Clofarabine, Cytarabine, and Idarubicin in Treating Patients With Intermediate-Risk or High-Risk Acute Myeloid Leukemia or High-Risk Myelodysplasia
- Conditions
- LeukemiaMyelodysplastic Syndromes
- Interventions
- Registration Number
- NCT00838240
- Brief Summary
RATIONALE: Drugs used in chemotherapy, such as clofarabine, cytarabine, and idarubicin, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells.
PURPOSE: This randomized phase I/II trial is studying the side effects and best dose of clofarabine and to see how well it works when given together with cytarabine and idarubicin in treating patients with intermediate-risk or high-risk acute myeloid leukemia or high-risk myelodysplasia.
- Detailed Description
OBJECTIVES:
Primary
* To determine the optimum dose of clofarabine in combination with cytarabine and idarubicin in patients with previously untreated intermediate- and high-risk acute myeloid leukemia or high-risk myelodysplasia. (Phase I)
* To determine the safety and tolerance of this regimen in order to determine the recommended phase II dose. (Phase I)
* To explore the antitumor activity of this regimen in these patients. (Phase II)
* To determine the activity expressed as complete remission (CR)/CR with incomplete hematopoietic recovery (CRi) rate following induction therapy. (Phase II)
Secondary
* To determine the activity expressed as CR/CRi rate following induction (1 or 2 courses) and consolidation therapy. (Phase I)
* To determine hematopoietic recovery (platelets and neutrophils) after induction and consolidation therapy.
* To determine safety and tolerability of this regimen. (Phase II)
* To determine activity expressed as CR/CRi rate after consolidation therapy. (Phase II)
* To determine feasibility of blood CD34 harvesting after consolidation therapy. (Phase II)
* To determine disease-free and overall survival from CR/CRi. (Phase II)
OUTLINE: This is a multicenter, phase I, dose-escalation study of clofarabine followed by an randomized phase II study. Patients are stratified according to center, and presence of poor prognostic features (WBC at diagnosis ≥ 100,000/μL vs presence of very high risk cytogenetic features -5/5q-, -7/7q-, presence of complex abnormalities \[\> 3 abnormalities\], 3q, t\[6;9\], or t\[9;22\]). Patients are randomized to 1 of 2 treatment arms.
* Induction therapy:
* Arm I: Patients receive idarubicin IV over 5 minutes on days 1, 3, and 5, cytarabine IV continuously on days 1-10, and clofarabine IV over 1 hour on days 2, 4, 6, 8, and 10.
* Arm II: Patients receive idarubicin IV and cytarabine IV as in arm I. Patients also receive clofarabine IV by push injection over 10 minutes on days 2, 4, 6, 8, and 10.
* Consolidation therapy: Patients receive cytarabine IV over 2 hours every 12 hours on days 1-6 and idarubicin IV over 5 minutes once daily on days 4-6.
After completion of study therapy, patients are followed periodically for 12 months.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 114
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm I cytarabine Patients receive idarubicin IV over 5 minutes on days 1, 3, and 5, cytarabine IV continuously on days 1-10, and clofarabine IV over 1 hour on days 2, 4, 6, 8, and 10. Arm I clofarabine Patients receive idarubicin IV over 5 minutes on days 1, 3, and 5, cytarabine IV continuously on days 1-10, and clofarabine IV over 1 hour on days 2, 4, 6, 8, and 10. Arm I idarubicin Patients receive idarubicin IV over 5 minutes on days 1, 3, and 5, cytarabine IV continuously on days 1-10, and clofarabine IV over 1 hour on days 2, 4, 6, 8, and 10. Arm II clofarabine Patients receive idarubicin IV and cytarabine IV as in arm I. Patients also receive clofarabine IV by push injection over 10 minutes on days 2, 4, 6, 8, and 10. Arm II cytarabine Patients receive idarubicin IV and cytarabine IV as in arm I. Patients also receive clofarabine IV by push injection over 10 minutes on days 2, 4, 6, 8, and 10. Arm II idarubicin Patients receive idarubicin IV and cytarabine IV as in arm I. Patients also receive clofarabine IV by push injection over 10 minutes on days 2, 4, 6, 8, and 10.
- Primary Outcome Measures
Name Time Method Response rate (Phase II) Toxicity as assessed by CTCAE v3.0 (Phase I)
- Secondary Outcome Measures
Name Time Method Toxicity as assessed by CTCAE v3.0 (Phase II) Response rate (Phase I) Duration of survival Disease-free survival from CR/CRi Incidence of relapse and incidence of death in CR/CRi Duration of survival from complete remission (CR)/CR with incomplete hematopoietic recovery (CRi) rate
Trial Locations
- Locations (10)
Institut Jules Bordet
🇧🇪Brussel, Belgium
Azienda Ospedallera Universitaria - Policlinico Tor Vergata
🇮🇹Roma, Italy
Univesita Degli Studi "La Sapienza"
🇮🇹Roma, Italy
Leiden University Medical Center
🇳🇱Leiden, Netherlands
Radboud University Nijmegen Medical Center
🇳🇱Nijmegen, Netherlands
Jeroen Bosch Ziekenhuis
🇳🇱s' Hertogenbosch, Netherlands
A.Z. Sint-Jan
🇧🇪Brugge, Belgium
CHU Sart-Tilman
🇧🇪Liège, Belgium
Hôpital Saint Antoine AP-HP
🇫🇷Paris, France
University Hospital Rebro
🇭🇷Zagreb, Croatia