T-cell Acute Lymphoblastic LeukemiaPhase 2NCT06686108
Demethylating Agents Combined With Venetoclax for High-risk T-cell Lymphoblastic Lymphoma/Leukemia Post-Transplant Relapse Prevention
A Phase 2 study testing Azacitidine (AZA) Days 1 - 5, Decitabine (DAC) and Venetoclax in people with T-cell Acute Lymphoblastic Leukemia and ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, run by Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.
Trial summary
This study is a prospective, phase II clinical trial with the primary objective of assessing the effectiveness of demethylating agents combined with venetoclax in the prevention of recurrence after allogeneic hematopoietic stem cell transplantation (allo-HSCT) of high risk T-lymphoblastic lymphoma/leukemia (T-LBL/ALL)… Read more about this study
- Who is it for?
- Ages 14 to 55 years
- Conditions the study is for
- T-cell Acute Lymphoblastic Leukemia, ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, Relapse
- What is being tested?
- Azacitidine (AZA) Days 1 - 5, Decitabine (DAC) and Venetoclax
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 59 participants
- Where
- 1 siteChina
- Study dates
- 30 Oct 2024to 30 Oct 2028
- Phase
- Phase 2
- Are there results?
- Not yet: the study is under way
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 14 to 55 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- 1.14-55 years old, male,or female.
- 2.Patients with allo-HSCT due to T-LBL/ALL, the donor type is not limited.
- 3.ECOG score is 0-2 points.
- 4.Blood routine: ANC ≥ 1.0 × 109/L, PLT ≥ 50 × 109/L.
- 5.One of the following high-risk factors:
- a. Age of initial diagnosis ≥ 35 years old.
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- b. Initial diagnosis of WBC ≥ 100 × 109/L.
- c. Initial diagnosis of LDH exceeding the upper limit of normal values.
- d. Initial diagnosis of bone marrow involvement (blast cells ≥ 5%).
- e. Initial diagnosis of a bulky in the mediastinum (longest diameter ≥ 10cm).
- f. ETP immunophenotype.
- g. During the induction chemotherapy process, 2 courses did not achieve partial remission and/or 4 courses did not achieve complete remission.
- h. Residual lesions before transplantation: Flow cytometry analysis showed that the proportion of abnormal lymphoid cells in the bone marrow was greater than 0.01%; Positive detection of minimal residual lesions in molecular biology; PET-CT scan shows that residual lesions are still active.
- i. Based on the ELN recommendation based on adult T-ALL: gene mutations involving myeloid related genes, RAS/PI3K/AKT, JAK/STAT signaling pathway, and epigenetics, such as FLT3, NRAS/KRAS, PTEN, IL7R, JAK1, JAK3, DNMT3A, IDH1, IDH2; TP53, BCL2 mutations; t (8; 14) (q24; q11)/MYC rearrangement; t (7; 19) (q34; p13)/TCR-LYL1,TCR-MEF2C; del(5q) (q14).
- j. High risk subgroups based on NGS definition: PI3K signaling pathway/NRAS, KRAS/TP53/IKZF1/DNTM3A/IDH1, IDH2 gene mutation with or without NOTCH1, FBXW7/PHF6/EP300 gene mutation.
Who cannot join
- 1.Central involvement during any course of the disease.
- 2.Patients who have not achieved complete remission before transplantation.
- 3.Identify those with available targeted drugs.
- 4.For those who are resistant to BCL-2 inhibitors before transplantation, if the disease progresses during the application process, or if 3-4 courses of induction therapy containing BCL2 inhibitors do not improve.
- 5.Individuals who are known to be allergic to demethylating drugs or venetoclax.
- 6.Individuals with grade 2 or more degrees of active acute GVHD.
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- 7.Individuals with moderate to severe chronic GVHD.
- 8.T-LBL/ALL relapse (flow cytometry abnormal lymphocyte cell proportion>0.01%, WT1 positive, fusion gene positive, or extramedullary recurrence), or transplant rejection, bone marrow donor cell chimerism<95%.
- 9.Blood routine: ANC<1.0 × 109/L or PLT<50 × 109/L.
- 10.Combined with severe organ dysfunction; The ratio of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) is more than 3 times the normal value or the normal value of direct bilirubin is more than 3 times; The endogenous creatinine clearance rate (Ccr) is less than 50mL/min or 1.5 times the normal value of blood creatinine, regardless of whether hemodialysis treatment is used.
- 11.Merge severe active infections.
- 12.Pregnant or lactating women.
- 13. Accepting other investigational drugs.
