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TerminatedNCT00052884Updated Jun 18, 2023

Amifostine and Melphalan in Treating Patients With Primary Systemic Amyloidosis Who Are Undergoing Peripheral Stem Cell Transplantation

A Phase 1 interventional study of filgrastim and amifostine trihydrate in Drug/Agent Toxicity by Tissue/Organ and Multiple Myeloma and Plasma Cell Neoplasm, sponsored by Eastern Cooperative Oncology Group. Terminated at 16 sites in United States. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2023-06-18.

Sponsored by Eastern Cooperative Oncology Group · Phase 1, Interventional, and Treatment

Why this study was terminated
Slow accrual and changes in clinical practice
Phase
Phase 1
Study type
Interventional
Enrollment
8
Allocation
Non-randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of plasma cells, either by killing the cells or by stopping them from dividing. Having a peripheral stem cell transplant to replace the blood-forming cells destroyed by chemotherapy, allows higher dose of chemotherapy to be given so that more plasma cells are killed. Giving a chemoprotective drug such as amifostine may protect kidney cells from the side effects of chemotherapy.

PURPOSE: This phase I trial is studying the side effects and best dose of melphalan given together with amifostine in treating patients who are undergoing peripheral stem cell transplant for primary systemic amyloidosis.

Read the detailed description

OBJECTIVES:

  • Determine the maximum tolerated dose (MTD) of high-dose melphalan administered with amifostine in patients with primary systemic amyloidosis undergoing autologous peripheral blood stem cell transplantation.
  • Determine the toxicity of high-dose melphalan when administered at the MTD in these patients.
  • Determine the response rate in patients treated with this regimen.

OUTLINE: This is a nonrandomized, multicenter, dose-escalation study of melphalan.

Patients receive filgrastim (G-CSF) subcutaneously once daily until peripheral blood stem cell (PBSC) collection is complete. Apheresis begins on day 5 of G-CSF administration and continues until the target number of PBSCs are collected.

Within 6 weeks of PBSC collection, patients receive amifostine IV over 5 minutes on days -2 and -1 and high-dose melphalan IV over 30-60 minutes on day -1. Patients undergo autologous PBSC infusion on day 0.

Cohorts of 3-6 patients receive escalating doses of melphalan until the maximum tolerated dose (MTD) is determined. The MTD is defined as the dose preceding that at which at least 2 of 3 or 2 of 6 patients experience dose-limiting toxicity. Once the MTD is determined, an additional 10 patients are treated at that dose.

Patients are followed approximately 3 months following transplantation, then every 6 months for 5 years.

PROJECTED ACCRUAL: A total of 3-46 patients will be accrued for this study within 2.3 years.

02

Conditions studied

  • Drug/Agent Toxicity by Tissue/Organ
  • Multiple Myeloma and Plasma Cell Neoplasm

Keywords

  • drug/agent toxicity by tissue/organ
  • primary systemic amyloidosis
03

In context

Drug-Related Side Effects and Adverse Reactions

449 studies on the registry are indexed under Drug-Related Side Effects and Adverse Reactions; 77 are open to participants now.

This study's enrollment of 8 is below the median of 108 across 262 interventional studies indexed under Drug-Related Side Effects and Adverse Reactions.

Browse Drug-Related Side Effects and Adverse Reactions studies →

Lead sponsor

Eastern Cooperative Oncology Group is the lead sponsor of 175 studies on the registry; 7 are open to participants now.

Of its 10 completed or terminated interventional studies of FDA-regulated products, 5 (50%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

DISEASE CHARACTERISTICS:

  • confirmed amyloidosis

    • No secondary familial or localized amyloidosis
  • Presence of monoclonal protein by immunoelectrophoresis or immunofixation of serum or urine
  • No primary amyloidosis manifested only by carpal tunnel syndrome or purpura
  • Amyloid deposits in a plasmacytoma or in bone marrow vessels in an asymptomatic individual not considered an amyloid syndrome

    • Amyloid syndromes include any of the following:

      • Hepatomegaly
      • Cardiomyopathy
      • Nephrotic range proteinuria
      • Peripheral or autonomic neuropathy
  • No multiple myeloma defined by 1 of the following:

    • Presence of lytic bone disease
    • More than 30% bone marrow plasma cells

PATIENT CHARACTERISTICS:

Age

  • 18 to 70

Performance status

  • 0-1

  • Not specified

Hematopoietic

  • count at least 100,000/mm\^3

Hepatic

  • See Disease Characteristics
  • Total or direct no greater than 2.0 mg/dL
  • Alkaline phosphatase no greater than 4 times

Renal

  • See Disease Characteristics
  • Creatinine less than 3.0 mg/dL

Cardiovascular

  • See Disease Characteristics
  • at least 45% by echocardiogram
  • No class III or IV heart disease
  • Systolic blood pressure ≥ 90 mmHg

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective
  • No active infection
  • No other within the past 5 years except surgically treated carcinoma in situ of the cervix, nonmelanoma skin cancer, or indolent prostate cancer

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • At least 4 weeks since prior interferon

Chemotherapy

  • At least 4 weeks since prior melphalan
  • Lifetime total melphalan dose less than 150 mg/m\^2 (based on ideal body weight)

Endocrine therapy

  • At least 4 weeks since prior dexamethasone

Radiotherapy

  • No prior radiotherapy for amyloidosis

Surgery

  • Not specified

Other

  • No antihypertensive medications for at least 24 hours prior to, during, and for 1 hour after amifostine administration
  • No other prior treatment
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
8 participants (actual)

Study arms

  • Experimental
    Amifostine, Melphalan, and Stem Cell Reconstitution

    Amifostine, Melphalan, and Stem Cell Reconstitution. Doses of Melphalan tested included 100 mg/m2 and 120 mg/m2

    Biological: filgrastim · Drug: amifostine trihydrate · Drug: melphalan · Procedure: bone marrow ablation with stem cell support · Procedure: peripheral blood stem cell transplantation

Interventions

06

What researchers measure

Primary outcomes

  1. Maximum Tolerated Dose

    The maximum tolerated dose is the highest dose level at which fewer than 1 of 3 or 2 of 6 patients experience dose-limiting toxicity, defined as any grade 3 or higher toxicity of any of the following: renal failure, alkaline phosphatase elevation, GI bleeding, and cardiac rhythm disturbances, assessed using NCI Common Toxicity Criteria, version 2.0.

    Time frame: Assessed over 30 days

07

Study locations

16 sites
  • Mayo Clinic Scottsdale
    Scottsdale, Arizona 85259-5499, United States
  • Indiana University Melvin and Bren Simon Cancer Center
    Indianapolis, Indiana 46202-5289, United States
  • Fairview Ridges Hospital
    Burnsville, Minnesota 55337, United States
  • Mercy and Unity Cancer Center at Mercy Hospital
    Coon Rapids, Minnesota 55433, United States
  • Fairview Southdale Hospital
    Edina, Minnesota 55435, United States
  • Mercy and Unity Cancer Center at Unity Hospital
    Fridley, Minnesota 55432, United States
  • Minnesota Oncology Hematology, PA - Maplewood
    Maplewood, Minnesota 55109, United States
  • Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
    Minneapolis, Minnesota 55407, United States
  • Hubert H. Humphrey Cancer Center at North Memorial Outpatient Center
    Robbinsdale, Minnesota 55422-2900, United States
  • Mayo Clinic Cancer Center
    Rochester, Minnesota 55905, United States
  • CCOP - Metro-Minnesota
    Saint Louis Park, Minnesota 55416, United States
  • Park Nicollet Cancer Center
    Saint Louis Park, Minnesota 55416, United States
  • United Hospital
    Saint Paul, Minnesota 55102, United States
  • Ridgeview Medical Center
    Waconia, Minnesota 55387, United States
  • Minnesota Oncology Hematology, PA - Woodbury
    Woodbury, Minnesota 55125, United States
  • Case Comprehensive Cancer Center
    Cleveland, Ohio 44106-5065, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 18, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT00052884
Responsible party
Sponsor
First posted
Jan 27, 2003
Start date
Jan 22, 2004
Primary completion
Sep 2007
Completion
Mar 2011
Last update
Jun 18, 2023

Study contacts

Morie A. Gertz, MD
study chair · Mayo Clinic

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Jun 2023. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Melphalan

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