Low-Intensity Stem Cell Transplantation With Multiple Lymphocyte Infusions to Treat Advanced Kidney Cancer

Sponsor
National Cancer Institute (NCI) (NIH)
Overall Status
Completed
CT.gov ID
NCT00923845
Collaborator
(none)
25
1
2
111.7
0.2

Study Details

Study Description

Brief Summary

Background:

Low-dose chemotherapy is easier for the body to tolerate than typical high-dose chemotherapy and involves a shorter period of complete immune suppression.

Donor immune cells called lymphocytes, or T cells, fight residual tumor cells that might have remained in the recipients body after stem cell transplant, in what is called a graft-versus-tumor (GVT) effect.

The immune-suppressing drug sirolimus appears to help prevent graft-versus-host disease (GVHD), a side effect of stem cell transplant in which donated T cells sometimes attack healthy tissues, damaging organs such as the liver, intestines and skin.

Th2 cells are cells collected from the transplant donor and grown in a high concentration of sirolimus.

Objectives:

To determine whether stem cell transplantation using low-dose chemotherapy and sirolimus-generated Th2 cells can cause a remission of advanced kidney cancer.

Eligibility:

Patients between 18 and 75 years of age who have kidney cancer that has spread beyond the kidney and who have a tissue-matched sibling stem cell donor.

Design:
Patients undergo stem cell transplantation as follows:
  • Low-intensity chemotherapy with pentostatin and cyclophosphamide over a 21-day period to reduce the level of the immune system to prepare for the transplant. Pentostatin is given through a vein (intravenous (IV)) on days 1, 8 and 15; cyclophosphamide tablets are taken by mouth for 21 consecutive days.

  • Sirolimus tablets, taken by mouth, starting 2 days before the transplant and continuing until 60 days after the transplant.

  • IV infusions of stem cells and Th2 cells.

Following the transplant, patients have the following procedures:
  • Additional Th2 cell infusions on days 14 and 45 after the transplant.

  • Follow-up visits at the National Institutes of Health (NIH) Clinical Center twice a week for the first 6 months after the transplant and then less frequently for at least 5 years to evaluate response to treatment and treatment side effects. Evaluations include a bone marrow aspirate and biopsy 1 month after transplant and periodic blood tests and imaging procedures (e.g., computed tomography (CT) or magnetic resonance imaging (MRI) scans).

Condition or Disease Intervention/Treatment Phase
  • Drug: Pentostatin
  • Drug: Sirolimus
  • Drug: Cyclophosphamide
  • Procedure: Allogeneic Hematopoietic Stem Cell Transplant (HSCT)
  • Procedure: Th2 rapa cells
  • Procedure: Donor Lymphocyte Harvest
  • Procedure: Induction Therapy
  • Procedure: GVHD prophylaxis
  • Procedure: Donor Hematopoietic Stem Cell Harvest
Phase 2

Detailed Description

Background:

Allogeneic hematopoietic stem cell transplantation (HSCT) represents a potentially effective treatment option for patients with metastatic renal cell carcinoma (RCC).

In a pilot clinical trial in refractory hematologic malignancy subjects, we have found that augmentation of a T cell-replete allograft with donor Th2 cells generated ex vivo in sirolimus (rapamycin; Th2.rapa cells) allows prompt donor engraftment after outpatient-intensity chemotherapy. This transplant approach has been associated with a low incidence of acute graft versus host disease (GVHD).

Based on these data, we seek to safely achieve objective clinical regression of metastatic RCC by the following new transplant approach. (1) The allograft will be administered after a low intensity, outpatient induction chemotherapy regimen consisting of pentostatin and cyclophosphamide. This regimen is intended to provide sufficient host immune T cell depletion, and as such, a conventional preparative regimen will not be administered. (2) To avoid mixed chimerism for rapid potentiation of graft-versus-tumor (GVT) effects, a growth colony stimulating factor (G-CSF) mobilized allograft will be augmented with donor lymphocyte infusion at day 14 post-transplant consisting of Th2.rapa cells.

Objectives:

Primary objective: (1) Determine whether this new, low-intensity transplant approach can yield objective partial or complete remission of metastatic RCC, with the goal of ruling out a partial response (PR)/complete response (CR) rate of 20% in favor of a rate of 60%.

Secondary objectives: (1) Evaluate the safety and immune-depleting properties of the pentostatin/cyclophosphamide regimen; (2) Characterize the engraftment kinetics and GVHD profile of this new transplant approach; and (3) Characterize post-transplant immunity in study subjects, including cytokine phenotype, immune reconstitution, and potential anti-tumor effector mechanisms.

Eligibility:

Adults (18 - 75 years) with metastatic RCC who have an eligible 6/6 human leukocyte antigen (HLA)-matched sibling donor.

Must have had one prior therapy with either sorafenib, sunitinib, or temsirolimus or any other Food and Drug Administration (FDA)-approved agent for therapy of metastatic renal cell carcinoma..

Life expectancy greater than or equal to 3 months, Karnofsky score greater than or equal to 80, relatively normal organ function, and absence of central nervous system (CNS) metastases.

Design:

Patients will receive a 21-day course of pentostatin (intravenous infusion on days 1, 8, and 15; 4 mg/m^2 per dose) and daily oral cyclophosphamide (200 mg per day).

Patients will receive a mobilized, T cell-replete allogeneic hematopoietic stem cell graft followed by a pre-emptive donor lymphocyte infusion with donor Th2 cells at day 14 post-transplant. GVHD prophylaxis will consist of a short-course of sirolimus plus maintenance therapy with cyclosporine A.

