- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT00075725
Dexamethasone Compared With Prednisone During Induction Therapy and Methotrexate With or Without Leucovorin During Maintenance Therapy in Treating Patients With Newly Diagnosed High-Risk Acute Lymphoblastic Leukemia
High Risk B-Precursor Acute Lymphoblastic Leukemia (ALL)
Přehled studie
Postavení
Podmínky
Detailní popis
OBJECTIVES:
I. Improve the outcome of children with high-risk acute lymphoblastic leukemia treated with 2 different chemotherapy regimens.
II. Determine the relative safety and efficacy of dexamethasone given for 14 days vs prednisone given for 28 days during induction.
III. Determine the relative safety and efficacy of high-dose methotrexate (5gm/m^2) with leucovorin rescue compared to escalating methotrexate without leucovorin rescue (Capizzi I) during interim maintenance I.
IV. Correlate Day 29 minimal residual disease (MRD) with event-free survival (EFS) and overall survival (OS).
V. Correlate early marrow response status with day-29 MRD status. VI. Improve outcome by identifying additional high risk patients by Day 29 MRD for treatment with fully augmented Berlin-Frankfurt-Munster (BFM).
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to early response (slow early response [SER] vs rapid early response [RER]). Induction therapy: Patients are randomized to 1 of 4 treatment arms.
ARM I: Patients receive cytarabine intrathecally (IT) on day 1, vincristine intravenously (IV) and daunorubicin IV on days 1, 8, 15, and 22, dexamethasone orally (PO) or IV twice daily (BID) on days 1-14, methotrexate (MTX) IT on days 8 and 29* and pegaspargase intramuscularly (IM) once on day 4, 5, or 6.
NOTE: *Patients with CNS3 disease (WBC > 5/mL in cerebrospinal fluid and positive for blasts on cytospin) also receive MTX IT on days 15 and 22.
ARM II: Patients receive induction therapy as in Arm I.
ARM III: Patients receive cytarabine, vincristine, daunorubicin, and pegaspargase as in Arm I. Patients also receive prednisone PO or IV BID on days 1-28 and MTX IT on days 8 and 29.
ARM IV: Patients receive induction therapy as in Arm III.
Patients in all arms are evaluated at day 29 of induction therapy. Patients with M3 disease are removed from study. Patients with M1 disease and less than 1% minimal residual disease (MRD) proceed to consolidation therapy beginning on day 36. Patients with M2 disease OR with MI disease and at least 1% MRD receive extended induction therapy for 2 additional weeks. Patients with SER disease and MLL rearrangements are removed from the study but may be eligible for treatment on protocol COG-AALL0031.
Extended induction therapy: Patients continue to receive therapy on the arm to which they were originally randomized.
ARMS I and II: Patients receive dexamethasone PO or IV BID on days 1-14, vincristine IV on days 1 and 8, daunorubicin IV on day 1 and pegaspargase IM on day 4, 5, or 6 and are then reevaluated.
ARMS III and IV: Patients receive prednisone PO or IV BID on days 1-14, and vincristine, daunorubicin, and pegaspargase as in Arms I and II and are then reevaluated.
Patients on all arms who have M1 disease and less than 1% MRD after extended induction proceed to consolidation therapy and continue as SER patients. All other patients are removed from study.
Consolidation therapy: All patients receive cyclophosphamide IV over 30 minutes on days 1 and 29, cytarabine IV or subcutaneously (SC) on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine (MP) PO on days 1-14 and 29-42, vincristine IV on days 15, 22, 43, and 50; pegaspargase IM on days 15 and 43 and MTX* IT on days 1, 8, 15, and 22. Patients with testicular disease also receive radiotherapy to the testes.
NOTE: *Patients with CNS3 disease receive MTX on days 1 and 8 only.
Interim maintenance therapy I: Patients continue to receive treatment on the arm to which they were originally randomized.
ARM I: (escalating-dose MTX) Patients receive vincristine IV and escalating-dose MTX IV on days 1, 11, 21, 31, and 41, pegaspargase IM on days 2 and 22 and MTX IT on days 1 and 21.
ARM II: (high-dose MTX) Patients receive vincristine IV and high-dose methotrexate IV over 24 hours on days 1, 15, 29, and 43, MP PO on days 1-56 and IT MTX on days 1 and 29. Patients also receive leucovorin calcium IV every 6 hours for at least 3 doses, beginning 42 hours after start of each MTX infusion.
ARM III: (escalating-dose MTX) Patients receive interim maintenance I therapy as in Arm I.
ARM IV: (high-dose MTX) Patients receive interim maintenance I therapy as in Arm II.
DELAYED INTENSIFICATION THERAPY I: All patients receive vincristine IV on days 1, 8, 15, 43, and 50, dexamethasone PO or IV BID on days 1 to 21 for patients age 1 to 12 OR on days 1-7 and 15-21 for patients age 13 and over, doxorubicin IV on days 1, 8, and 15, pegaspargase IM on day 4, 5, or 6 AND day 43, cyclophosphamide IV over 30 minutes on day 29, cytarabine IV or SC on days 30-33 and 37-40, thioguanine PO on days 29-42 and MTX IT on days 1, 29, and 36.After delayed intensification I, SER patients proceed to interim maintenance II and delayed intensification II. RER patients proceed directly to maintenance.
