- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT00004857
Fludarabine Followed by Alemtuzumab in Treating Patients With Chronic Lymphocytic Leukemia
A Phase II Study of Fludarabine Induction Followed by CAMPATH-1H Consolidation in Untreated Patients With B-Cell Chronic Lymphocytic Leukemia
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Monoclonal antibodies such as alemtuzumab can locate cancer cells and either kill them or deliver cancer-killing substances to them without harming normal cells.
PURPOSE: Phase II trial to study the effectiveness of fludarabine followed by alemtuzumab in treating patients who have chronic lymphocytic leukemia.
연구 개요
상세 설명
OBJECTIVES: I. Determine the overall response rate of previously untreated patients with stage I, II, III, or IV B-cell chronic lymphocytic leukemia when treated with fludarabine induction followed by alemtuzumab consolidation. II. Determine the infectious toxic effects and feasibility of this regimen in this patient population. III. Determine the treatment-related toxic effects, including infection and injection site reactions, of subcutaneous vs intravenous alemtuzumab in patients treated with this regimen. IV. Determine the progression-free and overall survival of patients treated with this regimen. V. Determine the immunologic effects of this regimen in these patients.
OUTLINE: Patients receive fludarabine IV over 30 minutes 5 days a week. Treatment repeats every 28 days for 4 courses in the absence of disease progression. Patients undergo clinical staging after completion of course 4 of fludarabine followed by 2 months of observation. Patients with stable or responding disease receive alemtuzumab subcutaneously 3 days a week for 6 weeks. Patients undergo clinical staging again after completion of 6 weeks of alemtuzumab followed by 2 more months of observation. Patients are followed every 3 months for 1 year and then every 6 months for 8 years.
연구 유형
등록 (실제)
단계
- 2 단계
연락처 및 위치
연구 장소
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Alabama
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Birmingham, Alabama, 미국, 35233-1996
- Veterans Affairs Medical Center - Birmingham
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California
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La Jolla, California, 미국, 92093-0658
- University of California San Diego Cancer Center
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San Francisco, California, 미국, 94121
- Veterans Affairs Medical Center - San Francisco
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San Francisco, California, 미국, 94143-0128
- UCSF Cancer Center and Cancer Research Institute
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Delaware
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Wilmington, Delaware, 미국, 19899
- CCOP - Christiana Care Health Services
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District of Columbia
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Washington, District of Columbia, 미국, 20307-5000
- Walter Reed Army Medical Center
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Washington, District of Columbia, 미국, 20007
- Lombardi Cancer Center
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Florida
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Miami Beach, Florida, 미국, 33140
- CCOP - Mount Sinai Medical Center
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Illinois
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Chicago, Illinois, 미국, 60612
- Veterans Affairs Medical Center - Chicago (Westside Hospital)
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Chicago, Illinois, 미국, 60637-1470
- University of Chicago Cancer Research Center
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Chicago, Illinois, 미국, 60612
- University of Illinois at Chicago Health Sciences Center
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Iowa
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Iowa City, Iowa, 미국, 52242-1009
- Holden Comprehensive Cancer Center at the University of Iowa
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Maine
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Togus, Maine, 미국, 04330
- Veterans Affairs Medical Center - Togus
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Maryland
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Baltimore, Maryland, 미국, 21201
- Marlene & Stewart Greenebaum Cancer Center, University of Maryland
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Massachusetts
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Boston, Massachusetts, 미국, 02115
- Dana-Farber Cancer Institute
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Worcester, Massachusetts, 미국, 01655
- University of Massachusetts Memorial Medical Center
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Minnesota
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Minneapolis, Minnesota, 미국, 55417
- Veterans Affairs Medical Center - Minneapolis
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Minneapolis, Minnesota, 미국, 55455
- University of Minnesota Cancer Center
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Missouri
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Columbia, Missouri, 미국, 65201
- Veterans Affairs Medical Center - Columbia (Truman Memorial)
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Columbia, Missouri, 미국, 65203
- Ellis Fischel Cancer Center - Columbia
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Saint Louis, Missouri, 미국, 63110
- Barnes-Jewish Hospital
