Rituximab Plus Chemotherapy for CD20+ Adult Acute Lymphoblastic Leukemia
Prospective Study of Rituximab Combined With Chemotherapy for CD20+ Adult Acute Lymphoblastic Leukemia
Studieöversikt
Status
Betingelser
Detaljerad beskrivning
Acute lymphoblastic leukemia (ALL) is a group of biologically heterogeneous diseases with diverse prognosis. Novel strategies for adult ALL have approached a CR rate of over 80%, which is similar to pediatric ALL. But the long term survival of adult ALL is only 30%-40%, much lower than pediatric patients.
In our trial, all the patients will first receive Vincristine 1.4mg/m2, max 2mg IV days 1,8,15,22, Daunorubicin 45mg/m2 IV days 1-3,Cyclophosphamide 750mg/m2 IV day 1 and prednisone 40-60mg/m2,by mouth days 1-14 (VDCP)regimen as initial induction therapy. If patients achieve complete remission after induction, they will be enrolled in our study for further consolidation and maintenance. If the tumor cells in bone marrow remain 5% to 20% after induction, the patients will receive VDCLP(VDCP+L-asparaginase 6000IU/m2 IV days5,7,9,11,13) and be enrolled until complete remission.
Rituximab is the main experimental intervention in our study.The consolidation regimen is HyperCVAD/MA or R-HyperCVAD/MA for totally 8 courses. The maintenance regimen includes 6-Mercaptopurine+Methotrexate for 24 months, Vincristine+Prednisone for the first 12 months, L-asparaginase in month 3 and 9 with or without Rituximab in month 6 and 12.
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 4
Kontakter och platser
Studieorter
-
-
Shanghai
-
Shanghai, Shanghai, Kina, 200025
- Ruijin Hospital
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Diagnosis of CD20-positive ALL
- Adequate liver function (bilirubin less than or equal to 1.5*ULN, unless considered due to tumor), and renal function (creatinine less than or equal to 1.5*ULN, unless considered due to tumor)
- Signed informed consent
Exclusion Criteria:
- Prior history of treatment with high-dose Ara-C, MTX or rituximab
- Pregnant or lactating women
- History of allergy to rituximab
- Unable to sign informed consent
- Active replication of HBV
- History of stem cell transplantation
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: HyperCVAD
Consolidation: HyperCVAD(odd courses) alternated with high-dose methotrexate + cytarabine (even courses) every 21 days or later to allow for myelosuppression recovery, for total of 8 courses. Maintenance: 6-Mercaptopurine+Methotrexate for 24 months. Vincristine+Prednisone for the first 12 months. L-asparaginase in month 3 and 9. |
50 mg/m2 IV under 2-24 timmar via CVC dag 4 efter sista dosen cyklofosfamid (udda kurser).
300 mg/m2 IV over 3 hours every 12 hours x 6 doses days 1, 2, 3 (total dose 1800 mg/m2)(odd courses).
Consolidation:1.4 mg/m2 (max 2mg) IV on day 4 and day 11 (odd courses).
Maintenance:1.4mg/m2(max 2mg) IV monthly from 1st to 12th month.
40mg IV or by mouth (P.O.) daily days 1-4 and days 11-14(odd courses)
2g/m2 IV over 2 hours every 12 hours for 4 doses on days 2, 3 (even courses).
Consolidation:1000 mg/m2 IV over 24 hours on day 1 (even courses).
Maintenance:25mg/m2 weekly for 24 months.
Maintenance:60mg/m2 daily for 24 months.
Maintenance:40mg/m2 from days 1-7 monthly from 1st to 12th month.
Maintenance:6000IU/m2 IV on days 1,3,5 of the 3rd and 9th month.
|
|
Experimentell: R-HyperCVAD
Consolidation: R-HyperCVAD(odd courses) alternated with high-dose methotrexate + cytarabine (even courses) every 21 days or later to allow for myelosuppression recovery, for total of 8 courses. Maintenance: 6-Mercaptopurine+Methotrexate for 24 months. Vincristine+Prednisone for the first 12 months. L-asparaginase in month 3 and 9. Rituximab in month 6 and 12. |
50 mg/m2 IV under 2-24 timmar via CVC dag 4 efter sista dosen cyklofosfamid (udda kurser).
300 mg/m2 IV over 3 hours every 12 hours x 6 doses days 1, 2, 3 (total dose 1800 mg/m2)(odd courses).
Consolidation:1.4 mg/m2 (max 2mg) IV on day 4 and day 11 (odd courses).
Maintenance:1.4mg/m2(max 2mg) IV monthly from 1st to 12th month.
40mg IV or by mouth (P.O.) daily days 1-4 and days 11-14(odd courses)
2g/m2 IV over 2 hours every 12 hours for 4 doses on days 2, 3 (even courses).
Consolidation:1000 mg/m2 IV over 24 hours on day 1 (even courses).
Maintenance:25mg/m2 weekly for 24 months.
Maintenance:60mg/m2 daily for 24 months.
Maintenance:40mg/m2 from days 1-7 monthly from 1st to 12th month.
Maintenance:6000IU/m2 IV on days 1,3,5 of the 3rd and 9th month.
Consolidation:375 mg/m2 IV day 1 for the odd courses of therapy (total 4 times). Maintenance:375 mg/m2 IV in 6th month and 12th month. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
CR duration
Tidsram: After two 21-day courses
|
Bone marrow MRD examination every two months
|
After two 21-day courses
|
|
disease free survival
Tidsram: 2 year
|
2 year
|
Samarbetspartners och utredare
Sponsor
Utredare
- Huvudutredare: Weili Zhao, MD,PhD, Department of hematology Ruijin Hospital/Shanghai Institute of Hematology
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
- Immunsystemets sjukdomar
- Neoplasmer efter histologisk typ
- Neoplasmer
- Lymfoproliferativa störningar
- Lymfatiska sjukdomar
- Immunproliferativa störningar
- Leukemi
- Prekursorcellslymfoblastisk leukemi-lymfom
- Leukemi, lymfoid
- Läkemedels fysiologiska effekter
- Molekylära mekanismer för farmakologisk verkan
- Anti-infektionsmedel
- Autonoma agenter
- Agenter från det perifera nervsystemet
- Antivirala medel
- Nukleinsyrasynteshämmare
- Enzyminhibitorer
- Antiinflammatoriska medel
- Antireumatiska medel
- Antimetaboliter, antineoplastiska
- Antimetaboliter
- Antineoplastiska medel
- Immunsuppressiva medel
- Immunologiska faktorer
- Tubulin modulatorer
- Antimitotiska medel
- Mitosmodulatorer
- Antiemetika
- Gastrointestinala medel
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitut och hormonantagonister
- Antineoplastiska medel, hormonella
- Antineoplastiska medel, Alkylering
- Alkyleringsmedel
- Myeloablativa agonister
- Antineoplastiska medel, fytogena
- Topoisomeras II-hämmare
- Topoisomerasinhibitorer
- Antineoplastiska medel, immunologiska
- Dermatologiska medel
- Antibiotika, antineoplastiska
- Reproduktionskontrollmedel
- Abortframkallande medel, icke-steroida
- Abortmedel
- Folsyraantagonister
- Dexametason
- Cyklofosfamid
- Rituximab
- Prednison
- Doxorubicin
- Cytarabin
- Metotrexat
- Vincristine
- Asparaginas
- Merkaptopurin
Andra studie-ID-nummer
- RJ-2010-56
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