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审核状态: Project audit state: |
通过审核 Successful |
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注册号: Registration number: |
ChiCTR2600127006 |
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最近更新日期: Date of Last Refreshed on: |
2026-06-22 17:53:45 |
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注册时间: Date of Registration: |
2026-06-22 00:00:00 |
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注册号状态: |
预注册 |
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Registration Status: |
Prospective registration |
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注册题目: |
一项在成人初诊Ph阴性B-ALL患者中比较14天短疗程贝林妥欧单抗联合短周期化疗与标准化疗疗效和安全性的多中心、II期随机对照研究 |
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Public title: |
A multicenter, phase II randomized controlled trial comparing the efficacy and safety of 14-day short-course blinatumomab combined with short-cycle chemotherapy versus standard chemotherapy in adult patients with newly diagnosed Ph-negative B-cell acute lymphoblastic leukemia |
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注册题目简写: |
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English Acronym: |
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研究课题的正式科学名称: |
一项在成人初诊Ph阴性B-ALL患者中比较14天短疗程贝林妥欧单抗联合短周期化疗与标准化疗疗效和安全性的多中心、II期随机对照研究 |
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Scientific title: |
A multicenter, phase II randomized controlled trial comparing the efficacy and safety of 14-day short-course blinatumomab combined with short-cycle chemotherapy versus standard chemotherapy in adult patients with newly diagnosed Ph-negative B-cell acute lymphoblastic leukemia |
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研究课题代号(代码): Study subject ID: |
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在二级注册机构或其它机构的注册号: The registration number of the Partner Registry or other register: |
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申请注册联系人: |
尹青松 |
研究负责人: |
尹青松 |
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Applicant: |
Qingsong Yin |
Study leader: |
Qingsong Yin |
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申请注册联系人电话: Applicant telephone: |
+86 371 6558 7358 |
研究负责人电话:
Study leader's |
+86 371 6558 7358 |
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申请注册联系人传真 : Applicant Fax: |
研究负责人传真: Study leader's fax: |
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申请注册联系人电子邮件: Applicant E-mail: |
jnyinqingsong@163.com |
研究负责人电子邮件: Study leader's E-mail: |
jnyinqingsong@163.com |
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申请单位网址(自愿提供): Applicant website(voluntary supply): |
研究负责人网址(自愿提供): Study leader's website(voluntary supply): |
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申请注册联系人通讯地址: |
河南省郑州市东明路127号 |
研究负责人通讯地址: |
河南省郑州市东明路127号 |
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Applicant address: |
127 Dongming Road, Zhengzhou City, Henan Province |
Study leader's address: |
127 Dongming Road, Zhengzhou City, Henan Province |
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申请注册联系人邮政编码: Applicant postcode: |
研究负责人邮政编码: Study leader's postcode: |
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申请人所在单位: |
河南省肿瘤医院 |
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Applicant's institution: |
Henan Cancer Hospital |
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研究负责人所在单位: |
河南省肿瘤医院 |
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Affiliation of the Leader: |
Henan Cancer Hospital |
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是否获伦理委员会批准: |
是 |
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Approved by ethic committee: |
Yes |