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Nebraska
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Omaha, Nebraska, 미국, 68198-3330
- University of Nebraska Medical Center
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Nevada
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Las Vegas, Nevada, 미국, 89106
- CCOP - Southern Nevada Cancer Research Foundation
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New Hampshire
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Lebanon, New Hampshire, 미국, 03756-0002
- Norris Cotton Cancer Center
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New York
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Buffalo, New York, 미국, 14263-0001
- Roswell Park Cancer Institute
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Buffalo, New York, 미국, 14215
- Veterans Affairs Medical Center - Buffalo
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Manhasset, New York, 미국, 11030
- CCOP - North Shore University Hospital
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Manhasset, New York, 미국, 11030
- North Shore University Hospital
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New Hyde Park, New York, 미국, 11040
- Long Island Jewish Medical Center
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New York, New York, 미국, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, 미국, 10021
- New York Presbyterian Hospital - Cornell Campus
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New York, New York, 미국, 10029
- Mount Sinai Medical Center, NY
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Syracuse, New York, 미국, 13210
- State University of New York - Upstate Medical University
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Syracuse, New York, 미국, 13210
- Veterans Affairs Medical Center - Syracuse
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Syracuse, New York, 미국, 13217
- CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.
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North Carolina
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Chapel Hill, North Carolina, 미국, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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Durham, North Carolina, 미국, 27705
- Veterans Affairs Medical Center - Durham
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Durham, North Carolina, 미국, 27710
- Duke Comprehensive Cancer Center
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Winston-Salem, North Carolina, 미국, 27104-4241
- CCOP - Southeast Cancer Control Consortium
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Winston-Salem, North Carolina, 미국, 27157-1082
- Comprehensive Cancer Center at Wake Forest University
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Ohio
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Columbus, Ohio, 미국, 43210-1240
- Arthur G. James Cancer Hospital - Ohio State University
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Rhode Island
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Providence, Rhode Island, 미국, 02903
- Rhode Island Hospital
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South Carolina
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Charleston, South Carolina, 미국, 29425-0721
- Medical University of South Carolina
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Tennessee
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Memphis, Tennessee, 미국, 38103
- University of Tennessee, Memphis Cancer Center
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Memphis, Tennessee, 미국, 38104
- Veterans Affairs Medical Center - Memphis
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Vermont
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Bennington, Vermont, 미국, 05201
- CCOP - Southwestern Vermont Regional Cancer Center
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Burlington, Vermont, 미국, 05401-3498
- Vermont Cancer Center
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White River Junction, Vermont, 미국, 05009
- Veterans Affairs Medical Center - White River Junction
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Virginia
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Richmond, Virginia, 미국, 23298-0037
- MBCCOP - Massey Cancer Center
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Richmond, Virginia, 미국, 23249
- Veterans Affairs Medical Center - Richmond
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Specific Diagnosis of B-Cell CLL
1.1 An absolute lymphocytosis of > 5,000/µl
1.1.1 Morphologically, the lymphocytes must appear mature with < 55% prolymphocytes.
1.1.2 Bone marrow examination must include at least a unilateral aspirate and biopsy. The aspirate smear must show > 30% of all nucleated cells to be lymphoid or the bone marrow core biopsy must show lymphoid infiltrates compatible with marrow involvement by CLL. The overall cellularity must be normocellular or hypercellular.
1.1.3 Local institution lymphocyte phenotype must reveal a predominant B-cell monoclonal population sharing a B-cell marker (CD19, CD20, CD23, CD24) with the CD5 antigen, in the absence of other pan-T-cell markers. Additionally, the B-cells must be monoclonal with regard to expression of either κ or λ and have surface immunoglobulin expression of low density. Patients with bright surface immunoglobulin levels must have CD23 co-expression.
1.2 Staging
1.2.1 Patients must be in the intermediate- or high-risk categories of the modified three-stage Rai staging system (i.e., stages I, II, III, or IV) per the protocol.