If greater than or equal to 2/5 partial or complete responses are observed within 6 months post-transplant, the therapy will be considered potentially promising, and will be expanded in a Simon two-stage design to evaluate a total of n = 14 subjects. If greater than or equal to 5/14 PR/CR are achieved, the therapy will be considered worthy of further investigation.

Study Design

Study Type:
Interventional
Actual Enrollment :
25 participants
Allocation:
Non-Randomized
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Low Intensity Allogeneic Hematopoietic Stem Cell Transplantation Therapy of Metastatic Renal Cell Carcinoma Using Early and Multiple Donor Lymphocyte Infusions Consisting of Sirolimus-Generated Donor Th2 Cells
Actual Study Start Date :
Mar 1, 2008
Actual Primary Completion Date :
Jun 1, 2015
Actual Study Completion Date :
Jun 22, 2017

Arms and Interventions

Arm Intervention/Treatment
Other: Donors

A sibling who is 6/6 HLA --matched with the recipient. Donors undergo donor lymphocyte harvest and stem cell mobilization and harvest.

Procedure: Donor Lymphocyte Harvest
Apheresis

Procedure: Donor Hematopoietic Stem Cell Harvest
Following lymphocyte harvest, donors for recipients will undergo stem cell mobilization and harvest.

Other: Recipients

Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.

Drug: Pentostatin
Pentostatin: 2- 4mg/m^2(CrCL based dosing) intravenous (IV) on days 1, 8, and 15
Other Names:
  • Nipent
  • Drug: Sirolimus
    Sirolimus: 4 mg by mouth (PO) on days -3 to +7 post-transplant (No Sirolimus administered after day 7 post-stem cell transplant (SCT))
    Other Names:
  • Rapamune
  • Drug: Cyclophosphamide
    Cyclosporine: 2 mg/kg every 12 hours PO or IV starting on day -4 of hematopoietic stem cell transplant (HSCT)
    Other Names:
  • Cytoxan
  • Procedure: Allogeneic Hematopoietic Stem Cell Transplant (HSCT)
    Allogeneic Hematopoietic Stem Cell Transplant

    Procedure: Th2 rapa cells
    Th2 rapa cell Transplantation

    Procedure: Induction Therapy
    Pentostatin and cyclophosphamide (PC) conditioning regimen.

    Procedure: GVHD prophylaxis
    Short course of sirolimus plus maintenance therapy with sirolimus A.

    Outcome Measures

    Primary Outcome Measures

    1. Clinical Regression of Metastatic Renal Cell Carcinoma (Partial Response (PR)) or Complete Remission of Tumor (Complete Response (CR)) [6 Months Post-Transplant (Day +100)]

      Response was assessed by computed tomography measurements and the Response Evaluation Criteria in Solid Tumors (RECIST). Complete response (CR) is disappearance of all target lesions. Partial response (PR) is at least a 30% decrease in the sum of the largest diameter (LD) of target lesions, taking as reference the baseline sum LD. Stable disease (SD) is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. Progressive disease (PD) is at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest LD recorded since the treatment started or the appearance of one or more new lesions.

    Secondary Outcome Measures

    1. Count of Participants With Adverse Events [50 months and 6 days]

      Here is the number of participants with adverse events. For a detailed list of adverse events, see the adverse event module.

    2. Count of Patients Having Neutropenia Attributable to the Pentostatin and Cyclophosphamide (PC) Regimen [During the 21-day PC regimen]

      Absolute neutrophil count determination by complete blood count methodology (Absolute Neutrophil Count (ANC) < 500 Cells/µL).

    3. Count of Patients Having an Infectious Complication Attributable to the Pentostatin and Cyclophosphamide (PC) Regimen [During the 21-day PC regimen]

      Occurrence of infection by Common Terminology Criteria for Adverse Events (CTCAE).

    4. Immune Depletion in Cluster of Differentiation 4 (CD4) Cells [Baseline and day 21 (completion of the pentostatin/cyclophosphamide regimen)]

      Reduction in cluster of differentiation 4 (CD4)+ T cells [change in median values and (range of values)].

    5. Immune Depletion in Cluster of Differentiation 8 (CD8)+ T Cells [Baseline and day 21 (completion of the pentostatin/cyclophosphamide regimen)]

      Reduction in cluster of differentiation 8 (CD8)+ T cells [change in median values and (range of values)].

    6. Immune Suppression [Cytokine analysis at baseline and within 24 hours of completion of the pentostatin/cyclophosphamide regimen]

      Immune suppression is defined by the frequency of elimination of a pre-transplant T cell cytokine value.

    7. Engraftment Donor T Cell and Myeloid Cell Chimerism [Days 14, 28, 45, and 60 post transplant]

      Donor Genetic Elements by variable number tandem repeat-polymerase chain reaction (VNTR-PCR) Analysis.

    8. Count of Patients With Grade II or Greater Acute Graft Versus Host Disease (GVHD) in First 100 Days Post-Transplant [100 days post transplant]

      Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD may include rash, diarrhea, and liver damage (i.e. rash Grading: <25% body surface area (BSA) = 1, rash 25-50% BSA = 2, generalized erythroderma = 3, and desquamation and bullae = 4); liver Grading: total bilirubin 2-3 mg/dl = 1, total bilirubin 3-6 mg/dl =2, total bilirubin 6-15 mg/dl =3, and total bilirubin >15 mg/dl = 4)).

    9. Count of Patients With Late Acute Graft Versus Host Disease (GVHD) After Day 100 Post-Transplant [100 days post-transplant through 5 years post-transplant]

      Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD may include rash, diarrhea, and liver damage (i.e. rash Grading: <25% body surface area (BSA) = 1, rash 25-50% BSA = 2, generalized erythroderma = 3, and desquamation and bullae = 4); liver Grading: total bilirubin 2-3 mg/dl = 1, total bilirubin 3-6 mg/dl =2, total bilirubin 6-15 mg/dl =3, and total bilirubin >15 mg/dl = 4)).

