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Combination Chemotherapy and Radiation Therapy in Treating Patients With Acute Lymphoblastic Leukemia That Has Relapsed in the CNS or Testes

14. Februar 2017 aktualisiert von: Children's Oncology Group

Treatment of Late Isolated Extramedullary Relapse From Acute Lymphoblastic Leukemia (ALL) (Initial CR1≥ 18 Months)

RATIONALE: Drugs used in chemotherapy work in different ways to stop cancer cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage cancer cells. Giving combination chemotherapy together with radiation therapy may kill more cancer cells.

PURPOSE: This clinical trial is studying how well giving chemotherapy together with radiation therapy works in treating patients with acute lymphoblastic leukemia that has relapsed in the CNS and/or testes.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

OBJECTIVES:

Primary

  • Determine the efficacy of intensified systemic chemotherapy with reduced-dose CNS radiotherapy in patients with acute lymphoblastic leukemia and late isolated CNS relapse.
  • Determine the efficacy of intensive systemic chemotherapy without testicular radiotherapy in patients with acute lymphoblastic leukemia and late isolated testicular relapse.
  • Determine the toxicity of these regimens in these patients.

Secondary

  • Determine whether bone marrow involvement is present at the time of extramedullary relapse in patients treated with these regimens.
  • Correlate pretreatment minimal residual disease with outcomes in patients treated with these regimens.
  • Correlate the role of host gene polymorphisms with toxicity of these regimens and incidence and outcome in these patients.
  • Determine the neuropsychological sequelae associated with isolated CNS relapse and these treatment regimens in these patients.

OUTLINE: This is a pilot, multicenter study. All patients receive common induction, consolidation, re-induction, and intensification chemotherapy. Patients are stratified to maintenance therapy according to site of extramedullary relapse (CNS vs testicular).

  • Induction therapy (weeks 1-4): Patients receive vincristine IV on days 1, 8, 15, and 22; oral dexamethasone twice daily on days 1-28; daunorubicin* IV over 15 minutes on days 1, 8, and 15; and intrathecal triple therapy** (ITT) comprising methotrexate, hydrocortisone, and cytarabine on days 1, 8, 15, and 22.

NOTE: *The total dose of anthracyclines on this study is capped at 450 mg/m2. Once this dose is reached, all subsequent doses of daunorubicin are omitted.

NOTE: **Patients with isolated testicular relapse receive ITT on day 1 only.

In addition to the above, patients with isolated testicular relapse also receive high-dose methotrexate IV continuously over 24 hours on day -14. Patients with clinical signs of disease at the end of induction undergo testicular biopsy.

Patients with CNS disease who do not achieve CNS remission after induction therapy receive additional ITT as above on days 29 and 36.

  • Consolidation therapy (weeks 5-10): Patients receive high-dose cytarabine IV over 3 hours twice daily on days 1-2 and 22-23 and pegaspargase intramuscularly (IM) on days 2 and 23. Patients also receive filgrastim (G-CSF) subcutaneously (SC) beginning on days 3 and 24 and continuing until blood counts recover.

Patients with isolated testicular relapse with positive biopsy results at the end of induction undergo testicular radiotherapy once daily for a total of 12 fractions during consolidation therapy.

  • Intensification I (weeks 11-22): Patients receive high-dose methotrexate with leucovorin calcium rescue IV over 24 hours on days 1, 22, 43, and 64 and oral mercaptopurine once daily on days 2-6, 23-27, 44-48, and 65-69. Patients also receive etoposide IV over 1 hour and cyclophosphamide IV over 15-30 minutes on days 8, 29, 50, and 71. Patients receive ITT* on days 15, 36, 57, and 78.

NOTE: *Patients with isolated testicular relapse receive ITT on days 36 and 78 only.

  • Reinduction therapy (weeks 23-26): Patients receive vincristine IV on days 1, 8, 15, and 22; oral dexamethasone twice daily on days 1-7 and 15-21, and daunorubicin IV over 15 minutes on days 1, 8, and 15.
  • Intensification II (weeks 27-50): Patients receive high-dose cytarabine IV over 3 hours twice daily on days 1-2, 43-44, 85-86, and 127-128; pegaspargase IM on days 2, 44, 86, and 128; ITT* on days 22, 64, 106, and 148; high-dose methotrexate IV continuously over 24 hours on days 29, 71, 113, and 155; oral mercaptopurine on days 30-34, 72-76, 114-118, and 156-160; and etoposide IV over 1 hour and cyclophosphamide IV over 15-30 minutes on days 36, 78, 120, and 162. Patients also receive G-CSF SC beginning on days 3, 45, 87, and 129 and continuing until blood counts recover.

