Clinical Trial: Treatment Study for Children and Adolescents With Acute Promyelocitic Leukemia
Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional
Official Title: Treatment Study for Children and Adolescents With Acute Promyelocitic Leukemia
Brief Summary: This study is open to all patients with a diagnosis of acute promyelocytic leukemia (APL) who are PCR positive for the PML-RARα transcript or rarer retinoid sensitive subtypes (i.e. NPM-RAR-alpha, NuMA-RARalpha) and less than 21 years of age (for AIEOP, see appendix A).
Detailed Summary:
This study is open to all patients with a diagnosis of acute promyelocytic leukemia (APL) who are PCR positive for the PML-RARα transcript or rarer retinoid sensitive subtypes (i.e. NPM-RARalpha, NuMA-RARalpha) and less than 21 years of age (for AIEOP, see appendix A). APL is a rare disease with each national group recruiting small numbers of patients to their trials annually. Therefore this will be an international study expecting to recruit 60-70 patients per annum and a total of 300 patients in 5 years. The study aims to limit the use of anthracyclines and stratify treatment by risk group: standard risk - WBC <10 x 109/l : high risk - WBC ≥10 x 109/l. All-trans retinoic acid (ATRA) is included in all phases of therapy and intermediate dose Ara-C (IDARAC) is given during consolidation treatment. Following one induction course of treatment standard risk patients have 2 consolidation blocks whilst high risk patients have 3 consolidation blocks.
The PML-RARα transcript will be monitored throughout and standard risk patients with detectable minimal residual disease by real time quantitative reverse transcriptase polymerase chain reaction (RQ-PCR+) at the end of the second consolidation block will receive a third consolidation block identical to high risk patients. Patients who are RQ-PCR+ for PML-RARα after completion of the third block of consolidation therapy will be candidates for refractory/relapse treatment, but will remain on study. Refractory/relapsed patients who remain RQ-PCR+ for PML-RARα will be candidates for allogeneic bone marrow transplantation (allo-BMT), whilst those who become RQ-PCR- for PML-RARα will have individualised treatment with ongoing MRD monitoring.
These study guidelines are intended to describe a collaborative international study in APL in children and adolesce
Sponsor: Associazione Italiana Ematologia Oncologia Pediatrica
Current Primary Outcome: • to conduct an international pediatric study for APL based on the GIMEMA-AIEOP/AIDA 93 protocol (the study from the Italian GIMEMA -AIEOP group which has produced the best results in children with APL to date), with optimal outcome and less toxicity [ Time Frame: 5 years ]
Original Primary Outcome: • to conduct an international pediatric study for APL based on the GIMEMA-AIEOP/AIDA 93 protocol (the study from the Italian GIMEMA -AIEOP group which has produced the best results in children with APL to date), with optimal outcome and less toxicity
Current Secondary Outcome: • To monitor cardiotoxicity by echocardiography [ Time Frame: 5 years ]
Original Secondary Outcome: • To monitor cardiotoxicity by echocardiography
Information By: Associazione Italiana Ematologia Oncologia Pediatrica
Dates:
Date Received: October 20, 2010
Date Started: January 2009
Date Completion: December 2018
Last Updated: January 25, 2017
Last Verified: July 2016