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Randomized Controlled Study of Post-transplant Azacitidine for Prevention of Acute Myelogenous Leukemia and Myelodysplastic Syndrome Relapse


Phase 3
18 Years
75 Years
Open (Enrolling)
Both
Leukemia, AML, MDS

Thank you

Trial Information

Randomized Controlled Study of Post-transplant Azacitidine for Prevention of Acute Myelogenous Leukemia and Myelodysplastic Syndrome Relapse


The Study Drug:

Azacitidine is designed to block certain genes in cancer cells whose job is to stop the
function of the tumor-fighting genes. By blocking the "bad" genes, the tumor-fighting genes
may be able to work better.

Study Groups:

If you are found to be eligible to take part in this study, you will be randomly assigned
(as in a flip of a coin) to 1 of 2 groups.

- If you are in Group 1, you will receive azacitidine.

- If you are in Group 2, you will not receive azacitidine.

Study Drug Administration:

If you are in Group 1, you will receive azacitidine through a needle under your skin on Days
1-5 of each cycle.

Each cycle is 28 days long.

Your dose of azacitidine may be lowered or stopped if certain side effects develop.

Study Visits:

About 2 or 3 days before each cycle and, if your doctor thinks it is needed, on Day 3 of
each cycle and 1 time during Weeks 2 and 3 of each cycle, blood (about 4 teaspoons each
time) will be drawn for routine tests.

At 3, 6, and 12 months after the stem cell transplant:

- You will have a complete medical history and physical exam.

- Blood (about 4 teaspoons each time) will be drawn for routine tests.

- You will have a bone marrow aspiration to check the status of the disease.

You may come back for study visits more often if the doctor thinks it is needed.

While on study, you will need to stay in Houston for about 3 months after the transplant
(this is standard after stem cell transplants).

Length of Study:

You will be on study treatment for up to 1 year (up to 12 cycles of azacitidine). You will
be taken off study early if you experience intolerable side effects or the disease gets
worse.

End-of-Treatment Visit:

After you complete the planned treatment with azacitidine, you will have an end-of-treatment
visit:

- You will have a complete medical history and physical exam.

- Blood (about 4 teaspoons) will be drawn for routine tests.

- You will have a bone marrow aspiration to check the status of the disease.

This is an investigational study. Azacitidine is FDA approved and is commercially available
for the treatment of myelodysplastic syndrome.

Up to 277 patients will take part in this study. All will be enrolled at MD Anderson.


Inclusion Criteria:



1. Patients with a diagnosis of AML (World Health Organization classification: >=20%
blasts in the bone marrow and / or peripheral blood) or MDS (International Prognostic
Scoring System intermediate-1 or higher) that at the time of allogeneic
transplantation were in: - Induction Failure, relapsed disease or second or greater
remission; patients in first complete remission that required more than 1 cycle of
treatment to achieve the remission, or that have AML evolving from MDS, or that had
the following abnormalities: FLT3 mutation, deletion of chromosome 5 or 7, MLL gene
rearrangement, or more than or equal to 3 cytogenetics abnormalities. Patients with
de novo or therapy-related MDS, CMML, or AML are also eligible, regardless of
cytogenetics or molecular rearrangements.

2. Biphenotypic Leukemia that at the time of allogeneic transplantation was in induction
failure, relapsed disease, first, second or greater remission.

3. Patients must be in complete remission post transplant.

4. Patient may be enrolled 40 to 100 days after transplant.

5. Age 18 to 75 years old.

6. Serum creatinine < 1.8 mg/dL or creatinine clearance greater or equal than 40 cc/min
as defined by the Cockcroft-Gault Equation*. a. Males(mL/min):(140-age)*IBW(kg) /
72*(serum creatinine(mg/dl)) b. Females(mL/min):0.85*(140-age)*IBW(kg) / 72*(serum
creatinine(mg/dl)).

7. Serum direct bilirubin < 1.5 mg/dL (unless Gilbert's syndrome).

8. SGPT
9. Be able to understand and sign informed consent.

Exclusion Criteria:

1. Active uncontrolled infection.

2. Presence of uncontrolled graft-versus-host disease.

3. Patients that underwent allogeneic transplantation as a treatment of graft failure.

4. Pregnancy or breast-feeding (women of childbearing potential, any female who has
experienced menarche and who has not undergone surgical sterilization or is not
post-menopausal with a positive serum pregnancy test.

5. Breast feeding or pregnancy. Pregnancy means a positive beta HCG test in a sexually
mature woman who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or
2) has not been naturally postmenopausal for at least 24 consecutive months (i.e.,
has had menses at any time in the preceding 24 consecutive months).

6. Known or suspected hypersensitivity to azacitidine or mannitol.

7. Patients with advanced malignant hepatic tumors.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Relapse-free survival (RFS) Time

Outcome Time Frame:

5 Years

Safety Issue:

No

Principal Investigator

Richard E. Champlin, MD, BS

Investigator Role:

Principal Investigator

Investigator Affiliation:

UT MD Anderson Cancer Center

Authority:

United States: Institutional Review Board

Study ID:

2008-0503

NCT ID:

NCT00887068

Start Date:

April 2009

Completion Date:

April 2015

Related Keywords:

  • Leukemia
  • AML
  • MDS
  • Leukemia
  • Acute myelogenous leukemia
  • AML
  • Myelodysplastic syndrome
  • MDS
  • Remission
  • Allogeneic stem cell transplant
  • Allotx
  • Azacitidine
  • 5-Azacitidine
  • 5-aza
  • Vidaza
  • 5-AZC
  • AZA-CR
  • Ladakamycin
  • NSC-102816
  • Leukemia
  • Leukemia, Myeloid, Acute
  • Leukemia, Myeloid
  • Myelodysplastic Syndromes
  • Preleukemia

Name

Location

UT MD Anderson Cancer CenterHouston, Texas  77030