Decitabine Followed by Clofarabine, Idarubicin, and Cytarabine in Acute Leukemia

Sponsor
M.D. Anderson Cancer Center (Other)
Overall Status
Completed
CT.gov ID
NCT01794702
Collaborator
(none)
65
1
1
58.7
1.1

Study Details

Study Description

Brief Summary

The goal of Phase I of this clinical research study is find the highest tolerable dose of clofarabine that can be given with decitabine, idarubicin, and cytarabine to patients with acute leukemia.

The goal of Phase II of this study is to learn if decitabine followed by the combination of clofarabine, idarubicin, and cytarabine can help to control acute leukemia. The safety of this drug combination will also be studied.

Decitabine and idarubicin are designed to damage the DNA (the genetic material of cells). This may cause cancer cells to die.

Clofarabine is designed to interfere with the growth and development of cancer cells.

Cytarabine is designed to insert itself into DNA and stop the DNA from repairing itself.

Condition or Disease Intervention/Treatment Phase
Phase 1/Phase 2

Detailed Description

Study Groups:

If you are found to be eligible to take part in this study, you will be assigned to a study group based on when you join this study. Up to 3 groups of 6 participants will be enrolled in the Phase I portion of the study. Up to 74 participants will be enrolled in Phase II.

Phase I:

If you are enrolled in the Phase I portion, the number of days of clofarabine you receive will depend on when you joined this study. The first group of participants will receive clofarabine for 4 days. Each new group will receive clofarabine for the same number of days, if no intolerable side effects were seen. The number of days may be reduced to 3. The clofarabine dose per day is the same from group to group.

All participants will receive the same dose level of decitabine, idarubicin and cytarabine.

Phase II:

If you are enrolled in the Phase II portion, you will receive decitabine, idarubicin, and cytarabine. You will receive clofarabine for the highest number of days that was tolerated in the Phase I portion.

All participants will receive the same dose level of decitabine, idarubicin, cytarabine, and clofarabine.

Study Drug Administration:

Each study drug cycle is 33 days. The first cycle of study drugs is called Induction. If the doctor thinks it is needed, you will have up to 2 Induction cycles.

Phase I (Induction):

On Days 1-5 of each cycle, you will receive decitabine 1 time a day by vein over about 1 hour.

On Days 6-10 of each cycle:
  • You will receive cytarabine 1 time a day by vein over about 2 hours.

  • On Days 6-8 only, you will receive idarubicin 1 time a day by vein over about 30 minutes.

  • You will receive clofarabine 1 time a day by vein over about 1 hour on Days 6-8 or 6-9, depending on when you join the study.

If the doctor thinks it is needed, your dose level will be reduced after Induction.

If the doctor thinks it is needed, you may receive fewer days of treatment in the Induction cycle(s).

Phase II (Induction):

On Days 1-5 of each cycle, you will receive decitabine 1 time a day by vein over about 1 hour.

On Days 6-10 of each cycle:
  • You will receive cytarabine 1 time a day by vein over about 2 hours.

  • On Days 6-8 only, you will receive idarubicin 1 time a day by vein over about 30 minutes.

  • You will receive clofarabine 1 time a day by vein over about 1 hour on Days 6-8 or 6-9, depending on the highest number of days clofarabine was tolerated in the Phase I portion of the study.

If the doctor thinks it is needed, your dose level will be reduced after Induction.

If the doctor thinks it is needed, you may receive fewer days of treatment in the Induction cycle(s).

Phases I and II (Consolidation):

If the disease responds to the study drugs, you may receive up to 6 more study drug cycles. This is called Consolidation.

On Days 1-5 of each cycle:

°You will receive decitabine 1 time a day by vein over 1 hour.

On Days 6-8 of each cycle:
  • You will receive cytarabine 1 time a day by vein over about 2 hours.

  • You will receive clofarabine 1 time a day by vein over about 1 hour.

  • On Days 6-7 only, you will receive idarubicin 1 time a day by vein over about 30 minutes.

If the doctor thinks it is needed, you may receive fewer days of treatment in the Consolidation cycles.

Study Visits:

Before the start of each cycle, you will have a physical exam, including measurement of your vital signs.

Every 3-7 days, blood (about 2 teaspoons) will be drawn for routine tests.

