Idarubicin and High-Dose Cytarabine in Treating Patients With Acute Myeloid Leukemia
Phase II Trial Utilizing Idarubicin in Combination With High Dose Ara-C for Induction Therapy for Adult Acute Myelogenous Leukemia (AML)
RATIONALE: Drugs used in chemotherapy, such as idarubicin and cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.
PURPOSE: This phase II trial is studying how well giving idarubicin together with high-dose cytarabine works in treating patients with acute myeloid leukemia.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Determine the complete remission rate (CR).
- Determine the proportion of patients who are bone marrow-positive at day 7 post-induction chemotherapy.
- Further evaluate the toxicity of this regimen.
OUTLINE: Patients receive cytarabine IV over 3 hours every 12 hours on days 1-4 and idarubicin IV over 5-10 minutes on days 1-3. Patients undergo bone marrow aspirate and biopsy 7 days after completion of induction chemotherapy. Patients with > 25% cellular biopsy or > 10% abnormal cells on aspirate receive 4 more doses of cytarabine and 1 dose of idarubicin.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Arizona
-
Phoenix, Arizona, United States, 85006
- Banner Good Samaritan Medical Center
-
-
California
-
Duarte, California, United States, 91010-3000
- City of Hope Comprehensive Cancer Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
Inclusion criteria:
Newly diagnosed acute myeloid leukemia (AML)
- Morphologic proof (bone marrow aspirate smears or touch prep of marrow biopsy) of disease
- FAB M0, M1, M2, M4, M5a, M5b, M6a, M6b, and M7 disease
Previously untreated with radiotherapy or chemotherapy
- Patients with treatment-related leukemia are eligible even if they have received prior chemotherapy and radiotherapy
- Patients with prior myelodysplastic syndrome are eligible
- Extramedullary leukemia allowed
- AML with lymphoid markers allowed
Exclusion criteria:
- Blastic transformation of chronic myelogenous leukemia
- Biphenotypic leukemia
- FAB M3 disease (acute promyelocytic leukemia)
PATIENT CHARACTERISTICS:
- Life expectancy ≥ 6 weeks
- Total bilirubin < 1.5 g/dL
- AST and ALT < 5 times upper limit of normal (ULN)
- Creatinine < 1.5 mg/dL OR creatinine clearance > 70 mL/min
- Ejection fraction ≥ 50% by MUGA unless decreased ejection fraction is secondary to leukemia infiltration
- HIV antibody-negative
PRIOR CONCURRENT THERAPY:
Inclusion criteria:
- See Disease Characteristics
- Prior hydroxyurea or corticosteroids allowed
- At least 48 hours since prior and no concurrent itraconazole or fluconazole
Exclusion criteria:
- More than 300 mg/m² of prior daunorubicin or equivalent dose of anthracycline
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Treatment (idarubicin, cytarabine)
Patients receive cytarabine IV over 3 hours every 12 hours on days 1-4 and idarubicin IV over 5-10 minutes on days 1-3.
Patients undergo bone marrow aspirate and biopsy 7 days after completion of induction chemotherapy.
Patients with > 25% cellular biopsy or > 10% abnormal cells on aspirate receive 4 more doses of cytarabine and 1 dose of idarubicin.
|
Other Names:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Complete Remission (CR)
Time Frame: 7 days post completion of induction chemotherapy
|
The peripheral blood neutrophil count is >= 1.5 x 10^9 / L and platelets more than 100 x 10^9 / L. Leukemia blast cells are not present in the peripheral blood.
The cellularity of the bone marrow is more than 20% with maturation of all cell lines.
The bone marrow contains less than 5% blast cells, and Auer rods is not detectable.
|
7 days post completion of induction chemotherapy
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Bone Marrow at Day 7 Post-Induction Chemotherapy
Time Frame: 7 days post completion of induction chemotherapy
|
Bone marrow positive, negative cells at day 7 post-induction chemotherapy for leukemia (%)
|
7 days post completion of induction chemotherapy
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Anthony S. Stein, MD, City of Hope Comprehensive Cancer Center
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- adult acute myeloid leukemia with 11q23 (MLL) abnormalities
- adult acute myeloid leukemia with inv(16)(p13;q22)
- adult acute myeloid leukemia with t(16;16)(p13;q22)
- adult acute myeloid leukemia with t(8;21)(q22;q22)
- secondary acute myeloid leukemia
- untreated adult acute myeloid leukemia
- adult acute megakaryoblastic leukemia (M7)
- adult acute minimally differentiated myeloid leukemia (M0)
- adult acute monoblastic leukemia (M5a)
- adult acute monocytic leukemia (M5b)
- adult acute myeloblastic leukemia with maturation (M2)
- adult acute myeloblastic leukemia without maturation (M1)
- adult acute myelomonocytic leukemia (M4)
- adult erythroleukemia (M6a)
- adult pure erythroid leukemia (M6b)
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Leukemia
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Enzyme Inhibitors
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Topoisomerase II Inhibitors
- Topoisomerase Inhibitors
- Antibiotics, Antineoplastic
- Cytarabine
- Idarubicin
Other Study ID Numbers
Other Study ID Numbers
- 93139
- P30CA033572 (U.S. NIH Grant/Contract)
- CHNMC-93139
- CHNMC-93139-94-03-1
- CDR0000564537 (REGISTRY: NCI PDQ)
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