- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00053014
S0125, Chemotherapy, Total-Body Irradiation, and Peripheral Stem Cell Transplantation in Treating Older Patients With Acute Myeloid Leukemia
S0125, A Phase II Study Of Chimerism-Mediated Immunotherapy (CMI) Using Nonmyeloablative Allogeneic Peripheral Blood Stem Cell Transplantation In Older Patients With Acute Myeloid Leukemia (AML) In First Complete Remission (A BMT Study)
RATIONALE: Peripheral stem cell transplantation may be able to replace immune cells that were destroyed by chemotherapy and radiation therapy. Sometimes the transplanted cells can make an immune response against the body's normal tissues. Cyclosporine and mycophenolate mofetil may prevent this from happening.
PURPOSE: Phase II trial to study the effectiveness of chemotherapy and total-body irradiation followed by donor peripheral stem cell transplantation, cyclosporine, and mycophenolate mofetil in treating older patients who have acute myeloid leukemia.
Aperçu de l'étude
Statut
Les conditions
Description détaillée
Primary objective:
- Determine whether allogeneic peripheral blood stem cell transplantation with pre-conditioning low dose total body irradiation and fludarabine followed by cyclosporine and mycophenolate mofetil, when given to elderly patients with acute myeloid leukemia in first complete remission, is sufficiently efficacious (in terms of survival 1 year after transplantation) to warrant a phase III investigation.
Secondary objective:
- Determine the frequency and severity of toxic effects of this regimen in these patients.
Other objectives as funding permits:
- Determine whether chimerism patterns in bone marrow and blood after transplantation are associated with relapse and/or graft-versus-host disease (GVHD) in these patients.
- Determine whether cytogenic, immunophenotypic, and molecular biologic features detected in pre- and post-transplantation specimens are related to transplant outcomes and risk of relapse in these patients.
OUTLINE: This is an open-label study.
- Conditioning regimen: Patients receive fludarabine IV over 1 hour on days -4 to -2. Patients also undergo total body irradiation on day 0.
- Peripheral blood stem cell infusion (PBSC): Patients receive unmodified filgrastim transplantation (G-CSF)-mobilized donor PBSC on day 0.
- Post-transplantation immunosuppression: Patients receive oral cyclosporine on days -3 to 35 followed by a taper until day 180. Patients also receive oral mycophenolate mofetil on day 0 to 27 without tapering.
- Donor lymphocyte infusions (DLI): Patients with relapsed disease receive DLI IV over 30 minutes for up to 2 infusions.
Patients are followed every 3 months for 1 year, every 6 months for 1 year, and then annually for 3 years.
PROJECTED ACCRUAL: A total of 25-51 patients will be accrued for this study.
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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Arizona
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Phoenix, Arizona, États-Unis, 85006
- Banner Good Samaritan Medical Center
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Tucson, Arizona, États-Unis, 85723
- Veterans Affairs Medical Center - Tucson
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Tucson, Arizona, États-Unis, 85724
- Arizona Cancer Center at University of Arizona Health Sciences Center
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Arkansas
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Little Rock, Arkansas, États-Unis, 72205
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
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Little Rock, Arkansas, États-Unis, 72205
- Veterans Affairs Medical Center - Little Rock
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California
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Duarte, California, États-Unis, 91010-3000
- City of Hope Comprehensive Cancer Center
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La Jolla, California, États-Unis, 92037-1027
- Scripps Cancer Center at Scripps Clinic
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Los Angeles, California, États-Unis, 90033
- USC/Norris Comprehensive Cancer Center and Hospital
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Los Angeles, California, États-Unis, 90095-1678
- Jonsson Comprehensive Cancer Center at UCLA
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Martinez, California, États-Unis, 94553
- Veterans Affairs Outpatient Clinic - Martinez
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Orange, California, États-Unis, 92868
- Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
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Sacramento, California, États-Unis, 95816
- Sutter Cancer Center
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Sacramento, California, États-Unis, 95817
- University of California Davis Cancer Center
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Stanford, California, États-Unis, 94305-5408
- Stanford Cancer Center at Stanford University Medical Center
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Travis Air Force Base, California, États-Unis, 94535
- General Robert Huyser Cancer Center at David Grant Medical Center
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Walnut Creek, California, États-Unis, 94598
- John Muir/Mt. Diablo Comprehensive Cancer Center
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Colorado
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Aurora, Colorado, États-Unis, 80010
- University of Colorado Cancer Center at University of Colorado Health Sciences Center
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Denver, Colorado, États-Unis, 80220
- Veterans Affairs Medical Center - Denver
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Florida
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Tampa, Florida, États-Unis, 33612
- Veterans Affairs Medical Center - Tampa (Haley)
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Georgia
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Atlanta, Georgia, États-Unis, 30342-1701
- CCOP - Atlanta Regional
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Decatur, Georgia, États-Unis, 30033
- Charles B. Eberhart Cancer Center at DeKalb Medical Center
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Fort Gordon, Georgia, États-Unis, 30905-5650
- Dwight David Eisenhower Army Medical Center
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Hawaii
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Honolulu, Hawaii, États-Unis, 96813