On Day 33 of every 2-3 cycles (+/- 7 days), if the doctor thinks it is needed, you will have a bone marrow aspirate to check the status of the disease. To collect a bone marrow aspirate, an area of the hip is numbed with anesthetic, and a small amount of bone marrow is withdrawn through a large needle.

Length of Treatment:

You may continue taking the study drugs for up to 8 cycles. You will no longer be able to take the study drugs if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Your participation on the study will be over once you have completed the long-term follow-up.

Long-term Follow-up:

Every 3 months for 1 year after your last study drug dose, the study staff will call you and ask how you are feeling, about any side effects you may be having, and about any other drugs you may be taking. These calls should last about 5 minutes each.

This is an investigational study. Decitabine is FDA approved and commercially available to treat myelodysplastic syndrome (MDS). Clofarabine is FDA approved and commercially available to treat ALL in children. Idarubicin and cytarabine are FDA approved and commercially available to treat AML. The study drug combination is investigational.

Up to 92 participants will be enrolled in this study. All will take part at MD Anderson.

Study Design

Study Type:
Interventional
Actual Enrollment :
65 participants
Intervention Model:
Sequential Assignment
Intervention Model Description:
Starting with Dose level 1, the participants were enrolled by cohort of 3. Once the DLT assessment is completed, another cohort of 3 patients will be enrolled. If at any time, we see more than 30% patients experiencing DLT, we will de-escalate to dose level (-1). Period 1: Dose level 1 Clofarabine 15mg/m^2 daily x 4 days (days 6-9) Period 2: Dose level-1 Clofarabine 15mg/m^2 daily x 3 days (days 6-8)Starting with Dose level 1, the participants were enrolled by cohort of 3. Once the DLT assessment is completed, another cohort of 3 patients will be enrolled. If at any time, we see more than 30% patients experiencing DLT, we will de-escalate to dose level (-1). Period 1: Dose level 1 Clofarabine 15mg/m2 daily x 4 days (days 6-9) Period 2: Dose level-1 Clofarabine 15mg/m2 daily x 3 days (days 6-8)
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Phase I/II Study of Decitabine (DAC) Followed by Clofarabine, Idarubicin, and Cytarabine (CIA) in Acute Leukemia
Actual Study Start Date :
Feb 20, 2013
Actual Primary Completion Date :
Jan 11, 2018
Actual Study Completion Date :
Jan 11, 2018

Arms and Interventions

Arm Intervention/Treatment
Experimental: Clofarabine + Cytarabine + Decitabine + Idarubicin

Phase I - Decitabine 20 mg/m2 by vein over approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m2 by vein over approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m2 by vein over approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour daily (number of days selected based on Phase I portion). Decitabine 20 mg/m2 by vein over approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m2 by vein over approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m2 by vein over approximately 2 hours daily for 5 days (days 6-10)

Drug: Decitabine
Phase I and II - 20 mg/m2 by vein daily for 5 days (days 1-5)
Other Names:
  • Dacogen
  • Drug: Idarubicin
    Phase I and II - 10 mg/m2 by vein daily for 3 days (days 6-8)
    Other Names:
  • Idamycin
  • Drug: Cytarabine
    Phase I and II - 1 g/m2 by vein daily for 5 days (days 6-10)
    Other Names:
  • Ara-C
  • Cytosar
  • DepoCyt
  • Cytosine Arabinosine Hydrochloride
  • Drug: Clofarabine
    Phase I Starting Dose - 15 mg/m2 by vein daily for 4 days (days 6-9) Phase II Starting Dose - Maximum tolerated dose from Phase I (number of days selected based on Phase I portion).
    Other Names:
  • Clofarex
  • Clolar
  • Outcome Measures

    Primary Outcome Measures

    1. Maximum Tolerated Dose (MTD) of Clofarabine [After second, 33 day cycle]

      Maximum tolerated dose (MTD) defined as the highest dose schedule in which 6 patients were treated with at most 1 experiencing a dose-limiting toxicity (DLT). Clofarabine 15 mg/m2 IV over approximately 1 hour daily (number of days selected based on Phase I portion).

    2. Number of Participants With a Response [56 days]

      Primary endpoint is overall response defined as the best response either complete response, complete remission without platelet recovery, or complete remission without incomplete blood count recovery within 56 days.

    Secondary Outcome Measures

    1. To Determine the Disease-free Survival (DFS). [Up to 2 years after participants off study date]

      Time from date of treatment start until the date of first objective documentation of return of disease.

    2. Overall Survival [Up to 2 years after participants off study date]

      Time from date of treatment start until date of death due to any cause or last Follow-up.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 64 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Sign an IRB-approved informed consent document.

    2. Age >/= 18 years and <65 years.

    3. Diagnosis of AML [other than acute promyelocytic leukemia] with refractory/relapsed disease (Patients must be primary refractory, in relapse 1, or in relapse 2). NOTE: Patients with AML arising from prior MDS or MPN would be eligible even if they have not received treatment for the AML. NOTE: Patients with relapsed/refractory ALL would also be eligible for the phase II part of the study. NOTE: Use of hydroxyurea and/or up to 4 doses of cytarabine, for emergent cytoreduction is allowed

    4. ECOG performance status of </=2 at study entry.

    5. Organ function as defined below (unless due to leukemia):Serum creatinine </= 3 mg/dL;Total bilirubin </= 2.5 mg/dL; ALT (SGPT) </= 3 x ULN or </= 5 x ULN if related to disease

    6. Cardiac ejection fraction ≥ 40% (by either cardiac ECHO or MUGA scan)

    7. Women of childbearing potential must have a negative serum or urine pregnancy test within 7 days. Men must agree not to father a child and agree to use a condom if his partner is of child bearing potential.

    Exclusion Criteria:
    1. Breast feeding women

    2. Patients with uncontrolled active infections (viral, bacterial, and fungal are not eligible).

    3. Patients with active secondary malignancy will not be eligible unless approved by the PI.

    4. NOTE: Prior therapy with decitabine, clofarabine, idarubicin, or cytarabine is allowed, unless the prior therapy is identical to the schema/schedule proposed in this study

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Texas MD Anderson Cancer Center Houston Texas United States 77030

    Sponsors and Collaborators

    • M.D. Anderson Cancer Center

    Investigators

    • Principal Investigator: Nitin Jain, MBBS, M.D. Anderson Cancer Center

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT01794702
    Other Study ID Numbers:
    • 2012-1064
    • NCI-2013-00548
    First Posted:
    Feb 20, 2013
    Last Update Posted:
    May 30, 2019
    Last Verified:
    May 1, 2019
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by M.D. Anderson Cancer Center
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Recruitment Period: 1/2013 to 01/2018
    Pre-assignment Detail All participants in the phase I portion of the study received dose level 1 of the study medication. None of the participants experienced a DLT as defined in the protocol. Period 1: Dose level 1 - Clofarabine 15mg/m^2 daily x 4 days (days 6-9) Period 2: Dose level-1 - Clofarabine 15mg/m^2 daily x 3 days (days 6-8)
    Arm/Group Title Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Arm/Group Description Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Starting Dose - 15 mg/m^2 by vein daily for 4 days (days 6-9) Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Dose level -1 - 15 mg/m^2 by vein daily for 3 days (days 6-9) Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m^2 by vein over approximately 1 hour for 4 days (days 6-9).
    Period Title: Overall Study
    STARTED 18 0 47
    COMPLETED 18 0 47
    NOT COMPLETED 0 0 0

    Baseline Characteristics

    Arm/Group Title Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin Total
    Arm/Group Description Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Starting Dose - 15 mg/m^2 by vein daily for 4 days (days 6-9) Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Dose -1 - 15 mg/m^2 by vein daily for 3 days (days 6-9) Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour for 4 days (days 6-9). Total of all reporting groups
    Overall Participants 18 0 47 65
    Age (Count of Participants)
    <=18 years
    0
    0%
    0
    NaN
    0
    0%
    0
    0%
    Between 18 and 65 years
    18
    100%
    0
    NaN
    47
    100%
    65
    100%
    >=65 years
    0
    0%
    0
    NaN
    0
    0%
    0
    0%
    Sex: Female, Male (Count of Participants)
    Female
    3
    16.7%
    0
    NaN
    15
    31.9%
    18
    27.7%
    Male
    15
    83.3%
    0
    NaN
    32
    68.1%
    47
    72.3%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    NaN
    0
    0%
    0
    0%
    Asian
    2
    11.1%
    0
    NaN
    2
    4.3%
    4
    6.2%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    NaN
    0
    0%
    0
    0%
    Black or African American
    1
    5.6%
    0
    NaN
    8
    17%
    9
    13.8%
    White
    14
    77.8%
    0
    NaN
    33
    70.2%
    47
    72.3%
    More than one race
    0
    0%
    0
    NaN
    0
    0%
    0
    0%
    Unknown or Not Reported
    1
    5.6%
    0
    NaN
    4
    8.5%
    5
    7.7%
    Region of Enrollment (participants) [Number]
    United States
    18
    100%
    47
    Infinity
    65
    138.3%

