Effect of Simvastatin on Sepsis and Febrile Neutropenia in Patients With Acute Lymphoblastic Leukemia

NCT ID: NCT05133310

Last Updated: 2022-01-04

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

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-19

Study Completion Date

2023-06-23

Brief Summary

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In general, the percentage of complete remissions is 85 - 90 % for acute lymphoid leukemia (ALL). In developing countries, percentages are lower secondary to higher sepsis-related mortality. Although the effect of statins on inflammatory response associated with sepsis has been demonstrated, including an effect on bacterial proliferation in patients with a state of immunosuppression, their effect has not been demonstrated so far in patients with hemato-oncological cancer.

Detailed Description

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Death associated with sepsis is one of the principal complications related to chemotherapy treatment; there are currently no strategies to prevent its development besides the use of prophylactic antibiotics or granulocyte colony stimulants to reduce the period of febrile neutropenia. Most of the trials on the use of statins are retrospective with controversial results and include patients with different clinical situations that conditioned the septic study.

Conditions

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Strains Acute Lymphoblastic Leukemia Sepsis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Clinical randomized trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard Care Group

Patients will receive the standard chemotherapy regimen assigned for their treatment and, they will be followed and monitored until the end of treatment and hospitalization.

Group Type NO_INTERVENTION

No interventions assigned to this group

Simvastatin Treatment Group

Patients will combine the standard CALGB treatment scheme plus Simvastatin 10mg orally every 24 hours during the first 7 days of treatment and then continue with 20mg every 24 hours until the end of treatment and hospitalization.

Group Type EXPERIMENTAL

Simvastatin

Intervention Type DRUG

Combination of Simvastatin with Standard Chemotherapy scheme for acute lymphoblastic patients.

Interventions

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Simvastatin

Combination of Simvastatin with Standard Chemotherapy scheme for acute lymphoblastic patients.

Intervention Type DRUG

Other Intervention Names

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Intervention Group

Eligibility Criteria

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Inclusion Criteria

* Patients diagnosed with acute leukemia under treatment of a chemotherapy regimen
* Stable performance status (ECOG: 0 or Karnofsky scale greater than 80%) at time of analysis and under chemotherapy regimen
* Life expectancy greater than 48 hours after diagnosis
* Oral route available
* Have signed informed consent at the time of the study
* Patients whose chemotherapy regimen is administered in a hospital rather than an outpatient manner

Exclusion Criteria

* Patients with acute leukemias over 55 years of age and with impaired functional status at the time of diagnosis
* Elevation of liver enzymes 3 times higher than the range established by the central laboratory
* Persistent kidney involvement despite having adequate hydration
* Pregnant patients
* Patients with peripheral neuropathy considered severe or disabling grade
* Patients with a history of psychiatric disorders or psychotic attacks
* Individuals who do not have the oral route available, who are maintained with a nasogastric tube, or who require support for the diagnosis through parenteral nutrition
* Patients undergoing peritoneal dialysis or hemodialysis treatment
* Patients with leukemia associated with Down syndrome
* Patients under low-intensity chemotherapy regimen or palliative regimen
* Previous allergy to any statin component
* Patients with a history of liver failure (Child-Pugh Stage B or C)
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital General de Mexico

OTHER_GOV

Sponsor Role lead

Responsible Party

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Christian Omar Ramos-Peñafiel, MD, PhD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adolfo Martinez Tovar, PhD

Role: STUDY_DIRECTOR

Hospital General de Mexico

Locations

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Hospital General de México "Dr. Eduardo Liceaga"

Mexico City, , Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Christian O Ramos Peñafiel, PhD

Role: CONTACT

+52 55 27892000 ext. 2020

Adan G Gallardo Rodriguez, MSc

Role: CONTACT

+52 55 27892000 ext. 2020

Facility Contacts

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Christian O Ramos Peñafiel, PhD

Role: primary

+52 55 2789 2000 ext. 2020

Adan G Gallardo-Rodriguez, MSc

Role: backup

+52 55 2789 2000 ext. 2020

References

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Escrihuela-Vidal F, Laporte J, Albasanz-Puig A, Gudiol C. Update on the management of febrile neutropenia in hematologic patients. Rev Esp Quimioter. 2019 Sep;32 Suppl 2(Suppl 2):55-58.

Reference Type BACKGROUND
PMID: 31475812 (View on PubMed)

Pirzad Jahromi G, P Shabanzadeh A, Mokhtari Hashtjini M, Sadr SS, Rasouli Vani J, Raouf Sarshoori J, Charish J. Bone marrow-derived mesenchymal stem cell and simvastatin treatment leads to improved functional recovery and modified c-Fos expression levels in the brain following ischemic stroke. Iran J Basic Med Sci. 2018 Oct;21(10):1004-1012. doi: 10.22038/IJBMS.2018.29382.7100.

Reference Type BACKGROUND
PMID: 30524673 (View on PubMed)

Pertzov B, Eliakim-Raz N, Atamna H, Trestioreanu AZ, Yahav D, Leibovici L. Hydroxymethylglutaryl-CoA reductase inhibitors (statins) for the treatment of sepsis in adults - A systematic review and meta-analysis. Clin Microbiol Infect. 2019 Mar;25(3):280-289. doi: 10.1016/j.cmi.2018.11.003. Epub 2018 Nov 23.

Reference Type BACKGROUND
PMID: 30472427 (View on PubMed)

Other Identifiers

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HGMDI/21/204/03/63

Identifier Type: -

Identifier Source: org_study_id

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