
    Period Title: Overall Study
    STARTED 6 8 10 6
    COMPLETED 6 8 9 6
    NOT COMPLETED 0 0 1 0

    Baseline Characteristics

    Arm/Group Title Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant Total
    Arm/Group Description Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) Total of all reporting groups
    Overall Participants 6 8 10 6 30
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    5
    83.3%
    7
    87.5%
    7
    70%
    6
    100%
    25
    83.3%
    >=65 years
    1
    16.7%
    1
    12.5%
    3
    30%
    0
    0%
    5
    16.7%
    Sex: Female, Male (Count of Participants)
    Female
    1
    16.7%
    3
    37.5%
    4
    40%
    4
    66.7%
    12
    40%
    Male
    5
    83.3%
    5
    62.5%
    6
    60%
    2
    33.3%
    18
    60%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    3
    50%
    1
    12.5%
    2
    20%
    0
    0%
    6
    20%
    Not Hispanic or Latino
    3
    50%
    5
    62.5%
    1
    10%
    3
    50%
    12
    40%
    Unknown or Not Reported
    0
    0%
    2
    25%
    7
    70%
    3
    50%
    12
    40%
    Region of Enrollment (participants) [Number]
    United States
    6
    100%
    8
    100%
    10
    100%
    6
    100%
    30
    100%

    Outcome Measures

    1. Primary Outcome
    Title Number of Participants With a 2-Year Progression-Free Survival (PFS)
    Description Response evaluated using the standard criteria response for lymphoma through CT scan.
    Time Frame 2 years (beginning day 30 after treatment)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Arm/Group Description Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT)
    Measure Participants 6 8 10 6
    Count of Participants [Participants]
    6
    100%
    8
    100%
    8
    80%
    5
    83.3%

