PETHEMA LAL-07FRAIL: All Treatment In Fragile Patients Ph' Negative Over 55 Years

NCT ID: NCT01358201

Last Updated: 2022-01-19

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-05-31

Study Completion Date

2022-12-31

Brief Summary

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The biological characteristics of the adult LAL, karyotypic and phenotypic particular, are fundamentally different from those of Acute Lymphoblastic Leukemia (ALL) children and, consequently, the results of treatment are substantially lower. Additionally, elderly patients tolerate the drugs considered relatively low-key in the management of the LAL and suffer more toxicity. Although the LAL is much more common in patients over 60 years of age than in younger adults, older adults with ALL are clearly underrepresented in prospective controlled studies. A good portion of elderly patients are not able to tolerate the intensity of the standard treatment applied to children or young adults and a significant portion of them receive only palliative or supportive treatment. The data in the literature relating specifically to the elderly population are scarce and most of them have obtained a stratification by age of study designed for young people (CALGB, GMALL, PETHEMA). To date, the group's recommendation was to treat PETHEMA the LAL-96RI protocol for elderly patients because this protocol less aggressive than those used in high-risk ALL. However, the development of inhibitors of tyrosine kinases LAL effective in Bcr / abl positive, a relatively common type of LAL in the older patient, requires a differentiated treat these patients. Moreover, analysis of data from patients treated so far with the LAL-96RI protocol has shown mediocre results even for LAL Bcr / abl negative. This analysis also showed a significant benefit in survival related to the reduction of treatment (removal of the L-asparaginase during induction and cyclophosphamide at the end of induction) attributed to a reduction in toxicity

Detailed Description

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Prephase (days -5 to -1) Dexamethasone 10 mg/m2 bolus day EV for 5 days (-5 to -1). Supplementary treatment: hydration minimum 2000 ml / day. allopurinol 300 mg / day. gastric protection (as center). daily monitoring of blood glucose daily monitoring of renal function.

Intrathecal treatment (diagnosis and prophylactic / therapeutic) day -5: 12 mg were administered intrathecal methotrexate. The morphological study of the CSF will be defining initial CNS involvement by LAL. Although it is recommended immunophenotypic study of CSF, the definition of CNS involvement by LAL (and its therapeutic consequences) based on morphological observation of blasts in CSF cytocentrifuge.

Remission induction :

Tolerance prephase period can be used to establish the final indication of treatment (standard protocol or frail patients). Day 0 is free of treatment and is considered as +1 the first day of induction.

Systemic treatment

* Vincristine (VCR) 1 mg (absolute dose) EV 1, 8, 15 and 22.
* Dexamethasone (DEX): 10 mg/m2 EV, IM or PO days 1-2, 8-9 days 15-16, 22-23.

Intrathecal chemotherapy

Triple therapy was administered with methotrexate (MTX), cytosine arabinoside (ARA-C) and hydrocortisone, days 1, 8, 15 and 22 (five doses total prophylactic between prephase and induction):

MTX 12 mg ARA-C 40 mg Dexamethasone 4 mg

If initial infiltration of the CNS is administered once every 72 hours until the disappearance of blast cell morphology CSF (cytocentrifugation) in at least two consecutive taps. Alternatively be administered liposomal cytarabine (DepoCyt) fortnightly if authorized by the center or in the context of a clinical trial

Maintenance treatment of first year :

Maintenance during the first year will start after full recovery after induction and after complete reassessment of the disease (including myelogram) and will last until one year from the time of documentation of complete remission.

The basic treatment to include mercaptopurine 50 mg/m2 PO day and methotrexate 20 mg/m2 IM weekly.

Once every 3 months will be added to maintenance treatment a "mini-reinduction" consisting

* VCR: 1 mg (absolute dose), i.v., day 1.
* Dexamethasone 40 mg / day, i.v. or p.o., days 1-2.
* Not considered more doses of triple intrathecal therapy. Reinduction only be practiced during the first year after remission, so a total of 4 quarterly.

Maintenance of the second year:

After the first year of maintenance will perform a complete reassessment of the disease (including myelogram) and if the patient remains in complete remission maintenance will continue (without reinduction) until two years from the time of diagnosis.

The initial dose of mercaptopurine and methotrexate will be identical to the first year. Must comply (by increases or decreases of 20% of the dose) to maintain the numbers of neutrophil counts between 1.5 and 3x109/l and platelets above 100x109 / L

Conditions

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Acute Lymphoblastic Leukemia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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vINCRISTINE

Intervention Type DRUG

Dexamethasone

Intervention Type DRUG

Methotrexate

Intervention Type DRUG

Cytosine arabinoside

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Adults over 55 years diagnosed with acute lymphoblastic leukemia Ph 'negative and not previously treated with frailty (\> 3 points in the Charlson comorbidity index)

Exclusion Criteria

LAL

1\. L3 type mature B phenotype (sIg +) or cytogenetic abnormalities characteristic of Burkitt LAL (t \[8, 14\], t \[2, 8\], t \[8, 22\]).

