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Enrolling by invitationNCT03507842Updated Mar 17, 2025

A Prospective Randomized Comparison of HDAC Vs AD in the Induction Chemothrapy for AML.

A Phase 3 interventional study of High dose Cytarabine and Cytarabine in Acute Myeloid Leukemia, sponsored by Asan Medical Center. Enrolling by invitation at 1 site in Korea, Republic of. Open to participants aged 15 Years to 60 Years. Per ClinicalTrials.gov, last updated 2025-03-17.

Sponsored by Asan Medical Center · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
380
Allocation
Randomized
Ages
15 Years to 60 Years
Sex
All
01

Study summary

This trial is a single-center, non-blind, two-arm randomized prospective controlled trial to compare the effectiveness of two induction chemotherapy regimens (high-dose cytarabine plus daunorubicin [HDAC] vs. cytarabine plus high-dose daunorubicin [AD]) in acute myeloid leukemia (AML). The primary hypothesis of the study is that AD is superior to HDAC in terms of event-free survival (EFS, time from registration to induction failure, relapse, or death).

Read the detailed description
  • Induction chemotherapy

    • Arm I [HDAC]: cytarabine 3.0 g/m2 q12hr 3-hour iv infusion on days 1, 3, 5 plus daunorubicin 45 mg/m2/day continuous iv infusion for 3 days (D1-3).
    • Arm II [AD]: cytarabine 200 mg/m2/day continuous iv infusion for 7 days (D1-7) plus daunorubicin 90 mg/m2/day continuous iv infusion for 3 days (D1-3).
  • Interim bone marrow examination Interim bone marrow aspiration and biopsy will be done between 14 and 21 days after start of induction chemotherapy. If bone marrow has blasts \< 10%, no additional chemotherapy will be given until the recovery of blood counts (absolute neutrophil counts rise over 1,000/μL and platelet counts over 100,000/μL) or post-induction day 35, when bone marrow examination will be repeated to evaluate CR. After the marrow examination, re-induction course will be given. If interim bone marrow examination shows persistent leukemia (blasts ≥ 10%), re-induction course could be given. Patients who did not attain CR after the re-induction chemotherapy will be eliminated from the study.
  • Re-induction chemotherapy

    • Cytarabine 200 mg/m2/day iv infusion for 5 days (D1-5) plus daunorubicin 45 mg/m2/day iv infusion for 2 days (D1-2) Post-remission consolidation chemotherapy
    • Adverse risk group: up to 3 courses of intermediate-dose cytarabine (1.0 g/m2/day iv for 5 days [D1-5]) plus etoposide (150 mg/m2/day iv for 3 days [D1-3])
    • Favorable/intermediate risk group: up to 3 courses of high-dose cytarabine (3.0 g/m2/day q12 hr iv for 3 days [D1, 3, 5])
    • Autologous or allogeneic hematopoietic cell transplantation (HCT) can be performed based on the risk of relapse.
    • The bone marrow examination will be done after the completion of consolidation chemotherapy or before HCT.
02

Conditions studied

  • Acute Myeloid Leukemia

Keywords

  • HDAC vs AD
03

In context

Leukemia

5,441 studies on the registry are indexed under Leukemia; 636 are open to participants now.

This study's planned enrollment of 380 is above the median of 38 across 4,247 interventional studies indexed under Leukemia.

Browse Leukemia studies →

Lead sponsor

Asan Medical Center is the lead sponsor of 562 studies on the registry; 71 are open to participants now.

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

04

Who can participate

Ages eligible
15 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Previously-untreated AML (≥ 20% blasts in bone marrow and/or peripheral blood)
  • Age of 15 years or older, 60 years or younger
  • Adequate performance status (Karnofsky score of 50 or more)
  • Adequate hepatic and renal function (AST, ALT, and bilirubin \< 2.5 x upper normal limit and creatinine \< 2.0 mg/dL \& creatinine clearance ≥ 50 mL/min). Elevation of AST or ALT due to hepatic infiltration of leukemic cells will be permitted.
  • Adequate cardiac function (left ventricular ejection fraction ≥45% on heart scan or echocardiogram)
  • Signed informed consent

Exclusion criteria

Exclusion Criteria:

  • Patients with history of chemotherapy for leukemia or cytarabine and anthracycline treatment for any malignancy. Hydroxyurea for reduction of leukemic cell burden before induction chemotherapy will be permitted.
  • Patients with acute promyelocytic leukemia
  • Patients with blast crisis of chronic myeloid leukemia
  • Patients with central nervous system (CNS) leukemia or granulocytic sarcoma without bone marrow involvement
  • Presence of uncontrolled and/or severe medical condition (infection, bleeding, cardiovascular disease including myocardial infarction within previous 6 months.)
  • Nursing women, pregnant women, women of childbearing potential who do not want adequate contraception
  • Patients with a diagnosis of prior malignancy unless disease-free for at least 5 years following therapy with curative intent (except curatively treated nonmelanoma skin cancer, in situ carcinoma, or cervical intraepithelial neoplasia)
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
380 participants (estimated)

Study arms

  • Experimental
    High-dose cytarabine

    High-dose cytarabine 3.0 g/m2 q12hr 3-hour iv infusion on days 1, 3, 5 plus daunorubicin 45 mg/m2/day continuous iv infusion for 3 days (D1-3).

    Drug: High dose Cytarabine

  • Experimental
    high-dose daunorubicin

    cytarabine 200 mg/m2/day continuous iv infusion for 7 days (D1-7) plus high-dose daunorubicin 90 mg/m2/day continuous iv infusion for 3 days (D1-3).

    Drug: Cytarabine · Drug: Hign dose Daunorubicin

Interventions

  • DrugHigh dose Cytarabine

    High dose Cytarabine 3.0 g/m2 q12hr 3-hour iv infusion on days 1, 3, 5 plus daunorubicin 45 mg/m2/day continuous iv infusion for 3 days (D1-3).

    Also known as: HDAC

  • DrugCytarabine

    cytarabine 200 mg/m2/day continuous iv infusion for 7 days (D1-7)

    Also known as: AD

  • DrugHign dose Daunorubicin

    Hign dose Daunorubicin 90 mg/m2/day continuous iv infusion for 3 days (D1-3).

    Also known as: AD

06

What researchers measure

Primary outcomes

  1. Cumulative incidence of relapse

    defined for all patients achieving CR; measured from the date of CR achievement until the date of relapse; patients not known to have relapsed are censored on the date they were last examined; patients who died without relapse are counted as a competing cause of failure

    Time frame: 3 years

Secondary outcomes

  1. Event-free survival

    Defined for all patients; measured from the starting date of registration to the date of induction treatment failure, or relapse from CR, or death from any cause; patients not known to have any of these events are censored on the date they were examined

    Time frame: 3years

  2. Overall survival

    Defined for all patients; measured from the starting date of registration to the date of death from any cause-patients not known to have died at last follow-up are censored on the date they were last known to be alive

    Time frame: 3years

07

Study locations

1 site
  • Asan Medical Center, University of Ulsan College of Medicine
    Seoul, 05505, Korea, Republic of
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 17, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03507842
Lead sponsor
Asan Medical Center
Responsible party
Je-Hwan Lee (Principal Investigator, Asan Medical Center) — Principal investigator
First posted
Apr 25, 2018
Start date
Mar 1, 2018
Primary completion
Dec 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Mar 17, 2025

Study contacts

Je-Hwan Lee, MD
principal investigator · Asan Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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