Full Text View
Tabular View
No Study Results Posted
Related Studies
Rituximab and Fludarabine in Treating Patients With Untreated Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), June 2009
First Received: July 11, 2001   Last Updated: June 9, 2009   History of Changes
Sponsor: National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00019370
  Purpose

RATIONALE: Monoclonal antibodies, such as rituximab, can block cancer growth in different ways. Some block the ability of cancer cells to grow and spread. Others find cancer cells and help kill them or carry cancer-killing substances to them. Drugs used in chemotherapy, such as fludarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

PURPOSE: This phase II trial is studying how well giving rituximab and fludarabine works in treating patients with untreated chronic lymphocytic leukemia or small lymphocytic lymphoma.


Condition Intervention Phase
Leukemia
Lymphoma
Biological: rituximab
Drug: fludarabine phosphate
Phase II

Study Type: Interventional
Study Design: Treatment, Open Label
Official Title: Rituximab and Fludarabine Treatment of Chronic Lymphocytic Leukemia (CLL/SLL): DNA Microarray Gene Expression Analysis

Resource links provided by NLM:


Further study details as provided by National Cancer Institute (NCI):

Primary Outcome Measures:
  • Changes in lymphocyte gene expression as measured by DNA microarray analysis during and after completion of study treatment [ Designated as safety issue: No ]
  • Gene expression of leukemic cells in blood, bone marrow, and lymph nodes as measured by DNA microarray analysis [ Designated as safety issue: No ]

Estimated Enrollment: 105
Study Start Date: April 1998
Estimated Primary Completion Date: April 2012 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

Primary

  • Evaluate changes in lymphocyte gene expression by DNA microarray analysis in patients with intermediate- or high-risk untreated B-cell chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) treated with rituximab and fludarabine.
  • Evaluate gene expression of leukemic cells in blood, bone marrow, and lymph nodes by DNA microarray analysis.

Secondary

  • Correlate gene expression analysis with the presence or absence of somatic mutations in tumor cells (e.g., p53 mutations or deletions) and clinical parameters.
  • Analyze protein expression using various proteomic approaches and the presence or absence of protein modifications in relation to gene expression profiles, CLL/SLL behavior, and treatment response.
  • Evaluate lymphocytes for gene expression by DNA microarray analysis and for chromosomal karyotyping by banding and FISH techniques and by multicolor immunophenotyping.
  • Correlate PET scan with gene expression profile in leukemic cells and with biologic and prognostic markers of CLL/SLL.
  • Understand the biology and treatment of CLL/SLL.

OUTLINE: Patients receive rituximab IV over 2-8 hours on day 1 and fludarabine IV over 30 minutes on days 1-5 (days 2-6 of cycle 1 only). Treatment repeats every 28 days for up to 4-6 courses in the absence of disease progression or unacceptable toxicity.

Patients are followed at 3 and 6 months and then at 1 and 2 years.

PROJECTED ACCRUAL: Approximately 105 patients will be accrued for this study within 2 years.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Histologically confirmed untreated B-cell chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)
  • Meets one of the following criteria:

    • Intermediate-risk disease

      • Stage I: Elevated lymphocyte count with enlarged lymph nodes
      • Stage II: Elevated lymphocyte count with enlarged spleen or liver
      • Stage I or II: Active disease, as evidenced by at least 1 of the following criteria:

        • Massive progressive splenomegaly or lymphadenopathy
        • More than 10% weight loss within the past 6 months
        • Constitutional symptoms of extreme fatigue, night sweats, recurrent fever of more than 100 degrees F (documented fevers must be occurring without evidence of specific infection), or bone pain
        • Progressive lymphocytosis with an increase of more than 50% over a 2 month period or an anticipated doubling time of less than 6 months
        • Chronic infections, defined as either an increased number of infections or prolonged infections
        • Other high-risk prognostic indicators (e.g., excess elevation of β-2-microglobulin, CD38 expression, or adverse cytogenetics)
    • High-risk disease