NOTE: *Patients with isolated testicular relapse receive ITT on days 22 and 106 only.

  • Chemotherapy and radiotherapy (weeks 51-54): Patients receive oral dexamethasone twice daily on days 1-7 and 15-21, vincristine IV on days 1, 8, and 15, and pegaspargase IM on days 1 and 15.

Patients with isolated CNS relapse also undergo cranial radiotherapy once daily, 5 days a week, for a total of 12 fractions.

  • Maintenance therapy for isolated CNS relapse: (weeks 55-104): Patients receive dexamethasone PO orIV twice daily on days 1-5; oral mercaptopurine once daily on days 1-42; methotrexate IM on days 1, 8, 15, 22, 29, and 36; and vincristine IV and cyclophosphamide IV over 1 hour on days 43, 50, 57, and 64. Treatment repeats every 10 weeks for 5 courses.

  • Maintenance therapy for isolated testicular relapse:

    • (Weeks 55-74): Patients receive ITT on day 1 and dexamethasone, mercaptopurine, methotrexate, vincristine, and cyclophosphamide as in maintenance therapy for isolated CNS relapse. Treatment repeats every 10 weeks for 2 courses.
    • (Weeks 75-106): Patients receive vincristine IV on day 1; dexamethasone orally or IV on days 1-5; oral mercaptopurine on days 1-28; and methotrexate IM on days 1, 8, 15, and 22. Treatment repeats every 28 days for 8 courses. Patients also receive ITT on day 1 every 12 weeks for 3 doses.

Patients with combined testicular and CNS relapse receive high-dose methotrexate IV continuously over 24 hours on day -14 in addition to the same chemotherapy and radiotherapy administered during the induction, consolidation, intensification I, reinduction, intensification II, and maintenance phases of therapy as isolated CNS relapse patients.

All patients undergo neuropsychological assessment within 3 months after completion of induction therapy (before cranial radiotherapy) and at 2 years after completion of treatment.

Patients are followed for survival.

Studientyp

Interventionell

Einschreibung (Tatsächlich)

