Combination Chemotherapy With or Without Idarubicin and Peripheral Stem Cell Transplantation in Treating Patients With Leukemia or Myelodysplastic Syndrome
A Randomized Phase III Study to Assess Intensification of the Conditioning Regimen for Allogenic Stem Cell Transplantation (ALLO-SCT) for Leukemia or Myelodysplastic Syndrome With a High Risk of Relapse
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining chemotherapy with peripheral stem cell transplantation may allow the doctor to give higher doses of chemotherapy drugs and kill more cancer cells.
PURPOSE: Randomized phase III trial to compare the effectiveness of idarubicin plus peripheral stem cell transplantation using the patient's own or donated stem cells in treating patients with leukemia or myelodysplastic syndrome.
研究概览
详细说明
OBJECTIVES: I. Assess the value of idarubicin added to the standard conditioning regimen of allogeneic and autologous stem cell transplantation in patients with leukemia or myelodysplastic syndrome at high risk of relapse. II. Determine time to recovery of polymorphonuclear neutrophil leukocyte (PMN) and platelet counts in these patients. III. Evaluate the rate and type of grade 3-4 toxicity, particularly mucositis, and the number of days with fever in these patients. IV. Determine the incidence of acute and chronic graft versus host disease (GVHD) in these patients.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to disease (acute myelogenous leukemia (AML) vs acute lymphocytic leukemia (ALL) or lymphoblastic leukemia (LL) vs myelodysplastic syndrome (MDS) or secondary AML vs chronic myelogenous leukemia (CML) vs non-Hodgkin's lymphoma vs multiple myeloma), stage of disease (if not CML, 1st complete response (CR) vs 2nd CR vs no 1st/2nd CR; if CML, 1st CR vs other phases), conditioning regimen (cyclophosphamide (CTX) and total body irradiation (TBI) vs busulfan (BU) and CTX vs other), source of donor (allogeneic vs autologous), T-cell depletion or autologous transplantation (no vs yes), and source of stem cells (bone marrow vs peripheral blood stem cell). Patients are randomized to receive a standard regimen or an intensified regimen. Standard pretransplant treatment: CTX on days -6 and -5 and TBI on days -4 through -2, or BU on days -8 through -5 and CTX on days -4 and -3, or BU on days -8 through -5 and melphalan IV on day -4. Intensified pretransplant regimens: I. Continuous infusion of idarubicin (IDA) over 48 hours on days -12 and -11, followed 5 days later with CTX on days -6 and -5 and TBI on days -4 to -2 II. IDA followed 5 days later with BU on days -8 through -5, and then CTX on days -4 and -3 III. IDA followed by BU on days -8 through -5 and melphalan IV on day -4. Stem cells are infused on day 0. Patients are followed every 3 months during the first 3 years, then every 6 months thereafter.
PROJECTED ACCRUAL: A total of 207 patients will be accrued for this study within 3 years.
研究类型
注册 (预期的)
阶段
- 第三阶段
联系人和位置
学习地点
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Tuebingen、德国、D-72076
- Eberhard Karls Universitaet
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Rome、意大利、00161
- Azienda Policlinico Umberto Primo
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Rome、意大利、00144
- Ospedale San Eugenio
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Brussels (Bruxelles)、比利时、1000
- Institut Jules Bordet
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Lyon、法国、69437
- Hôpital Edouard Herriot