INTERIM MAINTENANCE THERAPY II: All patients receive vincristine IV and MTX IV on days 1, 11, 21, 31, and 41, pegaspargase IM on days 2 and 22; and MTX IT on days 1 and 21. Patients then proceed to delayed intensification II.
DELAYED INTENSIFICATION THERAPY II: All patients receive therapy as in delayed intensification I, arm I. CNS3 patients also receive radiotherapy for 3-10 days, beginning on day 29. All other SER patients, patients with MLL rearrangements, and some patients pretreated with steroids (> 48 hours within the week prior to diagnosis) receive prophylactic cranial radiotherapy (CRT) for 8 days, beginning on day 29. Patients then proceed to maintenance therapy.
MAINTENANCE THERAPY: All patients receive vincristine IV on days 1, 29, and 57, dexamethasone PO BID on days 1-5, 29-33, and 57-61, MP PO on days 1-84, MTX IT on day 1*; and MTX PO on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64, 71, and 78.
NOTE: *RER (who did not undergo CRT) patients also receive MTX IT on day 29 for maintenance courses 1-4.
In all arms, maintenance therapy repeats every 12 weeks until total duration of therapy is 2 years from the start of interim maintenance I for female patients and 3 years from the start of interim maintenance I for male patients. Patients with testicular disease may receive testicular radiotherapy for 8 days during one of the first 3 courses of maintenance therapy. Patients are followed monthly for 1 year, every 2 months for 1 year, every 3 months for 1 year, every 6 months for 1 year, and then annually thereafter.
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 3
Kontakty a umístění
Studijní místa
-
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Queensland
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Herston, Queensland, Austrálie, 4029
- Royal Brisbane and Women's Hospital
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Herston, Queensland, Austrálie, 4029
- Royal Children's Hospital-Brisbane
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South Australia
-
North Adelaide, South Australia, Austrálie, 5006
- Women's and Children's Hospital-Adelaide
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Victoria
-
Parkville, Victoria, Austrálie, 3052
- Royal Children's Hospital
-
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Western Australia
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Perth, Western Australia, Austrálie, 6008
- Princess Margaret Hospital for Children
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-
-
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Alberta
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Calgary, Alberta, Kanada, T3B 6A8
- Alberta Children's Hospital
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Edmonton, Alberta, Kanada, T6G 2B7
- University of Alberta Hospital
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British Columbia
-
Vancouver, British Columbia, Kanada, V6H 3V4
- British Columbia Children's Hospital
-
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Manitoba
-
Winnipeg, Manitoba, Kanada, R3E 0V9
- CancerCare Manitoba
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Newfoundland and Labrador
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Saint John's, Newfoundland and Labrador, Kanada, A1B 3V6
- Janeway Child Health Centre
-
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Nova Scotia
-
Halifax, Nova Scotia, Kanada, B3K 6R8
- IWK Health Centre
-
-
Ontario
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Kingston, Ontario, Kanada, K7L 2V7
- Kingston Health Sciences Centre
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London, Ontario, Kanada, N6A 5W9
- Children's Hospital
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London, Ontario, Kanada, N6K 1C2
- Victoria Hospital
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Ottawa, Ontario, Kanada, K1H 8L1
- Children'S Hospital Of Eastern Ontario
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Toronto, Ontario, Kanada, M5G 1X8
- Hospital for Sick Children
-
-
Quebec
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Montreal, Quebec, Kanada, H3H 1P3
- The Montreal Children's Hospital of the MUHC
-
Sherbrooke, Quebec, Kanada, J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
-
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Saskatchewan
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Regina, Saskatchewan, Kanada, S4T 7T1
- Allan Blair Cancer Centre
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Saskatoon, Saskatchewan, Kanada, S7N 4H4
- Saskatoon Cancer Centre
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-
-
-
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Christchurch, Nový Zéland, 8011
- Christchurch Hospital
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Wellington, Nový Zéland, 6002
- Wellington Children's Hospital
-
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Auckland
-
Grafton, Auckland, Nový Zéland, 1145
- Starship Children's Hospital
-
-
-
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Alabama
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Birmingham, Alabama, Spojené státy, 35233
- University of Alabama at Birmingham Cancer Center
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Birmingham, Alabama, Spojené státy, 35233
- Children's Hospital of Alabama
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Mobile, Alabama, Spojené státy, 36604
- USA Health Strada Patient Care Center
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Arizona
-
Mesa, Arizona, Spojené státy, 85202
- Banner Children's at Desert
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Phoenix, Arizona, Spojené státy, 85016
- Phoenix Childrens Hospital
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Tucson, Arizona, Spojené státy, 85719