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伦理委员会批件文号: Approved No. of ethic committee: |
2026-169-002 |
伦理委员会批件附件: Approved file of Ethical Committee: |
查看附件View |
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批准本研究的伦理委员会名称: |
河南省肿瘤医院医学伦理委员会(第三伦理委员会) |
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Name of the ethic committee: |
Medical Ethics Committee of Henan Cancer Hospital (Third Ethics Committee) |
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伦理委员会批准日期: Date of approved by ethic committee: |
2026-04-27 00:00:00 | ||
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伦理委员会联系人: |
丁晶 |
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Contact Name of the ethic committee: |
Jing Ding |
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伦理委员会联系地址: |
河南省郑州市东明路127号 |
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Contact Address of the ethic committee: |
127 Dongming Road, Zhengzhou City, Henan Province |
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伦理委员会联系人电话: Contact phone of the ethic committee: |
+86 371 6558 8251 |
伦理委员会联系人邮箱: Contact email of the ethic committee: |
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研究实施负责(组长)单位: |
河南省肿瘤医院 |
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Primary sponsor: |
Henan Provincial Cancer Hospital |
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研究实施负责(组长)单位地址: |
河南省郑州市东明路127号 |
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Primary sponsor's address: |
127 Dongming Road, Zhengzhou City, Henan Province |
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试验主办单位(项目批准或申办者): Secondary sponsor: |
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经费或物资来源: |
河南省政府 |
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Source(s) of funding: |
Henan Provincial People's Government |
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研究疾病: |
急性B淋巴细胞白血病 |
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Target disease: |
Acute B lymphoblastic leukemia (ALL) |
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研究疾病代码: |
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Target disease code: |
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研究类型: |
干预性研究 |
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Study type: |
Interventional study |
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研究所处阶段: |
II期临床试验 | ||||||||||||||||||||||
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Study phase: |
2 |
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研究设计: |
随机平行对照 |
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Study design: |
Parallel |
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研究目的: |
评估成人Ph阴性B-ALL患者采用14天短疗程倍利妥联合缩短周期化疗的疗效与安全性。 |
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Objectives of Study: |
To evaluate the efficacy and safety of 14-day short-course blinatumomab combined with shortened-cycle chemotherapy in adult patients with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (Ph-negative B-ALL). |
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药物成份或治疗方案详述: |
干预治疗分为诱导期、巩固期和维持期三个阶段实施,治疗结束后随访2年。 1. 诱导治疗 - A组(试验组):接受减低剂量VIDP方案(1周)治疗,具体用药:去甲氧柔红霉素(IDA) 5 mg/m2/d d1;长春新碱(VCR) 1.4 mg/m2/d d1(单次最大剂量不超过2 mg);地塞米松(DEX) 9 mg/m2/d d1-7;培门冬酶(Peg) 2500 U/m2 d3。 - B组(对照组):接受标准剂量VIDP方案(4周)治疗,具体用药:IDA 5 mg/m2/d d1、8;VCR 1.4 mg/m2/d d1、8、15、22;DEX 9 mg/m2/d d1-7、6 mg/m2/d d8-28;Peg 2500 U/m2 d3。 诱导第14天评估骨髓白血病负荷,A组序贯14天贝林妥欧单抗(倍利妥)诱导:9 μg/d d15-21;28 μg/d d22-28;B组继续化疗。 2. 巩固治疗 - A组:接受4-6个周期大剂量化疗(推荐Hyper-CVAD-P/MA方案),其中第3周期为14天贝林妥欧单抗治疗(9 μg/d d1-4;28 μg/d d5-14)。 - B组:接受7个周期大剂量化疗。 - Hyper-CVAD-P方案:环磷酰胺 300 mg/m2 静脉滴注,q12h d1-3;VCR 1.4 mg/m2 d21,静脉滴注,d4、11;多柔比星 50 mg/m2,静脉滴注,d4;DEX 40 mg/d,静脉滴注或口服,d1-4、d11-14;Peg 2500 U/m2 d5。 - Hyper-MA方案:甲氨蝶呤(MTX) 1 g/m2 d1,持续静脉滴注24小时;四氢叶酸钙 25 mg/m2,MTX用药结束后12小时开始解救;阿糖胞苷(Ara-C) 2-3 g/m2 q12h d2、3。 基因分型高危患者(如IKZFplus)在巩固治疗2-3个周期后可进行异基因造血干细胞移植。 3. 维持治疗 - A组:接受POMP方案维持治疗2年,每年进行1次14天贝林妥欧单抗维持治疗(9 μg/d d1-4;28 μg/d d5-14)。 - B组:接受POMP方案维持治疗3年。 - POMP方案:巯嘌呤 50 mg/m2 d1-14;MTX 18 mg/m2 d1、8、15;DEX 6 mg/m2 d21-28;VCR 1.4 mg/m2 d21。 4. 鞘注化疗(IT) DEX+MTX±Ara-C,鞘注总次数≥16次,高危患者≥20次。 5. 治疗剂量调整与不良反应管理 a)血液学毒性:出现4级粒细胞/血小板减少时,给予升白治疗、成份输血等对症支持。 b)非血液学毒性:贝林妥欧单抗输注相关不良反应的预防与处理: - 预防用药:首次给药及每次剂量增加前1小时内,予地塞米松10 mg或甲强龙40 mg静脉注射(或由研究者决定)。 - 3级细胞因子释放综合征(CRS)、神经毒性或输液相关反应:暂时中断给药;若CRS/输液反应2周内恢复至≤1级、神经毒性7天内恢复至≤1级,可恢复原剂量给药。 - 4级CRS、神经毒性或输液相关反应:永久终止贝林妥欧单抗治疗。 患者入组预计3年内完成,计划入组例数52例。 |
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Description for medicine or protocol of treatment in detail: |
Intervention consists of three phases: induction, consolidation, and maintenance, with a 2-year follow-up after treatment completion. 1. Induction Therapy - Group A (Experimental Group): Reduced-dose 1-week VIDP regimen. Medications: Idarubicin (IDA) 5 mg/m2/d d1; Vincristine (VCR) 1.4 mg/m2/d d1 (max single dose ≤ 2 mg); Dexamethasone (DEX) 9 mg/m2/d d1-7; Pegaspargase (Peg) 2500 U/m2 d3. - Group B (Control Group): Standard-dose 4-week VIDP regimen. Medications: IDA 5 mg/m2/d d1, 8; VCR 1.4 mg/m2/d d1, 8, 15, 22; DEX 9 mg/m2/d d1-7, 6 mg/m2/d d8-28; Peg 2500 U/m2 d3. Bone marrow leukemia burden is assessed on day 14 of induction. Group A receives sequential 14-day blinatumomab induction: 9 μg/d d15-21; 28 μg/d d22-28. Group B continues chemotherapy. 2. Consolidation Therapy - Group A: 4-6 cycles of high-dose chemotherapy (Hyper-CVAD-P/MA recommended), with the 3rd cycle as 14-day blinatumomab therapy (9 μg/d d1-4; 28 μg/d d5-14). - Group B: 7 cycles of high-dose chemotherapy. - Hyper-CVAD-P: Cyclophosphamide 300 mg/m2 IV q12h d1-3; VCR 1.4 mg/m2 IV d4, 11; Doxorubicin 50 mg/m2 IV d4; DEX 40 mg/d IV/oral d1-4, d11-14; Peg 2500 U/m2 d5. - Hyper-MA: Methotrexate (MTX) 1 g/m2 continuous IV infusion over 24h d1; Leucovorin 25 mg/m2 IV starting 12h after MTX completion; Cytarabine (Ara-C) 2-3 g/m2 IV q12h d2, 3. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is allowed in high-risk genetic patients (e.g., IKZFplus) after 2-3 cycles of consolidation. 3. Maintenance Therapy - Group A: POMP regimen maintenance for 2 years, with one 14-day blinatumomab course per year (9 μg/d d1-4; 28 μg/d d5-14). - Group B: POMP regimen maintenance for 3 years. - POMP: Mercaptopurine 50 mg/m2 d1-14; MTX 18 mg/m2 d1, 8, 15; DEX 6 mg/m2 d21-28; VCR 1.4 mg/m2 d21. 4. Intrathecal Chemotherapy (IT) Regimen: DEX + MTX +/- Ara-C. Total IT administrations >=16 times; >=20 times for high-risk patients. 5. Dose Adjustment & Adverse Event Management a) Hematologic toxicity: Grade 4 neutropenia/thrombocytopenia managed with G-CSF support and component transfusion. b) Non-hematologic toxicity (blinatumomab-related): - Prophylaxis: 10 mg IV dexamethasone or 40 mg IV methylprednisolone 1h before the first dose and each dose escalation (investigator’s discretion). - Grade 3 CRS/neurotoxicity/infusion reaction: Hold administration; resume at original dose if CRS/infusion reaction recovers to <=Grade 1 within 2 weeks and neurotoxicity recovers to <=Grade 1 within 7 days. - Grade 4 CRS/neurotoxicity/infusion reaction: Permanent discontinuation of blinatumomab. Patient enrollment is expected to complete within 3 years, with a planned sample size of 52 cases. |
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纳入标准: |
1.根据WHO诊断标准,通过MICM新诊断的Ph阴性B-ALL患者; 2.年龄:18-70岁(包括18岁和70岁); 3.男女不限; 4.ECOG评分0-3级; 5.预期生存时间≥3个月; 6.肝功能:总胆红≤正常上限3倍;谷丙转氨酶≤正常上限3倍;谷草转氨酶≤正常上限3倍(考虑白血病浸润除外); 7.肾功能:内生肌酐清除率≥30 mL/min; 8.患者理解并愿意参加本研究,同时签署知情同意书。 |