168

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Australien
    • Western Australia
      • Perth, Western Australia, Australien, 6001
        • Princess Margaret Hospital for Children
  • Kanada
      • Quebec, Kanada, G1V 4G2
        • Centre Hospitalier Universitaire de Quebec
    • Alberta
      • Edmonton, Alberta, Kanada, T6G 1Z2
        • University of Alberta Hospital
    • British Columbia
      • Vancouver, British Columbia, Kanada, V6H 3V4
        • Children's & Women's Hospital of British Columbia
    • Manitoba
      • Winnipeg, Manitoba, Kanada, R3E 0V9
        • CancerCare Manitoba
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Kanada, A1B 3V6
        • Janeway Children's Health and Rehabilitation Centre
    • Nova Scotia
      • Halifax, Nova Scotia, Kanada, B3J 3G9
        • IWK Health Centre
    • Ontario
      • Hamilton, Ontario, Kanada, L8N 3Z5
        • McMaster Children's Hospital at Hamilton Health Sciences
      • Kingston, Ontario, Kanada, K7L 2V7
        • Cancer Centre of Southeastern Ontario At Kingston General Hospital
      • Ottawa, Ontario, Kanada, K1H 8L1
        • Children's Hospital of Eastern Ontario
    • Quebec
      • Montreal, Quebec, Kanada, H3T 1C5
        • Hopital Sainte Justine
    • Saskatchewan
      • Regina, Saskatchewan, Kanada, S4T 7T1
        • Allan Blair Cancer Centre at Pasqua Hospital
      • Saskatoon, Saskatchewan, Kanada, S7N 4H4
        • Saskatoon Cancer Centre at the University of Saskatchewan
  • Neuseeland
      • Auckland, Neuseeland, 1
        • Starship Children's Health
      • Christchurch, Neuseeland, 8140
        • Christchurch Hospital
  • Schweiz
      • Bern, Schweiz, 3010
        • Swiss Pediatric Oncology Group Bern
      • Geneva, Schweiz, 1205
        • Swiss Pediatric Oncology Group Geneva
      • Lausanne, Schweiz, 1011
        • Swiss Pediatric Oncology Group Lausanne
  • Vereinigte Staaten
    • Alabama
      • Birmingham, Alabama, Vereinigte Staaten, 35294
        • UAB Comprehensive Cancer Center
    • Arizona
      • Phoenix, Arizona, Vereinigte Staaten, 85016-7710
        • Phoenix Children's Hospital
      • Tucson, Arizona, Vereinigte Staaten, 85724-5024
        • Arizona Cancer Center at University of Arizona Health Sciences Center
    • Arkansas
      • Little Rock, Arkansas, Vereinigte Staaten, 72205
        • Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
    • California
      • Downey, California, Vereinigte Staaten, 90027
        • Southern California Permanente Medical Group
      • Duarte, California, Vereinigte Staaten, 91010-3000
        • City of Hope Comprehensive Cancer Center
      • Loma Linda, California, Vereinigte Staaten, 92354
        • Loma Linda University Cancer Institute at Loma Linda University Medical Center
      • Long Beach, California, Vereinigte Staaten, 90801
        • Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
      • Los Angeles, California, Vereinigte Staaten, 90095-1781
        • Jonsson Comprehensive Cancer Center at UCLA
      • Los Angeles, California, Vereinigte Staaten, 90027
        • Childrens Hospital Los Angeles
      • Madera, California, Vereinigte Staaten, 93638-8762
        • Children's Hospital Central California
      • Oakland, California, Vereinigte Staaten, 94609
        • Children's Hospital and Research Center Oakland
      • Orange, California, Vereinigte Staaten, 92868
        • Children's Hospital of Orange County
      • Palo Alto, California, Vereinigte Staaten, 95798
        • Lucile Packard Children's Hospital at Stanford University Medical Center
      • Sacramento, California, Vereinigte Staaten, 95816
        • Sutter Cancer center
      • Sacramento, California, Vereinigte Staaten, 95825
        • Kaiser Permanente Medical Center - Oakland
      • San Francisco, California, Vereinigte Staaten, 94115
        • UCSF Helen Diller Family Comprehensive Cancer Center
    • Colorado
      • Aurora, Colorado, Vereinigte Staaten, 80045
        • Children's Hospital Center for Cancer and Blood Disorders
      • Denver, Colorado, Vereinigte Staaten, 80218
        • Presbyterian - St. Luke's Medical Center
    • Connecticut
      • Hartford, Connecticut, Vereinigte Staaten, 06106
        • Connecticut Children's Medical Center
    • Delaware
      • Wilmington, Delaware, Vereinigte Staaten, 19803
        • Alfred I. DuPont Hospital for Children
    • District of Columbia
      • Washington, District of Columbia, Vereinigte Staaten, 20010-2970
        • Children's National Medical Center
    • Florida