- Banner University Medical Center - Tucson
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Arkansas
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Little Rock, Arkansas, Spojené státy, 72205
- University of Arkansas for Medical Sciences
-
Little Rock, Arkansas, Spojené státy, 72202-3591
- Arkansas Children's Hospital
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California
-
Downey, California, Spojené státy, 90242
- Kaiser Permanente Downey Medical Center
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Duarte, California, Spojené státy, 91010
- City of Hope Comprehensive Cancer Center
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Loma Linda, California, Spojené státy, 92354
- Loma Linda University Medical Center
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Long Beach, California, Spojené státy, 90806
- Miller Children's and Women's Hospital Long Beach
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Los Angeles, California, Spojené státy, 90027
- Children's Hospital Los Angeles
-
Los Angeles, California, Spojené státy, 90095
- UCLA / Jonsson Comprehensive Cancer Center
-
Los Angeles, California, Spojené státy, 90048
- Cedars Sinai Medical Center
-
Los Angeles, California, Spojené státy, 90095
- Mattel Children's Hospital UCLA
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Madera, California, Spojené státy, 93636
- Valley Children's Hospital
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Oakland, California, Spojené státy, 94609
- UCSF Benioff Children's Hospital Oakland
-
Oakland, California, Spojené státy, 94611
- Kaiser Permanente-Oakland
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Orange, California, Spojené státy, 92868
- Children's Hospital of Orange County
-
Palo Alto, California, Spojené státy, 94304
- Lucile Packard Children's Hospital Stanford University
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Sacramento, California, Spojené státy, 95816
- Sutter Medical Center Sacramento
-
Sacramento, California, Spojené státy, 95817
- University of California Davis Comprehensive Cancer Center
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San Diego, California, Spojené státy, 92123
- Rady Children's Hospital - San Diego
-
San Francisco, California, Spojené státy, 94143
- UCSF Medical Center-Parnassus
-
Santa Barbara, California, Spojené státy, 93102
- Santa Barbara Cottage Hospital
-
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Colorado
-
Aurora, Colorado, Spojené státy, 80045
- Children's Hospital Colorado
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Denver, Colorado, Spojené státy, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
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Denver, Colorado, Spojené státy, 80218
- Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
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Connecticut
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Farmington, Connecticut, Spojené státy, 06030
- University of Connecticut
-
Hartford, Connecticut, Spojené státy, 06106
- Connecticut Children's Medical Center
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New Haven, Connecticut, Spojené státy, 06520
- Yale University
-
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Delaware
-
Wilmington, Delaware, Spojené státy, 19803
- Alfred I duPont Hospital for Children
-
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District of Columbia
-
Washington, District of Columbia, Spojené státy, 20010
- Children's National Medical Center
-
Washington, District of Columbia, Spojené státy, 20007
- MedStar Georgetown University Hospital
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Florida
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Fort Lauderdale, Florida, Spojené státy, 33316
- Broward Health Medical Center
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Fort Myers, Florida, Spojené státy, 33908
- Golisano Children's Hospital of Southwest Florida
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Fort Myers, Florida, Spojené státy, 33901
- Lee Memorial Health System
-
Gainesville, Florida, Spojené státy, 32610
- University of Florida Health Science Center - Gainesville
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Hollywood, Florida, Spojené státy, 33021
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
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Jacksonville, Florida, Spojené státy, 32207
- Nemours Children's Clinic-Jacksonville
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Miami, Florida, Spojené státy, 33155
- Nicklaus Children's Hospital
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Miami, Florida, Spojené státy, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Spojené státy, 33176
- Miami Cancer Institute
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Orlando, Florida, Spojené státy, 32806
- Orlando Health Cancer Institute
-
Orlando, Florida, Spojené státy, 32806
- Nemours Children's Clinic - Orlando
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Orlando, Florida, Spojené státy, 32827
- Nemours Children's Hospital
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Orlando, Florida, Spojené státy, 32803
- AdventHealth Orlando
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Pensacola, Florida, Spojené státy, 32504
- Sacred Heart Hospital
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Pensacola, Florida, Spojené státy, 32504
- Nemours Children's Clinic - Pensacola
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Saint Petersburg, Florida, Spojené státy, 33701
- Johns Hopkins All Children's Hospital
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Tampa, Florida, Spojené státy, 33607
- Saint Joseph's Hospital/Children's Hospital-Tampa
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West Palm Beach, Florida, Spojené státy, 33407
