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The DCMG regimen includes decitabine or azacitidine (hypomethylating agents), mitoxantrone liposome, cytarabine, and granulocyte colony-stimulating factor (G-CSF), comprising four medications. This project initiates a prospective and exploratory clinical study on the DCMG chemotherapy regimen for the treatment of relapsed/refractory AML (Acute Myeloid Leukemia). The study aims to evaluate the efficacy and safety of the DCMG combination chemotherapy regimen in treating relapsed/refractory AML.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DCMG | Experimental | Patients are treated with DCMG chemotherapy regimen. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Decitabine, Azacitidine, Mitoxantrone liposome, Cytarabine, G-CSF | Drug | The specific administration times and dosages for the DCMG chemotherapy regimen are as follows: M: Mitoxantrone Hydrochloride Liposome Injection: 15 mg/m², IV, on Day 1, every 4 weeks (q4w); D: Decitabine: 20 mg/m², IV, Days 1-5, q4w; (or Azacitidine: 75 mg/m², IV, Days 1-7, q4w); C: Cytarabine: 100 mg, IV, every 12 hours on Days 1-5, q4w; For patients with hypoplastic bone marrow, the dose of cytarabine injection is 10 mg, every 12 hours, q4w; G: G-CSF: 5 μg/kg, subcutaneous injection, from Day 0 until the white blood cell count exceeds 10.0×10^9/L, at which point chemotherapy is stopped; or Pegylated Recombinant Human Granulocyte Stimulating Factor Injection: 100 μg/kg, subcutaneous injection, on Day 0. One cycle lasts for 4 weeks, with a planned administration of 1 or 2 cycles. |
| Measure | Description | Time Frame |
|---|---|---|
| Complete remission rate | Percentage of subjects with complete remission (CR) and incomplete hematologic recovery (CRi) | At the end of Cycle 2 (each cycle is 28 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Relapse-Free Survival | Time interval from leukemia free state to the first recurrence or death | 24 months |
| Overall Survival | Time interval from start of treatment until death or last follow-up |
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Inclusion Criteria:
The patient has fully understood the study, voluntarily agrees to participate, and has signed the Informed Consent Form (ICF);
Age between 18 and 75 years, with no gender restrictions;
Confirmed diagnosis of relapsed/refractory AML (Acute Myeloid Leukemia) by pathology (meeting any one of the following criteria):
Serum total bilirubin ≤ 1.5 times the upper limit of normal, serum ALT and AST both ≤ 2.5 times the upper limit of the normal range, serum creatinine ≤ 1.5 times the upper limit of normal;
Echocardiogram showing left ventricular ejection fraction (LVEF) ≥ 50%;
Estimated survival time ≥ 3 months;
ECOG performance status score of 0-2.
Exclusion Criteria:
The subject's prior anti-tumor treatment history meets one of the following conditions:
Cardiac function and disease meet any of the following conditions:
Underwent any major surgery, radiotherapy, chemotherapy, biological therapy, immunotherapy, or experimental treatment within 2 weeks before the first administration of the study drug;
Uncontrolled systemic diseases (such as progressive infections, uncontrolled hypertension, diabetes, etc.);
Previous or current diagnosis of other malignancies (excluding adequately controlled basal cell carcinoma of the skin that is non-melanoma, breast/cervical carcinoma in situ, or other malignancies that have been adequately controlled without treatment in the past five years);
Active hepatitis B or C infection during the viremic phase (Hepatitis B testing: if either HBsAg or core antibody is positive, add HBV-DNA testing; viral DNA levels exceeding 1x10^3 copies/mL; Hepatitis C testing: if HCV antibody is positive, add HCV-RNA testing; viral RNA levels exceeding 1x10^3 copies/mL);
Human Immunodeficiency Virus (HIV) infection (HIV antibody positive);
Pregnant women, breastfeeding women, patients who refuse to use effective contraception during the study period;
Significant neurological or psychiatric history;
Patients deemed unsuitable for participation in this study by the investigator.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dr. Gao Xiaoning, Chief Physician, Professor | Contact | 86+01066947169 | gaoxn@263.net |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chinese PLA General Hospital | Recruiting | Beijing | China |
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| ID | Term |
|---|---|
| D015470 | Leukemia, Myeloid, Acute |
| ID | Term |
|---|---|
| D007951 | Leukemia, Myeloid |
| D007938 | Leukemia |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D000077209 | Decitabine |
| D001374 | Azacitidine |
| D003561 | Cytarabine |
| D016179 | Granulocyte Colony-Stimulating Factor |
| ID | Term |
|---|---|
| D001372 | Aza Compounds |
| D009930 | Organic Chemicals |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
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|
| 24 months |
| Duration of response | Time interval from morphologic/MRD response to loss of response or death |
| Adverse events | Number of subjects with each adverse event. | Start of treatment to 2 weeks after end of treatment |
| D006402 |
| Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D011743 |
| Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012263 | Ribonucleosides |
| D001087 | Arabinonucleosides |
| D003115 | Colony-Stimulating Factors |
| D006023 | Glycoproteins |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D016298 | Hematopoietic Cell Growth Factors |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D011506 | Proteins |
| D001685 | Biological Factors |