- Cancer Research Center of Hawaii
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Honolulu, Hawaii, États-Unis, 96813
- MBCCOP - Hawaii
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Idaho
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Boise, Idaho, États-Unis, 83712
- Mountain States Tumor Institute - Boise
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Illinois
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Chicago, Illinois, États-Unis, 60612
- Veterans Affairs Medical Center - Chicago Westside Hospital
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Hines, Illinois, États-Unis, 60141
- Veterans Affairs Medical Center - Hines
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Maywood, Illinois, États-Unis, 60153-5500
- Cardinal Bernardin Cancer Center at Loyola University Medical Center
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Indiana
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Beech Grove, Indiana, États-Unis, 46107
- Indiana Blood and Marrow Transplantation
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Kansas
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Kansas City, Kansas, États-Unis, 66160-7353
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
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Wichita, Kansas, États-Unis, 67214-3882
- CCOP - Wichita
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Wichita, Kansas, États-Unis, 67218
- Veterans Affairs Medical Center - Wichita
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Kentucky
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Lexington, Kentucky, États-Unis, 40502-2236
- Veterans Affairs Medical Center - Lexington
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Lexington, Kentucky, États-Unis, 40536-0084
- Markey Cancer Center at University of Kentucky Chandler Medical Center
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Louisiana
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New Orleans, Louisiana, États-Unis, 70112
- Veterans Affairs Medical Center - New Orleans
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New Orleans, Louisiana, États-Unis, 70112
- MBCCOP - LSU Health Sciences Center
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New Orleans, Louisiana, États-Unis, 70115
- New Orleans Cancer Institute at Memorial Medical Center
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New Orleans, Louisiana, États-Unis, 70112
- Tulane Cancer Center at Tulane University Hospital and Clinic
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Shreveport, Louisiana, États-Unis, 71130-3932
- Feist-Weiller Cancer Center at Louisiana State University Health Sciences
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Shreveport, Louisiana, États-Unis, 71101-4295
- Veterans Affairs Medical Center - Shreveport
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Massachusetts
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Boston, Massachusetts, États-Unis, 02114
- Massachusetts General Hospital Cancer Center
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Boston, Massachusetts, États-Unis, 02118
- Cancer Research Center at Boston Medical Center
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Michigan
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Ann Arbor, Michigan, États-Unis, 48109-0948
- University Of Michigan Comprehensive Cancer Center
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Detroit, Michigan, États-Unis, 48201-1379
- Barbara Ann Karmanos Cancer Institute
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Detroit, Michigan, États-Unis, 48201-1932
- Veterans Affairs Medical Center - Detroit
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Detroit, Michigan, États-Unis, 48202
- Josephine Ford Cancer Center at Henry Ford Health System
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Southfield, Michigan, États-Unis, 48075
- Providence Cancer Institute at Providence Hospital - Southfield Campus
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Mississippi
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Jackson, Mississippi, États-Unis, 39216-4505
- University of Mississippi Medical Center
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Jackson, Mississippi, États-Unis, 39216
- Veterans Affairs Medical Center - Jackson
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Missouri
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Kansas City, Missouri, États-Unis, 64131
- CCOP - Kansas City
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Saint Louis, Missouri, États-Unis, 63110
- Saint Louis University Cancer Center
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Montana
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Billings, Montana, États-Unis, 59101
- CCOP - Montana Cancer Consortium
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New Mexico
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Albuquerque, New Mexico, États-Unis, 87108-5138
- Veterans Affairs Medical Center - Albuquerque
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New York
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Albany, New York, États-Unis, 12208
- Veterans Affairs Medical Center - Albany
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New York, New York, États-Unis, 10016
- NYU Cancer Institute at New York University Medical Center
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New York, New York, États-Unis, 10032
- Herbert Irving Comprehensive Cancer Center at Columbia University
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Rochester, New York, États-Unis, 14642
- James P. Wilmot Cancer Center at University of Rochester Medical Center
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Ohio
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Cincinnati, Ohio, États-Unis, 45220-2288
- Veterans Affairs Medical Center - Cincinnati
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Cleveland, Ohio, États-Unis, 44195-9001
- Cleveland Clinic Taussig Cancer Center
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Dayton, Ohio, États-Unis, 45429
- CCOP - Dayton
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Dayton, Ohio, États-Unis, 45428-1002
- Veterans Affairs Medical Center - Dayton
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Oklahoma
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Oklahoma City, Oklahoma, États-Unis, 73104
- Veterans Affairs Medical Center - Oklahoma City