- Saint Mary's Hospital
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Georgia
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Atlanta, Georgia, Spojené státy, 30322
- Emory University Hospital/Winship Cancer Institute
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Atlanta, Georgia, Spojené státy, 30322
- Children's Healthcare of Atlanta - Egleston
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Augusta, Georgia, Spojené státy, 30912
- Augusta University Medical Center
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Savannah, Georgia, Spojené státy, 31404
- Memorial Health University Medical Center
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Hawaii
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Honolulu, Hawaii, Spojené státy, 96813
- University of Hawaii Cancer Center
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Honolulu, Hawaii, Spojené státy, 96859
- Tripler Army Medical Center
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Idaho
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Boise, Idaho, Spojené státy, 83712
- Saint Luke's Cancer Institute - Boise
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Illinois
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Chicago, Illinois, Spojené státy, 60612
- Rush University Medical Center
-
Chicago, Illinois, Spojené státy, 60637
- University of Chicago Comprehensive Cancer Center
-
Chicago, Illinois, Spojené státy, 60612
- University of Illinois
-
Chicago, Illinois, Spojené státy, 60611
- Lurie Children's Hospital-Chicago
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Maywood, Illinois, Spojené státy, 60153
- Loyola University Medical Center
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Oak Lawn, Illinois, Spojené státy, 60453
- Advocate Children's Hospital-Oak Lawn
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Park Ridge, Illinois, Spojené státy, 60068
- Advocate Lutheran General Hospital
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Springfield, Illinois, Spojené státy, 62702
- Southern Illinois University School of Medicine
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Indiana
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Indianapolis, Indiana, Spojené státy, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Indianapolis, Indiana, Spojené státy, 46202
- Riley Hospital for Children
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Indianapolis, Indiana, Spojené státy, 46260
- Saint Vincent Hospital and Health Care Center
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Iowa
-
Des Moines, Iowa, Spojené státy, 50309
- Blank Children's Hospital
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Iowa City, Iowa, Spojené státy, 52242
- University of Iowa/Holden Comprehensive Cancer Center
-
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Kansas
-
Kansas City, Kansas, Spojené státy, 66160
- University of Kansas Cancer Center
-
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Kentucky
-
Lexington, Kentucky, Spojené státy, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Spojené státy, 40202
- Norton Children's Hospital
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Louisiana
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New Orleans, Louisiana, Spojené státy, 70112
- Tulane University Health Sciences Center
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New Orleans, Louisiana, Spojené státy, 70118
- Children's Hospital New Orleans
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Maine
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Bangor, Maine, Spojené státy, 04401
- Eastern Maine Medical Center
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Scarborough, Maine, Spojené státy, 04074
- Maine Children's Cancer Program
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Maryland
-
Baltimore, Maryland, Spojené státy, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
-
Baltimore, Maryland, Spojené státy, 21215
- Sinai Hospital of Baltimore
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Baltimore, Maryland, Spojené státy, 21201
- University of Maryland/Greenebaum Cancer Center
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Bethesda, Maryland, Spojené státy, 20889-5600
- Walter Reed National Military Medical Center
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Massachusetts
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Boston, Massachusetts, Spojené státy, 02114
- Massachusetts General Hospital Cancer Center
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Boston, Massachusetts, Spojené státy, 02111
- Tufts Children's Hospital
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Springfield, Massachusetts, Spojené státy, 01199
- Baystate Medical Center
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Worcester, Massachusetts, Spojené státy, 01655
- UMass Memorial Medical Center - University Campus
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Michigan
-
Ann Arbor, Michigan, Spojené státy, 48109
- C S Mott Children's Hospital
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Detroit, Michigan, Spojené státy, 48201
- Wayne State University/Karmanos Cancer Institute
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Detroit, Michigan, Spojené státy, 48236
- Ascension Saint John Hospital
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East Lansing, Michigan, Spojené státy, 48824-7016
- Michigan State University Clinical Center
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Flint, Michigan, Spojené státy, 48503
- Hurley Medical Center
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Grand Rapids, Michigan, Spojené státy, 49503
- Spectrum Health at Butterworth Campus
-
Grand Rapids, Michigan, Spojené státy, 49503
- Helen DeVos Children's Hospital at Spectrum Health
