Study of AMG 531 to Evaluate the Safety & Efficacy in Patients With Non-Hodgkin's Lymphoma
NCT ID: NCT00299182
Last Updated: 2021-09-21
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE1/PHASE2
50 participants
INTERVENTIONAL
2006-03-31
2012-04-30
Brief Summary
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Primary Objectives:
1. To determine the clinical safety and tolerability of AMG 531 administered following chemotherapy (R-HyperCVAD alternating with R-Ara-C/MTX) in patients with non-Hodgkin's lymphoma.
2. To determine an optimal biologic dose (OBD) of AMG 531 in patients receiving R-HyperCVAD and R-Ara-C/MTX.
3. To evaluate the effects of AMG 531 on the degree and duration of thrombocytopenia and platelet recovery following chemotherapy(chemo).
Secondary Objectives:
1\. To evaluate limited pharmacokinetics of AMG 531 administered by S.C. route with chemotherapy.
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Detailed Description
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Before you can start treatment on this study, you will have what are called "screening tests." These tests will help the doctor decide if you are eligible to take part in the study. You will have a complete medical history and physical exam, including measurement of vital signs (temperature, pulse, breathing rate, and blood pressure). You will have blood collected (about 3 teaspoons) for routine tests. Radiologic tests such as CT or MRI scans will be done as needed. Women who are able to have children must have a negative blood pregnancy test.
You will also have about 1 teaspoon of blood drawn to see if the you have antibodies to the study drug.
If you are found to be eligible to take part in this study, you will be randomly assigned (as in the toss of a coin) to one of four treatment groups. These 4 groups will also be split into 2 separate subgroups (Arm A and Arm B). Participants in Arm A will either receive AMG 531 or placebo on Day -5 (5 days before chemotherapy starts) and Day 5 (5 days after chemotherapy starts). A placebo is a substance that looks like the study drug but which has no active ingredients. Every 2 out of 3 participants in Arm A will receive AMG 531. One out of every 3 participants in Arm A will receive placebo.
Participants in Arm B will receive either AMG 531 or placebo on Day 5 and 7. Every 2 out of 3 participants in Arm B will receive AMG 531. One out of every 3 participants in Arm B will receive placebo. The dose of AMG 531 that participants in both Arms A and B receive will depend on when they enroll on the study. There are 3 different dose levels of AMG 531 being studied. Each new group of participants will receive a higher dose than the previous group.
All participants will receive treatment with R-HyperCVAD and R-Ara-C/MTX chemotherapy by vein in alternating cycles. In Cycle 1, all participants will receive R-HyperCVAD by itself. Each cycle is 3 weeks long.
Three (3) weeks later, in Cycle 2, all participants will receive either AMG 531 or placebo following R-Ara-C/MTX. The AMG 531/placebo will be given as an injection under the skin on Days -5 and 5 (Arm A) or on Days 5 and 7 (Arm B). After 2 cycles of treatment, based on response of the disease and tolerance to the treatment, all participants may be able to receive up to 4 more cycles of chemotherapy followed by AMG 531. For Cycles 3-6, you will follow the same schedule of therapy as in the first 2 cycles. The dose of AMG 531 may be increased at one time point during the study based on the response of the platelet counts.
Blood (about 1 teaspoon) will be collected for the evaluation of anti-AMG 531 antibody status at the end of Cycles 2 and 4. You will be taken off the study if your disease gets worse or intolerable side effects occur. The number of blood tests drawn will depend on your clinical condition. These samples (about 1 teaspoon each) will be taken at least 2 times a week and as often as once a day during anticipated periods of low blood cell counts.
At the end of the study, you will have an interim medical history and physical exam, including measurement of vital signs. You will have blood (about 1 teaspoon) drawn for routine end-of-study analysis. Blood (about 1 teaspoon) will also be collected for the evaluation of anti-AMG 531 antibody status.
This is an investigational study. R-HyperCVAD and R-Ara-C/MTX are commercially available chemotherapy drugs. AMG 531 is not FDA approved or commercially available. At this time, AMG 531 is being used in this study for research purposes only. About 36 evaluable patients (maximum of 50 patients) will take part in this study. All will be enrolled at University of Texas (UT) M. D. Anderson.
Conditions
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Study Design
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RANDOMIZED
FACTORIAL
TREATMENT
TRIPLE
Study Groups
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1 mcg/ kg AMG531 Pre & Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 1 mcg/ kg AMG 531 subcutaneously on days -5 and 5 (Arm A)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
3 mcg/ kg AMG531 Pre & Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 3 mcg/ kg AMG 531 subcutaneously on days -5 and 5 (Arm A)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
10 mcg/ kg AMG531 Pre & Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 10 mcg/ kg AMG 531 subcutaneously on days -5 and 5 (Arm A)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
Placebo (Arm A & Arm B) with Chemotherapy
Placebo Pre and Post (Arm A), or Post (Arm B) Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by placebo subcutaneously on days -5 and 5 (Arm A) or days 5 and 7 (Arm B)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
Placebo
Arm A: Placebo - subcutaneous injection administered on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm B: Placebo - subcutaneous injection administered on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
1 mcg/ kg AMG531 Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 1 mcg/ kg AMG 531 subcutaneously on days 5 and 7 (Arm B)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
3 mcg/ kg AMG531 Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 3 mcg/ kg AMG 531 subcutaneously on days 5 and 7 (Arm B)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
10 mcg/ kg AMG531 Post Chemotherapy
Cycle 1, Chemotherapy (R-HyperCVAD) alone.
