Symptoms and General Pathology

All Conditions

Neoplasms

Blood and Lymph Conditions

Rare Diseases

Syndrome

Leukemia

Preleukemia

Myelodysplastic Syndromes

Hematologic Diseases

Bone Marrow Diseases

Precancerous Conditions

Antineoplastic Agents

All Drugs and Chemicals

Azacitidine

Decitabine

Antimetabolites

Enzyme Inhibitors

Patients randomized to receive Decitabine 20 mg/m2 by vein daily for 3 days (days 1-3) every 28 days.

Patients randomized to receive Azacitidine 75 mg/m2 subcutaneously or by vein daily for 3 days (days 1-3) every 28 days.

20 mg/m2 by vein daily for 3 days (days 1-3) every 28 days.

75 mg/m2 subcutaneously or by vein daily for 3 days (days 1-3) every 28 days.

Elias Jabbour, MD

The goal of this clinical research study is to compare how two different drugs, decitabine and azacitidine, when given on a shorter than standard dosing schedule can help to control MDS. The safety of the drugs will also be studied.

Decitabine is designed to damage the DNA (the genetic material) of cells, which may cause cancer cells to die.

Azacitidine is designed to block certain proteins in cancer cells whose job is to stop the function of the tumor-fighting proteins. By blocking the "bad" proteins, the tumor-fighting genes may be able to work better. This could cause the cancer cells to die.

Study Groups:

If you are found to be eligible to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 groups:

* If you are in Group 1, you will receive decitabine by vein over about 1 hour.
* If you are in Group 2, you will receive azacitidine either as an injection under your skin or through a vein. If by vein, the infusion will take about an hour.

At first, there will be an equal chance of being assigned to either group. However, as the study goes on and more information becomes available, the chance of being assigned to the group that has shown the most effectiveness will increase. However, once you are already enrolled and assigned to a group, you will not be eligible to change groups.

Study Drug Administration:

Each cycle is 28 days.

You will receive the study drug on Days 1-3 of every cycle and you will receive at least 2 cycles of study drug.

Study Visits:

Every 7-14 days, blood (about 2 tablespoons) will be drawn for routine tests.

At the end of Cycle 2, you will have a bone marrow biopsy and/or aspirate to check the status of the disease. This will then be repeated every 2-4 cycles until any point that the disease appears to have responded to the study drug, then as often as the study doctor thinks is necessary. To collect a bone marrow biopsy/aspirate, an area of the hip bone is numbed with anesthetic, and a small amount of bone and/or bone marrow is withdrawn through a large needle.

After Cycle 3:

If the study doctor decides it is acceptable, you may be allowed to receive treatment from your local cancer doctor. However, you have to return to Houston at least every 3 months for your study visits.

The frequency of the visits will depend on what the doctor thinks is in your best interest.

Length of Study:

You may continue taking the study drug for as long as the doctor thinks it is in your best interest. You will no longer be able to take the study drug if the disease gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Follow-Up Visits:

One (1) time every 3 months after your last dose of study drug, you will return to the clinic for a bone marrow aspiration to check the status of the disease.

Other Information:

You may be given other drugs to help prevent side effects. The study staff will tell you about these drugs, how they will be given, and the possible risks.

This is an investigational study. Decitabine and Azacitidine are both FDA approved and commercially available for use in patients with MDS.

Up to 120 patients will take part in this study. All will be enrolled at MD Anderson.

Decitabine Versus Azacitidine in Myelodysplastic Syndrome Patients With Low and Intermediate-1 Risk

Phase II Randomized Study of Lower Doses of Decitabine (DAC; 20 mg/m2 IV Daily for 3 Days Every Month) Versus Azacitidine (AZA; 75 mg/m2 SC/IV Daily for 3 Days Every Month) in Myelodysplastic Syndrome (MDS) Patients With Low and Intermediate-1 Risk Disease

Overall Response = complete remission (CR) + partial remission (PR) + marrow CR (mCR) + hematologic improvement (HI). CR is normalization of peripheral blood and bone marrow with \<5% bone marrow blasts, a peripheral blood granulocyte count \> (1.0 x 10\^9/L, and platelet count \> 100 x 10\^9/L). PR is same as CR except for the presence of 6-15% marrow blasts, or 50% reduction if \<15% at start of treatment. Marrow CR is blasts \</= 5% and decreased by \>/=50% from baseline. HI is platelets increase by 50% and to above 30 x 10\^9/L untransfused (if lower than that pre-therapy; or hemoglobin increase by 2 g/dl; or transfusion independent; or splenomegaly reduction by \> 50%; or monocytosis reduction by \> 50% if pretreatment \> 5 X1 0\^9/L.

Participants who were transfusion dependent at baseline prior to starting therapy on the Decitabine or Azacitidine arm will be analyzed for transfusion independence. Transfusion independence defined as being transfusion-free for ≥8 consecutive weeks between the first dose and study treatment discontinuation.

M.D. Anderson Cancer Center

Patients randomized to receive Decitabine 20 mg/m2 by vein daily for 3 days (days 1-3) every 28 days.

Decitabine: 20 mg/m2 by vein daily for 3 days (days 1-3) every 28 days.

Patients randomized to receive Azacitidine 75 mg/m2 subcutaneously or by vein daily for 3 days (days 1-3) every 28 days.

Azacitidine: 75 mg/m2 subcutaneously or by vein daily for 3 days (days 1-3) every 28 days.

Total

Age, Categorical

Age, Continuous

Sex: Female, Male

Race (NIH/OMB)

United States

Region of Enrollment

Elias Joseph MD./Professor

Participants With a Response

Participants analyzed for Transfusion Independence must have been transfusion dependent at baseline. Thirty-seven participants in the Decitabine arm and nineteen participants in the Azacitidine arm where transfusion dependent prior to treatment on this study.

Number of Participants Who Became Transfusion Independent

Overall Study

Leukemia, Myeloid

Leukemia, Myeloid, Acute

Neoplasms by Histologic Type

Myeloid Leukemia

Acute Myeloid Leukemia

Acute Non Lymphoblastic Leukemia

Acute Graft Versus Host Disease

Anti-Infective Agents

Analgesics

Cytarabine

Mitoxantrone

Daunorubicin

Lenograstim

Cladribine

2-chloro-3'-deoxyadenosine

Antiviral Agents

Immunosuppressive Agents

Immunologic Factors

Anti-Bacterial Agents

Antibiotics, Antitubercular

Adjuvants, Immunologic

The first stage of treatment.

First DAC induction cycle is common to all patients (regardless of risk group). After completion of induction I occurs early assessment of bone marrow on the +14 day after the start of treatment (+7 day after completion of chemotherapy).

Patients with blasts in the bone marrow in D14\> 10% receive early second induction (CLAG) which start form +16 day.

Patients with blasts in the bone marrow in D14 ≤ 10% do not receive early second induction and are qualified to assess the response times on +28 day or after full morphology recovery (if it occurs before the +28 day

I induction cycle starts after complete remission (CR).

- After I consolidation, patients from Intermediate I an Intermediate II group (ELN prognostic system):

If compatible donor is present - allogeneic HSCT qualification after I or II consolidation. If compatible donor for allogeneic HSCT is not present - attempt to CD34+ mobilization for autologous SCT after II consolidation

- After I consolidation, patients from Adverse risk group (ELN prognostic system):

If compatible donor is present - immediate qualification for allogeneic HSCT.

- Finding a donor should be initiated in all patients, at the latest after the end of I induction. In the first place, it should be checked whether the patient has a donor family, if not - searching start for an unrelated donor. For patients with no compatible donor for allogeneic HSCT - need to start searching for an alternative donor

Patients from all 5 risk group receive second after first consolidation \[Ara-C\] Patient from Very adverse risk receive Ara-C + CLA (Cladribine). If it is needed - more intensive consolidation treatment with 2-Cda.

Patients form Very adverse risk receive Maintenance treatment:

Decitabine 20 mg/m2 60 min infusion iv (Intravenous injection) for 5 days every 6 weeks.

Patients from Favorable, - Intermediate I an Intermediate II risk groups: CD34+ mobilization (HSCT qualification).

Patients from Favorable, Intermediate I an Intermediate II risk groups receive III consolidation or autologous HSCT (depends on results of mobilization).

Patients from Adverse risk receive III Consolidation HiDAraC + Cladribina (CLA) If no CR: CLAG-M reinduction therapy and after CR - treatment according to protocol.

* DNR 60 mg/m2 0,5h infusion iv on 1-3 days
* 2-CdA 5 mg/m2 2h. infusion iv on 1-5 days
* Ara-C 200 mg/m2 12h infusion iv 2h after end of infusion with 2CdA on 1-7 days

* G-CSF 30MU sc, on 0-5 days
* Mitoxantrone 10mg/m2 30 min infusion iv, on 1-3 days
* Cladribine 5mg/m2 in 2h infusion iv, on 1-5 days
* Ara-C 2000mg/m2 4h infusion iv, infusion start after 2h of Cladribine infusion end, on 1-5 day

CLAG

* Ara-C 3g/m2; 3h infusion iv every 12h on 1,2,3 days
* Mitoxantrone 10mg/m2; 0,5h infusion iv on 3,4,5 days

Consolidation, I HAM cycle

• Ara-C 3g/m2 every 12h; 3h infusion iv on 1,3,5 days (+ mobilization of CD34+)

II Consolidation HiDAraC

* Ara-C 3g/m2 every 12h; 3h infusion iv on 1,3,5 days
* 2-CdA 5 mg/m2 2h infusion iv on 1,3,5 days, 2h before Ara-C

Consolidation, III HiDAraC cycle

Agnieszka Wierzbowska, dr hab.n.med.

Agnieszka Pluta, dr n.med.

Agnieszka Wierzbowska, Dr hab. n. med.

In view of the diversity of the biology of acute myeloid leukemia (AML) therapy in individual patients must be individualized. One of the tools for this is molecular-cytogenetic stratification. It divides patients into five categories (prognostic groups): Favorable, Intermediate-1, Intermediate-2, Adverse and Very adverse risk. After remission proceedings are tailored depending on prognostic determined groups.

Research of PALG group in the application in the second line regimen CLAG and CLAG-M proved high effectiveness of this treatment with low toxicity. Considering experience of PALG groups, it seems that the use of the schema CLAG early as the second induction therapy is a viable treatment option.

Patients with AML with one of 5 prognostic categories based on modified cytogenetic-molecular stratification (European Leukemia Net Prognostic System - ENL)

Favorable risk

t(8;21)(q22;q22); RUNX1-RUNX1T1 inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11 Mutated NPM1 without FLT3-ITD (NK) Mutated CEBPA (NK)

Intermediate I risk

Mutated NPM1 with FLT3-ITD (NK) Wild-type NPM1 and FLT3-ITD (NK) Wild-type NPM1 without FLT3-ITD (NK)

Intermediate II risk

t(9;11)(p22;q22); MLLT3-MLL cytogenic abnormalities other than favorable or adverse

Adverse risk

Inv(3)(q21q26.2) or t(3;3)(q21;q26.2); RPN-EVI1

Very adverse risk monosomal karyotype (MK): -5 or del(5q); -7; abnl(17p); complex karyotype

Goals:

* Evaluation of the impact of therapy tailored to the risk factors on outcome of AML patients aged ≤ 60.
* Evaluation of the possibility to improve the results of induction therapy through the use of early 2nd induction in patients with persistent leukemic infiltration of the bone marrow at the 14th day,
* Evaluation of the impact of the minimal residual disease (MRD) presence assessed by Immunophenotyping method, on the results of treatment of AML patients aged ≤ 60,
* Assessing the significance of monitoring the number of leukemic stem cells (LSC) in bone marrow and peripheral blood and their influence on clinical course and outcome of AML treatment,
* Assessment of the LSC determination usefulness in MRD monitoring in patients with AML,
* Evaluation of the prognostic significance of the expression of CXCR-4 on the surface of leukemic cells and their impact on the clinical course and outcome of AML - trying to select a group of patients who potentially would benefit from the use of chemosensitization with plerixafor,
* Evaluation of autologous HSCT effectiveness in consolidation therapy in AML patients from 3 following cytogenetic-molecular risk groups: Favorable, Intermediate I, Intermediate II,
* Comparison of the overall survive (OS) and leukemia-free survival after autologous and allogeneic HSCT in AML patients from Intermediate I and Intermediate II cytogenetic-molecular risk groups (biological randomization donor vs. donor).

Role of the Therapy Tailored to Risk Factors in Treating Adult Patients (≤60) With Acute Myeloid Leukemia

Evaluation of the Efficacy of Induction-consolidation Treatment Using a Double Induction in Patients With AML <60 Years Old, Depending on the Percentage of Blasts in the 14 Day, Residual Disease and Leukemic Hematopoietic Cells

Outcome measure after induction:

At +28 day after treatment or after full morphology recovery (if it occurs before the +28 day)

Complete remission, according to Cheson's CR criteria:

* Lack of extramedullary infiltration,
* Platelet count\> 100 G / L,
* Neutrophil count\> 1.0 G / L,
* Lack of blast cells in the blood,
* Bone marrow blasts \<5% in the cytomorphology.

After induction treatment, patients are qualified for one of the pro-remission treatment options, which is associated with cytogenetic-molecular risk groups, according to the modification of the molecular ELN / MDACC.

Therapeutic decisions are being made according to cytogenetic-molecular stratification: Favorable, Intermediate-1, Intermediate-2, Adverse and Very adverse risk.

Polish Adult Leukemia Group

Copernicus Memorial Hospital

dr hab. n. med. Agnieszka Wierzbowska

PhD in Copernicus Memorial Hospital, Hematology Department

Fludarabine

Fludarabine phosphate

Idarubicin

Induction I:

* DNR 90 mg/m2 D 1-3 in 30-60 min i.v. infusion
* Ara-C 100 mg/m2 D 1-7 in 24 h i.v. infusion

Induction I:

* DNR 60 mg/m2 D 1-3 in 30-60 min i.v. infusion
* cladribine 5 mg/m2 D 1-5 in 2 h i.v. infusion prior to Ara-C
* Ara-C 200 mg/m2 D 1-7 in 22 h i.v. infusion.

Cladribine 5mg/m2 in 2 h i.v. infusion on days (1-5) Ara-C 2 g/m2 in 4 h i.v. infusion, 2 h after cladribine infusion on days (1-5) Mitoxantrone 10 mg/m2 i.v. 1xd on days (1-3) G-CSF 30MU s.c. 1xd from day 0 to 5 of the treatment (6 doses).

Fludarabine 30 mg/m2 in 30-min i.v. infusion on days (1-5) Ara-C 2 g/m2 in 4 h i.v. infusion, 2 h after fludarabine infusion on days (1-5). Idarubicin 8 mg/m2 i.v. 1xd on days (1-3) G-CSF 30MU s.c. 1xd from day 0 to 5 of the treatment (6 doses).

After confirming the diagnosis, assuming the inclusion criteria and exclusion criteria are respected, the patients are randomized to one of two standard induction treatment protocols (A arm: DA-90 vs B arm: DAC). After completing induction I, an early bone marrow assessment is performed on day 14 from the beginning of the treatment (+ day 7 after finishing chemotherapy) using the cytological method and MRD is assessed by the immunophenotyping method. Therapeutic decision is taken on the basis of the cytological assessment. Patients, in whom the percentage of blasts in the bone marrow on day 14 is \> 10%, receive early induction II from day 16. An Immunophenotype test is a complementary examination.

A arm (DA-90)

B arm (DAC)

Patients who do not achieve CR after two courses of induction therapy or patients with relapsed leukemia are eligible for emergency treatment ("salvage") according to the CLAG- M or FLAG-IDA protocol.

A arm (CLAG-M)

B arm (FLAG-IDA)

Agnieszka Wierzbowska, Prof.

Gail Roboz, Prof.

Jarosław Piszcz, Dr

Andrzej Pluta, Dr

Maria Bieniaszewska, Dr

Marzena Wątek, Dr

Małgorzata Raźny, Dr

Jadwiga Hołojda

Marek Hus, Prof.

MAciej Kaźmierczak, Dr

Sebastian Giebel, Prof.

The study will include newly-diagnosed AML patients, not suffering acute promyelocytic leukemia; aged 18-60 years, who are eligible for standard induction chemotherapy. The patients will be randomized to one standard induction regimen (DAC or DA-90). At day seven after completion of induction, a bone marrow aspiration with MRD will be performed for an early evaluation of response to treatment. Patients without bone marrow blast reduction below 10% at day seven after induction will be given a second early induction course. Patients who do not achieve CR after two induction courses will be randomized to one of the standard salvage regimens (FLAG-IDA or CLAG-M). Postremission treatment intensity will be adjusted to risk group based on cytogenetic and molecular risk factors at diagnosis and AML biology (secondary AML, therapy related AML). Patients with a low risk of relapse will be allocated to consolidation, with three courses of high doses of Ara-C (HiDAC), or two courses of HiDAC with subsequent autologous stem cell transplantation. Intermediate- or high-risk patients will be referred for allogeneic stem cell transplantation, if they have a matched donor. Until transplantation, consolidation with HiDAC will be continued.