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Paris、法国、75181
- Hotel Dieu de Paris
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Villejuif、法国、F-94805
- Institut Gustave Roussy
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Leiden、荷兰、2300 CA
- Leiden University Medical Center
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Nijmegen、荷兰、NL-6500 HB
- University Medical Center Nijmegen
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
DISEASE CHARACTERISTICS: Acute myelogenous leukemia (AML), acute lymphocytic leukemia (ALL), lymphocytic leukemia (LL) or myelodysplastic syndromes (MDS) with at least one of the following high risk criteria: T-cell depleted stem cells or autologous stem cells Second complete response (CR) Previous CNS involvement No CR First CR achieved more than 5 weeks after start of remission-induction therapy Poor prognostic cytogenetic features: t(9;22), t(8;14), t(11;14), 11q23 anomalies, -5/5q-anomalies, -7/7q-anomalies, +8, complex cytogenetics Postcytotoxic/secondary AML Chronic myelogenous leukemia (CML) with at least one of the following high risk criteria: T-cell depleted stem cells Not in first chronic phase Non-Hodgkin's lymphoma or multiple myeloma Autologous stem cells
PATIENT CHARACTERISTICS: Age: 16 to 60 Performance status: WHO 0-2 Hematopoietic: Not specified Hepatic: Bilirubin no greater than 1.5 times upper limit of normal (ULN) Renal: Creatinine no greater than 1.5 times ULN Cardiovascular: No severe heart failure requiring diuretics No ejection fraction of less than 50% Neurologic: No severe concurrent neurological or psychiatric disease Other: HIV negative No allogeneic stem cells from donors other than HLA identical sibling(s)
PRIOR CONCURRENT THERAPY: See Disease Characteristics
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
合作者和调查者
调查人员
- 学习椅:Theo De Witte, MD, PhD、Universitair Medisch Centrum St. Radboud - Nijmegen
研究记录日期
研究主要日期
学习开始
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
- III期成人弥漫性大细胞淋巴瘤
- III期成人免疫母细胞大细胞淋巴瘤
- III期成人伯基特淋巴瘤
- IV期3级滤泡性淋巴瘤
- IV期成人弥漫性大细胞淋巴瘤
- IV期成人免疫母细胞大细胞淋巴瘤
- IV期成人Burkitt淋巴瘤
- 复发性 3 级滤泡性淋巴瘤
- 复发性成人弥漫性大细胞淋巴瘤
- 复发性成人免疫母细胞大细胞淋巴瘤
- 复发性成人伯基特淋巴瘤
- 既往治疗过的骨髓增生异常综合征
- 儿童骨髓增生异常综合征
- 复发性成人急性髓性白血病
- 缓解期成人急性髓性白血病
- 复发性成人弥漫性小裂细胞淋巴瘤
- 复发性成人弥漫性混合细胞淋巴瘤
- 复发性慢性粒细胞白血病
- III期2级滤泡性淋巴瘤
- III期3级滤泡性淋巴瘤
- III期成人弥漫性小裂细胞淋巴瘤
- III期成人弥漫性混合细胞淋巴瘤
- IV 期 1 级滤泡性淋巴瘤
- IV 期 2 级滤泡性淋巴瘤
- IV期成人弥漫性小裂细胞淋巴瘤
- IV期成人弥漫性混合细胞淋巴瘤
- III期套细胞淋巴瘤
- IV期套细胞淋巴瘤
- II期多发性骨髓瘤
- III期多发性骨髓瘤
- I 期 1 级滤泡性淋巴瘤
- I 期 2 级滤泡性淋巴瘤
- I期成人弥漫性小裂细胞淋巴瘤
- 复发性 1 级滤泡性淋巴瘤
- 复发性 2 级滤泡性淋巴瘤
- 连续 II 期 1 级滤泡性淋巴瘤
- 连续 II 期 2 级滤泡性淋巴瘤
- 连续 II 期成人弥漫性小裂细胞淋巴瘤
- 非连续性 II 期 1 级滤泡性淋巴瘤
- 非连续性 II 期 2 级滤泡性淋巴瘤
- 非连续性 II 期成人弥漫性小裂细胞淋巴瘤
- 非连续性 II 期小淋巴细胞淋巴瘤
- 非连续性 II 期边缘区淋巴瘤
- 复发性边缘区淋巴瘤
- 复发性小淋巴细胞淋巴瘤
- I期边缘区淋巴瘤
- I期小淋巴细胞淋巴瘤
- III期小淋巴细胞淋巴瘤
- III期边缘区淋巴瘤
- IV期小淋巴细胞淋巴瘤
- IV期边缘区淋巴瘤
- 连续II期边缘区淋巴瘤
- 相邻的 II 期小淋巴细胞淋巴瘤
- 黏膜相关淋巴组织结外边缘区B细胞淋巴瘤
- 淋巴结边缘区B细胞淋巴瘤
- 脾边缘区淋巴瘤
- I期多发性骨髓瘤
- 复发性成人淋巴母细胞淋巴瘤
- 复发性套细胞淋巴瘤
- 难治性慢性淋巴细胞白血病
- III期成人淋巴母细胞淋巴瘤
- IV期成人淋巴母细胞淋巴瘤
- 复发性成人急性淋巴细胞白血病
- 连续II期套细胞淋巴瘤
- 非连续性 II 期套细胞淋巴瘤
- 非连续性 II 期成人弥漫性大细胞淋巴瘤
- 非连续性 II 期成人弥漫性混合细胞淋巴瘤
- 非连续性 II 期成人淋巴母细胞淋巴瘤
- 非连续性 II 期 3 级滤泡性淋巴瘤
- 缓解期成人急性淋巴细胞白血病
- 非连续性 II 期成人伯基特淋巴瘤
- 非连续性 II 期成人免疫母细胞大细胞淋巴瘤
- I期套细胞淋巴瘤
- I期成人伯基特淋巴瘤
- 连续 II 期成人伯基特淋巴瘤
- 连续 II 期成人免疫母细胞大细胞淋巴瘤
- I期成人免疫母细胞大细胞淋巴瘤
- 连续 II 期 3 级滤泡性淋巴瘤
- I期3级滤泡性淋巴瘤
- 连续 II 期成人弥漫性大细胞淋巴瘤
- 连续II期成人弥漫性混合细胞淋巴瘤
- I期成人弥漫性大细胞淋巴瘤
- I期成人弥漫性混合细胞淋巴瘤
- 连续 II 期成人淋巴母细胞淋巴瘤
- I期成人淋巴母细胞淋巴瘤
其他相关的 MeSH 术语
其他研究编号
- CDR0000065526
- EORTC-06962
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