De-escalated Treatment Approach for Adult Ph-negative Acute Lymphoblastic Leukemia (ALL)

NCT ID: NCT03462095

Last Updated: 2018-03-13

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

NA

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-31

Study Completion Date

2022-12-01

Brief Summary

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No high-dose methotrexate (MTX) and high-dose cytarabine (ARA-C) consolidation blocks, L-asparaginaseis scheduled for 1 year of treatment, 21 intrathecal injections through the whole treament, T-ALL patients in complete remossion (CR) after the informed consent are randomized to: auto-HSCT vs no auto-HSCT, - with the similar further maintenance. Stem cell harvest is performed after the 3rd consolidation by G-SCF disregarding minimal residual disease (MRD) level. Auto-HSCT is planned after the 5th consolidation phase. All primary bone samples are collected and tested for cytogenetics and molecular markers, all included patients are monitored by flow cytometry by aberrant immunophenotype in a centralized lab.

Detailed Description

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* 7 days prednisolone prephase
* 8 weeks induction with de-escalation of induction chemotherapy: 3 instead of 4 dauno/vncr pulses,

1. instead of 2 Cph injections during induction,
2. instead of 4 ARA-C blocks, distribution of of L-asp injections through all phases
* After CR achievement T-cell ALL patients are being randomized to auto-HSCT vs no auto-HSCT
* Non-interruptive 5 consolidation phases with dose modification according to WBC and platelets count after CR achievement. Rotation of consolidation is permitted
* After the 3rd consolidation stem cells harvesting is carried out for T-cell ALL patients randomized to auto-HSCT
* Auto-HSCT after the 5th consolidation phase with non-myeloablative CEAM conditioning
* 2 years maintenance for all patients
* 21 TIT through the whole treatment with higher intensity during induction\|consolidation
* Centralized MRD monitoring at +70 d, + 133 d, + 190 days; before and after auto-HSCT
* Allo-HSCT is planned only for very high risk patients (11q23 ALL, MRD positivity at day +190)

Conditions

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Precursor Cell Lymphoblastic Leukemia-Lymphoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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no Auto-HSCT

After completing prolonged consolidation T-cell ALL patients will continue with 2 years maintenance

Group Type NO_INTERVENTION

No interventions assigned to this group

Auto-HSCT

After completing prolonged consolidation T-cell ALL patients will get autologous HSCT followed by 2 years maintenance

Group Type EXPERIMENTAL

Autologous HSCT

Intervention Type PROCEDURE

After the 3rd consolidation, T-cell ALL patients, randomized to auto-HSCT will be mobilised by G-SCF and harvested disregarding MRD-status. After completing the 5th consolidation T-ALL patients will be transplanted after non-myeloablative CEAM (CCNU, Ethoposide, ARA-C, Melphalan) conditioning, and after reconstitution will continue 2-years maintenance

Interventions

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Autologous HSCT

After the 3rd consolidation, T-cell ALL patients, randomized to auto-HSCT will be mobilised by G-SCF and harvested disregarding MRD-status. After completing the 5th consolidation T-ALL patients will be transplanted after non-myeloablative CEAM (CCNU, Ethoposide, ARA-C, Melphalan) conditioning, and after reconstitution will continue 2-years maintenance

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* age 18-55 yy, newly diagnosed non-treated Ph-negative ALL

Exclusion Criteria

* age \> 55 yy, Ph-positivity, relapsed\|refractory ALL, pretreated ALL
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Research Center for Hematology, Russia

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Valeriy V Savchenko, Academician

Role: STUDY_DIRECTOR

National Research Center for hematology, Moscow, Russia

Locations

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National Research Center for Hematology

Moscow, , Russia

Site Status RECRUITING

Countries

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Russia

Central Contacts

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Elena N Parovichnikova, MD,PhD

Role: CONTACT

+79161252623

Olga A Gavrilina, M.D.

Role: CONTACT

Facility Contacts

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Elena N Parovichnikova, MD PhD

Role: primary

+7(495)6124313

Other Identifiers

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ALL--2016

Identifier Type: -

Identifier Source: org_study_id

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