A Prospective Multicenter Clinical Trial of MRD-based Treatment Strategy in Children and Young Adults With AML
A Prospective Multicenter Clinical Trial of Treatment Strategy Based on MRD Level After 2 Initial Courses of Chemotherapy in Children and Young Adults With Acute Myeloid Leukemia
Minimal-residual disease (MRD) will be measured either by flow cytometry, or polymerase chain reaction (PCR) methods, in 3 check-points and it will be one of the decision-making control parameter for the optimal therapy tactics.
Patients with initially high-risk group and those with high MRD after 2 initial courses of chemotherapy will be assigned to the allogenic transplantation of the hematopoietic stem cells from Human Leucocyte Antigen (HLA) matched or haploidentical family donors.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Genetic alterations in acute myeloid leukemia (AML) clone are well known prognostic risk factors of AML relapse. Standard risk group includes favorable t (15;17) (q22; q21) and inv (16)/t (16;16). High-risk patients have a complex karyotype rearrangement (3 and more), inversion of the long arm in 3rd chromosome and EVI1 gene rearrangement, monosomy 5 and 7, translocations involving KMT2A gene and several rare translocations. All other genotype alterations attributed to the moderate risk group.
Besides genetic factors, detection of the minimal residual disease (MRD) after initial chemotherapy and its decrease rate after 1st postremission chemotherapy with high dose Cytarabine and anthracyclines, plays a crucial role in the development of the morphologic relapse. Patients with PCR-MRD<0,1% after 2 courses of chemotherapy have a 30% or less risk of relapse, while PCR-MRD>0,1% - over 70%. In the clinical trial investigators are planning to measure MRD either by immune-phenotype, or PCR methods, in 3 check-points and it will be one of decision-making control parameter for the optimal therapy tactics.
Patients with initially high-risk group and those with high MRD after 2 initial courses of chemotherapy will be assigned to the allogenic transplantation of the hematopoietic stem cells from HLA- matched or haploidentical family donors.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Irina Kalinina
- Phone Number: 7425 +7 495 287 65 70
- Email: oml-registration@fnkc.ru
Study Contact Backup
- Name: Zhanna Shekhovtsova
- Phone Number: 7538 +7 495 287 65 70
- Email: zhanna.shekhovtsova@fccho-moscow.ru
Study Locations
-
-
-
Moscow, Russian Federation, 117198
- Recruiting
- Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
-
Contact:
- Irina Kalinina
- Phone Number: 7432 84956647078
- Email: oml-registration@fnkc.ru
-
Contact:
- Zhanna Shekhovtsova
- Phone Number: 84956647078
- Email: zhanna.shekhovtsova@fccho-moscow.ru
-
-
Sverdlovsk Oblast
-
Ekaterinburg, Sverdlovsk Oblast, Russian Federation, 620149
- Not yet recruiting
- Regional Children's Clinical Hospital № 1
-
Contact:
- Oleg Arakaev
- Phone Number: (343) 231-91-09
-
Principal Investigator:
- Larisa Fechina, PhD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- de novo acute myeloid leukemia
- signed informed consent
Exclusion Criteria:
diagnosis of: Fanconi anemia, acute promyelocytic leukemia, MDS, JMML, AML as secondary malignancy, Dawn syndrome.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: intermediate risk MRD2>0,1%
MRD2>0,1% - FLA - MRD3 - HSCT
|
allogenic HSCT from 5-8 HLA-MM family donor as a first choice for patients with initial high risk of relapse and for patients with MRD2>0,1% and initial intermediate risk
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
relapse-free survival (RFS)
Time Frame: 1 year
|
relapse-free survival from date of diagnosis till date of relapse, or date of death (whichever comes first) or date of last follow up
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
overall survival (OS)
Time Frame: 1 year
|
1 year
|
|
|
event-free survival (EFS)
Time Frame: 2 years
|
Event=relapse/nonresponse, death or second malignancy
|
2 years
|
|
The proportion of of patients with severe adverse effects
Time Frame: 6 months
|
The proportion of of patients with severe adverse effects of therapy according to CTCAE (ver 4.3)
|
6 months
|
|
The proportion of of patients with severe infections
Time Frame: 1 month
|
The proportion of of patients with severe infections: number of episodes, grade, after each course of chemotherapy
|
1 month
|
|
The proportion of of patients with severe cardiotoxicity
Time Frame: 1 year
|
The proportion of of patients with severe cardiotoxicity: number of episodes and %EF by echocardiogam
|
1 year
|
|
MRD dynamic
Time Frame: 1 months
|
MRD (IFT and/or PCR) dynamic between check-points
|
1 months
|
|
MRD specificity and sensitivity
Time Frame: 1, 2, 3 months
|
MRD specificity and sensitivity in relapse prognosis
|
1, 2, 3 months
|
|
Cumulative incidence of relapse
Time Frame: 6 months, 1 year
|
competing event - death in CR
|
6 months, 1 year
|
|
Cumulative incidence of transplant-related mortality
Time Frame: 6 months after HSCT
|
for transplanted patients
|
6 months after HSCT
|
|
Cumulative incidence of aGvHD II-IV grade
Time Frame: 100 days after HSCT
|
for transplanted patients
|
100 days after HSCT
|
|
Cumulative incidence of cGvHD
Time Frame: 1 year after HSCT
|
for transplanted patients
|
1 year after HSCT
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Alexey Maschan, National Research Center for Pediatric Hematology , Moscow, Russian Federation
- Study Director: Michael Maschan, National Research Center for Pediatric Hematology , Moscow, Russian Federation
- Study Chair: Galina Novichkova, National Research Center for Pediatric Hematology , Moscow, Russian Federation
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NCPHOI-2018-05
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.