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Acute Myeloid LeukemiaPhase 2NCT02756962

Improving Risk Assessment of AML With a Precision Genomic Strategy to Assess Mutation Clearance

A Phase 2 study testing Cytarabine, Allogeneic stem cell transplant and Bone marrow aspiration in people with Acute Myeloid Leukemia, run by Washington University School of Medicine at 3 sites in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The investigators will prospectively determine whether the relapse-free and overall survival in patients who have cleared their leukemia-associated mutations treated with standard consolidation chemotherapy is superior to what is expected based on historical controls. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Acute Myeloid Leukemia
What is being tested?
Cytarabine, Allogeneic stem cell transplant and Bone marrow aspiration
Could I receive a placebo?
No, everyone receives an active treatment
How many people
107 participants
Where
3 sitesUnited States
Study dates
6 Jul 2016to 31 Jul 2029
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age 18-60 years.
  • Considered to be suitable intensive (cytotoxic) induction candidates.
  • Has previously untreated, de novo, non-M3 AML with intermediate-risk disease (Intermediate-I or Intermediate-II) as defined by ELN criteria OR normal cytogenetics with mutated NPM1 without FLT3-ITD. Monoallelic CEBPA mutations are not considered favorable risk and are therefore eligible.
  • Has undergone cytotoxic induction therapy
  • In a morphologic complete remission with incomplete blood count recovery, or morphologic complete remission post-induction after no more than 2 induction cycles as defined by revised IWG criteria
  • Patients at Washington University must be enrolled in HRPO# 201011766 ("Tissue Acquisition for Analysis of Genetic Progression Factors in Hematologic Diseases").This is not a requirement for secondary sites. However, secondary sites must provide informed consent forms that document that permission for whole genome, whole exome, and/or genome wide sequencing, and data sharing among institutions, was obtained. Because we will be also be sequencing non-diseased (normal) tissue, the informed consent forms must explicitly ask if patients wish to be informed, (or in the case of their death, their next-of-kin) if a deleterious mutation is identified in their non-diseased tissue, as this may be heritable.
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  • Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she must inform her treating physician immediately.
  • Able to understand and willing to sign an IRB approved written informed consent document.
  • Willing to comply with the treatment assignment:
  • Intent to proceed with HiDAC consolidation for LAM VAF <2.5%
  • Intent to proceed with either HiDAC consolidation or allogeneic stem cell transplantation, at the discretion of the treating physician, for LAM ≥2.5%

Who cannot join

  • Diagnosis acute promyelocytic leukemia (APL) with t(15;17)(q22;q12); PML-RARA.
  • Therapy-related AML (defined as occurrence of AML due to prior exposure to chemotherapy or radiation for malignancy).
  • Secondary AML (defined as development of AML in patients with an antecedent hematological malignancy).
  • Has a medical or psychosocial conditions that would prevent study compliance.
  • Known seropositivity for or active viral infection with human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). Patients who are seropositive because of hepatitis B vaccine are eligible.
  • History of allergic reaction to compounds of similar chemical or biologic composition to cytarabine.
  • Pregnant and/or breastfeeding. Women of childbearing potential must have a negative pregnancy test within 3 days of signing consent.

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • University of Florida

    Gainesville, Florida, 32608

  • University of Rochester

    Rochester, New York, 14642

  • Washington University School of Medicine

    St Louis, Missouri, 63110

Other trials in United States

About this study

The investigators will prospectively determine whether the relapse-free and overall survival in patients who have cleared their leukemia-associated mutations treated with standard consolidation chemotherapy is superior to what is expected based on historical controls. The investigators will also prospectively determine the relapse-free and overall survival of patients who have not cleared their mutations. Because the relapse rate of patients with persistent mutations is expected to be high, treatment with either standard of care consolidation therapy alone or alloSCT will be permitted, at the discretion of the treating physician.

Being tested
Cytarabine, Allogeneic stem cell transplant, Bone marrow aspiration, Punch skin biopsy, ClinSeq
Medical subject headings
Leukemia, Myeloid, Acute

What participants receive

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

  • CytarabineDrug

    Also called Ara-C, Cytosar-U, Tarabine-PFS, AraC

  • Allogeneic stem cell transplantProcedure or surgery

    Also called AlloSCT

  • Bone marrow aspirationProcedure or surgery

    • Baseline
    • Approximately 30 days after cytotoxic induction therapy
    • End of treatment
  • Punch skin biopsyProcedure or surgery

    • The first will be obtained with the initial blood and bone marrow collections, whenever possible.
    • The second will be obtained at the time of re-biopsy to confirm remission.
  • ClinSeqDevice

    Clinical Sequencing to determine clearance or persistence of leukemia-associate mutations performed at MGI CLIA lab

