Differentiation Induction in Acute Myelogenous Leukemia
NCT ID: NCT00175812
Last Updated: 2015-06-24
Study Results
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Basic Information
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COMPLETED
PHASE1/PHASE2
24 participants
INTERVENTIONAL
2004-11-30
2009-11-30
Brief Summary
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Adult patients (\<18 years of age) who can be included: Elderly patients (\>60 years of age) with newly diagnosed AML who cannot achieve standard chemotherapy, patients with relapsed or resistant AML. Patients with relapsed or resistant AML who cannot receive intensive chemotherapy.
Treatment: Patients will be treated with all-trans retinoic acid (oral administration), valproic acid (7 days intravenous administration and later oral administration)and theophyllamine (7 days intravenous administration and later oral administration). Duration of treatment at least 2 months or until disease progression. Maximal duration of treatment 2 years.
Followup: Clinical evaluation, peripheral blood samples, bone marrow samples.
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Detailed Description
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1. Elderly patients above 60 years of age with newly diagnosed acute myelogenous leukemia (AML) who cannot receive conventional intensive chemotherapy.
2. Adult patients of any age (\> 18 years of age)with relapsed or resistant AML who cannot receive conventional intensive chemotherapy or allogeneic stem cell transplantation.
We plan to include at least 20 patients, but if possible 30 patients during a 3 years period. The first patient was included November 2004.
Treatment:
All-trans retinoic acid (ATRA) administered orally 22.5 mg/m2 twice daily for 14 days, repeated every third month.
Valproic acid started on day 3 of ATRA therapy, the first week as intravenous administration and later oral administration.
Theophyllamine started on day 3 of ATRA therapy, the first week as intravenous administration and later oral administration.
Duration of treatment at least 2 months unless side effects,until disease progression or an overall duration of treatment of 2 years.
Supportive therapy according to the hospitals general guidelines.
Followup:
The first week treatment in hospital. Later out-patient treatment with regular controls including clinical examination, peripheral blood parameters (including serum valproic acid and theophyllamin levels), bone marrow samples.
Conditions
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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ATRA plus valproic acid plus theophyllin
ATRA for 14 days, continuous treatment with valproic acid and theophyllin
all-trans retinoic acid (ATRA)
All-trans retinoic acid 22.5 mg/square meter twice daily days 1-14
Valproic acid
Valproic acid, highest dose without side effects from day 3 until progression
Theophyllin
Theophyllin, targetted serum level 50-100 from day 3 until progression
Interventions
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all-trans retinoic acid (ATRA)
All-trans retinoic acid 22.5 mg/square meter twice daily days 1-14
Valproic acid
Valproic acid, highest dose without side effects from day 3 until progression
Theophyllin
Theophyllin, targetted serum level 50-100 from day 3 until progression
Eligibility Criteria
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Inclusion Criteria
* Patients above 60 years of age
* Patients who cannot receive conventional chemotherapy
* Patients with relapsed or refractory AML independent of age
Exclusion Criteria
* Intolerance to the study drugs
* Serious liver disease
* No informed consent
18 Years
ALL
Yes
Sponsors
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University of Bergen
OTHER
Responsible Party
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Øystein Bruserud
Professor
Principal Investigators
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Oystein Bruserud, MD
Role: PRINCIPAL_INVESTIGATOR
University of Bergen
Locations
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Haukeland University Hospital, University of Bergen
Bergen, , Norway
Countries
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References
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Ryningen A, Stapnes C, Lassalle P, Corbascio M, Gjertsen BT, Bruserud O. A subset of patients with high-risk acute myelogenous leukemia shows improved peripheral blood cell counts when treated with the combination of valproic acid, theophylline and all-trans retinoic acid. Leuk Res. 2009 Jun;33(6):779-87. doi: 10.1016/j.leukres.2008.10.005. Epub 2008 Nov 12.
Ryningen A, Stapnes C, Paulsen K, Lassalle P, Gjertsen BT, Bruserud O. In vivo biological effects of ATRA in the treatment of AML. Expert Opin Investig Drugs. 2008 Nov;17(11):1623-33. doi: 10.1517/13543784.17.11.1623.
Haaland I, Hjelle SM, Reikvam H, Sulen A, Ryningen A, McCormack E, Bruserud O, Gjertsen BT. p53 Protein Isoform Profiles in AML: Correlation with Distinct Differentiation Stages and Response to Epigenetic Differentiation Therapy. Cells. 2021 Apr 7;10(4):833. doi: 10.3390/cells10040833.
Reikvam H, Hovland R, Forthun RB, Erdal S, Gjertsen BT, Fredly H, Bruserud O. Disease-stabilizing treatment based on all-trans retinoic acid and valproic acid in acute myeloid leukemia - identification of responders by gene expression profiling of pretreatment leukemic cells. BMC Cancer. 2017 Sep 6;17(1):630. doi: 10.1186/s12885-017-3620-y.
Skavland J, Jorgensen KM, Hadziavdic K, Hovland R, Jonassen I, Bruserud O, Gjertsen BT. Specific cellular signal-transduction responses to in vivo combination therapy with ATRA, valproic acid and theophylline in acute myeloid leukemia. Blood Cancer J. 2011 Feb;1(2):e4. doi: 10.1038/bcj.2011.2. Epub 2011 Feb 11.
Other Identifiers
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REK-Vestnr21503
Identifier Type: -
Identifier Source: org_study_id
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