      • Stage III: Elevated lymphocyte count with anemia (hemoglobin less than 11 g/dL)
      • Stage IV: Elevated lymphocyte count with thrombocytopenia (platelet count less than 100,000/mm^3)
  • Patients with a diagnosis of CLL or SLL who do not meet eligibility criteria for receiving treatment with rituximab and fludarabine may enroll on this study for the purpose of donating cellular products

PATIENT CHARACTERISTICS:

Age:

  • 18 and over

Performance status:

  • ECOG 0-2

Life expectancy:

  • Not specified

Hematopoietic:

  • No active autoimmune hemolytic anemia or immune thrombocytopenia

Hepatic:

  • AST and ALT no greater than 2.0 times normal (unless due to liver disease)
  • Bilirubin no greater than 2.0 mg/dL (unless due to Gilbert's disease)

Renal:

  • BUN no greater than 1.5 times normal
  • Creatinine no greater than 1.5 times normal OR
  • Creatinine clearance greater than 50 mL/min

Other:

  • No medical condition that requires chronic use of corticosteroids
  • Not pregnant or nursing
  • Negative pregnancy test

PRIOR CONCURRENT THERAPY:

Biologic therapy:

  • No prior monoclonal antibody therapy

Chemotherapy:

  • No prior cytotoxic chemotherapy

Endocrine therapy:

  • Prior steroid therapy to control autoimmune hemolytic anemia or immune thrombocytopenia is allowed provided:

    • No current requirement for maintenance steroids
    • No current evidence of active autoimmune disease
    • Direct Coombs' test currently negative
  • No concurrent corticosteroids as prophylactic antiemetic therapy

Radiotherapy:

  • Not specified

Surgery:

  • Not specified
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00019370

Locations
United States, Maryland
NCI - Center for Cancer Research Recruiting
Bethesda, Maryland, United States, 20892
Contact: Clinical Trials Office - NCI - Center for Cancer Research     888-624-1937        
Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office Recruiting
Bethesda, Maryland, United States, 20892-1182
Contact: Patient Recruitment     1-888-NCI-1937        
Sponsors and Collaborators
Investigators
Study Chair: Wyndham H. Wilson, MD, PhD National Cancer Institute (NCI)
  More Information

Additional Information:
Publications:
Responsible Party: NCI - Center for Cancer Research ( Wyndham Hopkins Wilson )
Study ID Numbers: CDR0000065863, NCI-97-C-0178
Study First Received: July 11, 2001
Last Updated: June 9, 2009
ClinicalTrials.gov Identifier: NCT00019370     History of Changes
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
stage 0 chronic lymphocytic leukemia
stage I chronic lymphocytic leukemia
stage II chronic lymphocytic leukemia
stage III chronic lymphocytic leukemia
stage IV chronic lymphocytic leukemia
B-cell chronic lymphocytic leukemia
contiguous stage II small lymphocytic lymphoma
noncontiguous stage II small lymphocytic lymphoma
stage I small lymphocytic lymphoma
stage III small lymphocytic lymphoma
stage IV small lymphocytic lymphoma

Additional relevant MeSH terms:
Antimetabolites
Anti-Infective Agents
Vidarabine
Leukemia, Lymphoid
Antimetabolites, Antineoplastic
Immunologic Factors
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Physiological Effects of Drugs
Leukemia
Leukemia, Lymphocytic, Chronic, B-Cell
Therapeutic Uses
Lymphoma
Immunoproliferative Disorders
Neoplasms by Histologic Type
Immune System Diseases
Rituximab
Fludarabine monophosphate
Immunosuppressive Agents
Antiviral Agents
Pharmacologic Actions
Lymphatic Diseases
Neoplasms
Fludarabine
Antirheumatic Agents
Lymphoproliferative Disorders
Leukemia, B-Cell

ClinicalTrials.gov processed this record on November 27, 2009