Flavopiridol, Cytarabine, and Mitoxantrone in Treating Patients With Acute Leukemia
Recurrent Adult Acute Lymphoblastic Leukemia, Recurrent Adult Acute Myeloid Leukemia, Secondary Acute Myeloid Leukemia
About this trial
This is an interventional treatment trial for Recurrent Adult Acute Lymphoblastic Leukemia
Eligibility Criteria
Inclusion Criteria: Established diagnoses of poor-risk hematologic malignancies will be considered eligible for this Phase I/II study Pathological confirmation of the diagnosis of AML or ALL ECOG performance status 0,1,2 Patients must be able to give informed consent Female patients of childbearing age must have negative pregnancy test AST and ALT =< 2.5 x normal Alkaline phosphatase =< 2.5 x normal Bilirubin =< 1.5 x normal Serum creatinine =< 2.0 mg/dl Left ventricular ejection fraction must >= 45% by MUGA or Echocardiogram Acute Myelogenous Leukemia (AML) AML arising from MDS Secondary AML Relapsed or refractory AML, including primary induction failure Acute Lymphoblastic Leukemia (ALL) Relapsed or refractory ALL, including primary induction failure Patients who fail primary induction therapy or who relapse after achieving complete remission (CR) are eligible if they have undergone no more than 3 prior courses of induction/reinduction There should be an interval of at least 4 weeks from any previous intensive chemotherapy before beginning flavopiridol, with the exceptions non-aplasia producing treatments (i.e. hydroxyurea, interferon, imatinib, 6MP, thalidomide); patients should have recovered completely from any treatment-related toxicities; patients may have received hematopoietic growth factors previously, but must be off all growth factors (including EPO, G-CSF, GM-CSF, IL-3, IL-11) for at least 4 days prior to beginning flavopiridol Patients who have undergone stem cell transplantation (SCT), autologous or allogeneic, are eligible provided that they are >= 4 weeks from stem cell infusion, have no active GVHD, and meet other eligibility criteria Exclusion Criteria: Hyperleukocytosis with >= 50,000 leukemic blasts/mm^3 Active, uncontrolled infection Disseminated intravascular coagulation Active CNS leukemia Concomitant chemotherapy, radiation therapy or immunotherapy Intrinsic impaired cardiac function (MI within the preceding 3 months or history of severe coronary artery disease, cardiomyopathy, CHF > Class II) History of congestive heart disease, or arrhythmia without regard to time, severity or resolution Women who are pregnant or lactating will not be eligible for this trial, as the investigational agent may be harmful to the developing fetus or nursing infant
Sites / Locations
- Johns Hopkins University
Arms of the Study
Arm 1
Experimental
Treatment (flavopiridol, cytarabine, mitoxantrone)
Patients receive flavopiridol IV over 1 hour on days 1-3 and cytarabine IV continuously on days 6-9 followed by mitoxantrone IV over 30-150 minutes on day 9. Patients achieving a partial or complete response after the first course of therapy may receive an additional course of therapy beginning 35 ± 7 days after blood count recovery.