- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT00018954
Chemotherapy in Treating Patients With Acute Lymphoblastic Leukemia and Diffuse Non-Hodgkin's Lymphoma
PILOT MULTINATIONAL PROTOCOLS IN ACUTE LYMPHOBLASTIC LEUKEMIA AND DIFFUSE NON-HODGKIN'S LYMPHOMA
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Combining more than one drug may kill more tumor cells.
PURPOSE: Phase II trial to study the effectiveness of two treatment regimens for patients in developing countries with diffuse non-Hodgkin's lymphoma and acute lymphoblastic leukemia.
Studieoversigt
Status
Intervention / Behandling
- Medicin: cyclophosphamid
- Stråling: strålebehandling
- Medicin: prednison
- Medicin: asparaginase
- Medicin: cytarabin
- Medicin: daunorubicin hydrochlorid
- Medicin: etoposid
- Medicin: methotrexat
- Medicin: vincristinsulfat
- Medicin: mercaptopurin
- Medicin: doxorubicin hydrochlorid
- Procedure: konventionel kirurgi
- Medicin: ifosfamid
Detaljeret beskrivelse
OBJECTIVES:
- Provide a standard protocol for specific therapy that is relatively easy to administer and relatively inexpensive but conforms to modern treatment principles, and determine whether such therapy can be administered safely and effectively in patients with acute lymphoblastic lymphoma or diffuse non-Hodgkin's lymphoma who live in developing countries.
- Determine the rates of relapse and survival in patients treated with these protocols, and relate this data to disease subtype and clinical presentation in order to obtain a database on which to build future stratagems.
OUTLINE: This is a multicenter study.
Patients with acute lymphoblastic leukemia or lymphoblastic lymphoma with any degree of bone marrow involvement are assigned to Protocol MCP-841. Patients with mediastinal or localized lymphoblastic lymphoma (a single nodal or extranodal site) without bone marrow involvement, or other types of diffuse non-Hodgkin's lymphoma with or without bone marrow involvement are assigned to Protocol MCP-842.
Protocol MCP-841:
- First induction therapy: Patients receive daunorubicin (DNR) IV on days 8, 15, and 29; vincristine (VCR) IV on days 1, 8, 15, 22, and 29; asparaginase (ASP) intramuscularly (IM) every other day on days 2-20; oral prednisone (PRED) on days 1-28; and methotrexate (MTX) intrathecally (IT) on days 1, 8, 15, and 22. Second induction therapy: Patients receive oral mercaptopurine (MP) on days 1-7 and 15-21; cyclophosphamide (CTX) IV over 30 minutes on days 1 and 15; MTX IT as in first induction therapy; and cranial irradiation on days 4-14.
- Alternative to second induction (if a cranial irradiation facility is unavailable): Patients receive MP and CTX as in second induction therapy; cytarabine (ARA-C) IV every 12 hours on days 1, 2, 15, 16, 29, and 30; and MTX IT on days 8 and 22.
Patients with low-risk disease (WBC no greater than 10,000/mm3, age 3 to 6 years, no prominent lymphadenopathy (less than 3 cm in diameter in each nodal region), normal CSF, no mediastinal mass, no enlargement of liver or spleen, and no cranial nerve palsies) proceed directly to maintenance therapy. All other patients are considered high risk, and they repeat first induction therapy and then proceed to consolidation therapy.
- Consolidation therapy: Patients receive MP and CTX as in second induction therapy, VCR IV on days 1 and 15, and ARA-C subcutaneously (SC) every 12 hours on days 1-3 and 15-17.
- Maintenance therapy: Patients receive VCR IV on day 1; DNR IV on day 1; oral PRED on days 1-7; ASP IM on days 1, 3, 5, and 7; and oral MTX once weekly and oral MP daily on days 15-35, 43-63, and 71-91. Maintenance therapy continues for a total of 6 courses.
Protocol MCP-842:
- Patients undergo surgical resection of intra-abdominal masses, if feasible. Patients with low-risk disease (completely resected tumor or a single extra-abdominal site of involvement (other than the mediastinum), but without lymphoblastic lymphoma) are assigned to treatment group 2. All other patients, including those with lymphoblastic lymphoma without bone marrow involvement, are considered high risk and they are assigned to treatment group 1.
- Group 1 (high risk): Patients receive one course of regimen A comprising CTX IV over 15 minutes on days 1-4; VCR IV on days 1, 8, and 15; doxorubicin (DOX) IV on days 1 and 2; ARA-C IV over 3 hours every 12 hours on day 1; ARA-C IT on day 4; and MTX IT on days 8 and 12. Patients then receive one course of regimen B comprising ifosfamide IV over 30 minutes on days 1-5, etoposide IV over 1 hour and MTX IV on days 1-3, VCR IV on day 8, ARA-C IT on days 1 and 4, and MTX IT as in regimen A. Patients then receive a second course of regimen A, followed by a second course of regimen B.
