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Decitabine, Cytarabine, GCSF for Refractory AML/MDS

Primary Purpose

Myelodysplasia, Leukemia

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
chemotherapy
Sponsored by
Brown University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplasia focused on measuring myelodysplasia, refractory leukemia, acute leukemia

Eligibility Criteria

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

Inclusion Criteria:

  • All patients must have histological confirmation of disease prior to enrollment on study.
  • Patients with de novo AML who are not eligible for induction chemotherapy are eligible. Patients with refractory, relapsed AML are eligible.
  • Patients with AML evolving from prior MDS or secondary to prior chemotherapy are eligible provided they are not eligible for standard induction chemotherapy.
  • Patients with MDS and with blasts > 10% (RAEB-II) are eligible.
  • Patients with extramedullary relapse only (i.e., leukemia cutis or other extramedullary site) are eligible as long as disease can be monitored.
  • Patients who have relapsed after standard autologous and/or allogeneic bone marrow transplant are eligible as long as they meet all other eligibility criteria.
  • Patients must not have had any chemotherapy, except hydrea, or radiation for at least 4 weeks prior.
  • Patients must be > 18 years of age.
  • Patients with an active second malignancy other than non-melanoma skin cancers are not eligible.
  • Patients must have an expected life expectancy of > 12 weeks at the time of enrollment.
  • Patients with visceral, blood stream or nervous system opportunistic infection are eligible if the infection has been appropriately treated and controlled. Patients with fungal lung infections must have had treatment for at least one month and have proof of regression prior to enrollment. Patients may be on antimicrobials at the time of therapy.
  • Initial required laboratory values:

    • Total Bilirubin < 2 X upper limit of normal.
    • AST & ALT < 3 X upper limit of normal (if elevated liver enzymes thought likely due to Leukemic infiltrate discuss with the Principal Investigator and the BrUOG Central Office).
    • Creatinine < 2 mg/dl.
    • < 15,000 K/uI blast count-Hydroxyurea can be used to decrease count if more than 15,000 K/ul.
  • Patients must have an ECOG performance status of 0-2.
  • Patients must receive and sign a full informed consent.
  • Patients should not have co-existing medical illnesses which would limit survival < 12 weeks.
  • No known history of HIV.
  • The safety of decitabine in human pregnancy is unknown. Based on animal studies, decitabine may cause fetal harm when administered to a pregnant woman. Therefore, it is important that you do not become pregnant or father a child while receiving study medication and for 2 months afterwards because the drugs in this study may affect an unborn baby.
  • If you are a woman capable of becoming pregnant (not surgically sterile or post-menopausal), you must have a negative pregnancy test before beginning treatment.

If you do become pregnant, suspect you are pregnant, or if your partner becomes pregnant while you are on this study, you must notify your study doctor immediately. If you become pregnant, you will be taken off this study.

In addition, you must not breast feed at any time you are on this study since any drugs you are taking may also affect the child.

If you are capable of giving birth to or fathering a child, you must agree to use a form of birth control (examples of effective birth control are: a condom or a diaphragm with spermicidal jelly; oral, injectable, or implanted birth control; or abstinence) that is medically acceptable to your study doctor while taking part in this research study.

Sites / Locations

  • Lifespan Hospitals

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Chemotherapy

Arm Description

Decitabine 20 mg/m2 IV over 1 hr days 1-5 Cytarabine 20 mg/m2 subcut days 1-5 G-CSF 5mcg/kg subcut days 1-5

Outcomes

Primary Outcome Measures

Response Rate
Complete Response/Complete Remission: Complete remission (CR) is defined as the presence of all of the following: Peripheral blood - No leukemic blasts present. No extramedullary findings of leukemia or disappearance of such (i.e. CNS or soft tissue involvement) Bone marrow No Auer rods Less than 5% blast cells. CBC and bone marrow criteria must be met within one week of each other. Hemoglobin 9g/dl or greater Neutrophil count >1000 and platelet count >100,000. RBC Transfusion free for 2 weeks.

