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- Klinische proef NCT00004056
Combination Chemotherapy Followed by Melphalan and Peripheral Stem Cell Transplantation in Treating Children With Newly Diagnosed Acute Myeloid Leukemia
Treatment of Newly Diagnosed Childhood AML Using a Timed-Sequential Remission Induction and Consolidation Followed by Single Dose Melphalan With Peripheral Stem Cell Rescue: A POG Pilot Study
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Peripheral stem cell transplantation may allow doctors to give higher doses of chemotherapy drugs and kill more cancer cells.
PURPOSE: Phase I trial to study the effectiveness of combination chemotherapy followed by melphalan and peripheral stem cell transplantation in treating children who have newly diagnosed acute myeloid leukemia that has not been treated previously.
Studie Overzicht
Toestand
Conditie
Gedetailleerde beschrijving
OBJECTIVES: I. Determine the feasibility and toxicity of timed sequential remission induction and consolidation in children with newly diagnosed acute myeloid leukemia. II. Determine the feasibility and toxicity of a single high dose of melphalan with peripheral blood stem cell rescue following an intense timed sequential induction and consolidation in these children.
OUTLINE: This is a multicenter study. Remission induction: Patients receive daunorubicin IV over 15 minutes on days 1-3, cytarabine IV continuously on days 1-7, oral thioguanine daily on days 1-7, and cytarabine intrathecally (IT) on day 1. Cytarabine IV over 3 hours is administered every 12 hours on days 10-12. Filgrastim (G-CSF) is administered IV or subcutaneously (SQ) beginning on day 13 and continuing until blood counts recover. On approximately day 28, patients undergo a bone marrow aspirate and biopsy to assess response. Patients who have attained an M1 or M2a status proceed to consolidation or, if a 5/5 or 6/6 HLA matched sibling donor is available, proceed to allogeneic bone marrow transplantation. Patients with greater than 25% blasts go off study. Consolidation 1: Patients receive daunorubicin IV over 15 minutes on days 1 and 2, cytarabine IV over 3 hours every 12 hours on days 1, 2, 8, and 9, and asparaginase on days 2 and 9. G-CSF IV or SQ begins on day 10 and continues until blood counts recover. Consolidation 2: Patients receive cytarabine IV over 3 hours every 12 hours on days 1, 3, and 5. G-CSF IV or SQ begins on day 6 and continues until blood counts recover. Peripheral blood stem cells (PBSC) are collected after the second course of consolidation. Consolidation 3: Treatment is repeated as in consolidation 1. Patients who remain in morphologic remission after consolidation 3 proceed with therapy. Patients receive melphalan IV over 30 minutes on day -2, then PBSC are reinfused on day 0. G-CSF IV or SQ begins on day 1 and continues until blood counts recover. Patients are followed every 6 months for 4 years and then annually thereafter.
PROJECTED ACCRUAL: A total of 20-30 patients will be accrued for this study within 8 months.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 1
Contacten en locaties
Studie Locaties
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Quebec
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Montreal, Quebec, Canada, H3H 1P3
- Montreal Children's Hospital
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Alabama
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Birmingham, Alabama, Verenigde Staten, 35294
- University of Alabama Comprehensive Cancer Center
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Arizona
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Tucson, Arizona, Verenigde Staten, 85724
- Arizona Cancer Center
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Arkansas
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Little Rock, Arkansas, Verenigde Staten, 72205
- University of Arkansas for Medical Sciences
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California
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Palo Alto, California, Verenigde Staten, 94304
- Lucile Packard Children's Hospital at Stanford
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San Diego, California, Verenigde Staten, 92123-4282
- Children's Hospital and Health Center
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Florida
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Jacksonville, Florida, Verenigde Staten, 32207
- Nemours Children's Clinic
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30322
- Emory University Hospital - Atlanta
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Illinois
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Chicago, Illinois, Verenigde Staten, 60614
- Children's Memorial Hospital, Chicago
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Maine
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Scarborough, Maine, Verenigde Staten, 04074
- Maine Children's Cancer Program
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21231
- Johns Hopkins Oncology Center
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02114
- Massachusetts General Hospital Cancer Center
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Michigan
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Detroit, Michigan, Verenigde Staten, 48201
- Children's Hospital of Michigan
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Missouri
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Saint Louis, Missouri, Verenigde Staten, 63104
- Cardinal Glennon Children's Hospital
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New Jersey
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Hackensack, New Jersey, Verenigde Staten, 07601
- Hackensack University Medical Center
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Hackensack, New Jersey, Verenigde Staten, 07601
- Tomorrows Children's Institute
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New York
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New York, New York, Verenigde Staten, 10029
- Mount Sinai School of Medicine
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Texas
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Dallas, Texas, Verenigde Staten, 75235-9154
- Simmons Cancer Center - Dallas
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Fort Worth, Texas, Verenigde Staten, 76104
- Cook Children's Medical Center - Fort Worth
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Wisconsin
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Milwaukee, Wisconsin, Verenigde Staten, 53226
- Midwest Children's Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
DISEASE CHARACTERISTICS: Histologically proven, previously untreated primary acute myeloid leukemia (AML) Isolated granulocytic sarcoma (myeloblastoma) allowed Patients with cytopenias and bone marrow blasts greater than 5% but less than 30% eligible only if there is karyotypic abnormality characteristic of de novo AML (t(8;21), inv16, t(9;11), etc.) OR unequivocal presence of megakaryoblasts No acute promyelocytic leukemia (M3) No Down syndrome
PATIENT CHARACTERISTICS: Age: 21 and under Performance status: Not specified Life expectancy: Not specified Hematopoietic: Not specified Hepatic: Bilirubin no greater than 3 times upper limit of normal Renal: Creatinine no greater than 1.5 mg/dL Uric acid no greater than 8.0 mg/dL Cardiovascular: Cardiac function normal by echocardiogram Pulmonary: No uncontrolled, life threatening pneumonia Other: No uncontrolled, life threatening sepsis or meningitis Not pregnant Fertile patients must use effective contraception
PRIOR CONCURRENT THERAPY: No prior therapy
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Chemo + STEM cell
See detailed description.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Feasibility and toxicity of an intensive regimen that uses timed-sequential therapy
Tijdsspanne: Length of study
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To determine the feasibility and toxicity of an intensive regimen that uses timed-sequential therapy as a strategy for both remission induction and consolidation of newly diagnosed children with AML.
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Length of study
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Feasibility and toxicity of a single high dose of melphalan with peripheral stem cell rescue
Tijdsspanne: Length of study
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To test the feasibility and toxicity of a single high dose of melphalan with peripheral stem cell rescue following an intense timed-sequential induction and consolidation.
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Length of study
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Make observations regarding PCR evidence of Minimal Residual Disease
Tijdsspanne: Length of study
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To make observations regarding PCR evidence of Minimal Residual Disease in patients with relevant specific translocations who obtain a clinical remission.
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Length of study
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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Studie stoel: Craig A. Hurwitz, MD, Maine Children's Cancer Program at Barbara Bush Children's Hospital
Publicaties en nuttige links
Algemene publicaties
- Hurwitz CA, Chang M, Graham M, et al.: Timed-sequential remission induction and intensification followed by stem cell rescue for childhood AML -a POG pilot study. [Abstract] Proceedings of the American Society of Clinical Oncology 21: A-1553, 2002.
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
- acute erythroleukemie bij kinderen (M6)
- acute megakaryocytische leukemie bij kinderen (M7)
- acute minimaal gedifferentieerde myeloïde leukemie bij kinderen (M0)
- onbehandelde acute myeloïde leukemie bij kinderen en andere myeloïde maligniteiten
- acute myeloblastische leukemie bij kinderen zonder rijping (M1)
- acute myeloblastische leukemie bij kinderen met rijping (M2)
- acute myelomonocytaire leukemie bij kinderen (M4)
- acute monoblastaire leukemie bij kinderen en acute monocytische leukemie (M5)
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata per histologisch type
- Neoplasmata
- Leukemie
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Antivirale middelen
- Enzymremmers
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Antineoplastische middelen, alkylering
- Alkyleringsmiddelen
- Myeloablatieve agonisten
- Topoisomerase II-remmers
- Topoisomeraseremmers
- Adjuvantia, immunologisch
- Antibiotica, antineoplastiek
- Lenograstim
- Melfalan
- Cytarabine
- Daunorubicine
- Asparaginase
- Thioguanine
Andere studie-ID-nummers
- 9822
- POG-9822
- CDR0000067253
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