This phase II trial tests how well a modified, shorter version of standard high-dose cytarabine (HiDAC 123) compared to standard HiDAC 135 works in treating older patients with acute myeloid leukemia (AML) who are in complete remission after induction treatment. Cytarabine is in a class of medications called antimetabolites. It works by slowing or stopping the growth of cancer cells in the body. A higher dose of cytarabine causes more neurologic side effects in older patients, however when used at lower doses, this chemotherapy regimen does not have severe neurologic side effects in patients over the age of 60 years. Information gained from this trial may allow researchers to determine if a modified, shorter version of HiDAC chemotherapy will cause less of a decrease in white blood cell count, as well as potentially decrease the length of hospital stay, infections, transfusions, and other complications for older AML patients.
Additional locations may be listed on ClinicalTrials.gov for NCT04914676.
See trial information on ClinicalTrials.gov for a list of participating sites.
PRIMARY OBJECTIVE:
I. To determine the duration of neutropenia in older patients with de novo AML after consolidation chemotherapy with HiDAC 123 compared to historical controls with HiDAC 135.
SECONDARY OBJECTIVES:
I. To define duration of thrombocytopenia in older patients with de novo AML after consolidation chemotherapy with HiDAC 123 compared to historical controls with HiDAC 135.
II. To determine the safety of HiDAC 123 compared to standard HiDAC 135 in case controls.
EXPLORATORY OBJECTIVES:
I. Pharmacogenomics: To evaluate impact of cytarabine (Ara-C) single nucleotide polymorphism (SNP) score (ACSS) score for association with toxicity and efficacy in HiDAC 123 arm.
II. Describe relapse rate (RR), leukemia-free survival (LFS) and overall survival (OS) in each cohort.
OUTLINE:
Patients in complete remission after induction therapy receive HiDAC intravenously (IV) over 2-3 hours every 12 hours on days 1, 2, and 3 of each cycle. Treatment repeats every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity. Patients also undergo bone marrow biopsy and/or aspiration during screening and as clinically indicated and blood sample collection on study.
After completion of study treatment, patients are followed up every 3 months for up to 48 months after start of induction.
Lead OrganizationUniversity of Florida Health Science Center - Gainesville
Principal InvestigatorJack W. Hsu