Secondary Outcome Measures

Full Information

First Posted
August 21, 2008
Last Updated
January 5, 2022
Sponsor
Brown University
Collaborators
Memorial Hospital of Rhode Island, Roger Williams Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT00740181
Brief Title
Decitabine, Cytarabine, GCSF for Refractory AML/MDS
Official Title
A Phase II Study With Decitabine, Low Dose Cytarabine and G-CSF in High-risk Myelodysplastic Syndromes, Refractory Acute Myeloid Leukemia or Acute Myeloid Leukemia in Patients With Significant Co-morbidities.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Terminated
Why Stopped
Lack of efficacy
Study Start Date
August 2008 (undefined)
Primary Completion Date
February 2010 (Actual)
Study Completion Date
April 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Brown University
Collaborators
Memorial Hospital of Rhode Island, Roger Williams Medical Center

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will determine the activity of decitabine, low dose cytarabine (ARA-C) and G-CSF for patients with myelodysplasia and leukemia.
Detailed Description
The primary objective of this study is to determine the feasibility and toxicity of decitabine, ARA-C and G-CSF for patients with myelodysplasia, refractory acute leukemia and poor performance status acute leukemia.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplasia, Leukemia
Keywords
myelodysplasia, refractory leukemia, acute leukemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Chemotherapy
Arm Type
Experimental
Arm Description
Decitabine 20 mg/m2 IV over 1 hr days 1-5 Cytarabine 20 mg/m2 subcut days 1-5 G-CSF 5mcg/kg subcut days 1-5
Intervention Type
Drug
Intervention Name(s)
chemotherapy
Primary Outcome Measure Information:
Title
Response Rate
Description
Complete Response/Complete Remission: Complete remission (CR) is defined as the presence of all of the following: Peripheral blood - No leukemic blasts present. No extramedullary findings of leukemia or disappearance of such (i.e. CNS or soft tissue involvement) Bone marrow No Auer rods Less than 5% blast cells. CBC and bone marrow criteria must be met within one week of each other. Hemoglobin 9g/dl or greater Neutrophil count >1000 and platelet count >100,000. RBC Transfusion free for 2 weeks.
Time Frame
within 30 days of last treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All patients must have histological confirmation of disease prior to enrollment on study. Patients with de novo AML who are not eligible for induction chemotherapy are eligible. Patients with refractory, relapsed AML are eligible. Patients with AML evolving from prior MDS or secondary to prior chemotherapy are eligible provided they are not eligible for standard induction chemotherapy. Patients with MDS and with blasts > 10% (RAEB-II) are eligible. Patients with extramedullary relapse only (i.e., leukemia cutis or other extramedullary site) are eligible as long as disease can be monitored. Patients who have relapsed after standard autologous and/or allogeneic bone marrow transplant are eligible as long as they meet all other eligibility criteria. Patients must not have had any chemotherapy, except hydrea, or radiation for at least 4 weeks prior. Patients must be > 18 years of age. Patients with an active second malignancy other than non-melanoma skin cancers are not eligible. Patients must have an expected life expectancy of > 12 weeks at the time of enrollment. Patients with visceral, blood stream or nervous system opportunistic infection are eligible if the infection has been appropriately treated and controlled. Patients with fungal lung infections must have had treatment for at least one month and have proof of regression prior to enrollment. Patients may be on antimicrobials at the time of therapy. Initial required laboratory values: Total Bilirubin < 2 X upper limit of normal. AST & ALT < 3 X upper limit of normal (if elevated liver enzymes thought likely due to Leukemic infiltrate discuss with the Principal Investigator and the BrUOG Central Office). Creatinine < 2 mg/dl. < 15,000 K/uI blast count-Hydroxyurea can be used to decrease count if more than 15,000 K/ul. Patients must have an ECOG performance status of 0-2. Patients must receive and sign a full informed consent. Patients should not have co-existing medical illnesses which would limit survival < 12 weeks. No known history of HIV. The safety of decitabine in human pregnancy is unknown. Based on animal studies, decitabine may cause fetal harm when administered to a pregnant woman. Therefore, it is important that you do not become pregnant or father a child while receiving study medication and for 2 months afterwards because the drugs in this study may affect an unborn baby. If you are a woman capable of becoming pregnant (not surgically sterile or post-menopausal), you must have a negative pregnancy test before beginning treatment. If you do become pregnant, suspect you are pregnant, or if your partner becomes pregnant while you are on this study, you must notify your study doctor immediately. If you become pregnant, you will be taken off this study. In addition, you must not breast feed at any time you are on this study since any drugs you are taking may also affect the child. If you are capable of giving birth to or fathering a child, you must agree to use a form of birth control (examples of effective birth control are: a condom or a diaphragm with spermicidal jelly; oral, injectable, or implanted birth control; or abstinence) that is medically acceptable to your study doctor while taking part in this research study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Butera
Organizational Affiliation
Brown University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lifespan Hospitals
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02903
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Decitabine, Cytarabine, GCSF for Refractory AML/MDS

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