Non-Myeloablative Allogeneic HSCT From HLA Matched Related or Unrelated Donors for the Treatment of Low Grade B Cell Malignancies

UAB 0775 Phase II Trial of Non-Myeloablative Allogeneic Hematopoietic Cell Transplantation Protocol From HLA Matched Related Donors for The Treatment of Patients With Low Grade B Cell Malignancies

A non-myeloablative treatment strategy and uniform selection criteria will enable patients with a variety of low grade B-Cell malignancies to attain long term disease control without unacceptably high treatment related mortality.

Non myeloablative transplant aims to achieve the immunological advantage of graft versus tumor effect as conventional myeloablative therapy without causing high treatment related toxicities. Non myeloablative transplant has been gaining wider acceptance as a way to achieve longer disease free and over all survival in patients with low grade B-cell malignancies, which otherwise is an incurable disease. Recent studies of non-myeloablative HSCT have demonstrated the powerful effect of graft versus leukemia alone against myeloma and other malignant B-cell malignancies if the transplant is performed for low grade, low volume disease.

Inclusion Criteria:

• Stage II or III non-progressive disease Multiple Myeloma.
• CLL/SLL, and low grade Hodgkin Lymphomas that are in a very good partial response or complete response with non-progressive disease.
• ≤ 70 years old.
• Eligible and willing HLA matched related donor.
• Bilirubin <2xULN.
• ALT and AST <3xULN.
• LVEF > 40%.
• Creatinine Clearance >40mL/min.
• Pulmonary function DLCO corrected to ≥ 70%.
• Minimum performance score of 70%.
• Platelet count >130 x103 micro L.
• LDH ≤1.5xULN.
• No proceeding co-morbid condition that significantly increases the risk of severe regimen related toxicity.
• No uncontrolled infections.

Exclusion Criteria:

• Age >70 years old.
• Performance status <70%.
• Uncontrolled infections or is HIV positive
• Prior malignancies that are felt to have a <80% probability of being cured.
• Pregnant, breastfeeding, or refuse to use contraceptive techniques during and for 12 months following transplant.
• Prior Allograft
• History of rapidly growing disease at diagnosis or at any progression or have MDS.
• No eligible and willing HLA matched donor.