Trial Outcomes & Findings for Leukemia Stem Cell Detection in Acute Myeloid Leukemia (NCT NCT02927938)

NCT ID: NCT02927938

Last Updated: 2022-04-21

Results Overview

Comparison of 2 year RFS in patient with detectable LSCs in the marrow at the end of consolidation to the 2 year RFS of patients without detectable LSCs. IWG Criteria (Cheson 2003) was utilized to classify relapse, with relapse defined as ≥ 5% blasts in the marrow or peripheral blood, extramedullary disease, or disease presence determined by a physician upon clinical assessment.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

18 participants

Primary outcome timeframe

2 years

Results posted on

2022-04-21

Participant Flow

Participant milestones

Participant milestones
Measure
Evaluable Cohort - Transplant Arm
Standard of Care Consolidation (HCT) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT); HMA-based induction subjects: Are candidates for (as determined by the investigator) and receive HCT Allogeneic HCT
Evaluable Cohort - Consolidation Chemo Arm
Standard of Care Consolidation (cytarabine-based chemo) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT) Consolidation chemotherapy: Cytarabine-based consolidation chemotherapy
Observational Cohort 1
Enrolled subjects who do not achieve a CR to induction therapy, regardless of diagnostic phenotype. Following completion of induction therapy and remission bone marrow aspirate, if a subject is determined to not have achieved a complete remission to induction therapy, he or she would be included in observational cohort 1.
Observational Cohort 2
Enrolled subjects who achieve a CR to induction therapy but meet one or more of the following criteria: * Lack the immunophenotype of interest, * Cytarabine based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit or refusal)\] and do not receive consolidation therapy (cytarabine-based chemotherapy or HCT) * HMA-based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit, lack of donor, refusal)\] and do not receive HCT Final investigator determination of fit-ness can occur at any time until the start of consolidation therapy. HMA-based induction subjects will not receive consolidation cytarabine-based chemotherapy as part of the evaluable cohort if they do not receive HCT.
Overall Study
STARTED
1
6
4
7
Overall Study
COMPLETED
0
0
0
0
Overall Study
NOT COMPLETED
1
6
4
7

Reasons for withdrawal

Reasons for withdrawal
Measure
Evaluable Cohort - Transplant Arm
Standard of Care Consolidation (HCT) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT); HMA-based induction subjects: Are candidates for (as determined by the investigator) and receive HCT Allogeneic HCT
Evaluable Cohort - Consolidation Chemo Arm
Standard of Care Consolidation (cytarabine-based chemo) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT) Consolidation chemotherapy: Cytarabine-based consolidation chemotherapy
Observational Cohort 1
Enrolled subjects who do not achieve a CR to induction therapy, regardless of diagnostic phenotype. Following completion of induction therapy and remission bone marrow aspirate, if a subject is determined to not have achieved a complete remission to induction therapy, he or she would be included in observational cohort 1.
Observational Cohort 2
Enrolled subjects who achieve a CR to induction therapy but meet one or more of the following criteria: * Lack the immunophenotype of interest, * Cytarabine based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit or refusal)\] and do not receive consolidation therapy (cytarabine-based chemotherapy or HCT) * HMA-based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit, lack of donor, refusal)\] and do not receive HCT Final investigator determination of fit-ness can occur at any time until the start of consolidation therapy. HMA-based induction subjects will not receive consolidation cytarabine-based chemotherapy as part of the evaluable cohort if they do not receive HCT.
Overall Study
Death
0
1
0
4
Overall Study
Early Study Termination
1
5
4
3

Baseline Characteristics

Leukemia Stem Cell Detection in Acute Myeloid Leukemia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Evaluable Cohort - Transplant Arm
n=1 Participants
Standard of Care Consolidation (HCT) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT); HMA-based induction subjects: Are candidates for (as determined by the investigator) and receive HCT Consolidation chemotherapy: Cytarabine-based consolidation chemotherapy
Evaluable Cohort - Consolidation Chemo Arm
n=6 Participants
Standard of Care Consolidation (cytarabine-based chemo) Enrolled subjects that will contribute to the population of subjects who are evaluable for the primary and secondary objectives. This will not include any subjects who end up in either observational cohort. To be included in the evaluable cohort, the subject must meet the following requirements: 1. Complete remission (CR1) from standard cytarabine or HMA-based induction therapy per standard clinical criteria (Cheson Criteria) 2. Have confirmed presence of CD34+CD38-ALDHint population by flow cytometry at the diagnostic LSC assay (LSC0) 3. Cytarabine-based induction subjects: Are candidates for (as determined by the investigator) and receive consolidation therapy (cytarabine-based chemotherapy or HCT) Consolidation chemotherapy: Cytarabine-based consolidation chemotherapy
Observational Cohort 1
n=4 Participants
Enrolled subjects who do not achieve a CR to induction therapy, regardless of diagnostic phenotype. Following completion of induction therapy and remission bone marrow aspirate, if a subject is determined to not have achieved a complete remission to induction therapy, he or she would be included in observational cohort 1.
Observational Cohort 2
n=7 Participants
Enrolled subjects who achieve a CR to induction therapy but meet one or more of the following criteria: * Lack the immunophenotype of interest, * Cytarabine based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit or refusal)\] and do not receive consolidation therapy (cytarabine-based chemotherapy or HCT) * HMA-based induction subjects: Are not candidates for \[as determined by the investigator (e.g. unfit, lack of donor, refusal)\] and do not receive HCT Final investigator determination of fit-ness can occur at any time until the start of consolidation therapy. HMA-based induction subjects will not receive consolidation cytarabine-based chemotherapy as part of the evaluable cohort if they do not receive HCT.
Total
n=18 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Age, Categorical
Between 18 and 65 years
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
6 Participants
n=4 Participants
16 Participants
n=21 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
2 Participants
n=21 Participants
Age, Continuous
35.0 years
STANDARD_DEVIATION NA • n=5 Participants
44.3 years
STANDARD_DEVIATION 14.7 • n=7 Participants
51.0 years
STANDARD_DEVIATION 14.5 • n=5 Participants
46.3 years
STANDARD_DEVIATION 15.6 • n=4 Participants
46.1 years
STANDARD_DEVIATION 14.2 • n=21 Participants
Sex: Female, Male
Female
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
4 Participants
n=4 Participants
8 Participants
n=21 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
4 Participants
n=7 Participants
2 Participants
n=5 Participants
3 Participants
n=4 Participants
10 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
1 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
2 Participants
n=4 Participants
7 Participants
n=21 Participants
Race (NIH/OMB)
White
1 Participants
n=5 Participants
4 Participants
n=7 Participants
1 Participants
n=5 Participants
4 Participants
n=4 Participants
10 Participants
n=21 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
1 Participants
n=21 Participants
Region of Enrollment
United States
1 participants
n=5 Participants
6 participants
n=7 Participants
4 participants
n=5 Participants
7 participants
n=4 Participants
18 participants
n=21 Participants
AML Risk Level (prior to induction)
Favorable Risk
0 Participants
n=5 Participants
6 Participants
n=7 Participants
1 Participants
n=5 Participants
4 Participants
n=4 Participants
11 Participants
n=21 Participants
AML Risk Level (prior to induction)
Intermediate Risk
0 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
1 Participants
n=4 Participants
3 Participants
n=21 Participants
AML Risk Level (prior to induction)
Unfavorable Risk
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
4 Participants
n=21 Participants
Immunophenotype at LSC0
CD34-
0 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
5 Participants
n=4 Participants
6 Participants
n=21 Participants
Immunophenotype at LSC0
CD34+CD38-ALDH(int)
1 Participants
n=5 Participants
6 Participants
n=7 Participants
3 Participants
n=5 Participants
1 Participants
n=4 Participants
11 Participants
n=21 Participants
Immunophenotype at LSC0
CD34+CD38-ALDH(high)
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
1 Participants
n=21 Participants
LSC0 Status (prior to induction)
Leukemia Stem Cells Detected
1 Participants
n=5 Participants
6 Participants
n=7 Participants
3 Participants
n=5 Participants
1 Participants
n=4 Participants
11 Participants
n=21 Participants
LSC0 Status (prior to induction)
Leukemia Stem Cells Not Detected
0 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
6 Participants
n=4 Participants
7 Participants
n=21 Participants
Deletion 5 or 5q
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Deletion 5 or 5q
Negative
1 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
Deletion 5 or 5q
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Deletion 7 or 7q
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Deletion 7 or 7q
Negative
1 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
Deletion 7 or 7q
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
KNMT2A
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
KNMT2A
Negative
1 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
KNMT2A
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
inv(3) or t(3;3)
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
inv(3) or t(3;3)
Negative
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
inv(3) or t(3;3)
Uninterpretable results
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
t(6;9)
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
t(6;9)
Negative
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
t(6;9)
Uninterpretable results
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
t(9;22)
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
t(9;22)
Negative
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
t(9;22)
Uninterpretable results
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
t(8;21)
Positive
0 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
3 Participants
n=21 Participants
t(8;21)
Negative
1 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
6 Participants
n=4 Participants
15 Participants
n=21 Participants
t(8;21)
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
inv(16 or t(16;16)
Positive
0 Participants
n=5 Participants
2 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
2 Participants
n=21 Participants
inv(16 or t(16;16)
Negative
1 Participants
n=5 Participants
4 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
16 Participants
n=21 Participants
inv(16 or t(16;16)
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Plus 8
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Plus 8
Negative
1 Participants
n=5 Participants
6 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
18 Participants
n=21 Participants
Plus 8
Uninterpretable results
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Plus 21
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Plus 21
Negative
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
Plus 21
Uninterpretable results
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
t(9;11)
Positive
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
t(9;11)
Negative
1 Participants
n=5 Participants
5 Participants
n=7 Participants
4 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
t(9;11)
Uninterpretable results
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
1 Participants
n=21 Participants
LSC1 Status (post induction, at enrollment)
Leukemia Stem Cells Detected
0 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
1 Participants
n=4 Participants
2 Participants
n=21 Participants
LSC1 Status (post induction, at enrollment)
Leukemia Stem Cells Not Detected
0 Participants
n=5 Participants
6 Participants
n=7 Participants
2 Participants
n=5 Participants
4 Participants
n=4 Participants
12 Participants
n=21 Participants
LSC1 Status (post induction, at enrollment)
Indeterminate/Unknown Results
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
4 Participants
n=21 Participants