      • Fort Lauderdale, Florida, Vereinigte Staaten, 33316
        • Broward General Medical Center Cancer Center
      • Fort Myers, Florida, Vereinigte Staaten, 33901
        • Lee Cancer Care of Lee Memorial Health System
      • Gainesville, Florida, Vereinigte Staaten, 32610-0232
        • University of Florida Shands Cancer Center
      • Hollywood, Florida, Vereinigte Staaten, 33021
        • Memorial Cancer Institute at Memorial Regional Hospital
      • Jacksonville, Florida, Vereinigte Staaten, 32207
        • Nemours Children's Clinic
      • Miami, Florida, Vereinigte Staaten, 33136
        • University of Miami Sylvester Comprehensive Cancer Center - Miami
      • Miami, Florida, Vereinigte Staaten, 33155
        • Miami Children's Hospital
      • Miami, Florida, Vereinigte Staaten, 33176
        • Baptist-South Miami Regional Cancer Program
      • Orlando, Florida, Vereinigte Staaten, 32803-1273
        • Florida Hospital Cancer Institute at Florida Hospital Orlando
      • Orlando, Florida, Vereinigte Staaten, 32806
        • Nemours Children's Clinic - Orlando
      • Orlando, Florida, Vereinigte Staaten, 32806
        • M.D. Anderson Cancer Center at Orlando
      • Pensacola, Florida, Vereinigte Staaten, 32504
        • Sacred Heart Cancer Center at Sacred Heart Hospital
      • Saint Petersburg, Florida, Vereinigte Staaten, 33701
        • All Children's Hospital
      • Tampa, Florida, Vereinigte Staaten, 33607
        • St. Joseph's Cancer Institute at St. Joseph's Hospital
      • West Palm Beach, Florida, Vereinigte Staaten, 33407
        • Kaplan Cancer Center at St. Mary's Medical Center
    • Georgia
      • Atlanta, Georgia, Vereinigte Staaten, 30322
        • AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Egleston Campus
    • Hawaii
      • Honolulu, Hawaii, Vereinigte Staaten, 96813
        • Cancer Research Center of Hawaii
    • Idaho
      • Boise, Idaho, Vereinigte Staaten, 83712-6297
        • Mountain States Tumor Institute at St. Luke's Regional Medical Center
    • Illinois
      • Chicago, Illinois, Vereinigte Staaten, 60612-7243
        • University of Illinois Cancer Center
      • Maywood, Illinois, Vereinigte Staaten, 60153
        • Cardinal Bernardin Cancer Center at Loyola University Medical Center
      • Oak Lawn, Illinois, Vereinigte Staaten, 60453
        • Keyser Family Cancer Center at Advocate Hope Children's Hospital
      • Park Ridge, Illinois, Vereinigte Staaten, 60068-1174
        • Advocate Lutheran General Cancer Care Center
      • Springfield, Illinois, Vereinigte Staaten, 62794-9677
        • Simmons Cooper Cancer Institute
    • Indiana
      • Indianapolis, Indiana, Vereinigte Staaten, 46202-5289
        • Indiana University Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Vereinigte Staaten, 46260
        • St. Vincent Indianapolis Hospital
    • Iowa
      • Des Moines, Iowa, Vereinigte Staaten, 50309
        • Blank Children's Hospital
      • Iowa City, Iowa, Vereinigte Staaten, 52242-1002
        • Holden Comprehensive Cancer Center at University of Iowa
    • Kansas
      • Kansas City, Kansas, Vereinigte Staaten, 66160-7357
        • Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
    • Kentucky
      • Lexington, Kentucky, Vereinigte Staaten, 40536-0093
        • Lucille P. Markey Cancer Center at University of Kentucky
      • Louisville, Kentucky, Vereinigte Staaten, 40232
        • Kosair Children's Hospital
    • Maine
      • Bangor, Maine, Vereinigte Staaten, 04401
        • CancerCare of Maine at Eastern Maine Medical Center
    • Maryland
      • Baltimore, Maryland, Vereinigte Staaten, 21215
        • Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02111
        • Floating Hospital for Children at Tufts - New England Medical Center
    • Michigan
      • Ann Arbor, Michigan, Vereinigte Staaten, 48109-0286
        • C.S. Mott Children's Hospital at University of Michigan Medical Center
      • Detroit, Michigan, Vereinigte Staaten, 48201-1379
        • Barbara Ann Karmanos Cancer Institute
      • Flint, Michigan, Vereinigte Staaten, 48503
        • Hurley Medical Center
      • Grand Rapids, Michigan, Vereinigte Staaten, 49503-2560
        • Butterworth Hospital at Spectrum Health
      • Grosse Pointe Woods, Michigan, Vereinigte Staaten, 48236
        • Van Elslander Cancer Center at St. John Hospital and Medical Center
      • Kalamazoo, Michigan, Vereinigte Staaten, 49007-5381
        • CCOP - Kalamazoo
      • Lansing, Michigan, Vereinigte Staaten, 48910
