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Allogeneic Stem Cell Transplant With Clofarabine, Ara-C and TBI for AML and ALL
This study is currently recruiting participants.
Verified by Columbia University, August 2009
First Received: September 11, 2007   Last Updated: August 28, 2009   History of Changes
Sponsor: Columbia University
Collaborator: Genzyme
Information provided by: Columbia University
ClinicalTrials.gov Identifier: NCT00529360
  Purpose

Hypothesis: Myeloablative conditioning using a dose escalation of clofarabine in combination with cytarabine (ARA-C) and total body irradiation (TBI) will lead to improved survival for previously untransplanted children and adolescents with acute lymphoblastic leukemia (ALL) and acute non-lymphoblastic leukemia (ANLL)followed by allogeneic stem cell transplantation (AlloSCT).


Condition Intervention Phase
Acute Lymphoblastic Leukemia
Acute Myelogenous Leukemia
Drug: Clofarabine
Phase I
Phase II

Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study
Official Title: Clofarabine in Combination With Cytarabine and Total Body Irradiation Followed by Allogeneic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukemia and Acute Non-Lymphoblastic Leukemia

Resource links provided by NLM:


Further study details as provided by Columbia University:

Primary Outcome Measures:
  • To determine the maximum tolerated dose (MTD) and/or the safe, tolerated dose of clofarabine in combination with ARA-C and TBI followed by AlloSCT in children with ALL and ANLL. [ Time Frame: 2.5 years ] [ Designated as safety issue: Yes ]
  • To define the toxicity and safety of the conditioning regimen of clofarabine, ARA-C, TBI followed by AlloSCT in children with ALL and ANLL. [ Time Frame: 2.5 years ] [ Designated as safety issue: Yes ]
  • To define the pharmacokinetics of clofarabine given in combination with ARA-C and TBI followed by AlloSCT in children with ALL and ANLL. [ Time Frame: 2.5 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • To determine the event-free, disease-free and overall survival of the conditioning regimen of clofarabine, ARA-C and TBI followed by AlloSCT in children with ALL and AML. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  • To estimate the time to hematopoietic reconstitution, stratified by cell source, following clofarabine, ARA-C and TBI followed by AlloSCT in children with ALL and AML. [ Time Frame: 2.5 years ] [ Designated as safety issue: No ]
  • To measure the changes in minimal residual disease with ALL and AML following clofarabine, ARA-C and TBI followed by AlloSCT [ Time Frame: 5 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: June 2007
Estimated Study Completion Date: December 2012
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Part A: Experimental
Part A will be the dose escalation phase to determine the MTD and/or safe/tolerated dose of clofarabine.
Drug: Clofarabine
Dose escalation of clofarabine on Days -9, -8, -7, -6, -5: 1 - 30 mg/m2; 2 - 40 mg/m2; 2 - 46 mg/m2; 3 - 52 mg/m2; 4 - 60 mg/m2
Part B: Experimental
Part B will accrue patients to further define the event free, disease free and overall survival at the MTD or safe/tolerated dose of clofarabine.
Drug: Clofarabine
Use dose of clofarabine established in Part A to further define event free, disease free and overall survival.

  Show Detailed Description

  Eligibility

Ages Eligible for Study:   up to 30 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age: Patients must be <30 years of age.
  • Disease Status: ALL in relapse, induction failure, CR3, or CR3P (Part A ONLY); AML in relapse, induction failure, CR3, or CR3P (Part A ONLY); ALL in CR3 or CR3P (Part A and Part B); AML in CR3 or CR3P (Part A and BONLY); CR3/CR3P must be documented by bone marrow and CNS assessment within 14 days of initiation of the pre-transplant conditioning regimen.
  • Creatinine clearance >40 ml/min/m2 or >60 ml/min/1.73 m2 or an equivalent radioisotope glomerular filtration rate (GFR) as determined by the institutional normal range or serum creatinine based on age
  • Adequate liver function defined as: Total bilirubin <2.5 mg/dl l, or SGOT (AST) or SGPT (ALT) <5 x upper limit of normal
  • Adequate cardiac function defined as: Shortening fraction >27% by echocardiogram, or Ejection fraction of >50% by radionuclide angiogram or echocardiogram.
  • Adequate pulmonary function defined as: Corrected DLCO >60% by pulmonary function test; For children who are uncooperative, no evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry >94% on room air.
  • Performance Status: For patients age 1-16 years, Lansky score of >60; For patients > 16 years, Karnofsky score of >60.
  • Patients must have received a minimum of one round of re-induction and one round of consolidation chemotherapy after relapse #2

Exclusion Criteria:

  • Patients with prior myeloablative allogeneic stem cell transplantation and /or TBI.
  • Females who are pregnant (positive HCG) or lactating.
  • Karnofsky <60% or Lansky <60% if less than 16 years of age
  • Age >30 years of age
  • Any patient with uncontrolled infection prior to study entry
  • Patients with evidence of active disease.
  • Patients with Down syndrome are excluded
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00529360

Contacts
Contact: Mitchell S Cairo, MD 212-305-8316 mc1310@columbia.edu
Contact: Lauren Harrison, RN 978-993-4372 la313@columbia.edu

Locations
United States, New York
Columbia Presbyterian Medical Center Recruiting
New York, New York, United States, 10032
Principal Investigator: Mitchell S Cairo, MD            
Sub-Investigator: Mary Brigid Bradley, MD            
Sub-Investigator: Prakash Satwani, MD            
Sub-Investigator: Diane George, MD            
Sub-Investigator: Monica Bhatia, MD            
Sponsors and Collaborators
Columbia University
Genzyme
Investigators
Principal Investigator: Mitchell S Cairo, MD Columbia University
  More Information

No publications provided

Responsible Party: Columbia University ( Mitchell S. Cairo, MD/ Principal Investigator )
Study ID Numbers: CHNY-06-532, AAAC0918
Study First Received: September 11, 2007
Last Updated: August 28, 2009
ClinicalTrials.gov Identifier: NCT00529360     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by Columbia University:
Acute Leukemia
Allogeneic Stem Cell Transplant
Clofarabine
Acute Lymphoblastic Leukemia
Acute Myelogenous Leukemia

Additional relevant MeSH terms:
Clofarabine
Leukemia, Lymphoid
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Neoplasms by Histologic Type
Immunoproliferative Disorders
Immune System Diseases
Antineoplastic Agents
Leukemia, Myeloid
Leukemia, Myeloid, Acute
Pharmacologic Actions
Leukemia
Lymphatic Diseases
Neoplasms
Therapeutic Uses
Lymphoproliferative Disorders

ClinicalTrials.gov processed this record on November 09, 2009