PRIMARY outcome

Timeframe: 2 years

Population: The primary efficacy analyses will be conducted on the subset of subjects who were included in the evaluable cohort (HCT or chemo treatment arm) and who also had a successful/interpretable end of consolidation eLSC assay. This excludes subjects in OC1 and 2, as they did not achieve CR to induction or did not have the immunophenotype of interest.

Comparison of 2 year RFS in patient with detectable LSCs in the marrow at the end of consolidation to the 2 year RFS of patients without detectable LSCs. IWG Criteria (Cheson 2003) was utilized to classify relapse, with relapse defined as ≥ 5% blasts in the marrow or peripheral blood, extramedullary disease, or disease presence determined by a physician upon clinical assessment.

Outcome measures

Outcome measures
Measure
eLSC+ (Evaluable Cohort)
Of the subjects enrolled in the evaluable cohort (either allo HCT or consolidation chemotherapy), those who had leukemia stem cells detected post-consolidation. Note, eLSC indicates the time point after consolidation.
eLSC- (Evaluable Cohort)
n=5 Participants
Of the subjects enrolled in the evaluable cohort (either allo HCT or consolidation chemotherapy), those who had leukemia stem cells not detected post-consolidation. Note, eLSC indicates the time point after consolidation.
2 Year Relapse Free Survival (RFS)
NA Participants
Study terminated early, with immature outcome data. There was not enough follow up to determine 2-year RFS status for these subjects prior to study termination.

Adverse Events

Evaluable Cohort - Transplant Arm

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

Evaluable Cohort - Consolidation Chemo Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths

Observational Cohort 1

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

Observational Cohort 2

Serious events: 0 serious events
Other events: 0 other events
Deaths: 4 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. James Symanowski; Chair, Department of Cancer Biostatistics

Levine Cancer Institute

Phone: 9804422371

Results disclosure agreements

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