- 14.According to the researchers' assessment, the patient may have complications that could lead to other dangers.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
China1 site, 1 recruiting
- Recruiting
Shanghai General Hospital
Shanghai
Xianmin Song, +8613501672508, shongxm@139.com
About this study
Official title: Safety and Efficacy Study of Demethylating Agents With Venetoclax in Preventing Recurrence of High-risk T-cell Lymphoblastic Lymphoma/Leukemia After Transplantation
This study is a prospective, phase II clinical trial with the primary objective of assessing the effectiveness of demethylating agents combined with venetoclax in the prevention of recurrence after allogeneic hematopoietic stem cell transplantation (allo-HSCT) of high risk T-lymphoblastic lymphoma/leukemia (T-LBL/ALL) patients.
Read the detailed description
The experimental group included high risk T-ALL/LBL patients after allo-HSCT, who received relapse prevention treatment with demethylating agents such as azacitidine or decitabine, combined with venetoclax.
The historical control consisted of high-risk T-ALL/LBL patients who received allo-HSCT but did not receive any prophylactic treatment from multiple centers, and their basic information, disease information, treatment details, and efficacy data were collected. Propensity score matching was conducted with historical data to compare the advantages and disadvantages of the experimental regimen with the control group.
The primary endpoint was the relapse-free survival(RFS) rate after prophylaxis, while secondary endpoints included cumulative incidence of relapse (CIR), overall survival (OS), and the GVHD-relapse-free survival (GRFS). This study aims to provide a effective and safer prophylaxis treatment for high-risk T-LBL/ALL patients after all-HSCT.
- Conditions
- T-cell Acute Lymphoblastic Leukemia, ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, Relapse
- Being tested
- Azacitidine (AZA) Days 1 - 5, Decitabine (DAC), Venetoclax
- Keywords
- T-cell lymphoblastic lymphoma/leukemia, relapse, allogeneic hematopoietic stem cell transplantation
- Medical subject headings
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Recurrence, Leukemia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Azacitidine (AZA) Days 1 - 5Drug
Azacitidine, ih, 32mg/m2/d, days 1-5 of each 28-day cycle
Decitabine (DAC)Drug
decitabine, 5mg/m2/d, days 1-5 of each 28-day cycle.
VenetoclaxDrug
venetoclax, 400mg/d, days 1-7 of each 28-day cycle
| Study group | Role | What they receive |
|---|---|---|
| combination therapy | Experimental | There is only 1 arm. Combination therapy arm included venetoclax combined with hypomethylating agents such as azacitidine or decitabine. 1. venetoclax: 400mg/d, po, days 1-7 of each 28-day cycle. 2.For patients without TP53 mutation, azacitidine was administered: 32mg/m2/d, ih, days 1-5 of each 28-day cycle; for patients with TP53 mutation, decitabine was administered: 5mg/m2/d, iv, days 1-5 of each 28-day cycle. Receives: Drug: Azacitidine (AZA) Days 1 - 5; Drug: Decitabine (DAC); Drug: Venetoclax |
What is being measured
The primary outcome is the main question the study is designed to answer.
RFS
1-year relapse-free survival
Measured: 1 year
RFS
2-year relapse-free survival
Measured: 2 year
Secondary outcomes (9)
CIR
1-year cumulative incidence of relapse
Measured: 1 year
CIR
2-year cumulative incidence of relapse
Measured: 2 year
OS
1-year overall survival
Measured: 1 year
OS
2-year overall survival
Measured: 2 year
GRFS
1-year graft-versus-host disease (GVHD)-free/relapse-free survival (GRFS) rates
Measured: 1 year
GRFS
2-year graft-versus-host disease (GVHD)-free/relapse-free survival (GRFS) rates
Measured: 2 year
cGVHD
1-year cumulative incidence of cGVHD
Measured: 1 year
cGVHD
2-year cumulative incidence of cGVHD
Measured: 2 year
adverse events
adverse events during research
Measured: at the end of every cycle (each cycle is 28 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Nov 2024
- Study start30 Oct 2024
- Primary completion30 Oct 2027 (estimated)
- Study completion30 Oct 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for T-cell Acute Lymphoblastic LeukemiaStudies of the same condition, open and under way.
