Bendamustine and Dexamethasone in Patients With Relapsed AL Amyloidosis
The study is being done to see if the combination of bendamustine and dexamethasone will help people with amyloidosis that has returned after standard treatment. Bendamustine is currently approved by the Food and Drug Administration (FDA) for treatment of chronic lymphocytic leukemia (CLL) and is under clinical development in the United States for the treatment of non-Hodgkin lymphoma (NHL). Dexamethasone is a synthetic (man-made) steroid with powerful anti-inflammatory effects. It can also alter the body's immune response.
Study Start Date
Estimated Completion Date
- Drug: Bendamustine
- Drug: Dexamethasone
- Oncology: Leukemia/Lymphoma
University of Pittsburgh -- 10-012
University of Pittsburgh
- Male or female patients aged >= 18 years old
- Histopathology of amyloidosis or light chain deposition disease based on detection by polarizing microscopy of green bi-refringent material in Congo red-stained tissue specimens or characteristic electron microscopy appearance
- Demonstrate measurable disease as defined by one or more of the following:
- Serum monoclonal protein >= 0.5 g/dL by serum electrophoresis
- Urine monoclonal protein > 200 mg/dL in a 24 hr urine electrophoresis
- Serum immunoglobulin free light chain >= 10 mg/dL AND abnormal serum immunoglobulin kappa lambda free light chain ratio.
- Demonstrate clonal population of plasma cells in the bone marrow or immunohistochemical stain with anti-light chain anti-sera of amyloid fibrils
- ECOG performance status of 0, 1, or 2
- Patients had at least one prior regimen consisting of at least 1 cycle
- If not previously transplanted, patient should be either ineligible for ASCT, or must have declined the option of ASCT. Patients who have previously had ASCT and have subsequently progressed are eligible, provided other entry criteria are met
- Ability to provide written informed consent obtained prior to participation in the study and any related procedures being performed
- Patients must meet the following laboratory criteria:
- ANC >= 1.5 x 10^9/L
- Hemoglobin >= 9 g/dl (May transfuse PRBC to meet parameter)
- Platelets >= 100x 10^9/L (Must be independent of platelet transfusion)
- Calculated CrCl greater than or equal to 40 mL/min (Cockcroft-Gault Formula )
- AST and ALT <= 2.5 x upper limit of normal (ULN)
- Serum bilirubin <1.5 x ULN
- Albumin > 3.0 g/dl
- Serum potassium >= lower limit of normal (LLN)
- Total serum calcium (corrected for serum albumin) or ionized calcium >= LLN,
- Serum magnesium >= LLN
- Serum phosphorus >= LLN
- TSH and free T4 within normal limits. Patients are permitted to receive thyroid hormone supplements to treat underlying hypothyroidism.
- Patients meeting the criteria for symptomatic MM:
- lytic lesions on skeletal survey or
- plasmacytoma Patients meeting International Myeloma Working Group definition of symptomatic myeloma with symptoms only related to associated amyloidosis who would otherwise only meet the criteria for smoldering MM are potentially eligible
- Myocardial infarction within 6 months prior to enrollment or has New York Heart Association (NYHA) Class III or IV heart failure uncontrolled angina, severe uncontrolled ventricular arrhythmias, or
- electrocardiographic evidence of acute ischemia or active conduction system abnormalities (not including 1st degree AV-block, Wenckebach type 2nd degree heart block, or left bundle branch block. Prior to study entry, any ECG abnormality at Screening has to be documented by the investigator or an authorized physician sub-investigator as not medically relevant). Note: There is no lower limit of left ventricular ejection fraction below which patients are excluded from participation.
- Patient has received other investigational drugs within 14 days prior to enrollment
- Any form of secondary / familial amyloidosis
- Serious concurrent illness, which in the opinion of the investigator or an authorized physician sub-investigator would interfere with participation in this clinical study,
- Known HIV infection.
- Inability to provide informed consent or to comply with the schedule of office and treatment visits
- Female subject is pregnant or breast-feeding. Confirmation that the subject is not pregnant must be established by a negative serum beta-human chorionic gonadotropin pregnancy test result obtained during screening. Pregnancy testing is not required for post-menopausal or surgically sterilized women(woman not of child-bearing potential is defined as any woman whose menstrual periods have stopped in the past 12 consecutive months or have had a complete hysterectomy or both ovaries surgically removed).
- Diagnosed or treated for another malignancy within 3 years of enrollment, with the exception of complete resection of basal cell carcinoma or squamous cell carcinoma of the skin, an in situ malignancy, low-risk prostate cancer, or cancer after curative treatment.
18 Years and older
Accepts Healthy Volunteers
Study Locations and Contact Information (10)
|Tufts Medical Center - Boston, Massachusetts||3.2 miles||None||None||None|
|Tufts Medical Center - Boston, Massachusetts||3.2 miles||Jodi Jensenfirstname.lastname@example.org|
|Boston Medical Center - Boston, Massachusetts||3.5 miles||None||None||None|
|Columbia University - New York, New York||181.2 miles||Ryan Shelton||212-304-5485||None|
|Columbia University - New York, New York||181.2 miles||None||None||None|
|Mt Sinai Medical Center - New York, New York||185.4 miles||Lisa Laemail@example.com|
|Mt Sinai Medical Center - New York, New York||185.4 miles||None||None||None|
|Memorial SloanKettering Cancer Center - New York, New York||187.1 miles||Heather Landau MD||646-497-9062||None|
|Memorial SloanKettering Cancer Center - New York, New York||187.1 miles||None||None||None|
|Barbara Ann Karmanos Cancer Institute - Detroit, Michigan||611.5 miles||None||None||None|