TRIAL OF 17-AAG AND CYTARABINE IN LEUKEMIA AND MYELODSPLASTIC SYNDROME

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目及 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 肿瘤类型：AML：根据WHO诊断标准，任何非FAB M3（APL）AML必须属于以下类别之一 初始诱导方案未能达到CR 首次CR后1年内首次复发 首次或第二次复发时重新诱导治疗失败 第二或第三次复发的患者接受不超过三次 不同诱导方案 既往血液学疾病（MDS，慢性骨髓增生性疾病， 慢性骨髓单核细胞白血病） 既往接受过非血液系统恶性肿瘤化疗 高危细胞遗传学异常（染色体5、7、8或 11，或= 3核型异常） ALL：任何属于以下类别之一的ALL 初始诱导方案未能达到CR 首次CR后1年内首次复发 首次或第二次复发时重新诱导治疗失败 第二或第三次复发的患者接受不超过三次 不同诱导方案 CML：患者骨髓中原始细胞百分比必须增加 （> 10%，即加速期或“急变期”）且伊马替尼治疗失败 甲磺酸盐患者可能只接受了一种额外的治疗方案， 除了伊马替尼治疗他们的CML。 CMML：患者必须同时具有原始细胞百分比增加（> 10%，即 CMML 2）以及器官浸润或即将发生骨髓衰竭的证据 表现为血细胞减少。此外，患者不应有t（5;12）， 细胞遗传学，除非他们没有失败的试验伊马替尼甲磺酸盐。 MDS：高级别MDS患者（定义为骨髓细胞结构原始细胞>10%） （RAEB-2）或IPSS MDS预后评分>1.5） 体能状态：ECOG体能状态（PS）0、1或2。 允许的异常器官功能：在登记前≥ 7天获得以下实验室检查值： 直接胆红素=1.5 x正常上限（ULN）（除非归因于基础疾病） 肌酐清除率计算值=60 mL/min 治疗计划：阿糖胞苷400 mg/m2/天，连续输注，第1 - 5天 17-第3天和第6天，60分钟内静脉注射AAG 在骨髓恢复或出院后30至5天重复 来自上一周期

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Tumor Types: AML: Any non-FAB M3 (APL) AML by WHO diagnostic criteria must fall into 1 of the categories below Failure to achieve a CR with initial induction regimen First relapse within one year of initial CR Failure of re-induction therapy at first or second relapse Second or third relapse in a patient who has received no more than three different induction regimens Antecedent hematologic disorder (MDS, chronic myeloproliferative disease, chronic myelo-monocytic leukemia) Prior chemotherapy for a non-hematologic malignancy High risk cytogenetic abnormalities (abnormalities of chromosome 5,7,8, or 11, or = 3 karyotypic abnormalities) ALL: Any ALL falling into one of the categories below Failure to achieve a CR with initial induction regimen First relapse within one year of initial CR Failure of re-induction therapy at first or second relapse Second or third relapse in a patient who has received no more than three different induction regimens CML: Patients must have an increase in blast percentage in the bone marrow (>10%, i.e. either accelerated or "blast phase") and have failed imatinib mesylate. Patients may have had only one additional treatment regimen in addition to imatinib for their CML. CMML: Patients must have both an increase in blast percentage (>10 %, i.e. CMML 2) as well as evidence of organ infiltration or impending marrow failure as manifested by cytopenias. Additionally patients should not have a t(5;12) by cytogenetics unless they have failed a trial of imatinib mesylate. MDS: High grade MDS patients (defined as >10% blasts on marrow cellularity (RAEB-2) or IPSS MDS prognostic score of >1.5) Performance Status: ECOG Performance Status (PS) 0, 1, or 2. Abnormal Organ Function Permitted: The following laboratory values obtained =7 days prior to registration: Direct bilirubin =1.5 x upper limit of normal (ULN) (unless attributable to underlying disease) Calculated creatinine clearance =60 mL/min Treatment Plan: Cytarabine 400 mg/m2/day continuous infusion days 1 through 5 17-AAG intravenously over 60 minutes on days 3 and 6 Repeat 30 ¿ 5 days after marrow recovery or hospital discharge From previous cycle