Adult T-cell Leukemia/Lymphoma
Conditions
Brief summary
ETP-ALL like patients have poor outcomes and prognosis, and the optimal therapeutic approaches are poorly characterized. The goal of this clinical trial is to evaluate the efficacy and safety of the venetoclax combined with azacitidine, chidamide, vindesine, and dexamethasone regimen in newly diagnosed ETP-ALL like patinets (including ETP-ALL, near ETP-ALL and T-ALL with myeloid mutations) .
Interventions
DRUGVEN (Venetoclax)
Orally
DRUGAzacitidine (AZA)
Subcutaneous injection
DRUGChidamide
Orally
DRUGvindesine
intravenous infusion
DRUGDexamethasone
intravenous infusion or orally
Sponsors
The First Affiliated Hospital of Soochow University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
14 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Age: \>14 to 65 years (inclusive). 2. Diagnosis: Patients diagnosed with ETP-ALL like disease meeting the following flow cytometry immunophenotypic criteria: ETP-ALL: CD7+, CD1a-, CD8-, CD5 positivity rate ≤75%, and positive for at least one myeloid/stem cell antigen marker (including but not limited to CD34, CD117, HLA-DR, CD13, CD33, CD11b, or CD65); MPO negative. Near-ETP-ALL: CD7+, CD1a-, CD8-, CD5 positivity rate \>75%, AND positive for at least one myeloid/stem cell antigen marker (including but not limited to CD34, CD117, HLA-DR, CD13, CD33, CD11b, or CD65); MPO negative. T-ALL with myeloid mutations: FLT3, DNMT3A, STAG2, IDH1/IDH2, RUNX1, EZH2, WT1, ASXL1/ASXL2, SF3B1, TET2, BCOR, BCORL1. 3. Newly diagnosed patients who have not received any prior induction therapy before enrollment (excluding hydroxyurea, dexamethasone, low-dose cytarabine, venetoclax with a cumulative dose \<0.5g, and leukapheresis). 4. Eastern Cooperative Oncology Group (ECOG) performance status score of 0-2. 5. Expected survival \>6 months. 6. Demonstrated capacity to understand the study and willingness to provide informed consent.
Exclusion criteria
1. Pregnancy, breastfeeding, or unwillingness to use contraception in women of childbearing potential 2. Presence of uncontrolled active infection (including bacterial, fungal, or viral infections); concurrent active HBV, HCV, or HIV infection. 3. Severe Organ Dysfunction: Cardiac Insufficiency: Left ventricular ejection fraction (LVEF) ≤40%, OR history of congestive heart failure, unstable coronary artery disease, or severe arrhythmia. Respiratory Failure: Partial pressure of arterial oxygen (PaO₂) ≤60 mmHg. Hepatic Impairment: Total bilirubin ≥2 times the upper limit of normal (ULN), OR alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥3 times ULN. Renal Impairment: Serum creatinine ≥2 mg/dL, OR creatinine clearance ≤30 mL/min/1.73m². Hypersensitivity: History of hypersensitivity to any of the study drugs or compounds of similar chemical structure. 4. Presence of central nervous system (CNS) leukemia. 5. Any other condition deemed by the investigator to make the subject unsuitable for participation in this trial.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite Complete Remission Rate（CRc） after induction therapy | Time from the completion of induction and before consolidation therapy（up to 42 days） | Rates of complete remission (CR), and complete remission with incomplete hematologic recovery (CRi) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival（OS） | 2 years | Time from the date of enrollment to death from any cause or the last follow-up |
| Relapse-Free Survival(RFS) | 2 years | The duration from the date of the first complete remisson to the occurrence of relapse, death from any cause, or the last follow-up. |
| duration of remission (DOR) | 2 years | Time between the first remission and relapse |
| AE | Within 30 days after the last chemotherapy | Adverse events during the chemotherapy treatment. |
| MRD | At the end of induction（up to 42 days）, 1 cycle of consolidation（up to 42 days）, 2 cycle of consolidation （up to 42 days）and the end of consolidation（up to 42 days） | Percentage of participants who converted to MRD \< 10\^-4 by flow cytometry |
Countries
China
Contacts
Primary ContactYang Xu
Outcome results
None listed