MYELO-CAN: A Randomized Control Trial Platform
Overview
MYELO-CAN is a trial platform designed by patients and clinicians whose priority is to improve patient-prioritized outcomes for those affected by myelodysplastic syndrome and acute leukemia.
Files
Study overview
Recruitment
Closed to recruitment March 5, 2024.
Number of patients enrolled: 8428
Number of Sites: 10
Contact us
MYELO-CAN
CancerCare Manitoba
675 McDermot Ave
Winnipeg, MB R3E 0V9, Canada
Developing enduring infrastructure to efficiently evaluate treatments for patients with Myelodysplastic Syndrome (MDS) and Acute Myeloid Leukemia (AML)
| Title | Evaluation of supportive care treatments among outpatients with myelodysplastic syndrome and acute myeloid leukemia: a multicenter pilot trial (MYELO-CAN) |
| Description | Myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) are serious, life changing blood cancers associated with significant morbidity and mortality. Morbidity is to a large extent due to anemia, neutropenia and thrombocytopenia (i.e. bone marrow failure). Despite the need for supportive care interventions such as transfusions and antimicrobials to manage these patients, evidence-informed outpatient supportive care strategies are lacking to prevent the most common adverse events (eg: bleeding and infection). |
| Aim | The primary objective is to build clinical trial platform infrastructure to create a patient-centred learning health system to advance knowledge and improve patient outcomes, quality-of-life and survival in patients with MDS and AML. |
| Endpoints | This platform is intended to host trials focused on various aspects of MDS and AML care at different phases of investigation. Therefore, we cannot specify a single primary endpoint for the entire platform. |
Two ongoing trials
1. Tranexamic Acid (TXA) Trial
Enrolling as of Sept 2025
Patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) commonly experience complications related to bleeding, despite the best efforts of their care team. These complications affect patient quality-of-life and can sometimes lead to hospitalization or death. Evaluation of affordable and widely available treatments to minimize bleeding complications among patients with MDS and AML is needed.
Tranexamic acid (TXA) reduces clinically relevant bleeding events in a variety of settings. However, the efficacy and safety of TXA in outpatients with MDS and AML is unknown; clinical trials are needed to inform best practice.
2. Antibiotic Prophylaxis (ABX) Trial
Anticipated start Mar 2026
Patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) commonly experience complications related to infection, despite the best efforts of their care team. These complications affect patient quality-of-life and can sometimes lead to hospitalization or death. Evaluation of affordable and widely available treatments to minimize infection complications among patients with MDS and AML is needed.
Levofloxacin (antibiotic) prophylaxis is shown to minimize febrile neutropenia and infectious complications in a variety of settings. However, the efficacy and safety of levofloxacin in outpatients with MDS and AML is unknown; clinical trials are needed to inform best practice.
Details of our ongoing trials
| 1. Tranexamic Acid (TXA) Trial | 2. Antibiotic Prophylaxis (ABX) Trial | |
|---|---|---|
| Protocol number | CHI-001-1 | CHI-001-2 |
| Title | Evaluation of tranexamic acid among outpatients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML): a multicenter pilot trial (MYELO-CAN TXA) | Evaluation of antibiotic prophylaxis in myelodysplastic syndrome and acute myeloid leukemia: a multicenter pilot trial (MYELO-CAN ABX) |
| Aim | To evaluate trial feasibility to inform our larger phase III trial of TXA among at-risk patients. Ultimately, we will evaluate the efficacy and safety of TXA to minimize bleeding in patients with MDS and AML treated in the outpatient setting. | To evaluate trial feasibility to inform our larger phase III trial of levofloxacin among at-risk patients. Ultimately, we will evaluate the efficacy and safety of levofloxacin prophylaxis to minimize infection in patients with MDS and AML treated in the outpatient setting. |
| Patient population | Patients with MDS and AML receiving less-intensive chemotherapy with severe thrombocytopenia (platelet count <30×109/L). | Patients with MDS and AML receiving less-intensive chemotherapy who are at-risk for infection. |
| Intervention | Tranexamic acid 1 gram orally 2-3 times per day for 60 days. | Levofloxacin 500mg orally once daily for 90 days. |
| Comparator | Placebo orally 2-3 times per day for 60 days. | Standard of care (no antibiotic prophylaxis). |
| Primary outcome | Ability to enrol a median of 1 patient / site / month. | Ability to enroll a median of 1 patient / site / month. |
FUNDERS AND COLLABORATORS
Participating Sites
MYELO-CAN TEAM
Principal Investigators
Site: CancerCare Manitoba
Assistant Professor, Hematologist, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba
Dr. Houston is a scientist at the Paul Albrechtsen Research Institute, and her primary programs of research focus on optimizing supportive care strategies to reduce bleeding and infection in patients with myelodysplastic syndrome and acute myeloid leukemia.
