Ceplene/IL-2 remission maintenance therapy has been shown to significantly prolong Leukemia Free Survival in patients with Acute Myeloid Leukemia (AML) in first complete remission. This is an international, multicenter, open-label study to evaluate the effects of remission maintenance therapy with Ceplene/IL-2 in adult patients with AML in CR1 on specific immune system cells (T and NK cells) and prospectively defined markers of immune response that are known to reflect T and NK cell ability to combat AML.
Outcome Measures: Primary: 1. To assess the quantitative and qualitative pharmacodynamic effects of Ceplene plus low-dose IL-2 (Ceplene/IL-2) by monitoring T and natural killer (NK) cell phenotypes and their functionality after the first and third treatment cycles in adult patients with acute myeloid leukemia (AML) in first complete remission (CR1). 2. To evaluate minimal residual disease (MRD) in AML patients receiving Ceplene/IL-2. Secondary: To document, in adult AML patients in CR1 treated with Ceplene/IL-2: 1. Leukemia-free survival (LFS) after a follow-up period of up to two years. 2. The safety of Ceplene/IL-2 therapy. 3. The potential relationship of Ceplene/IL-2 effects on T and NK cell phenotypes and their functionality to MRD.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
84
Ceplene 0.5 mg subcutaneously twice daily and IL-2 1 µg/kg \[16,400 IU/kg\] body weight twice daily for 10, 21 day cycles
Sahlgrenska Academy, University of Gothenburg
Gothenburg, Sweden
Minimal residual disease (MRD) in AML patients receiving Ceplene/IL-2
A second primary objective of this study is to evaluate MRD in patients who are receiving remission maintenance therapy with Ceplene/IL-2. MRD will be evaluated using RQ-PCR for molecular detection of genetic markers of AML. Patients' MRD status will be quantified at the time of enrollment (baseline) and within ten days after completion of Cycles 3, 5, 6, 7, 9 and 10 of Ceplene/IL-2 therapy, corresponding to approximately every 3 months during this immunotherapy.
Time frame: Comparison at baseline and various time points up to 2 years
Pharmacodynamic effects of Ceplene plus low dose IL-2 (Ceplene/IL-2) by monitoring T and NK cell phenotypes and their functionality after the first and third cycles of treatment
The quantitative and qualitative pharmacodynamic effects of Ceplene/IL-2 on the immune responses of T and NK cells will be assessed as follows: 1. Changes in T and NK cell phenotypes (CD56, CD3, CD4, CD8) in peripheral blood from Day 1 (baseline) to Day 21‡ of Cycle 1 and from Day 1 (pre-treatment Cycle 3) to Day 21‡ of Cycle 3. 2. Changes in immune response markers (CD3, NKp46 \[and other NCRs\], CD25, CD69, and IFN-γ) in peripheral blood from Day 1 (baseline) to Day 21‡ of Cycle 1 and from Day 1 (pre-treatment Cycle 3) to Day 21‡ of Cycle 3
Time frame: Baseline vs Cycle 1 and 3
Duration of LFS
Duration of LFS: LFS will be defined as the time from achieving CR after successful induction therapy until relapse of AML (defined as 5% or more blast cells in the bone marrow).
Time frame: up to 2 years
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