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Chemotherapy in Treating Children With Relapsed Acute Leukemia, Acute Myeloid Leukemia, or Blastic Phase Chronic Myelogenous Leukemia

Phase 2
Completed
Conditions
Leukemia
Interventions
Registration Number
NCT00003735
Lead Sponsor
Children's Oncology Group
Brief Summary

RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die.

PURPOSE: Phase II trial to study the effectiveness of topotecan in treating children who have relapsed acute leukemia, acute myeloid leukemia, or blast phase chronic myelogenous leukemia.

Detailed Description

OBJECTIVES: I. Determine the response rate of patients with relapsed acute lymphocytic leukemia, acute myeloid leukemia, or blastic phase chronic myelogenous leukemia treated with oral topotecan. II. Determine the toxic effects and pharmacokinetics of this regimen in these patients.

OUTLINE: Patients are stratified by disease type (acute lymphocytic leukemia vs acute myeloid leukemia). Patients receive oral topotecan once daily on days 1-21. Courses repeat every 28 days in the absence of blasts in the blood, M3 bone marrow, or unacceptable toxicity. Patients are followed every 6 months until death.

PROJECTED ACCRUAL: A total of 50 patients (25 per stratum) will be accrued for this study within 2 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
11
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Stratum 2 - Stage 2topotecan hydrochlorideTopotecan hydrochloride (0.8 mg/m²/day) by mouth for 21 days. Bone marrow will be obtained on approximately Day 28 of Course 1 and 2 and in any course where the CBC suggests that a relapse has occurred. One additional course may be given if the blood is cleared of blasts and the bone marrow is M1, M2 or M3. The patient is off protocol therapy if blasts are still present in the blood and the marrow is M3. Subsequent courses of topotecan may be given only if the bone marrow after Course 2 is M1 or M2. If the bone marrow is M2 on Day 28 of any course, another bone marrow aspirate will be done at the end of the next course. If the patient is in CR, a bone marrow aspirate will be required only every other course unless the peripheral blood suggests that a relapse has occurred. Each subsequent course should begin within six weeks of the start of the previous course.
Stratum 1 - Stage 1topotecan hydrochlorideTopotecan hydrochloride (0.8 mg/m²/day) by mouth for 21 days. Bone marrow will be obtained on approximately Day 28 of Course 1 and 2 and in any course where the CBC suggests that a relapse has occurred. One additional course may be given if the blood is cleared of blasts and the bone marrow is M1, M2 or M3. The patient is off protocol therapy if blasts are still present in the blood and the marrow is M3. Subsequent courses of topotecan may be given only if the bone marrow after Course 2 is M1 or M2. If the bone marrow is M2 on Day 28 of any course, another bone marrow aspirate will be done at the end of the next course. If the patient is in CR, a bone marrow aspirate will be required only every other course unless the peripheral blood suggests that a relapse has occurred. Each subsequent course should begin within six weeks of the start of the previous course.
Primary Outcome Measures
NameTimeMethod
Disease Progression21 days

For each stratum, this trial will determine topotecan to have insufficient activity for further investigation with probability 0.10 if the true response rate is 20%. For each stratum, this trial will determine topotecan to be of sufficient activity to warrant further investigation with probability 0.12 if the true response rate is 5%. Any patient who receives at least 21 days of therapy will be considered evaluable for response.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (38)

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Jonsson Comprehensive Cancer Center, UCLA

🇺🇸

Los Angeles, California, United States

Lineberger Comprehensive Cancer Center, UNC

🇺🇸

Chapel Hill, North Carolina, United States

CCOP - Kalamazoo

🇺🇸

Kalamazoo, Michigan, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

University of Michigan Comprehensive Cancer Center

🇺🇸

Ann Arbor, Michigan, United States

Mayo Clinic Cancer Center

🇺🇸

Rochester, Minnesota, United States

Children's Mercy Hospital

🇺🇸

Kansas City, Missouri, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

NYU School of Medicine's Kaplan Comprehensive Cancer Center

🇺🇸

New York, New York, United States

St. Joseph's Hospital and Medical Center

🇺🇸

Paterson, New Jersey, United States

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

Herbert Irving Comprehensive Cancer Center

🇺🇸

New York, New York, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

University of Wisconsin Comprehensive Cancer Center

🇺🇸

Madison, Wisconsin, United States

British Columbia Children's Hospital

🇨🇦

Vancouver, British Columbia, Canada

IWK Grace Health Centre

🇨🇦

Halifax, Nova Scotia, Canada

Children's Hospital of Orange County

🇺🇸

Orange, California, United States

Princess Margaret Hospital for Children

🇦🇺

Perth, Western Australia, Australia

Veterans Affairs Medical Center - Fargo

🇺🇸

Fargo, North Dakota, United States

CCOP - Merit Care Hospital

🇺🇸

Fargo, North Dakota, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Indiana University Cancer Center

🇺🇸

Indianapolis, Indiana, United States

UCSF Cancer Center and Cancer Research Institute

🇺🇸

San Francisco, California, United States

Children's Hospital of Denver

🇺🇸

Denver, Colorado, United States

Doernbecher Children's Hospital

🇺🇸

Portland, Oregon, United States

Ireland Cancer Center

🇺🇸

Cleveland, Ohio, United States

University of Texas - MD Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Children's Hospital and Regional Medical Center - Seattle

🇺🇸

Seattle, Washington, United States

Children's Hospital Medical Center - Cincinnati

🇺🇸

Cincinnati, Ohio, United States

Children's Hospital of Columbus

🇺🇸

Columbus, Ohio, United States

Children's Hospital of Pittsburgh

🇺🇸

Pittsburgh, Pennsylvania, United States

Huntsman Cancer Institute

🇺🇸

Salt Lake City, Utah, United States

Fred Hutchinson Cancer Research Center

🇺🇸

Seattle, Washington, United States

Vanderbilt Cancer Center

🇺🇸

Nashville, Tennessee, United States

Long Beach Memorial Medical Center

🇺🇸

Long Beach, California, United States

Cancer Institute of New Jersey

🇺🇸

New Brunswick, New Jersey, United States

Children's National Medical Center

🇺🇸

Washington, District of Columbia, United States

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