Study groups in NCT02756962
Study groupRoleWhat they receive
Cohort A: HiDACExperimental* At the time of diagnostic bone marrow biopsy, samples will be clinically sequenced via ClinSeq * Patients who have clearance of their leukemia-associated mutations, defined as a LAM VAF <2.5% will be assigned to the high-dose cytarabine consolidation (HiDAC) arm. * HiDAC = Standard regimen of cytarabine 1.5 g/m^2 or 3 g/m^2 over 2-3 hours twice a day on Days 1, 3, \& 5 of each 28 day cycle for 3-4 cycles. Can be replaced by Onureg with permission from PI. * For patients with the FLT3-ITD or a FLT3-TKD mutation, therapy with the FDA-approved FLT3 inhibitor midostaurin is permitted at the discretion of the treating physician.
Receives: Drug: Cytarabine; Procedure: Bone marrow aspiration; Procedure: Punch skin biopsy; Device: ClinSeq
Cohort B: Investigator's choice (HiDAC, AlloSCT)Experimental* At the time of diagnostic bone marrow biopsy, samples will be clinically sequenced via ClinSeq * Patients who have persistent leukemia-associated mutations, defined as a LAM VAF ≥2.5% will be assigned to the investigator's choice arm. * Patients assigned to this arm may received either HiDAC or AlloSCT. * HiDAC = Standard regimen of cytarabine 1.5 g/m^2 or 3 g/m^2 over 2-3 hours twice a day on Days 1, 3, \& 5 of each 28 day cycle for 3-4 cycles. Can be replaced by Onureg with permission from PI. * The source of stem cell product, donor selection, conditioning regimen, graft-versus-host-prophylaxis, and supportive care will be at the discretion of the treatment physician * For patients with the FLT3-ITD or a FLT3-TKD mutation, therapy with the FDA-approved FLT3 inhibitor midostaurin is permitted at the discretion of the treating physician.
Receives: Drug: Cytarabine; Procedure: Allogeneic stem cell transplant; Procedure: Bone marrow aspiration; Procedure: Punch skin biopsy; Device: ClinSeq

What is being measured

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

  1. Relapse free survival of Cohort A compared to intermediate risk historical control group

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

Secondary outcomes (13)
  1. Overall survival (OS) of Cohort A compared intermediate risk historical control group

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

  2. Relapse free survival (RFS) of Cohort B

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

  3. Overall survival (OS) of Cohort B

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

  4. Compare relapse free survival of Cohort A to Cohort B

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

  5. Compare overall survival of Cohort A to Cohort B

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

  6. Compare relapse free survival of Cohort A to Cohort B

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: 1 year

  7. Compare overall survival of Cohort A to Cohort B

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: 1 year

  8. Relapse free survival of Cohort B patients who receive alloSCT

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

  9. Overall survival of Cohort B patients who receive alloSCT

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

  10. Relapse free survival of Cohort B patients who do not receive alloSCT

    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

  11. Overall survival of Cohort B patients who do not receive alloSCT

    Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

  12. Relapse free survival of patients with a LAM VAF <1.0% treated in Cohort A compared to intermediate risk historical control group

    • LAM VAF = Leukemia Associated Mutations variant allele frequency
    • Relapse-free survival is the time from study enrollment (morphologic complete remission (CR) or morphologic complete remission with incomplete blood count recovery (CRi) is required) until documented disease relapse, or death from any cause.
    • CR=Defined as morphologic leukemia-free state, defined as less than 5% blasts in aspirate with marrow spicules and a count of ≥200 nucleated cells and no blasts with Auer rods or any persistence of extramedullary disease. In addition, ANC >1000/μl and platelet count of ≥100,000/μl. Patient must be independent of transfusions. No duration requirement for this designation.
    • CRi=Defined as morphologic complete recovery with the exception of neutropenia <1000/μl or thrombocytopenia <100,000/μl.

    Measured: Up to 5 years

  13. Overall survival of patients with a LAM VAF <1.0% treated in Cohort A compared to intermediate risk historical control group

    --LAM VAF = Leukemia Associated Mutations variant allele frequency

    -Overall survival is the time from enrollment on study until death from any cause.

    Measured: Up to 5 years

Timeline

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

  1. First posted29 Apr 2016 (estimated)
  2. Study start6 Jul 2016
  3. Primary completion31 Jul 2029 (estimated)
  4. Study completion31 Jul 2029 (estimated)

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
107 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02756962
Sponsor's protocol ID
201606003
Status last verified
Oct 2026
First submitted
27 Apr 2016
Last updated
29 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Jacoby MA, Spencer DH, Gao F, Uy GL, Burton T, Heath SE, Du F, O'Laughlin M, Fulton RS, Miller CA, Duncavage EJ, Schroeder MA, Ghobadi A, Pusic I, Stockerl-Goldstein KE, Kahl BS, Cashen AF, Christopher MJ, Singh N, Vij R, Crees ZD, Wartman LD, Day RB, Fehniger TA, Oetjen KA, Patel DA, Kim MY, Slade MJ, Ferraro F, Walter MJ, Abboud CN, Abboud R, Link DC, Al-Mansour ZA, Cogle CR, Huselton EJ, DiPersio JF, Westervelt P, Ley TJ. Consolidation Therapy Based on Mutation Clearance in Acute Myeloid Leukemia. NEJM Evid. 2026 Sep;5(9):EVIDoa2500352. doi: 10.1056/EVIDoa2500352. Epub 2026 Aug 25.

    PubMed 42640163

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Cytarabine, Allogeneic stem cell transplant and Bone marrow aspiration in people with Acute Myeloid Leukemia, run by Washington University School of Medicine at 3 sites in United States.

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 11 inclusion and 7 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: under way, not looking for participants, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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?

Relapse free survival of Cohort A compared to intermediate risk historical control group (time frame: Up to 5 years). 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 NCT02756962, which also lists 1 linked publication.

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 29 Oct 2026.

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