A Phase II Study of Sulindac, a COX Inhibitor, in Older Patients With Acute Myeloid Leukemia in First Complete Remission

To determine if you are eligible to participate in this study you will be asked to undergo some screening tests or procedures. Many of these tests and procedures are likely to be part of regular cancer care and may be done even if it turns out you do not take part in the research study. If you have had some of these tests or procedures recently, they may or may not have to be repeated. These procedures include a medical history, performance status, medical record review, routine blood tests, electrocardiogram, echocardiogram and research blood samples. If these tests show that you are eligible to participate in the research study, you will begin the study treatment. If you do not meet the eligibility criteria, you will not be able to participate in this research study. You will begin the study with up to two cycles of chemotherapy that is an accepted approach treatment of your type of leukemia. This is called consolidation chemotherapy. If you experience severe side effects, you may only be given one cycle. You will begin to take sulindac after you complete consolidation therapy. The consolidation therapy that is commonly used for your type of cancer is a chemotherapy drug called cytarabine. Each cycle of consolidation chemotherapy will be 28 days, or four weeks. You will receive cytarabine via IV infusion on Days 1-5 of each cycle, over a period of 3 hours. You will be admitted to MGH for approximately a week during each cycle of consolidation chemotherapy with cytarabine. Before starting sulindac, the same tests and procedures done at the screening visit listed above will be repeated. This visit is "Day 0", meaning it takes place prior to study treatment with sulindac. In addition, you will also have a sample of your bone marrow taken for research purposes. This sample is related to the study and will help us understand better the activity of the study drug, sulindac, on leukemia cells and the effect of the body on the sulindac. You will take sulindac twice a day. Sulindac comes in the form of tablets and can be taken at home by mouth. Your first day of taking sulindac will be called day 1. The following tests and procedures will be one in the outpatient clinic on Day 1 of the study: Blood samples will be taken at 3 points on day 1. These will occur before the first dose of sulindac, 1 hour after the first dose of sulindac, and 4 hours after the first dose of sulindac. Approximately 3 teaspoons of blood will be drawn each time. These samples are related to the study and will help us understand better the activity of the study drug, sulindac, on leukemia cells and the effect of the body on sulindac. You will come into the clinic for dosing on day 2 (Visit 3) of the study. Approximately 3 teaspoons of blood will be drawn before dosing. 3 teaspoons of blood will also be drawn prior to dosing on days 8, 15 and 28 of study treatment with sulindac. These samples will be stored for as long as research is ongoing with currently no end date. You will continue sulindac twice daily for the duration of the study, which will be 12 months. You will be monitored for bleeding, since COX inhibitors can also decrease platelet function and affect clotting abilities, and for gastritis or ulcer disease, as COX inhibitors can damage the lining of the stomach. These occur in the minority of participants, but you will be monitored closely on this study for these unexpected effects. If you develop toxicities on therapy, your dose of sulindac may be reduced or if your symptoms are severe enough, you may be taken off sulindac. If for whatever reason you are unable to participate in the study or adhere to the schedules and study treatments, you will be taken off the study treatment and discontinued from the study. You may choose to stop treatment and come off the study at any time. We would like to keep track of your medical condition and overall health following the 12 months of study treatment on study with sulindac. This will not involve any communication, but only occasional review of your medical record in regards to medical condition and overall health.