Conditions: Non-Hodgkin's Lymphoma
Keywords: relapsed mantle cell lymphoma
Allocation: NA | Intervention model: SINGLE_GROUP
Enrollment: 25
Healthy volunteers: no

Brief summary:
Primary Objective:

Evaluate the clinical activity of the RT-PEPC combination regimen (rituximab, thalidomide, and prednisone, etoposide, procarbazine, cyclophosphamide) in patients with relapsed mantle cell lymphoma. Specifically, response rate (RR) and time to disease progression (TTP) will be assessed.

Secondary Objectives:

1. Assess the toxicity profiles of RT-PEPC treatment in patients with relapsed mantle cell lymphoma.
2. Prospectively characterize the angiogenic profile of patients with mantle cell lymphoma during treatment with RT-PEPC. The dynamics of the angiogenic profile will be correlated with clinical response to RT-PEPC therapy.
3. Assess the quality of life of patients receiving RT-PEPC treatment

Detailed description:

Arms:
arm 1: None

Interventions: intervention 1: PEPC intervention 2: Thalidomide intervention 3: Rituximab
Intervention descriptions: intervention 1: Induction phase (month 1-3)

• PEPC daily (prednisone 20 mg/day, cyclophosphamide 50 mg/day, etoposide 50 mg/day, and procarbazine 50 mg/day) until expected drop in neutrophil count (ANC \< 3000), unless due to disease. After ANC returns to above 2,000/ul, PEPC resumes at alternate day or fractionated weekly basis.

Maintenance phase (month 4-12) • PEPC QOD or fractionated weekly basis.

Post-Month 12 Maintenance phase (post-month 12 until disease progression)

• PEPC QOD or fractionated weekly basis intervention 2: Induction phase (month 1-3)

• Daily thalidomide at 50 mg/day for the first 8 weeks, then dose escalated as tolerated to a maximum of 100 mg/day.

Maintenance phase (month 4-12) • Daily low dose thalidomide (50-100 mg/d)

Post-Month 12 Maintenance phase (post-month 12 until disease progression)

• Daily low dose thalidomide (50-100mg/d) intervention 3: Induction phase (month 1-3)

• Rituximab weekly x 4 (375 mg/m2/week) starting at week 1.

Maintenance phase (month 4-12) • Rituximab (375 mg/m2/week) weekly x 4 administered every 4 months.

Post-Month 12 Maintenance phase (post-month 12 until disease progression)

• Rituximab (375 mg/m2/week) weekly x 4 administered every 4 months

Protocol document: