Adult Acute Myeloid Leukemia in Remission Clinical Trial
Official title:
HLA-Mismatched Allogeneic Cellular Therapy (Microtransplantation) After Chemotherapy in Patients With Intermediate-Risk Acute Myeloid Leukemia < 60 Years
This phase II trial studies how well donor cellular therapy after cytarabine works in treating patients with intermediate-risk acute myeloid leukemia with a decrease in or disappearance of signs and symptoms of cancer. Donor cellular therapy is a short-term transfusion of cells from a family member who is incompletely matched. The use of these partially matched white blood cells may help improve response to standard chemotherapy (cytarabine) and reduce some of the risks of infection, without a permanent transplant. Drugs used in chemotherapy, such as cytarabine, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving donor cellular therapy after cytarabine may kill more cancer cells.
PRIMARY OBJECTIVES:
I. To assess 2-year disease-free survival (as defined by time to death from any cause or
disease relapse, whichever is earlier) for patients < 60 years of age with intermediate-risk
acute myeloid leukemia (AML), in complete remission (CR) after induction chemotherapy, who
receive microtransplantation, compared to patients who received consolidation chemotherapy
only in a historical published comparable cohort of patients.
SECONDARY OBJECTIVES:
I. To obtain estimates of rate of relapse, treatment related mortality (TRM), all cause
mortality, in the microtransplantation (MST) group and compare it with allogeneic stem cell
group (historical cohort).
II. To obtain estimates of rate acute graft-versus-host disease (GVHD), chronic GVHD, time to
recovery of absolute neutrophil counts and platelets in patients with intermediate risk AML
receiving of chemotherapy in combination with microtransplantation.
TERTIARY OBJECTIVES:
I. Presence or absence of detectable donor chimerism post-microtransplantation until 6 months
after the last infusion.
II. Characteristics of the infused cells and composition of the graft. III. Dynamics of
T-cell clonality. IV. Immune cell subset analysis.
OUTLINE:
Approximately 4-6 weeks after completion of induction chemotherapy, patients receive
cytarabine intravenously (IV) over 1-3 hours twice daily (BID) on days -7 to -2 and
granulocyte colony stimulating factor (G-CSF) mobilized peripheral blood cells
(microtransplant) IV over 15-20 minutes on day 0. Treatment repeats every 8-10 weeks for 3
courses in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed up at least every 3 months for 2
years.
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