The successful treatment of acute myeloid leukemia (AML) depends on the ability to achieve complete remission (CR) and to prevent relapse. Both may be affected by the efficacy of induction chemotherapy. The gold standard for treatment since 1982 has been DA, a regimen of three days of daunorubicin (DNR) and seven days of cytarabine (Ara-C) which results in complete remission in 50 to 75% of patients; this is typically administered intravenously, with daunorubicin administered at a dose of 45 mg per square meter of body-surface area daily for three days, and cytarabine given at a dose of 100 mg per square meter daily for seven days. Neither substituting DNR with another anthracycline nor the addition of thioguanine or etoposide has been demonstrated to improve outcome. Recently it has been proved that high-dose daunorubicin (90 mg/m2) in induction (DA-90) resulted in a higher rate of complete remission (70.6% vs. 57.3%, P\<0.001) and improved overall survival (median, 23.7 vs. 15.7 months; P = 0.003) without any increase in serious adverse events, compared with the standard dose of the drug.

An alternative method to intensify induction treatment is by the addition of the purine analog cladribine. Cladribine was demonstrated to increase cellular uptake of Ara-C and accumulation of Ara-CTP in leukemic blasts by 50% to 65% and to have direct antileukemic activity based on incorporation of metabolites into the DNA of proliferating cells. In two randomized trials by the Polish Adult Leukemia Group (PALG), the investigators demonstrated that the combination of cladribine with DNR (60 mg/m2) and Ara-C (DAC) resulted in a significantly increased CR rate after a single induction course compared with the standard two-drug induction (DA-60). The DAC arm was found to have a survival advantage over the DA-60 arm for patients aged 50 years or older (P =. 005), those with an initial leukocyte count above 50G /L (P \< .03), and those with an unfavorable karyotype (P \< .03). Both induction protocols have the same level of recommendation by the National Cancer Comprehensive Network (NCCN) for routine use (level I), and are commonly used for the treatment of newly diagnosed AML in Poland.

As no randomized comparison of these two standard protocols has yet been performed, the aim of the proposed study is to compare the efficacy of these two standard induction protocols in terms of achievement of CR, early leukemia elimination (at day seven, post induction) and quality of remission measured by minimal residual disease level. Additionally, overall survival (OS), event-free survival (EFS) and disease-free survival (DFS) will be analyzed. It is also intended to compare the hematological and non-hematological toxicity of both regimens.

However, in younger adults with AML treated with standard induction chemotherapy, 20-35% do not achieve CR and 50-70% with CR may be expected to relapse within three years. Patients with primary refractory disease and with relapses following CR1 have a significantly poorer outcome. The optimum strategy at the time of relapse or for patients with refractory disease remains uncertain. Allogeneic transplantation can be curative for the minority of patients who achieve second CR (2CR) and for whom a suitable donor is available. For the majority of patients, additional chemotherapy is given in the hope of achieving remission. Most salvage therapies utilize high or intermediate doses of arabinoside cytosine (Ara-C) in combination with other agents to overcome resistance in leukemic cells. Previous studies have shown that a combination of the purine analog fludarabine (FA) and cytosine arabinoside (Ara-C) increases the accumulation of Ara-C-5' triphosphate (Ara-CTP) responsible for the cytotoxic effect in leukemic blasts. This combination of FA plus Ara-C was initially explored in refractory and relapsed AML patients with satisfactory results. It is also likely that these results can be improved by the addition of granulocyte-colony stimulating factor (G-CSF). Such a combination of FA, Ara-C, idarubicin and G-CSF (the FLAG-IDA regimen) has been used in the treatment of refractory and relapsed AML and poor prognosis myelodysplastic syndromes (MDS), with CR rates of between 30-80% being reported. Recent studies have shown that another purine analog, cladribine (2-CdA), is also able to enhance Ara-CTP accumulation in leukemic blasts and that the combination of 2-Cda with Ara-C exhibited synergistic effect on inhibition of myeloid leukemic cell proliferation, induction of apoptosis, and on disruption of mitochondrial membrane potential.

Two previous PALG studies have confirmed that the CLAG-M regimen (a combination of cladribine, Ara-C, G-CSF and mitoxantrone) has high efficacy and low toxicity in refractory/relapsed AML patients. This salvage regimen was particularly effective in a very poor-risk subgroup with primary refractoriness, early relapse or relapse after stem cell transplantation. Both salvage protocols, CLAG-M and FLAG-Ida, are wildly used in the treatment of relapsed/refractory AML and both have the highest level of NCCN recommendation. However, these two standard salvage protocols have yet to be examined as part of any randomized study. Therefore, the aim of this study is to compare the efficacy of these two standard reinduction protocols (CLAG-M vs FLAG-IDA) in terms of achievement of CR, and quality of remission measured by minimal residual disease level. Additionally, the overall survival (OS), event-free survival (EFS) and disease-free survival (DFS) will be analyzed. The study will also compare the hematological and non-hematological toxicity of both regimens.

