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NCT01812252: ICT-HCT

Chemotherapy in Treating Patients With Myelodysplastic Syndrome Before Donor Stem Cell Transplant

Completed Phase 2 Results posted Last updated 15 February 2024
What this trial tests

Phase 2 trial testing Azacitidine (AZC) in Chronic Myelomonocytic Leukemia in 50 participants. Completed in 26 October 2022.

Timeline
19 August 2013
Primary endpoint
26 October 2022
26 October 2022

Quick facts

Lead sponsorFred Hutchinson Cancer Center
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposetreatment
Enrollment50
Start date19 August 2013
Primary completion26 October 2022
Estimated completion26 October 2022
Sites4 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Fred Hutchinson Cancer Center — full company profile →

Who can join

18 and older, any sex, with Chronic Myelomonocytic Leukemia or de Novo Myelodysplastic Syndrome. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Failure-free Survival (Failure Defined as Death or Relapse) Primary · 18 months

18-month failure-free survival (failure defined as death or relapse).

GroupValue95% CI
Arm A (Decitabine or Azacitidine)6
Arm B (Induction-like Chemotherapy Regimen)10
Quality of Life Will be Assessed Using the European Organization for Research and Treatment of Cancer Quality of Life (QoL) Questionnaire (EORTC QLQ-C30) Questionnaire. Secondary · EORTC QLQ-C30 questionnaire will be collected at screening, after completion of therapy (HMA 4-6 month, and up to 6 months for induction-like chemotherapy) just prior to stem cell infusion and 100 (± 14) days after stem cell infusion (HSCT).

The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) (version 3) is a 30-item cancer-specific questionnaire for measuring the health-related quality of life (QOL) in cancer patients. It includes five functioning scales (physical, PF; role, RF; cognitive, CF; emotional, EF; and social, SF), three symptom scales (fatigue, FA; pain, PA; and nausea and vomiting, NV), a global health status/QOL scale (GL), and six single items (dyspnea, appetite loss, sleep disturbance, constipation, diarrhea, and financial impact of the disease and treatment). All items em

EORTCQLQ-C30 at Screening 1. Do you have any trouble doing strenuous activities?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)2.271 – 4
Arm B (Induction Like Chemotherapy)1.721 – 4
EORTCQLQ-C30 at Pre-Transplant 1. Do you have any trouble doing strenuous activities?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)2.141 – 4
Arm B (Induction Like Chemotherapy)2.01 – 4
EORTCQLQ-C30 at post-transplant 1. Do you have any trouble doing strenuous activities?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)2.01 – 4
Arm B (Induction Like Chemotherapy)1.811 – 4
EORTCQLQ-C30 at Screening 2. Do you have any trouble taking a long walk?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)2.401 – 4
Arm B (Induction Like Chemotherapy)1.961 – 4
EORTCQLQ-C30 at Pre-transplant 2. Do you have any trouble taking a long walk?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)1.851 – 4
Arm B (Induction Like Chemotherapy)1.831 – 4
EORTCQLQ-C30 at Post-transplant 2. Do you have any trouble taking a long walk?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)1.91 – 4
Arm B (Induction Like Chemotherapy)1.631 – 4
EORTCQLQ-C30 at Screening 3. Do you have any trouble taking a short walk outside of the house?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)1.51 – 4
Arm B (Induction Like Chemotherapy)1.241 – 4
EORTCQLQ-C30 at Pre-transplant 3. Do you have any trouble taking a short walk outside of the house?
GroupValue95% CI
Arm A (Azacitidine or Decitabine)1.421 – 4
Arm B (Induction Like Chemotherapy)1.301 – 4
Quality of Life Will be Assessed Using the EORTC QLQ-HDC29 a Supplementary Module Assessing the Quality of Life During and After High-dose Chemotherapy and Stem Cell Transplantation. Secondary · EORTC QLQ-HDC29 questionnaire will be collected after completion of therapy (HMA 4-6 month, and up to 6 months for induction-like chemotherapy) pre stem cell infusion (HSCT), and 100 (± 14) days post stem cell infusion (HSCT).

European Organization for Research and Treatment of Cancer Quality of Life Questionnaire High Dose Chemotherapy (EORTC QLQ-HDC29) is a treatment-specific quality of life questionnaire that addresses treatment specific side effects as well as emotional, social, and family issues for patients treated with high dose regimens and HCT. The QLQ-HDC29 module includes 29 items, consisting of 6 multi-item scales and 8 single-items; all items employ a 4-point Likert scale, ranging from 1 (not at all) to 4 (very much) with lower scores representing a better outcome and higher scores a worse outcome with

