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Optimal Treatment Strategy Based on for Pediatric AML

Phase 2
Conditions
Pediatric Acute Myeloid Leukemia
Interventions
Procedure: Hematopoietic stem cell transplantation
Registration Number
NCT02848183
Lead Sponsor
Samsung Medical Center
Brief Summary

The purpose of this study is to optimize therapy according to the known risk factors and treatment response in pediatric acute myeloid leukemia (AML)

Detailed Description

I. Risk group assessment Favorable prognosis group: Low risk features + Good response

Intermediate prognosis group:

1. Low risk features + Delayed response-1

2. Standard risk features + Good response

3. Standard risk features + Delayed response-1

Poor prognosis group:

1. Any high risk features irrespective of treatment response

2. Any delayed response-2 irrespective of risk features

3. Any refractory state irrespective of risk features

4. Any early relapse

II. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide

III. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
350
Inclusion Criteria
  • Patients who were newly diagnosed with de novo AML
  • Patients who had recurrent cytogenetic abnormalities of AML even though the bone marrow blast percent is lower than 20%
Exclusion Criteria
  • Acute promyelocytic leukemia
  • Down syndrome AML
  • Therapy-related AML
  • AML developed from myelodysplastic syndrome or other marrow failure syndrome
  • Isolated myeloid sarcoma without bone marrow involvement
  • Patients who cannot undergo chemotherapy as scheduled due to serious complications at diagnosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Pediatric de novo acute myeloid leukemiaHematopoietic stem cell transplantationI. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide II. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning
Pediatric de novo acute myeloid leukemiaCytarabineI. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide II. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning
Pediatric de novo acute myeloid leukemiaIdarubicinI. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide II. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning
Pediatric de novo acute myeloid leukemiaEtoposideI. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide II. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning
Pediatric de novo acute myeloid leukemiaMitoxantroneI. Chemotherapy Induction-1: Cytarabine + idarubicin Induction-2: High dose (HD) cytarabine + mitoxantrone Consolidation-1: Cytarabine + idarubicin Consolidation-2: HD cytarabine + etoposide Consolidation-3: HD cytarabine + mitoxantrone Consolidation-4: HD cytarabine + etoposide II. Allogeneic hematopoietic stem cell transplantation (HSCT) Favorable prognosis group: chemotherapy only Intermediate prognosis group: chemotherapy or HSCT with reduced intensity conditioning Poor prognosis group: HSCT with myeloablative conditioning
Primary Outcome Measures
NameTimeMethod
Rate of event free survivalUp to 5 years
Secondary Outcome Measures
NameTimeMethod
Proportion of patients who achieved complete remissionUp to 3 months

Trial Locations

Locations (3)

Chonnam National University Hwasun Hospital

🇰🇷

Chonnam, Korea, Republic of

St. Mary Hospital

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

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