Site: CancerCare Manitoba
Associate professor, Hematologist, Critical Care Physician, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba
Dr. Zarychanski is a senior scientist at the Paul Albrechtsen Research Institute and an affiliate member of the George and Fay Yee Centre for Healthcare Innovation. His research focuses on the hematologic aspects of critical illness where he leads several national and international randomized trials in the fields of sepsis and transfusion medicine.
Site: Odette Cancer Centre
Associate professor, Hematologist, and Clinician-Scientist at the Sunnybrook Research Institute and Sunnybrook Hospital
Dr. Buckstein’s research is focused on novel biological therapies for MDS and lymphomas. She conducts investigator-initiated research in targeted therapy and immunotherapy, red blood cell transfusions in MDS, MDS mutations as a component of aging, health outcomes research, patient-reported outcomes, and frailty and comorbidity as prognostic factors.
Site: Queen’s University
Associate professor, Hematologist, and Clinician-Scientist at Queen’s University
Dr. Hay leads and organizes multidisciplinary teams and brings experience in design and conduct of national and international multicentre clinical trials and health economic studies.
Site: McMaster University
Assistant professor at McMaster University and statistical methodology lead.
Dr. Park has experience in adaptive trial design and is the director of the platform trial initiative through CCTG.
UM Trial Operations Team
Nora Choi has worked in clinical research for 9 years and currently manages the MYELO-CAN trial.
CancerCare Manitoba Site Team
Assistant Professor, Hematologist, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba
Dr. Paulson is a hematologist with additional training in the fields of acute leukemia and blood and marrow transplantation. He also led the Canadian cell therapy and acute leukemia registries and is the PI on multiple international investigator-initiated clinical trials. Locally, he is chair of the Leukemia Disease Site Group at CancerCare Manitoba.
Assistant Professor and Hematologist at the University of Manitoba and CancerCare Manitoba
Dr. Szwajcer is the Manitoba Blood and Marrow Transplant Program Director as well as the medical director of the Cellular Therapy Laboratory, which supports a GMP manufacturing facility.
Assistant Professor and Hematologist at the University of Manitoba and CancerCare Manitoba
Dr. Speziali has an interest in comparative clinical effectiveness and clinical outcomes research in leukemia and blood and marrow transplantation. He completed a fellowship in leukemia and blood and marrow transplant with the Manitoba Blood and Marrow Transplant Program and the University of Manitoba in 2017.
Assistant Professor and Hematologist at the University of Manitoba and CancerCare Manitoba
Dr. Menard has special interest in lymphoma, leukemia, and bone marrow transplantation. She completed her medical degree and post-graduate training in Internal Medicine and Hematology at the University of Manitoba, as well as a fellowship in Advanced Training in Hematologic Malignancies. Dr. Menard obtained a Master of Science in Healthcare Quality through Queens University and uses her knowledge in Quality Improvement to enhance care delivery and reduce diagnostic delays for patients with cancer in Manitoba. She provides clinical services within the Lymphoma, Leukemia, and Bone Marrow Transplant Disease Site Groups.
Assistant Professor and Hematologist at the University of Manitoba and CancerCare Manitoba
Dr. Brown serves as the course leader of the Blood and Immunology course for Undergraduate Medical Education at the Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba. His non-clinical interests include medical education, health leadership, and health economics.
Assistant Professor, Hematologist, and Clinician-Scientist at the University of Manitoba and CancerCare Manitoba
Dr. Rimmer is the medical director of the Therapeutic Apheresis program in Manitoba and is co-leading a Canada-wide pilot RCT of plasma exchange in septic shock (PLEXSIS trial).
