Trial Outcomes & Findings for Study of Hyper-CVAD Plus Imatinib Mesylate for Philadelphia-Positive Acute Lymphocytic Leukemia (NCT NCT00038610)

NCT ID: NCT00038610

Last Updated: 2015-09-18

Results Overview

Complete Remission (CR): Defined as the presence of 5% or less blasts in the bone marrow, with a granulocyte count of 1.0 × 109/L or higher and a platelet count of 100 × 109/L and no extramedullary disease. Partial Response (PR): As above for CR except for the presence of 6-25% marrow blasts. Molecular CR: Same as for CR with RT-PCR negativity for bcr-abl. Induction Death: Defined as death occurring after start of therapy without meeting the definition of CR or resistant disease.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

54 participants

Primary outcome timeframe

Baseline to 6 months

Results posted on

2015-09-18

Participant Flow

Recruitment Period: March 28, 2001 to October 04, 2006. All recruitment done at The University of Texas (UT) MD Anderson Cancer Center.

Participant milestones

Participant milestones
Measure
Hyper-CVAD + Imatinib
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Overall Study
STARTED
54
Overall Study
COMPLETED
54
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Study of Hyper-CVAD Plus Imatinib Mesylate for Philadelphia-Positive Acute Lymphocytic Leukemia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Hyper-CVAD + Imatinib
n=54 Participants
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Age, Continuous
51 years
n=99 Participants
Sex: Female, Male
Female
26 Participants
n=99 Participants
Sex: Female, Male
Male
28 Participants
n=99 Participants
Region of Enrollment
United States
54 participants
n=99 Participants

PRIMARY outcome

Timeframe: Baseline to 6 months

Population: Of the 54 participants, 39 (72%) presented with de novo disease, 6 (11%) were refractory to standard induction therapy, and 9 (17%) entered the study in complete remission (CR) after one course of standard induction therapy.

Complete Remission (CR): Defined as the presence of 5% or less blasts in the bone marrow, with a granulocyte count of 1.0 × 109/L or higher and a platelet count of 100 × 109/L and no extramedullary disease. Partial Response (PR): As above for CR except for the presence of 6-25% marrow blasts. Molecular CR: Same as for CR with RT-PCR negativity for bcr-abl. Induction Death: Defined as death occurring after start of therapy without meeting the definition of CR or resistant disease.

Outcome measures

Outcome measures
Measure
Hyper-CVAD + Imatinib
n=54 Participants
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Response To Induction Therapy With Hyper-CVAD Plus Imatinib Mesylate
Complete Remission
42 participants
Response To Induction Therapy With Hyper-CVAD Plus Imatinib Mesylate
Partial Remission
1 participants
Response To Induction Therapy With Hyper-CVAD Plus Imatinib Mesylate
Molecular Complete Remission
17 participants
Response To Induction Therapy With Hyper-CVAD Plus Imatinib Mesylate
Induction Death
1 participants

PRIMARY outcome

Timeframe: Baseline to 2-year and 5-year

Disease-Free Survival (DFS) was calculated from the time of complete remission until relapse or death due to any cause.

Outcome measures

Outcome measures
Measure
Hyper-CVAD + Imatinib
n=54 Participants
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Disease-Free Survival Rate at 2-year and 5-year.
5-year DFS rate
43 percentage of participants
Disease-Free Survival Rate at 2-year and 5-year.
2-year DFS rate
49 percentage of participants

SECONDARY outcome

Timeframe: Baseline to 2-year and 5-year

Overall survival (OS) was calculated from the date of initiation of therapy until death.

Outcome measures

Outcome measures
Measure
Hyper-CVAD + Imatinib
n=54 Participants
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Overall Survival Rate at 2-year and 5-year.
2-year OS rate
57 percentage of participants
Overall Survival Rate at 2-year and 5-year.
5-year OS rate
43 percentage of participants

Adverse Events

Hyper-CVAD + Imatinib

Serious events: 36 serious events
Other events: 54 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Hyper-CVAD + Imatinib
n=54 participants at risk
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Cardiac disorders
Pericardial and pleural effusion
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
Death
64.8%
35/54 • Number of events 35 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.

