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Polycythemia VeraPhase 3DALIAHNCT01387763

A Study of Low Dose Interferon Alpha Versus Hydroxyurea in Treatment of Chronic Myeloid Neoplasms

A Phase 3 study testing PegIntron, Pegasys and Hydrea in people with Polycythemia Vera and Essential Thrombocythemia, run by Thomas Stauffer Larsen at 8 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to compare the efficacy and toxicity including quality of life of two types of low-dose interferon alpha compounds (PegIntron and Pegasys) with hydroxyurea (Hydrea), and to investigate the occurence of neutralizing antibodies against recombinant interferon. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
PegIntron, Pegasys and Hydrea
Could I receive a placebo?
No, everyone receives an active treatment
How many people
202 participants
Where
8 sitesDenmark
Study dates
Jan 2012to Jun 2020
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female > 18 years of age
  • Newly diagnosed, or previously diagnosed untreated patients with ET, PV or PMF including prefibrotic myelofibrosis according to the WHO classification
  • Active disease defined by one of the following criteria:
  • need for phlebotomy
  • leukocytosis > 10 mia/l
  • thrombocytosis > 400 mia/l
Show all 10Show fewer
  • constitutional symptoms (fatigue, weight loss, night sweats or fewer > 38 degrees celsius)
  • Pruritus
  • splenomegaly causing symptoms
  • previous thrombosis

Who cannot join

  • Fertile women without a negative pregnancy test
  • Other malignant disease within last 5 years
  • ECOG performance score >/= 3
  • Creatinine > 2x ULN
  • Bilirubin > 1.5x ULN
  • ALAT > 3x ULN
Show all 9Show fewer
  • Previous psychiatric disorder (depression)
  • active autoimmune disease
  • Uncontrolled thyroid disease

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

Denmark8 sites
  • Dept of Hematology, Aalborg hospital

    Aalborg, 9000

  • Dept. of Hematology, Aarhus University Hospital

    Aarhus, 8000

  • Dept of Hematology, Rigshospitalet

    Copenhagen, 2100

  • Dept of Hematology, Esbjerg Hospital

    Esbjerg, 6700

  • Dept of Hematology, Herlev Hospital

    Herlev, 2730

  • Dept of Hematology, Holstebro Hospital

    Holstebro, 7500

  • Dept of hematology, Odense University Hospital

    Odense, 5000

  • Dept. of Hematology, Roskilde Hospital

    Roskilde, 4000

Other trials in Denmark

About this study

Official title: Danish Study of Low-dose Interferon Alpha Versus Hydroxyurea in the Treatment of Philadelphia Chromosome Negative (Ph-)Chronic Myeloid Neoplasms.

The purpose of the study is to compare the efficacy and toxicity including quality of life of two types of low-dose interferon alpha compounds (PegIntron and Pegasys) with hydroxyurea (Hydrea), and to investigate the occurence of neutralizing antibodies against recombinant interferon.

Read the detailed description

Chronic myeloid neoplasms (CMPN) consists of three main entities, polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). These three disorders have many overlapping clinical features. The diseases are clonal stem cell disorders characterized by a chronic excess production of mainly mature myeloid cells. The excess production of clonal red cells (in PV), platelets (in PV, ET and PMF) and leukocytes (mainly PV and PMF)leads to a highly increased risk of thrombosis. Patients may also suffer from constitutional symptoms, pruritus and splenomegaly. An inherent feature of these diseases are the risk of ET and PV of transformation to myelofibrosis and a risk of both ET, PV and PMF of leukemic transformation.

In 2005 major breakthrough in our understanding of the molecular pathophysiology was achieved with the identification of the JAK2 V617F mutation which is present in almost all patients with PV (98%) and about half of patients with ET and PMF. This somatic gain-of-function point mutation in the JAK2 tyrosine kinase leads to constitutive activation of the kinase. By this mechanism a clonal non-growth factor dependent myeloproliferation is established.