Cycle 2, Chemotherapy (R-Ara-C/MTX), followed by 10 mcg/ kg AMG 531 subcutaneously on days 5 and 7 (Arm B)
R-HyperCVAD alternating with R-Ara-C/MTX where R-HyperCVAD is Rituximab 375 mg/m\^2; plus Cyclophosphamide 300 mg/m\^2, Vincristine 1.4 mg/m\^2, Doxorubicin (Adriamycin) 50 mg/m\^2, and Dexamethasone 40 mg (CVAD), Mesna 600mg/m\^2; and, R-Ara-C/MTX is Rituximab 375 mg/m\^2, Cytarabine 3 g/m\^2 and Methotrexate 200 mg/m\^2.
AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
Interventions
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AMG 531
Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm A: AMG531 - 1, 3, or 10 mcg/kg subcutaneous injection administered on on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Rituximab
375 mg/m\^2 by vein over 4-6 hour infusion day 1, each cycle.
Cyclophosphamide
300 mg/m\^2 by vein over 3 hours every 12 hours for 6 doses (days 2-4), Cycles 1,3, \& 5.
Vincristine
1.4 mg/m\^2/dose (maximum 2 mg) by vein over 15 minutes Days 5 and 12, Cycles 1,3,\& 5.
Doxorubicin
50 mg/m\^2/dose by vein over 15 minutes on Day 5 or by continuous infusion over 24-48 hours (days 5-6), Cycles 1,3,\& 5.
Dexamethasone
40 mg/day by mouth or by vein days 2-5 and 12-15, Cycles 1,3,\& 5.
Methotrexate
200 mg/m\^2 by vein over 2 hours followed by 800 mg/m\^2 over 22 hours Day 2, Cycles 2, 4 \& 6.
Cytarabine
3 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4; OR,1 g/m\^2 by vein over 2 hours every 12 hours for 4 doses, days 3 \& 4 for patients \> 60 years and for patients with serum creatinine \> 1.5 mg/dL; Cycles 2,4,\& 6.
Placebo
Arm A: Placebo - subcutaneous injection administered on days -5 and 5 (pre and post chemotherapy dose) beginning with Cycle 2; OR, Arm B: Placebo - subcutaneous injection administered on days 5 and 7 (post chemotherapy doses only) beginning with Cycle 2.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Patients age \>/= 18 years.
3. Karnofsky Performance Scale \>/= 70.
4. Adequate hematologic (ANC \>/= 1000/mm(3), platelet count \>/= 100,000/mm(3) and Hgb \>/= 8gm/dL), renal (serum creatinine \< 2mg/dL), and hepatic functions (total bilirubin \</= 2 times, serum glutamate pyruvate transaminase (SGPT) or serum glutamate oxaloacetate transaminase (SGOT) \</= 3 times the upper limit of the respective normal range).
5. Patients (male and female) with childbearing potential (defined as not post-menopausal for 12 months or no previous surgical sterilization) must use adequate birth control.
6. Institutional Review Board (IRB)-approved signed informed consent.
Exclusion Criteria
2. History of Central Nervous System (CNS) involvement.
3. Co-morbid medical or psychiatric illnesses that preclude treatment with intense dose chemotherapy.
4. Patients with history of deep vein thrombosis (DVT) or pulmonary embolus.
5. History of any platelet disorders including Idiopathic thrombocytopenic purpura (ITP), Thrombotic thrombocytopenic purpura (TTP) or bleeding disorders.
6. Prior surgery or Radiation Therapy (RT) within 2 weeks of study entry.
7. Patients with significant cardiac disease (New York Heart Association (NYHA) Class III or IV), dysrrhythmia, or recent history of myocardial ischemia (MI) or ischemia, transient ischemic attack or cerebrovascular accident (CVA) within the previous 6 months of study entry.
18 Years
ALL
No
Sponsors
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Amgen
INDUSTRY
M.D. Anderson Cancer Center
OTHER
Responsible Party
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Principal Investigators
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Saroj Vadhan-Raj, MD
Role: PRINCIPAL_INVESTIGATOR
M.D. Anderson Cancer Center
Locations
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UT MD Anderson Cancer Center
Houston, Texas, United States
Countries
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Related Links
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University of Texas MD Anderson Cancer Center official website
Other Identifiers
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2005-0146
Identifier Type: -
Identifier Source: org_study_id
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