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Kalamazoo, Michigan, Spojené státy, 49007
- Bronson Methodist Hospital
-
Kalamazoo, Michigan, Spojené státy, 49008
- Kalamazoo Center for Medical Studies
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Royal Oak, Michigan, Spojené státy, 48073
- William Beaumont Hospital-Royal Oak
-
Royal Oak, Michigan, Spojené státy, 48073
- Beaumont Children's Hospital-Royal Oak
-
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Minnesota
-
Minneapolis, Minnesota, Spojené státy, 55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
-
Minneapolis, Minnesota, Spojené státy, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Spojené státy, 55905
- Mayo Clinic in Rochester
-
Saint Paul, Minnesota, Spojené státy, 55102
- Children's Hospital and Clinic-Saint Paul
-
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Mississippi
-
Jackson, Mississippi, Spojené státy, 39216
- University of Mississippi Medical Center
-
-
Missouri
-
Columbia, Missouri, Spojené státy, 65201
- Columbia Regional
-
Columbia, Missouri, Spojené státy, 65212
- University of Missouri - Ellis Fischel
-
Kansas City, Missouri, Spojené státy, 64108
- Children's Mercy Hospitals and Clinics
-
Saint Louis, Missouri, Spojené státy, 63110
- Washington University School of Medicine
-
Saint Louis, Missouri, Spojené státy, 63104
- Cardinal Glennon Children's Medical Center
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Nebraska
-
Omaha, Nebraska, Spojené státy, 68198
- University Of Nebraska Medical Center
-
Omaha, Nebraska, Spojené státy, 68114
- Children's Hospital and Medical Center of Omaha
-
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Nevada
-
Las Vegas, Nevada, Spojené státy, 89169
- Nevada Cancer Research Foundation NCORP
-
-
New Hampshire
-
Lebanon, New Hampshire, Spojené státy, 03756
- Dartmouth Hitchcock Medical Center
-
-
New Jersey
-
Hackensack, New Jersey, Spojené státy, 07601
- Hackensack University Medical Center
-
Livingston, New Jersey, Spojené státy, 07039
- Saint Barnabas Medical Center
-
Morristown, New Jersey, Spojené státy, 07960
- Morristown Medical Center
-
New Brunswick, New Jersey, Spojené státy, 08901
- Saint Peter's University Hospital
-
New Brunswick, New Jersey, Spojené státy, 08903
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
-
Newark, New Jersey, Spojené státy, 07112
- Newark Beth Israel Medical Center
-
Paterson, New Jersey, Spojené státy, 07503
- Saint Joseph's Regional Medical Center
-
Summit, New Jersey, Spojené státy, 07902
- Overlook Hospital
-
-
New Mexico
-
Albuquerque, New Mexico, Spojené státy, 87102
- University of New Mexico Cancer Center
-
-
New York
-
Albany, New York, Spojené státy, 12208
- Albany Medical Center
-
Bronx, New York, Spojené státy, 10467
- Montefiore Medical Center - Moses Campus
-
Brooklyn, New York, Spojené státy, 11219
- Maimonides Medical Center
-
Brooklyn, New York, Spojené státy, 11201
- Brooklyn Hospital Center
-
Brooklyn, New York, Spojené státy, 11212
- Brookdale Hospital Medical Center
-
Buffalo, New York, Spojené státy, 14263
- Roswell Park Cancer Institute
-
Mineola, New York, Spojené státy, 11501
- NYU Winthrop Hospital
-
New Hyde Park, New York, Spojené státy, 11040
- The Steven and Alexandra Cohen Children's Medical Center of New York
-
New York, New York, Spojené státy, 10029
- Mount Sinai Hospital
-
New York, New York, Spojené státy, 10065
- NYP/Weill Cornell Medical Center
-
New York, New York, Spojené státy, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Stony Brook, New York, Spojené státy, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Spojené státy, 13210
- State University of New York Upstate Medical University
-
Valhalla, New York, Spojené státy, 10595
- New York Medical College
-
-
North Carolina
-
Asheville, North Carolina, Spojené státy, 28801
- Mission Hospital
-
Chapel Hill, North Carolina, Spojené státy, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte, North Carolina, Spojené státy, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Spojené státy, 28204
- Novant Health Presbyterian Medical Center
-
Durham, North Carolina, Spojené státy, 27710
- Duke University Medical Center
-
Greenville, North Carolina, Spojené státy, 27834
- East Carolina University
-
Winston-Salem, North Carolina, Spojené státy, 27157
- Wake Forest University Health Sciences
-
-
North Dakota
-
Fargo, North Dakota, Spojené státy, 58122
- Sanford Broadway Medical Center
-
-
Ohio
-
Akron, Ohio, Spojené státy, 44308
- Children's Hospital Medical Center of Akron
-
Cincinnati, Ohio, Spojené státy, 45229
- Cincinnati Children's Hospital Medical Center
-
Cleveland, Ohio, Spojené státy, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, Spojené státy, 44106
- Rainbow Babies and Childrens Hospital
-
Columbus, Ohio, Spojené státy, 43205
- Nationwide Children's Hospital
-
Dayton, Ohio, Spojené státy, 45404
- Dayton Children's Hospital
-
Toledo, Ohio, Spojené státy, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Toledo, Ohio, Spojené státy, 43614
- University of Toledo
-
Toledo, Ohio, Spojené státy, 43608
- Mercy Children's Hospital
-
Youngstown, Ohio, Spojené státy, 44501
- Tod Children's Hospital - Forum Health
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Spojené státy, 73104
- University of Oklahoma Health Sciences Center
-
Tulsa, Oklahoma, Spojené státy, 74136
- Natalie Warren Bryant Cancer Center at Saint Francis
-
-
Oregon
-
Portland, Oregon, Spojené státy, 97239
- Oregon Health and Science University
-
Portland, Oregon, Spojené státy, 97227
- Legacy Emanuel Children's Hospital
-
Portland, Oregon, Spojené státy, 97227
- Legacy Emanuel Hospital and Health Center
-
-
Pennsylvania
-
Bethlehem, Pennsylvania, Spojené státy, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Danville, Pennsylvania, Spojené státy, 17822
