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Leukemia, Monocytic, AcutePhase 2/3SCCLG-M5NCT05313958

Treateament of Newly Diagnosed Acute Monocytic Leukemia in Children

A Phase 2/3 study testing Cladribine, G-CSF and Cytarabine in people with Leukemia, Monocytic, Acute and Pediatric AML, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University at 9 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a multicenter, single arm, prospective, intervention trial. Since cladribine can enhance the biological activity and self-protection of cytarabine, giving cladribine and cytarabine together may kill more cancer cells. Read more about this study

Who is it for?
Ages 1 month to 14 years
Conditions the study is for
Leukemia, Monocytic, Acute, Pediatric AML
What is being tested?
Cladribine, G-CSF and Cytarabine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
9 sitesChina
Study dates
1 Dec 2021to 30 Mar 2026
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 month to 14 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • 0-14 years old
  • Cytologically proven acute monocytic leukemia (M5) with other treatment

Who cannot join

  • Secondary to immunodeficiency or MDS
  • Second tumor
  • Dowm's syndrome
  • Evolution of chronic myelogenous leukemia to blast crisis
  • Death or quit treatment in seven days at the begining of induction therapy
  • Treatment with other effective chemotherapy drugs for AML, excluding the low dose chemotherapy for the purpose of reducing leukocytes in hyperleukocytic leukemia
  • Concurrent severe and/or uncontrolled medical condition (e.g. uncontrolled heart, brain, liver and kidney failure etc.)
  • Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule

Trial locations and contacts

9 sites in 1 country.

dunhua zhou, M.D contact

13560099258

zdunhua@163.com

9 sites in 1 country

China9 sites, 9 recruiting
  • Second Xiangya Hospital of Central South University

    Changsha, Hunan

    wuqing wan, 13507316963, wanwuqing65@163.com

    Recruiting
  • Maternal and Child Health Hospital of Foshan

    Foshan, Guangdong

    riling chen, M.D, 19820318067, chenrl319@163.com

    Recruiting
  • Guangzhou First People's Hospital

    Guangzhou, Guangdong

    lina wang, M.D, 18922234317, wanglina_11@yeah.net

    Recruiting
  • The First Affiliated Hospital of Guangzhou Medical University

    Guangzhou, Guangdong

    yawei zhou, M.D, 136423337577, zywyhscg@qq.com

    Recruiting
  • Third Affiliated Hospital, Sun Yat-Sen University

    Guangzhou, Guangdong

    huiqin chen, M.D, 13724819908, chenhuiqinchq@126.com

    Recruiting
  • Zhujiang Hospital of Southern Medical University

    Guangzhou, Guangdong

    lihua yang, M.D, 13580532469, yanglihua@163.com

    Recruiting
  • Jiangxi Province Children's Hospital Southern Medical University, China

    Nanchang, Jiangxi

    changda liang, M.D, 13879175309, liangchangda@163.com

    Recruiting
  • The First Affiliated Hospital of Nanchang University

    Nanchang, Jiangxi

    qiwen chen, M.D, 13970807656, 13970807656@163.com

    Recruiting
  • Guangzhou First People's Hospital First Affiliated Hospital of Shantou University Medical College

    Shantou, Guangdong

    beiyan wu, M.D, 13802336066, 1261305798@qq.com

    Recruiting

Other trials in China

About this study

Official title: Treateament of Newly Diagnosed Acute Monocytic Leukemia in Children: A Prospective Multicenter Study in South China

This is a multicenter, single arm, prospective, intervention trial. Since cladribine can enhance the biological activity and self-protection of cytarabine, giving cladribine and cytarabine together may kill more cancer cells. 10 centers from South China Childhood Leukaemia Collaborative Group carry out the SCCLG-M5-2022 regimen including two courses of CLAG(cladribine, darubicin and cytarabine) in the induction period for the treatment of newly dignosed acute monocytic leukemia (M5). The targeted drugs sorafenib is used for FLT3 positive acute monocytic leukemia to inhibit the serine / threonine kinase activity of FLT3.