    Outcome Measures

    1. Primary Outcome
    Title Maximum Tolerated Dose (MTD) of Clofarabine
    Description Maximum tolerated dose (MTD) defined as the highest dose schedule in which 6 patients were treated with at most 1 experiencing a dose-limiting toxicity (DLT). Clofarabine 15 mg/m2 IV over approximately 1 hour daily (number of days selected based on Phase I portion).
    Time Frame After second, 33 day cycle

    Outcome Measure Data

    Analysis Population Description
    All participants in the phase I portion of the study received dose level 1 of the study medication. None of the participants experienced a DLT as defined in the protocol. Period 1: Dose level 1 - Clofarabine 15mg/m^2 daily x 4 days (days 6-9) Period 2: Dose level-1 - Clofarabine 15mg/m^2 daily x 3 days (days 6-8)
    Arm/Group Title Period 1 Period 2
    Arm/Group Description Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein over approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein over approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein over approximately 2 hours daily for 5 days (days 6-10) Clofarabine 15 mg/m^2 by vein over approximately 1 hour daily Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein over approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein over approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein over approximately 2 hours daily for 5 days (days 6-10) Clofarabine 15 mg/m^2 by vein over approximately 1 hour daily
    Measure Participants 18 0
    Number [mg/m^2 x 4 days (6-9)]
    15
    2. Primary Outcome
    Title Number of Participants With a Response
    Description Primary endpoint is overall response defined as the best response either complete response, complete remission without platelet recovery, or complete remission without incomplete blood count recovery within 56 days.
    Time Frame 56 days

    Outcome Measure Data

    Analysis Population Description
    One of the 47 participants on the Phase II portion of this study who received study medication was not evaluable for response.
    Arm/Group Title Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Arm/Group Description Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour for 4 days (days 6-9).
    Measure Participants 46
    Count of Participants [Participants]
    20
    111.1%
    3. Secondary Outcome
    Title To Determine the Disease-free Survival (DFS).
    Description Time from date of treatment start until the date of first objective documentation of return of disease.
    Time Frame Up to 2 years after participants off study date

    Outcome Measure Data

    Analysis Population Description
    One of the 47 participants on the Phase II portion of this study who received study medication was not evaluable for response.
    Arm/Group Title Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Arm/Group Description Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour for 4 days (days 6-9).
    Measure Participants 46
    Median (Full Range) [months]
    17.9
    4. Secondary Outcome
    Title Overall Survival
    Description Time from date of treatment start until date of death due to any cause or last Follow-up.
    Time Frame Up to 2 years after participants off study date

    Outcome Measure Data

    Analysis Population Description
    One of the 47 participants on the Phase II portion of this study who received study medication was not evaluable for response.
    Arm/Group Title Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Arm/Group Description Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour for 4 days (days 6-9).
    Measure Participants 46
    Median (Full Range) [Months]
    7.7

    Adverse Events

    Time Frame 3 years
    Adverse Event Reporting Description All participants in the phase I portion of the study received dose level 1 of the study medication. None of the participants experienced a DLT as defined in the protocol. Period 1 Dose level 1 - Clofarabine 15mg/m^2 daily x 4 days (days 6-9) Period 2 Dose level-1 - Clofarabine 15mg/m^2 daily x 3 days (days 6-8)
    Arm/Group Title Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Arm/Group Description Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Starting Dose - 15 mg/m^2 by vein daily for 4 days (days 6-9) Phase I Clofarabine + Cytarabine + Decitabine + Idarubicin Phase I - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Clofarabine: Phase I Dose level -1 - 15 mg/m^2 by vein daily for 3 days (days 6-9) Phase II - Decitabine 20 mg/m^2 by vein for approximately 1 hour daily for 5 days (days 1-5) Idarubicin 10 mg/m^2 by vein for approximately 30 minutes daily for 3 days (days 6-8) Cytarabine 1 g/m^2 by vein for approximately 2 hours daily for 5 days (days 6-10) Phase II - Clofarabine 15 mg/m2 by vein over approximately 1 hour for 4 days (days 6-9).
    All Cause Mortality
    Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 1/18 (5.6%) 0/0 (NaN) 5/46 (10.9%)
    Serious Adverse Events
    Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 18/18 (100%) 0/0 (NaN) 33/46 (71.7%)
    Blood and lymphatic system disorders
    Gastric Hemorrhage 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Intracranial Hemorrhage 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Cardiac disorders
    Hypotension 1/18 (5.6%) 1 1/0 (Infinity) 1 1/46 (2.2%) 1
    Left Ventricular Failure 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Gastrointestinal disorders
    Mucositis 2/18 (11.1%) 2 2/0 (Infinity) 2 0/46 (0%) 0
    Diarrhea 0/18 (0%) 0 0/0 (NaN) 0 3/46 (6.5%) 3
    Nausea 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Typhlitis 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    General disorders
    Death 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Pain 3/18 (16.7%) 4 3/0 (Infinity) 4 2/46 (4.3%) 2
    Headache 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Infections and infestations
    Neutropenic Fever 13/18 (72.2%) 24 13/0 (Infinity) 24 24/46 (52.2%) 38
    Sepsis 1/18 (5.6%) 1 1/0 (Infinity) 1 1/46 (2.2%) 1
    Septic Shock 2/18 (11.1%) 2 2/0 (Infinity) 2 1/46 (2.2%) 1
    Infection 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Neutropenia 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Metabolism and nutrition disorders
    Elevated Transaminases 3/18 (16.7%) 5 3/0 (Infinity) 5 0/46 (0%) 0
    Hyperbilirubinemia 2/18 (11.1%) 2 2/0 (Infinity) 2 0/46 (0%) 0
    Hyperkalemia 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Nervous system disorders
    Seizures 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Dizziness 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Renal and urinary disorders
    Acute Kidney Injury 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Respiratory, thoracic and mediastinal disorders
    Respiratory Failure 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0
    Bronchopulmonary Hemorrhage 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Skin and subcutaneous tissue disorders
    Abcess 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Other (Not Including Serious) Adverse Events
    Period 1 Period 2 Phase II Clofarabine + Cytarabine + Decitabine + Idarubicin
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 17/18 (94.4%) 0/0 (NaN) 27/46 (58.7%)
    Cardiac disorders
    Hypotension 0/18 (0%) 0 0/0 (NaN) 0 1/46 (2.2%) 1
    Gastrointestinal disorders
    Mucositis 2/18 (11.1%) 2 2/0 (Infinity) 2 0/46 (0%) 0
    Diarrhea 5/18 (27.8%) 5 5/0 (Infinity) 5 1/46 (2.2%) 1
    Nausea 3/18 (16.7%) 3 3/0 (Infinity) 3 0/46 (0%) 0
    Vomiting 2/18 (11.1%) 2 2/0 (Infinity) 2 0/46 (0%) 0
    General disorders
    Pain 2/18 (11.1%) 2 2/0 (Infinity) 2 0/46 (0%) 0
    Infections and infestations
    Infection 1/18 (5.6%) 1 1/0 (Infinity) 1 5/46 (10.9%) 5
    Metabolism and nutrition disorders
    Hyperbilirubinemia 13/18 (72.2%) 13 13/0 (Infinity) 13 15/46 (32.6%) 17
    Elevated Transaminases 10/18 (55.6%) 10 10/0 (Infinity) 10 13/46 (28.3%) 14
    Skin and subcutaneous tissue disorders
    Rash 1/18 (5.6%) 1 1/0 (Infinity) 1 0/46 (0%) 0

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT 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 Nitin Jain, MD./Associate Professor
    Organization The University of Texas MD Anderson Cancer Center
    Phone 713-745-6080
    Email njain@mdanderson.org
    Responsible Party:
    M.D. Anderson Cancer Center
    ClinicalTrials.gov Identifier:
    NCT01794702
    Other Study ID Numbers:
    • 2012-1064
    • NCI-2013-00548
    First Posted:
    Feb 20, 2013
    Last Update Posted:
    May 30, 2019
    Last Verified:
    May 1, 2019