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Reactogenicity, Immunogenicity of Trivalent Influenza Vaccine With Recombinant Interferon Alpha Among Chronic Lymphocytic Leukemia

Primary Purpose

Chronic Lymphocytic Leukemia

Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Influenza Vaccine Trivalent Inactivated (TIV)
Pegylated interferon (PEGrIFN-α, Pegasys)
Interferon (IFNα, Roferon-A)
Sponsored by
M.D. Anderson Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Lymphocytic Leukemia focused on measuring Leukemia, CLL, Influenza Vaccine Trivalent Inactivated, TIV, Flu, Pegasys, Pegylated interferon, Roferon, Interferon

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Capable of understanding the protocol requirements and risks and providing written informed consent.
  2. Patients with histologically or cytologically confirmed diagnosis of chronic lymphocytic leukemia according to established guidelines.
  3. Patients with Rai stages 0 to 4.
  4. Age >/= 18 years old.
  5. If patients have been treated with antineoplastic therapy, it must have been finished 3 months or longer prior to enrollment.
  6. Patients with complete or partial remission and those with stable (CLL) disease will be considered.
  7. Patients who have received influenza vaccine in past 4 months will also be considered.
  8. Patients willing to receive recombinant cytokine.
  9. Patient willing to receive commercially available influenza vaccine that will not provide protection against the following years of influenza strains.
  10. Patients must have adequate hepatic function defined as follows: total bilirubin </= 2.0 mg/dL; SGOT and /or SGPT </= 3 x upper normal limit of the reference laboratory value unless liver function abnormalities are considered due to underlying cancer or congenital hemolytic disorders.
  11. Patient should avoid H2 blockers while on study. However, if H2 blockers are required to use, this will be reported and will be taken in consideration during response rate analysis.
  12. Females patients who are able to have children must agrees to remain abstinent or use (or have their partner use) 2 acceptable methods of birth control during the time period starting 2 weeks prior to enrollment through 1 month from last vaccination dose. Acceptable methods of birth control are: intrauterine device (IUD), diaphragm with spermicide, contraceptive sponge and condom. If they suspect pregnancy during the study, they must notify the study doctor.

Exclusion Criteria:

  1. Concurrent serious medical illness in the opinion of Principle Investigator that could potentially interfere with protocol compliance.
  2. Concurrent or previous malignancy whose prognosis is poor (< 90% probability of survival is 5 years).
  3. History of known chronic viral infections within 12 months, including HIV and Hepatitis B or Hepatitis C. A screening for hepatitis or HIV will not be performed for this study.
  4. Positive screening pregnancy test within 2 weeks in non-menopausal women or breast-feeding.
  5. Patients with known allergy to either vaccine or interferon preparation.
  6. Patients with neutropenia (ANC < 500 cells/uL) within 4 weeks.
  7. Patients with lymphocytopenia (ALC < 300 cells/uL) within 4 weeks.
  8. Concomitant use of investigational vaccines and/or medications within four weeks prior to study entry, or expected use of experimental or licensed vaccines or blood/blood products prior to study completion.
  9. Receipt of immunoglobulin in 3 months.
  10. Subject is enrolled in a conflicting clinical trial.
  11. History of Guillain-Barre Syndrome.
  12. Has an acute illness including an oral temperature greater than 100.4°F, within one week of vaccination.
  13. In patients who have prior therapy with fludarabine or alemtuzumab (Campath®), the treatment must have completed 12 months prior to enrollment.
  14. In patients who have prior therapy with Rituximab (Rituxan®), the treatment must have completed 6 months prior to enrollment.
  15. Patients with history of medically significant psychiatric disease, especially endogenous depression (not reactive to diagnosis of cancer), psychosis and bipolar disorder.
  16. Patients with seizure disorders requiring anticonvulsant therapy.
  17. Patients with history of severe cardiac disease with New York Heart Association (NYHA) grade 3 or 4.
  18. Patients with severe renal disease requiring hemodialysis.
  19. Patients who have received H2 blockers such as Ranitidine, Cimetidine, or Famotidine within 4 weeks prior to enrollment.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Experimental