Other adverse events

Other adverse events
Measure
Hyper-CVAD + Imatinib
n=54 participants at risk
Imatinib 600 mg orally days 1-14, course 1, \& 600 mg daily days 1-14 (daily if tolerated course 1), even courses. Cyclophosphamide 300 mg/m\^2 intravenous (IV) for 6 doses days 1-3, odd courses. Doxorubicin 50 mg/m\^2 IV day 4; Vincristine 2 mg IV days 4 \& 11; \& Dexamethasone 40 mg IV or orally daily days 1-4 \& 11-14 odd courses 1, 3, 5, 7. Methotrexate 12 mg intrathecally (6 mg if via Ommaya reservoir) day 2, odd courses and 200 mg/m\^2 IV over 2 hours followed by 800 mg/m\^2 over 22 hours day 1 of even courses. Cytarabine 100 mg intrathecally day 7 for odd courses and 3 gm/m\^2 IV every 12 hours for 4 doses days 2-3 for even courses. Mesna 600 mg/m\^2 IV daily, odd courses. G-CSF 10 mcg/kg/day after completion of chemotherapy until neutrophil recovery to 1 x 109/L or higher for all courses.
Metabolism and nutrition disorders
ALBUMIN, SERUM-LOW
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
BILIRUBIN INCREASE
3.7%
2/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Musculoskeletal and connective tissue disorders
BONE PAIN
5.6%
3/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
CONSTIPATION
3.7%
2/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
DEHYDRATION
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
DIARRHEA
5.6%
3/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Nervous system disorders
DIZZINESS
1.9%
1/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Respiratory, thoracic and mediastinal disorders
DYSPNEA
5.6%
3/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Cardiac disorders
DYSRHYTHMIA
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Blood and lymphatic system disorders
EDEMA
11.1%
6/54 • Number of events 8 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
FATIGUE
5.6%
3/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
FEVER NEUTROPENIC
13.0%
7/54 • Number of events 13 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
FEVER WITHOUT NEUTROPENIA
5.6%
3/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
GASTRITIS
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
GLUCOSE, SERUM-HIGH
7.4%
4/54 • Number of events 5 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Nervous system disorders
HEADACHE
11.1%
6/54 • Number of events 7 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
HEMORRHOIDAL BLEED
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPERGLYCEMIA
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPOGLYCEMIA
1.9%
1/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPOKALEMIA
5.6%
3/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPONATREMIA
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Cardiac disorders
HYPOTENSION
1.9%
1/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
INFECTION FEBRILE NEUTROPENIA
9.3%
5/54 • Number of events 6 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
INFECTION NEUTROPENIC
3.7%
2/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
INFECTION WITHOUT NEUTROPENIA
5.6%
3/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Musculoskeletal and connective tissue disorders
MOTOR
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
NAUSEA ALONE
11.1%
6/54 • Number of events 7 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Respiratory, thoracic and mediastinal disorders
PLEURAL EFFUSION
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
PLEURITIC PAIN
1.9%
1/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Skin and subcutaneous tissue disorders
PRURITUS/ITCHING
3.7%
2/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Renal and urinary disorders
RENAL GENITOURINARY
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
WOUND INFECTION
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Renal and urinary disorders
URINARY TRACT INFECTION
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Infections and infestations
INFECTION
7.4%
4/54 • Number of events 5 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Nervous system disorders
SENSORY
5.6%
3/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Respiratory, thoracic and mediastinal disorders
HICCUPS
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Cardiac disorders
TACHYCARDIA
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPOMAGNESEMIA
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Nervous system disorders
SYNCOPE
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
VOMITING
7.4%
4/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Gastrointestinal disorders
STOMATITIS
1.9%
1/54 • Number of events 4 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Respiratory, thoracic and mediastinal disorders
SORE THROAT
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
TRANSAMINASE INCREASE
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Vascular disorders
THROMBOSIS/EMBOLISM
5.6%
3/54 • Number of events 3 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
EPISTAXIS
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Respiratory, thoracic and mediastinal disorders
PNEUMOTHORAX
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
HYPOCALCEMIA
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Nervous system disorders
SPEECH IMPAIRMENT
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
CREATININE INCREASE
3.7%
2/54 • Number of events 2 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Musculoskeletal and connective tissue disorders
MYALGIA
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Metabolism and nutrition disorders
FIBRINOGEN DECREASE
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Musculoskeletal and connective tissue disorders
FRACTURE
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
Cardiac disorders
CARDIAC
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.
General disorders
BACK PAIN
1.9%
1/54 • Number of events 1 • Adverse events and serious adverse events were collected from receiving of induction therapy to discontinuation of study drug. Collection period: April, 2001 to June 2013.

Additional Information

Naval Daver, MD/Leukemia

The University of Texas (UT) MD Anderson Cancer Center

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place