Autologous Stem Cell Transplant for Neurologic Autoimmune Diseases
United States53 participantsStarted 2008-06
Plain-language summary
This phase II trial studies the side effects and how well carmustine, etoposide, cytarabine and melphalan together with antithymocyte globulin before a stem cell transplant works in treating patients with autoimmune neurologic disease that did not respond to previous therapy. In autoimmune neurological diseases, the patient's own immune system 'attacks' the nervous system which might include the brain/spinal cord and/or the peripheral nerves. Giving high-dose chemotherapy, including carmustine, etoposide, cytarabine, melphalan, and antithymocyte globulin, before a stem cell transplant weakens the immune system and may help stop the immune system from 'attacking' a patient's nervous system. When the patient's own (autologous) stem cells are infused into the patient they help the bone marrow make red blood cells, white blood cells, and platelets so the blood counts can improve.
Who can participate
Age range71 Years
SexALL
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Inclusion Criteria:
* Patients with an autoimmune disorder of the central or peripheral nervous system will be eligible; this will include:
* Primary Central Nervous System (CNS) vasculitis
* Rasmussen's encephalitis
* Autoimmune peripheral neuropathy (anti-Hu \[Anna-1\], anti-GM1 \[GD1b\], anti-MAG, anti-ganglioside, anti-sulfatide)
* Autoimmune cerebellar degeneration
* Gait Ataxia with Late age Onset Polyneuropathy (GALOP)
* Stiff Person Syndrome
* Chronic Inflammatory Demyelinating Polyneuropathy
* Myasthenia Gravis
* Lambert-Eaton myasthenic syndrome
* Human T-cell lymphotropic virus (HTLV)-1-associated myelopathy (HAM) / tropical spastic paraparesis (TSP)
* Opsoclonus/myoclonus (anti-Ri)
* Neuromyelitis optica
* Multiple sclerosis
* Other central or peripheral nervous system autoimmune diseases as approved by study neurologists and the Fred Hutchinson Cancer Research Center (FHCRC) faculty at Patient Care Conference (PCC)
* Patients must satisfy the criteria for a diagnosis of one of the severe neurological autoimmune disorders outlined
* Patients age =\< 70 years
* Evidence of disease activity as outlined (e.g. gadolinium enhancement on magnetic resonance imaging of the brain or clinical progression)
* Patients must have failed at least 2 lines of standard therapy as outlined for the specific diseases
* DONOR: Sibling of any patient enrolled on this protocol proven by ABO typing, human leukocyte antigen (HLA) typing and variable number tan…