Antifungal Therapy for Fever and Neutropenia in Patients Receiving Treatment for Hematologic Cancer

NCT ID: NCT00002742

Last Updated: 2013-03-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

1996-01-31

Study Completion Date

2007-09-30

Brief Summary

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RATIONALE: Antifungal therapy with liposomal nystatin may reduce fever and neutropenia in patients undergoing treatment for hematologic cancer. It is not yet known whether liposomal nystatin is more effective than standard amphotericin B in treating patients with fever and neutropenia who are receiving chemotherapy for hematologic cancer or bone marrow transplantation for leukemia.

PURPOSE: Randomized phase III trial to study the effectiveness of liposomal nystatin compared with standard amphotericin B to treat fever and neutropenia in patients receiving chemotherapy for hematologic cancer or bone marrow transplantation for leukemia.

Detailed Description

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OBJECTIVES: I. Compare the efficacy of liposomal nystatin vs standard amphotericin B for the empiric treatment of persistent febrile neutropenic patients. II. Compare the incidence of drug-related toxicity or impairment and infusion-related toxicity in patients treated with liposomal nystatin vs standard amphotericin B. III. Determine the pharmacokinetics of liposomal nystatin.

OUTLINE: Randomized, double-blind study. Arm I: Antifungal Therapy. Liposomal Nystatin. Arm II: Antifungal Therapy. Amphotericin B, NSC-527017.

PROJECTED ACCRUAL: 350 evaluable patients will be studied in this multicenter trial.

Conditions

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Chronic Myeloproliferative Disorders Infection Leukemia Lymphoma Multiple Myeloma and Plasma Cell Neoplasm Myelodysplastic Syndromes

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

SUPPORTIVE_CARE

Interventions

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amphotericin B deoxycholate

Intervention Type DRUG

nystatin

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS: Persistent febrile neutropenia associated with 1 of the following within 3 months prior to entry: Cytotoxic chemotherapy Bone marrow transplantation Neutropenia defined as either: ANC no greater than 500/mm3 ANC no greater than 1,000/mm3 and expected to decrease to 500/mm3 or less within 2 days after entry Persistent continuous or spiking fever of at least 38 C No association with administration of pyrogenic substances No response to at least 72 hours of empiric, broad-spectrum antibacterial therapy No microbiologically documented source of infection At least 30 days since documented invasive fungal infection

PATIENT CHARACTERISTICS: Age: 2 and over Performance status: Not specified Life expectancy: At least 28 days Hematopoietic: Not specified Hepatic: No grade 2 or greater hepatic impairment Renal: No grade 2 or greater renal impairment No peritoneal dialysis or hemodialysis Other: No history of severe allergic reaction to polyene antifungal agent No pregnant or nursing women Negative pregnancy test required of fertile women Effective contraception required of fertile women during and for 3 months after study

PRIOR CONCURRENT THERAPY: At least 2 weeks since polyene antifungal therapy Concurrent oral prophylactic antifungal therapy with an azole antifungal agent (e.g., fluconazole, itraconazole) allowed if patient remains febrile No concurrent azole therapy At least 30 days since other investigational drug or device except investigational formulation of amphotericin B
Minimum Eligible Age

2 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aronex Pharmaceuticals

INDUSTRY

Sponsor Role lead

Principal Investigators

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David S. Gordon, MD

Role: STUDY_CHAIR

Aronex Pharmaceuticals

Locations

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Veterans Affairs Medical Center - Phoenix (Hayden)

Phoenix, Arizona, United States

Site Status

Holt-Krock Clinic

Fort Smith, Arkansas, United States

Site Status

Arkansas Children's Hospital

Little Rock, Arkansas, United States

Site Status

Office of Rosalda Rodriguez, M.D.

Chula Vista, California, United States

Site Status

Beckman Research Institute, City of Hope

Duarte, California, United States

Site Status

Eisenhower Medical Center

Rancho Mirage, California, United States

Site Status

University of Colorado Cancer Center

Denver, Colorado, United States

Site Status

New Britain General Hospital

New Britain, Connecticut, United States

Site Status

Vincent T. Lombardi Cancer Research Center, Georgetown University

Washington D.C., District of Columbia, United States

Site Status

Sylvester Cancer Center, University of Miami

Miami, Florida, United States

Site Status

Tampa Children's Hospital

Tampa, Florida, United States

Site Status

Rush-Presbyterian-St. Luke's Medical Center

Chicago, Illinois, United States

Site Status

St. John's Pavilion - Springfield Clinic Research Department

Springfield, Illinois, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

Lake Charles Medical and Surgical Clinic

Lake Charles, Louisiana, United States

Site Status

Johns Hopkins Oncology Center

Baltimore, Maryland, United States

Site Status

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

Boston University School of Medicine

Boston, Massachusetts, United States

Site Status

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

United Hospital

Saint Paul, Minnesota, United States

Site Status

Columbia Comprehensive Cancer Care Clinic

Columbia, Missouri, United States

Site Status

University of Missouri-Columbia Hospital and Clinics

Columbia, Missouri, United States

Site Status

Children's Mercy Hospital - Kansas City

Kansas City, Missouri, United States

Site Status

Veterans Affairs Medical Center - Kansas City

Kansas City, Missouri, United States

Site Status

Antibiotic Research Associates

Kansas City, Missouri, United States

Site Status

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Jersey Shore Cancer Center

Neptune City, New Jersey, United States

Site Status

Riverview Medical Center

Red Bank, New Jersey, United States

Site Status

Brooklyn Hospital Center

Brooklyn, New York, United States

Site Status

Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

Long Island Jewish Medical Center

New Hyde Park, New York, United States

Site Status

St. Vincent's Medical Center of Richmond

Staten Island, New York, United States

Site Status

Albert Einstein Comprehensive Cancer Center

The Bronx, New York, United States

Site Status

Duke Comprehensive Cancer Center

Durham, North Carolina, United States

Site Status

Brookview Research, Inc.

Winston-Salem, North Carolina, United States

Site Status

Comprehensive Cancer Center of Wake Forest University Baptist Medical Center

Winston-Salem, North Carolina, United States

Site Status

Summa Health System

Akron, Ohio, United States

Site Status

Ireland Cancer Center

Cleveland, Ohio, United States

Site Status

Cleveland Clinic Cancer Center

Cleveland, Ohio, United States

Site Status

Office of Ian Baird & Mark Herbert

Columbus, Ohio, United States

Site Status

Infectious Disease Associates of N.W. Ohio

Toledo, Ohio, United States

Site Status

Northeast Ohio Infectious Disease Associates, Inc.

Youngstown, Ohio, United States

Site Status

Medical Specialists, Inc.

Zanesville, Ohio, United States

Site Status

University of Oklahoma - Department of Pharmacy Practice

Oklahoma City, Oklahoma, United States

Site Status

University of Pennsylvania Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Albert Einstein Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh Cancer Institute

Pittsburgh, Pennsylvania, United States

Site Status

University of Tennessee Medical Center at Knoxville

Knoxville, Tennessee, United States

Site Status

Baptist Clinical Research Services

Memphis, Tennessee, United States

Site Status

Texas Cancer Center at Brackenridge Hospital

Austin, Texas, United States

Site Status

University of Texas Southwestern Medical School

Dallas, Texas, United States

Site Status

Infectious Disease Associates of Houston

Houston, Texas, United States

Site Status

University of Texas - MD Anderson Cancer Center

Houston, Texas, United States

Site Status

Wilford Hall - 59th Medical Wing

Lackland Air Force Base, Texas, United States

Site Status

South Texas Oncology and Hematology

San Antonio, Texas, United States

Site Status

Scott and White Clinic

Temple, Texas, United States

Site Status

Infections Limited, P.S.

Tacoma, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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AR-95-41.356-006

Identifier Type: -

Identifier Source: secondary_id

NCI-V96-0845

Identifier Type: -

Identifier Source: secondary_id

CDR0000064660

Identifier Type: -

Identifier Source: org_study_id

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