- Geisinger Medical Center
-
Hershey, Pennsylvania, Spojené státy, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Hershey, Pennsylvania, Spojené státy, 17033
- Penn State Children's Hospital
-
Philadelphia, Pennsylvania, Spojené státy, 19104
- Children's Hospital of Philadelphia
-
Philadelphia, Pennsylvania, Spojené státy, 19134
- Saint Christopher's Hospital for Children
-
Philadelphia, Pennsylvania, Spojené státy, 19104
- Children's Oncology Group
-
Pittsburgh, Pennsylvania, Spojené státy, 15224
- Children's Hospital of Pittsburgh of UPMC
-
-
Rhode Island
-
Providence, Rhode Island, Spojené státy, 02903
- Rhode Island Hospital
-
-
South Carolina
-
Charleston, South Carolina, Spojené státy, 29425
- Medical University of South Carolina
-
Columbia, South Carolina, Spojené státy, 29203
- Prisma Health Richland Hospital
-
Greenville, South Carolina, Spojené státy, 29605
- BI-LO Charities Children's Cancer Center
-
Greenville, South Carolina, Spojené státy, 29605
- Greenville Cancer Treatment Center
-
-
South Dakota
-
Sioux Falls, South Dakota, Spojené státy, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
-
Tennessee
-
Chattanooga, Tennessee, Spojené státy, 37403
- T C Thompson Children's Hospital
-
Knoxville, Tennessee, Spojené státy, 37916
- East Tennessee Childrens Hospital
-
Nashville, Tennessee, Spojené státy, 37232
- Vanderbilt University/Ingram Cancer Center
-
-
Texas
-
Amarillo, Texas, Spojené státy, 79106
- Texas Tech University Health Sciences Center-Amarillo
-
Austin, Texas, Spojené státy, 78723
- Dell Children's Medical Center of Central Texas
-
Corpus Christi, Texas, Spojené státy, 78411
- Driscoll Children's Hospital
-
Dallas, Texas, Spojené státy, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Spojené státy, 75230
- Medical City Dallas Hospital
-
Fort Worth, Texas, Spojené státy, 76104
- Cook Children's Medical Center
-
Galveston, Texas, Spojené státy, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Spojené státy, 77030
- M D Anderson Cancer Center
-
Houston, Texas, Spojené státy, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Lubbock, Texas, Spojené státy, 79410
- Covenant Children's Hospital
-
San Antonio, Texas, Spojené státy, 78229
- University of Texas Health Science Center at San Antonio
-
San Antonio, Texas, Spojené státy, 78229
- Methodist Children's Hospital of South Texas
-
Temple, Texas, Spojené státy, 76508
- Scott and White Memorial Hospital
-
-
Utah
-
Salt Lake City, Utah, Spojené státy, 84113
- Primary Children's Hospital
-
-
Vermont
-
Burlington, Vermont, Spojené státy, 05405
- University of Vermont and State Agricultural College
-
-
Virginia
-
Charlottesville, Virginia, Spojené státy, 22908
- University of Virginia Cancer Center
-
Falls Church, Virginia, Spojené státy, 22042
- Inova Fairfax Hospital
-
Norfolk, Virginia, Spojené státy, 23507
- Children's Hospital of The King's Daughters
-
Portsmouth, Virginia, Spojené státy, 23708-2197
- Naval Medical Center - Portsmouth
-
Richmond, Virginia, Spojené státy, 23298
- Virginia Commonwealth University/Massey Cancer Center
-
Roanoke, Virginia, Spojené státy, 24014
- Carilion Children's
-
-
Washington
-
Seattle, Washington, Spojené státy, 98105
- Seattle Children's Hospital
-
Spokane, Washington, Spojené státy, 99204
- Providence Sacred Heart Medical Center and Children's Hospital
-
Tacoma, Washington, Spojené státy, 98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma, Washington, Spojené státy, 98431
- Madigan Army Medical Center
-
-
West Virginia
-
Charleston, West Virginia, Spojené státy, 25304
- West Virginia University Charleston Division
-
Morgantown, West Virginia, Spojené státy, 26506
- West Virginia University Healthcare
-
-
Wisconsin
-
Green Bay, Wisconsin, Spojené státy, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
La Crosse, Wisconsin, Spojené státy, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Spojené státy, 53792
- University of Wisconsin Hospital and Clinics
-
Marshfield, Wisconsin, Spojené státy, 54449
- Marshfield Medical Center-Marshfield
-
Milwaukee, Wisconsin, Spojené státy, 53226
- Children's Hospital of Wisconsin
-
-
-
-
-
Bern, Švýcarsko, 3010
- Swiss Pediatric Oncology Group - Bern
-
Geneva, Švýcarsko, 1205
- Swiss Pediatric Oncology Group - Geneva
-
Lausanne, Švýcarsko, 1011
- Swiss Pediatric Oncology Group - Lausanne
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Must be eligible for and enrolled on classification study COG-AALL03B1
Newly diagnosed B-precursor acute lymphoblastic leukemia
- WBC > 50,000/mm^3 for patients age 1 to 9
- Any WBC for patients age 10 to 30 OR patients who have received prior steroid therapy OR patients with testicular disease
Whit blood cell (WBC) criteria:
- Age 1 - 9 years: WBC >= 50,000/uL
- Age 10 - 30 years: any WBC
- Prior steroid therapy: any WBC
- Testicular disease: any WBC
- Patients shall have had no other prior cytotoxic chemotherapy with the exception of steroids and intrathecal cytarabine
- Patients receiving prior steroid therapy (as described in AALL03B1) are eligible for study; the dose and duration of previous steroid therapy should be carefully documented
- All patients and/or their parents or legal guardians must sign a written informed consent
- All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met
Exclusion Criteria:
- Patients with Down syndrome are ineligible to enroll onto this study
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Přiřazení jedné skupiny
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Aktivní komparátor: Arm I
Patients in arm I receive intrathecal cytarabine in week 1; infusions of vincristine and daunorubicin once a week in weeks 1-4; dexamethasone by mouth or infusion twice a day in weeks 1 and 2; intrathecal methotrexate in weeks 2 and 5 or 2-5; and an injection of pegaspargase in week 1.
