Overview

Immune Mobilization of Autologous Peripheral Blood Stem Cells Using Interleukin-2 and GM-CSF

Status:
Completed
Trial end date:
2011-04-01
Target enrollment:
0
Participant gender:
All
Summary
We postulate that the combination of IL-2 and GM-CSF immunotherapy will efficiently mobilize autologous peripheral blood stem cells and activated immune effector cells in patients with a hematologic malignancy. These activated effector cells will improve the immune function of the graft. These hypotheses will be tested using this proposed clinical trial to mobilize autologous peripheral blood stem cells pre-transplantation.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Dartmouth-Hitchcock Medical Center
Treatments:
Interleukin-2
Criteria
Inclusion Criteria:

- All patients must have pathologic diagnosis of one of the following malignancies:
Non-Hodgkin's Lymphoma, Hodgkin's Disease, Multiple Myeloma or other plasma cell
dyscrasia (Waldenstrom, Amyloidosis), Leukemia (AML, ALL, CLL)

- Prior Treatment: > 2 weeks prior to initiation of therapy.

- Performance Status: Karnofsky > 70%

- Age >18

- Life Expectancy > 4 months

- Bone Marrow: bone marrow biopsy and aspirate

- Blood counts: The patient must have adequate bone marrow function, i.e. a total WBC of
> 2,000/ul, a Hgb of > 7 mg/dl, and a platelet count of > 50,000/ul, unless this
abnormality is believed to be due to the underlying disease.

- Pulmonary function tests: DLCO > 55% predicted.

- Cardiac: Left ventricular ejection fraction of > 40% by radionuclide scan or
echocardiography.

- Liver function tests (bilirubin, alkaline phosphatase, and SGOT/SGPT) < 3 x normal
(unless believed to be elevated due to disease).

- No significant co-morbid medical or psychiatric illness that would significantly
compromise the patient's clinical care and chances of survival.

- Informed Consent: Informed consent must be signed prior to the treatment. Patients
must be aware of the neoplastic nature of their disease and willingly consent after
being informed of the procedure to be followed, the nature of the therapy,
alternatives, potential benefits, side effects, risks and discomforts. The patient is
not deemed eligible if there is any other serious medical or psychiatric illness that
would prevent informed consent. (Human protection committee approval of this protocol
and a consent form is required.)

Exclusion Criteria:

- Medical, social, or psychological factors which would prevent the patient from
receiving or cooperating with the full course of therapy.

- Evidence on physical exam, LP, CT, or MRI scans of CNS involvement with malignancy.

- Uncontrolled or severe cardiovascular disease, including recent (< 6 months)
myocardial infarction, congestive heart failure, angina (symptomatic despite optimal
medical management), life-threatening arrhythmia, or hypertension or clinically
significant obstructive/restrictive pulmonary disease.

- Serology positive for HIV

- History of seizures.

- Concurrent or expected need for therapy with systemic corticosteroids (since systemic
steroids may suppress the effects of IL-2).

- Current and clinically significant pleural effusion, pericardial effusion, or ascites.

- Positive pregnancy test or presence of lactation.

- Uncontrolled active infection.

- Documented hypersensitivity to any of the drugs used in the protocol.

- No concomitant, ongoing malignancy that is life-threatening, based on PI's evaluation