Combined Bone Marrow and Kidney Transplant for Multiple Myeloma with Kidney Failure - Article High blood pressure (hypertension)
Clinical Trial: Combined Bone Marrow and Kidney Transplant for Multiple Myeloma with Kidney Failure
This study is currently recruiting patients.
The purpose of this study is to determine whether a combined bone marrow and kidney transplant will be effective in treating stage II or greater multiple myeloma and associated kidney failure. This study will determine whether transplant rejection and the need for immunosuppressive drugs are decreased with this combined transplant approach.
Study hypothesis: Combined renal transplantation with bone marrow transplantation from the same donor, using nonmyeloablative, relatively non-toxic conditioning, can cure the underlying malignancy while allowing acceptance of a donor renal allograft without chronic immunosuppression.
|Condition||Treatment or Intervention||Phase|
|Kidney Failure, Chronic |
| Procedure: Combined bone marrow and kidney transplant ||Phase I |
MedlinePlus related topics: Kidney Failure; Multiple Myeloma
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Secondary Outcomes: Graft vs. host disease (GVHD); opportunistic infections; T cell recovery and immune reconstitution
Expected Total Enrollment: 10
Study start: June 2003
In very limited human testing, a combined kidney and bone marrow transplant appears to be safe and effective in treating multiple myeloma and associated kidney failure. This study will evaluate this approach in 10 patients with kidney failure due to or in association with stage II or greater multiple myeloma. Treatment prior to transplant will include cyclophosphamide, ATGAM (a lymphocyte-specific immunosuppressant), local radiation to the thymus, and cyclosporine (an immunosuppressive drug).
An infusion of donor bone marrow and a kidney graft from a closely matched, related donor will be transplanted simultaneously. An additional infusion of donor white blood cells may be administered between day 45 and 74 after transplant in an effort to eliminate any remaining cancer cells. Patients will remain on cyclosporine for a defined period of time. The cyclosporine doses will be slowly decreased and stopped if graft rejection and graft-versus-host disease do not occur.
Each participant will be involved in the study for 3 years; this includes the intervention phase (time from initial screening at approximately 7 days before transplant through 100 days after the transplant) and continued follow-up visits for at least 2 years following the transplant.
Hypothesis: combined renal transplantation with bone marrow transplantation from the same donor, using nonmyeloablative, relatively non-toxic conditioning, can cure the underlying malignancy while allowing acceptance of a donor renal allograft without chronic immunosuppression.
Ages Eligible for Study: 18 Years - 65 Years, Genders Eligible for Study: Both
- End-stage renal disease (ESRD) due to or in association with stage II or greater multiple myeloma
- Participants in whom the development of ESRD is not due to the underlying myeloma will be included if they have evidence of active myeloma despite past treatment with standard therapies (e.g., prednisone, melphalan, or high-dose radiation therapy with autologous stem cell transplantation)
- On dialysis or have a creatinine clearance > 20 ml/min
- HLA-matched or one of six HLA antigen-mismatched related donor
- Compromised pulmonary, cardiac, or liver function
- Active infection
Location and Contact Information
Massachusetts General Hospital, Boston, Massachusetts, 02114-2696, United States; Recruiting
Megan Sykes, MD, Principal Investigator
A. Benedict Cosmini, MD, Principal Investigator
Thomas Spitzer, MD, Sub-Investigator
Megan Sykes, MD, Principal Investigator, Massachussets General Hospital
Immune Tolerance Network
Record last reviewed: January 2005
Last Updated: March 9, 2005
Record first received: June 9, 2003
ClinicalTrials.gov Identifier: NCT00062621
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08
Cache Date: April 9, 2005
- High Blood Pressure and Kidney Disease (National Institute of Diabetes and Digestive and Kidney Diseases)