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During the last fifteen years, the landscape of AML diagnosis and therapeutical options has markedly evolved. Refined genetic and prognostic characterizations, together with new drug approvals and new allogeneic hematopoietic stem cell transplantation (HSCT) procedures, have increased patient journey diversity.
During the last fifteen years, the landscape of AML diagnosis and therapeutical options has markedly evolved. Refined genetic and prognostic characterizations, together with new drug approvals and new allogeneic hematopoietic stem cell transplantation (HSCT) procedures, have increased patient journey diversity.
I - At initial AML diagnosis, not all newly diagnosed patients are entering clinical trials. A substantial proportion of them are treated with standard therapies outside of any trial. To date, the standard approved frontline treatment options include:
The investigator's choice is guided by AML and patient's characteristics, and by the approved indications for each of these treatment options. This study will thus start including these specific options. Further study amendments might be necessary in case of new standard treatment definition.
II - Secondly, no specific salvage regimen has emerged as a standard in patients with primary refractory or relapsed AML (R/R AML). R/R AML is thus an important field for investigational new drugs (INDs) and precision medicine development. To date, the only IND approved to treat R/R AML is gilteritinib for FLT3-mutated AML patients. The French agency ANSM also allow to use GO for treating R/R AML patients in the frame of a RTU (Recommendation Temporaire d'Utilisation).
In the "real life", because of the multiplicity of treatments used in these patients, some of them being now quite efficient, it has become difficult to accurately describe the general outcome of R/R AML patients.
III - Thirdly, allogeneic HSCT is no more considered at the ultimate and final goal of AML therapy in all patients, as it was in the past. Transplant indications have been better described and HSCT in now evaluated in the context of the whole treatment course, including pre- and post-transplant therapy, as well as pre- and post-transplant minimal residual disease (MRD) levels.
For all these reasons, it is of utmost importance to document the various characteristics, treatments and outcomes of patients treated in the real-life, outside of clinical trials, for 1) real-world treatment evaluation; 2) post-approval use of recently approved drugs; 3) standardization and improvement of routine patient management; and 4) better disease understanding.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard intensive 3+7 YOUNG OR ELDERLY | Standard intensive 3+7 (anthracycline + cytarabine) chemotherapy ± an approved FLT3 inhibitor (midostaurine, Rydapt® or ± quizartinib, Vanflyta®), according to different dose schedules in older versus younger patients | ||
| GO, (Mylotarg®) with 3+7 | Combination of sequential gemtuzumab ozogamicin (GO, Mylotarg®) with 3+7 | ||
| CPX-351, (Vyxeos®) | Liposomal formulation of daunorubicin + cytarabine (CPX-351, Vyxeos®) | ||
| Less intensive chemotherapy with azacytidine combined or not with venetoclax; LDAC; ivosidenib | Less intensive chemotherapy with azacytidine either combined or not with venetoclax or low dose cytarabine (LDAC) or in AML bearing an IDH1 somatic mutation, with ivosidenib in newly diagnosed patients considered as not eligible for the more intensive options above | ||
| Refractory or relapsed AML | Secondly, no specific salvage regimen has emerged as a standard in patients with primary refractory or relapsed AML (R/R AML). R/R AML is thus an important field for investigational new drugs (INDs) and precision medicine development. To date, the only IND approved to treat R/R AML is gilteritinib for FLT3-mutated AML patients. The French agency ANSM also allow to use GO for treating R/R AML patients in the frame of a RTU (Recommendation Temporaire d'Utilisation). In the "real life", because of the multiplicity of treatments used in these patients, some of them being now quite efficient, it has become difficult to accurately describe the general outcome of R/R AML patients. |
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| Measure | Description | Time Frame |
|---|---|---|
| OS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 1 year |
| OS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 3 years |
| OS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 5 years |
| OS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
|
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Inclusion Criteria:
Exclusion Criteria:
More specific eligibility criteria might be requested to enter some study modules
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Natural History and assessment of the outcomes of different standard approved treatments in recently diagnosed or relapsed/refractory AML patients
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Karine CELLI LEBRAS, Mrs | Contact | 33 1 57 27 67 17 | karine.cellilebras@alfa-leukemia.org | |
| Hervé DOMBRET, MD-Prof | Contact | 33 1 57 27 67 17 | herve.dombret@mac.com |
| Name | Affiliation | Role |
|---|---|---|
| Hervé DOMBRET, PD-Prof | Acute Leukemia French Association | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chu Amiens | Recruiting | Amiens | France |
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Peripheral blood and bone marrow samples will be collected. Cells, and nucleic acids will be cryopreserved.
| 10 years |
| EFS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 1 year |
| EFS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 3 years |
| EFS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 5 years |
| EFS | The primary objective of this multicenter non-interventional study is to record and prospectively evaluate the real-life characteristics, treatments and outcomes of adult patients with newly diagnosed or R/R AML, when managed and treated in the French ALFA centers according to standard practices outside of a clinical trial. The two co-primary endpoints are event-free (EFS) and overall survival (OS) estimations at 1, 3, 5 and 10 years:
| 10 years |
| Centre Hospitalier Victor Dupouy | Recruiting | Argenteuil | France |
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| AP-HP-GHU - Hôpital AVICENNE | Recruiting | Bobigny | France |
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| CHU de la cote de Nacre | Recruiting | Caen | France |
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| Hôpital MILITAIRE PERCY | Recruiting | Clamart | France |
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| Centre hospitalier Sud Francilien | Recruiting | Corbeil-Essonnes | France |
|
| Hôpital Henri Mondor AP-HP | Recruiting | Créteil | France |
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| CHU Dijon- François Mitterrand | Active, not recruiting | Dijon | 21000 | France |
| Centre Hospitalier de Dunkerque | Recruiting | Dunkirk | France |
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| Centre Hospitalier de Versailles André Mignot | Recruiting | Le Chesnay | France |
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| Centre Hospitalier Dr Schaffner | Recruiting | Lens | France |
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| CHRU de Lille- Hopital C. HURIEZ | Recruiting | Lille | France |
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| GHICL-Hopital St Vincent de Paul | Recruiting | Lille | France |
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| C H U DE LIMOGES- Hopital Dupuytren | Recruiting | Limoges | France |
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| CHU La Conception | Recruiting | Marseille | France |
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| Centre Hopsitalier de l'Est Francilien - Site de Meaux | Recruiting | Meaux | France |
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| Centre Antoine Lacassagne | Recruiting | Nice | France |
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| CHU Nice,Hopital Archet 1 | Recruiting | Nice | France |
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| Hopital Pitié-Salpétrière APHP | Recruiting | Paris | France |
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| Hôpital Necker - APHP | Recruiting | Paris | France |
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| Hôpital SAINT ANTOINE-APHP | Recruiting | Paris | France |
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| Hôpital Saint Louis- APHP | Recruiting | Paris | France |
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| Centre Hospitalier Lyon Sud | Recruiting | Pierre-Bénite | France |
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| Centre Hospitalier René Dubos | Recruiting | Pontoise | France |
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| Centre Hospitalier de Roubaix | Recruiting | Roubaix | France |
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| Centre Henri Becquerel | Recruiting | Rouen | France |
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| Institut Curie - Hôpital René HUGUENIN | Not yet recruiting | Saint-Cloud | France |
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| Centre Hospitalier de St Quentin | Recruiting | Saint-Quentin | France |
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| Centre Hospitalier Valenciennes | Not yet recruiting | Valenciennes | France |
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| Institut Gustave Roussy | Recruiting | Villejuif | France |
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| ID | Term |
|---|---|
| D015470 | Leukemia, Myeloid, Acute |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
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