Combination Chemotherapy With or Without Imatinib Mesylate and/or Peripheral Stem Cell Transplant in Treating Patients With Acute Lymphoblastic Leukemia (LAL0904)
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Purpose
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Imatinib mesylate may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. A peripheral stem cell transplant may be able to replace blood-forming cells that were destroyed by chemotherapy. When the healthy stem cells are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. Giving combination chemotherapy together with imatinib mesylate and peripheral stem cell transplant may be an effective treatment for acute lymphoblastic leukemia.
Nevertheless, in the last few years GIMEMA has pubblished a paper in which 100% of Ph+ ALL patients reach HCR only with Imatinib, without any chemiotherapy. Thus, this treatment will be implemented in patients pertaining to this category.
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia |
Drug: asparaginase Drug: daunorubicin hydrochloride Drug: etoposide Drug: idarubicin Drug: imatinib mesylate Drug: mercaptopurine Drug: methotrexate Drug: methylprednisolone Drug: mitoxantrone hydrochloride Drug: prednisone Drug: vincristine sulfate Procedure: allogeneic hematopoietic stem cell transplantation Procedure: autologous hematopoietic stem cell transplantation Procedure: peripheral blood stem cell transplantation Radiation: radiation therapy |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Prospective Multicenter Phase II Study for the Treatment of Adult Acute Lymphoblastic Leukaemia (ALL): Imatinib in Combination With Chemotherapy in Ph+ Patients, and Post-remissional Treatment Intensification in High-risk Ph- Patients, With Minimal Residual Disease Monitoring. |
- Disease-free survival [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]Evaluation of disease free survival in patients with high risk of remission obtaining a Complete Remission as from the date of hematological complete remission.
- Complete response after HAM [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]Evaluation, in terms of complete response, of HAM as 2nd line treatment in resistant patients not in progression after the 2nd or 3rd induction cycle
- Feasibility of minimal residual disease (MRD) monitoring [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]Feasibility of minimal residual disease in hight and standard risk patients
- Negative prognostic role of MRD positivity [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]
- Rate of complete hematological response after induction therapy in Ph+ patients [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]
- Disease free survival in Ph+ patients [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]
- Cumulative incidence of relapse [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]
- Molecular monitoring of BCR/ABL after complete hematological response [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]
- Overall survival [ Time Frame: At 4 years from study entry ] [ Designated as safety issue: No ]Overall survival from diagnosis
| Estimated Enrollment: | 253 |
| Study Start Date: | October 2004 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
Eligibility| Ages Eligible for Study: | 15 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of acute lymphoblastic leukemia (ALL) meeting the following criteria:
- Negative myeloperoxidase stain
- Phenotype T (T-ALL) or B (B-ALL)
- No mature B-ALL (FAB L3, serum immunoglobulin-positive, terminal deoxynucleotidyl transferase-negative)
PATIENT CHARACTERISTICS:
- Creatinine ≤ 2.5 mg/dL (after adequate hydration)
- SGOT and SGPT ≤ 3 times upper limit of normal
- LVEF ≥ 50%
- No severe psychiatric disorders
- No other concurrent malignant disease
- No presence of documented infections not responding to antibiotic and/or antifungal therapy
- Not pregnant
PRIOR CONCURRENT THERAPY:
- No prior steroids
- No prior antiblastic chemotherapy
- No other concurrent chemotherapy or radiotherapy
Contacts and Locations
Show 66 Study Locations| Study Chair: | Roberto Foa, MD | Universita Degli Studi "La Sapeinza" |
More Information
Additional Information:
Publications:
| Responsible Party: | Gruppo Italiano Malattie EMatologiche dell'Adulto |
| ClinicalTrials.gov Identifier: | NCT00458848 History of Changes |
| Other Study ID Numbers: | LAL0904, GIMEMA-LAL0904, EUDRACT-2004-001738-11 |
| Study First Received: | April 9, 2007 |
| Last Updated: | August 20, 2012 |
| Health Authority: | Italy: Ethics Committee |
Keywords provided by Gruppo Italiano Malattie EMatologiche dell'Adulto:
|
B-cell adult acute lymphoblastic leukemia T-cell adult acute lymphoblastic leukemia untreated adult acute lymphoblastic leukemia |
L1 adult acute lymphoblastic leukemia L2 adult acute lymphoblastic leukemia TdT positive adult acute lymphoblastic leukemia |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Lymphoid Precursor Cell Lymphoblastic Leukemia-Lymphoma Neoplasm, Residual Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Neoplastic Processes Pathologic Processes 6-Mercaptopurine Methotrexate Imatinib |
Asparaginase Daunorubicin Etoposide Idarubicin Methylprednisolone Hemisuccinate Prednisolone Mitoxantrone Prednisone Vincristine Methylprednisolone acetate Prednisolone acetate Methylprednisolone Prednisolone hemisuccinate Prednisolone phosphate Antimetabolites |
ClinicalTrials.gov processed this record on May 21, 2013