- Group 2 (low risk): Patients receive one course of regimen A, followed by one course of regimen B, and then a second course of regimen A. DOX is withheld during both courses of regimen A. IT therapy is withheld during the second course of regimen A.
Patients are followed every 2 months for 1 year (Protocol MCP-841) or at 1, 2, 3, 4, 6, and 8 months (Protocol MCP-842), every 6 months for 5 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 4,000 patients will be accrued for this study.
Undersøgelsestype
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
-
-
-
Cairo, Egypten
- National Cancer Institute of Egypt
-
-
-
-
Maryland
-
Bethesda, Maryland, Forenede Stater, 20892-1182
- Warren Grant Magnuson Clinical Center - NCI Clinical Studies Support
-
-
-
-
-
Bangalore, Indien, 560029
- Kidwai Memorial Institute of Oncology
-
Madras, Indien, 600020
- Cancer Institute (W.I.A.)
-
Mumbai, Indien, 400012
- Tata Memorial Centre
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
DISEASE CHARACTERISTICS:
Newly diagnosed acute lymphoblastic leukemia (ALL)
Lymphoblasts comprising more than 25% of nucleated cells on bone marrow aspirate
- Associated with an appropriate clinical syndrome
- OR
- Histologically proven newly diagnosed diffuse non-Hodgkin's lymphoma (NHL)
- Immunologic and/or cytochemical confirmation of diagnosis preferred
PATIENT CHARACTERISTICS:
Age:
ALL:
- Under 25
NHL:
- Not specified
Performance status:
- Not specified
Life expectancy:
- Not specified
Hematopoietic:
- Not specified
Hepatic:
- Not specified
Renal:
- Not specified
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- Not specified
Endocrine therapy
- Not specified
Radiotherapy
- Not specified
Surgery
- Not specified
Other
- No prior therapy for ALL or NHL
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
Samarbejdspartnere og efterforskere
Samarbejdspartnere
Efterforskere
- Studiestol: Ian Trevor Magrath, MD, FRCP, FRCPath, National Cancer Institute (NCI)
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
- stadium III voksent diffust storcellet lymfom
- stadium III voksen immunoblastisk storcellet lymfom
- stadium III voksen Burkitt lymfom
- stadium IV voksent diffust storcellet lymfom
- stadium IV voksen immunoblastisk storcellet lymfom
- stadium IV voksen Burkitt lymfom
- stadium III barndoms små ikke-spaltede celle lymfom
- stadium IV barndom små non-cleaved cell lymfom
- stadium IV storcellet lymfom i barndommen
- ubehandlet akut lymfatisk leukæmi hos børn
- stadium III voksent diffust små spaltet celle lymfom
- stadium III voksent diffust blandet celle lymfom
- stadium IV voksent diffust små spaltet celle lymfom
- stadium IV voksent diffust blandet celle lymfom
- stadium III mantelcellelymfom
- stadium IV mantelcellelymfom
- stadium I voksent diffust små spaltet celle lymfom
- sammenhængende stadium II voksent diffust små spaltet celle lymfom
- ikke-sammenhængende stadium II voksent diffust små spaltet celle lymfom
- ikke-sammenhængende trin II lille lymfocytisk lymfom
- noncontiguous stadium II marginal zone lymfom
- stadium I marginal zone lymfom
- stadium I lille lymfatisk lymfom
- stadium III lille lymfatisk lymfom
- stadium III marginal zone lymfom
- stadium IV lille lymfocytisk lymfom
- stadium IV marginal zone lymfom
- sammenhængende stadium II marginal zone lymfom
- sammenhængende fase II lille lymfocytisk lymfom
- ekstranodal marginal zone B-celle lymfom af slimhinde-associeret lymfoid væv
- nodal marginal zone B-celle lymfom
- milt marginal zone lymfom
- stadium III voksen lymfoblastisk lymfom
- stadium IV voksen lymfoblastisk lymfom
- stadium I barndom storcellet lymfom
- stadium II storcellet lymfom i barndommen
- stadium III barndoms storcellet lymfom
- stadium I barndoms lymfoblastisk lymfom
- stadium II barndoms lymfoblastisk lymfom
- stadium III barndoms lymfoblastisk lymfom
- stadium IV barndoms lymfoblastisk lymfom
