Status:

COMPLETED

3-AP and Fludarabine in Treating Patients With Myeloproliferative Disorders, Chronic Myelomonocytic Leukemia, or Accelerated Phase or Blastic Phase Chronic Myelogenous Leukemia

Lead Sponsor:

National Cancer Institute (NCI)

Conditions:

Accelerated Phase Chronic Myelogenous Leukemia

Atypical Chronic Myeloid Leukemia, BCR-ABL1 Negative

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

This phase II trial is studying how well giving 3-AP together with fludarabine works in treating patients with myeloproliferative disorders (MPD), chronic myelomonocytic leukemia (CMML), or accelerate...

Detailed Description

OBJECTIVES: I. Determine the efficacy of 3-AP (Triapine®) followed by fludarabine phosphate in patients with myeloproliferative disorders or chronic myelomonocytic leukemia in aggressive phase or tra...

Eligibility Criteria

Inclusion

  • Criteria:
  • Not pregnant or nursing
  • Histopathologically confirmed diagnosis of 1 of the following:
  • Myeloproliferative disorders (MPDs) in aggressive phase or transformation
  • CML in accelerated phase or blast crisis
  • Chronic myelomonocytic leukemia in aggressive phase (5-19% bone marrow blasts) or transformation (\> 20% bone marrow blasts)
  • Myeloproliferative disorders (MPDs) in aggressive phase or transformation, including the following:
  • Polycythemia vera (PV)
  • Essential thrombocythemia (ET)
  • Myelofibrosis with myeloid metaplasia
  • Hypereosinophilic syndrome
  • Atypical (Philadelphia chromosome negative) chronic myelogenous leukemia (Ph- CML)
  • Patients with aggressive phase MPD (PV, ET, or Ph- CML) must meet ≥ 1 of the following criteria:
  • Marrow blasts \> 5%
  • Peripheral blood blasts plus progranulocytes \> 10%
  • New onset or increasing myelofibrosis
  • New onset or \> 25% increase in hepatomegaly or splenomegaly
  • New onset constitutional symptoms (fever, weight loss, splenic pain, bone pain)
  • Multilineage bone marrow failure
  • Ineligible for established curative regimens, including stem cell transplantation
  • ECOG performance status 0-2
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No chronic toxicity from prior chemotherapy \> grade 1
  • No history of severe coronary artery disease
  • Creatinine normal OR creatinine clearance \>= 60 mL/min
  • AST and ALT =\< 2.5 times normal
  • Bilirubin =\< 2.0 mg/dL unless due to leukemia, Gilbert's syndrome, or hemolysis
  • No arrhythmias (other than atrial flutter or fibrillation) requiring medication
  • No uncontrolled congestive heart failure
  • No dyspnea at rest or with minimal exertion
  • No severe pulmonary disease requiring supplemental oxygen
  • No history of allergic reactions attributed to compounds of similar chemical or biological composition to 3-AP (Triapine®) and/or fludarabine phosphate
  • No other life-threatening illness
  • No history of mental deficits and/or psychiatric illness that would preclude study compliance
  • No more than 4 prior induction regimens (3 cytotoxic chemotherapy regimens)
  • At least 3 weeks since prior myelosuppressive cytotoxic agents (6 weeks for mitomycin C or nitrosoureas) and recovered
  • At least 1 week since prior nonmyelosuppressive treatment
  • At least 48 hours since prior noncytotoxic agents for peripheral blood leukemic cell count control, including but not limited to the following:
  • Hydroxyurea
  • Imatinib mesylate
  • Interferon
  • Mercaptopurine
  • Cyclophosphamide
  • At least 2 weeks since prior and no concurrent radiotherapy to treat cancer
  • At least 1 week since prior biologic therapy, including hematopoietic growth factors (e.g., epoetin alfa, darbepoetin alfa, filgrastim \[G-CSF\], sargramostim \[GM-CSF\], interleukin-3, or interleukin-11)
  • No other concurrent chemotherapy to treat cancer
  • No concurrent immunotherapy to treat cancer
  • No known glucose-6-phosphate dehydrogenase \[G6PD) deficiency (G6PD screening required for high-risk groups (i.e., patients of African, Asian, or Mediterranean origin/ancestry)\]
  • No active heart disease
  • No concurrent myeloid growth factors
  • No active uncontrolled infection (Infections under active treatment and controlled with antibiotics are allowed)
  • No chronic hepatitis

Exclusion

    Key Trial Info

    Start Date :

    August 1 2006

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    March 1 2011

    Estimated Enrollment :

    35 Patients enrolled

    Trial Details

    Trial ID

    NCT00381550

    Start Date

    August 1 2006

    End Date

    March 1 2011

    Last Update

    January 6 2015

    Active Locations (1)

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    Johns Hopkins University/Sidney Kimmel Cancer Center

    Baltimore, Maryland, United States, 21287