Haploidentical BMT With Post-Transplant Cyclophosphamide and Bendamustine

Korábbi kezelés

• Refractory to chemotherapy lymphoma
• Documented fungal infection or highly suspected and receiving treatment for presumed fungal infection within 3 months of BMT

Más betegség

• Refractory acute leukemia (>5% blasts) or progressive disease
• Active infection at time of hospital admission of Haplo BMT
• HIV positive
• Severe psychiatric illness or mental deficiency making compliance to treatment unlikely and/or informed consent impossible.

Laborértékek

• Aspartate Aminotransferase (AST)/ Alanine Aminotransferase (ALT) > 5 x upper limit of normal (ULN)
• Bilirubin > 2 x ULN
• Creatinine greater than >2 x ULN for age or creatinine clearance/glomerular filtration rate (GFR) <40 ml/min/1.73m2
• Cardiac: left ventricular ejection fraction <35%

Életkor

• Positive pregnancy test for girls post menarche or women of childbearing age.

Egyéb

• Untreated or progressive central nervous system leukemia
• Co-morbidities precluding patient's ability to tolerate BMT
• Pulmonary function: Diffusing capacity of the lung for carbon monoxide (DLCO) < 40% of normal or O2 Sat <92%
• Karnofsky score (adults) < 60% or Lansky score < 50% (pediatrics).
• Any reason, at the investigator's discretion, that the participation of the patient in this protocol would not be in patient's best interest, or where the patient would be unable to adhere to the study requirements.

• Be willing and able to provide written consent/assent for the trial.
• Diagnosed with one of the following high-risk malignancies, which require hematopoietic cell transplantation (HCT) but do not have an available Human Leukocyte Antigen (HLA)-matched related or unrelated donor or acceptable cord blood
• High risk acute lymphoblastic leukemia (ALL) in 1st complete remission (CR1) or greater
• High risk acute myelogenous leukemia (AML) in CR1 or greater
• High risk undifferentiated acute leukemia
• High risk myelodysplastic syndrome (MDS)
• Chronic Myelogenous Leukemia (CML) failing or intolerant to Tyrosine Kinase Inhibitors (TKIs) or in accelerated, blastic phase, or in second or subsequent chronic phase
• Lymphoma, (Hodgkin and Non-Hodgkins Lymphoma including marginal zone, follicular lymphoma, chemotherapy-sensitive large-cell, mantle cell lymphoma, gray zone, and Burkitt's lymphoma in remission).
• At least one haploidentical related donor is available for bone marrow harvest.
• Molecular based HLA typing for the HLA-A, -B, -Cw, beta chain (-DRB1) and - DQ Beta 1 Locus (DQB1loci) to the resolution is needed to establish haploidentity.
• A minimum match of 5/10 is required.
• No availability of an 8/8 HLA-matched related or unrelated donor or clinical urgency for transplant (e.g., needed within 4-8 weeks) at which time an acceptable unrelated donor will not be available.