A Remission Induction Therapy and Risk-oriented Postremission Strategy for Adult Acute Myelogenous Leukemia (AML)
Recruitment status was Recruiting
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Purpose
The study was set up to assess:
- Standard-dose versus high-dose remission induction therapy. A standard ICE chemotherapy vs sequential high-dose cytarabine, with appropriate supportive/prophylactic measures, followed by morphological, cytogenetic and molecular monitoring of remission.
A risk-oriented postremission therapy: HR patients will be electively submitted to allogeneic stem cell transplantation (allo-SCT), whenever possible (related/unrelated donor/cord blood; ablative/non-ablative conditioning according to national and local protocols and guidelines). Provided sufficient blood stem cells were previously collected (>2x10e6/kg CD34+ cells), SR patients and HR patients excluded from allo-SCT and aged 65 years or less will be randomized to: myeloablative autologous blood stem cell transplantation vs non-myeloablative, multicycle, autologous blood stem cell-supported high-dose cytarabine-based therapy.
- HR/SR patients unable to be randomized because of inadequate blood stem cell yield will receive intermediate-dose consolidation; patients aged >65 years will be treated with age-adapted therapy.
| Condition | Intervention | Phase |
|---|---|---|
|
Acute Myelogenous Leukemia |
Drug: cytosine arabinoside |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase III Trial in AML Comparing Standard-dose vs High-dose Remission Induction and, Within a Risk-oriented Postremission Strategy, Autologous Blood Stem Cell Transplantation vs Blood Stem Cell-supported Multicycle High-dose Program |
- Remission induction (R1): Complete remission (CR) rate after cycle 1 [ Time Frame: 30 days after beginning chemotherapy. ] [ Designated as safety issue: Yes ]
- Remission consolidation (R2): Length of remission (DFS, disease-free survival) [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
- R1: CR with incomplete hematological recovery [ Time Frame: 30 days after beginning chemotherapy ] [ Designated as safety issue: No ]
- R1:Complete cytogenetic remission [ Time Frame: 30 days after beginning chemotherapy ] [ Designated as safety issue: No ]
- R1: Treatment-related death (TRD) [ Time Frame: 2 months ] [ Designated as safety issue: Yes ]
- R2: Overall survival (OS) [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
- Remission duration and cumulative incidence of relapse [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Treatment-related death [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
- Quality of Life [ Time Frame: 1 year and 3 years ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 500 |
| Study Start Date: | November 2006 |
| Estimated Study Completion Date: | December 2011 |
| Estimated Primary Completion Date: | December 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: A
Remission induction arm A is with conventional chemotherapy cycle ("ICE": idarubicin, standard-dose cytarabine, etoposide)
|
Drug: cytosine arabinoside
Arm A: use of standard-dose cytosine arabinoside (100 mg/m2/bd iv. on days 1-7) in association with idarubicin and etoposide. Arm B: use of high-dose cytosine arabinoside (1000-2000 mg/m2/bd according to age +/-65 years iv. on days 1-2 and 8-9) in association with idarubicin. Other Names:
|
|
Experimental: B
Remission induction therapy with high-dose cytarabine sequential regimen (HD-Ara-C, idarubicin)
|
Drug: cytosine arabinoside
Arm A: use of standard-dose cytosine arabinoside (100 mg/m2/bd iv. on days 1-7) in association with idarubicin and etoposide. Arm B: use of high-dose cytosine arabinoside (1000-2000 mg/m2/bd according to age +/-65 years iv. on days 1-2 and 8-9) in association with idarubicin. Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 16 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion criteria (Random 1):
- Age 16+ years
- Diagnosis of untreated (or only hydroxyurea/cyclophosphamide) acute myelogenous leukemia (AML, including myeloid sarcoma) or high-risk myelodysplasia (RAEB-2), either de novo or following an antecedent hematological disorder, or secondary to chemo-radiotherapy for other cancer
- Signed informed consent
- Adequate sampling for full cytological, cytochemical, cytogenetic and immunobiological disease characterization by revised FAB, EGIL and WHO criteria
- ECOG performance status 0-2 or reversible ECOG 3 score following intensive care of complications.
