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| ID | Type | Description | Link |
|---|---|---|---|
| EBMT-EBMTLYM1 | |||
| BNLI-EBMT-EBMTLYM1 | |||
| EU-99050 |
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| Name | Class |
|---|---|
| Lymphoma Trials Office | OTHER |
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells. Monoclonal antibodies such as rituximab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells. It is not yet known if combination chemotherapy plus peripheral stem cell transplantation is more effective with or without rituximab for non-Hodgkin's lymphoma.
PURPOSE: This randomized phase III trial is studying giving combination chemotherapy and peripheral stem cell transplantation together with rituximab to see how well it works compared to combination chemotherapy and peripheral stem cell transplantation alone in treating patients with relapsed non-Hodgkin's lymphoma.
OBJECTIVES:
OUTLINE: This is a randomized, open-label, multicenter study. Patients are stratified according to type of remission (complete vs good partial) and which remission (second vs third). Patients are randomized to one of four treatment arms.
All patients receive induction chemotherapy comprising cyclophosphamide IV over 3-4 hours on day 0 or a standard induction chemotherapy regimen. Filgrastim (G-CSF) is administered subcutaneously daily beginning on day 1.
Patients are then randomized to receive either in vivo rituximab purging or no purging following restaging after completion of induction. For those patients receiving purging (arms I and II), rituximab is administered IV once weekly for 4 weeks.
Peripheral blood stem cells (PBSC) are collected between days 8 and 12 post induction chemotherapy. Within 4 weeks of PBSC collection, patients receive carmustine IV over 2 hours on day -6, etoposide IV over 2 hours on days -5 to -2, cytarabine IV over 5 minutes twice daily on days -5 to -2, and melphalan IV over 10-15 minutes on day -1. (Alternatively, high dose cyclophosphamide and total body irradiation beginning 2-4 weeks after cyclophosphamide or standard induction chemotherapy priming is also allowed.) PBSC are reinfused on day 0.
Patients are further randomized to receive either rituximab maintenance or observation only. For those patients receiving maintenance (arms I and III), rituximab is administered IV once every 2 months for 4 doses beginning 30 days after PBSC reinfusion.
Patients are followed at 30 days, 3, 6, 9, and 12 months after PBSC transplant, every 6 months for 2 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 460 patients (115 per treatment arm) will be accrued for this study within 5 years.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| filgrastim | Biological | |||
| rituximab | Biological | |||
| carmustine | Drug | |||
| cyclophosphamide | Drug | |||
| cytarabine | Drug | |||
| etoposide | Drug | |||
| melphalan | Drug | |||
| bone marrow ablation with stem cell support |
| Measure | Description | Time Frame |
|---|---|---|
| Time to disease progression |
| Measure | Description | Time Frame |
|---|---|---|
| Response rate and survival | ||
| Molecular remission rates | ||
| Safety |
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DISEASE CHARACTERISTICS:
Relapsed or resistant follicular non-Hodgkin's lymphoma (NHL)
CD20 positive with no evidence of transformation
Achievement of complete remission (CR) or very good partial remission (VGPR) following reinduction chemotherapy with any standard regimen
Platelet count greater than 100,000/mm^3 after induction chemotherapy and before randomization
No CNS involvement
PATIENT CHARACTERISTICS:
Age:
Performance status:
Life expectancy:
Hematopoietic:
Hepatic:
Renal:
Cardiovascular:
Pulmonary:
Other:
PRIOR CONCURRENT THERAPY:
Biologic therapy:
Chemotherapy:
Endocrine therapy:
Radiotherapy:
Surgery:
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| Name | Affiliation | Role |
|---|---|---|
| Ruth Pettengell, MD | St George's, University of London | Study Chair |
| David C. Linch | Middlesex Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sydney Cancer Centre at Royal Prince Alfred Hospital | Sydney | New South Wales | 2050 | Australia | ||
| Westmead Institute for Cancer Research at Westmead Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23547078 | Derived | Pettengell R, Schmitz N, Gisselbrecht C, Smith G, Patton WN, Metzner B, Caballero D, Tilly H, Walewski JA, Bence-Bruckler I, To B, Geisler CH, Schots R, Kimby E, Taverna CJ, Kozak T, Dreger P, Uddin R, Ruiz de Elvira C, Goldstone AH. Rituximab purging and/or maintenance in patients undergoing autologous transplantation for relapsed follicular lymphoma: a prospective randomized trial from the lymphoma working party of the European group for blood and marrow transplantation. J Clin Oncol. 2013 May 1;31(13):1624-30. doi: 10.1200/JCO.2012.47.1862. Epub 2013 Apr 1. |
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| Procedure |
| peripheral blood stem cell transplantation | Procedure |
| Westmead |
| New South Wales |
| 2145 |
| Australia |
| Royal Brisbane and Women's Hospital | Brisbane | Queensland | 4029 | Australia |
| Royal Adelaide Hospital Cancer Centre | Adelaide | South Australia | 5000 | Australia |
| Queen Elizabeth Hospital | Woodville | South Australia | 5011 | Australia |
| Royal Melbourne Hospital | Parkville | Victoria | 3050 | Australia |
| Fremantle Hospital | Fremantle | Western Australia | 6160 | Australia |
| Royal Perth Hospital | Perth | Western Australia | 6000 | Australia |
| Allgemeines Krankenhaus - Universitatskliniken | Vienna | A-1090 | Austria |
| Ziekenhuis Netwerk Antwerpen Middelheim | Antwerp | B-2020 | Belgium |
| Institut Jules Bordet | Brussels | 1000 | Belgium |
| Academisch Ziekenhuis der Vrije Universiteit Brussel | Brussels | 1090 | Belgium |
| Universitair Ziekenhuis Gent | Ghent | B-9000 | Belgium |
| U.Z. Gasthuisberg | Leuven | B-3000 | Belgium |
| CHU Liege - Domaine Universitaire du Sart Tilman | Liège | B-4000 | Belgium |
| Clinique Universitaire De Mont-Godinne | Mont-Godinne Yvoir | 5530 | Belgium |
| H. Hartziekenhuis - Roeselaere. | Roeselaere | 8800 | Belgium |
| Tom Baker Cancer Centre - Calgary | Calgary | Alberta | T2N 4N2 | Canada |
| Ottawa Hospital Regional Cancer Centre - General Campus | Ottawa | Ontario | K1H 8L6 | Canada |
| University Hospital Kralovske Vinohr | Prague | 10034 | Czechia |
| Aalborg Hospital | Aalborg | DK-9000 | Denmark |
| Rigshospitalet - Copenhagen University Hospital | Copenhagen | 2100 | Denmark |
| Odense University Hospital | Odense | DK-5000 | Denmark |
| Centre Hospitalier Regional et Universitaire d'Angers | Angers | 49033 | France |
| Polyclinique Du Parc | Caen | 14052 | France |
| Centre Regional Francois Baclesse | Caen | 14076 | France |
| CHU de Grenoble - Hopital de la Tronche | Grenoble | 38043 | France |
| Centre Leon Berard | Lyon | 69373 | France |
| Polyclinique Saint Jean | Melun | 77000 | France |
| Centre Regional de Lutte Contre le Cancer - Centre Val d'Aurelle | Montpellier | 34298 | France |
| CHR Hotel Dieu | Nantes | 44093 | France |
| Hopital Saint-Louis | Paris | 75475 | France |
| CHU Pitie-Salpetriere | Paris | 75651 | France |
| Centre Hospitalier Lyon Sud | Pierre-Bénite | 69495 | France |
| Centre Hospitalier Universitaire de Rennes | Rennes | 35033 | France |
| Centre Henri Becquerel | Rouen | 76038 | France |
| Centre Hospitalier Universitaire Bretonneau de Tours | Tours | 37044 | France |
| Institut Gustave Roussy | Villejuif | F-94805 | France |
| Klinikum Augsburg | Augsburg | DOH-86156 | Germany |
| DIAKO Ev. Diakonie Krankenhaus gGmbH | Bremen | D-28239 | Germany |
| Universitaetsklinikum Goettingen | Göttingen | D-37075 | Germany |
| Asklepios Klinik St. Georg | Hamburg | D-20099 | Germany |
| Medical University Hospital Homburg | Homburg | 66421 | Germany |
| Universitaetsklinikum des Saarlandes | Homburg | D-66424 | Germany |
| Klinikum Nuernberg - Klinikum Nord | Nuremberg | D-90419 | Germany |
| Klinikum Oldenburg | Oldenburg | D-26133 | Germany |
| Southwest German Cancer Center at Eberhard-Karls-University | Tübingen | D-72076 | Germany |
| Chaim Sheba Medical Center | Tel Litwinsky | 52621 | Israel |
| Auckland City Hospital | Auckland | 1 | New Zealand |
| Canterbury Health Laboratories | Christchurch | New Zealand |
| Waikato Hospital | Hamilton | 2020 | New Zealand |
| Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology | Warsaw | 02-781 | Poland |
| K. Dluski Hospital-Medical Academy | Wroclaw | 53 439 | Poland |
| Instituto Portugues de Oncologia de Francisco Gentil - Centro Regional de Oncologia de Lisboa, S.A. | Lisbon | 1099-023 Codex | Portugal |
| Hospital Juan Canalejo | A Coruña | 15000 | Spain |
| Hospital General - Alicante | Alicante | 3010 | Spain |
| Hospital de Cruces | Barakaldo Bilbao | E-48903 | Spain |
| Centro Medico Teknon | Barcelona | 08022 | Spain |
| Hospital de la Santa Cruz i Sant Pau | Barcelona | 08025 | Spain |
| Hospital Clinic de Barcelona | Barcelona | 08036 | Spain |
| Hospital Universitari Germans Trias i Pujol | Barcelona | 08916 | Spain |
| Hospital Universitario Puerta Del Mar | Cadiz | 11000 | Spain |
| Hospital General de Castellon | Castellon | 12004 | Spain |
| Hospital San Pedro de Alcantara | Cáceres | 10000 | Spain |
| Hospital Virgen de la Arrixaca | El Palmar | 30120 | Spain |
| Hospital de Galdakao | Galdakao Vizcaya | 48000 | Spain |
| Hospital Virgen de las Nieves | Granada | 18014 | Spain |
| Hospital Cuidad de Jaen | Jaén | E-23006 | Spain |
| Hospital de Gran Canaria Dr. Negrin | Las Palmas de Gran Canaria | 350311 | Spain |
| Hospital de la Princesa | Madrid | 28006 | Spain |
| Hospital General Universitario Gregorio Maranon | Madrid | 28007 | Spain |
| Hospital Ramon y Cajal | Madrid | 28034 | Spain |
| Hospital Universitario San Carlos | Madrid | 28040 | Spain |
| Hospital Universitario 12 de Octubre | Madrid | 28041 | Spain |
| Hospital Universitario de Getafe | Madrid | 28905 | Spain |
| Hospital General Universitario Morales Meseguer | Murcia | 30008 | Spain |
| Hospital Universitario Central de Asturias | Oviedo | 33006 | Spain |
| Hospital Son Dureta | Palma de Mallorca | 07014 | Spain |
| Hospital Virgen de la Vega | Salamanca | 37007 | Spain |
| University Hospital - Salamanca | Salamanca | 37007 | Spain |
| Hospital Universitario Marques de Valdecilla | Santander | 39008 | Spain |
| Hospital Universidad Virgen Del Rocio | Seville | E- 41013 | Spain |
| Hospital Mutua de Terrassa | Terrassa | 08221 | Spain |
| Hospital Clinico Universitario de Valencia | Valencia | 46010 | Spain |
| Unidad De Oncol/Hemat. Hospital | Valencia | 46017 | Spain |
| Complexo Hospitalario Xeral de Vigo | Vigo Pontevedra | 36204 | Spain |
| Hospital Clinico Universitario Lozano Blesa | Zaragoza | 50006 | Spain |
| Hospital Universitario Miguel Servet | Zaragoza | 50009 | Spain |
| Karolinska University Hospital - Huddinge | Stockholm | SE-141 86 | Sweden |
| Kantonsspital Bruderholz | Bruderholz | CH-4101 | Switzerland |
| UniversitaetsSpital Zuerich | Zurich | CH-8091 | Switzerland |
| Ibn-i Sina Hospital | Ankara | 06100 | Turkey (Türkiye) |
| Stoke Mandeville Hospital | Aylesbury-Buckinghamshire | England | HP21 8AL | United Kingdom |
| Royal United Hospital | Bath | England | BA1 3NG | United Kingdom |
| Birmingham Heartlands Hospital | Birmingham | England | B9 5SS | United Kingdom |
| Royal Bournemouth Hospital | Bournemouth | England | BH7 7DW | United Kingdom |
| Bristol Haematology and Oncology Centre | Bristol | England | BS2 8ED | United Kingdom |
| Royal Devon and Exeter Hospital | Exeter | England | EX2 5DW | United Kingdom |
| Huddersfield Royal Infirmary | Huddersfield, West Yorks | England | HD3 3EA | United Kingdom |
| Hull Royal Infirmary | Hull | England | HU3 2KZ | United Kingdom |
| Kettering General Hosptial | Kettering, Northants | England | NNI6 8UZ | United Kingdom |
| Clinical Trials and Research Unit of the University of Leeds | Leeds | England | LS2 9N9 | United Kingdom |
| Leicester Royal Infirmary | Leicester | England | LE1 5WW | United Kingdom |
| Royal Liverpool and Broadgreen Hospitals NHS Trust | Liverpool | England | L7 8XP | United Kingdom |
| Liverpool University Hospital | Liverpool | England | L9 7AL | United Kingdom |
| Saint Bartholomew's Hospital | London | England | EC1A 7BE | United Kingdom |
| St. Thomas' Hospital | London | England | SE1 7EH | United Kingdom |
| Clinique Sainte Elisabeth | London | England | SW17 ORE | United Kingdom |
| St. Georges, University of London | London | England | SW17 ORE | United Kingdom |
| University College Hospital - London | London | England | WC1E 6AU | United Kingdom |
| Middlesex Hospital | London | England | WC1E 6HX | United Kingdom |
| James Paget Hospital | Norfolk | England | NR31 6LA | United Kingdom |
| Nottingham City Hospital NHS Trust | Nottingham | England | NG5 1PB | United Kingdom |
| Oxford Radcliffe Hospital | Oxford | England | 0X3 9DU | United Kingdom |
| Pontefract General Infirmary | Pontefract West Yorkshire | England | WF8 1PL | United Kingdom |
| Rotherham District General Hospital - NHS Trust | Rotherham | England | S60 2UD | United Kingdom |
| Cancer Research Centre at Weston Park Hospital | Sheffield | England | S1O 2SJ | United Kingdom |
| Southampton University Hospital NHS Trust | Southampton | England | SO16 6YD | United Kingdom |
| Staffordshire General Hospital | Stafford | England | ST16 3SA | United Kingdom |
| Royal Marsden NHS Foundation Trust - Surrey | Sutton | England | SM2 5PT | United Kingdom |
| Great Western Hospital | Swindon | England | SN3 6BB | United Kingdom |
| Princess Margaret Hospital | Swindon | England | SN3 6BB | United Kingdom |
| Hillingdon Hospital | Uxbridge | England | UB8 3NN | United Kingdom |
| Sandwell General Hospital | West Bromwich | England | B71 4HJ | United Kingdom |
| Centre for Cancer Research and Cell Biology at Belfast City Hospital | Belfast | Northern Ireland | BT9 7AB | United Kingdom |
| Aberdeen Royal Infirmary | Aberdeen | Scotland | AB25 2ZN | United Kingdom |
| Royal Infirmary - Castle | Glasgow | Scotland | G4 0SF | United Kingdom |
| Pinderfields Hospital NHS Trust | Wakefield | Scotland | WF1 4DG | United Kingdom |
| Ysbyty Gwynedd | Bangor | Wales | LL57 2PW | United Kingdom |
| Prince Philip Hospital | Dyfed | Wales | SA14 8QF | United Kingdom |
| Singleton Hospital of the Swansea NHS Trust | Swansea | Wales | SA2 8QA | United Kingdom |
| ID | Term |
|---|---|
| D008223 | Lymphoma |
| D008224 | Lymphoma, Follicular |
| ID | Term |
|---|---|
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D008228 | Lymphoma, Non-Hodgkin |
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| ID | Term |
|---|---|
| D000069585 | Filgrastim |
| D000069283 | Rituximab |
| D002330 | Carmustine |
| D003520 | Cyclophosphamide |
| D003561 | Cytarabine |
| D005047 | Etoposide |
| D008558 | Melphalan |
| D036102 | Peripheral Blood Stem Cell Transplantation |
| ID | Term |
|---|---|
| D016179 | Granulocyte Colony-Stimulating Factor |
| D003115 | Colony-Stimulating Factors |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D016298 | Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D058846 | Antibodies, Monoclonal, Murine-Derived |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D009607 | Nitrosourea Compounds |
| D014508 | Urea |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D009603 | Nitroso Compounds |
| D010752 | Phosphoramide Mustards |
| D009588 | Nitrogen Mustard Compounds |
| D009150 | Mustard Compounds |
| D006846 | Hydrocarbons, Halogenated |
| D006838 | Hydrocarbons |
| D063088 | Phosphoramides |
| D009943 | Organophosphorus Compounds |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001087 | Arabinonucleosides |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D011083 | Polycyclic Compounds |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D010649 | Phenylalanine |
| D024322 | Amino Acids, Aromatic |
| D000598 | Amino Acids, Cyclic |
| D000596 | Amino Acids |
| D018380 | Hematopoietic Stem Cell Transplantation |
| D033581 | Stem Cell Transplantation |
| D017690 | Cell Transplantation |
| D064987 | Cell- and Tissue-Based Therapy |
| D001691 | Biological Therapy |
| D013812 | Therapeutics |
| D014180 | Transplantation |
| D013514 | Surgical Procedures, Operative |
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