Assistant Professor and Hematologist at the University of Manitoba and CancerCare Manitoba
Dr. Landego’s primary area of interest is immune therapies for lymphoproliferative disorders, including bispecific antibodies, checkpoint inhibitors, cellular therapeutics, and bone marrow transplantation. His research interests aim to increase our understanding of disease pathogenesis and aid in the development and approval of novel immunotherapeutic strategies for primary and relapsed/refractory disease.
Kingston Health Sciences Centre – Site Team
Assistant Professor and Hematologist at Queen’s University.
Bio coming soon!
Clinical Research Professional, Kingston Health Sciences Centre.
Bio coming soon!
Site: Kingston Health Sciences Centre
Assistant Professor and Hematologist at Queen’s University.
Bio coming soon!
Assistant Professor and Hematologist at Queen’s University
Dr. Lui’s chief academic interest is in medical education, and she has completed a Certificate of Health Professions Education program at the University of Illinois at Chicago. Passionate about clinical teaching, she was awarded the Queen’s University Internal Medicine Sub-specialty Teaching Award in 2016 and 2021.
Assistant Professor and Hematologist at Queen’s University
Bio coming soon!
Associate Professor and Hematologist/Oncologist at Queen’s University
Dr. Lee is a clinician and educator. His practice and teaching encompasses benign and malignant conditions across ambulatory and inpatient settings. He also lectures to undergraduate trainees in the classroom setting. His teaching has been recognized by the Dept. of Medicine Clinical Teaching Award and the Aesculapian Society Lectureship Award.
Assistant Professor and Hematologist at Queen’s University
Dr. Gauthier completed a fellowship in myeloproliferative neoplasms (MPNs) and leukemia at Princess Margaret Cancer Centre in Toronto. She also completed a masters in healthcare quality at Queen’s University. Her research and academic interests focus on frailty in patients with MPNs, novel mutations in patients with triple-negative MPNs, and quality improvement in oncology.
Hamilton Health Sciences – Site Team
Assistant Professor and Hematologist at McMaster University and Hamilton Health Sciences- Juravinski Cancer Centre
Dr. Radford is a hematologist specializing in the treatment of acute leukemia, myelodysplastic syndromes, and myeloid disorders at the Juravinski Hospital and Cancer Centre. He is also a specialist in Allogeneic Stem Cell Transplantation and Cellular Therapies, having completed a two-year fellowship at McMaster University in 2023. His clinical and research interests include: clinical trials in acute leukemia/myeloid disorders and transplantation, chimerism as a predictive and prognostic biomarker post allogeneic stem cell transplant.
Assistant Professor and Hematologist at McMaster University and Hamilton Health Sciences- Juravinski Cancer Centre
Dr. Dalmia has a clinical focus in acute leukemia, MPN, and MDS. His academic interests are based in quality improvement, health services research, and clinical trials.
Assistant Professor and Hematologist at McMaster University and Hamilton Health Sciences- Juravinski Cancer Centre
Dr. Garcia-Horton is a hematologist specializing in the treatment of acute leukemia, myelodysplastic neoplasms, and myeloid disorders at the Juravinski Hospital and Cancer Centre (JCC), Hamilton, ON, Canada. He is also a specialist in Allogeneic Stem Cell Transplantation. He is the Leukemia Site Lead at JCC. He is also the Survivorship Program Lead for the Transplant and Cellular Therapy Program at JCC. His clinical and research interests include clinical trials in acute leukemias/myeloid disorders and transplantation, prevention of post-transplant complications, and survivorship care in stem cell transplant recipients. He also focuses on trial design, retrospective studies, and systematic reviews.
Assistant Professor and Hematologist at McMaster University and Hamilton Health Sciences- Juravinski Cancer Centre
Dr. Aziz is a hematologist specializing in the treatment of malignant blood disorders with a focus on leukemia, cellular therapy and allogeneic stem cell transplantation at the Juravinski Hospital and Cancer Centre. Dr. Aziz’s research focus is in clinical trials and health services research in leukemia, cellular therapy and allogenic transplantation. His commitment to education to include the supervision of residents, clinical research fellows, and undergraduate medical students.