Exclusion criteria:
- Diagnosis of acute promyelocytic leukemia
- Pre-existing, uncontrolled pathology such as cardiac disease (congestive/ischemic, acute myocardial infarction within the past 3 months, untreatable arrythmias, NYHA classes III and IV), severe liver disease with serum bilirubin >3 mg/dL and/or ALT >3 x upper normal limit (unless attributable to AML), kidney function impairment with serum creatinine >2 mg/dL (unless attributable to AML), and severe neuropsychiatric disorder that impairs the patient's ability to understand and sign the informed consent, or to cope with the intended treatment plan
- Known HIV positive serology
- Other active hematological or non-hematological cancers with life expectancy <1 year
- Pregnancy (fertile women will be advised not to become pregnant while on treatment; and male patients to adopt contraceptive methods)
Contacts and Locations| Contact: Roberto Marchioli, MD | +39 0872570250 | marchioli@negrisud.it |
| Contact: Giovanna Borrelli, Dr Sci | +39 0872570324 | borrelli@negrisud.it |
| Italy | |
| Dipartimento di Ematologia e Medicina Trasfusionale - Azienda Osp. Nazionale Santi Antonio e Biagio e Cesare Arrigo | Recruiting |
| Alessandria, AL, Italy | |
| Principal Investigator: Alessandro Levis, MD | |
| Sub-Investigator: Flavia Salvi, MD | |
| Sub-Investigator: Lorella Depaoli, MD | |
| USC Ematologia Ospedali Riuniti di Bergamo | Recruiting |
| Bergamo, BG, Italy | |
| Principal Investigator: Renato Bassan, MD | |
| Sub-Investigator: Tamara Intermesoli, MD | |
| Sub-Investigator: Elena Oldani, Dr. Biol Sci | |
| Sub-Investigator: Federica Delaini, Dr. Biol Sci | |
| Sub-Investigator: Orietta Spinelli, Dr. Biol Sci | |
| Sub-Investigator: Vittoria Guerini | |
| S.C. Ematologia - Azienda Ospedaliera S.Croce e Carle | Recruiting |
| Cuneo, CN, Italy | |
| Principal Investigator: Daniele Mattei, MD | |
| Sub-Investigator: Andrea Gallamini, MD | |
| Ematologia - AOU Careggi | Recruiting |
| Firenze, FI, Italy | |
| Principal Investigator: Alberto Bosi, MD | |
| Sub-Investigator: Franco Leoni, MD | |
| Sub-Investigator: Giacomo Gianfaldoni, MD | |
| Sub-Investigator: Francesco Mannelli, MD | |
| Sub-Investigator: Alessandro Vannucchi, MD | |
| Ematologia Centro TMO - Fondazione IRCSS Ospedale Maggiore | Not yet recruiting |
| Milano, MI, Italy | |
| Principal Investigator: Giorgio Lambertenghi-Deliliers, MD | |
| Sub-Investigator: Agostino Cortelezzi, MD | |
| Sub-Investigator: Maria Cristina Pasquini, MD | |
| Sub-Investigator: Nicola Fracchiolla, MD | |
| Sub-Investigator: Claudio Annaloro, MD | |
| Sub-Investigator: Angelo Gardellini, MD | |
| Sub-Investigator: Kathrin Von Hohenstaufen, MD | |
| Ematologia e TMO - Ospedale San Raffaele | Recruiting |
| Milano, MI, Italy | |
| Principal Investigator: Fabio Ciceri, MD | |
| Sub-Investigator: Massimo Bernardi, MD | |
| Sub-Investigator: Michela Tassara, MD | |
| Sub-Investigator: Alessandro Crotta, MD | |
| Ematologia - TMO - Ospedale San Gerardo | Recruiting |
| Monza, MI, Italy | |
| Principal Investigator: Enrico Pogliani, MD | |
| Sub-Investigator: Elisabetta Terruzzi, MD | |
| Sub-Investigator: Matteo Parma, MD | |
| Sub-Investigator: Monica Fumagalli, MD | |
| Sub-Investigator: Luisa Verga, MD | |
| Ematologia 2 - Osp. Molinette San Giovanni Battista | Recruiting |
| Torino, TO, Italy | |
| Principal Investigator: Eugenio Gallo, MD | |
| Sub-Investigator: Filippo Mormont, MD | |
| Sub-Investigator: Ernesta Audisio, MD | |
| Sub-Investigator: Stefano D'Ardia, MD | |
| Principal Investigator: | Renato Bassan, MD | Ospedali Riuniti di Bergamo USC Ematologia |
More Information
No publications provided
| Responsible Party: | Renato Bassan, MD, Coordinator, Northern Italy Leukemia Group |
| ClinicalTrials.gov Identifier: | NCT00495287 History of Changes |
| Other Study ID Numbers: | NILG-AML 02/06 |
| Study First Received: | July 2, 2007 |
| Last Updated: | March 31, 2011 |
| Health Authority: | Italy: Ministry of Health |
Keywords provided by Northern Italy Leukemia Group:
|
Acute myelogenous leukemia Adult patients Cytogenetic risk class Clinico-cytogenetic risk model Risk-oriented therapy |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Myeloid, Acute Leukemia, Myeloid Neoplasms by Histologic Type Neoplasms Cytarabine Antimetabolites, Antineoplastic Antimetabolites Molecular Mechanisms of Pharmacological Action |
Pharmacologic Actions Antineoplastic Agents Therapeutic Uses Antiviral Agents Anti-Infective Agents Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 19, 2013