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Oklahoma City, Oklahoma, États-Unis, 73104
- Oklahoma University Medical Center
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Oregon
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Portland, Oregon, États-Unis, 97225
- CCOP - Columbia River Oncology Program
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Portland, Oregon, États-Unis, 97201-3098
- Cancer Institute at Oregon Health and Science University
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South Carolina
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Charleston, South Carolina, États-Unis, 29401-5799
- Veterans Affairs Medical Center - Charleston
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Greenville, South Carolina, États-Unis, 29615
- CCOP - Greenville
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Tennessee
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Memphis, Tennessee, États-Unis, 38104
- University of Tennessee Cancer Institute at Methodist Central Hospital
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Texas
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Amarillo, Texas, États-Unis, 79106
- Veterans Affairs Medical Center - Amarillo
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Houston, Texas, États-Unis, 77030
- Baylor College of Medicine
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Lackland Air Force Base, Texas, États-Unis, 78236-5300
- Wilford Hall Medical Center
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Lubbock, Texas, États-Unis, 79415-3364
- UMC Southwest Cancer and Research Center
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San Antonio, Texas, États-Unis, 78229-3900
- University of Texas Health Science Center at San Antonio
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San Antonio, Texas, États-Unis, 78229
- Veterans Affairs Medical Center - San Antonio (Murphy)
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Temple, Texas, États-Unis, 76504
- Veterans Affairs Medical Center - Temple
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Utah
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Salt Lake City, Utah, États-Unis, 84148
- Veterans Affairs Medical Center - Salt Lake City
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Salt Lake City, Utah, États-Unis, 84132
- Huntsman Cancer Institute at University of Utah
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Washington
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Seattle, Washington, États-Unis, 98101
- CCOP - Virginia Mason Research Center
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Seattle, Washington, États-Unis, 98108
- Veterans Affairs Medical Center - Seattle
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Seattle, Washington, États-Unis, 98109-1024
- Fred Hutchinson Cancer Research Center
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Seattle, Washington, États-Unis, 98104
- Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
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Tacoma, Washington, États-Unis, 98431-5000
- Madigan Army Medical Center
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Tacoma, Washington, États-Unis, 98405-0986
- CCOP - Northwest
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
DISEASE CHARACTERISTICS:
- Morphologically confirmed acute myeloid leukemia (AML) (within 180 days of diagnosis) OR
- Secondary AML (secondary to myelodysplastic syndromes (MDS) or to prior leukemogenic therapy)
- Must have A1 marrow, B1 blood, and C1 extramedullary disease status
- Must have received prior remission induction chemotherapy
- Must have a genotypically HLA-identical sibling donor available that is not a monozygotic identical twin
- No M3 AML or blastic transformation of chronic myelogenous leukemia
- If history of CNS leukemia, no leukemia cells in CNS by lumbar puncture within past 7 days
- Must be concurrently enrolled on protocols SWOG-9007 and SWOG-S9910
PATIENT CHARACTERISTICS:
Age
- 55 to 69
Performance status
- Zubrod 0-2
Life expectancy
- Not specified
Hematopoietic
- See Disease Characteristics
Hepatic
- Not specified
Renal
- Not specified
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- HIV negative
No other malignancy within the past 2 years except for the following:
- Adequately treated basal cell or squamous cell skin cancer
- Carcinoma in situ of the cervix
- Adequately treated stage I or II cancer in complete remission
PRIOR CONCURRENT THERAPY:
Biologic therapy
- No prior allogeneic hematopoietic stem cell transplantation
Chemotherapy
- See Disease Characteristics
- Prior consolidation therapy allowed
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Prior organ transplantation allowed provided not concurrently receiving immunosuppressive therapy
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: treatment
patient conditioning - fludarabine 30 mg/m2 IV over 1 hour Days -4, -3, -2; TBI 6-7 cGy/min Day 0 post-transplant immunosuppression - cyclosporine 6.25 mg/kg bid PO D -3 to +180 (begin taper on D+35); mycophenolate mofetil 15mg/kg bid PO D0 to +27
|
Autres noms:
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Overall Survival
Délai: 1 year
|
measured from date of registration to study until death from any cause with patients still alive censored at date of last contact
|
1 year
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Serious Adverse Events
Délai: 9 months
|
Twice a week for the first two months, one time a week during month 3, one time every two weeks for months 4-9.
|
9 months
|
Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chaise d'étude: Peter McSweeney, MD, Rocky Mountain Cancer Centers - Denver Midtown
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- Tumeurs par type histologique
- Tumeurs
- Leucémie
- Leucémie myéloïde
- Leucémie, myéloïde, aiguë
- Effets physiologiques des médicaments
- Mécanismes moléculaires de l'action pharmacologique
- Agents anti-infectieux
- Inhibiteurs d'enzymes
- Agents antirhumatismaux
- Agents antinéoplasiques
- Agents immunosuppresseurs
- Facteurs immunologiques
- Agents dermatologiques
- Agents antibactériens
- Antibiotiques, Antinéoplasiques
- Agents antifongiques
- Agents antituberculeux
- Antibiotiques, Antituberculeux
- Inhibiteurs de la calcineurine
- Fludarabine
- Acide mycophénolique
- Ciclosporine
- Cyclosporines
Autres numéros d'identification d'étude
- S0125 (Autre identifiant: SWOG)
- U10CA032102 (Subvention/contrat des NIH des États-Unis)
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