ALFA-0703 Study in Older Patients With Acute Myeloblastic Leukemia (AML) (ALFA-0703)
Acute Myeloid Leukemia
About this trial
This is an interventional treatment trial for Acute Myeloid Leukemia focused on measuring Acute Myeloid Leukemia, Aged of 65 to 79 years, Older Patients with Acute Myeloblastic Leukemia
Eligibility Criteria
Inclusion Criteria:
- Aged of 65 to 79 years
- With a morphologically proven diagnosis of AML according to WHO classification either de novo or AML with "myelodysplasia related changes"
- Not previously treated for AML
- Signed informed consent.
Exclusion Criteria:
- APL in the WHO classification.
- Ph1-positive AML or prior Ph1-positive disease
- AML evolving from a prior MPN in the WHO 2008 classification.
- Prior treatment with chemotherapy or radiotherapy for another tumor
- Prior tumor, if not stable for at least two years, except in-situ carcinoma and skin carcinoma
- Prior advanced malignant hepatic tumor
- ECOG Performance Status Score > 2
- Creatinine level more than 2x's the upper limit of the normal range (ULN) at the laboratory where the analysis was performed, except if AML-related.
- Total serum bilirubin more than 2x's the ULN at the laboratory where the analysis was performed, except if AML-related.
- AST (SGOT) or ALT (SGPT) more than 2.5x's the ULN at the laboratory where the analysis was performed, except if AML-related
- LVEF less than.55 or equivalent by doppler echocardiography
- Known intolerance to Azacitidine, mannitol, retinoids
- Positive serum test for HIV and HTLV-1
- NYHA Grade 3/4 cardiac disease .
- Severe infection at inclusion time.
- Psychiatric disease or an history of non-compliance to medical regimens or patients considered potentially unreliable.
- Absence of health care insurance (affiliation à un régime de Sécurité Sociale)
- Participation to any study requiring informed consent
Sites / Locations
- Chu Amiens Sud
- CH
- Hopital Avicenne
- Chu Boulogne Sur Mer
- CH
- Hopital Percy
- Ch Sud Francilien
- Hopital Henri Mondor
- Ch Dunkerque
- CH
- CHU
- CH
- Hopital Edouard Herriot
- CH
- Centre Antoine Lacassagne
- Necker Hospital
- St Antoine Hospital
- Hopital Pitie-Salpetriere
- Hopital Saint-Louis
- Ch Rene Dubos
- CH
- CHU
- CNLCC
- CH
- CH
- IGR
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Experimental
No Intervention
Experimental
Experimental
Experimental
Experimental
R1 Arm A : ATRA
R1 Arm B : no ATRA
R2 Arm 1A : AZACITIDINE and ATRA
R2 Arm 1B : AZACITIDINE and No ATRA
R2 Arm 2A : ATRA
R2 Arm 2B : no ATRA
Idarubicin: 9 mg/m2/d D1 to D4 Cytarabine : 200 mg/m2/d Continuous IV from D1 to D7 Peg-filgrastim : 6 mg SC D9 or filgrastim 5ug/kg/d SC or lenograstim 263ug/d IV 30mn, both from D9 to myeloid recovery(PMN >1G/l over 2 days at minimum All-trans retinoic acid (ATRA): 45mg/m2/day in two divided doses from D8 to D28
Idarubicin: 9 mg/m2/d D1 to D4 Cytarabine : 200 mg/m2/d Continuous IV from D1 to D7 Peg-filgrastim : 6 mg SC D9 or filgrastim 5ug/kg/d SC or lenograstim 263ug/d IV 30mn, both from D9 to myeloid recovery(PMN >1G/l over 2 days at minimum
Azacitidine: 75 mg/m2/12h SC from D1 to D5 Idarubicine: 9 mg/m2/d IV on D5 All-trans retinoic acid (ATRA): 45mg/m2/d in two divided doses from D8 to D21
Azacitidine: 75 mg/m2/12h SC from D1 to D5 Idarubicine: 9 mg/m2/d IV on D5
Idarubicine : 9 mg/m2/d IV on D1 Cytarabine : 60 mg/m2/12h SC from D1 to D5 All-trans retinoic acid (ATRA): 45mg/ m2/d in two divided doses from D8 to D21
Idarubicine : 9 mg/m2/d IV on D1 Cytarabine : 60 mg/m2/12h SC from D1 to D5