It is the objective of our studies to improve the results of treatment
with high dose therapy and autografting in Hodgkin's disease and the
non-Hodgkin's lymphomas. We intend to accomplish this goal through
the study of novel preparatory regimens and post-transplant
immunotherapy. Complementary pathology studies are planned to better
define biologic correlates of the clinical results.
The proposed clinical studies build on our previous research in these
diseases. A new preparatory regimen (CCNU, VP16, cyclophosphamide)
developed at Stanford University will be evaluated in patients with
low risk Hodgkin's disease. Multiple cycle high dose therapy has been
developed to reduce relapse in high risk Hodgkin's disease patients.
We will compare the efficacy and toxicity of high dose sequential
chemotherapy with our standard preparatory regimen in a Phase III
trial in non-Hodgkin's lymphoma. Correlations will be made with a
number of biologic parameters assessed in lymphoma tissues in order
to further elucidate factors that may predict the treatment outcome
after high dose therapy and autografting. All autografted patients
will be studied by sensitive molecular and cytogenetic techniques
designed to predict genomic instability and the risk for treatment-
related myelodysplasia or acute leukemia. In collaboration with
investigators in Project III, we will study the feasibility and
toxicity of infusing cytokine-induced killer cells into patients with
refractory non-Hodgkin's lymphoma. These CIK cells represent a novel
therapeutic which, when used as an adjunct to high dose therapy and
autografting, may reduce the major problem of relapse after
autografting.
The studies in Project II are based on past accomplishments in the
research laboratory and the clinic. Analysis of previous experience
allows us to define risk groups in Hodgkin's disease and structure
preparatory regimens accordingly. We plan a comprehensive approach
to the study of non-Hodgkin's lymphoma by characterizing lymphoma
tissues, purging lymphoma from the apheresis product, comparing two
preparatory regimens, and introducing a novel post-transplant
immunotherapy to the clinic. The potential for myelodysplasia or
acute leukemia as a late effect of high dose therapy will be studied
prospectively in all patients. Project II will serve as a clinical
resource for other subprojects.
No Sub Projects information available for 5P01CA049605-12 0002
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