Lomustine and Intermediate Dose Cytarabine in Older Patients With AML
Study Details
Study Description
Brief Summary
A multicenter randomized trial was performed comparing induction therapy (IC: Idarubicin and Cytarabine, 5+7) to ICL (the same drugs plus lomustine (CCNU), 200mg\m2 orally at day 1). Patients in complete remission (CR) were then randomized to receive either maintenance therapy or intensification with intermediate-dose cytarabine and idarubicin followed by maintenance therapy.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 3 |
Detailed Description
Induction therapy: Patients were randomized to receive idarubicin plus cytarabine (IC) or the same drugs plus lomustine (ICL), the latter given at the dose of 200 mg/m2 orally at day 1. Patients with persistent leukemia in the bone marrow, defined by at least 20% marrow cellularity with more than 5% blasts on day 14 or at a subsequent time point following initiation of induction therapy, received a second course of induction chemotherapy identical to the initial induction course. Non-responders to the second induction course were taken off the protocol.
Consolidation therapy: After completing induction treatment, patients who were in complete remission after 1 or 2 induction courses received a course of consolidation (IC') therapy with idarubicin and subcutaneous cytarabine. Subsequently, if stable remission persisted, the patients received maintenance therapy or maintenance therapy preceded by a second consolidation (IIC) with intermediate-dose cytarabine. Randomization was performed as soon as CR was achieved.
Maintenance therapy: This was conducted in all patients with persisting CR one month after completing the first (IC) or second (IIC) consolidation and consisted of the following: five courses of combination chemotherapy at 1, 3, 6, 9 and 13 months from the last consolidation, namely cytarabine (subcutaneously) and idarubicin and between these courses for one year: a continuous regimen of methotrexate and 6-mercaptopurine, as alternating 10 day-courses .
Study Design
Outcome Measures
Primary Outcome Measures
- Primary Outcomes: The primary objective of this study was to assess the ability of lomustine to increase the CR rate and to improve overall survival [13 months]
Secondary Outcome Measures
- Secondary Outcomes: The secondary objective was to test intermediate-dose cytarabine on survival, and to analyze the impact of prognostic factors on CR and survival. [13 months]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients aged 60 years and older with de novo AML according to FAB criteria
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With normal cardiac function with left ventricular ejection fraction >= 50%, absence of unstable cardiac arrhythmia or unstable angina.
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Unimpaired renal (creatinin <180µmol\L)
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Unimpaired liver (bilirubin <35µmol\L) functions.
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Performance status <3
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Signed and dated informed consent.
Exclusion Criteria:
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Acute promyelocytic leukemia
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Patients with myeloproliferative syndromes prior to diagnosis of AML
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Patients who previously had myelodysplastic syndrome
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Patients pretreated with chemo- or radiotherapy
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Performance status <2
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Positive serology for HIV
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Josy REIFFERS, MD MS | Pessac | France | 33604 |
Sponsors and Collaborators
- French Innovative Leukemia Organisation
Investigators
- Principal Investigator: JOSY REIFFERS, MD, CHU Haut-Leveque Pessac 33604 France
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- BGMT95-V