ClinicalTrials.gg
RecruitingNCT06687772CNS-PHLATUpdated Aug 28, 2026

CNS-Relapse Prevention in High-Risk Diffuse Large B-cell Lymphoma With Thiotepa-based Autologous Stem Cell Transplant

A Phase 2 interventional study of Thiotepa and Carmustine in Diffuse Large B Cell Lymphoma, sponsored by Washington University School of Medicine. Recruiting at 1 site in United States. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-08-28.

Sponsored by Washington University School of Medicine · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2025; still recruiting 1 year 9 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
36
Allocation
Not applicable
Ages
18 Years to 75 Years
Sex
All
01

Study summary

A serious consequence of systemic diffuse large B-cell lymphoma (DLBCL) is secondary central nervous system (CNS) relapse, which occurs in approximately 5% of all patients. Many CNS relapses occur within the first year after completion of frontline treatment and are associated with significantly increased mortality; thus, it is important to tailor frontline treatment to provide prophylaxis against CNS relapse in those patients who are determined to be high-risk.

Autologous stem cell transplantation (ASCT) is standard of care for patients with DLBCL who relapse one year or more after first remission, and it has been shown to improve progression-free survival for patients with primary CNS lymphoma.

The four-drug BEAM regimen (carmustine, etoposide, cytarabine, and melphalan) is the preferred conditioning regimen for DLBCL patients undergoing ASCT; however, patients with primary CNS lymphoma receive thiotepa plus carmustine as their conditioning regimen due to its better CNS penetration.

This study tests the hypothesis that consolidation thiotepa/carmustine ASCT in first complete remission will reduce the risk of CNS relapse in transplant-eligible patients with DLBCL with no prior CNS disease at high risk of secondary CNS recurrence.

02

Conditions studied

  • Diffuse Large B Cell Lymphoma

Keywords

  • Diffuse large B-cell lymphoma
  • Autologous stem cell transplant
  • CNS lymphoma
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In context

Lymphoma, Large B-Cell, Diffuse

1,868 studies on the registry are indexed under Lymphoma, Large B-Cell, Diffuse; 355 are open to participants now.

This study's planned enrollment of 36 is below the median of 45 across 1,497 interventional studies indexed under Lymphoma, Large B-Cell, Diffuse.

Browse Lymphoma, Large B-Cell, Diffuse studies →

Lead sponsor

Washington University School of Medicine is the lead sponsor of 1,803 studies on the registry; 271 are open to participants now.

Of its 329 completed or terminated interventional studies of FDA-regulated products, 216 (66%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Screening Inclusion Criteria:

  • Newly diagnosed diffuse large B-cell lymphoma, large B-cell lymphoma transformed from underlying indolent lymphoma, or high-grade B-cell lymphoma. Patients with secondary CNS lymphoma are eligible. Patients with Richter's transformation are NOT eligible.
  • At high risk for CNS relapse prior to start of induction as defined by at least one of the criteria below:

    • CNS-IPI ≥ 4
    • Kidney or adrenal involvement
    • Testicular involvement
    • Breast involvement
    • Ovarian involvement
    • Uterine involvement
    • Skin involvement
    • Double hit lymphoma as defined by containing translocations of MYC gene together with rearrangement of BCL2 and/or BCL6.
    • Bone marrow involvement
    • Myocardium involvement
    • CNS adjacent
    • Secondary CNS involvement
  • Intend to receive a full course of curative-intent anthracycline-based induction treatment and has not yet received more than 2 cycles at the time of screening. Can receive induction chemotherapy outside of Siteman if still compliant with study eligibility, laboratory studies, lumbar punctures, imaging, and other events.
  • Ages 18 to 75.
  • Ability to understand and willingness to sign an IRB-approved written document. Legally authorized representatives may sign and give informed consent on behalf of study participants if patient is otherwise unable to sign for themselves or unable to understand consent document.

Treatment Eligibility Criteria:

  • Currently undergoing anthracycline-based induction treatment. Dose modifications and/or delays during induction therapy may be made at the discretion of the treating physician and will not affect eligibility for continuation in the study.
  • performance status ≤ 2.
  • PET/CT assessment performed between the end of induction Cycle #2 and end of induction Cycle #4 demonstrates no evidence of progressive disease, and patient is eligible for stem cell transplant as determined by the treating physician.
  • Has signed treatment consent form following mid-induction PET/CT and prior to conditioning treatment with thiotepa/carmustine.
  • Thiotepa and carmustine can cause fetal harm when administered to a pregnant person. For this reason, women of and men must agree to use adequate prior to study entry, for the duration of study treatment, and for 6 months following receipt of thiotepa and/or carmustine (for women) and 12 months following receipt of thiotepa and/or carmustine (or 3 months following receipt of carmustine if discontinuing before thiotepa) (for men). Should a woman become pregnant or suspect she is pregnant during treatment or within 6 months of the last dose of either thiotepa or carmustine or should a man suspect he has fathered a child, s/he must inform the treating physician immediately.

