Home
Search
Study Topics
Glossary
|
|
|
|
|
Sponsored by: |
National Heart, Lung, and Blood Institute (NHLBI) |
---|---|
Information provided by: | National Institutes of Health Clinical Center (CC) |
ClinicalTrials.gov Identifier: | NCT00345345 |
This study will examine the use of alemtuzumab (Campath(Registered Trademark)) in patients with T cell large granular lymphocytic leukemia (T-LGL). Patients with T-LGL often have reduced white blood cells, red blood cells and platelets, and increased numbers of abnormal cells called large granular lymphocytes (LGLs). Patients may have recurrent infections, anemia, or abnormal bleeding. Campath(Registered Trademark) destroys specific parts of the abnormal LGLs, which interfere with the production of normal blood cells. This study will determine whether Campath(Registered Trademark) can increase blood counts and reduce the number of abnormal LGLs in patients and will examine the side effects of the drug.
Patients 18 to 85 years of age with T-LGL leukemia may be eligible for this study. Participants undergo the following procedures:
Before starting Campath(Registered Trademark) treatment
The procedure is done using local anesthetic.
During Campath(Registered Trademark) treatment
Echocardiogram and 24-hour Holter monitor after the last dose of Campath(Registered Trademark).
Follow-up evaluations after Campath(Registered Trademark) treatment ends
Condition | Intervention | Phase |
---|---|---|
Lymphoprofilerative Disorders |
Drug: Alemtuzumab (Campath) |
Phase II |
Study Type: | Interventional |
Study Design: | Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study |
Official Title: | Treatment of T-Large Granular Lymphocyte (T-LGL) Lymphoproliferative Disorders With Alemtuzumab (Campath) |
Estimated Enrollment: | 39 |
Study Start Date: | June 2006 |
Estimated Study Completion Date: | June 2011 |
Estimated Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
T Cell Large Granular Lymphocyte (T-LGL) lymphoproliferative disorders are a heterogeneous group of uncommon diseases which may involve a polyclonal or a monoclonal T cell population, which bear characteristic surface markers corresponding to activated cytotoxic (CD3+, CD8+) lymphocytes. They are often associated with quite severe neutropenia, anemia, and thrombocytopenia, which may be life-threatening. There is some evidence that the abnormal cytotoxic lymphocyte population may cause the cytopenias by suppressing hematopoiesis, although the mechanism is unclear. Immunosuppressive therapy has been shown to improve the cytopenias of T-LGL leukemia, however the long term use of the commonly used agents often lead to significant toxicity in the older patients which are affected by this disease.
Alemtuzumab (Campath[R]) is currently approved as second line agent in patients with chronic lymphocytic leukemia (CLL) and has been used successfully in the treatment of certain autoimmune disorders. In the Hematology Branch, Campath is currently being investigated in two bone marrow failure syndromes: aplastic anemia and myelodysplasia.
Cytopenia(s) is an important characteristic of patients with T-LGL leukemia, often being the indication for immunosuppressive therapy. Our preliminary experience with Campath indicates that it is well tolerated, in particular among the elderly patients.
Therefore, we propose this pilot, Phase II, single agent, study which will evaluate the efficacy and safety of alemtuzumab (Campath[R]), an immunosuppressive drug, in subjects with T-LGL leukemia. Commercially available alemtuzumab (Campath[R]) will be administered off label at 10 mg per day by intravenous infusion for 10 days total. Subjects who do not show a response to initial Campath or relapse may receive a second cycle of drug after the 3 month time point.
The primary end point of the study is the response rate at three months, defined as improvement in cytopenia(s).
Secondary endpoints will include relapse-free survival, response at 6 months, life threatening toxicity, reduction in the number of abnormal T-LGL clone, response to second cycle of Campath, and overall survival.
Ages Eligible for Study: | 18 Years to 85 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Clinical history supportive of the diagnosis of T-LGL leukemia (i.e. a history of cytopenias with peripheral blood morphologic evidence of LGLs)
Immunophenotypic studies of peripheral blood showing an increased population of T-LGLs (suggested by staining with CD3+, CD8+ and CD16+ or CD57+) or gammadelta T cells.
Restricted or clonal rearrangement of the T-cell receptor by PCR AND one or more of the following:
Severe neutropenia (less than 500 neutrophils/microliter); OR
Severe thrombocytopenia (less than 20,000 platelets/microliter), or moderate thrombocytopenia (less than 50,000 platelets/microliter) with active bleeding; OR
Symptomatic anemia with a hemoglobin less than 9 g/dL or red blood cell transfusion requirement of greater than 2 units/month for two months prior to initiation of Campath
Ages 18-85
EXCLUSION CRITERIA:
A reactive LGL lymphocytosis to a viral infection
Serologic evidence of HIV infection
Infection not adequately responding to appropriate therapy
Previous immunosuppressive therapy with alemtuzumab
History of carcinoma that is not considered cured (excluding non-melanoma skin carcinoma)
Moribund status or concurrent hepatic, renal, cardiac, neurologic, pulmonary, infectious, or metabolic disease of such severity that it would preclude the subject's ability to tolerate protocol therapy or that death within 7-10 days is likely.
Current pregnancy, or unwilling to take oral contraceptives or refrain from pregnancy if of childbearing potential
Not able to understand the investigational nature of the study or give informed consent.
Contact: Patient Recruitment and Public Liaison Office | (800) 411-1222 | prpl@mail.cc.nih.gov |
Contact: TTY | 1-866-411-1010 |
United States, Maryland | |
National Institutes of Health Clinical Center, 9000 Rockville Pike | Recruiting |
Bethesda, Maryland, United States, 20892 |
Responsible Party: | National Institutes of Health ( Phillip Scheinberg, M.D./National Heart, Lung, and Blood Institute ) |
Study ID Numbers: | 060190, 06-H-0190 |
Study First Received: | June 27, 2006 |
Last Updated: | September 3, 2009 |
ClinicalTrials.gov Identifier: | NCT00345345 History of Changes |
Health Authority: | United States: Federal Government |
Neutropenia Monoclonal Antibody Therapy Anti-CD52 T-LGL Leukemia LGL Leukemia Anemia |
Immunosuppression Chronic T Cell Lymphocytosis with Neutropenia LGL Leukemia T-LGL Leukemia Leukemia |
Immunoproliferative Disorders Large Granular Lymphocyte Leukemia Anemia Antibodies, Monoclonal Leukemia Neutropenia Lymphatic Diseases |
Antibodies Lymphocytosis Alemtuzumab Lymphoproliferative Disorders Leukemia, Large Granular Lymphocytic Immunoglobulins |
Lymphatic Diseases Immunoproliferative Disorders Pathologic Processes Disease Immune System Diseases |
Antineoplastic Agents Therapeutic Uses Alemtuzumab Lymphoproliferative Disorders Pharmacologic Actions |