    10. Count of Patients With Chronic Graft Versus Host Disease (GVHD) [For the duration of post-transplant follow-up]

      Chronic GVHD was assessed by the 2005 Chronic GVHD Consensus Project. Chronic GVHS may include dryness of the mouth and eyes, weight loss, liver damage and lung damage leading to cough and shortness of breath (i.e. skin Grading: no symptoms = 0, <18% body surface area (BSA) = 1, 19-50% BSA = 2, and >50% BSA = 3); oral cavity Grading: no symptoms = 0, mild symptoms = 1, moderate symptoms =2 and severe symptoms =3)).

    11. Cluster of Differentiation 4 (CD4) T Cells Immune Reconstitution [Days 14, 60, and 100 post transplant]

      CD4 T Cells immune reconstitution is defined as distribution of CD4+ T cells subsets within naïve, central memory, effector memory, and effector memory-RA cells analyzed by flow cytometry.

    12. Cluster of Differentiation 8 (CD8)+ T Cells Immune Reconstitution [Days 14, 60, and 100 post transplant]

      CD8+ T Cells immune reconstitution is defined as distribution of CD8+ T cells subsets within naïve, central memory, effector memory, and effector memory-RA cells analyzed by flow cytometry.

    13. Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the Th2 Transcription Factor GATA Binding Protein 3 (GATA-3) [Days 14, 60 and 100 post transplant]

      Intra-cellular flow cytometry detection of GATA3 transcription factor.

    14. Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the Th1 Transcription Factor T-bet [Days 14, 60, and 100 post transplant]

      CD4+ T cells were analyzed by flow cytometry for intracellular detection of Tbet transcription factor.

    15. Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the T-reg Transcription Factor Forkhead Box P3 (FoxP3)) [Days 14, 60, and 100 post transplant]

      CD4+ T cells were analyzed by flow cytometry for intracellular expression of FoxP3.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 75 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    • INCLUSION CRITERIA: Recipient

    Diagnosis of metastatic renal cell carcinoma, either clear cell type or non-clear cell type. The diagnosis must be confirmed by the Laboratory of Pathology of National Cancer Institute (NCI) or Hackensack (there will be no central pathology review).

    The consent process will include a discussion of the potential role of high-dose interleukin-2 (IL-2) therapy prior to protocol enrollment. High-dose IL-2 therapy is not widely available, but may be available on an NCI protocol (Dr. Yang) or through Dr. Alter for Hackensack patients. IL-2 therapy may also be administered by any other qualified physician; the Novartis web-site has a list of such physicians. For subjects who are deemed to be eligible for high-dose IL-2 and elect to receive this therapy, such subjects must have progressive disease post-IL-2 to enter this study; such subjects must also have received and have had progressive disease after therapy with one of the agents listed below.

    Subject must have progressive disease after therapy consisting of one of the following Food and Drug Administration (FDA)-approved agents: sorafenib, sunitinib, or temsirolimus.

    Patients 18 - 75 years of age. Subjects older than 75 will not be enrolled due to an increased rate of transplant-related complications.

    Must have consenting sibling matched at 6/6 human leukocyte antigen (HLA) antigens (A, B, DR).

    Patient or legal guardian must be able to give informed consent.

    All previous therapy must be completed at least 2 weeks prior to study entry. Any grade 3 or 4 non-hematologic toxicity of any previous therapy must have resolved to grade 2 or less.

    Karnofsky performance status greater than or equal to 80%.

    Life expectancy of at least 3 months.

    Left ventricular ejection fraction greater than 40% (multi-gated acquisition scan (MUGA) or echo) within 28 days of enrollment.

    Carbon monoxide diffusing capacity (DLCO) greater than 50% of expected value (hemoglobin (Hb) corrected), obtained within 28 days of enrollment.

    Creatinine clearance greater than or equal to 40 ml/min. Creatinine clearance will be determined by testing of a 24 hour urine collection and simultaneous serum creatinine value. In previous studies, the creatine clearance of patients with metastatic renal cell cancer who underwent nephrectomy was 53 plus or minus 19.

    Serum total bilirubin less than 2.5 mg/dl, and serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values less than or equal to 2.5 times the upper limit of normal. ALT and AST values above these levels may be accepted (up to a maximum of 5 times the upper limit of normal), at the discretion of the principal investigator (PI) or study chairperson, if such elevations are thought to be due to liver involvement by malignancy.

    INCLUSION CRITERIA : Donor

    Sibling who is 6/6 HLA-matched with recipient.

    Ability to give informed consent.

    Age 18 years to 80 years. Donors older than 80 will not be eligible due to potentially increased complications from the donation procedure.

    Adequate venous access for peripheral apheresis, or consent to use a temporary central venous catheter for apheresis.

    Donors must be human immunodeficiency virus (HIV) negative, hepatitis B surface antigen negative, and hepatitis C antibody negative. This is to prevent the possible transmission of these infections to the recipient. Donors with a history of hepatitis B or hepatitis C infections may be eligible. However, eligibility determination of such patients will require a hepatology consultation. The risk/benefit of the transplant and the possibility of transmitting hepatitis will be discussed with the patient and eligibility will then be determined by the principal investigator.

    A donor who is lactating must substitute formula feeding for her infant during the period of cytokine administration. Filgrastim may be secreted in human milk, although its bioavailability from this source is not known. Limited clinical data suggest that administration of filgrastim or to neonates is not associated with adverse outcomes.

    EXCLUSION CRITERIA: Recipient

    Active infection that is not responding to antimicrobial therapy.

