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Molecular Evaluation of AML Patients After Stem Cell Transplant to Understand Relapse Events

Active, not recruiting
Conditions
Acute Myeloid Leukemia in Remission
Interventions
Other: Prospective determination of the clinical utility of measurable residual disease (MRD) testing
Registration Number
NCT05224661
Lead Sponsor
Center for International Blood and Marrow Transplant Research
Brief Summary

Prospective determination of the clinical utility of measurable residual disease (MRD) testing for relapse and survival of patients with acute myeloid leukemia (AML) undergoing allogeneic hematopoietic cell transplantation (alloHCT).

Detailed Description

This is a multi-center non-randomized prospective study designed to establish a national framework for introducing measurable residual disease testing into the clinical care of AML patients undergoing allogeneic transplantation.

Enrollment is expected to occur over a 4-year period, with an additional 3 years of follow-up. Subject participation this study will be approximately 3 years. Up to 1,000 subjects will be enrolled.

Subjects will be asked to provide blood samples at months 1-6, 9, 12, 15, and 18 post-transplant, and archived specimens from time of AML diagnosis and any bone marrow samples collected for clinical purposes will be requested for research testing. Additional blood and marrow samples will be requested at relapse (if applicable).

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
303
Inclusion Criteria
  1. Provision of signed and dated informed consent form

  2. Stated willingness to comply with all study procedures and availability for the duration of the study

  3. Aged at least 18 years old at time of consent

  4. Diagnosed with AML, in complete remission

    1. Complete remission (CR) definition per local institutional criteria
    2. CR with incomplete hematologic recovery (CRi) is not an exclusion criterion
    3. MRD positivity is not an exclusion criterion
  5. Undergoing alloHCT

  6. Has a diagnostic AML specimen available

Exclusion Criteria
  1. Diagnosis of acute promyelocytic leukemia
  2. Prior alloHCT

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Adult patients with AML in complete remission undergoing alloHCTProspective determination of the clinical utility of measurable residual disease (MRD) testingAdult patients with AML in complete remission undergoing alloHCT
Primary Outcome Measures
NameTimeMethod
Overall SurvivalThrough up to 3 years post-alloHCT

Overall survival post-alloHCT via comparison between those testing positive or negative using an optimized molecular monitoring approach.

Cumulative incidence of relapseThrough up to 3 years post-alloHCT

Cumulative incidence of relapse post-alloHCT via comparison between those testing positive or negative using an optimized molecular monitoring approach.

Secondary Outcome Measures
NameTimeMethod
Relapse Prediction - Testing ApproachesThrough up to 3 years post-alloHCT

Proportion of post-alloHCT relapses identified by different MRD testing approaches with optimal test thresholds at peri-transplant timepoints.

Relapse Prediction - Early PredictionThrough up to 3 years post-alloHCT

Proportion of post-alloHCT relapses identified one month or more earlier than local testing by post-alloHCT optimized monitoring.

Relapse Prediction - Pre-Transplant TestingThrough up to 3 years post-alloHCT

Proportion of post-alloHCT relapses predicted by pre-transplant testing (comparing blood with marrow when available).

Biology of Relapse - Change in Genetic ProfileThrough up to 3 years post-alloHCT

for subjects with relapse sample available) - Proportion of relapses with change in genetic profile to diagnosis.

Relapse Prediction - Time to RelapseThrough up to 3 years post-alloHCT

Time from testing positive by optimized monitoring to relapse.

Biology of Relapse - Change in ImmunophenotypeThrough up to 3 years post-alloHCT

(for subjects with relapse sample available) - Proportion of relapses with change in immunophenotype to diagnosis.

Biology of Relapse - HLA LossThrough up to 3 years post-alloHCT

(for subjects with relapse sample available) - Proportion of relapses with evidence of human leukocyte antigen (HLA) loss.

Trial Locations

Locations (18)

City of Hope

🇺🇸

Duarte, California, United States

University of California, San Francisco

🇺🇸

San Francisco, California, United States

Stanford University

🇺🇸

Stanford, California, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

University of Miami

🇺🇸

Miami, Florida, United States

H. Lee Moffitt Cancer Center

🇺🇸

Tampa, Florida, United States

Northside Hospital

🇺🇸

Atlanta, Georgia, United States

University of Chicago Medicine

🇺🇸

Chicago, Illinois, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Dana Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Roswell Park Comprehensive Cancer Center

🇺🇸

Buffalo, New York, United States

Memorial Sloan Kettering Cancer Center

🇺🇸

New York, New York, United States

New York Presbyterian / Weill Cornell Medical Center

🇺🇸

New York, New York, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

The Ohio State University Comprehensive Cancer Center

🇺🇸

Columbus, Ohio, United States

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Fred Hutchinson Cancer Center

🇺🇸

Seattle, Washington, United States

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