|
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Podstoupit radiační terapii
Ostatní jména:
Vzhledem k IM
Ostatní jména:
Vzhledem k IT nebo IV
Ostatní jména:
Given IT, SC, or IV
Ostatní jména:
|
|
Aktivní komparátor: Arm II
Patients in arm II will receive intrathecal cytarabine in week 1; infusions of vincristine and daunorubicin once a week in weeks 1-4; dexamethasone by mouth or infusion twice a day in weeks 1 and 2; intrathecal methotrexate in weeks 2 and 5 or 2-5; and an injection of pegaspargase in week 1.
|
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Podstoupit radiační terapii
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k IM
Ostatní jména:
Vzhledem k IT nebo IV
Ostatní jména:
Given IT, SC, or IV
Ostatní jména:
|
|
Experimentální: Arm III
Patients in arm III will receive cytarabine, vincristine, daunorubicin, and pegaspargase as in groups one and two. They will also receive prednisone by mouth or infusion twice a day in weeks 1-4 and intrathecal methotrexate in weeks 2 and 5. Some patients in all groups may receive induction therapy for 2 additional weeks. Beginning in week 6 or 7, patients may receive combination chemotherapy by infusion, injection, intrathecally, and by mouth for up to 8 weeks. |
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Podstoupit radiační terapii
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k IM
Ostatní jména:
Vzhledem k IT nebo IV
Ostatní jména:
Given IT, SC, or IV
Ostatní jména:
|
|
Experimentální: Arm IV
Patients in arm IV will receive cytarabine, vincristine, daunorubicin, and pegaspargase as in groups one and two. They will also receive prednisone by mouth or infusion twice a day in weeks 1-4 and intrathecal methotrexate in weeks 2 and 5. Some patients in all groups may receive induction therapy for 2 additional weeks. Beginning in week 6 or 7, patients may receive combination chemotherapy by infusion, injection, intrathecally, and by mouth for up to 8 weeks. |
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k PO
Ostatní jména:
Podstoupit radiační terapii
Ostatní jména:
Daný PO nebo IV
Ostatní jména:
Vzhledem k tomu, IV
Ostatní jména:
Vzhledem k IM
Ostatní jména:
Vzhledem k IT nebo IV
Ostatní jména:
Given IT, SC, or IV
Ostatní jména:
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Comparison of the Increase in Cure Rate of High Risk ALL Without Causing More Serious Side Effects Between Interventions
Časové okno: 5 years
|
Event Free Probability.
|
5 years
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Correlation of Minimal Residual Disease (MRD) Positive With Overall Survival (OS)
Časové okno: 5 Years
|
Bone marrow MRD status is defined as positive with >= 0.1 detectable leukemia cells, and negative with < 0.1 detectable leukemia cells.
|
5 Years
|
|
Correlation of Minimal Residual Disease (MRD) Negative With Overall Survival (OS).
Časové okno: 5 years
|
Bone marrow MRD status is defined as negative with < .01
detectable leukemia cells.
|
5 years
|
|
Correlation of Early Marrow Response Status With MRD Positive.
Časové okno: Day 29
|
Bone marrow status is defined as: M1: < 5% lymphoblasts; M2: 5-25% lymphoblasts; M3: > 25% lymphoblasts.
Bone marrow MRD status is defined as positive with >= 0.1 detectable leukemia cells, and negative with < 0.1 detectable leukemia cells.
|
Day 29
|
|
Correlation of Early Marrow Response Status With MRD Negative.
Časové okno: Day 29
|
Bone marrow status is defined as: M1: < 5% lymphoblasts; M2: 5-25% lymphoblasts; M3: > 25% lymphoblasts.
Bone marrow MRD status is defined as positive with >= 0.1 detectable leukemia cells, and negative with < 0.1 detectable leukemia cells.
|
Day 29
|
|
Correlation of Minimal Residual Disease (MRD) Positive With Event Free Survival (EFS)
Časové okno: 5 years
|
Bone marrow MRD status is defined as positive with >= 0.1 detectable leukemia cells.
|
5 years
|
|
Correlation of Minimal Residual Disease (MRD) Negative With Event Free Survival (EFS).
Časové okno: 5 years
|
Bone marrow MRD status is defined as negative with < 0.1 detectable leukemia cells.
|
5 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Vrchní vyšetřovatel: Eric C Larsen, Children's Oncology Group
Publikace a užitečné odkazy
Obecné publikace
- Fernandez CA, Smith C, Yang W, Date M, Bashford D, Larsen E, Bowman WP, Liu C, Ramsey LB, Chang T, Turner V, Loh ML, Raetz EA, Winick NJ, Hunger SP, Carroll WL, Onengut-Gumuscu S, Chen WM, Concannon P, Rich SS, Scheet P, Jeha S, Pui CH, Evans WE, Devidas M, Relling MV. HLA-DRB1*07:01 is associated with a higher risk of asparaginase allergies. Blood. 2014 Aug 21;124(8):1266-76. doi: 10.1182/blood-2014-03-563742. Epub 2014 Jun 26.
- Advani AS, Larsen E, Laumann K, Luger SM, Liedtke M, Devidas M, Chen Z, Yin J, Foster MC, Claxton D, Coffan K, Tallman MS, Appelbaum FR, Erba H, Stone RM, Hunger SP, McNeer JL, Loh ML, Raetz E, Winick N, Carroll W, Larson RA, Stock W. Comparison of CALGB 10403 (Alliance) and COG AALL0232 toxicity results in young adults with acute lymphoblastic leukemia. Blood Adv. 2021 Jan 26;5(2):504-512. doi: 10.1182/bloodadvances.2020002439.
