- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00002590
Combination Chemotherapy in Treating Children With Lymphoma
A Pilot Study For The Treatment of Newly-Diagnosed Disseminated Anaplastic Large Cell Ki-1 Lymphoma and T-Large Cell 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 combination chemotherapy in treating children who have lymphoma.
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
- Arzneimittel: Cyclophosphamid
- Arzneimittel: Leucovorin-Calcium
- Strahlung: Strahlentherapie
- Arzneimittel: Prednison
- Arzneimittel: Cytarabin
- Arzneimittel: Daunorubicinhydrochlorid
- Arzneimittel: Etoposid
- Arzneimittel: Methotrexat
- Arzneimittel: Vincristinsulfat
- Arzneimittel: Thioguanin
- Arzneimittel: Doxorubicinhydrochlorid
- Biologisch: Filgrastim
- Arzneimittel: Pegaspargase
Detaillierte Beschreibung
OBJECTIVES: I. Estimate the toxicity and feasibility of intensifying the New York I (NYI) regimen by adding etoposide and cytarabine, increasing the dose of methotrexate, using pegaspargase, and compressing the treatment duration (11 months) in previously untreated children with disseminated anaplastic (Ki-1 positive) large cell and large cell T-cell lymphoma. II. Provide preliminary data for a future phase III study that will compare this intensified regimen with the high-risk ALL regimen NYI in children with disseminated lymphoblastic lymphoma. III. Continue to investigate the immunophenotype, cytogenetics, and molecular biology of lymphoblastic lymphoma and their relationship to leukemia. IV. Obtain preliminary data on treatment of anaplastic large cell (Ki-1) and T-cell large cell lymphoma treated with intensive NYI.
OUTLINE: Patients with CNS disease at diagnosis receive craniospinal irradiation on Regimen A at the conclusion of Maintenance chemotherapy. The following acronyms are used: ARA-C Cytarabine, NSC-63878 CF Leucovorin calcium, NSC-3590 CTX Cyclophosphamide, NSC-26271 DNR Daunorubicin, NSC-82151 DOX Doxorubicin, NSC-123127 G-CSF Granulocyte Colony-Stimulating Factor (Amgen), NSC-614629 MTX Methotrexate, NSC-740 PEG-ASP Pegaspargase, NSC-624239 PRED Prednisone, NSC-10023 TG Thioguanine, NSC-752 VCR Vincristine, NSC-67574 VP-16 Etoposide, NSC-141540 Induction: 5-Drug Combination Systemic Chemotherapy with Hematopoietic Stimulation plus 2-Drug Combination Intrathecal Chemotherapy. VCR/PRED/CTX/DNR/PEG-ASP; with G-CSF; plus IT ARA-C/IT MTX. Consolidation: 7-Drug Combination Systemic Chemotherapy with Hematopoietic Stimulation plus Single-Agent Intrathecal Chemotherapy. VCR/PRED/PEG-ASP/VP-16/TG/ARA-C/MTX/CF; with G-CSF; plus IT MTX. Maintenance: Sequential Pulses of 2-, 3-, 3-, and 2-Drug Systemic Chemotherapy Combinations plus Single-Agent Intrathecal Chemotherapy. CTX/TG/IT MTX; VCR/PRED/DOX; VCR/MTX/CF/PEG-ASP; ARA-C/VP-16. Regimen A: Radiotherapy. Craniospinal irradiation using megavoltage equipment.
PROJECTED ACCRUAL: 40 patients will be entered over approximately 10 months. If 4 or more toxic deaths occur in the first 15 patients or 5 or more toxic deaths occur in the first 30 patients, accrual will stop. As of 05/96, asparaginase has been replaced with pegaspargase; 15-25 additional patients will be accrued. As of 01/97, a maximum of 35 patients will be accrued for PEG asparaginase-containing treatment regimen. As of 5/97, this study is open only to patients with anaplastic large cell and T cell large cell lymphoma. Approximately 60-90 patients will be accrued.
Studientyp
Einschreibung (Tatsächlich)
Phase
- Phase 2
Kontakte und Standorte
Studienorte
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Western Australia
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Perth, Western Australia, Australien, 6001
- Princess Margaret Hospital for Children
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British Columbia
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Vancouver, British Columbia, Kanada, V6H 3V4
- British Columbia Children's Hospital
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Nova Scotia
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Halifax, Nova Scotia, Kanada, B3J 3G9
- IWK Grace Health Centre
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California
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Long Beach, California, Vereinigte Staaten, 90806
- Long Beach Memorial Medical Center
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Los Angeles, California, Vereinigte Staaten, 90095-1781
- Jonsson Comprehensive Cancer Center, UCLA
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Los Angeles, California, Vereinigte Staaten, 90027-0700
- Children's Hospital Los Angeles
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Orange, California, Vereinigte Staaten, 92668
- Children's Hospital of Orange County
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San Francisco, California, Vereinigte Staaten, 94115-0128
- UCSF Cancer Center and Cancer Research Institute
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Colorado
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Denver, Colorado, Vereinigte Staaten, 80218
- Children's Hospital of Denver
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District of Columbia
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Washington, District of Columbia, Vereinigte Staaten, 20010-2970
- Children's National Medical Center
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Illinois
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Chicago, Illinois, Vereinigte Staaten, 60637
- University of Chicago Cancer Research Center
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Indiana
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Indianapolis, Indiana, Vereinigte Staaten, 46202-5265
- Indiana University Cancer Center
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Iowa
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Iowa City, Iowa, Vereinigte Staaten, 52242
- University of Iowa Hospitals and Clinics
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Michigan
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Ann Arbor, Michigan, Vereinigte Staaten, 48109-0752
- University Of Michigan Comprehensive Cancer Center
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Minnesota
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Rochester, Minnesota, Vereinigte Staaten, 55905
- Mayo Clinic Cancer Center
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Missouri
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Kansas City, Missouri, Vereinigte Staaten, 64108
- Children's Mercy Hospital
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Nebraska
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Omaha, Nebraska, Vereinigte Staaten, 68198-3330
- University of Nebraska Medical Center
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New Jersey
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Paterson, New Jersey, Vereinigte Staaten, 07503
- St. Joseph's Hospital and Medical Center
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New York
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New York, New York, Vereinigte Staaten, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Vereinigte Staaten, 10016
- NYU School of Medicine's Kaplan Comprehensive Cancer Center
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New York, New York, Vereinigte Staaten, 10032
- Herbert Irving Comprehensive Cancer Center
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North Carolina
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Chapel Hill, North Carolina, Vereinigte Staaten, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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Ohio
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Cincinnati, Ohio, Vereinigte Staaten, 45229-3039
- Children's Hospital Medical Center - Cincinnati
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Cleveland, Ohio, Vereinigte Staaten, 44106-5065
- Ireland Cancer Center
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Columbus, Ohio, Vereinigte Staaten, 43205-2696
- Children's Hospital of Columbus
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Oregon
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Portland, Oregon, Vereinigte Staaten, 97201-3098
- Doernbecher Children's Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, Vereinigte Staaten, 19104
- Children's Hospital of Philadelphia
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Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213
- Children's Hospital of Pittsburgh
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Tennessee
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Nashville, Tennessee, Vereinigte Staaten, 37232-6838
- Vanderbilt Cancer Center
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Texas
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Houston, Texas, Vereinigte Staaten, 77030-4009
- University of Texas - MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Vereinigte Staaten, 84132
- Huntsman Cancer Institute
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Washington
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Seattle, Washington, Vereinigte Staaten, 98105
- Children's Hospital and Regional Medical Center - Seattle
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Wisconsin
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Madison, Wisconsin, Vereinigte Staaten, 53792
- University of Wisconsin Comprehensive Cancer Center
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
DISEASE CHARACTERISTICS: Histologically confirmed and previously untreated anaplastic large cell Ki-1 lymphoma and T-cell large cell lymphoma Malignant lymphoblasts (identified by immunophenotype) in pleural fluid, ascitic fluid, or bone marrow sufficient for diagnosis Large cell lymphoma with T-cell phenotype eligible Localized mediastinal disease and bone lymphoma eligible CNS disease eligible and defined as: Any clearly identifiable tumor cells in cerebral spinal fluid Cranial nerve palsy (if not explained by extra cranial tumor) Clinical Spinal Cord Compression Isolated intra cerebral mass No cranial nerve palsies requiring immediate CNS irradiation
PATIENT CHARACTERISTICS: Age: Under 21 Performance status: Not specified Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Cardiovascular: Shortening fraction greater than 27% on echocardiogram (ECHO) OR Left ventricular ejection fraction greater than 47% on radionuclide scan (RCNA) OR Cardiac function assessed as within normal limits by cardiologist ECHO or RCNA obtained as close as clinically possible to start of therapy
PRIOR CONCURRENT THERAPY: No prior therapy except emergency treatment of airway obstruction or superior vena cava syndrome No more than 72 hours between emergency radiotherapy or steroids and initiation of protocol therapy
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
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Experimental: Schema A
Siehe ausführliche Beschreibung.