Traditionally the excess platelet and white cell production in ET, PV and PMF has been treated with cytoreductive agents such as hydroxyurea and busulfan in order to normalize the blood counts and thereby reducing the risk of thrombosis. However, in younger patients there is a concern of the leukemogenic potential of these agents. In younger patients an alternative treatment option is recombinant pegylated interferon alpha (IFN-alpha), which has demonstrated high clinical efficacy and has no leukemogenic potential. Within recent years IFN-alpha has demonstrated a capacity of inducing deep molecular remission (evaluated by JAK2 V617F qPCR) and normalisation of bone marrow morphology. These remissions have been sustained for up to 3 years after discontinuation of IFN-alpha therapy. Accordingly a perspective of changing the natural history of these disorders towards myelofibrosis and ultimately acute leukemia has emerged. However toxicity has been a major issue and drop-of rates have been reported consistently around 25 %.

It is well known from other diseases (e.g multiple sclerosis and hepatitis) that some patients develop neutralizing antibodies against IFN-alpha. This issue is however only scarcely investigated in CMPN and has never been tested in a prospective design.

The purpose of this study is to compare the efficacy (hematological and molecular) and toxicity profile of two different recombinant interferon alpha products, IFN-alpha2a and IFN-alpha2b in a prospective randomized design. In patients over the age of 60 there will be a third study arm with hydroxyurea.

In order to decrease drop out rates and thereby increasing response rates patients will be started of at a low-dose of IFN-alpha. If patients fail to respond or looses their response and develops neutralizing antibodies against IFN-alpha therapy will be stopped. If patients have a sustained deep molecular response (below 1 % JAK2 V617F mutated alleles for 12 months) therapy will be stopped to asses the sustainability of the remission off therapy.Patients over the age of 75 and intolerant or resistant to hydroxyurea will be offered rescue treatment with orally busulfan (Myleran). As an important part of the study quality of life will be investigated.

Being tested
PegIntron, Pegasys, Hydrea
Medical subject headings
Polycythemia Vera, Thrombocythemia, Essential, Primary Myelofibrosis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PegIntronDrug

    Also called Pegylated interferon alpha 2b

    PegIntron, prefilled syringe 50 micrograms/0.5 ml. 30 micrograms subcutaneously once weekly.

  • PegasysDrug

    Also called Pegylated interferon alpha 2a

    Pegasys, prefilled syringe 180 micrograms/0.5 ml 45 micrograms subcutaneously once weekly

  • PegIntronDrug

    Also called Pegylated interferon alpha 2b

    PegIntron, prefilled syringe 50 micrograms/0.5 ml. 30 micrograms subcutaneously once weekly.

  • PegasysDrug

    Also called Pegylated interferon alpha 2a

    Pegasys, prefilled syringe 180 micrograms/0.5 ml 45 micrograms subcutaneously once weekly

  • HydreaDrug

    Also called hydroxyurea, hydroxycarbamide

    Capsule Hydrea 500-2000 mg orally QD or BID

Study groups in NCT01387763
Study groupRoleWhat they receive
PegIntron <= 60 yearsActive comparatorIn patients <= 60 years PegIntron is started at low-dose 35 micrograms once weekly. Dose escalation to 50 micrograms weekly if lack of complete hematological response at 4 months or lack of at least partial molecular response at 8 months. If complete hematological response or lack of at least partial molecular response is not achieved at 50 micrograms weekly at 12 months and 18 months respectively, dose escalation to 96 micrograms weekly.
Receives: Drug: PegIntron
Pegasys <= 60 yearsActive comparatorIn patients <= 60 years Pegasys is started at low-dose 45 micrograms once weekly. Dose escalation to 90 micrograms weekly if lack of complete hematological response at 4 months or lack of at least partial molecular response at 8 months. If complete hematological response or lack of at least partial molecular response is not achieved at 90 micrograms weekly at 12 months and 18 months respectively, dose escalation to 135 micrograms weekly.
Receives: Drug: Pegasys
PegIntron > 60 yearsActive comparatorIn patients < 60 years PegIntron is started at low-dose 35 micrograms once weekly. Dose escalation to 50 micrograms weekly if lack of complete hematological response at 4 months or lack of at least partial molecular response at 8 months. If complete hematological response or lack of at least partial molecular response is not achieved at 50 micrograms weekly at 12 months and 18 months respectively, dose escalation to 96 micrograms weekly.
Receives: Drug: PegIntron
Pegasys > 60 yearsActive comparatorIn patients > 60 years Pegasys is started at low-dose 45 micrograms once weekly. Dose escalation to 90 micrograms weekly if lack of complete hematological response at 4 months or lack of at least partial molecular response at 8 months. If complete hematological response or lack of at least partial molecular response is not achieved at 90 micrograms weekly at 12 months and 18 months respectively, dose escalation to 135 micrograms weekly.
Receives: Drug: Pegasys
Hydroxyurea > 60 yearsActive comparatorCapsule Hydrea 500-2000 mg orally QD or BID
Receives: Drug: Hydrea

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. molecular response (changes from baseline)

    Molecular responses (JAK V617F allele burden) are assessed by qPCR according to the ELN guidelines.

    Measured: 18, 36 and 60 months

Secondary outcomes (6)
  1. toxicity (discontinuation of therapy due to intolerability)

    The proportion of patients treated with PegIntron, Pegasys and Hydrea who need to discontinue therapy due to intolerability

    Measured: 18 months

  2. Quality of life (changes from baseline)

    Quality of life will be evaluated according to EORTC QLQ C-30 and MPN-SAF

    Measured: 4, 12, 24, 36, 48 and 60 months

  3. Histopathological response (changes from baseline)

    A bone marrow sample will be evaluated in order to detect and grade changes in bone marrow morphology.

    Measured: 36 and 60 months

  4. Sustained molecular response (changes from level at time of discontinuation of therapy)

    investigation of the sustainability of an obtained molecular remission (<

    1% JAK2V617F mutated alleles) after discontinuation of interferon- alpha( Pegasys, PegIntron, Multiferon) or Hydrea.

    Measured: 12, 24 and 36 months

  5. Neutralizing antibodies against PegIntron and Pegasys

    Proportion of patients treated with Peintron and Pegasys who have developed neutralizing antibodies.

    Measured: 24 months

  6. hematological response

    Hematological response will be evaluated according to the ELN guidelines.

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jul 2011 (estimated)
  2. Study startJan 2012
  3. Primary completionJun 2020
  4. Study completionJun 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
202 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01387763
Sponsor's protocol ID
daliah2011
Acronym
DALIAH
Status last verified
Apr 2022
First submitted
23 Jun 2011
Last updated
27 Apr 2022
Results posted
No
Data monitoring committee
Yes

Publications

  • Knudsen TA, Hansen DL, Ocias LF, Bjerrum OW, Brabrand M, Christensen SF, Eickhardt-Dalboge CS, Ellervik C, El Fassi D, Frederiksen M, Kjaer L, Kristensen TK, Kruse TA, Larsen MK, Mourits-Andersen T, Moller S, Overgaard UM, Severinsen MT, Skov V, Sorensen AL, Stentoft J, Starklint J, de Stricker K, Thomassen M, Larsen TS, Hasselbalch HC. Interferon-alpha vs hydroxyurea in patients with myeloproliferative neoplasms (DALIAH): a multicentre, randomised, open-label, phase 3 trial in Denmark. EClinicalMedicine. 2026 Sep 9;100:104193. doi: 10.1016/j.eclinm.2026.104193. eCollection 2026 Oct.

    PubMed 42751490
  • Bistrup CN, Larsen MK, Junker P, Skov V, Kjaer L, Knudsen TA, Karsdal M, Willumsen N, Hasselbalch HC. Collagen Turnover Is Associated with Disease Severity, Bone Marrow Fibrosis, and the JAK2V617F Variant Allele Frequency in Myeloproliferative Neoplasms. Cancers (Basel). 2026 Aug 6;18(15):2529. doi: 10.3390/cancers18152529.

    PubMed 42588744

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing PegIntron, Pegasys and Hydrea in people with Polycythemia Vera and Essential Thrombocythemia, run by Thomas Stauffer Larsen at 8 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

molecular response (changes from baseline) (time frame: 18, 36 and 60 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01387763, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Apr 2022.

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