Exclusion Criteria (applies at both screening and treatment)

  • diffuse large B-cell lymphoma or high-grade B-cell lymphoma. Prior treatment for underlying indolent lymphoma is permitted.
  • Diagnosis of primary CNS lymphoma.
  • Prior or concurrent whose natural history has the potential to interfere with the safety or efficacy assessment of the regimen as determined by the PI. Patients with prior or concurrent malignancy that does NOT meet that definition are eligible for this trial.
  • Currently receiving any other investigational agents.
  • A history of allergic reactions attributed to compounds of similar chemical or biologic composition to thiotepa, carmustine, or other agents used in the study.
  • Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 7 days prior to start of induction (for people enrolling prior to induction) or within 7 days of enrollment (for people enrolling after the start of induction).
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Relapsed and refractory

Relapsed: the illness came back after treatment had worked. Refractory: it did not respond to treatment, or stopped responding while still on it.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
36 participants (estimated)

Study arms

  • Experimental
    Anthracycline-based induction chemotherapy + ASCT + Thiotepa + Carmustine

    * Patients should receive induction treatment with anthracycline-based chemotherapy regimen per standard of care. Between the end of induction Cycle #2 and the end of induction Cycle #4, a PET/CT scan should be performed to assess response. If there are no signs of progressive disease and the treating physician recommends patient is eligible for ASCT, patients should be consented with the treatment consent. Treatment with thiotepa and carmustine may not take place prior to this second patient consent. Within 3 weeks after the end of the final cycle of induction, a PET-/CT scan should be performed to assessconfirm treatment response and eligibility for ASCT. * After signing the treatment consent and confirming complete response (CR) following induction therapy, patients will begin conditioning with thiotepa (days -5 and -4) and carmustine (day -6), followed by ASCT on day 0.

    Drug: Thiotepa · Drug: Carmustine · Procedure: Autologous Stem Cell Transplant · Drug: Anthracycline-based induction chemotherapy

Interventions

  • Thiotepa will be given intravenously twice daily on Days -5 and -4 over 120 minutes at a dose of 5 mg/kg.

  • Carmustine will be given intravenously on Day -6 over 120 minutes at a dose of 400 mg/m\^2.

  • ProcedureAutologous Stem Cell Transplant

    Infusion of autologous peripheral blood stem cells on Day 0.

    Also known as: ASCT

  • DrugAnthracycline-based induction chemotherapy

    Standard of care, not dictated by protocol.

06

What researchers measure

Primary outcomes

  1. Feasibility of treatment

    \- The treatment (thiotepa/carmustine conditioning and ASCT) will be considered feasible if \> 50% of enrolled patients meet the following criteria: * Achieve CR at the end of induction chemotherapy * Remain eligible for ASCT * Collect sufficient stem cells for ASCT (CD34+ cell goal ≥2 x 10\^6/kg) * Complete thiotepa/carmustine chemotherapy and undergo ASCT

    Time frame: Through completion of treatment (estimated to be 6 months)

Secondary outcomes

  1. Rate of selected transplant-related grade 3-5 adverse events

    Time frame: From start of study treatment through day 30 after transplant (estimated to be 7 months)

  2. Rate of CNS relapse

    Time frame: At 2 years post-thiotepa/carmustine conditioning and ASCT (estimated to be 2.5 years)

  3. Progression-free survival (PFS)

    Time frame: At 2 years post-thiotepa/carmustine conditioning and ASCT (estimated to be 2.5 years)

  4. Overall survival (OS)

    Time frame: At 2 years post-thiotepa/carmustine conditioning and ASCT (estimated to be 2.5 years)

  5. Non-relapse mortality

    Time frame: At 2 years post-thiotepa/carmustine conditioning and ASCT (estimated to be 2.5 years)

07

Study locations

1 of 1 sites recruiting
  • Washington University School of Medicine
    St Louis, Missouri 63110, United States
    Recruiting
    • Amanda F Cashen, M.D. · Contactacashen@wustl.edu · 314-454-8306
    • Amanda F Cashen, M.D. · Principal investigator
    • Nancy L Bartlett, M.D. · Sub investigator
    • Hunter Cassidy Cochran, M.D. · Sub investigator
    • Todd Fehniger, M.D., Ph.D. · Sub investigator
    • Brad Kahl, M.D. · Sub investigator
    • Neha Mehta-Shah, M.D. · Sub investigator
    • David Russler-Germain, M.D., Ph.D. · Sub investigator
    • Dilan Patel, M.D. · Sub investigator
    • Feng Gao, M.D., Ph.D. · Sub investigator
08

References and documents

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06687772
Responsible party
Sponsor
First posted
Nov 14, 2024
Start date
Jan 16, 2025
Primary completion
Jul 31, 2028 (estimated)
Completion
Jul 31, 2030 (estimated)
Last update
Aug 28, 2026

Study contacts

Amanda F Cashen, M.D.
Contact
acashen@wustl.edu
314-454-8306
Amanda F Cashen, M.D.
principal investigator · Washington University School of Medicine

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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