2 . biphenotypic acute leukemias and bilinear 3 . acute undifferentiated leukemia 4 . Patients with a Charlson comorbidity index less than or equal to 3 (and therefore that could potentially benefit from more intensive treatment PETHEMA LAL-07OLD).

5 . General condition affected (grades 3 and 4 WHO scale), not attributable to the LAL.

6 . LAL Ph 'positive (though still must register their LAL07OPH specific protocol).

7 . Lack of consent by the patient to use their clinical data
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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PETHEMA Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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H. Son Llatzer

Palma de Mallorca, Balearic Islands, Spain

Site Status RECRUITING

Consorci Sanitari de Terrassa

Terrassa, Barcelona, Spain

Site Status RECRUITING

Clínica Universitaria de Navarra

Pamplona, Navarre, Spain

Site Status RECRUITING

Hospital Juan Canalejo

A Coruña, , Spain

Site Status RECRUITING

Complejo Hospitalario Universitario de Albacete

Albacete, , Spain

Site Status RECRUITING

Fundación Hospital Alcorcón

Alcorcón, , Spain

Site Status RECRUITING

Hospital de Alcorcón

Alcorcón, , Spain

Site Status RECRUITING

Hoapital General

Alicante, , Spain

Site Status RECRUITING

Hospital General de Alicante

Alicante, , Spain

Site Status RECRUITING

Hospital General de Alicante

Alicante, , Spain

Site Status RECRUITING

Hospital Germans Trias i Pujol

Badalona, , Spain

Site Status RECRUITING

Hospital Clinic y Provincial de Barcelona

Barcelona, , Spain

Site Status RECRUITING

Hospital de la Santa Creu i Sant Pau.

