Objectives: To compare the efficacy and safety in childhood and adolescent patients (\<20 years) diagnosed as essential thrombocythemia treated with the Pegylated Interferon Alfa-2b vs. Interferon Alfa. Study Design: A prospective, open-label, nonrandomized, single-center clinical trial
This is a prospective, open-label, nonrandomized, single-center clinical trial between Interferon Alfa and Pegylated Interferon Alfa-2b in childhood and adolescent essential thrombocythemia (\<20 years). Patients will be divided into the following two treatment groups: 1. Recombinant Interferon Alpha, with an initial dose of 300 wu twice a week. Other interferons that have been listed can be used if Recombinant Interferon Alpha (300 wu) is not available, and the specific dose will be determined by the researchers; 2. Pegylated Interferon Alfa-2b, with an initial dose of 135 ug once a week (body surface area \< 1.73 m2) or 180 ug once a week ( body surface area≥1.73 m2). The current drug therapies and possible risks of Pegylated Interferon Alfa-2b and Interferon Alfa in the treatment of childhood and adolescent essential thrombocythemia will be fully introduced to the guardians (childhood patients) or patients (adolescent patients) by the researchers. Then the patients will be divided into one of the two groups according to the guardians' (childhood patients) or patients' (adolescent patients) will. The dosage will be adjusted according to the results of laboratory examinations and patient tolerance. The patient will be transferred to the other group if intolerance or resistance occurs.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
Recombinant Interferon Alpha, with an initial dose of 300 wu twice a week. Other interferons that have been listed can be used if Recombinant Interferon Alpha (300 wu) is not available, and the specific dose will be determined by the researchers;
Pegylated Interferon Alfa-2b, with an initial dose of 135 ug once a week (body surface area \< 1.73 m2) or 180 ug once a week ( body surface area≥1.73 m2).
Institute of Hematology & Blood Diseases Hospital
Tianjin, Tianjin Municipality, China
RECRUITINGChange in platelet count
Proportion of subjects with a continuous platelet count ≤600×109/L or decrease ≥50% (\<1000×109/L ) (at least 12 weeks) from baseline during treatment will be evaluated.
Time frame: From the start of study treatment (Day 1) up to the end of month 12
The complete hematologic response rates
To compare the complete hematologic response rates between different treatment groups
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Time to response in platelet count
Time to response in platelet count (\<600×109/L) between different treatment groups
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Impact of therapy on key biomarkers
To compare the proportion of subjects that display change on key biomarkers of the disease- JAK2V617F, CALR, MPL mutations.
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Incidence of major cardiovascular and thrombotic events
To estimate incidence of major cardiovascular and thrombotic events (defined as cardiovascular death, myocardial infarction, stroke, transient ischemic attack, pulmonary embolism, Budd Chiari syndrome, deep vein thrombosis, and any other clinically relevant thrombotic event) while on active treatment or observation following end of treatment between different treatment groups
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Incidence of development of myelodysplastic disorders, myelofibrosis, or leukemic transformation.
To estimate incidence of development of myelodysplastic disorders, myelofibrosis, or leukemic transformation between different treatment groups
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Time frame: From the start of study treatment (Day 1) up to the end of month 12
Change in Myeloproliferative Neoplasm Symptom Assessment Form total symptom score
To compare the proportion of subjects that display change in Myeloproliferative Neoplasm Symptom Assessment Form total symptom score (0-100 scores, higher scores mean a worse outcome) between different treatment groups.
Time frame: 12 months
Specific pre-defined toxicity
To compare incidence of specific pre-defined toxicity including fatigue, flu-like symptoms, dizziness, injection site necrosis, dyspnea, pain, depression, blurred Vision, insomnia, anorexia, weight Loss, weakness, pruritis, sweating, fever, decreased Libido, hot Flashes, flushing.
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Impact of therapy on bone marrow histopathology (selectable)
To compare the proportion of subjects that display change on bone marrow histopathology
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Impact of therapy on cytogenetic abnormalities (selectable)
To compare the proportion of subjects that display change on cytogenetic abnormalities.
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Death while on active treatment or observation following end of treatment
To compare the incidence of death while on active treatment or observation following end of treatment
Time frame: From the start of study treatment (Day 1) up to the end of month 12
Change in platelet count
Proportion of subjects with a continuous platelet count \<1000×109/L in those with platelet count ≥1000×109/L before treatment (at least 12 weeks) will be evaluated.
Time frame: From the start of study treatment (Day 1) up to the end of month 12