Personalized Therapy of Precursor Lymphoid Neoplasms

NCT ID: NCT01665001

Last Updated: 2012-08-17

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

PHASE2

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-08-31

Study Completion Date

2018-08-31

Brief Summary

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The primary goal of this study by The Polish Adult Leukemia Group (PALG) is to verify if individual therapeutic approach taking into account biological and phenotypic differences as well as response at the level of minimal residual disease is associated with improved outcome of adults with precursor lymphoid neoplasms

Detailed Description

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Between 1997-2010 the PALG run three prospective studies. In the most recent PLAG 5-2007 protocol attempts have been made to individualize treatment. In particular, stratification to high and standard risk group was based on both conventional clinical criteria and the level of MRD after induction and consolidation. Patients with unsatisfactory response were referred for allogeneic hematopoietic stem cell transplantation (alloHSCT). Interim analysis showed significant improvement compared to previous PALG 4-2002 protocol with regard to both overall survival and leukemia-free survival. The reasons of failure were relapses and non-relapse mortality (NRM) associated with alloHSCT.

In the current protocol we intend to further adjust the therapy for individual patients needs. We assume that this way we will be able to reduce the risk of relapse and NRM and improve the cure rate. All patients will receive multiagent induction and consolidation chemotherapy. The type and intensity of the therapy, as well as indications for allogeneic and autologous HSCT will depend on age, status of MRD, immunophenotype and the presence of BCR/ABL fusion gene.

Conditions

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Precursor Lymphoid Neoplasms

Keywords

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Acute lymphoblastic leukemia Induction Consolidation Minimal residual disease Hematopoietic stem cell transplantation

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Multiagent induction-consolidation

Induction, consolidation, HSCT, maintenance for adults with newly diagnosed precursor lymphoid neoplasms

Group Type EXPERIMENTAL

Treatment strategy: induction, consolidation, HSCT, maintenance

Intervention Type OTHER

Patients \<55 years Ph-neg.: induction (daunorubicin, prednisone, vincristin, PEG-asparaginase), 2nd induction (if non-remission or MRD\>0.1%; FLAM, MiniFLAM or FLAM-CAMP dependent on age and phenotype), consolidation (methotrexate, etoposide, cytarabine, cyclophosphamide, PEG-asparaginase). If MRD \<0.01%: autoHSCT + maintenance (mercaptopurine, methotrexate) or multiagent maintenance (additionally daunorubicin, vincristin, prednisone); remaining patients: alloHSCT. Prophylaxis of leptomeningeal involvement: liposomal cytarabine intrathecally.

Patients \>55 years, Ph-neg.: as above, reduced doses. AlloHSCT with reduced conditioning.

Patients Ph-pos.: as above, reduced doses in combination with continues imatinib. All intended for alloHSCT.

Interventions

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Treatment strategy: induction, consolidation, HSCT, maintenance

Patients \<55 years Ph-neg.: induction (daunorubicin, prednisone, vincristin, PEG-asparaginase), 2nd induction (if non-remission or MRD\>0.1%; FLAM, MiniFLAM or FLAM-CAMP dependent on age and phenotype), consolidation (methotrexate, etoposide, cytarabine, cyclophosphamide, PEG-asparaginase). If MRD \<0.01%: autoHSCT + maintenance (mercaptopurine, methotrexate) or multiagent maintenance (additionally daunorubicin, vincristin, prednisone); remaining patients: alloHSCT. Prophylaxis of leptomeningeal involvement: liposomal cytarabine intrathecally.

Patients \>55 years, Ph-neg.: as above, reduced doses. AlloHSCT with reduced conditioning.

Patients Ph-pos.: as above, reduced doses in combination with continues imatinib. All intended for alloHSCT.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* New diagnosis of PLN according to WHO 2008 classification
* Age ≥18 years
* Biological status allowing administration of induction therapy
* Informed patient consent form signed

Exclusion Criteria

* Pregnancy
* Psychiatric diseases
* History of other malignancies
* HIV infection
* Active hepatitis
* Hypersensitivity to drugs used in induction
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Polish Adult Leukemia Group

OTHER

Sponsor Role collaborator

Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sebastian Giebel, MD

Role: PRINCIPAL_INVESTIGATOR

Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

Locations

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Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch

Gliwice, , Poland

Site Status

Countries

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Poland

Central Contacts

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Sebastian Giebel, MD

Role: CONTACT

Phone: 0048322788523

Email: [email protected]

Facility Contacts

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Sebastian Giebel, MD

Role: primary

References

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Holowiecki J, Krawczyk-Kulis M, Giebel S, Jagoda K, Stella-Holowiecka B, Piatkowska-Jakubas B, Paluszewska M, Seferynska I, Lewandowski K, Kielbinski M, Czyz A, Balana-Nowak A, Krol M, Skotnicki AB, Jedrzejczak WW, Warzocha K, Lange A, Hellmann A. Status of minimal residual disease after induction predicts outcome in both standard and high-risk Ph-negative adult acute lymphoblastic leukaemia. The Polish Adult Leukemia Group ALL 4-2002 MRD Study. Br J Haematol. 2008 Jun;142(2):227-37. doi: 10.1111/j.1365-2141.2008.07185.x. Epub 2008 May 19.

Reference Type BACKGROUND
PMID: 18492099 (View on PubMed)

Related Links

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http://palg.witaj.pl

The Polish Adult Leukemia Goup

Other Identifiers

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PALG ALL6

Identifier Type: -

Identifier Source: org_study_id