Treatment of Newly Diagnosed Childhood Acute Myeloid Leukemia (AML) Using Intensive MRC-Based Therapy and Gemtuzumab Ozogamicin (GMTZ): A COG Pilot Study
OBJECTIVES:
Primary
- Determine the safety of gemtuzumab ozogamicin in children with newly diagnosed acute
myeloid leukemia undergoing intensive remission induction and intensification therapy.
- Determine the complete remission rate of patients treated with this regimen.
Secondary
- Determine the feasibility of performing biological studies (e.g., FLT3-ITD and MRD) for
risk group stratification in these patients.
- Determine the effect of karyotypic abnormalities on survival in patients treated with
this regimen.
OUTLINE: This is a multicenter study.
- Induction I: Patients receive high-dose cytarabine (ARA-C) IV twice daily on days 1-10;
daunorubicin IV over 6 hours on days 1, 3, and 5; etoposide IV over 4 hours on days
1-5; and gemtuzumab ozogamicin IV over 2 hours on day 6. Patients with CNS-negative
disease receive ARA-C intrathecally (IT) on day 1. Patients with CNS-positive disease
receive ARA-C IT twice weekly for 2-3 weeks. Between days 28-35, patients are
evaluated. Patients achieving remission or who have no more than 20% blasts proceed to
induction II.
- Induction II: Patients receive ARA-C IV twice daily on days 1-8; ARA-C IT on day 1; and
daunorubicin IV and etoposide IV as in induction I. Between days 28-35 patients are
evaluated. Patients achieving complete remission proceed to intensification course I.
- Intensification course I: Patients receive ARA-C IV over 1 hour twice daily on days
1-5; ARA-C IT as in induction II; and etoposide IV over 1 hour on days 1-5. Patients
are evaluated at day 28. Patients with a 5/6 or 6/6 matched family donor proceed to
allogeneic bone marrow transplantation. All other patients in complete remission
proceed to intensification course II.
- Intensification course II: Patients receive ARA-C IV over 2 hours twice daily on days
1-4; ARA-C IT as in induction II; mitoxantrone IV over 1 hour on days 3-6; and
gemtuzumab ozogamicin IV over 2 hours on day 7. Patients are evaluated on day 28 and
then proceed to intensification course III.
- Intensification course III: Patients receive ARA-C IV over 3 hours twice daily on days
1, 2, 8, and 9 and asparaginase intramuscularly on days 2 and 9.
- Allogeneic bone marrow transplantation: Patients receive a preparative regimen
comprising busulfan IV over 2 hours 4 times daily on days -9 to -6 and cyclophosphamide
IV over 1 hour once daily on days -5 to -2. Allogeneic stem cells are infused on day 0.
- Graft-versus-host disease prophylaxis: Patients receive oral or IV cyclosporine twice
daily on days -1 to 50 and methotrexate IV once daily on days 1, 3, 6, and 11.
In all courses, treatment continues in the absence of disease progression or unacceptable
toxicity.
Patients are followed monthly for 6 months, every 2 months for 6 months, every 4 months for
1 year, every 6 months for 1 year, and then annually thereafter.
PROJECTED ACCRUAL: A total of 330 patients will be accrued for this study.
Interventional
Masking: Open Label, Primary Purpose: Treatment
Safety
Yes
Janet Franklin, MD, MPH
Study Chair
Children's Hospital Los Angeles
United States: Federal Government
CDR0000330133
NCT00070174
December 2003
Name | Location |
---|---|
Roswell Park Cancer Institute | Buffalo, New York 14263 |
Children's Hospital of Philadelphia | Philadelphia, Pennsylvania 19104 |
Mayo Clinic Cancer Center | Rochester, Minnesota 55905 |
Emory University Hospital - Atlanta | Atlanta, Georgia 30322 |
University of Chicago Cancer Research Center | Chicago, Illinois 60637 |
Indiana University Cancer Center | Indianapolis, Indiana 46202-5265 |
Barbara Ann Karmanos Cancer Institute | Detroit, Michigan 48201 |
University of Mississippi Medical Center | Jackson, Mississippi 39216-4505 |
University of Texas Health Science Center at San Antonio | San Antonio, Texas 78284-7811 |
Midwest Children's Cancer Center | Milwaukee, Wisconsin 53226 |
CCOP - Kalamazoo | Kalamazoo, Michigan 49007-3731 |
Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center | Farmington, Connecticut 06360-2875 |
Van Elslander Cancer Center at St. John Hospital and Medical Center | Grosse Pointe Woods, Michigan 48236 |
CCOP - MeritCare Hospital | Fargo, North Dakota 58122 |
Geisinger Medical Center | Danville, Pennsylvania 17822-0001 |
Penn State Cancer Institute at Milton S. Hershey Medical Center | Hershey, Pennsylvania 17033-0850 |
Vanderbilt-Ingram Cancer Center | Nashville, Tennessee 37232-6838 |
Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center | La Crosse, Wisconsin 54601 |
Comprehensive Cancer Center at Wake Forest University | Winston-Salem, North Carolina 27157-1082 |
Lutheran General Cancer Care Center | Park Ridge, Illinois 60068 |
Newark Beth Israel Medical Center | Newark, New Jersey 07112 |
New York Medical College | Valhalla, New York 10595 |
St. Vincent Hospital | Green Bay, Wisconsin 54307-3508 |
University of Wisconsin Comprehensive Cancer Center | Madison, Wisconsin 53792 |
University of Miami Sylvester Comprehensive Cancer Center | Miami, Florida 33136 |
Holden Comprehensive Cancer Center at University of Iowa | Iowa City, Iowa 52242-1002 |
Keesler Medical Center - Keesler Air Force Base | Keesler AFB, Mississippi 39534-2576 |
Siteman Cancer Center at Barnes-Jewish Hospital | Saint Louis, Missouri 63110 |
Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill | Chapel Hill, North Carolina 27599-7570 |
CCOP - Scott and White Hospital | Temple, Texas 76508 |
Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins | Baltimore, Maryland 21231-2410 |
Cancer Research Center of Hawaii | Honolulu, Hawaii 96813 |
St. Barnabas Medical Center | Livingston, New Jersey 07039 |
Cleveland Clinic Taussig Cancer Center | Cleveland, Ohio 44195 |
Madigan Army Medical Center | Tacoma, Washington 98431-5048 |
Sutter Cancer Center | Sacramento, California 95816 |
Hackensack University Medical Center | Hackensack, New Jersey 07601 |
Children's Hospital Los Angeles | Los Angeles, California 90027-0700 |
Children's Hospital of Orange County | Orange, California 92668 |
Children's National Medical Center | Washington, District of Columbia 20010-2970 |
Children's Mercy Hospital | Kansas City, Missouri 64108 |
St. Joseph's Hospital and Medical Center | Paterson, New Jersey 07503 |
Children's Hospital of Pittsburgh | Pittsburgh, Pennsylvania 15213 |
Children's Hospital and Regional Medical Center - Seattle | Seattle, Washington 98105 |
University of California Davis Cancer Center | Sacramento, California 95817 |
Nemours Children's Clinic | Jacksonville, Florida 32207 |
Miami Children's Hospital | Miami, Florida 33155-4069 |
All Children's Hospital | St. Petersburg, Florida 33701 |
Children's Memorial Hospital - Chicago | Chicago, Illinois 60614 |
Wesley Medical Center | Wichita, Kansas 67214 |
Maine Children's Cancer Program | Scarborough, Maine 04074-9308 |
Floating Hospital for Children | Boston, Massachusetts 02111 |
Cardinal Glennon Children's Hospital | Saint Louis, Missouri 63104 |
University of New Mexico Cancer Research and Treatment Center | Albuquerque, New Mexico 87131 |
Schneider Children's Hospital | New Hyde Park, New York 11042 |
St. Christopher's Hospital for Children | Philadelphia, Pennsylvania 19134-1095 |
Driscoll Children's Hospital | Corpus Christi, Texas 78466 |
Inova Fairfax Hospital | Falls Church, Virginia 22042-3300 |
Fletcher Allen Health Care - University Health Center Campus | Burlington, Vermont 05401 |
Phoenix Children's Hospital | Phoenix, Arizona 85016-7710 |
Southern California Permanente Medical Group | Downey, California 90242 |
Children's Hospital Central California | Madera, California 93638-8762 |
Southern Illinois University School of Medicine | Springfield, Illinois 62794-9658 |
Kosair Children's Hospital | Louisville, Kentucky 40202-3830 |
Children's Hospital of Omaha | Omaha, Nebraska 68114 |
Sunrise Hospital and Medical Center | Las Vegas, Nevada 89109-2306 |
Brooklyn Hospital Center | Brooklyn, New York 11201 |
Maimonides Medical Center | Brooklyn, New York 11219 |
Children's Hospital Medical Center of Akron | Akron, Ohio 44308 |
Children's Medical Center - Dayton | Dayton, Ohio 45404 |
Palmetto Health South Carolina Cancer Center | Columbia, South Carolina 29203 |
Texas Tech University Health Sciences Center School of Medicine | Amarillo, Texas 79106 |
Children's Hospital of Austin | Austin, Texas 78701 |
Covenant Children's Hospital | Lubbock, Texas 79410 |
Arkansas Cancer Research Center at University of Arkansas for Medical Sciences | Little Rock, Arkansas 72205 |
Markey Cancer Center at University of Kentucky Chandler Medical Center | Lexington, Kentucky 40536-0084 |
Herbert Irving Comprehensive Cancer Center at Columbia University | New York, New York 10032 |
Cancer Institute at Oregon Health and Science University | Portland, Oregon 97201-3098 |
Blumenthal Cancer Center at Carolinas Medical Center | Charlotte, North Carolina 28232-2861 |