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
|---|---|
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Estimate toxicity and feasibility of 11 month multiagent chemotx
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Estimate the toxicity and feasibility of a short (11 month) aggressive multiagent chemotherapy regimen - Intensive NYI\NHL
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
|---|---|
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Provide preliminary data for a future phase III study
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Investigate the biology of lymphoblastic lymphoma
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To continue to investigate the biology of lymphoblastic lymphoma and its relationship to leukemia through the study of immunophenotyping, cytogenetics and molecular analysis.
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Obtain preliminary data on treatment of anaplastic large cell
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To obtain preliminary data on treatment of anaplastic large cell (Ki-1) and T-cell large cell lymphoma treated with intensive NYI.
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Mitarbeiter und Ermittler
Sponsor
Mitarbeiter
Ermittler
- Studienstuhl: Minnie Abromowitch, MD, Children's Hospital Medical Center, Cincinnati
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Lones MA, Perkins SL, Sposto R, Tedeschi N, Kadin ME, Kjeldsberg CR, Wilson JF, Zwick DL, Cairo MS. Non-Hodgkin's lymphoma arising in bone in children and adolescents is associated with an excellent outcome: a Children's Cancer Group report. J Clin Oncol. 2002 May 1;20(9):2293-301. doi: 10.1200/JCO.2002.06.017.
- Lowe EJ, Sposto R, Perkins SL, Gross TG, Finlay J, Zwick D, Abromowitch M; Children's Cancer Group Study 5941. Intensive chemotherapy for systemic anaplastic large cell lymphoma in children and adolescents: final results of Children's Cancer Group Study 5941. Pediatr Blood Cancer. 2009 Mar;52(3):335-9. doi: 10.1002/pbc.21817.
- Abromowitch M, Sposto R, Perkins S, Zwick D, Siegel S, Finlay J, Cairo MS; Children's Oncology Group. Shortened intensified multi-agent chemotherapy and non-cross resistant maintenance therapy for advanced lymphoblastic lymphoma in children and adolescents: report from the Children's Oncology Group. Br J Haematol. 2008 Oct;143(2):261-7. doi: 10.1111/j.1365-2141.2008.07320.x. Epub 2008 Aug 28.
- Abromowitch M, Sposto R, Perkins S, et al.: Outcome of Children's Cancer Group (CCG) 5941: a pilot study for the treatment of newly diagnosed pediatric patients with disseminated lymphoblastic lymphoma. [Abstract] Proceedings of the American Society of Clinical Oncology 19: A2295, 2000.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Erkrankungen des Immunsystems
- Neubildungen nach histologischem Typ
- Neubildungen
- Lymphoproliferative Erkrankungen
- Lymphatische Erkrankungen
- Immunproliferative Erkrankungen
- Lymphom
- Physiologische Wirkungen von Arzneimitteln
- Molekulare Mechanismen der pharmakologischen Wirkung
- Antiinfektiva
- Antivirale Mittel
- Inhibitoren der Nukleinsäuresynthese
- Enzym-Inhibitoren
- Entzündungshemmende Mittel
- Antirheumatika
- Antimetaboliten, antineoplastisch
- Antimetaboliten
- Antineoplastische Mittel
- Immunsuppressive Mittel
- Immunologische Faktoren
- Tubulin-Modulatoren
- Antimitotische Mittel
- Mitose-Modulatoren
- Glukokortikoide
- Hormone
- Hormone, Hormonersatzstoffe und Hormonantagonisten
- Antineoplastische Mittel, hormonell
- Schutzmittel
- Antineoplastische Mittel, alkylierend
- Alkylierungsmittel
- Myeloablative Agonisten
- Antineoplastische Mittel, Phytogen
- Topoisomerase-II-Inhibitoren
- Topoisomerase-Inhibitoren
- Dermatologische Wirkstoffe
- Mikronährstoffe
- Antibiotika, antineoplastische
- Vitamine
- Reproduktionskontrollmittel
- Gegenmittel
- Vitamin B-Komplex
- Abtreibungsmittel, nichtsteroidal
- Abtreibungsmittel
- Folsäure-Antagonisten
- Cyclophosphamid
- Etoposid
- Leucovorin
- Levoleucovorin
- Prednison
- Doxorubicin
- Liposomales Doxorubicin
- Cytarabin
- Methotrexat
- Vincristin
- Daunorubicin
- Asparaginase
- Thioguanin
- Pegaspargase
Andere Studien-ID-Nummern
- 5941
- CCG-5941 (Andere Kennung: Children's Cancer Group)
- CDR0000063751 (Andere Kennung: NCI)
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