Donor T Cells After Donor Stem Cell Transplant in Treating Patients With Hematologic Malignancies
Condition: Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Blastic Phase Chronic Myelogenous Leukemia; Childhood Burkitt Lymphoma; Childhood Chronic Myelogenous Leukemia; Childhood Diffuse Large Cell Lymphoma; Childhood Immunoblastic Large Cell Lymphoma; Childhood Myelodysplastic Syndromes; Childhood Nasal Type Extranodal NK/T-cell Lymphoma; Chronic Phase Chronic Myelogenous Leukemia; Cutaneous B-cell Non-Hodgkin Lymphoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Hepatosplenic T-cell Lymphoma; Intraocular Lymphoma; Nodal Marginal Zone B-cell Lymphoma; Noncutaneous Extranodal Lymphoma; Peripheral T-cell Lymphoma; Post-transplant Lymphoproliferative Disorder; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Adult T-cell Leukemia/Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Childhood Anaplastic Large Cell Lymphoma; Recurrent Childhood Grade III Lymphomatoid Granulomatosis; Recurrent Childhood Large Cell Lymphoma; Recurrent Childhood Lymphoblastic Lymphoma; Recurrent Childhood Small Noncleaved Cell Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Relapsing Chronic Myelogenous Leukemia; Secondary Myelodysplastic Syndromes; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia
MeSH terms: Burkitt Lymphoma; Mycoses; Lymphoma; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Lymphoma, Follicular; Lymphoma, Non-Hodgkin; Preleukemia; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Leukemia, Lymphoid; Lymphoma, B-Cell; Leukemia, Lymphocytic, Chronic, B-Cell; Hodgkin Disease; Lymphoma, Mantle-Cell; Lymphoma, T-Cell; Lymphoma, T-Cell, Peripheral; Lymphoma, B-Cell, Marginal Zone; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Lymphoma, Large B-Cell, Diffuse; Hematologic Neoplasms; Lymphoma, Large-Cell, Immunoblastic; Plasmablastic Lymphoma; Mycosis Fungoides; Sezary Syndrome; Leukemia, T-Cell; Lymphoma, T-Cell, Cutaneous; Waldenstrom Macroglobulinemia; Leukemia-Lymphoma, Adult T-Cell; Lymphoma, Large-Cell, Anaplastic; Leukemia, Hairy Cell; Leukemia, Myeloid, Chronic-Phase; Blast Crisis; Lymphomatoid Granulomatosis; Leukemia, Myeloid, Accelerated Phase; Lymphoma, Extranodal NK-T-Cell; Intraocular Lymphoma; Leukemia, Large Granular Lymphocytic; Myelodysplastic Syndromes; Lymphoproliferative Disorders; Immunoblastic Lymphadenopathy; Syndrome; Recurrence
Study type: Interventional
Phase: Phase 2

Summary: 
      This pilot phase II trial studies how well giving donor T cells after donor stem cell
      transplant works in treating patients with hematologic malignancies. In a donor stem cell
      transplant, the donated stem cells may replace the patient's immune cells and help destroy
      any remaining cancer cells (graft-versus-tumor effect). Giving an infusion of the donor's T
      cells (donor lymphocyte infusion) after the transplant may help increase this effect.
    

Detailed description: 
      PRIMARY OBJECTIVES:

      I. To determine the feasibility of escalating dose regimen (EDR) donor lymphocyte infusion
      (DLI) as measured by the proportion of patients who receive at least one DLI.

      SECONDARY OBJECTIVES:

      I. To assess progression free survival (PFS) at 2 years after stem cell transplant (SCT) for
      high-risk hematologic malignancies receiving T-cell depleted grafts followed by escalating
      dose regimen (EDR) prophylactic DLI compared to historical controls not receiving DLI.

      II. To assess the safety of EDR DLI for high-risk hematologic malignancies as measured by
      cumulative incidence of severe grade III-IV acute graft-versus-host disease (GVHD).

      III. To measure outcomes of grade II-IV acute GVHD, non-relapse mortality, overall survival
      and chronic GVHD of EDR DLI.

      IV. To assess the full donor chimerism rate in the CD3 compartment and immune reconstitution
      after EDR DLI.

      OUTLINE:

      Patients receive DLI intravenously (IV). Treatment repeats every 4-8 weeks for 5 doses in the
      absence of disease progression or unacceptable toxicity.

      After completion of study treatment, patients are followed up periodically for 2 years.
    

Intervention name(s): therapeutic allogeneic lymphocytes; laboratory biomarker analysis
Intervention type(s): Biological; Other
Intervention description(s): Given IV; Correlative studies
Other intervention name(s): ALLOLYMPH
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment