Early Allogeneic Hematopoietic Cell Transplantation in Treating Patients With Relapsed or Refractory High-Grade Myeloid Neoplasms
Study Details
Study Description
Brief Summary
This clinical trial studies how well early stem cell transplantation works in treating patients with high-grade myeloid neoplasms that has come back after a period of improvement or does not respond to treatment. Drugs used in chemotherapy, such as filgrastim, cladribine, cytarabine and mitoxantrone hydrochloride, 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 chemotherapy before a donor peripheral blood cell transplant helps stop the growth of cells in the bone marrow, including normal blood-forming cells (stem cells) and cancer cells. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets. The donated stem cells may also replace the patient's immune cells and help destroy any remaining cancer cells. Early stem cell transplantation may result in more successful treatment for patients with high-grade myeloid neoplasms.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
|
Phase 2 |
Detailed Description
OUTLINE:
RE-INDUCTION CHEMOTHERAPY: Patients receive filgrastim subcutaneously (SC) on days 0-5, mitoxantrone hydrochloride intravenously (IV) over 60 minutes on days 1-3, cladribine IV over 2 hours on days 1-5, and cytarabine IV over 2 hours on days 1-5.
CONDITIONING REGIMEN: Beginning 14-60 days after re-induction chemotherapy, patients receive fludarabine phosphate IV over 30 minutes on days -6 to -2, melphalan IV on days -3 to -2, cyclosporine orally (PO) twice daily (BID) starting on day -3. Sirolimus PO BID starting on day -3 will be given to patients who have matched unrelated donors or mismatched unrelated donors. Patients >55 years or with significant co-morbidities will only receive melphalan IV on day -2 and will also receive total body irradiation (TBI) on day -1 or day 0.
EARLY TRANSPLANT: Patients undergo allogeneic HCT after conditioning regimen on day 0.
GVHD PROPHYLAXIS: Patients with matched donors will receive mycophenolate mofetil PO three times daily (TID) on days 0-30, then twice a day (BID) until day 40; and cyclosporine PO BID on days -3 to 96, with a taper until day 150. Patients with matched unrelated donors also receive sirolimus PO BID on days -3 to 150, with a taper until day 180. Patients with mismatched unrelated donors will receive mycophenolate mofetil PO TID on days 0-30, then BID until day 100, with a taper until day 150; cyclosporine PO BID on days -3 to 150, then taper until day 180; and sirolimus BID PO days -3 to 180, then a taper until day 365.
After completion of study treatment, patients are followed up periodically.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Treatment (chemotherapy, HCT) See Detailed Description |
Drug: Cladribine
Given IV
Other Names:
Drug: Cyclosporine
Given PO
Other Names:
Drug: Cytarabine
Given IV
Other Names:
Biological: Filgrastim
Given SC
Other Names:
Drug: Fludarabine Phosphate
Other Names:
Procedure: Allogeneic Hematopoietic Stem Cell Transplantation
Undergo allogeneic hematopoietic stem cell transplantation
Other Names:
Other: Laboratory Biomarker Analysis
Correlative studies
Drug: Melphalan
Given IV
Other Names:
Drug: Mitoxantrone Hydrochloride
Given IV
Other Names:
Drug: Mycophenolate Mofetil
Given PO
Other Names:
Other: Questionnaire Administration
Ancillary studies
Drug: Sirolimus
Given PO
Other Names:
Radiation: Total-Body Irradiation
Undergo TBI
Other Names:
Drug: Melphalan Hydrochloride
Given IV
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Feasibility of Early Allogeneic Hematopoietic Cell Transplant Assessed by Enrollment and Incidence of Early Transplant [Up to 60 days after start of chemotherapy]
Success will be defined as enrollment of at least 30 patients with transplants occurring in 15 of these 30 (50%) within 60 days of enrollment or start of induction chemotherapy with G-CLAM, whichever is earlier.
- Feasibility of Early Allogeneic Hematopoietic Cell Transplant Assessed by Relapsed-free Survival 6 Months After Transplant [6 months after early allogeneic HCT on study]
Success will be defined as observing a 40% of higher 6-month relapse-free survival among patients who received early transplant on study.
Secondary Outcome Measures
- Response Assessments After Early Allogeneic Hematopoietic Cell Transplant, Day 28 [Approximately 28 days after early allogeneic HCT]
Complete Remission (CR), defined as <5% blasts in bone marrow with hematologic recovery (ANC>1000/ul and platelets >100,000/ml). CRi, defined as complete remission with insufficient hematologic recovery (ANC<1000/ul or platelets<100,000/ul). CRp, defined as complete remission but platelets <100,000/ul. Minimal residual disease (MRD), defined as any detectable disease by flow cytometry, cytogenetics, FISH or PCR in a patient otherwise fulfilling remission criteria. Morphologic leukemia-free state (MLFS), defined as <5% blasts in bone marrow with no hematologic recovery. Relapse, defined as >5% blasts in bone marrow, flow cytometry, or manual differential; OR treatment for active relapsed disease.
- Response Assessments After Early Allogeneic Hematopoietic Cell Transplant, Day 84 [Approximately 84 days after early allogeneic HCT]
Complete Remission (CR), defined as <5% blasts in bone marrow with hematologic recovery (ANC>1000/ul and platelets >100,000/ml). CRi, defined as complete remission with insufficient hematologic recovery (ANC<1000/ul or platelets<100,000/ul). CRp, defined as complete remission but platelets <100,000/ul. Minimal residual disease (MRD), defined as any detectable disease by flow cytometry, cytogenetics, FISH or PCR in a patient otherwise fulfilling remission criteria. Morphologic leukemia-free state (MLFS), defined as <5% blasts in bone marrow with no hematologic recovery. Relapse, defined as >5% blasts in bone marrow, flow cytometry, or manual differential; OR treatment for active relapsed disease.
- Relapse-free Survival (RFS) Among Patients Who Received Early Transplant [Up to 100 days post-transplant]
Relapse-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Relapse-free Survival (RFS) Among Patients Who Received Early Transplant [Up to 6 months post-transplant]
Relapse-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Event-free Survival (EFS) Among Patients Who Received Early Transplant [Up to 100 days post-transplant]
Event-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. Events included death, relapse, and grade 3-4 acute graft vs host disease.
- Event-free Survival (EFS) Among Patients Who Received Early Transplant [Up to 6 months post-transplant]
Event-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. Events included death, relapse, and grade 3-4 acute graft vs host disease.
- Overall Survival (OS) Among Patients Who Received Early Transplant. [Up to 100 days post-transplant]
Overall survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Overall Survival (OS) Among Patients Who Received Early Transplant. [Up to 6 months post-transplant]
Overall survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Overall Survival (OS) Among Patients Who Did Not Receive Early Transplant [Up to 100 days after induction day 1]
Overall survival among patients who did not receive early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Overall Survival (OS) Among Patients Who Did Not Receive Early Transplant [Up to 6 months after induction day 1]
Overall survival among patients who did not receive early allogeneic HCT on study as estimated with the Kaplan-Meier method.
- Acute Graft Versus Host Disease Among Patients Who Received Early Transplant [At day 100]
Acute graft versus host disease (graded II, III, or IV) among patients who received early allogeneic HCT on study.
- Treatment Related Mortality Among Patients Who Received Early Transplant vs Patients Who Did Not Receive Early Transplant [At day 100]
Treatment related mortality calculated among patients who received early allogeneic HCT on study vs patients who did not receive early transplant on study.
- Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - TREATMENT RELATED MORTALITY [From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study)]
Patients who receive early transplant will be compared to those that don't using the Wilcoxon rank sum test for the quantitative variable of treatment-related mortality (TRM). This outcome measure is intended to report a predicted TRM score assessed at the time of feasibility evaluation. The TRM score is used to measure "treatment-related mortality," or likelihood of death within 28 days of initiation of induction chemotherapy for patients with AML. The score is normalized from 0 to 100, so that a score of 0 demonstrates the patient has a very low likelihood of TRM and a score of 100 a very high likelihood of death. A calculation is used to predict TRM using age, performance status, if they have secondary AML, albumin, creatinine, platelet count, white blood cell count, and peripheral blood blast percentage. The higher the TRM score, the higher the risk of TRM. Calculator and table of relationship between TRM score and TRM probability found here: https://trmcalculator.fredhutch.org/.
- Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - GENDER [From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study)]
Patients who receive early transplant will be compared to those that don't using the Fisher's exact test for the categorical variables of gender.
- Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - AGE [From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study)]
Patients who receive early transplant will be compared to those that don't using the Wilcoxon rank sum test for the quantitative variable of age.
- Demonstrate the Feasibility of Collecting Patient-reported Outcomes for Trial Participants [Up to 12 months post-HCT]
The amount of returned patient-reported outcome questionnaires will be summarized for each collection timepoint using percent collection from surviving patients for PRO timepoints.
- Demonstrate the Feasibility of Collecting Resource Utilization Data for Trial Participants [Within the first year of induction chemotherapy on study]
The amount of days of hospitalization (the major driver of costs within the first year) will be collected for resource utilization.