The study will include newly-diagnosed AML patients, not suffering acute promyelocytic leukemia; aged 18-60 years, who are eligible for standard induction chemotherapy. The patients will be randomized to one standard induction regimen (DAC or DA-90). At day seven after completion of induction, a bone marrow aspiration with MRD will be performed for an early evaluation of response to treatment. Patients without bone marrow blast reduction below 10% at day seven after induction will be given a second early induction course. Patients who do not achieve CR after two induction courses will be randomized to one of the standard salvage regimens (FLAG-IDA or CLAG-M). Postremission treatment intensity will be adjusted to risk group based on cytogenetic and molecular risk factors at diagnosis and AML biology (secondary AML, therapy related AML). Patients with a low risk of relapse will be allocated to consolidation, with three courses of high doses of Ara-C (HiDAC), or two courses of HiDAC with subsequent autologous stem cell transplantation. Intermediate- or high-risk patients will be referred for allogeneic stem cell transplantation, if they have a matched donor. Until transplantation, consolidation with HiDAC will be continued.

The primary end point of the study is CR rate after one and two induction courses. The secondary end-points are the quality of CR (MRD), OS, DFS, PFS, CR rate after salvage regimen.

It is planned to include 582 patients with newly-diagnosed AML. This will allow a 10% difference in CR rate between DAC and DA-90 induction regimens to be confirmed with a power of 80% and level of significance 0.05.

The study includes neither any experimental drug nor procedures that are not of the standard of treatment for AML.

Comparison of the efficacy of two standard induction treatment protocols (DA-90 and DAC) in patients with newly-diagnosed AML (with the exception of acute promyelocytic leukemia). Comparison of the efficacy of two standard reinduction treatment protocols (CLAG-M and FLAG-IDA) in patients with refractory and relapsed AML.

A PALG Prospective Multicenter Clinical Trial to Compare the Efficacy of Two Standard Induction Therapies (DA-90 vs DAC) and Two Standard Salvage Regimens (FLAG-IDA vs CLAG-M) in AML Patients ≤ 60 Years Old

Comparison of total remission rates after 1 induction course of DA-90 and DAC.

Comparison of total remission rates after II induction course of DA-90 and DAC.

Comparison of total remission rates after I reinduction course of CLAG-M and FLAG-IDA

Comparison of total remission rates after II reinduction course of CLAG-M and FLAG-IDA

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Decitabine Versus Azacitidine in Myelodysplastic Syndrome Patients With Low and Intermediate-1 Risk	NCT01720225	Leukemia	Decitabine Azacitidine	18 Years -	M.D. Anderson Cancer Center
Role of the Therapy Tailored to Risk Factors in Treating Adult Patients (≤60) With Acute Myeloid Leukemia	NCT02072811	Acute Myeloid L...	DAC CLAG Consolidation, ... II Consolidatio... Consolidation, ...	18 Years - 60 Years	Polish Adult Leukemia Group
Decitabine Versus Azacitidine in Myelodysplastic Syndrome Patients With Low and Intermediate-1 Risk	NCT01720225	Leukemia	Decitabine Azacitidine	18 Years -	M.D. Anderson Cancer Center
Role of the Therapy Tailored to Risk Factors in Treating Adult Patients (≤60) With Acute Myeloid Leukemia	NCT02072811	Acute Myeloid L...	DAC CLAG Consolidation, ... II Consolidatio... Consolidation, ...	18 Years - 60 Years	Polish Adult Leukemia Group
A PALG Prospective Multicenter Clinical Trial to Compare the Efficacy of Two Standard Induction Therapies (DA-90 vs DAC) and Two Standard Salvage Regimens (FLAG-IDA vs CLAG-M) in AML Patients ≤ 60 Years Old	NCT03257241	Acute Myeloid L...	A arm (DA-90) B arm (DAC) A arm (CLAG-M) B arm (FLAG-IDA...	18 Years - 60 Years	Polish Adult Leukemia Group

Spots Global Cancer Trial Database for dac

Every month we try and update this database with for dac cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for dac

Every month we try and update this database with for dac cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for dac cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.