Assistant Professor and Hematologist at McMaster University and Hamilton Health Sciences- Juravinski Cancer Centre
Dr. Berg is the Director of the Translational Oncology Program with McMaster’s Centre for Discovery in Cancer Research, is Medical Director of the HHS Specimen Processing Facility at JHCC, and is the lead on the HHS/McMaster University Cancer Research Stem Cell Bank. Dr. Berg is also an Associate Member with the Department of Biochemistry and Biomedical Sciences, as well as with McMaster’s Medical Sciences Graduate Program. Dr. Berg holds the Marta and Owen Boris Foundation Chair in Leukemia and Hematopoietic Stem Cell Translational Research.
Queen Elizabeth II Health Science Centre – Site Team
Assistant Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Trottier is an assistant professor in the division of hematology. Thus far, she has established a local translational research program and a hereditary hematologic malignancy risk clinic, equipped with local clinical germline genetic testing capabilities for hereditary hematologic malignancy syndromes.
Assistant Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Shivakumar is a dedicated clinician-scientist. He has collaborated extensively with thrombosis specialists across Canada and plays a key leadership role as a board member of Thrombosis Canada. Dr. Shivakumar has significant experience in the design and execution of large, multicenter clinical trials in thrombosis, serving in roles such as steering committee member, local principal investigator, and member of data safety monitoring boards. This work has contributed to the successful recruitment of patients and the completion of high-impact randomized controlled trials in the field of Thrombosis.
Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. White’s research interest is the treatment of multiple myeloma. He is a member of the myeloma subcommittee of the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG), the Canadian Blood and Marrow Transplant Group (CBMTG), and the Scientific Advisory Board of Myeloma Canada.
Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Robinson is the local principal investigator for a number of trials related to chronic lymphocytic leukemia. She has also spearheaded studies involving people with bleeding and thrombotic disorders.
Associate Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Mary-Margaret Keating completed her hematology training at Dalhousie in 2011. Her clinical practice is focused on lymphoma and bleeding disorders. She, along with Dr. Forward and Dr. Murphy, leads the lymphoma clinical trials portfolio at the QEII. She also works in the bleeding disorders clinic and serves on the board of the Association of Hemophilia Clinic Directors of Canada.
Assistant Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Forward currently serves as Residency Program Director for Adult Hematology, and as the Clerkship Director for the Department of Medicine. His clinical interests include all types of malignant Hematology, with a special interest in lymphoma and lymphoproliferative disorders.
Associate Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Elsawy’s research interests are focused on the management of myeloid malignancies in older adults and on providing Immune Effector Cell Therapy (IEC) e.g., CAR T-cell therapy. Additionally, he has a special interest in making individualized treatment decisions guided by incorporating patients’ comorbidity assessment and studying patient reported outcomes (PROs) and quality of life. Dr. Elsawy is actively engaged in building local capacity in NS for point-of-care manufacturing of academic CAR T-cell products as part of a national effort.
Assistant Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Kelly is a hematologist at Dalhousie University and is the co-director of Thrombosis and Anticoagulation. Her clinical interests are in thrombosis, anticoagulation, and other hematological benign conditions, including iron deficiency anemia and hematological disorders in pregnancy.
Professor and Hematologist at Dalhousie University and Queen Elizabeth II Health Sciences Centre
Dr. Chen’s clinical and research interests are in rare inflammatory diseases including: cytokine storm syndromes (HLH, Castleman disease and COVID-cytokine storm), histiocyte disorders (Rosai-Dorfman-Destombes disease, Langerhans Cell histiocytosis, Erdheim-Chester disease), autoinflammatory diseases (VEXAS, Still’s), IgG4-related disease and eosinophilic disorders.
University of Alberta Hospital – Site Team
Assistant Professor and Hematologist at the University of Alberta Hospital
Dr. Zhu’s area of clinical interest is in myelodysplastic syndrome, and she has a busy MDS practice in Edmonton. She participates as a Local Primary Investigator for International Clinical Trials, and has also contributed to Canadian National MDS Management Guidelines and collaborative research within the Canadian MDS Consortium.
Professor, Hematologist and Clinician-Scientist at the University of Alberta Hospital
Dr. Brandwein’s clinical and research focus is on acute leukemias. He has been involved with numerous clinical studies in AML and ALL, and has published extensively in the field, with over 180 publications. He is a member of the Canadian Leukemia Study Group executive, CCTG Leukemia Site Lead, Leukemia Site Lead in the Alberta Provincial Hematology Tumour Group and Director of Adult Hematology Clinical Research at University of Alberta Hospital.