        • Breslin Cancer Center at Ingham Regional Medical Center
    • Minnesota
      • Minneapolis, Minnesota, Vereinigte Staaten, 55404
        • Children's Hospitals and Clinics of Minnesota - Minneapolis
      • Rochester, Minnesota, Vereinigte Staaten, 55905
        • Mayo Clinic Cancer Center
    • Mississippi
      • Jackson, Mississippi, Vereinigte Staaten, 39216-4505
        • University of Mississippi Cancer Clinic
    • Missouri
      • Columbia, Missouri, Vereinigte Staaten, 65203
        • Ellis Fischel Cancer Center at University of Missouri - Columbia
      • Kansas City, Missouri, Vereinigte Staaten, 64108
        • Children's Mercy Hospital
    • Nevada
      • Las Vegas, Nevada, Vereinigte Staaten, 89109-2306
        • CCOP - Nevada Cancer Research Foundation
    • New Hampshire
      • Lebanon, New Hampshire, Vereinigte Staaten, 03756-0002
        • Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
    • New Jersey
      • Hackensack, New Jersey, Vereinigte Staaten, 07601
        • Hackensack University Medical Center Cancer Center
      • Morristown, New Jersey, Vereinigte Staaten, 07962
        • Overlook Hospital
      • New Brunswick, New Jersey, Vereinigte Staaten, 08901
        • Saint Peter's University Hospital
      • New Brunswick, New Jersey, Vereinigte Staaten, 08903
        • Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School
      • Newark, New Jersey, Vereinigte Staaten, 07112
        • Newark Beth Israel Medical Center
      • Paterson, New Jersey, Vereinigte Staaten, 07503
        • St. Joseph's Hospital and Medical Center
    • New Mexico
      • Albuquerque, New Mexico, Vereinigte Staaten, 87131-5636
        • University of New Mexico Cancer Center
    • New York
      • Bronx, New York, Vereinigte Staaten, 10461
        • Albert Einstein Cancer Center at Albert Einstein College of Medicine
      • Brooklyn, New York, Vereinigte Staaten, 11201-5493
        • Brooklyn Hospital Center
      • Brooklyn, New York, Vereinigte Staaten, 11219
        • Maimonides Cancer Center at Maimonides Medical Center
      • Buffalo, New York, Vereinigte Staaten, 14263-0001
        • Roswell Park Cancer Institute
      • Mineola, New York, Vereinigte Staaten, 11501
        • Winthrop University Hospital
      • New Hyde Park, New York, Vereinigte Staaten, 11040
        • Schneider Children's Hospital
      • New York, New York, Vereinigte Staaten, 10016
        • NYU Cancer Institute at New York University Medical Center
      • New York, New York, Vereinigte Staaten, 10032
        • Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center
      • Rochester, New York, Vereinigte Staaten, 14642
        • James P. Wilmot Cancer Center at University of Rochester Medical Center
      • Stony Brook, New York, Vereinigte Staaten, 11794-9446
        • Stony Brook University Cancer Center
      • Syracuse, New York, Vereinigte Staaten, 13210
        • SUNY Upstate Medical University Hospital
      • Valhalla, New York, Vereinigte Staaten, 10595
        • New York Medical College
    • North Carolina
      • Charlotte, North Carolina, Vereinigte Staaten, 28232-2861
        • Blumenthal Cancer Center at Carolinas Medical Center
      • Charlotte, North Carolina, Vereinigte Staaten, 28233-3549
        • Presbyterian Cancer Center at Presbyterian Hospital
      • Durham, North Carolina, Vereinigte Staaten, 27710
        • Duke Comprehensive Cancer Center
      • Winston-Salem, North Carolina, Vereinigte Staaten, 27157-1096
        • Wake Forest University Comprehensive Cancer Center
    • North Dakota
      • Fargo, North Dakota, Vereinigte Staaten, 58122
        • CCOP - MeritCare Hospital
    • Ohio
      • Akron, Ohio, Vereinigte Staaten, 44308-1062
        • Akron Children's Hospital
      • Cleveland, Ohio, Vereinigte Staaten, 44195
        • Cleveland Clinic Taussig Cancer Center
      • Cleveland, Ohio, Vereinigte Staaten, 44106-5000
        • Rainbow Babies and Children's Hospital
      • Columbus, Ohio, Vereinigte Staaten, 43205-2696
        • Nationwide Children's Hospital
      • Dayton, Ohio, Vereinigte Staaten, 45404-1815
        • Dayton Children's - Dayton
      • Toledo, Ohio, Vereinigte Staaten, 43614
        • Medical University of Ohio Cancer Center
      • Youngstown, Ohio, Vereinigte Staaten, 44501
        • Tod Children's Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, Vereinigte Staaten, 73104
        • Oklahoma University Cancer Institute
    • Oregon
      • Portland, Oregon, Vereinigte Staaten, 97239-3098
        • