Intensification Therapy of Mature B-ALL, Burkitt and Burkitt Like and Other High Grade Non-Hodgkin's Lymphoma in Adults

September 14, 2009 updated by: University of Bologna

All patients are treated according to the same therapy regimen. Therapy duration (number of cycles) and radiotherapy vary according to age group, stage and response. Chemotherapy consists of a pre-phase-treatment (for all patients) and varying A, B and C cycles. Therapy for Patients in the 18-55 Age Group

  • Patients in stages III-IV and all patients with mediastinal tumors or extranodal involvement are administered 6 cycles (A1, B1, A2, B2, A3, B3).
  • Chemotherapy is stopped after 4 cycles (A1, B1, A2, B2) for patients with stage I/ II if a clear CR has been achieved and there is initially no mediastinal or extranodal involvement.
  • In cases of refractory or progressive disease after 4 cycles, study therapy is stopped. These patients are to be given salvage therapy with subsequent stem cell transplantation. Therapy for Patients older than 55 years
  • The course corresponds to that of patients in the younger age group, but the regimen is dose reduced (A1*, B1*,A2*, B2*, A3*, B3*). Antibody therapy with anti-CD20 is to be administered on day 1 of each chemotherapy cycle (A, B). After end of chemotherapy (6 or 4 cycles) 2 more cycles of anti-CD 20 are to be administered to reach a total number of 8 resp. 6 cycles antibody therapy.

Study Overview

Status

Unknown

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

25

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Bologna, Italy
        • Recruiting
        • Institute of Haematology "L. e A. Seragnoli"

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Acute lymphoblastic leukemia of the mature B-cell type (L3-ALL)
  • High-grade non-Hodgkin's lymphoma of the following subtypes (WHO classification)

    • Burkitt's lymphoma (including atypical Burkitt's lymphoma)
    • Precursor B-lymphoblastic lymphoma
    • Anaplastic large-cell lymphoma (Ki1+, B-, T- oder Null-cell-type)
    • Mediastinal large B-cell-lymphoma (subtype of diffuse large B-cell lymphoma)
  • Age = 18 years
  • Patient's Informed Consent

Exclusion Criteria:

  • Serious complications caused by leukemia/ lymphoma or by a second illness: e.g.

    • Severe, unmanageable complications such as sepsis, pneumonia with oxygen deficiency,
    • Shock, hemorrhage at the time of diagnosis
    • Renal insufficiency from leukemia/lymphoma-unrelated causes
    • Severe cardiac or hepatic insufficiency
    • Severe obstructive or restrictive lung disease that would compromise patient's treatment with intensified chemotherapy
    • HIV infection
    • Secondary lymphoma following prior chemotherapy/ radiotherapy or an active second malignancy
    • Known severe allergy to foreign proteins
  • Cytostatic pretreatment for B-ALL/lymphoma (exceptions: short-term administration of steroids = 7 days, single administration of vincristine or cyclophosphamide, one cycle of CHOP, a single administration in an emergency of other cytostatic agents) for another malignant disease within the last 5 years
  • Pregnancy/ nursing period
  • Severe psychiatric illness or other circumstances giving ground to the assumption that a patient cannot give his consent to therapy or act co-operatively
  • Absence of patient's informed consent
  • Participation in another clinical study that would possibly interfere with study therapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: therapy
Other Names:
  • Cyclophosphamide, Prednisone, Dexamethasone, Vincristine, Ifosfamide, Cytarabine, Adriamycin, G-CSF

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Test of the tolerability and efficacy of new therapy elements to improve remission
Rates, overall survival and remission duration
Administration of anti-CD20 (rituximab ®) together with combination chemotherapy
Combination therapy with high-dose methotrexate and high-dose cytarabine together with conventional cytostatic agents (cycle C)
Prophylactic administration of G-CSF after every cycle of chemotherapy
Localised irradiation after 6 cycles in mediastinal tumor cases, CNS involvement and residual tumor

Secondary Outcome Measures

Outcome Measure
Test of the age-adapted therapy stratification according to biological age
(18< age <55)
Definition of prognostic factors
Setting up of a central reference pathology panel

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Giovanni Martinelli, MD, Institute of Haematology "L.e A. Seragnoli" Bologne-Italy

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2006

Study Registration Dates

First Submitted

November 24, 2008

First Submitted That Met QC Criteria

November 24, 2008

First Posted (Estimate)

November 25, 2008

Study Record Updates

Last Update Posted (Estimate)

September 15, 2009

Last Update Submitted That Met QC Criteria

September 14, 2009

Last Verified

September 1, 2009

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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