NCT02774850

Brief Summary

Treatment for pediatric acute myeloid leukemia (AML) involves intensive chemotherapy regimens that result in periods of profound neutropenia leaving patients susceptible to severe infectious complications. Infectious complications are the leading cause of treatment related mortality among AML patients, but there are little clinical data to inform whether management of neutropenia post AML chemotherapy should occur in an outpatient or inpatient setting. The primary objective of this study is to compare the clinical effectiveness of outpatient versus inpatient management of neutropenia in children with AML.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
610

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jun 2015

Longer than P75 for all trials

Geographic Reach
1 country

17 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2015

Completed
12 months until next milestone

First Submitted

Initial submission to the registry

May 13, 2016

Completed
4 days until next milestone

First Posted

Study publicly available on registry

May 17, 2016

Completed
3.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 26, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 26, 2019

Completed
5 months until next milestone

Results Posted

Study results publicly available

December 23, 2019

Completed
Last Updated

December 23, 2019

Status Verified

December 1, 2019

Enrollment Period

4.2 years

First QC Date

May 13, 2016

Results QC Date

September 4, 2019

Last Update Submit

December 2, 2019

Conditions

Keywords

PediatricNeutropenia ManagementAcute Myeloid LeukemiaChart AbstractionChemotherapy

Outcome Measures

Primary Outcomes (1)

  • Occurrence of Post-chemotherapy Bacteremia

    Identification of bacteremia will begin three days after completion of a chemotherapy course and will continue until recovery of absolute neutrophil count (ANC \> 200 uL), or until the start of the next course (for a very small number of patients who begin the next course of chemotherapy prior to count recovery). Bacteremia will be defined as a single positive blood culture for a bacterial pathogen (including Viridans group Streptococci). If the bacterium is an organism considered as a common commensal organism by the National Healthcare Safety Network, two separate positive blood cultures will be required for classification as bacteremia.

    Identification of bacteremia will begin three days after completion of a chemotherapy course and will continue until recovery of absolute neutrophil count (ANC > 200 uL), or until the start of the next course.

Secondary Outcomes (1)

  • Time to the Initiation of the Next Chemotherapy Course

    The number of days from the three days after the completion chemotherapy in a given course until the first day of the next course

Study Arms (2)

Early Discharge Management

Discharge to outpatient management during neutropenia within 3 days after chemotherapy completion in a given course

Inpatient Management

Remain hospitalized during chemotherapy-induced neutropenia

Eligibility Criteria

AgeUp to 19 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodNon-Probability Sample
Study Population

The study population will include all AML patients who received or will receive chemotherapy between January 1, 2012 and December 31, 2019 at any of the fifteen participating pediatric institutions across the US. Patients discharged within 3 days after completion of that chemotherapy course will be categorized as 'early discharge' to outpatient management during neutropenia. Patients meeting eligibility criteria for 'early discharge' but remaining in the hospital more than 3 days after completion of that chemotherapy course will be categorized as inpatient management. Patients will be considered early discharge-eligible if there is no evidence of fever, infection or intensive care unit (ICU) level care within ± 3 days of the last dose of chemotherapy.

You may qualify if:

  • Males or females of age less than 19 at diagnosis.
  • Receipt or planned receipt of AML chemotherapy between January 1, 2012 and December 31, 2019.

You may not qualify if:

  • Patients being treated for relapsed AML
  • Patients with Acute Promyelocytic Leukemia (APML)
  • Patients undergoing stem cell transplant (SCT)
  • Patients receiving reduced intensity frontline chemotherapy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (17)

Arkansas Children's Hospital

Little Rock, Arkansas, 72202, United States

Location

Lucile Packard Children's Hospital

Palo Alto, California, 94304, United States

Location

Rady Children's Hospital

San Diego, California, 92123, United States

Location

Children's Hospital of Colorado

Aurora, Colorado, 80045, United States

Location

Alfred I DuPont Hospital for Children

Wilmington, Delaware, 19803, United States

Location

Children's Healthcare of Atlanta

Atlanta, Georgia, 30329, United States

Location

Ann & Robert H Lurie Children's Hospital

Chicago, Illinois, 60611, United States

Location

Ochsner Medical Center

New Orleans, Louisiana, 70121, United States

Location

Dana-Farber Cancer Institute/Boston Children's Hospital

Boston, Massachusetts, 02215, United States

Location

C.S. Mott Children's Hospital

Ann Arbor, Michigan, 48109, United States

Location

Children's Hospital of Michigan

Detroit, Michigan, 48201, United States

Location

University of Mississippi Medical Center

Jackson, Mississippi, 39216, United States

Location

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

Location

Children's Medical Center of Dallas

Dallas, Texas, 75235, United States

Location

Texas Children's Hospital

Houston, Texas, 77030, United States

Location

Primary Children's Hospital

Salt Lake City, Utah, 84132, United States

Location

Seattle Children's Hospital

Seattle, Washington, 98105, United States

Location

MeSH Terms

Conditions

Leukemia, Myeloid, AcuteNeutropeniaBacteremia

Condition Hierarchy (Ancestors)

Leukemia, MyeloidLeukemiaNeoplasms by Histologic TypeNeoplasmsHematologic DiseasesHemic and Lymphatic DiseasesAgranulocytosisLeukopeniaCytopeniaLeukocyte DisordersBacterial InfectionsBacterial Infections and MycosesInfectionsSepsisSystemic Inflammatory Response SyndromeInflammationPathologic ProcessesPathological Conditions, Signs and Symptoms

Results Point of Contact

Title
Dr. Richard Aplenc
Organization
Children's Hospital of Philadelphia

Study Officials

  • Richard Aplenc, MD, PhD

    Children's Hospital of Philadelphia

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
OTHER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 13, 2016

First Posted

May 17, 2016

Study Start

June 1, 2015

Primary Completion

July 26, 2019

Study Completion

July 26, 2019

Last Updated

December 23, 2019

Results First Posted

December 23, 2019

Record last verified: 2019-12

Data Sharing

IPD Sharing
Will not share

Coded, limited data sets will be shared with participating sites upon approved request. Only aggregate level data will be shared with the study sponsor Patient-Centered Outcomes Research Institute (PCORI).

Locations