    Active central nervous system (CNS) involvement by malignancy.

    HIV infection. There is theoretical concern that the degree of immune suppression associated with the treatment may result in progression of HIV infection.

    Chronic active hepatitis B. Patient may be hepatitis B core antibody positive. For patients with concomitant positive hepatitis B surface antigen, patient will require a hepatology consultation. The risk/benefit profile of transplant and hepatitis B will be discussed with the patient and eligibility determined by the principal investigator and protocol chairperson.

    Hepatitis C infection. Patient may have hepatitis C infection. However, each patient will require a hepatology consultation. The risk/benefit profile of transplant and hepatitis C will be discussed with the patient and eligibility determined by the principal investigator and protocol chairperson.

    Pregnant or lactating. Patients of childbearing potential must use an effective method of contraception from the time of study entry to at least one year post-transplant; effective methods include intrauterine device (IUD), hormonal (birth control pills, injections, or implants), tubal ligation/hysterectomy, partner s vasectomy, or barrier methods (condom, diaphragm, or cervical cap). Males on the protocol, and their partners of child-bearing potential, must also use an effective form of contraception at study entry and for one year post-transplant. The effects of the chemotherapy, the subsequent transplant, and the medications used after the transplant are highly likely to be harmful to a fetus. The effects upon breast milk are also unknown and may be harmful to the infant; therefore, women should not breastfeed during the interval from study entry to one year post-transplant.

    History of psychiatric disorder which may compromise compliance with transplant protocol, or which does not allow for appropriate informed consent (as determined by principal investigator or study chairman).

    EXCLUSION CRITERIA: Donor

    History of psychiatric disorder which may compromise compliance with transplant protocol, or which does not allow for appropriate informed consent.

    History of hypertension that is not controlled by medication, stroke, or severe heart disease. Individuals with symptomatic angina will be considered to have severe heart disease and will not be eligible to be a donor.

    No other medical contraindications to stem cell donation (i.e. severe atherosclerosis, autoimmune disease, iritis or episcleritis, deep venous thrombosis, cerebrovascular accident). Patients with a history of coronary artery bypass grafting or angioplasty will receive a cardiology evaluation and be considered on a case-by-case basis.

    History of prior malignancy. However, cancer survivors who have undergone potentially curative therapy may be considered for stem cell donation on a case-by-case basis. The risk/benefit of the transplant and the possibility of transmitting viable tumor cells at the time of transplantation will be discussed with the patient.

    Donors must not be pregnant. The effects of cytokine therapy on a fetus are unknown. Donors of childbearing potential must use an effective method of contraception from the time of study entry until at least one year post-transplant.

    Anemia (Hb less than 11 gm/dl) or thrombocytopenia (platelets less than 100,000 per microliter).

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 National Institutes of Health Clinical Center, 9000 Rockville Pike Bethesda Maryland United States 20892

    Sponsors and Collaborators

    • National Cancer Institute (NCI)

    Investigators

    • Principal Investigator: Daniel H Fowler, M.D., National Cancer Institute (NCI)

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    Responsible Party:
    Daniel Fowler, M.D., Principal Investigator, National Institutes of Health Clinical Center (CC)
    ClinicalTrials.gov Identifier:
    NCT00923845
    Other Study ID Numbers:
    • 080088
    • 08-C-0088
    • NCT00641485
    First Posted:
    Jun 18, 2009
    Last Update Posted:
    Sep 29, 2017
    Last Verified:
    Sep 1, 2017
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by Daniel Fowler, M.D., Principal Investigator, National Institutes of Health Clinical Center (CC)
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Donors Recipients
    Arm/Group Description A sibling who is 6/6 HLA --matched with the recipient. Donors undergo donor lymphocyte harvest and stem cell mobilization and harvest. Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Period Title: Donor Lymphocyte Harvest
    STARTED 13 0
    COMPLETED 13 0
    NOT COMPLETED 0 0
    Period Title: Donor Lymphocyte Harvest
    STARTED 13 0
    COMPLETED 13 0
    NOT COMPLETED 0 0
    Period Title: Donor Lymphocyte Harvest
    STARTED 0 12
    COMPLETED 0 10
    NOT COMPLETED 0 2
    Period Title: Donor Lymphocyte Harvest
    STARTED 0 10
    Received Each of 3 Planned T-Rapa DLI 0 8
    Received More Unmanipulated DLI for PD 0 6
    COMPLETED 0 10
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title Donors Recipients Total
    Arm/Group Description A sibling who is 6/6 HLA --matched with the recipient. Donors undergo donor lymphocyte harvest and stem cell mobilization and harvest. Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis. Total of all reporting groups
    Overall Participants 13 12 25
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    0%
    0
    0%
    Between 18 and 65 years
    12
    92.3%
    10
    83.3%
    22
    88%
    >=65 years
    1
    7.7%
    2
    16.7%
    3
    12%
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    53.14
    (9.06)
    58.03
    (8.01)
    55.48
    (8.75)
    Sex: Female, Male (Count of Participants)
    Female
    7
    53.8%
    4
    33.3%
    11
    44%
    Male
    6
    46.2%
    8
    66.7%
    14
    56%
    Ethnicity (NIH/OMB) (Count of Participants)
    Hispanic or Latino
    0
    0%
    1
    8.3%
    1
    4%
    Not Hispanic or Latino
    11
    84.6%
    10
    83.3%
    21
    84%
    Unknown or Not Reported
    2
    15.4%
    1
    8.3%
    3
    12%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    0
    0%
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    1
    7.7%
    1
    8.3%
    2
    8%
    White
    12
    92.3%
    11
    91.7%
    23
    92%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    0
    0%
    0
    0%
    0
    0%
    Region of Enrollment (participants) [Number]
    United States
    13
    100%
    12
    100%
    25
    100%