1.2.2 Patients in the intermediate-risk group must have evidence of active disease as demonstrated by at least one of the following criteria:
- Massive or progressive splenomegaly and/or lymphadenopathy
- Presence of weight loss > 10% over the preceding 6 month period;
- Grade 2 or 3 fatigue
- Fevers > 100.5°C or night sweats for greater than 2 weeks without evidence of infection
- Progressive lymphocytosis with an increase of > 50% over a 2 month period or an anticipated doubling time of less than 6 months.
- Prior Treatment: No prior therapy for CLL including corticosteroids for autoimmune complications that have developed since the initial diagnosis of CLL.
- No medical condition requiring chronic use of oral corticosteroids.
- Age ≥18 years.
- Performance Status 0 - 2.
- No HIV disease. Due to alterations in host immunity, patients with HIV may not be enrolled.
- Non-pregnant and non-nursing. Due to the unknown teratogenic potential of Campath-1H, pregnant or nursing women may not be enrolled. Women and men of reproductive potential should agree to use an effective means of birth control.
- Initial Required Laboratory Values:
Creatinine <1.5 x upper limit of institutional normal value Coomb's Testing NEGATIVE
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위화되지 않음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Fludarabine + Campath-1H
Standard of care induction with fludarabine followed by consolidation antibody therapy
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30 mg subQ injection tiw for 6 weeks
다른 이름들:
25mg/sq m/day IV infusion x 5 days Wks 1, 5, 9, and 13
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
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Response
기간: 2 months post consolidation
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2 months post consolidation
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
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Toxicity
기간: 2 months post consolidation
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2 months post consolidation
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공동 작업자 및 조사자
수사관
- 연구 의자: Kanti R. Rai, MD, Long Island Jewish Medical Center
간행물 및 유용한 링크
일반 간행물
- Rai KR, Freter CE, Mercier RJ, Cooper MR, Mitchell BS, Stadtmauer EA, Santabarbara P, Wacker B, Brettman L. Alemtuzumab in previously treated chronic lymphocytic leukemia patients who also had received fludarabine. J Clin Oncol. 2002 Sep 15;20(18):3891-7. doi: 10.1200/JCO.2002.06.119.
- Morrison VA, Peterson BL, Rai KR, et al.: Alemtuzumab increases serious infections in patients with previously untreated chronic lymphocytic leukemia (CLL) receiving fludarabine-based therapy: a comparative analysis of 3 Cancer and Leukemia Group B studies (CALGB 9011, 9712, 19901). [Abstract] Blood 110 (11): A-756, 2007.
- Byrd JC, Peterson BL, Rai KR, Hurd D, Hohl R, Perry MC, Gockerman J, Nattam S, Larson RA. Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901. Leuk Lymphoma. 2009 Oct;50(10):1589-96. doi: 10.1080/10428190903150839.
- Rai KR, Byrd JC, Peterson B: Subcutaneous alemtuzumab following fludarabine for previously untreated patients with chronic lymphocytic leukemia (CLL): CALGB study 19901. [Abstract] Blood 102 (11 Pt 1): A-2506, 2003.
- Rai KR, Byrd JC, Peterson BL, et al.: A phase II trial of fludarabine followed by alemtuzumab (Campath-1H) in previously untreated chronic lymphocytic leukemia (CLL) patients with active disease: Cancer and Leukemia Group B (CALGB) study 19901. [Abstract] Blood 100 (11 Pt 1): A-772, 2002.
- Jones JA, Ruppert AS, Zhao W, Lin TS, Rai K, Peterson B, Larson RA, Marcucci G, Heerema NA, Byrd JC. Patients with chronic lymphocytic leukemia with high-risk genomic features have inferior outcome on successive Cancer and Leukemia Group B trials with alemtuzumab consolidation: subgroup analysis from CALGB 19901 and CALGB 10101. Leuk Lymphoma. 2013 Dec;54(12):2654-9. doi: 10.3109/10428194.2013.788179. Epub 2013 May 9.
연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- CALGB-19901
- U10CA031946 (미국 NIH 보조금/계약)
- CDR0000067506 (레지스트리 식별자: NCI Physician Data Query)
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