Read the detailed description

PRIMARY OBJECTIVES

1.To study the 3 year-overall survival of newly diagnosed monocytic leukemia treated with Cladribine and cytarabine in children.

SECONDARY OBJECTIVES

  1. To describe the complete response rate following CLAG (cladribine, cytarabine and granulocyte stimulating factor) in newly diagnosed monocytic leukemia in children for intensive induction therapy.
  2. To evaluate the 3-year progression-free survival in response to CLAG in children.
  3. To assess the toxicity of CLAG including cumulative infection incidence, cumulative adverse effects and chemotherapy-related mortality (TRD).
  4. To study the progression-free survival and overall survival (1 year, 2 year and 3 year) of newly diagnosed monocytic leukemia with positive FLT3 treated with CLAG in children and the side effects of sorafenib.

OUTLINE:

  1. The induction phase includes two parts including induction therapy I(CLAG) and induction therpay II(CLAG+I/M).
  2. The diagnosis and classified criteria is according to the 2016 WHO classification criteria for hematopoietic and lymphoid tissue tumors, and the consolidation therapy consists the therapeutic phases as the NOPHO-AML 2004 protocol prescribed. INDUCTION THERAPY I: Patients receive cladribine intravenously (IV) at a dose of 5mg/m2/day combined with cytarabine 2g/m2/day on day 1-5 and granulocyte stimulating factor 5ug/kg/day on day 0-6. When blood count recover(WBC>2.0×109/L, ANC1.0×109/L、PLT≥50×109/L) , Patients achieving a morphological leukemia free state (< 5% blasts) or MRD< 1% receive a second course treatment as above. INDUCTION THERPAY II: Patients receive cladribine intravenously (IV) at a dose of 5mg/m2/day combined with cytarabine 2g/m2/day on day 1-5, mitoxantrone/idarubicin 10mg/m2/day on day 1-3 and granulocyte stimulating factor 5ug/kg/day on day 0-6. Patients achieving blast count≥5% or MRD ≥1% proceed to induction II therpy.
  3. For FLT3 positive acute monocytic leukemia children, sorafenib 200mg/m2/day was taken orally until molecular biology remission for 2 years.
  4. After two courses of indution phase, patients with incomplete response(MRD≥0.1%)are recommended into hematopoietic stem cell transplantation.
  5. After two courses of indution phase, patients with persisting positive adverse prognosis cytogenetic abnormalities are recommended into hematopoietic stem cell transplantation.

Patients must meet one of the following risk criteria:

Standard-risk (SR) group meeting all of the following criteria:

Initial WBC < 10,000/μL

M1 (<5%) blasts or MRD<1% in bone marrow after the first course of induction therapy

M1 (<5%) blasts or MRD<0.1% in bone marrow after two courses of induction therapy

Cytogenetic abnormalities with good prognosis

Intermediate-risk (IR) group meeting the following criteria:

Lack of low-risk and high-risk conditions

High-risk (HR) group meeting ≥ 1 of the following criteria:

M2/M3(≥5%) blasts or MRD>5% in bone marrow after the first course of induction therapy

MRD≥0.1% in bone marrow after two course of induction therapy

Cytogenetic abnormalities with poor prognosis

Being tested
Cladribine, G-CSF, Cytarabine, Idarubicin, Mitoxantrone
Keywords
Acute monocytic leukemia, pediatric, Cladribine, sorafenib
Medical subject headings
Leukemia, Monocytic, Acute

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CladribineDrug

    Also called cladribine injection

    5mg/㎡/day d1-5 in 2 hours, before the use of Cytarabine

  • G-CSFDrug

    Also called granulocyte

    5ug/kg/day d0-5,if Peripheral blood leukocytes<20,000/ul

  • CytarabineDrug

    Also called Ara-C

    2g/㎡/day d1-5 in 4 hours, after the use of Cladribine

  • IdarubicinDrug

    Also called Idamycin, IDA

    Idarubicin 10mg/m2/day or mitoxantrone 10mg/m2/day on day 1-3 in the induction therapy II

  • MitoxantroneDrug

    Also called MIT

    Idarubicin 10mg/m2/day or mitoxantrone 10mg/m2/day on day 1-3 in the induction therapy II