    Outcome Measures

    1. Primary Outcome
    Title Clinical Regression of Metastatic Renal Cell Carcinoma (Partial Response (PR)) or Complete Remission of Tumor (Complete Response (CR))
    Description Response was assessed by computed tomography measurements and the Response Evaluation Criteria in Solid Tumors (RECIST). Complete response (CR) is disappearance of all target lesions. Partial response (PR) is at least a 30% decrease in the sum of the largest diameter (LD) of target lesions, taking as reference the baseline sum LD. Stable disease (SD) is neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started. Progressive disease (PD) is at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest LD recorded since the treatment started or the appearance of one or more new lesions.
    Time Frame 6 Months Post-Transplant (Day +100)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Partial Response (PR)
    0
    0%
    Complete Response (CR)
    0
    0%
    Progressive Disease (PD)
    8
    61.5%
    Stable Disease (SD)
    1
    7.7%
    Not Applicable (NA)
    1
    7.7%
    2. Secondary Outcome
    Title Count of Participants With Adverse Events
    Description Here is the number of participants with adverse events. For a detailed list of adverse events, see the adverse event module.
    Time Frame 50 months and 6 days

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Donor Recipient
    Arm/Group Description A sibling who is 6/6 HLA --matched with the recipient. Donors undergo donor lymphocyte harvest and stem cell mobilization and harvest. Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 13 12
    Count of Participants [Participants]
    0
    0%
    12
    100%
    3. Secondary Outcome
    Title Count of Patients Having Neutropenia Attributable to the Pentostatin and Cyclophosphamide (PC) Regimen
    Description Absolute neutrophil count determination by complete blood count methodology (Absolute Neutrophil Count (ANC) < 500 Cells/µL).
    Time Frame During the 21-day PC regimen

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 12
    Count of Participants [Participants]
    0
    0%
    4. Secondary Outcome
    Title Count of Patients Having an Infectious Complication Attributable to the Pentostatin and Cyclophosphamide (PC) Regimen
    Description Occurrence of infection by Common Terminology Criteria for Adverse Events (CTCAE).
    Time Frame During the 21-day PC regimen

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 12
    Count of Participants [Participants]
    0
    0%
    5. Secondary Outcome
    Title Immune Depletion in Cluster of Differentiation 4 (CD4) Cells
    Description Reduction in cluster of differentiation 4 (CD4)+ T cells [change in median values and (range of values)].
    Time Frame Baseline and day 21 (completion of the pentostatin/cyclophosphamide regimen)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Baseline
    503
    Day 21
    54
    6. Secondary Outcome
    Title Immune Depletion in Cluster of Differentiation 8 (CD8)+ T Cells
    Description Reduction in cluster of differentiation 8 (CD8)+ T cells [change in median values and (range of values)].
    Time Frame Baseline and day 21 (completion of the pentostatin/cyclophosphamide regimen)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Baseline
    239
    Day 21
    45
    7. Secondary Outcome
    Title Immune Suppression
    Description Immune suppression is defined by the frequency of elimination of a pre-transplant T cell cytokine value.
    Time Frame Cytokine analysis at baseline and within 24 hours of completion of the pentostatin/cyclophosphamide regimen

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Positive at baseline
    100
    Negative at baseline
    0
    Positive 24 hours after regimen
    0
    Negative 24 hours after regimen
    100
    8. Secondary Outcome
    Title Engraftment Donor T Cell and Myeloid Cell Chimerism
    Description Donor Genetic Elements by variable number tandem repeat-polymerase chain reaction (VNTR-PCR) Analysis.
    Time Frame Days 14, 28, 45, and 60 post transplant

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14 donor T cell chimerism
    61
    Day 28 donor T cell chimerism
    72
    Day 45 donor T cell chimerism
    74
    Day 60 donor T cell chimerism
    77
    Day 14 myeloid cell chimerism
    0
    Day 28 myeloid cell chimerism
    13
    Day 45 myeloid cell chimerism
    18
    Day 60 myeloid cell chimerism
    26
    9. Secondary Outcome
    Title Count of Patients With Grade II or Greater Acute Graft Versus Host Disease (GVHD) in First 100 Days Post-Transplant
    Description Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD may include rash, diarrhea, and liver damage (i.e. rash Grading: <25% body surface area (BSA) = 1, rash 25-50% BSA = 2, generalized erythroderma = 3, and desquamation and bullae = 4); liver Grading: total bilirubin 2-3 mg/dl = 1, total bilirubin 3-6 mg/dl =2, total bilirubin 6-15 mg/dl =3, and total bilirubin >15 mg/dl = 4)).
    Time Frame 100 days post transplant

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 12
    Count of Participants [Participants]
    0
    0%
    10. Secondary Outcome
    Title Count of Patients With Late Acute Graft Versus Host Disease (GVHD) After Day 100 Post-Transplant
    Description Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD is assessed by the 1994 Consensus Conference on Acute GVHD grading criteria. Acute GVHD may include rash, diarrhea, and liver damage (i.e. rash Grading: <25% body surface area (BSA) = 1, rash 25-50% BSA = 2, generalized erythroderma = 3, and desquamation and bullae = 4); liver Grading: total bilirubin 2-3 mg/dl = 1, total bilirubin 3-6 mg/dl =2, total bilirubin 6-15 mg/dl =3, and total bilirubin >15 mg/dl = 4)).
    Time Frame 100 days post-transplant through 5 years post-transplant

    Outcome Measure Data

    Analysis Population Description
    Only 6 patients were evaluable for this endpoint due to death due to malignancy.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 6
    Count of Participants [Participants]
    4
    30.8%
    11. Secondary Outcome
    Title Count of Patients With Chronic Graft Versus Host Disease (GVHD)
    Description Chronic GVHD was assessed by the 2005 Chronic GVHD Consensus Project. Chronic GVHS may include dryness of the mouth and eyes, weight loss, liver damage and lung damage leading to cough and shortness of breath (i.e. skin Grading: no symptoms = 0, <18% body surface area (BSA) = 1, 19-50% BSA = 2, and >50% BSA = 3); oral cavity Grading: no symptoms = 0, mild symptoms = 1, moderate symptoms =2 and severe symptoms =3)).
    Time Frame For the duration of post-transplant follow-up

    Outcome Measure Data

    Analysis Population Description
    Only 4 patients were evaluable due to mortality from malignancy.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 4
    Count of Participants [Participants]
    1
    7.7%
    12. Secondary Outcome
    Title Cluster of Differentiation 4 (CD4) T Cells Immune Reconstitution
    Description CD4 T Cells immune reconstitution is defined as distribution of CD4+ T cells subsets within naïve, central memory, effector memory, and effector memory-RA cells analyzed by flow cytometry.
    Time Frame Days 14, 60, and 100 post transplant

    Outcome Measure Data

    Analysis Population Description
    The values for each subset were stable at days 60 and 100 relative to day 14 values.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14
    22
    (3)
    Day 60
    20
    (2)
    Day 100
    19
    (2)
    13. Secondary Outcome
    Title Cluster of Differentiation 8 (CD8)+ T Cells Immune Reconstitution
    Description CD8+ T Cells immune reconstitution is defined as distribution of CD8+ T cells subsets within naïve, central memory, effector memory, and effector memory-RA cells analyzed by flow cytometry.
    Time Frame Days 14, 60, and 100 post transplant

    Outcome Measure Data

    Analysis Population Description
    The values for each subset were stable at days 60 and 100 relative to day 14 values.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14
    6
    (1)
    Day 60
    5
    (1)
    Day 100
    4
    (1)
    14. Secondary Outcome
    Title Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the Th2 Transcription Factor GATA Binding Protein 3 (GATA-3)
    Description Intra-cellular flow cytometry detection of GATA3 transcription factor.
    Time Frame Days 14, 60 and 100 post transplant

    Outcome Measure Data

    Analysis Population Description
    The values for each subset were stable at days 60 and 100 relative to day 14 values.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14
    42
    Day 60
    37
    Day 100
    43
    15. Secondary Outcome
    Title Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the Th1 Transcription Factor T-bet
    Description CD4+ T cells were analyzed by flow cytometry for intracellular detection of Tbet transcription factor.
    Time Frame Days 14, 60, and 100 post transplant

    Outcome Measure Data

    Analysis Population Description
    The values for each subset were stable at days 60 and 100 relative to day 14 values.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14
    8
    Day 60
    8
    Day 100
    6
    16. Secondary Outcome
    Title Percentage of Cluster of Differentiation 4 (CD4)+ T Cells Expressing the T-reg Transcription Factor Forkhead Box P3 (FoxP3))
    Description CD4+ T cells were analyzed by flow cytometry for intracellular expression of FoxP3.
    Time Frame Days 14, 60, and 100 post transplant

    Outcome Measure Data

    Analysis Population Description
    The values for each subset were stable at days 60 and 100 relative to day 14 values.
    Arm/Group Title Recipient
    Arm/Group Description Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    Measure Participants 10
    Day 14
    8
    Day 60
    6
    Day 100
    3