- stadium I barndom små non-cleaved cell lymfom
- stadium II barndom små ikke-spaltede celle lymfom
- sammenhængende fase II mantelcellelymfom
- ikke-sammenhængende stadium II mantelcellelymfom
- ikke-sammenhængende stadium II voksent diffust storcellet lymfom
- ikke-sammenhængende stadium II voksent diffust blandet celle lymfom
- ikke-sammenhængende stadium II voksen lymfoblastisk lymfom
- ikke-sammenhængende stadium II voksen Burkitt lymfom
- ikke-sammenhængende stadium II voksent immunoblastisk storcellet lymfom
- stadium I mantelcellelymfom
- stadium I voksen Burkitt lymfom
- sammenhængende stadium II voksen Burkitt lymfom
- sammenhængende stadium II voksent immunoblastisk storcellet lymfom
- stadium I voksen immunoblastisk storcellet lymfom
- ubehandlet akut lymfatisk leukæmi hos voksne
- sammenhængende stadium II voksent diffust storcellet lymfom
- sammenhængende stadium II voksent diffust blandet celle lymfom
- stadium I voksent diffust storcellet lymfom
- stadium I voksent diffust blandet celle lymfom
- sammenhængende stadium II voksen lymfoblastisk lymfom
- stadium I voksen lymfoblastisk lymfom
Yderligere relevante MeSH-vilkår
- Sygdomme i immunsystemet
- Neoplasmer efter histologisk type
- Neoplasmer
- Lymfoproliferative lidelser
- Lymfesygdomme
- Immunproliferative lidelser
- Lymfom
- Leukæmi
- Lymfom, Non-Hodgkin
- Precursorcelle lymfoblastisk leukæmi-lymfom
- Leukæmi, lymfoid
- Lægemidlers fysiologiske virkninger
- Molekylære mekanismer for farmakologisk virkning
- Anti-infektionsmidler
- Antivirale midler
- Nukleinsyresyntesehæmmere
- Enzymhæmmere
- Anti-inflammatoriske midler
- Antirheumatiske midler
- Antimetabolitter, Antineoplastisk
- Antimetabolitter
- Antineoplastiske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Tubulin modulatorer
- Antimitotiske midler
- Mitose modulatorer
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Antineoplastiske midler, hormonelle
- Antineoplastiske midler, Alkylering
- Alkyleringsmidler
- Myeloablative agonister
- Antineoplastiske midler, fytogene
- Topoisomerase II-hæmmere
- Topoisomerasehæmmere
- Dermatologiske midler
- Antibiotika, antineoplastisk
- Reproduktive kontrolmidler
- Abortfremkaldende midler, ikke-steroide
- Aborterende midler
- Folinsyreantagonister
- Cyclofosfamid
- Etoposid
- Ifosfamid
- Prednison
- Doxorubicin
- Liposomal doxorubicin
- Cytarabin
- Methotrexat
- Vincristine
- Daunorubicin
- Asparaginase
- Mercaptopurin
Andre undersøgelses-id-numre
- CDR0000077227
- NCI-92-C-0030
- NCI-T91-0259N
- OH92-C-0030
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med cyclophosphamid
-
Children's Hospital Los AngelesLucile Packard Children's HospitalAfsluttetMetaboliske sygdomme | Stamcelletransplantation | Kronisk granulomatøs sygdom | Knoglemarvstransplantation | Thalassæmi | Wiskott-Aldrich syndrom | Genetiske sygdomme | Perifer blodstamcelletransplantation | Pædiatri | Diamond-Blackfan Anæmi | Allogen Transplantation | Kombineret immundefekt | X-bundet lymfoproliferativ...
-
Medical College of WisconsinNational Cancer Institute (NCI); National Heart, Lung, and Blood Institute... og andre samarbejdspartnereAfsluttetAnæmi, aplastiskForenede Stater
-
Centre Oscar LambretAfsluttet
-
Institut BergoniéMerck Sharp & Dohme LLC; National Cancer Institute, France; Transgene; Fondation...RekrutteringBrystkræft | Blødt væv sarkom | Faste tumorerFrankrig
-
Columbia UniversityUkendtAlvorlig kombineret immundefekt | Fanconi Anæmi | Knoglemarvssvigt | OsteopetroseForenede Stater
-
Shandong Cancer Hospital and InstituteUkendt
-
Mahidol UniversityAfsluttetNyreinsufficiens | InfektionThailand
-
National Cancer Institute, NaplesImmatics Biotechnologies GmbH; CureVac; European Commission -FP7-Health-2013-Innovation-1AfsluttetHepatocellulært karcinomBelgien, Tyskland, Italien, Spanien, Det Forenede Kongerige
-
Tao OUYANGAfsluttet
-
University of Turin, ItalyUkendt