Phase II Efficacy and Safety Study of Dasatinib in Patients With Chronic and Accelerated Phase Chronic Myeloid Leukemia Relapsing After Allogeneic Blood or Bone Marrow Transplantation
1. To assess the efficacy of Dasatinib therapy in chronic and accelerated phase BCR-ABL
(+) (Ph + and Ph -) CML patients that undergo molecular, cytogenetic or haematological
relapse following SCT.
1. To assess the impact of Dasatinib therapy on patient survival after relapse post-SCT
and the incidence of any subsequent need for 'rescue' DLI.
2. To assess the safety of Dasatinib in this clinical context using this specific dose
Chronic myeloid leukaemia (CML) is a form of cancer that starts in cells within the bone
marrow called haematopoietic stem cells. Stem cells are immature cells which can divide many
times and eventually produce all the lymphocytes and myeloid cells present in the blood.
They are produced in the bone marrow - the spongy tissue found in large bones, including the
pelvis, sternum, limb bones and the ribs.
Leukaemia is a cancer of the white blood cells. In CML, too many myeloid cells (one of the
main types of white blood cells which defend the body against infectious diseases) are
produced. The myeloid cells are released into the blood when they are immature and unable to
work properly. These immature white blood cells are known as blasts.
The immature cells fill up the bone marrow and prevent it from making blood cells properly.
As the leukaemia cells do not mature, they can't do the work of normal white blood cells,
which leads to an increased risk of infection. Because the bone marrow is overcrowded with
immature white cells it also can't make enough healthy red cells and platelets.
CML usually develops very slowly, which is why it is called 'chronic' myeloid leukaemia.
The aim of this study is to assess the efficacy (indicates the capacity for beneficial
change or therapeutic effect) of a leukaemia treatment called dasatinib (sprycel) in
patients with relapsed Chronic Myeloid Leukaemia (CML) following a Stem Cell Transplant
(SCT) and who are not benefiting from other treatment, such as imatinib therapy.
A relapse is when an illness that has seemed to be getting better, or to have been cured,
comes back or gets worse again.
Dasatinib works by blocking (inhibiting) signals within cancer cells that cause the cell to
grow and divide.
The growth of cells in our bodies is controlled by signals that switch on and off within the
cells. When the signals for growth are switched on the cells are triggered to grow and
multiply. People with CML have an abnormal signaling protein inside their leukaemia cells.
This abnormal protein sends out grow-and-divide signals to the cells at all times and never
Dasatinib finds the faulty protein and locks onto it. This prevents the protein from
stimulating the cells to grow. Dasatinib is known as a signal transduction inhibitor,
because it blocks the 'grow' signal. The chemical it blocks is called tyrosine kinase, so
dasatinib is also known as a tyrosine kinase inhibitor.
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
CMR as determined by two consecutive (-) RT-PCR tests for the presence of BCR-ABL transcripts in peripheral blood samples 1 year after starting Dasatinib therapy. The expected CMR of >30% would be regarded as being clinically relevant
Eduardo L Olavarria, Dr
Hospital De Navarra Irunlarrea, Spain
France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)