Acute Myeloid Leukemia Clinical Trial
Official title:
Dose Escalation Study of Clofarabine in Combination With Cytarabine (Ara-C) and G-CSF Priming for Relapsed or Refractory Acute Myeloid Leukemia (AML) Patients
RATIONALE: Drugs used in chemotherapy, such as clofarabine and cytarabine, work in different
ways to stop the growth of cancer cells, either by killing the cells or stopping them from
dividing. Colony stimulating factors, such as G-CSF, may increase the number of immune cells
found in bone marrow or peripheral blood and may help the immune system recover from the side
effects of chemotherapy.
PURPOSE: This phase I trial is studying the side effects and best dose of clofarabine to see
how well it works when given together with cytarabine and G-CSF in treating patients with
relapsed or refractory acute myeloid leukemia
PRIMARY OBJECTIVES:
I. To determine the maximum tolerated dose of clofarabine, and the dose-limiting toxicities
of the combination of clofarabine and cytarabine with G-CSF priming, in the treatment of
patients with relapsed or refractory AML.
SECONDARY OBJECTIVES:
I. To determine the hematological and non-hematological side effect profile of the
combination of clofarabine, cytarabine, and G-CSF.
II. To determine the efficacy of clofarabine in combination with cytarabine and G-CSF priming
in the treatment of patients with relapsed or refractory AML.
III. To determine the disease-free and overall survival after therapy with clofarabine,
cytarabine, and G-CSF for relapsed or refractory AML.
OUTLINE: This is a dose escalation study of clofarabine.
PART I:
INDUCTION THERAPY: Patients receive clofarabine IV over 1 hour and cytarabine IV over 2 hours
on days 1-5, and filgrastim (G-CSF) subcutaneously once daily beginning 24 hours prior to
chemotherapy and continuing until blood count recover. Patients with residual leukemia (>= 5%
blasts by morphology) at day 14 and if blast remain > 5% by day 21 receive a second course of
induction therapy.
CONSOLIDATION THERAPY: Patients receive clofarabine, cytarabine, and G-CSF as in induction
therapy. Patients may receive a second course of consolidation therapy depending on response
and whether additional therapy (e.g., stem cell transplant or donor lymphocyte infusion) is
planned.
PARTS II and III:
Patients receive induction therapy and consolidation therapy as in part 1.
After completion of study treatment, patients are followed every 3 months for 2 years and
then annually for 3 years.
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