Flavopiridol in Treating Patients With Relapsed or Refractory Acute Myeloid Leukemia, Acute Lymphoblastic Leukemia, or Chronic Myelogenous Leukemia

• Status: Terminated
• Trial end date: 1969-12-31
• Target enrollment: 0
• Participant gender: All

Summary

This phase I trial is studying the side effects and best dose of flavopiridol in treating patients with relapsed or refractory acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myelogenous leukemia. Drugs used in chemotherapy, such as flavopiridol, work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

• Phase: Phase 1
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: National Cancer Institute (NCI)
• Treatments: Alvocidib

Criteria

Inclusion Criteria:

• Histologically confirmed diagnosis of one of the following:

• Acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) meeting 1 of the following criteria:

• Refractory to initial treatment (stratum 1)

• Recurrent disease after prior high-dose chemotherapy with or without stem cell support (stratum 1)

• High-risk refractory disease defined as failed ≥ 2 regimens for remission induction (i.e., twice induction failure) (stratum 2)

• High-risk relaspsed disease defined as disease in second or greater bone marrow relapse (stratum 2)

• Chronic myelogenous leukemia in blast crisis (stratum 1)

• Myeloid or lymphoid blast crisis that did not respond to or progressed after prior high-dose imatinib mesylate (600-800 mg/day for ≥ 2 weeks)

• No acute promyelocytic leukemia

• Ineligible for or unwilling to undergo potentially curative allogeneic or autologous stem cell transplantation

• Patients with relapsed AML that is refractory to re-induction therapy comprising an active, intensive salvage regimen are eligible

• CNS involvement allowed provided there are no residual leukemic cells in the cerebrospinal fluid after intrathecal chemotherapy or radiotherapy

• Performance status - ECOG ≥ 2 for patients > 10 years of age

• Performance status - Lansky 50-100% for patients ≤ 10 years of age

• At least 8 weeks

• Bilirubin ≤ 2 times upper limit of normal (ULN)* (unless due to Gilbert's syndrome)

• ALT and AST ≤ 5 times ULN*

• Creatinine ≤ 2.0 mg/dL* (stratum 1)

• Creatinine > 1.3 times ULN (stratum 2)

• LVEF ≥ 40% by echocardiogram or MUGA (stratum 1)

• Shortening fraction ≥ 28% by echocardiogram (stratum 2)

• No symptomatic congestive heart failure

• No unstable angina pectoris

• No cardiac arrhythmia

• Not pregnant or nursing

• Negative pregnancy test

• Fertile patients must use effective contraception

• HIV negative

• No history of allergy to study drug

• No active infection requiring IV antibiotics

• No serious medical or psychiatric illness that would preclude giving informed consent or limit survival

• No other uncontrolled illness

• See Disease Characteristics

• Recovered from all prior immunotherapy treatment-related toxicity (stratum 2)

• More than 8 weeks since prior biological agents (e.g., monoclonal antibodies) (stratum 2)

• See Disease Characteristics

• Recovered from all prior chemotherapy treatment-related toxicity (stratum 2)

• More than 24 hours since prior hydroxyurea (for patients who do not have highly proliferative disease)*

• More than 2 weeks since other prior chemotherapy (6 weeks for nitrosourea or mitomycin)

• No other concurrent chemotherapy

• Prior hydrea and/or steroids allowed (stratum 2)

• No concurrent hormones, except steroids for adrenal failure or infusional toxicity (i.e., cytokine release syndrome) or hormones for non-disease-related conditions (e.g., insulin for diabetes)

• See Disease Characteristics

• Recovered from all prior radiotherapy treatment-related toxicity (stratum 2)

• More than 2 weeks since prior radiotherapy

• No concurrent palliative radiotherapy

• Post stem cell transplant allowed provided completion ≥ 4 months prior to study entry and no evidence of active acute or chronic graft vs host disease (stratum 2)

• No other concurrent investigational agents

• No concurrent chronic systemic anticoagulant therapy for a medical condition (e.g., deep vein thrombosis or atrial fibrillation)

• Concurrent heparin allowed to maintain central line patency (i.e., catheter flush)

• No other concurrent anticancer therapy