  • SorafenibDrug

    Also called sorafinib, Nexavar, sorafenib tosylate

    200mg/m2/day was taken orally until molecular biology remission for 2 years

Study groups in NCT05313958
Study groupRoleWhat they receive
treatment armExperimentalThe patients in this arm will receive SCCLG-M5 2022 regimen for newly dignosed acute monocytic leukemia (M5) ,including two courses of CLAG(cladribine, darubicin and cytarabine) in the induction period and followed by three courses(HA1M, HA2E, HA3) in consolidation therapy prescribed as the NOPHO-AML 2004 protocol. The targeted drugs sorafenib 200mg/m2/day orally is used for FLT3 positive acute monocytic leukemia until molecular biology remission for 2 years.
Receives: Drug: Cladribine; Drug: G-CSF; Drug: Cytarabine; Drug: Idarubicin; Drug: Mitoxantrone; Drug: Sorafenib

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall survival (OS)

    TOS was defined as time from diagnostic date through the date of death due to any reasons. For all other participants, the last follow-up available was taken as the last control. If the participant had not completed the study, the date of the last visit available was considered.

    Measured: 3 years

Secondary outcomes (3)
  1. Induced remission rate (CR)

    According to the time point specified in the treatment plan (22 days after the end of induction I, 29-43 days after the end of induction II and before each consolidation scheme) bone marrow puncture and lumbar puncture were performed. The follow-up contents included the detection of the count of primitive / immature lymphocytes and flow MRD. If there was a positive gene at the onset, the quantitative monitoring of the gene should be performed as MRD data at the same time. If the gene cannot be analyzed quantitatively, PCR qualitative analysis should still be performed as the monitoring basis

    Measured: 3 years

  2. Safety,including cumulative infection incidence, adverse reaction and chemotherapy-related mortality (TRD)

    During treatment, closely monitor relevant laboratory tests, register adverse reaction records, and report the records according to the requirements of CRF form.

    Measured: 3 years

  3. Event-free survival (EFS)

    EFS was estimated from date of diagnosis until date of one of the following events: relapse, refractory disease, second malignancy or death from any reason.

    Measured: 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Apr 2022
  2. Study start1 Dec 2021
  3. Primary completion30 Mar 2026 (estimated)
  4. Study completion30 Mar 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
43 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05313958
Sponsor's protocol ID
2021-KY-052
Other IDs
2021A1515011809
Acronym
SCCLG-M5
Status last verified
Jul 2023
First submitted
26 Dec 2021
Last updated
27 Jul 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Liu LP, Zhang AL, Ruan M, Chang LX, Liu F, Chen X, Qi BQ, Zhang L, Zou Y, Chen YM, Chen XJ, Yang WY, Guo Y, Zhu XF. Prognostic stratification of molecularly and clinically distinct subgroup in children with acute monocytic leukemia. Cancer Med. 2020 Jun;9(11):3647-3655. doi: 10.1002/cam4.3023. Epub 2020 Mar 26.

    PubMed 32216042
  • Weis TM, Marini BL, Bixby DL, Perissinotti AJ. Clinical considerations for the use of FLT3 inhibitors in acute myeloid leukemia. Crit Rev Oncol Hematol. 2019 Sep;141:125-138. doi: 10.1016/j.critrevonc.2019.06.011. Epub 2019 Jun 28.

    PubMed 31279288
  • Rubnitz JE, Crews KR, Pounds S, Yang S, Campana D, Gandhi VV, Raimondi SC, Downing JR, Razzouk BI, Pui CH, Ribeiro RC. Combination of cladribine and cytarabine is effective for childhood acute myeloid leukemia: results of the St Jude AML97 trial. Leukemia. 2009 Aug;23(8):1410-6. doi: 10.1038/leu.2009.30. Epub 2009 Feb 26.

    PubMed 19242495

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Cladribine, G-CSF and Cytarabine in people with Leukemia, Monocytic, Acute and Pediatric AML, run by Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University at 9 sites in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 27 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact dunhua zhou, M.D (13560099258, zdunhua@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall survival (OS) (time frame: 3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05313958, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jul 2023.

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