Intensity-Modulated Radiation Therapy, Etoposide, and Cyclophosphamide Followed By Donor Stem Cell Transplant in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia or Acute Myeloid Leukemia

Korábbi kezelés

• Prior radiation therapy that would exclude the use of total-body irradiation
• Patients who have undergone bone marrow transplantation previously and who have relapsed

Más betegség

• Patients with psychological or medical condition that patients physician deems unacceptable to proceed to allogeneic bone marrow transplant

Laborértékek

• Electrocardiogram (EKG) showing ischemic changes or abnormal rhythm and/or an echocardiogram or MUGA scan showing abnormal wall motion or ejection fraction < 50%

Egyéb

• Pregnancy

• Patients with acute lymphocytic leukemia or acute myelogenous leukemia who are not in first or second remission (i.e., after failing remission induction therapy or in relapse or beyond second remission)
• All candidates for this study must have a human leukocyte antigen (HLA) (A, B, C, DR) identical sibling who is willing to donate bone marrow or primed blood stem cells or a 10/10 allele matched unrelated donor; a single allele mismatch at A, B, C, DR, or DQ and a KIR mismatch at C will be allowed; all ABO blood group combinations of the donor/recipient are acceptable since even major ABO compatibilities can be dealt with by various techniques
• Prior therapy with VP-16, Busulfan, and Cytoxan is allowed
• A cardiac evaluation with an electrocardiogram showing no ischemic changes or abnormal rhythm and an ejection fraction of >= 50% established by multi gated acquisition scan (MUGA) or echocardiogram
• Patients must have a serum creatinine of less than or equal to 1.2 or creatinine clearance > 80 ml/min
• A bilirubin of less than or equal to 1.5
• Serum glutamic oxaloacetic transaminase (SGOT) less than 5 times the upper limit of normal
• Serum glutamate pyruvate transaminase (SGPT) less than 5 times the upper limit of normal
• Pulmonary functioning tests including diffusing capacity of carbon monoxide (DLCO) will be performed; forced expiratory volume in one second (FEV1) and DLCO should be greater than 50% of the predicted normal value
• The time from the end last induction or reinduction attempt should be >= 14 days
• Signed informed consent form approved by the Institutional Review Board (IRB) is required
  • DONOR: Any sibling donors who are histocompatible with the prospective recipient will be considered a suitable donor
• Donors will be excluded if for psychological or medical reasons they are unable to tolerate the procedure
• Donor should be able to donate peripheral blood stem cells or bone marrow