    Experimental

    Experimental

    Arm Label

    TIV

    TIV + PEGrIFN-α

    TIV + IFNα

    Arm Description

    TIV (Influenza Vaccine Trivalent Inactivated) alone

    TIV + Pegylated Interferon

    TIV + Interferon

    Outcomes

    Primary Outcome Measures

    Immunogenicity rate

    Secondary Outcome Measures

    Full Information

    First Posted
    August 19, 2009
    Last Updated
    August 2, 2012
    Sponsor
    M.D. Anderson Cancer Center
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00962715
    Brief Title
    Reactogenicity, Immunogenicity of Trivalent Influenza Vaccine With Recombinant Interferon Alpha Among Chronic Lymphocytic Leukemia
    Official Title
    A Randomized, Phase I/II Clinical Trial Evaluating the Safety, Reactogenicity, and Immunogenicity of Licensed Trivalent Influenza Vaccine Administered With Recombinant Interferon Alpha Among Patients With Chronic Lymphocytic Leukemia
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2012
    Overall Recruitment Status
    Withdrawn
    Study Start Date
    April 2011 (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    M.D. Anderson Cancer Center

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The goal of this clinical study is to learn if Pegasys (pegylated interferon) or Roferon (interferon) can make the Trivalent Inactivated Influenza vaccine (TIV) more effective in increasing the body's immune reaction against the flu virus in patients with Chronic Lymphocytic Leukemia (CLL).
    Detailed Description
    The Study Drugs: Pegylated interferon and interferon are designed to stop the growth of viruses. Pegylated interferon has a molecule that makes it last longer in the body. Standard interferon does not have this molecule that makes it last longer. TIV is designed to prevent the flu. Screening Test: Before you can start treatment on this study, you will have a "screening test" to help the doctor decide if you are eligible to take part in this study. Blood (about 4 teaspoons) will be drawn for routine tests. If you have had a routine blood test in the last 4 weeks, this blood will not need to be drawn. Women who are able to have children must have a negative blood (about 1 teaspoon) blood test within 2 weeks of study entry. Study Groups: If you are found to be eligible to take part in this study, you will be randomly assigned (as in the roll of dice) to 1 of 3 groups. If you are assigned to Group 1, you will receive TIV alone. If you are assigned to Group 2, you will receive pegylated interferon with TIV. If you are assigned to Group 3, you will receive interferon with TIV. You will have an equal chance of being assigned to any of the 3 groups. Your doctor, the study doctor, study staff, and you will know which group you are in. Study Drug Administration: You will receive TIV through a needle into a muscle in your arm (the arm you do not write with) on Days 1 and 28. If you are in Group 1, you will only receive TIV If you are in Group 2, you will receive pegylated interferon right before you receive TIV. It will be given through a needle under the skin. It will be given near the TIV injection site. If you are in Group 3, you will receive interferon right before you receive TIV. It will be given through a needle under the skin. It will be given near the TIV injection site. After you are given the injection(s), you will be watched for 15 minutes in the clinic before you are allowed to go home. You will keep a diary for 1 week (7 days) after the injection(s). In it, you will record any symptoms you may be experiencing, and you will also record your body temperature. Study Visits: On Day 1, blood (about 4 teaspoons) will be drawn to check your immune system's response to the flu virus. On Day 8, you will be asked to return to the clinic and your symptom/temperature diary will be reviewed. If you cannot come to the clinic, a member of the research staff will call you to review this information. This phone call will take 15-30 minutes. On Day 28, blood (about 4 teaspoons) will be drawn to check your immune system response to the flu virus. On Day 56, blood (about 4 teaspoons) will be drawn to check you immune system response to the flu virus. If you live out of town and cannot return to M. D. Anderson for this visit, you may have your blood drawn at a local clinic. You will then mail the blood to the study doctor in a pre-paid envelope. On Month 6, you will be called and asked about any side effects you may have experienced. This phone call will take 15-30 minutes. Length of Study: You will be considered off study after the Month 6 phone call. You will be taken off-study early if intolerable side effects or an allergic reaction occurs. This is an investigational study. TIV, pegylated interferon, and interferon are FDA approved and commercially available. At this time, the use of pegylated interferon and standard interferon with TIV is only being used for research. Up to 60 patients will take part in this study. All will be enrolled at M. D. Anderson.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Chronic Lymphocytic Leukemia
    Keywords
    Leukemia, CLL, Influenza Vaccine Trivalent Inactivated, TIV, Flu, Pegasys, Pegylated interferon, Roferon, Interferon

