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S0125, Chemotherapy, Total-Body Irradiation, and Peripheral Stem Cell Transplantation in Treating Older Patients With Acute Myeloid Leukemia

5. mars 2015 oppdatert av: Southwest Oncology Group

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.

Studieoversikt

Status

Avsluttet

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Faktiske)

5

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Arizona
      • Phoenix, Arizona, Forente stater, 85006
        • Banner Good Samaritan Medical Center
      • Tucson, Arizona, Forente stater, 85723
        • Veterans Affairs Medical Center - Tucson
      • Tucson, Arizona, Forente stater, 85724
        • Arizona Cancer Center at University of Arizona Health Sciences Center
    • Arkansas
      • Little Rock, Arkansas, Forente stater, 72205
        • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
      • Little Rock, Arkansas, Forente stater, 72205
        • Veterans Affairs Medical Center - Little Rock
    • California
      • Duarte, California, Forente stater, 91010-3000
        • City of Hope Comprehensive Cancer Center
      • La Jolla, California, Forente stater, 92037-1027
        • Scripps Cancer Center at Scripps Clinic
      • Los Angeles, California, Forente stater, 90033
        • USC/Norris Comprehensive Cancer Center and Hospital
      • Los Angeles, California, Forente stater, 90095-1678
        • Jonsson Comprehensive Cancer Center at UCLA
      • Martinez, California, Forente stater, 94553
        • Veterans Affairs Outpatient Clinic - Martinez
      • Orange, California, Forente stater, 92868
        • Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center
      • Sacramento, California, Forente stater, 95816
        • Sutter Cancer Center
      • Sacramento, California, Forente stater, 95817
        • University of California Davis Cancer Center
      • Stanford, California, Forente stater, 94305-5408
        • Stanford Cancer Center at Stanford University Medical Center
      • Travis Air Force Base, California, Forente stater, 94535
        • General Robert Huyser Cancer Center at David Grant Medical Center
      • Walnut Creek, California, Forente stater, 94598
        • John Muir/Mt. Diablo Comprehensive Cancer Center
    • Colorado
      • Aurora, Colorado, Forente stater, 80010
        • University of Colorado Cancer Center at University of Colorado Health Sciences Center
      • Denver, Colorado, Forente stater, 80220
        • Veterans Affairs Medical Center - Denver
    • Florida
      • Tampa, Florida, Forente stater, 33612
        • Veterans Affairs Medical Center - Tampa (Haley)
    • Georgia
      • Atlanta, Georgia, Forente stater, 30342-1701
        • CCOP - Atlanta Regional
      • Decatur, Georgia, Forente stater, 30033
        • Charles B. Eberhart Cancer Center at DeKalb Medical Center
      • Fort Gordon, Georgia, Forente stater, 30905-5650
        • Dwight David Eisenhower Army Medical Center
    • Hawaii
      • Honolulu, Hawaii, Forente stater, 96813
        • Cancer Research Center of Hawaii
      • Honolulu, Hawaii, Forente stater, 96813
        • MBCCOP - Hawaii
    • Idaho
      • Boise, Idaho, Forente stater, 83712
        • Mountain States Tumor Institute - Boise
    • Illinois
      • Chicago, Illinois, Forente stater, 60612
        • Veterans Affairs Medical Center - Chicago Westside Hospital
      • Hines, Illinois, Forente stater, 60141
        • Veterans Affairs Medical Center - Hines
      • Maywood, Illinois, Forente stater, 60153-5500
        • Cardinal Bernardin Cancer Center at Loyola University Medical Center
    • Indiana
      • Beech Grove, Indiana, Forente stater, 46107
        • Indiana Blood and Marrow Transplantation
    • Kansas
      • Kansas City, Kansas, Forente stater, 66160-7353
        • Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
      • Wichita, Kansas, Forente stater, 67214-3882
        • CCOP - Wichita
      • Wichita, Kansas, Forente stater, 67218
        • Veterans Affairs Medical Center - Wichita
    • Kentucky
      • Lexington, Kentucky, Forente stater, 40502-2236
        • Veterans Affairs Medical Center - Lexington
      • Lexington, Kentucky, Forente stater, 40536-0084
        • Markey Cancer Center at University of Kentucky Chandler Medical Center
    • Louisiana
      • New Orleans, Louisiana, Forente stater, 70112
        • Veterans Affairs Medical Center - New Orleans
      • New Orleans, Louisiana, Forente stater, 70112
        • MBCCOP - LSU Health Sciences Center
      • New Orleans, Louisiana, Forente stater, 70115
        • New Orleans Cancer Institute at Memorial Medical Center
      • New Orleans, Louisiana, Forente stater, 70112
        • Tulane Cancer Center at Tulane University Hospital and Clinic
      • Shreveport, Louisiana, Forente stater, 71130-3932
        • Feist-Weiller Cancer Center at Louisiana State University Health Sciences
      • Shreveport, Louisiana, Forente stater, 71101-4295
        • Veterans Affairs Medical Center - Shreveport
    • Massachusetts
      • Boston, Massachusetts, Forente stater, 02114
        • Massachusetts General Hospital Cancer Center
      • Boston, Massachusetts, Forente stater, 02118
        • Cancer Research Center at Boston Medical Center
    • Michigan
      • Ann Arbor, Michigan, Forente stater, 48109-0948
        • University Of Michigan Comprehensive Cancer Center
      • Detroit, Michigan, Forente stater, 48201-1379
        • Barbara Ann Karmanos Cancer Institute
      • Detroit, Michigan, Forente stater, 48201-1932
        • Veterans Affairs Medical Center - Detroit
      • Detroit, Michigan, Forente stater, 48202
        • Josephine Ford Cancer Center at Henry Ford Health System
      • Southfield, Michigan, Forente stater, 48075
        • Providence Cancer Institute at Providence Hospital - Southfield Campus
    • Mississippi
      • Jackson, Mississippi, Forente stater, 39216-4505
        • University of Mississippi Medical Center
      • Jackson, Mississippi, Forente stater, 39216
        • Veterans Affairs Medical Center - Jackson
    • Missouri
      • Kansas City, Missouri, Forente stater, 64131
        • CCOP - Kansas City
      • Saint Louis, Missouri, Forente stater, 63110
        • Saint Louis University Cancer Center
    • Montana
      • Billings, Montana, Forente stater, 59101
        • CCOP - Montana Cancer Consortium
    • New Mexico
      • Albuquerque, New Mexico, Forente stater, 87108-5138
        • Veterans Affairs Medical Center - Albuquerque
    • New York
      • Albany, New York, Forente stater, 12208
        • Veterans Affairs Medical Center - Albany
      • New York, New York, Forente stater, 10016
        • NYU Cancer Institute at New York University Medical Center
      • New York, New York, Forente stater, 10032
        • Herbert Irving Comprehensive Cancer Center at Columbia University
      • Rochester, New York, Forente stater, 14642
        • James P. Wilmot Cancer Center at University of Rochester Medical Center
    • Ohio
      • Cincinnati, Ohio, Forente stater, 45220-2288
        • Veterans Affairs Medical Center - Cincinnati
      • Cleveland, Ohio, Forente stater, 44195-9001
        • Cleveland Clinic Taussig Cancer Center
      • Dayton, Ohio, Forente stater, 45429
        • CCOP - Dayton
      • Dayton, Ohio, Forente stater, 45428-1002
        • Veterans Affairs Medical Center - Dayton
    • Oklahoma
      • Oklahoma City, Oklahoma, Forente stater, 73104
        • Veterans Affairs Medical Center - Oklahoma City
      • Oklahoma City, Oklahoma, Forente stater, 73104
        • Oklahoma University Medical Center
    • Oregon
      • Portland, Oregon, Forente stater, 97225
        • CCOP - Columbia River Oncology Program
      • Portland, Oregon, Forente stater, 97201-3098
        • Cancer Institute at Oregon Health and Science University
    • South Carolina
      • Charleston, South Carolina, Forente stater, 29401-5799
        • Veterans Affairs Medical Center - Charleston
      • Greenville, South Carolina, Forente stater, 29615
        • CCOP - Greenville
    • Tennessee
      • Memphis, Tennessee, Forente stater, 38104
        • University of Tennessee Cancer Institute at Methodist Central Hospital
    • Texas
      • Amarillo, Texas, Forente stater, 79106
        • Veterans Affairs Medical Center - Amarillo
      • Houston, Texas, Forente stater, 77030
        • Baylor College of Medicine
      • Lackland Air Force Base, Texas, Forente stater, 78236-5300
        • Wilford Hall Medical Center
      • Lubbock, Texas, Forente stater, 79415-3364
        • UMC Southwest Cancer and Research Center
      • San Antonio, Texas, Forente stater, 78229-3900
        • University of Texas Health Science Center at San Antonio
      • San Antonio, Texas, Forente stater, 78229
        • Veterans Affairs Medical Center - San Antonio (Murphy)
      • Temple, Texas, Forente stater, 76504
        • Veterans Affairs Medical Center - Temple
    • Utah
      • Salt Lake City, Utah, Forente stater, 84148
        • Veterans Affairs Medical Center - Salt Lake City
      • Salt Lake City, Utah, Forente stater, 84132
        • Huntsman Cancer Institute at University of Utah
    • Washington
      • Seattle, Washington, Forente stater, 98101
        • CCOP - Virginia Mason Research Center
      • Seattle, Washington, Forente stater, 98108
        • Veterans Affairs Medical Center - Seattle
      • Seattle, Washington, Forente stater, 98109-1024
        • Fred Hutchinson Cancer Research Center
      • Seattle, Washington, Forente stater, 98104
        • Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
      • Tacoma, Washington, Forente stater, 98431-5000
        • Madigan Army Medical Center
      • Tacoma, Washington, Forente stater, 98405-0986
        • CCOP - Northwest

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

55 år til 69 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Intervensjonsmodell: Enkeltgruppeoppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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
Stråling: strålebehandling
Biologisk: terapeutiske allogene lymfocytter
Fremgangsmåte: stamcelletransplantasjon av perifert blod
Legemiddel: cyklosporin
Legemiddel: mykofenolatmofetil
Andre navn:
  • MMF
Legemiddel: fludarabin

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Overall Survival
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Serious Adverse Events
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Southwest Oncology Group

Samarbeidspartnere

National Cancer Institute (NCI)

Etterforskere

  • Studiestol: Peter McSweeney, MD, Rocky Mountain Cancer Centers - Denver Midtown

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. april 2003

Primær fullføring (Faktiske)

1. juni 2005

Studiet fullført (Faktiske)

1. juni 2006

Datoer for studieregistrering

Først innsendt

27. januar 2003

Først innsendt som oppfylte QC-kriteriene

27. januar 2003

Først lagt ut (Anslag)

28. januar 2003

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

25. mars 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

5. mars 2015

Sist bekreftet

1. mars 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • S0125 (Annen identifikator: SWOG)
  • U10CA032102 (U.S. NIH-stipend/kontrakt)

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Abonnere