Fairview University Medical Center - University Campus | Minneapolis, Minnesota 55455 |
Winthrop University Hospital | Mineola, New York 11501 |
Oklahoma University Medical Center | Oklahoma City, Oklahoma 73104 |
Sioux Valley Hospital and University of South Dakota Medical Center | Sioux Falls, South Dakota 57117-5134 |
Comprehensive Cancer Center at University of Alabama at Birmingham | Birmingham, Alabama 35294 |
Loma Linda University Cancer Institute at Loma Linda University Medical Center | Loma Linda, California 92354 |
Jonathan Jaques Children's Cancer Center at Miller Children's Hospital | Long Beach, California 90801 |
Children's Hospital and Research Center - Oakland | Oakland, California 94609-1809 |
Kaiser Permanente Medical Center - Oakland | Sacramento, California 95825 |
Children's Hospital and Health Center - San Diego | San Diego, California 92123-4282 |
Lee Cancer Care of Lee Memorial Health System | Fort Myers, Florida 33901 |
Broward General Medical Center Cancer Center | Ft. Lauderdale, Florida 33316 |
University of Florida Shands Cancer Center | Gainesville, Florida 32610-0232 |
Baptist-South Miami Regional Cancer Program | Miami, Florida 33176 |
Florida Hospital Cancer Institute at Florida Hospital Orlando | Orlando, Florida 32803-1273 |
Sacred Heart Cancer Center at Sacred Heart Hospital | Pensacola, Florida 32504 |
St. Joseph's Cancer Institute at St. Joseph's Hospital | Tampa, Florida 33607 |
Kaplan Cancer Center at St. Mary's Medical Center | West Palm Beach, Florida 33407 |
Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center | Savannah, Georgia 31403-3089 |
St. Luke's Mountain States Tumor Institute - Boise | Boise, Idaho 83712-6297 |
St. Vincent Indianapolis Hospital | Indianapolis, Indiana 46260 |
Via Christi Cancer Center at Via Christi Regional Medical Center | Wichita, Kansas 67214 |
CancerCare of Maine at Eastern Maine Medial Center | Bangor, Maine 04401 |
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital | Baltimore, Maryland 21215 |
C.S. Mott Children's Hospital at University of Michigan | Ann Arbor, Michigan 48109-0238 |
Spectrum Health Cancer Care - Butterworth Campus | Grand Rapids, Michigan 49503-2560 |
Breslin Cancer Center at Ingham Regional Medical Center | Lansing, Michigan 48910 |
Albert Einstein Cancer Center at Albert Einstein College of Medicine | Bronx, New York 10461 |
SUNY Upstate Medical University Hospital | Syracuse, New York 13210 |
Mission Hospitals - Memorial Campus | Asheville, North Carolina 28801 |
Presbyterian Cancer Center at Presbyterian Hospital | Charlotte, North Carolina 28233-3549 |
Cincinnati Children's Hospital Medical Center | Cincinnati, Ohio 45229-3039 |
Rainbow Babies and Children's Hospital | Cleveland, Ohio 44106-5000 |
Toledo Hospital | Toledo, Ohio 43606 |
Hollings Cancer Center at Medical University of South Carolina | Charleston, South Carolina 29425 |
Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas | Dallas, Texas 75390 |
Methodist Children's Hospital of South Texas | San Antonio, Texas 78229-3993 |
Primary Children's Medical Center | Salt Lake City, Utah 84113-1100 |
Massey Cancer Center at Virginia Commonwealth University | Richmond, Virginia 23298-0037 |
Carilion Cancer Center of Western Virginia | Roanoke, Virginia 24029 |
Providence Cancer Center at Sacred Heart Medical Center | Spokane, Washington 99220-2555 |
West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division | Charleston, West Virginia 25302 |
Lombardi Cancer Center at Georgetown University Medical Center | Washington, District of Columbia 20007 |
Memorial Cancer Institute at Memorial Regional Hospital | Hollywood, Florida 33021 |
Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center | Los Angeles, California 90048-1865 |
Alfred I. duPont Hospital for Children | Wilmington, Delaware 19803 |
Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School | New Brunswick, New Jersey 08903 |
Mary Bridge Children's Hospital and Health Center - Tacoma | Tacoma, Washington 98405 |
Cabell Huntington Hospital | Huntington, West Virginia 25701 |
Children's Hospital Cancer Center | Denver, Colorado 80218 |
Children's Hospitals and Clinics - Minneapolis/St. Paul | Minneapolis, Minnesota 55404 |
Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital | Greenville, North Carolina 27858-4354 |
Columbus Children's Hospital | Columbus, Ohio 43205-2696 |
M.D. Anderson Cancer Center - Orlando | Orlando, Florida 32806 |
Medical College of Ohio Cancer Institute | Toledo, Ohio 43614 |