- More trials run by Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 59 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Xianmin Song, MD, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06686108
- Sponsor's protocol ID
- SHSYXY-T-LBL-AZA/VEN-Rel-2024
- Status last verified
- Oct 2024
- First submitted
- 11 Nov 2024
- Last updated
- 7 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 7 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Safety and Efficacy Study of Demethylating Agents With Venetoclax in Preventing Recurrence of High-risk T-cell Lymphoblastic Lymphoma/Leukemia After Transplantation
- ClinicalTrials.gov ID
- NCT06686108
- Acronym / sponsor ID
- SHSYXY-T-LBL-AZA/VEN-Rel-2024
- Conditions
- T-cell Acute Lymphoblastic Leukemia, ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, Relapse
- Keywords
- T-cell lymphoblastic lymphoma/leukemia, relapse, allogeneic hematopoietic stem cell transplantation
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 59 participants (estimated)
- Lead sponsor
- Shanghai General Hospital, Shanghai Jiao Tong University School of MedicineUniversity, hospital or other
- Study start
- 30 Oct 2024 (actual)
- Primary completion
- 30 Oct 2027 (estimated)
- Study completion
- 30 Oct 2028 (estimated)
- First posted
- 13 Nov 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is a prospective, phase II clinical trial with the primary objective of assessing the effectiveness of demethylating agents combined with venetoclax in the prevention of recurrence after allogeneic hematopoietic stem cell transplantation (allo-HSCT) of high risk T-lymphoblastic lymphoma/leukemia (T-LBL/ALL) patients.
Detailed description
The experimental group included high risk T-ALL/LBL patients after allo-HSCT, who received relapse prevention treatment with demethylating agents such as azacitidine or decitabine, combined with venetoclax.
The historical control consisted of high-risk T-ALL/LBL patients who received allo-HSCT but did not receive any prophylactic treatment from multiple centers, and their basic information, disease information, treatment details, and efficacy data were collected. Propensity score matching was conducted with historical data to compare the advantages and disadvantages of the experimental regimen with the control group.
The primary endpoint was the relapse-free survival(RFS) rate after prophylaxis, while secondary endpoints included cumulative incidence of relapse (CIR), overall survival (OS), and the GVHD-relapse-free survival (GRFS). This study aims to provide a effective and safer prophylaxis treatment for high-risk T-LBL/ALL patients after all-HSCT.
Study design
- Primary purpose
- Prevention
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| combination therapy | Experimental | Drug: Azacitidine (AZA) Days 1 - 5, Drug: Decitabine (DAC), Drug: VenetoclaxThere is only 1 arm. Combination therapy arm included venetoclax combined with hypomethylating agents such as azacitidine or decitabine. 1. venetoclax: 400mg/d, po, days 1-7 of each 28-day cycle. 2.For patients without TP53 mutation, azacitidine was administered: 32mg/m2/d, ih, days 1-5 of each 28-day cycle; for patients with TP53 mutation, decitabine was administered: 5mg/m2/d, iv, days 1-5 of each 28-day cycle. |
Who may qualify
- Ages
- 14 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (15 listed)
- 1.14-55 years old, male,or female.
- 2.Patients with allo-HSCT due to T-LBL/ALL, the donor type is not limited.
- 3.ECOG score is 0-2 points.
- 4.Blood routine: ANC ≥ 1.0 × 109/L, PLT ≥ 50 × 109/L.
- 5.One of the following high-risk factors:
Key exclusion criteria (14 listed)
- 1.Central involvement during any course of the disease.
- 2.Patients who have not achieved complete remission before transplantation.
- 3.Identify those with available targeted drugs.
- 4.For those who are resistant to BCL-2 inhibitors before transplantation, if the disease progresses during the application process, or if 3-4 courses of induction therapy containing BCL2 inhibitors do not improve.
- 5.Individuals who are known to be allergic to demethylating drugs or venetoclax.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Azacitidine (AZA) Days 1 - 5Azacitidine, ih, 32mg/m2/d, days 1-5 of each 28-day cycle | Drug | combination therapy |
| Decitabine (DAC)decitabine, 5mg/m2/d, days 1-5 of each 28-day cycle. | Drug | combination therapy |
| Venetoclaxvenetoclax, 400mg/d, days 1-7 of each 28-day cycle | Drug | combination therapy |
Primary outcome
RFS
Time frame: 1 year
1-year relapse-free survival
RFS
Time frame: 2 year
2-year relapse-free survival
9 secondary outcomes
CIR
Time frame: 1 year
CIR
Time frame: 2 year
OS
Time frame: 1 year
OS
Time frame: 2 year
GRFS
Time frame: 1 year
GRFS
Time frame: 2 year
cGVHD
Time frame: 1 year
cGVHD
Time frame: 2 year
adverse events
Time frame: at the end of every cycle (each cycle is 28 days)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 May 2025.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Azacitidine (AZA) Days 1 - 5, Decitabine (DAC) and Venetoclax in people with T-cell Acute Lymphoblastic Leukemia and ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION, run by Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine at 1 site 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 15 inclusion and 14 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: looking for participants now, as of the sponsor's last update on 7 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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 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.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Xianmin Song (+8613501672508, shongxm@139.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
RFS (time frame: 1 year). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 7 May 2025.