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Inclusion criteria |
1. Newly diagnosed Philadelphia chromosome-negative B-ALL patients confirmed by MICM classification according to WHO diagnostic criteria; 2. Age: 18–70 years old (including 18 and 70 years old); 3. No restriction on gender; 4. ECOG performance status score: 0–3; 5. Expected survival time >= 3 months; 6. Liver function: total bilirubin <= 3 times the upper limit of normal (ULN); alanine transaminase (ALT) <= 3×ULN; aspartate transaminase (AST) <= 3×ULN (except for liver infiltration caused by leukemia); 7. Renal function: endogenous creatinine clearance rate >= 30 mL/min; 8. Patients fully understand and voluntarily participate in this study, and sign the informed consent form. |
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排除标准: |
1.合并中枢神经系统白血病; 2.急性混合细胞白血病; 3.MRD阳性B-ALL; 4.Ph阳性B-ALL; 5.乙型肝炎、丙型肝炎活动期; 6.严重肺部、心脏、肝脏、肾脏疾病; 7.妊娠、哺乳期,或有生育能力但未采取避孕措施的女性患者; 8.有严重自身免疫性疾病、精神疾病或认知障碍者。 |
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Exclusion criteria: |
1. Combined central nervous system leukemia; 2. Acute mixed phenotypic leukemia; 3. MRD-positive B-cell acute lymphoblastic leukemia; 4. Philadelphia chromosome-positive B-ALL; 5. Active hepatitis B or hepatitis C infection; 6. Severe pulmonary, cardiac, hepatic or renal diseases; 7. Pregnant or lactating females, as well as females of childbearing potential without effective contraception; 8. Patients with severe autoimmune diseases, psychiatric disorders or cognitive impairment. |
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研究实施时间: Study execute time: |
从 From 2026-09-01 00:00:00至 To 2029-09-01 00:00:00 |
征募观察对象时间: Recruiting time: |
从 From 2026-09-01 00:00:00 至 To 2029-09-01 00:00:00 |
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干预措施: Interventions: |
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研究实施地点: Countries of recruitment and research settings: |
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测量指标: Outcomes: |
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采集人体标本:
Collecting sample(s)
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征募研究对象情况: Recruiting status: |
尚未开始 Not yet recruiting |
年龄范围: Participant age: |
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性别: |
男女均可 |
Gender: |
Both |
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随机方法(请说明由何人用什么方法产生随机序列): |
随机数字表法 |
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Randomization Procedure (please state who generates the random number sequence and by what method): |
Random number table |
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是否公开试验完成后的统计结果: Calculated Results after the Study Completed public access: |
公开/Public |
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盲法: |
开放标签 |
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Blinding: |
Open-label study |
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试验完成后的统计结果(上传文件): |
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Calculated Results after
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是否共享原始数据: IPD sharing |
否No |
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共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址): |
无 |
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The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url): |
None |
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数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC: |
病例记录表 |
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Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture: |
Case Record Form |
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数据与安全监察委员会: Data and Safety Monitoring Committee: |
有/Yes |