    Adverse Events

    Time Frame 50 months and 6 days
    Adverse Event Reporting Description
    Arm/Group Title Donor Recipient
    Arm/Group Description A sibling who is 6/6 HLA --matched with the recipient. Donors undergo donor lymphocyte harvest and stem cell mobilization and harvest. Recipients undergo induction therapy, allogeneic stem cell therapy and GVHD prophylaxis.
    All Cause Mortality
    Donor Recipient
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/13 (0%) 7/12 (58.3%)
    Serious Adverse Events
    Donor Recipient
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/13 (0%) 8/12 (66.7%)
    Blood and lymphatic system disorders
    Infection with normal ANC or Grade 1 or 2 neutrophils::Blood 0/13 (0%) 0 2/12 (16.7%) 2
    Gastrointestinal disorders
    Dysphagia (difficulty swallowing) 0/13 (0%) 0 1/12 (8.3%) 1
    Hemorrhage, GI::Lower GI NOS 0/13 (0%) 0 1/12 (8.3%) 1
    Nausea 0/13 (0%) 0 1/12 (8.3%) 1
    Vomiting 0/13 (0%) 0 1/12 (8.3%) 1
    General disorders
    Death not associated with CTCAE term::Death NOS 0/13 (0%) 0 2/12 (16.7%) 2
    Death not associated with CTCAE term::Disease progression NOS 0/13 (0%) 0 5/12 (41.7%) 5
    Immune system disorders
    Allergic reaction/hypersensitivity (including drug fever) 0/13 (0%) 0 1/12 (8.3%) 1
    Renal and urinary disorders
    Infection with normal ANC or Grade 1 or 2 neutrophils::Urinary tract NOS 0/13 (0%) 0 1/12 (8.3%) 1
    Respiratory, thoracic and mediastinal disorders
    Pleural effusion (non-malignant) 0/13 (0%) 0 1/12 (8.3%) 1
    Skin and subcutaneous tissue disorders
    Rash/desquamation 0/13 (0%) 0 1/12 (8.3%) 1
    Other (Not Including Serious) Adverse Events
    Donor Recipient
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/13 (0%) 12/12 (100%)
    Blood and lymphatic system disorders
    Hemoglobin 0/13 (0%) 0 9/12 (75%) 61
    Hemolysis (e.g., immune hemolytic anemia, drug-related hemolysis) 0/13 (0%) 0 2/12 (16.7%) 3
    Hemorrhage/Bleeding - Other 0/13 (0%) 0 1/12 (8.3%) 2
    Infection with normal ANC or Grade 1 or 2 neutrophils::Blood 0/13 (0%) 0 1/12 (8.3%) 2
    Infection with unknown ANC::Blood 0/13 (0%) 0 1/12 (8.3%) 1
    Leukocytes (total WBC) 0/13 (0%) 0 8/12 (66.7%) 43
    Neutrophils/granulocytes (ANC/AGC) 0/13 (0%) 0 6/12 (50%) 25
    PTT (Partial Thromboplastin Time) 0/13 (0%) 0 1/12 (8.3%) 3
    Platelets 0/13 (0%) 0 5/12 (41.7%) 60
    Cardiac disorders
    Cardiac Arrhythmia - Other 0/13 (0%) 0 2/12 (16.7%) 2
    Cardiac General - Other 0/13 (0%) 0 2/12 (16.7%) 4
    Edema: limb 0/13 (0%) 0 1/12 (8.3%) 2
    Hypertension 0/13 (0%) 0 2/12 (16.7%) 2
    Hypotension 0/13 (0%) 0 2/12 (16.7%) 2
    Syncope (fainting) 0/13 (0%) 0 1/12 (8.3%) 1
    Thrombosis/embolism (vascular access-related) 0/13 (0%) 0 4/12 (33.3%) 5
    Endocrine disorders
    Thyroid function, low (hypothyroidism) 0/13 (0%) 0 1/12 (8.3%) 1
    Eye disorders
    Dry eye syndrome 0/13 (0%) 0 1/12 (8.3%) 1
    Ocular/Visual - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Gastrointestinal disorders
    Anorexia 0/13 (0%) 0 2/12 (16.7%) 3
    Constipation 0/13 (0%) 0 3/12 (25%) 4
    Diarrhea 0/13 (0%) 0 3/12 (25%) 3
    Dry mouth/salivary gland (xerostomia) 0/13 (0%) 0 1/12 (8.3%) 1
    Gastritis (including bile reflux gastritis) 0/13 (0%) 0 1/12 (8.3%) 1
    Gastrointestinal - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Heartburn/dyspepsia 0/13 (0%) 0 1/12 (8.3%) 1
    Hemorrhage, GI::Cecum/appendix 0/13 (0%) 0 1/12 (8.3%) 1
    Hemorrhage, GI::Liver 0/13 (0%) 0 1/12 (8.3%) 1
    Hemorrhage, GI::Rectum 0/13 (0%) 0 1/12 (8.3%) 1
    Infection with unknown ANC::Small bowel NOS 0/13 (0%) 0 1/12 (8.3%) 1
    Mucositis/stomatitis (clinical exam)::Oral cavity 0/13 (0%) 0 2/12 (16.7%) 2
    Mucositis/stomatitis (functional/symptomatic)::Oral cavity 0/13 (0%) 0 1/12 (8.3%) 1
    Nausea 0/13 (0%) 0 2/12 (16.7%) 3
    Pain::Oral cavity 0/13 (0%) 0 1/12 (8.3%) 1
    Vomiting 0/13 (0%) 0 1/12 (8.3%) 12
    General disorders
    Fatigue (asthenia, lethargy, malaise) 0/13 (0%) 0 5/12 (41.7%) 5
    Fever (in the absence of neutropenia, where neutropenia is defined as ANC <1.0 x 10e9/L) 0/13 (0%) 0 2/12 (16.7%) 2
    Growth and Development - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Pain - Other 0/13 (0%) 0 5/12 (41.7%) 5
    Pain::Pain NOS 0/13 (0%) 0 2/12 (16.7%) 2
    Syndromes - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Weight loss 0/13 (0%) 0 2/12 (16.7%) 4
    Hepatobiliary disorders
    ALT, SGPT (serum glutamic pyruvic transaminase) 0/13 (0%) 0 5/12 (41.7%) 18
    AST, SGOT(serum glutamic oxaloacetic transaminase) 0/13 (0%) 0 6/12 (50%) 44
    Albumin, serum-low (hypoalbuminemia) 0/13 (0%) 0 5/12 (41.7%) 15
    Alkaline phosphatase 0/13 (0%) 0 2/12 (16.7%) 3
    Hepatobiliary/Pancreas - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Immune system disorders
    Allergic reaction/hypersensitivity (including drug fever) 0/13 (0%) 0 1/12 (8.3%) 1
    Infections and infestations
    Infection - Other 0/13 (0%) 0 2/12 (16.7%) 4
    Infection with normal ANC or Grade 1 or 2 neutrophils::Catheter-related 0/13 (0%) 0 1/12 (8.3%) 1
    Metabolism and nutrition disorders
    Acidosis (metabolic or respiratory) 0/13 (0%) 0 3/12 (25%) 3
    Adrenal insufficiency 0/13 (0%) 0 1/12 (8.3%) 1
    Alkalosis (metabolic or respiratory) 0/13 (0%) 0 1/12 (8.3%) 1
    Amylase 0/13 (0%) 0 1/12 (8.3%) 1
    Bilirubin (hyperbilirubinemia) 0/13 (0%) 0 3/12 (25%) 4
    Calcium, serum-high (hypercalcemia) 0/13 (0%) 0 1/12 (8.3%) 2
    Glucose, serum-high (hyperglycemia) 0/13 (0%) 0 2/12 (16.7%) 2
    Lipase 0/13 (0%) 0 1/12 (8.3%) 1
    Magnesium, serum-high (hypermagnesemia) 0/13 (0%) 0 1/12 (8.3%) 1
    Metabolic/Laboratory - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Phosphate, serum-low (hypophosphatemia) 0/13 (0%) 0 8/12 (66.7%) 25
    Potassium, serum-high (hyperkalemia) 0/13 (0%) 0 3/12 (25%) 3
    Potassium, serum-low (hypokalemia) 0/13 (0%) 0 1/12 (8.3%) 1
    Sodium, serum-low (hyponatremia) 0/13 (0%) 0 7/12 (58.3%) 34
    Musculoskeletal and connective tissue disorders
    Pain::Back 0/13 (0%) 0 2/12 (16.7%) 2
    Pain::Bone 0/13 (0%) 0 2/12 (16.7%) 2
    Pain::Buttock 0/13 (0%) 0 1/12 (8.3%) 1
    Pain::Chest wall 0/13 (0%) 0 1/12 (8.3%) 1
    Pain::Chest/thorax NOS 0/13 (0%) 0 1/12 (8.3%) 1
    Pain::Extremity-limb 0/13 (0%) 0 1/12 (8.3%) 1
    Pain::Joint 0/13 (0%) 0 1/12 (8.3%) 2
    Nervous system disorders
    Confusion 0/13 (0%) 0 2/12 (16.7%) 2
    Mood alteration::Anxiety 0/13 (0%) 0 1/12 (8.3%) 1
    Mood alteration::Depression 0/13 (0%) 0 1/12 (8.3%) 1
    Neurology - Other 0/13 (0%) 0 4/12 (33.3%) 4
    Neuropathy: sensory 0/13 (0%) 0 1/12 (8.3%) 1
    Pain::Head/headache 0/13 (0%) 0 1/12 (8.3%) 1
    Speech impairment (e.g., dysphasia or aphasia) 0/13 (0%) 0 1/12 (8.3%) 1
    Renal and urinary disorders
    Creatinine 0/13 (0%) 0 2/12 (16.7%) 2
    Cystitis 0/13 (0%) 0 1/12 (8.3%) 1
    Hemorrhage, GU::Urinary NOS 0/13 (0%) 0 2/12 (16.7%) 3
    Infection with normal ANC or Grade 1 or 2 neutrophils::Urinary tract NOS 0/13 (0%) 0 2/12 (16.7%) 3
    Renal failure 0/13 (0%) 0 1/12 (8.3%) 2
    Renal/Genitourinary - Other 0/13 (0%) 0 1/12 (8.3%) 2
    Reproductive system and breast disorders
    Pain::Pelvis 0/13 (0%) 0 1/12 (8.3%) 2
    Vaginal discharge (non-infectious) 0/13 (0%) 0 1/12 (8.3%) 1
    Respiratory, thoracic and mediastinal disorders
    Cough 0/13 (0%) 0 1/12 (8.3%) 1
    Dyspnea (shortness of breath) 0/13 (0%) 0 3/12 (25%) 3
    Hypoxia 0/13 (0%) 0 4/12 (33.3%) 6
    Infection 0/13 (0%) 0 1/12 (8.3%) 2
    Infection with normal ANC or Grade 1 or 2 neutrophils::Lung (pneumonia) 0/13 (0%) 0 1/12 (8.3%) 1
    Infection with normal ANC or Grade 1 or 2 neutrophils::Upper airway NOS 0/13 (0%) 0 1/12 (8.3%) 2
    Infection with unknown ANC::Lung (pneumonia) 0/13 (0%) 0 1/12 (8.3%) 1
    Infection with unknown ANC::Trachea 0/13 (0%) 0 1/12 (8.3%) 1
    Nasal cavity/paranasal sinus reactions 0/13 (0%) 0 1/12 (8.3%) 1
    Pleural effusion (non-malignant) 0/13 (0%) 0 4/12 (33.3%) 4
    Pneumothorax 0/13 (0%) 0 2/12 (16.7%) 2
    Pulmonary/Upper Respiratory - Other 0/13 (0%) 0 1/12 (8.3%) 1
    Voice changes/dysarthria (e.g., hoarseness, loss or alteration in voice, laryngitis) 0/13 (0%) 0 1/12 (8.3%) 2
    Skin and subcutaneous tissue disorders
    Dermatology/Skin - Other 0/13 (0%) 0 3/12 (25%) 3
    Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils 0/13 (0%) 0 1/12 (8.3%) 1
    Infection with normal ANC or Grade 1 or 2 neutrophils::Skin (cellulitis) 0/13 (0%) 0 1/12 (8.3%) 1
    Infection with normal ANC or Grade 1 or 2 neutrophils::Ungual (nails) 0/13 (0%) 0 1/12 (8.3%) 1
    Rash/desquamation 0/13 (0%) 0 3/12 (25%) 4
    Rash: acne/acneiform 0/13 (0%) 0 2/12 (16.7%) 2
    Ulceration 0/13 (0%) 0 2/12 (16.7%) 5

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT 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 Dr. Daniel Fowler
    Organization National Cancer Institute
    Phone 301-435-8641
    Email fowlerda@mail.nih.gov
    Responsible Party:
    Daniel Fowler, M.D., Principal Investigator, National Institutes of Health Clinical Center (CC)
    ClinicalTrials.gov Identifier:
    NCT00923845
    Other Study ID Numbers:
    • 080088
    • 08-C-0088
    • NCT00641485
    First Posted:
    Jun 18, 2009
    Last Update Posted:
    Sep 29, 2017
    Last Verified:
    Sep 1, 2017