Full TitlePartially HLA-Mismatched Related Donor Hematopoietic Stem Cell Transplantation Using Killer Immunoglobulin Receptor and Human Leukocyte Antigen Based Donor Selection
The donation of stem cells from one person to another is called allogeneic stem cell transplantation. This therapy is used to treat some patients with blood or bone marrow cancers or lymphoma. Not every patient who needs a stem cell transplant has a fully matched donor. Haploidentical or “half-matched” family donors may be used in this setting.
Killer immunoglobulin-like receptors (KIRs) are proteins that control how activated part of the immune system can become. KIRs may be used to predict if a donor’s immune system will become more activated against cancer after transplant. In this study, researchers want to see if this is the case for haploidentical donors: They want to learn if certain KIR genes in the half-matched donor will reduce cancer recurrence in the transplant recipient.
In this study, patients will first receive a combination of chemotherapy drugs. Their donors will have KIR testing, and if possible, patients’ donors will be chosen based on KIR typing. (Patients whose donors do not have the beneficial KIR genes will still receive a transplant.) Patients will undergo a stem cell transplant, followed by an additional chemotherapy dose three to four days later to reduce a potential complication called graft-versus-host disease (GVHD, in which white blood cells from the donor attack tissues of the recipient). Researchers will determine if patients who received a transplant of stem cells from a donor with favorable KIR genes have a lower risk of cancer recurrence.
To be eligible for this study, patients must meet several criteria, including but not limited to the following:
- Patients must have acute or chronic leukemia, Hodgkin or non-Hodgkin lymphoma, myelodysplastic syndromes (MDS), or myelofibrosis and be candidates for stem cell transplantation.
- Patients may not have an HLA-matched sibling donor.
- Patients must have a partially HLA-matched donor.
- This study is for patients ages 18 to 75.