Eligibility Criteria
Criteria
Inclusion Criteria:
INCLUSION CRITERIA (ENROLLMENT)
-
Relapsed or refractory high-grade myeloid neoplasms, defined as having a blast count of >= 10% blasts at initial diagnosis; examples include excess blasts (EB)-2, with >= 10% blasts at initial diagnosis, acute myeloid leukemia (AML) or chronic myelomonocytic leukemia (CMML-2); standard definitions of relapse will apply (i.e., characterized by >= 5% abnormal blasts or blast equivalents as assessed by multiparameter flow cytometry or morphologic examination; peripheral blood blasts or blast equivalents; or extramedullary granulocytic sarcoma, per European LeukemiaNet [ELN] 2017 guidelines); bone marrow aspirate/biopsy will be accepted if performed outside University of Washington/Fred Hutchinson Cancer Research Center (UW/FHCRC); determination of disease status should occur within 30 days of signing informed consent
-
R/R high-grade myeloid neoplasm following intensive induction chemotherapy; relapsed high-grade myeloid neoplasm: patients will be classified as relapsed if they have >= 5% blasts after being in a complete remission (CR) following treatment for high-grade myeloid neoplasm; refractory high-grade myeloid neoplasm: patients may be classified as refractory if they have received at least one prior cycle of induction chemotherapy, whether with cladribine cytarabine mitoxantrone (GCLAM) or another regimen
** Patients may have received up to two courses of intensive induction chemotherapy during initial treatment prior to enrollment on this protocol; for example, patients who have received two courses of granulocyte colony stimulating factor (G-CSF) GCLAM (or similar) chemotherapy, with most recent high-dose cytarabine-containing chemotherapy > 6 months ago and CR lasting > 6 months, will be eligible for this protocol; regimens "similar to GCLAM" would include cytarabine at doses of 1g/m^2 for at least 5 doses; examples of regimens "similar to GCLAM" would be GCLA, fludarabine cytarabine granulocyte (FLAG), and FLAG-idarubicin (ida); however, patients who received more than two courses of GCLAM (or similar) chemotherapy, or patients who received two courses of GCLAM and had CR lasting < 6 months, would not be eligible
-
R/R high-grade myeloid neoplasm following less intensive induction chemotherapy. Patients who have received at least three cycles of treatment with a hypomethylating agent (HMA; such as azacitidine or decitabine) and still have >= 10% blasts will be eligible for the study (they will be considered refractory); similarly, patients who have received three or more cycles of HMA therapy who have had a response (e.g., achieving CR with < 5% blasts), but who then progress using standard definitions of relapse, will also be eligible (they will be considered relapsed)
-
Potentially eligible for reduced intensity conditioning based on known organ function (formal organ function testing may occur after consent)
-
Caregiver capable of providing post-HCT care
-
Written informed consent
INCLUSION CRITERIA (TRANSPLANT)
-
Identified donor (see DONOR SELECTION below for further details)
-
Matched related or unrelated (one allele mismatch in HLA-A, B, or C OK) donor according to institutional standards
-
Unrelated volunteer donor who is mismatched with the recipient (i.e. 9/10 match)
-
Caregiver capable of providing post-HCT care, who will be present once induction therapy with filgrastim, cladribine, cytarabine, mitoxantrone hydrochloride (GCLAM) begins
-
Written informed consent for transplant
-
Either bone marrow or peripheral blood is allowed
Exclusion Criteria:
EXCLUSION CRITERIA (ENROLLMENT)
-
Prior allogeneic HCT
-
More than two prior courses of induction chemotherapy
-
Relapse after minimal residual disease (MRD)-negative CR within 3 months of most recent GCLAM chemotherapy
-
Low likelihood of being eligible for reduced intensity conditioning HCT based on known information
-
Cardiac ejection fraction < 40% or symptomatic coronary artery disease or uncontrolled arrhythmia, as assessed by multigated acquisition (MUGA) or transthoracic echocardiography (TTE) within previous 3 months and since the most recent anthracycline exposure
-
Corrected diffusing capacity of the lungs for carbon monoxide (DLCOc) < 40% or forced expiratory volume in 1 second (FEV1) < 50%
-
Estimated glomerular filtration rate (GFR) < 40 ml/min
-
Need for supplemental oxygen
-
Direct bilirubin or alanine aminotransferase (ALT) > 2 x upper limit of normal, unless these abnormalities are thought to be related to Gilbert's disease or leukemic infiltration of hepatic parenchyma
-
Known human immunodeficiency virus (HIV) positivity
-
Pregnant or nursing (to be confirmed with quantitative human chorionic gonadotropin [HCG] testing)
-
Invasive solid tumor within 5 years; non-melanoma skin cancer or in situ malignancies are allowed
-
Evidence of serious uncontrolled infection
-
Eastern Cooperative Oncology Group (ECOG) of 3 or 4
-
EXCLUSION CRITERIA (TRANSPLANT)
-
Donor specific antibodies against donor HLA-DQ or -DP
-
Active bacterial, fungal or viral infections unresponsive to medical therapy
-
Active leukemia in the central nervous system (CNS)
-
HIV positive
-
Cardiac ejection fraction < 40% or symptomatic coronary artery disease or uncontrolled arrhythmia
-
DLCOc < 40% or FEV1 < 50%
-
Estimated GFR < 40 ml/min
-
Need for supplemental oxygen
-
Direct bilirubin or ALT > 2 x upper limit of normal, unless these abnormalities are thought to be related to Gilbert's disease or leukemic infiltration of hepatic parenchyma
DONOR SELECTION:
Identification of an appropriate donor will follow the general guidelines listed below.
-
HLA-matched related or unrelated donor. Donors must be:
-
Matched for HLA-A, B, C, DRB1 and DQB1 by high resolution typing
-
Only a single allele disparity will be allowed for HLA-A, B, or C as defined by high resolution typing
-
HLA-mismatched unrelated donor. Unrelated volunteer donors who are mismatched with the recipient within one of the following limitations will be permitted:
-
Mismatch for one HLA class I antigen with or without an additional mismatch for one HLA-class I allele, but matched for HLA-DRB1 and HLA-DQ, OR
-
Mismatched for two HLA class I alleles, but matched for HLA-DRB1 and HLA-DQ
-
HLA class I HLA-A, -B, -C allele matched donors allowing for any one or two DRB1 and/or DQB1 antigen/allele mismatch
HLA-matching must be based on results of high resolution typing at HLA-A, -B, -C, -DRB1, and -DQ. If the patient is homozygous at the mismatch HLA class I locus or II locus, the donor must be heterozygous at that locus and one allele must match the patient (i.e., patient is homozygous A01:01 and donor is heterozygous A01:01, A*02:01)
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Fred Hutch/University of Washington Cancer Consortium | Seattle | Washington | United States | 98109 |
Sponsors and Collaborators
- University of Washington
- National Cancer Institute (NCI)
Investigators
- Principal Investigator: Mary-Elizabeth Percival, Fred Hutch/University of Washington Cancer Consortium
Study Documents (Full-Text)
More Information
Publications
None provided.- 9567
- NCI-2016-00477
- 9567
- P30CA015704
- RG1016011
Study Results
Participant Flow
| Recruitment Details | |
|---|---|
| Pre-assignment Detail |
| Arm/Group Title | Treatment (Chemotherapy, HCT) |
|---|---|
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). HCT conditioning consisted of fludarabine and melphalan, with total body irradiation for patients over age 55 or with significant co-morbidities. HCT was to be received within 60 days of starting G-CLAM chemotherapy. |
| Period Title: Overall Study | |
| STARTED | 30 |
| COMPLETED | 30 |
| NOT COMPLETED | 0 |
Baseline Characteristics
| Arm/Group Title | Treatment (Chemotherapy, HCT) |
|---|---|
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). HCT conditioning consisted of fludarabine and melphalan, with total body irradiation for patients over age 55 or with significant co-morbidities. HCT was to be received within 60 days of starting G-CLAM chemotherapy. |
| Overall Participants | 30 |
| Age, Customized (years) [Median (Full Range) ] | |
| Median (Full Range) [years] |
56.5
|
| Sex/Gender, Customized (Count of Participants) | |
| Female |
18
60%
|
| Male |
12
40%
|
| Ethnicity (NIH/OMB) (Count of Participants) | |
| Hispanic or Latino |
3
10%
|
| Not Hispanic or Latino |
27
90%
|
| Unknown or Not Reported |
0
0%
|
| Race (NIH/OMB) (Count of Participants) | |
| American Indian or Alaska Native |
2
6.7%
|
| Asian |
1
3.3%
|
| Native Hawaiian or Other Pacific Islander |
1
3.3%
|
| Black or African American |
0
0%
|
| White |
26
86.7%
|
| More than one race |
0
0%
|
| Unknown or Not Reported |
0
0%
|
| Region of Enrollment (Count of Participants) | |
| United States |
30
100%
|
| High-Grade Myeloid Diagnosis (Count of Participants) | |
| Acute myeloid leukemia (AML) |
29
96.7%
|
| Myelodysplastic syndrome excess blasts 2 (MDS EB-2) |
1
3.3%
|
| Disease Status (Count of Participants) | |
| Relapsed |
16
53.3%
|
| Refractory |
14
46.7%
|
| Treatment Related Mortality Score (units on a scale (0-100)) [Median (Full Range) ] | |
| Median (Full Range) [units on a scale (0-100)] |
2.33
|
| ELN 2017 Risk Stratification (Count of Participants) | |
| Favorable |
5
16.7%
|
| Intermediate |
10
33.3%
|
| Adverse |
15
50%
|
| Prior Lines of Therapy (Number of prior treatment regimens) [Median (Full Range) ] | |
| Median (Full Range) [Number of prior treatment regimens] |
2
|
| Duration of First Complete Remission (Months) [Median (Full Range) ] | |
| Median (Full Range) [Months] |
2
|
Outcome Measures
| Title | Feasibility of Early Allogeneic Hematopoietic Cell Transplant Assessed by Enrollment and Incidence of Early Transplant |
|---|---|
| Description | Success will be defined as enrollment of at least 30 patients with transplants occurring in 15 of these 30 (50%) within 60 days of enrollment or start of induction chemotherapy with G-CLAM, whichever is earlier. |
| Time Frame | Up to 60 days after start of chemotherapy |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Treatment (Chemotherapy, HCT) |
|---|---|
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). HCT conditioning consisted of fludarabine and melphalan, with total body irradiation for patients over age 55 or with significant co-morbidities. HCT was to be received within 60 days of starting G-CLAM chemotherapy. |
| Measure Participants | 30 |
| Received allogeneic HCT on study within 60 days (feasibility success) |
9
30%
|
| Did not receive allogeneic HCT on study within 60 days (feasibility failure) |
21
70%
|
| Title | Feasibility of Early Allogeneic Hematopoietic Cell Transplant Assessed by Relapsed-free Survival 6 Months After Transplant |
|---|---|
| Description | Success will be defined as observing a 40% of higher 6-month relapse-free survival among patients who received early transplant on study. |
| Time Frame | 6 months after early allogeneic HCT on study |
Outcome Measure Data
| Analysis Population Description |
|---|
| Nine subjects received allogeneic HCT on study, however one subject died shortly after HCT and was not including in this analysis. |
| Arm/Group Title | Received Early Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| No relapse within 6 months post-HCT (feasibility success) |
6
20%
|
| Relapse within 6 months post-HCT (feasibility failure) |
2
6.7%
|
| Title | Response Assessments After Early Allogeneic Hematopoietic Cell Transplant, Day 28 |
|---|---|
| Description | Complete Remission (CR), defined as <5% blasts in bone marrow with hematologic recovery (ANC>1000/ul and platelets >100,000/ml). CRi, defined as complete remission with insufficient hematologic recovery (ANC<1000/ul or platelets<100,000/ul). CRp, defined as complete remission but platelets <100,000/ul. Minimal residual disease (MRD), defined as any detectable disease by flow cytometry, cytogenetics, FISH or PCR in a patient otherwise fulfilling remission criteria. Morphologic leukemia-free state (MLFS), defined as <5% blasts in bone marrow with no hematologic recovery. Relapse, defined as >5% blasts in bone marrow, flow cytometry, or manual differential; OR treatment for active relapsed disease. |
| Time Frame | Approximately 28 days after early allogeneic HCT |
Outcome Measure Data
| Analysis Population Description |
|---|
| Nine subjects received allogeneic HCT on study, however one subject died shortly after HCT and was not including in this analysis. |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| CR with MRD |
0
0%
|
| CR without MRD |
7
23.3%
|
| CRi with MRD |
0
0%
|
| CRi without MRD |
1
3.3%
|
| MLFS with MRD |
0
0%
|
| MLFS without MRD |
0
0%
|
| Relapse |
0
0%
|
| Title | Response Assessments After Early Allogeneic Hematopoietic Cell Transplant, Day 84 |
|---|---|
| Description | Complete Remission (CR), defined as <5% blasts in bone marrow with hematologic recovery (ANC>1000/ul and platelets >100,000/ml). CRi, defined as complete remission with insufficient hematologic recovery (ANC<1000/ul or platelets<100,000/ul). CRp, defined as complete remission but platelets <100,000/ul. Minimal residual disease (MRD), defined as any detectable disease by flow cytometry, cytogenetics, FISH or PCR in a patient otherwise fulfilling remission criteria. Morphologic leukemia-free state (MLFS), defined as <5% blasts in bone marrow with no hematologic recovery. Relapse, defined as >5% blasts in bone marrow, flow cytometry, or manual differential; OR treatment for active relapsed disease. |
| Time Frame | Approximately 84 days after early allogeneic HCT |
Outcome Measure Data
| Analysis Population Description |
|---|
| Nine subjects received allogeneic HCT on study, however one subject died shortly after HCT and was not included in this analysis. |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| CR with MRD |
0
0%
|
| CR without MRD |
4
13.3%
|
| CRi with MRD |
0
0%
|
| CRi without MRD |
2
6.7%
|
| MLFS with MRD |
0
0%
|
| MLFS without MRD |
0
0%
|
| Relapse |
2
6.7%
|
| Title | Relapse-free Survival (RFS) Among Patients Who Received Early Transplant |
|---|---|
| Description | Relapse-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 100 days post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
91
303.3%
|
| Title | Relapse-free Survival (RFS) Among Patients Who Received Early Transplant |
|---|---|
| Description | Relapse-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 6 months post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
82
273.3%
|
| Title | Event-free Survival (EFS) Among Patients Who Received Early Transplant |
|---|---|
| Description | Event-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. Events included death, relapse, and grade 3-4 acute graft vs host disease. |
| Time Frame | Up to 100 days post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
91
303.3%
|
| Title | Event-free Survival (EFS) Among Patients Who Received Early Transplant |
|---|---|
| Description | Event-free survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. Events included death, relapse, and grade 3-4 acute graft vs host disease. |
| Time Frame | Up to 6 months post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
82
273.3%
|
| Title | Overall Survival (OS) Among Patients Who Received Early Transplant. |
|---|---|
| Description | Overall survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 100 days post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
91
303.3%
|
| Title | Overall Survival (OS) Among Patients Who Received Early Transplant. |
|---|---|
| Description | Overall survival among patients who received early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 6 months post-transplant |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Number (95% Confidence Interval) [Percentage of participants] |
82
273.3%
|
| Title | Overall Survival (OS) Among Patients Who Did Not Receive Early Transplant |
|---|---|
| Description | Overall survival among patients who did not receive early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 100 days after induction day 1 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Did Not Receive Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 21 |
| Number (95% Confidence Interval) [Percentage of participants] |
75
250%
|
| Title | Overall Survival (OS) Among Patients Who Did Not Receive Early Transplant |
|---|---|
| Description | Overall survival among patients who did not receive early allogeneic HCT on study as estimated with the Kaplan-Meier method. |
| Time Frame | Up to 6 months after induction day 1 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Did Not Receive Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 21 |
| Number (95% Confidence Interval) [Percentage of participants] |
62
206.7%
|
| Title | Acute Graft Versus Host Disease Among Patients Who Received Early Transplant |
|---|---|
| Description | Acute graft versus host disease (graded II, III, or IV) among patients who received early allogeneic HCT on study. |
| Time Frame | At day 100 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study |
|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 |
| Count of Participants [Participants] |
0
0%
|
| Title | Treatment Related Mortality Among Patients Who Received Early Transplant vs Patients Who Did Not Receive Early Transplant |
|---|---|
| Description | Treatment related mortality calculated among patients who received early allogeneic HCT on study vs patients who did not receive early transplant on study. |
| Time Frame | At day 100 |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study | Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 | 21 |
| Number (95% Confidence Interval) [Percentage of participants] |
9
30%
|
23.8
NaN
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Treatment (Chemotherapy, HCT), Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | 0.18 |
| Comments | ||
| Method | Wilcoxon (Mann-Whitney) | |
| Comments | ||
| Title | Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - TREATMENT RELATED MORTALITY |
|---|---|
| Description | Patients who receive early transplant will be compared to those that don't using the Wilcoxon rank sum test for the quantitative variable of treatment-related mortality (TRM). This outcome measure is intended to report a predicted TRM score assessed at the time of feasibility evaluation. The TRM score is used to measure "treatment-related mortality," or likelihood of death within 28 days of initiation of induction chemotherapy for patients with AML. The score is normalized from 0 to 100, so that a score of 0 demonstrates the patient has a very low likelihood of TRM and a score of 100 a very high likelihood of death. A calculation is used to predict TRM using age, performance status, if they have secondary AML, albumin, creatinine, platelet count, white blood cell count, and peripheral blood blast percentage. The higher the TRM score, the higher the risk of TRM. Calculator and table of relationship between TRM score and TRM probability found here: https://trmcalculator.fredhutch.org/. |
| Time Frame | From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study) |
Outcome Measure Data
| Analysis Population Description |
|---|
| Only 18 of the 21 patients who did not receive an allogeneic hematopoietic peripheral blood stem cell within 60 days of bridge chemotherapy on study were analyzed. |
| Arm/Group Title | Received Allogeneic HCT on Study | Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 | 18 |
| Median (Full Range) [units on a scale] |
2.15
|
3.045
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Treatment (Chemotherapy, HCT), Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | 0.18 |
| Comments | ||
| Method | Wilcoxon (Mann-Whitney) | |
| Comments | ||
| Title | Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - GENDER |
|---|---|
| Description | Patients who receive early transplant will be compared to those that don't using the Fisher's exact test for the categorical variables of gender. |
| Time Frame | From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study) |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study | Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 | 21 |
| Female |
8
26.7%
|
10
NaN
|
| Male |
1
3.3%
|
11
NaN
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Treatment (Chemotherapy, HCT), Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | 0.049 |
| Comments | ||
| Method | Fisher Exact | |
| Comments | ||
| Title | Factors That Distinguish Patients Who Received Early Transplant From Those Who Did Not - AGE |
|---|---|
| Description | Patients who receive early transplant will be compared to those that don't using the Wilcoxon rank sum test for the quantitative variable of age. |
| Time Frame | From time of subject's study enrollment to time of subject's feasibility success assessment (i.e. when subject received transplant within 60 days or when it was determined subject would not proceed with transplant on study) |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Received Allogeneic HCT on Study | Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Arm/Group Description | Patients who received an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. | Patients who did not receive an allogeneic hematopoietic peripheral blood stem cell transplantation within 60 days of bridge chemotherapy on study. |
| Measure Participants | 9 | 21 |
| Median (Full Range) [years] |
55
|
57
|
Statistical Analysis 1
| Statistical Analysis Overview | Comparison Group Selection | Treatment (Chemotherapy, HCT), Did Not Receive Allogeneic HCT on Study |
|---|---|---|
| Comments | ||
| Type of Statistical Test | Other | |
| Comments | ||
| Statistical Test of Hypothesis | p-Value | 0.77 |
| Comments | ||
| Method | Wilcoxon (Mann-Whitney) | |
| Comments | ||
| Title | Demonstrate the Feasibility of Collecting Patient-reported Outcomes for Trial Participants |
|---|---|
| Description | The amount of returned patient-reported outcome questionnaires will be summarized for each collection timepoint using percent collection from surviving patients for PRO timepoints. |
| Time Frame | Up to 12 months post-HCT |
Outcome Measure Data
| Analysis Population Description |
|---|
| The number analyzed in each of the rows below represent the patients alive at that timepoint who were due to complete a survey. |
| Arm/Group Title | Treatment (Chemotherapy, HCT) |
|---|---|
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). HCT conditioning consisted of fludarabine and melphalan, with total body irradiation for patients over age 55 or with significant co-morbidities. HCT was to be received within 60 days of starting G-CLAM chemotherapy. |
| Measure Participants | 30 |
| Enrollment PROs returned |
27
90%
|
| Post G-CLAM PROs returned |
23
76.7%
|
| Pre-HCT PROs returned |
8
26.7%
|
| 6 months post-HCT PROs returned |
4
13.3%
|
| 12 months post-HCT PROs returned |
3
10%
|
| Title | Demonstrate the Feasibility of Collecting Resource Utilization Data for Trial Participants |
|---|---|
| Description | The amount of days of hospitalization (the major driver of costs within the first year) will be collected for resource utilization. |
| Time Frame | Within the first year of induction chemotherapy on study |
Outcome Measure Data
| Analysis Population Description |
|---|
| [Not Specified] |
| Arm/Group Title | Treatment (Chemotherapy, HCT) |
|---|---|
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). HCT conditioning consisted of fludarabine and melphalan, with total body irradiation for patients over age 55 or with significant co-morbidities. HCT was to be received within 60 days of starting G-CLAM chemotherapy. |
| Measure Participants | 30 |
| Median (Inter-Quartile Range) [days] |
49
|
Adverse Events
| Time Frame | Serious adverse events monitoring started Day 1 of G-CLAM therapy or the date of consent, whichever date came first, until: • Up to day 100 after transplant, for subjects who are "successes" • The date the subject is off-study, for subjects who are "failures" and did not receive transplant within 60 days All-cause mortality monitoring started on Day 1 of G-CLAM therapy or the date of consent, whichever date came first, to 6-months post transplant. | |||
|---|---|---|---|---|
| Adverse Event Reporting Description | Other (not including serious) adverse events were not collected and reported. | |||
| Arm/Group Title | Post-Chemotherapy | Post-Transplant | ||
| Arm/Group Description | All patients enrolled received bridge chemotherapy prior to anticipated allogeneic hematopoietic cell transplantation (HCT). Patients received G-CLAM chemotherapy (consisting of G-CSF, mitoxantrone, cladribine, and cytarabine). | Allogeneic peripheral blood stem cell transplant with reduced-intensity conditioning regimen consisted of fludarabine and melphalan, with total body irradiation for subjects over age 55. Prophylaxis for acute graft-vs-host-disease was mycophenylate mofetil (MMF), cyclosporine, and sirolimus. | ||
All Cause Mortality |
||||
| Post-Chemotherapy | Post-Transplant | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 5/30 (16.7%) | 2/9 (22.2%) | ||
Serious Adverse Events |
||||
| Post-Chemotherapy | Post-Transplant | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 30/30 (100%) | 9/9 (100%) | ||
| Blood and lymphatic system disorders | ||||
| Febrile neutropenia | 14/30 (46.7%) | 17 | 8/9 (88.9%) | 8 |
| Cardiac disorders | ||||
| Atrial fibrillation | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Heart failure | 2/30 (6.7%) | 2 | 0/9 (0%) | 0 |
| Cardiogenic shock | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Cardiac arrest | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Gastrointestinal disorders | ||||
| Typhlitis | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Bowel perforation | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Lower gastrointestinal hemorrhage | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Diverticulitis | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Abdominal distension | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Diarrhea | 2/30 (6.7%) | 2 | 2/9 (22.2%) | 2 |
| Nausea | 1/30 (3.3%) | 1 | 2/9 (22.2%) | 2 |
| Nausea with vomiting | 0/30 (0%) | 0 | 3/9 (33.3%) | 4 |
| Mucositis | 0/30 (0%) | 0 | 6/9 (66.7%) | 6 |
| Esophagitis | 0/30 (0%) | 0 | 2/9 (22.2%) | 2 |
| General disorders | ||||
| Edema in limbs | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Multi-organ failure | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Deconditioning/poor functional status | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Hepatobiliary disorders | ||||
| Hepatic failure | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Liver fibrosis | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Immune system disorders | ||||
| Allergic reaction | 2/30 (6.7%) | 2 | 0/9 (0%) | 0 |
| Infections and infestations | ||||
| Lung infection | 6/30 (20%) | 7 | 0/9 (0%) | 0 |
| Abdominal infection | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Urinary tract infection | 1/30 (3.3%) | 1 | 2/9 (22.2%) | 2 |
| Skin infection | 3/30 (10%) | 3 | 0/9 (0%) | 0 |
| Bacteremia | 12/30 (40%) | 16 | 2/9 (22.2%) | 2 |
| Sepsis | 2/30 (6.7%) | 3 | 1/9 (11.1%) | 1 |
| Investigations | ||||
| Ejection fraction decreased | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Electrocardiogram QT corrected interval prolonged | 0/30 (0%) | 0 | 2/9 (22.2%) | 2 |
| Metabolism and nutrition disorders | ||||
| Anorexia | 1/30 (3.3%) | 1 | 4/9 (44.4%) | 4 |
| Hypokalemia | 2/30 (6.7%) | 2 | 1/9 (11.1%) | 1 |
| Hyperglycemia | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Hyponatremia | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Aspartate aminotransferase increased | 1/30 (3.3%) | 2 | 0/9 (0%) | 0 |
| Alanine aminotransferase increased | 1/30 (3.3%) | 2 | 0/9 (0%) | 0 |
| Alkaline phosphatase increased | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Blood bilirubin increased | 1/30 (3.3%) | 1 | 2/9 (22.2%) | 2 |
| Nervous system disorders | ||||
| Headache | 3/30 (10%) | 3 | 0/9 (0%) | 0 |
| Intracranial lesions | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Syncope | 2/30 (6.7%) | 2 | 0/9 (0%) | 0 |
| Stroke | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Encephalopathy | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Psychiatric disorders | ||||
| Delirium | 0/30 (0%) | 0 | 2/9 (22.2%) | 2 |
| Hallucinations | 1/30 (3.3%) | 1 | 1/9 (11.1%) | 1 |
| Depression | 1/30 (3.3%) | 1 | 1/9 (11.1%) | 1 |
| Anxiety | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Insomnia | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Renal and urinary disorders | ||||
| Acute kidney injury | 3/30 (10%) | 3 | 1/9 (11.1%) | 1 |
| Respiratory, thoracic and mediastinal disorders | ||||
| Hypoxia | 5/30 (16.7%) | 5 | 1/9 (11.1%) | 2 |
| Acute hypoxemic respiratory failure | 2/30 (6.7%) | 2 | 1/9 (11.1%) | 2 |
| Diffuse aveolar hemorrhage | 0/30 (0%) | 0 | 1/9 (11.1%) | 1 |
| Cough | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Pleural effusion | 1/30 (3.3%) | 1 | 0/9 (0%) | 0 |
| Pneumonitis | 0/30 (0%) | 0 | 1/9 (11.1%) | 2 |
| Pulmonary edema | 1/30 (3.3%) | 1 | 1/9 (11.1%) | 1 |
| Skin and subcutaneous tissue disorders | ||||
| Rash maculo-papular | 3/30 (10%) | 3 | 0/9 (0%) | 0 |
| Vascular disorders | ||||
| Hypertension | 1/30 (3.3%) | 1 | 2/9 (22.2%) | 2 |
| Hypotension | 2/30 (6.7%) | 3 | 1/9 (11.1%) | 1 |
Other (Not Including Serious) Adverse Events |
||||
| Post-Chemotherapy | Post-Transplant | |||
| Affected / at Risk (%) | # Events | Affected / at Risk (%) | # Events | |
| Total | 0/0 (NaN) | 0/0 (NaN) | ||
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
| Name/Title | Mary-Elizabeth Percival, MD, MS |
|---|---|
| Organization | University of Washington/Seattle Cancer Care Alliance |
| Phone | 206-606-1320 |
| mperciva@seattlecca.org |
- 9567
- NCI-2016-00477
- 9567
- P30CA015704
- RG1016011