Phenylbutyrate, Dexamethasone, and Sargramostim in Treating Patients With Refractory or Relapsed Acute Myeloid Leukemia - Full Text View

Sponsor:	National Heart, Lung, and Blood Institute (NHLBI)
Information provided by:	National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:	NCT00006240

Purpose

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Colony-stimulating factors such as sargramostim may increase the number of immune cells found in bone marrow or peripheral blood and may help a person's immune system recover from the side effects of chemotherapy.

PURPOSE: Phase II trial to study the effectiveness of combining phenylbutyrate, dexamethasone, and sargramostim in treating patients who have refractory or relapsed acute myeloid leukemia.

Condition	Intervention	Phase
Leukemia	Biological: sargramostim Drug: dexamethasone Drug: oral sodium phenylbutyrate	Phase II

Study Type:	Interventional
Study Design:	Treatment
Official Title:	A Pilot Study of Phenylbutyrate, Dexamethasone and GM-CSF in Refractory or Relapsed t(8;21) Acute Myeloid Leukemia

Resource links provided by NLM:

MedlinePlus related topics: Cancer Leukemia, Adult Acute Leukemia, Adult Chronic

Drug Information available for: Dexamethasone Dexamethasone acetate Doxiproct plus Granulocyte-macrophage colony-stimulating factor Sargramostim Sodium phenylbutyrate Dexamethasone Sodium Phosphate

U.S. FDA Resources

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

Study Start Date:

October 2000

Detailed Description:

OBJECTIVES:

Determine the objective response (complete hematologic remission induction) of phenylbutyrate, dexamethasone, and sargramostim (GM-CSF) in patients with refractory or relapsed t(8;21) acute myeloid leukemia.
Determine the correlation between histone acetylation, differentiation, and apoptosis in bone marrow mononuclear cells with response rate in patients treated with this regimen.
Determine the overall survival of patients on this regimen.
Determine the correlation between histone acetylation, differentiation, and apoptosis in bone marrow mononuclear cells with pharmacokinetics of this regimen in these patients.
Determine the safety and toxicity of this regimen in these patients.

OUTLINE: This is a multicenter study.

Patients receive phenylbutyrate IV continuously and sargramostim (GM-CSF) subcutaneously on days 1-7 and 15-21. Patients also receive oral dexamethasone on days 1-4 and 15-18. Treatment continues every 28 days in the absence of disease progression or unacceptable toxicity until complete hematologic remission is induced. Patients with stable disease at the end of 1 course receive at least 2 additional courses.

Patients are followed twice a week for 3 months, monthly for 1 year, every three months for the next 4 years, and then annually thereafter.

PROJECTED ACCRUAL: A total of 9-24 patients will be accrued for this study in at least 2 years.

Eligibility

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

Criteria

DISEASE CHARACTERISTICS:

Diagnosis of t(8;21) acute myeloid leukemia (AML)
- Failed standard induction chemotherapy or stem cell transplantation (SCT) OR
- Relapsed after standard induction chemotherapy or SCT OR
- Refused or not a candidate for SCT or matched allogeneic sibling bone marrow transplantation or donor lymphocyte infusion OR
- Refused of not a candidate for autologous SCT or bone marrow transplantation
No CNS leukemia

PATIENT CHARACTERISTICS:

Age:

18 and over

Performance status:

ECOG 0-2

Life expectancy:

At least 7 days

Hematopoietic:

Not specified

Hepatic:

AST or ALT no greater than 3 times upper limit of normal (ULN)
Bilirubin no greater than 3 times ULN
No hepatic disease that would preclude study

Renal:

Creatinine no greater than 2 mg/dL
Creatinine clearance at least 60 mL/min
No renal disease that would preclude study

Cardiovascular:

No cardiac disease that would preclude study
No New York Heart Association class III or IV heart disease
No myocardial infarction within past 8 weeks

Other:

No active infection except cystitis
Not pregnant or nursing
No altered mental status or seizure disorder
No other serious disease that would preclude study

PRIOR CONCURRENT THERAPY:

Biologic therapy:

See Disease Characteristics

Chemotherapy:

See Disease Characteristics

Endocrine therapy:

Not specified

Radiotherapy:

Not specified

Surgery:

Not specified

Other:

At least 3 weeks since prior investigational antineoplastic drugs

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00006240

Locations

United States, Maryland
National Heart, Lung, and Blood Institute
Bethesda, Maryland, United States, 20892
Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
Bethesda, Maryland, United States, 20892-1182
United States, New York
Mount Sinai Medical Center, NY
New York, New York, United States, 10029
United States, Pennsylvania
University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania, United States, 15213-3489

Sponsors and Collaborators

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

Study Chair:

Johnson Liu, MD

National Heart, Lung, and Blood Institute (NHLBI)

More Information

Additional Information:

Clinical trial summary from the National Cancer Institute's PDQ® database This link exits the ClinicalTrials.gov site

No publications provided

Study ID Numbers:	CDR0000068165, NHLBI-00-H-0156, NCI-171
Study First Received:	September 11, 2000
Last Updated:	February 6, 2009
ClinicalTrials.gov Identifier:	NCT00006240 History of Changes
Health Authority:	United States: Federal Government

Keywords provided by National Cancer Institute (NCI):

recurrent adult acute myeloid leukemia

Additional relevant MeSH terms:

Anti-Inflammatory Agents
Dexamethasone
Neoplasms by Histologic Type
Antineoplastic Agents, Hormonal
Antineoplastic Agents
4-phenylbutyric acid
Physiological Effects of Drugs
Hormones, Hormone Substitutes, and Hormone Antagonists
Gastrointestinal Agents
Antiemetics
Leukemia, Myeloid

Leukemia, Myeloid, Acute
Hormones
Glucocorticoids
Pharmacologic Actions
Leukemia
Neoplasms
Autonomic Agents
Therapeutic Uses
Peripheral Nervous System Agents
Central Nervous System Agents
Dexamethasone acetate

ClinicalTrials.gov processed this record on November 09, 2009