Chronic Lymphocytic LeukemiaPhase 2NCT00899431
Nonmyeloablative Stem Cell Transplantation for Chronic Lymphocytic Leukemia (CLL)
A Phase 2 study testing Lenalidomide, Fludarabine and Rituximab in people with Chronic Lymphocytic Leukemia, run by M.D. Anderson Cancer Center at 1 site in United States.
Trial summary
The goal of this clinical research study is to learn if lenalidomide, when given with a stem cell transplant and chemotherapy (bendamustine, fludarabine, and rituximab), can help to control CLL. The safety of this treatment combination will also be studied. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Chronic Lymphocytic Leukemia
- What is being tested?
- Lenalidomide, Fludarabine and Rituximab
- Type of treatment
- Pill or oral medicine, Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 39 participants
- Where
- 1 siteUnited States
- Study dates
- 6 May 2009to 7 Oct 2018
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18-75 years at the time of signing the informed consent form.
- Disease: CLL in relapse, after failing conventional chemo-antibody combination therapy; CLL patients who failed to achieve CR with frontline conventional chemo-antibody; CLL patients with 17p deletion; CLL in Richter's.
- Able to adhere to the study visit schedule and other protocol requirements.
- Donor: HLA compatible related (HLA-A,-B,-DRBI matched or with one-antigen mismatched) or HLA compatible unrelated.
- ECOG performance status of </= 2 at study entry
- FEV1, FVC and DLCO >/= 40%.
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- Left ventricular EF > 40% with no uncontrolled arrhythmias or symptomatic heart disease.
- Serum creatinine </= 1.6 mg/dL. Serum bilirubin < 1.6 mg/dL.
- SGPT < 2x upper limit of normal.
- 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performance of any study-related procedure not part of normal medical care, with the understanding that consent may be withdrawn by the subject at any time without prejudice to future medical care.
- All previous cancer therapy, including radiation, hormonal therapy and surgery, must have been discontinued at least 3 weeks prior to treatment in this study.
- Disease free of prior malignancies for >/= 5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "insitu" of the cervix or breast.
- Females of childbearing potential (FCBP)† must have a negative serum or urine pregnancy test with a sensitivity of at least 50 mIU/mL within 10 - 14 days prior to study entry.
- Disease must be chemosensitive (ie, patients must have PR or better based on CT Scans, PET Scan, and bone marrow biopsy).
- Patients suspected to have Richter's transformation (such as elevated LDH) and/or who are PET positive, should have a lymph node biopsy to assess histological status of the disease
- Patients must be off of alemtuzumab for 6 weeks prior to consenting.
Who cannot join
- Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
- Pregnant or breast feeding females. (Lactating females must agree not to breast feed while taking lenalidomide).
- Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
- Use of any other experimental drug or therapy within 28 days of baseline.
- Known hypersensitivity to thalidomide, lenalidomide, bendamustine, fludarabine. For patients will unrelated donors: Known hypersensitivity to thymoglobulin.
- The development of erythema nodosum if characterized by a desquamating rash while taking thalidomide or similar drugs.
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- Concurrent use of other anti-cancer agents or treatments.
- Known positive for HIV or infectious hepatitis, type A, B or C.
- Sinuses should be evaluated by either CT neck or CT sinuses to exclude infections
- Deep-vein thrombosis or pulmonary embolism within 3 months of study entry.
- History of serious infection requiring hospitalization within the last 3 months of consenting.
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Texas MD Anderson Cancer Center
Houston, Texas, 77030
About this study
Official title: Nonmyeloablative Stem Cell Transplantation With or Without Lenalidomide for Chronic Lymphocytic Leukemia (RV-CLL-PI-0294)
The goal of this clinical research study is to learn if lenalidomide, when given with a stem cell transplant and chemotherapy (bendamustine, fludarabine, and rituximab), can help to control CLL. The safety of this treatment combination will also be studied.
Read the detailed description
The Study Drugs Lenalidomide is designed to change the body's immune system. It may also interfere with the development of tiny blood vessels that help support tumor growth. Therefore, in theory, it may decrease or prevent the growth of cancer cells.
Bendamustine is designed to damage and destroy the DNA (genetic material) of cancer cells.
Fludarabine is designed to make cancer cells less able to repair damaged DNA (the genetic material of cells). This may increase the likelihood of the cells dying.
Rituximab is designed to attach to leukemia cells, which may cause them to die.
Before receiving the study drugs, 21 or more days must have passed since your last biological therapy, chemotherapy, radiotherapy, or other investigational therapy.
Before you begin therapy, you will have the following tests and procedures performed. The blood may need to be drawn daily. The doctor will tell you how often the other tests will need to be performed:
- You will have a physical exam.
- You will have blood transfusions of blood and platelets as needed.
- Blood (about 2 tablespoons) and urine will be collected for routine tests.
- Blood (about 6-10 tablespoons) will be drawn to check the effects of the transplant.
- You will have a chest x-ray and CT scans to check the status of the disease.
- You will have an ECG.
- You will have a bone marrow biopsy and aspirate, when the doctor thinks it is needed.
Study Treatment:
If you are found to be eligible to take part in this study, you will begin treatment within 30 days after the screening visit. All liquid study drugs will be given through a central venous catheter (CVC) that will be left in place throughout treatment. A CVC is a sterile flexible tube that will be placed into a large vein while you are under local anesthesia. Your doctor will explain this procedure to you in more detail, and you will be required to sign a separate consent form for this procedure.
On Days -13, -6, +1, and +8, you will receive rituximab over 5-7 hours by CVC.
On Days -5 to -3, you will receive fludarabine over 1 hour and bendamustine over 1 hour by CVC. You will be given standard drugs such as hydrocortisone and Tylenol to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks.
On Days -2 to -1, if the donor is not related or is not completely matched, you will receive thymoglobulin (ATG) over 4 hours by CVC. This will help to reduce the risk of your body rejecting the transplant.
On Days -2 to -1, if the donor is related, you will "rest" (not receive chemotherapy).
On Day -2, you will start to receive tacrolimus by CVC to help prevent graft-versus-host disease. This will be changed to a dose of tacrolimus by mouth, once you are discharged from the hospital. You will continue to take tacrolimus by mouth for 6-8 months following your transplant.
On Day 0, the blood stem cells that were collected from your donor will be transplanted (given back to your body) through the CVC over 30-45 minutes.
On Days 1, 3, and 6 after the stem cell transplant (and Day 11 if the donor is not related or not completely matched), you will receive methotrexate over 30-60 minutes by CVC to help prevent graft-versus-host disease.
On Day 7 after the transplant, G-CSF (filgrastim) will be injected under your skin once a day until your white blood cell counts recover. Filgrastim is designed to help increase the number of white blood cells.
Treatment with Lenalidomide:
If your blood cell counts are high enough and if you have not experienced side effects, between Days 90 and 100 after the transplant, you will be randomly assigned (as in the flip of a coin) into 1 of 2 groups. If you are in Group 1 you will take lenalidomide in addition to the treatment listed above. If you are in Group 2, you will not take lenalidomide.
If you are in Group 1, you will take lenalidomide 1 time every day for 3-12 months, depending on the disease response to the treatment.
You should swallow lenalidomide capsules whole, with water, at the same time each day. Do not break, chew, or open the capsules.
If you miss a dose of lenalidomide, take it as soon as you remember on the same day. If you miss taking your dose for the entire day, take your regular dose the next scheduled day (do NOT take double your regular dose to make up for the missed dose).
If you take more than the prescribed dose of lenalidomide you should seek emergency medical care (if needed) and contact the study staff right away.
You will be given standard drugs such as aspirin, Coumadin (warfarin), heparin, and/or allopurinol to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks.
If the doctor thinks it is needed, your dose and schedule of lenalidomide will be changed.
If you are in Group 2, you will take no additional drugs.
Pregnancy Tests While Taking Lenalidomide:
Women who are able to become pregnant must have 2 negative pregnancy tests: the first test within 10-14 days before lenalidomide is prescribed and the second test within 24 hours before lenalidomide is prescribed. This blood test will be taken as part of a routine blood draw. The prescription must be filled within 7 days.
Once a week for the first month you take lenalidomide, women who are able to become pregnant will have blood (about 1 teaspoon) drawn for a pregnancy test. Then, in females with regular menstrual cycles, blood (about 1 teaspoon) will be drawn for pregnancy testing every 4 weeks, at the end of study, and 28 days after the last dose of lenalidomide. If menstrual cycles are irregular, blood (about 1 teaspoon) will be drawn every 2 weeks, at the end of study, and 14 and 28 days after the last dose of lenalidomide.
Study Visits (both Groups):
You must stay in the Houston area for about 100 days after the stem cell transplant.
Between Days 25 and 35 and then about 3 months after the stem cell transplant:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scan to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests and to check the level of tacrolimus.
- You will have a bone marrow biopsy/aspirate to check the status of the disease.
Study Visits (Group 1):
If you are in Group 1, blood (about 2 tablespoons) will be drawn for routine tests weekly until the maximum dose of lenalidomide is reached, then once every 2 weeks while you are taking lenalidomide.
Follow-up:
Every 3 months during the first 18 months and then every 6 months up to 3 years:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scans to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests.
- You will have a bone marrow biopsy to check the status of the disease.
Length of Study:
You will be on study up to about 3 years. You will be taken off study if the disease gets worse or you experience any intolerable side effects.
End-of-Study Visit:
After you are off study, you will have an end-of-study visit:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scans to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests.
- You will have a bone marrow biopsy to check the status of the disease.
Data Confidentiality Plan:
Data will be collected in the SCT\&CT departmental database (BMTWeb). This database is password-protected, contains audit tracking, and follows all federal guidelines. Your personal identifying information will be removed for this analysis; no sensitive information will be shared.
This is an investigational study. All of the drugs used in this study are FDA approved and commercially available for the treatment of CLL. The use of the drugs together in this study is investigational.
Up to 80 patients will take part in this study. All will be enrolled at MD Anderson.
- Conditions
- Chronic Lymphocytic Leukemia
- Being tested
- Lenalidomide, Fludarabine, Rituximab, Thymoglobulin, Stem Cell Transplantation
- Keywords
- Nonmyeloablative Stem Cell Transplantation, Chronic Lymphocytic Leukemia, CLL, Immunomanipulation, Fludarabine, Lenalidomide, Rituximab, Thymoglobulin, Stem Cell Transplantation
- Medical subject headings
- Leukemia, Lymphocytic, Chronic, B-Cell
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
LenalidomideDrug
Also called CC-5013, Revlimid
Starting dose 5 mg by mouth every other day; increase to 5 mg/d daily in 4-5 weeks for 6 - 12 months
FludarabineDrug
Also called Fludara, Fludarabine Phosphate
30 mg/m^2 intravenously daily on days -5, -4, -3.
RituximabDrug
Also called Rituxan
375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8.
ThymoglobulinDrug
Also called ATG, rabbit anti-thymocyte globulin
1.0 mg/kg intravenously over 4 hours (day -2 and -1).
Stem Cell TransplantationProcedure or surgery
Also called SCT, Nonmyeloablative Stem Cell Transplantation
On Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes.
BendamustineDrug
Also called Bendamustine Hydrochloride, Bendamustine HCL, CEP-18083, SDX-105
130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine).
AllopurinolDrug
Also called Lopurin, Zurinol, Zyloprim
300 mg by mouth daily beginning at the start of lenalidomide therapy and continuing for 3 months.
| Study group | Role | What they receive |
|---|---|---|
| Group 1: Lenalidomide | Active comparator | Chemotherapy, Plus Lenalidomide - Lenalidomide starting dose 5 mg by mouth every other day; increase to 5 mg/d daily in 4-5 weeks for 6 - 12 months. Fludarabine 30 mg/m^2 intravenously daily on days -5, -4, -3. Rituximab 375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8. Thymoglobulin 1.0 mg/kg intravenously over 4 hours (day -2 and -1). On Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes. Bendamustine 130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine). Allopurinol 300 mg by mouth daily beginning at the start of lenalidomide therapy and continuing for 3 months. Receives: Drug: Lenalidomide; Drug: Fludarabine; Drug: Rituximab; Drug: Thymoglobulin; Procedure: Stem Cell Transplantation; Drug: Bendamustine; Drug: Allopurinol |
| Group 2: No Lenalidomide | Active comparator | Chemotherapy Treatment, No Lenalidomide - Fludarabine 30 mg/m^2 intravenously daily on days -5, -4, -3. Rituximab 375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8. Thymoglobulin 1.0 mg/kg intravenously over 4 hours (day -2 and -1). On Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes. Bendamustine 130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine). Receives: Drug: Fludarabine; Drug: Rituximab; Drug: Thymoglobulin; Procedure: Stem Cell Transplantation; Drug: Bendamustine |
What is being measured
The primary outcome is the main question the study is designed to answer.
Immunomanipulation After Non-myeloablative Stem Cell Transplantation for CLL (Chronic Lymphocytic Leukemia).
To compare the need for immunomanipulation within 18 months after non-myeloablative allogeneic transplantation for CLL between the two combination therapies with or without lenalidomide maintenance. For this purpose, "immunomanipulation" is defined as any one of the following events: 1) Cessation of administering tacrolimus treatment with in the first 6 months after allotransplant due to persistent disease or progression. 2) Boost of donor lymphocytic infusion (DLI) administered anytime between 3 and 18 months after allotransplant.
Measured: Up to 18 months after allotransplant.
Secondary outcomes (1)
Percentage of Participants With GVHD (Graft Versus Host Disease)
Acute grade 2 to 4 Graft versus host disease( GVHD )for patients who were able to be analyzed by measuring the T cell counts for increased CD3+ before and after lenalidomide.
Measured: Up to 6 months after allotransplant
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 May 2009 (estimated)
- Study start6 May 2009
- Primary completion7 Oct 2018
- Study completion7 Oct 2018
Why it stopped: Terminated per PI's request at the time of continuing review
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Chronic Lymphocytic LeukemiaStudies of the same condition, open and under way.
- More trials run by M.D. Anderson Cancer CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 39 participants (actual)
Sponsor and investigators
- Lead sponsor
- M.D. Anderson Cancer Center
- Sponsor type
- University, hospital or other
- Collaborators
- Celgene Corporation
- Responsible party
- Sponsor
- Investigators
- Issa F. Khouri, MD, BS, Study chair, M.D. Anderson Cancer Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00899431
- Sponsor's protocol ID
- 2007-0871
- Other IDs
- NCI-2012-01620
- Status last verified
- Jan 2020
- First submitted
- 8 May 2009
- Last updated
- 27 Jan 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Jan 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Nonmyeloablative Stem Cell Transplantation With or Without Lenalidomide for Chronic Lymphocytic Leukemia (RV-CLL-PI-0294)
- ClinicalTrials.gov ID
- NCT00899431
- Acronym / sponsor ID
- 2007-0871
- Conditions
- Chronic Lymphocytic Leukemia
- Keywords
- Nonmyeloablative Stem Cell Transplantation, Chronic Lymphocytic Leukemia, CLL, Immunomanipulation, Fludarabine, Lenalidomide, Rituximab, Thymoglobulin
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Terminated per PI's request at the time of continuing review
- Enrolment
- 39 participants (actual)
- Lead sponsor
- M.D. Anderson Cancer CenterUniversity, hospital or other
- Collaborators
- Celgene Corporation
- Study start
- 6 May 2009 (actual)
- Primary completion
- 7 Oct 2018 (actual)
- Study completion
- 7 Oct 2018 (actual)
- First posted
- 12 May 2009 (estimated)
- Results
- Posted 27 Jan 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical research study is to learn if lenalidomide, when given with a stem cell transplant and chemotherapy (bendamustine, fludarabine, and rituximab), can help to control CLL. The safety of this treatment combination will also be studied.
Detailed description
The Study Drugs Lenalidomide is designed to change the body's immune system. It may also interfere with the development of tiny blood vessels that help support tumor growth. Therefore, in theory, it may decrease or prevent the growth of cancer cells.
Bendamustine is designed to damage and destroy the DNA (genetic material) of cancer cells.
Fludarabine is designed to make cancer cells less able to repair damaged DNA (the genetic material of cells). This may increase the likelihood of the cells dying.
Rituximab is designed to attach to leukemia cells, which may cause them to die.
Before receiving the study drugs, 21 or more days must have passed since your last biological therapy, chemotherapy, radiotherapy, or other investigational therapy.
Before you begin therapy, you will have the following tests and procedures performed. The blood may need to be drawn daily. The doctor will tell you how often the other tests will need to be performed:
- You will have a physical exam.
- You will have blood transfusions of blood and platelets as needed.
- Blood (about 2 tablespoons) and urine will be collected for routine tests.
- Blood (about 6-10 tablespoons) will be drawn to check the effects of the transplant.
- You will have a chest x-ray and CT scans to check the status of the disease.
- You will have an ECG.
- You will have a bone marrow biopsy and aspirate, when the doctor thinks it is needed.
Study Treatment:
If you are found to be eligible to take part in this study, you will begin treatment within 30 days after the screening visit. All liquid study drugs will be given through a central venous catheter (CVC) that will be left in place throughout treatment. A CVC is a sterile flexible tube that will be placed into a large vein while you are under local anesthesia. Your doctor will explain this procedure to you in more detail, and you will be required to sign a separate consent form for this procedure.
On Days -13, -6, +1, and +8, you will receive rituximab over 5-7 hours by CVC.
On Days -5 to -3, you will receive fludarabine over 1 hour and bendamustine over 1 hour by CVC. You will be given standard drugs such as hydrocortisone and Tylenol to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks.
On Days -2 to -1, if the donor is not related or is not completely matched, you will receive thymoglobulin (ATG) over 4 hours by CVC. This will help to reduce the risk of your body rejecting the transplant.
On Days -2 to -1, if the donor is related, you will "rest" (not receive chemotherapy).
On Day -2, you will start to receive tacrolimus by CVC to help prevent graft-versus-host disease. This will be changed to a dose of tacrolimus by mouth, once you are discharged from the hospital. You will continue to take tacrolimus by mouth for 6-8 months following your transplant.
On Day 0, the blood stem cells that were collected from your donor will be transplanted (given back to your body) through the CVC over 30-45 minutes.
On Days 1, 3, and 6 after the stem cell transplant (and Day 11 if the donor is not related or not completely matched), you will receive methotrexate over 30-60 minutes by CVC to help prevent graft-versus-host disease.
On Day 7 after the transplant, G-CSF (filgrastim) will be injected under your skin once a day until your white blood cell counts recover. Filgrastim is designed to help increase the number of white blood cells.
Treatment with Lenalidomide:
If your blood cell counts are high enough and if you have not experienced side effects, between Days 90 and 100 after the transplant, you will be randomly assigned (as in the flip of a coin) into 1 of 2 groups. If you are in Group 1 you will take lenalidomide in addition to the treatment listed above. If you are in Group 2, you will not take lenalidomide.
If you are in Group 1, you will take lenalidomide 1 time every day for 3-12 months, depending on the disease response to the treatment.
You should swallow lenalidomide capsules whole, with water, at the same time each day. Do not break, chew, or open the capsules.
If you miss a dose of lenalidomide, take it as soon as you remember on the same day. If you miss taking your dose for the entire day, take your regular dose the next scheduled day (do NOT take double your regular dose to make up for the missed dose).
If you take more than the prescribed dose of lenalidomide you should seek emergency medical care (if needed) and contact the study staff right away.
You will be given standard drugs such as aspirin, Coumadin (warfarin), heparin, and/or allopurinol to help decrease the risk of side effects. You may ask the study staff for information about how the drugs are given and their risks.
If the doctor thinks it is needed, your dose and schedule of lenalidomide will be changed.
If you are in Group 2, you will take no additional drugs.
Pregnancy Tests While Taking Lenalidomide:
Women who are able to become pregnant must have 2 negative pregnancy tests: the first test within 10-14 days before lenalidomide is prescribed and the second test within 24 hours before lenalidomide is prescribed. This blood test will be taken as part of a routine blood draw. The prescription must be filled within 7 days.
Once a week for the first month you take lenalidomide, women who are able to become pregnant will have blood (about 1 teaspoon) drawn for a pregnancy test. Then, in females with regular menstrual cycles, blood (about 1 teaspoon) will be drawn for pregnancy testing every 4 weeks, at the end of study, and 28 days after the last dose of lenalidomide. If menstrual cycles are irregular, blood (about 1 teaspoon) will be drawn every 2 weeks, at the end of study, and 14 and 28 days after the last dose of lenalidomide.
Study Visits (both Groups):
You must stay in the Houston area for about 100 days after the stem cell transplant.
Between Days 25 and 35 and then about 3 months after the stem cell transplant:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scan to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests and to check the level of tacrolimus.
- You will have a bone marrow biopsy/aspirate to check the status of the disease.
Study Visits (Group 1):
If you are in Group 1, blood (about 2 tablespoons) will be drawn for routine tests weekly until the maximum dose of lenalidomide is reached, then once every 2 weeks while you are taking lenalidomide.
Follow-up:
Every 3 months during the first 18 months and then every 6 months up to 3 years:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scans to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests.
- You will have a bone marrow biopsy to check the status of the disease.
Length of Study:
You will be on study up to about 3 years. You will be taken off study if the disease gets worse or you experience any intolerable side effects.
End-of-Study Visit:
After you are off study, you will have an end-of-study visit:
- You will have a physical exam.
- You will have CT scans to check the status of the disease.
- You will have PET scans to check the status of the disease, if the doctor thinks it is needed.
- Blood (about 2 tablespoons) will be drawn for routine tests.
- You will have a bone marrow biopsy to check the status of the disease.
Data Confidentiality Plan:
Data will be collected in the SCT\&CT departmental database (BMTWeb). This database is password-protected, contains audit tracking, and follows all federal guidelines. Your personal identifying information will be removed for this analysis; no sensitive information will be shared.
This is an investigational study. All of the drugs used in this study are FDA approved and commercially available for the treatment of CLL. The use of the drugs together in this study is investigational.
Up to 80 patients will take part in this study. All will be enrolled at MD Anderson.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group 1: Lenalidomide | Active comparator | Drug: Lenalidomide, Drug: Fludarabine, Drug: Rituximab, Drug: Thymoglobulin, Procedure: Stem Cell Transplantation, Drug: Bendamustine, Drug: AllopurinolChemotherapy, Plus Lenalidomide - Lenalidomide starting dose 5 mg by mouth every other day; increase to 5 mg/d daily in 4-5 weeks for 6 - 12 months. Fludarabine 30 mg/m^2 intravenously daily on days -5, -4, -3. Rituximab 375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8. Thymoglobulin 1.0 mg/kg intravenously over 4 hours (day -2 and -1). On Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes. Bendamustine 130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine). Allopurinol 300 mg by mouth daily beginning at the start of lenalidomide therapy and continuing for 3 months. |
| Group 2: No Lenalidomide | Active comparator | Drug: Fludarabine, Drug: Rituximab, Drug: Thymoglobulin, Procedure: Stem Cell Transplantation, Drug: BendamustineChemotherapy Treatment, No Lenalidomide - Fludarabine 30 mg/m^2 intravenously daily on days -5, -4, -3. Rituximab 375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8. Thymoglobulin 1.0 mg/kg intravenously over 4 hours (day -2 and -1). On Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes. Bendamustine 130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine). |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Age 18-75 years at the time of signing the informed consent form.
- Disease: CLL in relapse, after failing conventional chemo-antibody combination therapy; CLL patients who failed to achieve CR with frontline conventional chemo-antibody; CLL patients with 17p deletion; CLL in Richter's.
- Able to adhere to the study visit schedule and other protocol requirements.
- Donor: HLA compatible related (HLA-A,-B,-DRBI matched or with one-antigen mismatched) or HLA compatible unrelated.
- ECOG performance status of </= 2 at study entry
Key exclusion criteria (11 listed)
- Any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
- Pregnant or breast feeding females. (Lactating females must agree not to breast feed while taking lenalidomide).
- Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
- Use of any other experimental drug or therapy within 28 days of baseline.
- Known hypersensitivity to thalidomide, lenalidomide, bendamustine, fludarabine. For patients will unrelated donors: Known hypersensitivity to thymoglobulin.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| LenalidomideAlso: CC-5013, RevlimidStarting dose 5 mg by mouth every other day; increase to 5 mg/d daily in 4-5 weeks for 6 - 12 months | Drug | Group 1: Lenalidomide |
| FludarabineAlso: Fludara, Fludarabine Phosphate30 mg/m^2 intravenously daily on days -5, -4, -3. | Drug | Group 1: Lenalidomide, Group 2: No Lenalidomide |
| RituximabAlso: Rituxan375 mg/m2 intravenously on day -13, and 1000 mg/m^2 on days -6, +1 and +8. | Drug | Group 1: Lenalidomide, Group 2: No Lenalidomide |
| ThymoglobulinAlso: ATG, rabbit anti-thymocyte globulin1.0 mg/kg intravenously over 4 hours (day -2 and -1). | Drug | Group 1: Lenalidomide, Group 2: No Lenalidomide |
| Stem Cell TransplantationAlso: SCT, Nonmyeloablative Stem Cell TransplantationOn Day 0, donor blood stem cells collected will be transplanted over 30-45 minutes. | Procedure or surgery | Group 1: Lenalidomide, Group 2: No Lenalidomide |
| BendamustineAlso: Bendamustine Hydrochloride, Bendamustine HCL, CEP-18083, SDX-105130 mg/m2/day by vein daily on day -5, -4, -3 (following Fludarabine). | Drug | Group 1: Lenalidomide, Group 2: No Lenalidomide |
| AllopurinolAlso: Lopurin, Zurinol, Zyloprim300 mg by mouth daily beginning at the start of lenalidomide therapy and continuing for 3 months. | Drug | Group 1: Lenalidomide |
Primary outcome
Immunomanipulation After Non-myeloablative Stem Cell Transplantation for CLL (Chronic Lymphocytic Leukemia).
Time frame: Up to 18 months after allotransplant.
To compare the need for immunomanipulation within 18 months after non-myeloablative allogeneic transplantation for CLL between the two combination therapies with or without lenalidomide maintenance. For this purpose, "immunomanipulation" is defined as any one of the following events: 1) Cessation of administering tacrolimus treatment with in the first 6 months after allotransplant due to persistent disease or progression. 2) Boost of donor lymphocytic infusion (DLI) administered anytime between 3 and 18 months after allotransplant.
1 secondary outcome
Percentage of Participants With GVHD (Graft Versus Host Disease)
Time frame: Up to 6 months after allotransplant
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jan 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- University of Texas MD Anderson Cancer Center WebsiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Issa F. Khouri, MD, BS study chair
M.D. Anderson Cancer Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Lenalidomide, Fludarabine and Rituximab in people with Chronic Lymphocytic Leukemia, run by M.D. Anderson Cancer Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 27 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 27 Jan 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Immunomanipulation After Non-myeloablative Stem Cell Transplantation for CLL (Chronic Lymphocytic Leukemia). (time frame: Up to 18 months after allotransplant.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jan 2020.