Protocol For the Treatment Acute Lymphoblastic Leukemia With Ph 'Negative in Elderly Patients (> 55 Years)

Last updated: January 17, 2022
Sponsor: PETHEMA Foundation
Overall Status: Active - Recruiting

Phase

4

Condition

Leukemia

Lymphoproliferative Disorders

Platelet Disorders

Treatment

N/A

Clinical Study ID

NCT01366898
LAL-07OLD
  • Ages > 55
  • All Genders

Study Summary

The protocol objective is providing adequate treatment and based on broad consensus in elderly patients with Acute Lymphoblastic Leukemia (ALL). Apply uniform treatment that enables a joint analysis of results strong enough to make conclusions on specific subgroups of patients (genotypic subtypes, particularly LAL Bcr/abl positive, phenotype, or strata of age or associated diseases). Provide results of a treatment to consider standard against which to compare the results of phase II trials of experimental drugs that undoubtedly will be activated in the coming years

Eligibility Criteria

Inclusion

Inclusion Criteria: Adults over 55 years diagnosed with ALL with chromosome Ph 'negative and naïve

Exclusion

Exclusion Criteria:

  1. L3 ALL with mature B phenotype or cytogenetic abnormalities ALL characteristics ofBurkitt type (t [8, 14], t [2, 8], t [8, 22]).
  2. Biphenotypic acute leukemias and bilinear
  3. Acute undifferentiated leukemia The criteria for exclusion from treatment (but not patient record) any of thefollowing:
  4. Patients with a history of severe and uncontrolled disease, including:
  • Coronary artery disease, valvular or hypertensive heart disease.
  • Chronic liver disease (active viral or alcoholic).
  • Chronic respiratory failure.
  • Renal failure not due to the ALL.
  • Serious neurological disorder not due to the ALL. f. Improperly controlleddiabetes.
  1. General condition affected (grades 3 and 4 of the WHO scale, see Appendix II), notattributable to the LAL.
  2. LAL chromosome Ph 'positive (must register even if you follow a specific protocol).
  3. Lack of consent by the patient to use their medical records.

Study Design

Total Participants: 100
Study Start date:
June 30, 2007
Estimated Completion Date:
December 31, 2022

Study Description

Prephase (days -5 to -1) Dexamethasone 10 mg/m2 bolus day IV for 5 days (-5 to -1). Supplementary treatment: hydration minimum 2000 ml/day, allopurinol 300 mg / day, gastric protection (as center), daily monitoring of blood glucose, daily monitoring of renal function. Intrathecal treatment (diagnosis and prophylactic) day -5: 12 mg were administered intrathecal methotrexate. The morphological study of the CSF will be defining initial CNS involvement by LAL. Although it is recommended immunophenotypic study of CSF, the definition of CNS involvement by LAL (and its therapeutic consequences) based on morphological observation of blasts in CSF cytocentrifuge.

Remission induction:

Tolerance prephase period can be used to establish the final indication of treatment (standard protocol or frail patients). Day 0 is free of treatment and is considered as +1 the first day of induction. The total duration of the induction is 30 days, consists of two phases (Phase I, days +1 to +14 and phase II, days +15 to +30). Mandatory testing is considered counting the percentage of blasts in peripheral blood +8 day of induction, a myelogram to day +14 to assess early response and a day +35 to assess the complete remission

(days +1 to +14)

  • Vincristine (VCR) 1 mg (absolute dose) IV 1 and 8.

  • Idarubicin (IDA): 10 mg (absolute dose) IV 1, 2, 8 and 9.

  • Dexamethasone (DEX): 10 mg/m2 bolus days 1 and 2 IV, 8 to 11

days +15 to +30)

  • cyclophosphamide (CFM): 300 mg / m 2 iV in 1 hour 15 to 17. (3 total doses).

  • Cytarabine (ARAC): 60 mg / m 2 iV in 1 hour 16 to 19, 23 to 26. (8 total doses).

  • Vincristine (VCR) 1 mg (absolute dose) iV 1 and 8.

  • Idarubicin (IDA): 10 mg (absolute dose) iV 1, 2, 8 and 9.

  • Dexamethasone (DEX): 10 mg/m2 bolus days 1 and 2 iV, 8 to 11

Consolidation:

Cycles 1, 3, 5 MTX: 1,000 mg/m2, IV infusion of 24 hours day 1 L-ASA. 10,000 IU / m 2 IV or IM Day 2 Cycles 2, 4, 6 ARAC: 1,000 mg/m2, IV in 3 hours on days 1, 3 and 5

Connect with a study center

  • Hospital Germans Trias i Pujol and all Hospital Pethema

    Badalona, Barcelona
    Spain

    Active - Recruiting

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