This protocol is an open label, single arm, non-randomized, phase I / II clinical trial investigating the use of pegylated interferon alpha-2a (peg-IFN-α, Pegasys®, Genentech) for prevention of relapse in acute myeloid leukemia (AML) not in remission at the time of allogeneic hematopoietic stem cell transplantation (HCT).
This protocol is an open label, single arm, non-randomized, phase I / II clinical trial investigating the use of pegylated interferon alpha-2a (peg-IFN-α, Pegasys®, Genentech) for prevention of relapse in acute myeloid leukemia (AML) not in remission at the time of allogeneic hematopoietic stem cell transplantation (HCT). The inability to attain remission status following induction therapy for AML remains a significant problem and is associated with poor outcomes. While HCT remains a curative option, its activity in the setting of relapsed or refractory AML is significantly diminished due to high relapse.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
37
Calcineurin inhibitor administered along with HCT for Graft Versus Host Disease (GVHD) prophylaxis. Cyclosporine may be substituted if patients cannot tolerate tacrolimus.
University of Michigan Comprehensive Cancer Center
Ann Arbor, Michigan, United States
Phase 1: Maximum Tolerated Dose (MTD) of Peg-IFN-α
The dose level assigned to the most participants is selected as the MTD. Participants from the arms for dose level 1 (90mcg, 3 participants) and dose level 2 (180mcg, 33 participants) were analyzed together to determine the MTD. Dosage levels are determined by dose-limiting toxicities (DLTs). Only DLTs encountered during the treatment period, prior to day 56 post HCT (or 14 days after final treatment, whichever comes later), are counted. DLTs after the treatment period are counted only if they reflect an ongoing toxicity that initiated in the treatment period.
Time frame: Up to day 56 post-transplant or up to 14 days after final treatment with peg-IFN-α, whichever comes later. Data was collected up to 63 days.
Phase 2: Number of Patients That Relapse
The cumulative incidence of relapse, estimated using proportional hazard model for the competing risk of non-relapse mortality (NRM).
Time frame: 6 Months Post HCT
Phase 2: Overall Survival Time
Estimated using Kaplan-Meier methods, overall survival (OS) will be calculated from the day of transplantation (day 0) until death; shown at 6 month and 2 year estimates
Time frame: 1 year or until study stops, whichever is later. Median time of follow-up was 25 months.
Phase 2: Event Free Survival Time
Defined for this study as Leukemia Free Survival, and estimated using Kaplan-Meier methods.
Time frame: 1 year or until study stops, whichever is later. Median time of follow-up was 25 months.
Acute GVHD
Grade 2-4 Acute GVHD estimated using proportional hazards ratio. Graded according to CTCAE v. 4.0; higher grades represent more severe events.
Time frame: 6 months
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Administered along with HCT for Graft Versus Host Disease (GVHD) prophylaxis.
Non-Relapse Mortality
The cumulative incidence of non-relapse mortality is estimated by proportional hazard models methods.
Time frame: 1 year or until study stops, whichever is later. Median time of follow-up was 25 months.