    Adverse Events

    Time Frame 3 Years
    Adverse Event Reporting Description
    Arm/Group Title Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Arm/Group Description Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) Zevalin + BEAM + Rituximab Followed by Stem Cell Transplant Zevalin: (111In Zevalin) 5 millicurie (mCi) by vein and (90Y Zevalin) 0.4 mCI/kg by vein. Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant and Maintenance Rituximab Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT) BEAM + Rituximab Followed by Stem Cell Transplant Carmustine: 300 mg/m^2 by vein. Etoposide: 200 mg/m^2 by vein every 12 hours. Cytarabine: 200 mg/m^2 by vein every 12 hours. Melphalan: 140 mg/m^2 by vein. Rituximab: Arm 1, Arm 2 = 250 mg/m^2 by vein; Arm 1, Arm 2, Arm 3, Arm 4 = 1000 mg/m^2 by vein following Stem Cell Transplant; Arm 1, Arm 3 = 375 mg/m² by vein Maintenance Therapy. Stem Cell Transplant: Injection of stem cells (Autologous SCT)
    All Cause Mortality
    Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/6 (0%) 0/8 (0%) 1/10 (10%) 0/6 (0%)
    Serious Adverse Events
    Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/6 (0%) 0/8 (0%) 1/10 (10%) 0/6 (0%)
    Cardiac disorders
    CD OTH 0/6 (0%) 0/8 (0%) 1/10 (10%) 0/6 (0%)
    Nervous system disorders
    NE OTH 0/6 (0%) 0/8 (0%) 1/10 (10%) 0/6 (0%)
    Other (Not Including Serious) Adverse Events
    Group 1 - Zevalin + BEAM + Rituximab +Stem Cell Transplant Group 1 - Zevalin + BEAM + Stem Cell Transplant Group 2 - BEAM + Rituximab + Stem Cell Transplant Group 2 - BEAM + Stem Cell Transplant
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 6/6 (100%) 8/8 (100%) 9/10 (90%) 5/6 (83.3%)
    Blood and lymphatic system disorders
    Bleeding (no GI no PUL) 1/6 (16.7%) 0/8 (0%) 0/9 (0%) 0/6 (0%)
    Febrile neutropenia 2/6 (33.3%) 6/8 (75%) 5/9 (55.6%) 5/6 (83.3%)
    Cardiac disorders
    CD OTH 0/6 (0%) 0/8 (0%) 0/9 (0%) 0/6 (0%)
    Chest pain 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 0/6 (0%)
    Dysrhythmia 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 0/6 (0%)
    Gastrointestinal disorders
    Diarrhea 6/6 (100%) 7/8 (87.5%) 4/9 (44.4%) 2/6 (33.3%)
    Nausea 6/6 (100%) 8/8 (100%) 9/9 (100%) 5/6 (83.3%)
    Oral mucositis 6/6 (100%) 8/8 (100%) 7/9 (77.8%) 5/6 (83.3%)
    General disorders
    Bone pain 0/6 (0%) 0/8 (0%) 0/9 (0%) 1/6 (16.7%)
    Edema 0/6 (0%) 0/8 (0%) 0/9 (0%) 1/6 (16.7%)
    Fatigue 1/6 (16.7%) 0/8 (0%) 0/9 (0%) 1/6 (16.7%)
    Fever 0/6 (0%) 1/8 (12.5%) 3/9 (33.3%) 1/6 (16.7%)
    Flu like syndrome 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 0/6 (0%)
    Fluid overload 2/6 (33.3%) 2/8 (25%) 4/9 (44.4%) 1/6 (16.7%)
    Immune system disorders
    Allergic reaction 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 1/6 (16.7%)
    Infections and infestations
    Bacterial 2/6 (33.3%) 2/8 (25%) 2/9 (22.2%) 0/6 (0%)
    Fungal 0/6 (0%) 1/8 (12.5%) 0/9 (0%) 0/6 (0%)
    IN FEC 1/6 (16.7%) 0/8 (0%) 0/9 (0%) 0/6 (0%)
    Viral 1/6 (16.7%) 0/8 (0%) 0/9 (0%) 1/6 (16.7%)
    Investigations
    ALK increased 1/6 (16.7%) 3/8 (37.5%) 1/9 (11.1%) 4/6 (66.7%)
    ALT increased 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 1/6 (16.7%)
    Creatinine increased 0/6 (0%) 1/8 (12.5%) 1/9 (11.1%) 0/6 (0%)
    T bilirubin increased 1/6 (16.7%) 1/8 (12.5%) 1/9 (11.1%) 2/6 (33.3%)
    Nervous system disorders
    Headache 0/6 (0%) 1/8 (12.5%) 1/9 (11.1%) 0/6 (0%)
    NE COR 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 0/6 (0%)
    NE OTH 0/6 (0%) 0/8 (0%) 0/9 (0%) 0/6 (0%)
    Psychiatric disorders
    Confusion 0/6 (0%) 1/8 (12.5%) 0/9 (0%) 0/6 (0%)
    Respiratory, thoracic and mediastinal disorders
    Dyspnea 0/6 (0%) 0/8 (0%) 0/9 (0%) 1/6 (16.7%)
    Pleural effusion 0/6 (0%) 0/8 (0%) 1/9 (11.1%) 0/6 (0%)
    Pneumonitis 1/6 (16.7%) 2/8 (25%) 1/9 (11.1%) 1/6 (16.7%)
    Skin and subcutaneous tissue disorders
    Rash 2/6 (33.3%) 0/8 (0%) 2/9 (22.2%) 2/6 (33.3%)
    Vascular disorders
    Hypertension 2/6 (33.3%) 3/8 (37.5%) 1/9 (11.1%) 1/6 (16.7%)
    Hypotension 1/6 (16.7%) 1/8 (12.5%) 1/9 (11.1%) 0/6 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    All Principal Investigators ARE employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Issa F. Khouri, MD / Stem Cell Transplantation
    Organization University of Texas MD Anderson Cancer Center
    Phone 713-792-8750
    Email ikhouri@mdanderson.org
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT00591630
    Other Study ID Numbers:
    • 2006-1018
    • NCI-2012-01753
    First Posted:
    Jan 11, 2008
    Last Update Posted:
    Feb 2, 2021
    Last Verified:
    Jan 1, 2021