QLQ-HDC 29 Pre-HSCT 31. Have you had soreness in your mouth?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.361 – 4
Arm B (Induction-like Chemotherapy Regimen)1.081 – 4
QLQ-HDC 29 Post-HSCT 31. Have you had soreness in your mouth?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.21 – 4
Arm B (Induction-like Chemotherapy Regimen)1.01 – 4
QLQ-HDC 29 Pre-HSCT 32. Have you had a dry mouth?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.361 – 4
Arm B (Induction-like Chemotherapy Regimen)1.621 – 4
QLQ-HDC 29 Post-HSCT 32. Have you had a dry mouth?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)2.01 – 4
Arm B (Induction-like Chemotherapy Regimen)1.71 – 4
QLQ-HDC 29 Pre-HSCT 33. Have you had trouble swallowing?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.071 – 4
Arm B (Induction-like Chemotherapy Regimen)1.151 – 4
QLQ-HDC 29 Post-HSCT 33. Have you had trouble swallowing?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.21 – 4
Arm B (Induction-like Chemotherapy Regimen)1.31 – 4
QLQ-HDC 29 Pre-HSCT 34. Did food and drink taste different from usual?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.571 – 4
Arm B (Induction-like Chemotherapy Regimen)1.921 – 4
QLQ-HDC 29 Post-HSCT 34. Did food and drink taste different from usual?
GroupValue95% CI
Arm A (Decitabine or Azacitidine)1.91 – 4
Arm B (Induction-like Chemotherapy Regimen)2.21 – 4
Overall Survival Secondary · Up to 18 months

The total length of follow-up will be 18 months from the start of treatment (day 1). Four categories were added for participants alive 18 months from start of treatment (day 1) 1) Participants alive after 18 months from start of treatment who received hematopoietic cell transplantation (HCT); 2) Participants alive after 18months from start of treatment who did not receive HCT.; 3) Participants deceased after 18 months from start of treatment who received HCT; 4) Participants deceased after 18 months from start of treatment who did not receive HCT.

GroupValue95% CI
Arm A (Decitabine or Azacitidine)7
Arm B (Induction-like Chemotherapy Regimen)10
Arm A (Decitabine or Azacitidine)2
Arm B (Induction-like Chemotherapy Regimen)1
Arm A (Decitabine or Azacitidine)5
Arm B (Induction-like Chemotherapy Regimen)3
Arm A (Decitabine or Azacitidine)11
Arm B (Induction-like Chemotherapy Regimen)11
Number of Patients Who Relapse Post-transplant Secondary · Up to 18 months

To compare which of the two, intensive chemotherapy versus hypomethylating agent-based therapy, have a factor of relapse post hematopoietic cell transplantation (HCT).

GroupValue95% CI
Arm A (Decitabine or Azacitidine)6
Arm B (Induction-like Chemotherapy Regimen)3
Arm A (Decitabine or Azacitidine)6
Arm B (Induction-like Chemotherapy Regimen)10
Number of Participants Who Received a Hematopoietic Cell Transplantation (HCT). Secondary · Up to 18 months

Frequency at which the participants received a hematopoietic cell transplantation (HCT)

GroupValue95% CI
Arm A (Decitabine or Azacitidine)12
Arm B (Induction-like Chemotherapy Regimen)13
Arm A (Decitabine or Azacitidine)13
Arm B (Induction-like Chemotherapy Regimen)12

Sponsor's own description

This randomized clinical trial studies different chemotherapies in treating patients with myelodysplastic syndrome before donor stem cell transplant. Giving chemotherapy before a donor stem cell transplant helps stop the growth of cancer cells in the bone marrow, including normal blood-forming cells (stem cells) and cancer cells, and may prevent the myelodysplastic syndrome from coming back after the transplant. When the healthy stem cells from a donor are infused into the patient they may help the patient's bone marrow make stem cells, red blood cells, white blood cells, and platelets.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Allogeneic hematopoietic stem cell transplantation for MDS and CMML: recommendations from an international expert panel.
    de Witte T, Bowen D, Robin M, Malcovati L, et al · · 2017 · cited 273× · PMID 28096091 · DOI 10.1182/blood-2016-06-724500
  2. Trial Watch: Chemotherapy with immunogenic cell death inducers.
    Vacchelli E, Aranda F, Eggermont A, Galon J, et al · · 2014 · cited 123× · PMID 24800173 · DOI 10.4161/onci.27878
  3. Understanding the Continuum between High-Risk Myelodysplastic Syndrome and Acute Myeloid Leukemia.
    Zavras PD, Sinanidis I, Tsakiroglou P, Karantanos T. · · 2023 · cited 11× · PMID 36902450 · DOI 10.3390/ijms24055018
  4. BMT for Myelodysplastic Syndrome: When and Where and How.
    Jain AG, Elmariah H. · · 2021 · cited 11× · PMID 35070975 · DOI 10.3389/fonc.2021.771614
  5. In MDS, is higher risk higher reward?
    Sanz GF. · · 2019 · cited 7× · PMID 31808894 · DOI 10.1182/hematology.2019000042
  6. Historical expectations with DNA methyltransferase inhibitor monotherapy in MDS: when is combination therapy truly "promising"?
    Brunner AM, Fell G, Steensma DP. · · 2022 · cited 3× · PMID 35143613 · DOI 10.1182/bloodadvances.2021006357
  7. Hypomethylating agents plus venetoclax for high-risk MDS and CMML as bridge therapy to transplant: a GESMD study.
    Zugasti I, Lopez-Guerra M, Castaño-Díez S, Esteban D, et al · · 2025 · cited 2× · PMID 40287746 · DOI 10.1186/s40164-025-00652-5
  8. Existing agents, novel agents, or transplantation for high-risk MDS.
    Scott BL. · · 2020 · PMID 33275695 · DOI 10.1182/hematology.2020000125

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