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    TIV
    Arm Type
    Experimental
    Arm Description
    TIV (Influenza Vaccine Trivalent Inactivated) alone
    Arm Title
    TIV + PEGrIFN-α
    Arm Type
    Experimental
    Arm Description
    TIV + Pegylated Interferon
    Arm Title
    TIV + IFNα
    Arm Type
    Experimental
    Arm Description
    TIV + Interferon
    Intervention Type
    Biological
    Intervention Name(s)
    Influenza Vaccine Trivalent Inactivated (TIV)
    Intervention Description
    15 μg (0.5 ml) through needle into arm muscle on Days 1 and 28.
    Intervention Type
    Drug
    Intervention Name(s)
    Pegylated interferon (PEGrIFN-α, Pegasys)
    Other Intervention Name(s)
    Pegasys, Peginterferon alfa-2a
    Intervention Description
    180 μg (0.5 ml) before receiving TIV, through a needle under the skin.
    Intervention Type
    Drug
    Intervention Name(s)
    Interferon (IFNα, Roferon-A)
    Other Intervention Name(s)
    Roferon-A, Interferon alfa-2a
    Intervention Description
    3 million units (0.5 ml) before receiving TIV, through a needle under the skin.
    Primary Outcome Measure Information:
    Title
    Immunogenicity rate
    Time Frame
    Day 1, 8, 28, 56 and 6 Months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Capable of understanding the protocol requirements and risks and providing written informed consent. Patients with histologically or cytologically confirmed diagnosis of chronic lymphocytic leukemia according to established guidelines. Patients with Rai stages 0 to 4. Age >/= 18 years old. If patients have been treated with antineoplastic therapy, it must have been finished 3 months or longer prior to enrollment. Patients with complete or partial remission and those with stable (CLL) disease will be considered. Patients who have received influenza vaccine in past 4 months will also be considered. Patients willing to receive recombinant cytokine. Patient willing to receive commercially available influenza vaccine that will not provide protection against the following years of influenza strains. Patients must have adequate hepatic function defined as follows: total bilirubin </= 2.0 mg/dL; SGOT and /or SGPT </= 3 x upper normal limit of the reference laboratory value unless liver function abnormalities are considered due to underlying cancer or congenital hemolytic disorders. Patient should avoid H2 blockers while on study. However, if H2 blockers are required to use, this will be reported and will be taken in consideration during response rate analysis. Females patients who are able to have children must agrees to remain abstinent or use (or have their partner use) 2 acceptable methods of birth control during the time period starting 2 weeks prior to enrollment through 1 month from last vaccination dose. Acceptable methods of birth control are: intrauterine device (IUD), diaphragm with spermicide, contraceptive sponge and condom. If they suspect pregnancy during the study, they must notify the study doctor. Exclusion Criteria: Concurrent serious medical illness in the opinion of Principle Investigator that could potentially interfere with protocol compliance. Concurrent or previous malignancy whose prognosis is poor (< 90% probability of survival is 5 years). History of known chronic viral infections within 12 months, including HIV and Hepatitis B or Hepatitis C. A screening for hepatitis or HIV will not be performed for this study. Positive screening pregnancy test within 2 weeks in non-menopausal women or breast-feeding. Patients with known allergy to either vaccine or interferon preparation. Patients with neutropenia (ANC < 500 cells/uL) within 4 weeks. Patients with lymphocytopenia (ALC < 300 cells/uL) within 4 weeks. Concomitant use of investigational vaccines and/or medications within four weeks prior to study entry, or expected use of experimental or licensed vaccines or blood/blood products prior to study completion. Receipt of immunoglobulin in 3 months. Subject is enrolled in a conflicting clinical trial. History of Guillain-Barre Syndrome. Has an acute illness including an oral temperature greater than 100.4°F, within one week of vaccination. In patients who have prior therapy with fludarabine or alemtuzumab (Campath®), the treatment must have completed 12 months prior to enrollment. In patients who have prior therapy with Rituximab (Rituxan®), the treatment must have completed 6 months prior to enrollment. Patients with history of medically significant psychiatric disease, especially endogenous depression (not reactive to diagnosis of cancer), psychosis and bipolar disorder. Patients with seizure disorders requiring anticonvulsant therapy. Patients with history of severe cardiac disease with New York Heart Association (NYHA) grade 3 or 4. Patients with severe renal disease requiring hemodialysis. Patients who have received H2 blockers such as Ranitidine, Cimetidine, or Famotidine within 4 weeks prior to enrollment.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Amar Safdar, MD
    Organizational Affiliation
    UT MD Anderson Cancer Center
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Links:
    URL
    http://www.mdanderson.org
    Description
    UT MD Anderson Cancer Center website

    Learn more about this trial

    Reactogenicity, Immunogenicity of Trivalent Influenza Vaccine With Recombinant Interferon Alpha Among Chronic Lymphocytic Leukemia

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