Recurrent Childhood Acute Lymphoblastic Leukemia Clinical Trial
Official title:
A Phase II Study of Compound 506U78 in Patients With Refractory T-Cell Malignancies-POG/CCG Intergroup Study
Phase II trial to study the effectiveness of 506U78 in treating patients with recurrent or refractory hematologic cancer. Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die.
OBJECTIVES:
I. Determine the response rate to compound 506U78
(2-amino-9-b-D-arabinofuranosyl-6-methoxy-9H-purine) administered as a 1 hour infusion daily
for 5 days in patients with recurrent T-cell malignancies.
II. Determine the toxicities of compound 506U78 in this group of patients. III. Correlate
the biochemical pharmacology of compound 506U78 (e.g., ara-G nucleotides in leukemic blasts
and CSF concentrations) with clinical response.
IV. Determine the impact of compound 506U78 therapy on survival and duration of response of
patients with recurrent T-cell malignancies.
OUTLINE: Patients are stratified according to disease characteristics: Group 1: T-cell ALL
or NHL in first relapse (greater than 25% bone marrow blasts, with or without concomitant
extramedullary relapse other than CNS); Group 2: T-cell ALL or NHL in second or later
relapse (greater than 25% bone marrow blasts, with or without concomitant extramedullary
relapse other than CNS); Group 3: T-cell ALL or NHL with positive bone marrow and CSF
(greater than 5% bone marrow blasts and CNS 2 or 3 involvement); Group 4: Extramedullary
relapse and less than 25% blasts in the bone marrow (excluding isolated CNS relapse)
GROUP 1: Patients receive a 1 hour infusion of compound 506U78 daily for 5 days in the
absence of neurologic toxicity. The course repeats every 21 days. If a first relapse T-cell
ALL study of higher priority is not open, then the patient may continue to receive the drug
every 21 days for a maximum of 2 years provided that the patient has achieved a second
complete response.
GROUPS 2 and 4: Patients receive compound 506U78 every 21 days for a maximum of 2 years, in
the absence of disease progression. After 3 courses a patient may be given CNS prophylaxis
with triple intrathecal therapy (TIT), consisting of methotrexate, cytarabine and
hydrocortisone after consultation with study coordinator. TIT should be given every 12
weeks.
GROUP 3: Patients receive compound 506U78 every 21 days for a maximum of 2 years, in the
absence of disease progression. TIT will be given on day 1 of weeks 1-4, 6, 9 and every 6
weeks for 12 weeks, and then every 9 weeks thereafter. This stratum is open.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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