- Wood B, Wu D, Crossley B, Dai Y, Williamson D, Gawad C, Borowitz MJ, Devidas M, Maloney KW, Larsen E, Winick N, Raetz E, Carroll WL, Hunger SP, Loh ML, Robins H, Kirsch I. Measurable residual disease detection by high-throughput sequencing improves risk stratification for pediatric B-ALL. Blood. 2018 Mar 22;131(12):1350-1359. doi: 10.1182/blood-2017-09-806521. Epub 2017 Dec 28.
- Karol SE, Mattano LA Jr, Yang W, Maloney KW, Smith C, Liu C, Ramsey LB, Fernandez CA, Chang TY, Neale G, Cheng C, Mardis E, Fulton R, Scheet P, San Lucas FA, Larsen EC, Loh ML, Raetz EA, Hunger SP, Devidas M, Relling MV. Genetic risk factors for the development of osteonecrosis in children under age 10 treated for acute lymphoblastic leukemia. Blood. 2016 Feb 4;127(5):558-64. doi: 10.1182/blood-2015-10-673848. Epub 2015 Nov 20.
- Karol SE, Yang W, Van Driest SL, Chang TY, Kaste S, Bowton E, Basford M, Bastarache L, Roden DM, Denny JC, Larsen E, Winick N, Carroll WL, Cheng C, Pei D, Fernandez CA, Liu C, Smith C, Loh ML, Raetz EA, Hunger SP, Scheet P, Jeha S, Pui CH, Evans WE, Devidas M, Mattano LA Jr, Relling MV. Genetics of glucocorticoid-associated osteonecrosis in children with acute lymphoblastic leukemia. Blood. 2015 Oct 8;126(15):1770-6. doi: 10.1182/blood-2015-05-643601. Epub 2015 Aug 11.
- Borowitz MJ, Wood BL, Devidas M, Loh ML, Raetz EA, Salzer WL, Nachman JB, Carroll AJ, Heerema NA, Gastier-Foster JM, Willman CL, Dai Y, Winick NJ, Hunger SP, Carroll WL, Larsen E. Prognostic significance of minimal residual disease in high risk B-ALL: a report from Children's Oncology Group study AALL0232. Blood. 2015 Aug 20;126(8):964-71. doi: 10.1182/blood-2015-03-633685. Epub 2015 Jun 29.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Další relevantní podmínky MeSH
- Onemocnění imunitního systému
- Novotvary podle histologického typu
- Novotvary
- Lymfoproliferativní poruchy
- Lymfatická onemocnění
- Imunoproliferativní poruchy
- Leukémie
- Lymfoblastická leukémie-lymfom prekurzorových buněk
- Leukémie, lymfoidní
- Fyziologické účinky léků
- Molekulární mechanismy farmakologického působení
- Antiinfekční látky
- Autonomní agenti
- Agenti periferního nervového systému
- Antivirová činidla
- Inhibitory syntézy nukleových kyselin
- Inhibitory enzymů
- Protizánětlivé látky
- Antirevmatika
- Antimetabolity, Antineoplastika
- Antimetabolity
- Antineoplastická činidla
- Imunosupresivní látky
- Imunologické faktory
- Tubulinové modulátory
- Antimitotické látky
- Modulátory mitózy
- Antiemetika
- Gastrointestinální látky
- Glukokortikoidy
- Hormony
- Hormony, hormonální náhražky a antagonisté hormonů
- Antineoplastická činidla, Hormonální
- Inhibitory proteázy
- Ochranné prostředky
- Antineoplastická činidla, Alkylační
- Alkylační činidla
- Myeloablativní agonisté
- Antineoplastické látky, fytogenní
- Inhibitory topoizomerázy II
- Inhibitory topoizomerázy
- Dermatologická činidla
- Mikroživiny
- Antibiotika, antineoplastika
- Vitamíny
- Činidla pro zachování hustoty kostí
- Hormony a látky regulující vápník
- Činidla pro kontrolu reprodukce
- Protijedy
- Vitamín B komplex
- Hematinika
- Abortivní látky, nesteroidní
- Abortivní látky
- Antagonisté kyseliny listové
- Dexamethason
- Dexamethason acetát
- BB 1101
- Cyklofosfamid
- Leukovorin
- Vápník
- Levoleukovorin
- Prednison
- Doxorubicin
- Lipozomální doxorubicin
- Cytarabin
- Methotrexát
- Vinkristine
- Daunorubicin
- Asparagináza
- Merkaptopurin
- Kyselina listová
- Vápník, dietní
- Kortizon
- Thioguanin
- Pegaspargase
- 2-Aminopurin
Další identifikační čísla studie
- AALL0232 (Jiný identifikátor: CTEP)
- U10CA098543 (Grant/smlouva NIH USA)
- 11723 (DAIDS ES Registry Number)
- NCI-2009-00301 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
- COG-AALL0232
- CDR0000349182
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .