Trial Outcomes & Findings for S0530 Cytarabine and Clofarabine in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia (NCT NCT00337168)

NCT ID: NCT00337168

Last Updated: 2015-03-25

Results Overview

Complete remission is defined as: less than 5% bone marrow blasts, neutrophils greater or equal to 1,000 per microliter, platelets greater than 100,000 per microliter, no blasts in the peripheral blood, and no extramedullary disease

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

36 participants

Primary outcome timeframe

Between day 28 and day 35 inclusive

Results posted on

2015-03-25

Participant Flow

Participant milestones

Participant milestones
Measure
Induction
Clofarabine (40 mg per meters squared per day) and cytarabine (1 g per meters squared per day)
Overall Study
STARTED
37
Overall Study
Eligible
37
Overall Study
Eligible and Treated
36
Overall Study
COMPLETED
29
Overall Study
NOT COMPLETED
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Induction
Clofarabine (40 mg per meters squared per day) and cytarabine (1 g per meters squared per day)
Overall Study
Death
5
Overall Study
Not protocol specified
2
Overall Study
Did not start therapy
1

Baseline Characteristics

S0530 Cytarabine and Clofarabine in Treating Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Induction
n=36 Participants
Age, Continuous
41 years
n=5 Participants
Sex: Female, Male
Female
13 Participants
n=5 Participants
Sex: Female, Male
Male
23 Participants
n=5 Participants
Region of Enrollment
United States
36 participants
n=5 Participants

PRIMARY outcome

Timeframe: Between day 28 and day 35 inclusive

Population: Eligible patients who started therapy

Complete remission is defined as: less than 5% bone marrow blasts, neutrophils greater or equal to 1,000 per microliter, platelets greater than 100,000 per microliter, no blasts in the peripheral blood, and no extramedullary disease

Outcome measures

Outcome measures
Measure
Induction
n=36 Participants
Number of Patients With Complete Remission
3 participants

SECONDARY outcome

Timeframe: On average, two weeks before treatment started

Population: Eligible patients who submitted paraffin-embedded tissue

Expression was examined in paraffin-embedded tissue by immunohistochemistry. Intensities were scored on a 0-2+ scale. High expression was a score of 2+.

Outcome measures

Outcome measures
Measure
Induction
n=13 Participants
Expression of Nucleoside Transporters
High expression of dCK nuclear
4 participants
Expression of Nucleoside Transporters
High expression of hENT1
7 participants
Expression of Nucleoside Transporters
High expression of hCNT3
6 participants
Expression of Nucleoside Transporters
High expression of dCK cytoplasmic
4 participants

SECONDARY outcome

Timeframe: On average, 2 weeks before treatment started

Population: Eligible patients with acceptable centrally reviewed cytogenetics

Outcome measures

Outcome measures
Measure
Induction
n=17 Participants
Number of Patients With Very Poor Risk Cytogenetics
10 participants

SECONDARY outcome

Timeframe: Patients were assess for adverse events after each induction cycle (up to two cycles) and after the one consolidation cycle

Population: Eligible patients who started therapy

Number of patients with Grade 3-5 adverse events that are related to study drug by given type of adverse event

Outcome measures

Outcome measures
Measure
Induction
n=36 Participants
Toxicity
ALT, SGPT (serum glutamic pyruvic transaminase)
5 Participants with a given type of AE
Toxicity
Ascites (non-malignant)
2 Participants with a given type of AE
Toxicity
Bilirubin (hyperbilirubinemia)
3 Participants with a given type of AE
Toxicity
Pain - Bone
1 Participants with a given type of AE
Toxicity
Platelets
20 Participants with a given type of AE
Toxicity
Pleural effusion (non-malignant)
1 Participants with a given type of AE
Toxicity
Renal failure
3 Participants with a given type of AE
Toxicity
Tumor lysis syndrome
1 Participants with a given type of AE
Toxicity
AST, SGOT (serum glut oxaloacetic transaminase)
7 Participants with a given type of AE
Toxicity
Albumin, serum-low (hypoalbuminemia)
3 Participants with a given type of AE
Toxicity
Anorexia
1 Participants with a given type of AE
Toxicity
Calcium, serum-low (hypocalcemia)
1 Participants with a given type of AE
Toxicity
Colitis
1 Participants with a given type of AE
Toxicity
Colitis, infectious (e.g., Clostridium difficile)
2 Participants with a given type of AE
Toxicity
Confusion
1 Participants with a given type of AE
Toxicity
Creatinine
4 Participants with a given type of AE
Toxicity
DIC (disseminated intravascular coagulation)
1 Participants with a given type of AE
Toxicity
Death not assoc with CTCAE term-Multi-organ fail
1 Participants with a given type of AE
Toxicity
Dermatology/Skin-Other (Specify)
1 Participants with a given type of AE
Toxicity
Diarrhea
2 Participants with a given type of AE
Toxicity
Dyspnea (shortness of breath)
1 Participants with a given type of AE
Toxicity
Edema: limb
1 Participants with a given type of AE
Toxicity
Fatigue (asthenia, lethargy, malaise)
2 Participants with a given type of AE
Toxicity
Febrile neutropenia
14 Participants with a given type of AE
Toxicity
Glucose, serum-high (hyperglycemia)
1 Participants with a given type of AE
Toxicity
Hemoglobin
13 Participants with a given type of AE
Toxicity
Hypotension
3 Participants with a given type of AE
Toxicity
Hypoxia
1 Participants with a given type of AE
Toxicity
INR
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Bladder (urin
1 Participants with a given type of AE
Toxicity
IInfec with Gr 3\4 neutrophils - Blood
9 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Catheter-rela
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Colon
2 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Conjunctiva
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Larynx
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Lung (pneumon
2 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Skin (celluli
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Urinary tract
1 Participants with a given type of AE
Toxicity
Infec with Gr 3\4 neutrophils - Wound
1 Participants with a given type of AE
Toxicity
Infection with unknown ANC - Lung (pneumonia)
1 Participants with a given type of AE
Toxicity
Infection-Other (Specify)
1 Participants with a given type of AE
Toxicity
Leukocytes (total WBC)
11 Participants with a given type of AE
Toxicity
Liver dysfunction/failure (clinical)
1 Participants with a given type of AE
Toxicity
Lymphopenia
7 Participants with a given type of AE
Toxicity
Mental status
1 Participants with a given type of AE
Toxicity
Neutrophils/granulocytes (ANC/AGC)
18 Participants with a given type of AE
Toxicity
PTT (Partial thromboplastin time)
1 Participants with a given type of AE
Toxicity
Pain - Abdomen NOS
1 Participants with a given type of AE
Toxicity
Pain - Back
1 Participants with a given type of AE
Toxicity
Pneumonitis/pulmonary infiltrates
1 Participants with a given type of AE
Toxicity
Potassium, serum-high (hyperkalemia)
1 Participants with a given type of AE
Toxicity
Potassium, serum-low (hypokalemia)
4 Participants with a given type of AE
Toxicity
Pruritus/itching
1 Participants with a given type of AE
Toxicity
Restrictive cardiomyopathy
1 Participants with a given type of AE
Toxicity
Sodium, serum-high (hypernatremia)
1 Participants with a given type of AE
Toxicity
Sodium, serum-low (hyponatremia)
2 Participants with a given type of AE
Toxicity
Supraventricular and nodal arrhythmia
1 Participants with a given type of AE
Toxicity
Typhlitis (cecal inflammation)
1 Participants with a given type of AE
Toxicity
Uric acid, serum-high (hyperuricemia)
1 Participants with a given type of AE

Adverse Events

Induction

Serious events: 5 serious events
Other events: 31 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Induction
n=36 participants at risk
Up to two induction cycles with clofarabine and cytarabine
Blood and lymphatic system disorders
Febrile neutropenia
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Colitis
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
General disorders
Death not associated with CTCAE term - Multi-organ failure
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Infections and infestations
Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils - Blood
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Renal and urinary disorders
Renal failure
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Vascular disorders
Hypotension
2.8%
1/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment

Other adverse events

Other adverse events
Measure
Induction
n=36 participants at risk
Up to two induction cycles with clofarabine and cytarabine
Blood and lymphatic system disorders
Febrile neutropenia
38.9%
14/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Blood and lymphatic system disorders
Hemoglobin
50.0%
18/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Cardiac disorders
Supraventricular and nodal arrhythmia - Sinus tachycardia
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Ascites (non-malignant)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Constipation
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Diarrhea
30.6%
11/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Mucositis/stomatitis (clinical exam) - Oral cavity
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Mucositis/stomatitis (functional/symptomatic) - Oral cavity
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Nausea
47.2%
17/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Pain - Abdomen NOS
16.7%
6/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Typhlitis (cecal inflammation)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Gastrointestinal disorders
Vomiting
13.9%
5/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
General disorders
Edema: limb
16.7%
6/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
General disorders
Fatigue (asthenia, lethargy, malaise)
27.8%
10/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
General disorders
Rigors/chills
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Infections and infestations
Colitis, infectious (e.g., Clostridium difficile)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Infections and infestations
Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils - Blood
25.0%
9/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Infections and infestations
Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils - Colon
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Infections and infestations
Infection (documented clinically or microbiologically) with Grade 3 or 4 neutrophils - Lung (pneumon
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
ALT, SGPT (serum glutamic pyruvic transaminase)
30.6%
11/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
AST, SGOT (serum glutamic oxaloacetic transaminase)
30.6%
11/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Alkaline phosphatase
13.9%
5/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Bilirubin (hyperbilirubinemia)
27.8%
10/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Creatinine
19.4%
7/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
INR (International Normalized Ratio of prothrombin time)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Leukocytes (total WBC)
30.6%
11/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Lymphopenia
19.4%
7/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Metabolic/Laboratory-Other (Specify)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Neutrophils/granulocytes (ANC/AGC)
50.0%
18/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
PTT (Partial thromboplastin time)
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Platelets
55.6%
20/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Investigations
Weight loss
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Albumin, serum-low (hypoalbuminemia)
25.0%
9/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Anorexia
13.9%
5/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Calcium, serum-low (hypocalcemia)
19.4%
7/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Glucose, serum-high (hyperglycemia)
11.1%
4/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Magnesium, serum-low (hypomagnesemia)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Potassium, serum-high (hyperkalemia)
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Potassium, serum-low (hypokalemia)
25.0%
9/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Metabolism and nutrition disorders
Sodium, serum-low (hyponatremia)
13.9%
5/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Musculoskeletal and connective tissue disorders
Pain - Back
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Musculoskeletal and connective tissue disorders
Pain - Bone
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Nervous system disorders
Pain - Head/headache
27.8%
10/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Psychiatric disorders
Confusion
11.1%
4/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Psychiatric disorders
Insomnia
11.1%
4/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Psychiatric disorders
Mood alteration - depression
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Renal and urinary disorders
Renal failure
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Respiratory, thoracic and mediastinal disorders
Cough
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Respiratory, thoracic and mediastinal disorders
Dyspnea (shortness of breath)
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Respiratory, thoracic and mediastinal disorders
Hiccoughs (hiccups, singultus)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Respiratory, thoracic and mediastinal disorders
Pain - Throat/pharynx/larynx
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Respiratory, thoracic and mediastinal disorders
Pneumonitis/pulmonary infiltrates
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Skin and subcutaneous tissue disorders
Dermatology/Skin-Other (Specify)
11.1%
4/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Skin and subcutaneous tissue disorders
Petechiae/purpura (hemorrhage/bleeding into skin or mucosa)
5.6%
2/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Skin and subcutaneous tissue disorders
Rash/desquamation
16.7%
6/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Skin and subcutaneous tissue disorders
Rash: hand-foot skin reaction
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Skin and subcutaneous tissue disorders
Sweating (diaphoresis)
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment
Vascular disorders
Hypotension
8.3%
3/36 • While the patient is on treatment until resolution of acute toxicities with maximum grade reported
Regular investigator assessments are reported after each cycle of protocol treatment

Additional Information

SWOG Leukemia Statistician

SWOG Statistical Office

Phone: 206-667-4623

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place