Barcelona, , Spain

Site Status RECRUITING

Hospital del Mar

Barcelona, , Spain

Site Status RECRUITING

Hospital Valle Hebrón

Barcelona, , Spain

Site Status RECRUITING

Institut Català d'oncología

Barcelona, , Spain

Site Status RECRUITING

Basurtuko Ospitalea

Basurto, , Spain

Site Status RECRUITING

Hospital de Cruces

Bilbao, , Spain

Site Status RECRUITING

Complejo Hospitalario de Cáceres

Cáceres, , Spain

Site Status RECRUITING

Complejo Hospitalario Reina Sofía

Córdoba, , Spain

Site Status RECRUITING

Area Hospitalaria Juan Ramón Jimenez

Huelva, , Spain

Site Status RECRUITING

Hospital Médico Quirúrgico Ciudad de Jaén

Jaén, , Spain

Site Status RECRUITING

H. de Jerez

Jerez de la Frontera, , Spain

Site Status RECRUITING

Complejo Hospitalario León

León, , Spain

Site Status RECRUITING

Hospital Arnau de Vilanova

Lleida, , Spain

Site Status RECRUITING

Complexo Hospitalario Xeral-Calde

Lugo, , Spain

Site Status RECRUITING

Clínica La Concepción

Madrid, , Spain

Site Status RECRUITING

Clínica Puerta de Hierro

Madrid, , Spain

Site Status RECRUITING

Clínica Rúber

Madrid, , Spain

Site Status RECRUITING

Fundación Jiménez Díaz

Madrid, , Spain

Site Status RECRUITING

Hospital 12 de Octubre. Madrid

Madrid, , Spain

Site Status RECRUITING

Hospital Clinico San Carlos

Madrid, , Spain

Site Status RECRUITING

Hospital Clínico San Carlos de Madrid

Madrid, , Spain

Site Status RECRUITING

Hospital de Fuenlabrada

Madrid, , Spain

Site Status RECRUITING

Hospital de la Princesa

Madrid, , Spain

Site Status RECRUITING

Hospital de Madrid, S.A.- Norte Hospital General

Madrid, , Spain

Site Status RECRUITING

Hospital La Paz

Madrid, , Spain

Site Status RECRUITING

Althaia, Xarxa Asistencial de Manresa

Manresa, , Spain

Site Status RECRUITING

Fundación Hospital Sant Joan de Déu de Martorell

Martorell, , Spain

Site Status RECRUITING

. Hospital Clínico Universitario Virgen de la Victoria

Málaga, , Spain

Site Status RECRUITING

Complejo Hospital Costa del Sol

Málaga, , Spain

Site Status RECRUITING

H. Carlos Haya

Málaga, , Spain

Site Status RECRUITING

Hospital Carlos Haya

Málaga, , Spain

Site Status RECRUITING

Hospital General Morales Meseguer

Murcia, , Spain

Site Status RECRUITING

Hospital Morales Messeguer. Murcia

Murcia, , Spain

Site Status RECRUITING

Hospital Sta. Maria del Rosell

Murcia, , Spain

Site Status RECRUITING

Hospital Central de Asturias

Oviedo, , Spain

Site Status RECRUITING

Hospital del Río Carrión

Palencia, , Spain

Site Status RECRUITING

Complejo Asistencial Son Dureta

Palma de Mallorca, , Spain

Site Status RECRUITING

Complejo Hospitalario de Pontevedra_Hospital Montecelo

Pontevedra, , Spain

Site Status RECRUITING

Complejo Hospitalario de Pontevedra_Hospital Provincial

Pontevedra, , Spain

Site Status RECRUITING

Corporació Sanitaria Parc Taulí

Sabadell, , Spain

Site Status RECRUITING

Hospital Clinico Universitario

Salamanca, , Spain

Site Status RECRUITING

Hospital Clínico de Salamanca

Salamanca, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Salamanca

Salamanca, , Spain

Site Status RECRUITING

Hospital Clínico Universitario de Salamanca

Salamanca, , Spain

Site Status RECRUITING

Clínica Sant Camil

Sant Pere de Ribes, , Spain

Site Status RECRUITING

Hoaspital Marqués de Valdecilla

Santander, , Spain

Site Status RECRUITING

Complejo Hospitalario Universitario de Santiago

Santiago de Compostela, , Spain

Site Status RECRUITING

Hospital General de Segovia

Segovia, , Spain

Site Status RECRUITING

Complejo Hospitalario Regional Virgen del Rocío

Seville, , Spain

Site Status RECRUITING

Hospital Joan XXIII

Tarragona, , Spain

Site Status RECRUITING

Fundación Instituto Valenciano de Oncología

Valencia, , Spain

Site Status RECRUITING

Hoapital La Fe

Valencia, , Spain

Site Status RECRUITING

Hospital Clínico de Valencia.

Valencia, , Spain

Site Status RECRUITING

Hospital Clínico de Valencia

Valencia, , Spain

Site Status RECRUITING

Hospital Clínic

Valencia, , Spain

Site Status RECRUITING

Hospital Dr Pesset

Valencia, , Spain

Site Status RECRUITING

Hospital General

Valencia, , Spain

Site Status RECRUITING

Hospital La Fe

Valencia, , Spain

Site Status RECRUITING

Hospital Clínico de Valladolid

Valladolid, , Spain

Site Status RECRUITING

Complejo Hospitalario Universitario de Vigo

Vigo, , Spain

Site Status RECRUITING

Comarcal de Vinaros

Vinaròs, , Spain

Site Status RECRUITING

Hospital Clinico Lozano Blesa

Zaragoza, , Spain

Site Status RECRUITING

Hospital Lozano Blesa. Zaragoza

Zaragoza, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Josep Mª Ribera, Dr

Role: CONTACT

Facility Contacts

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Prosper Felipe, Dr

Role: primary

Deben Guillermo, Dr

Role: primary

Peñalver Francisco, Dr

Role: primary

Fernandez Abellan Pascual, Dr

Role: primary

Fernández Abellán Pascual, Dr

Role: primary

Ribera Josep Mª, Dr

Role: primary

Esteve Jordi, Dr

Role: primary

Sierra Jordi, Dr

Role: primary

Boqué Concha, Dr

Role: primary

Beltran de Heredia José Mª, Dr

Role: primary

Bergua Juan Miguel, Dr

Role: primary

Torres Antonio, Dr

Role: primary

Fernández Antonio, Dr

Role: primary

Alcala Antonio, Dr

Role: primary

José Luis Guzmán Zamudio, Dr

Role: primary

Sanchez Juan Manuel, Dr

Role: primary

Román Alejandro, Dr

Role: primary

Lahuerta juan José, Dr

Role: primary

Martínez Rafael, Dr

Role: primary

Diaz Mediavilla Joaquin, Dr

Role: primary

Hernández Rivas José Angel, Dr

Role: primary

Adrián Alegre, Dr

Role: primary

Canales Miguel Ángel, Dr

Role: primary

María Casanova Espinosa, Dr

Role: primary

Barrios Manuel, Dr

Role: primary

Amigo Mª Luz, Dr

Role: primary

Rayón MC, Dr

Role: primary

Ortega Frenando, Dr

Role: primary

Del Cañizo Consuelo, Dr

Role: primary

San Miguel Jesús, Dr

Role: primary

Mateos Maria Victoria, Dr

Role: backup

Hernández Rivas Jesús Mª, Dr

Role: primary

Mateos Mª Victoria, Dr

Role: primary

Martín Sánchez Jesús, Dr

Role: primary

Escoda Lourdes, Dr

Role: primary

Sanz Miguel Angel, Dr

Role: primary

96 386 27 58

Tormo Mar, Dra

Role: primary

Terol Maria José, Dr

Role: primary

Ferrer Secundino, Dr

Role: primary

Carbonell Félix, Dr

Role: primary

De la Rubia Javier, Dr

Role: primary

Olave Mª Teresa, Dr

Role: primary

Related Links

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Other Identifiers

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PETHEMA LAL-07FRAIL

Identifier Type: -

Identifier Source: org_study_id

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