Clinical Trial: Low-Dose Cytarabine in Treating Infants With Down Syndrome and Transient Myeloproliferative Disorder

Study Status: Withdrawn
Recruit Status: Withdrawn
Study Type: Interventional

Official Title: Treatment of Transient Myeloproliferative Disorder (TMD) in Children With Down Syndrome (DS)

Brief Summary:

RATIONALE: Drugs used in chemotherapy, such as cytarabine, work in different ways to stop the growth of abnormal cells, either by killing the cells or by stopping them from dividing. Giving low-doses of cytarabine may be an effective treatment for Down syndrome and transient myeloproliferative disorder. Sometimes the disease may not need treatment until it progresses. In this case, observation may be sufficient.

PURPOSE: This phase III trial is studying low-dose cytarabine to see how well it works in treating infants with Down syndrome and transient myeloproliferative disorder.


Detailed Summary:

OBJECTIVES:

Primary

  • Determine whether very low-dose cytarabine can improve event-free survival (EFS) rates in infants with high-risk transient myeloproliferative disorder (TMD), using high-risk TMD patients from clinical trial COG-A2971 for historic comparison, and in infants with intermediate-risk TMD, using intermediate-risk TMD patients from clinical trial COG-A2971 for historic comparison.
  • Maintain the current high overall EFS rate in low-risk TMD patients.

Secondary

  • Assess the toxicity of this regimen in these patients.

OUTLINE: This is a nonrandomized, multicenter, crossover study. Patients are stratified according to disease risk (high or intermediate vs low).

  • Group I (patients with high- or intermediate-risk transient myeloproliferative disorder [TMD]): Patients receive very low-dose cytarabine subcutaneously twice daily on days 1-7. Treatment repeats every 14 days for up to 4 courses in the absence of disease progression or unacceptable toxicity. Patients achieving stable disease or complete or hepatic clinical remission undergo observation.
  • Group II (patients with low-risk TMD): Patients are observed. If symptoms of intermediate- or high-risk disease develop, patients may crossover to group I.

After completion of study treatment, patients are followed periodically for 10 years.

PROJECTED ACCRUAL: A total of 180 patients will be accrued
Sponsor: Children's Oncology Group

Current Primary Outcome: Event-free survival

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Overall survival
  • Disease-related mortality
  • Percentage of patients experiencing grade 3-4 toxicity
  • Incidence of subsequent leukemia in patients for whom transient myeloproliferative disorder is resolved


Original Secondary Outcome: Same as current

Information By: Children's Oncology Group

Dates:
Date Received: December 11, 2006
Date Started: March 2006
Date Completion:
Last Updated: September 28, 2015
Last Verified: August 2013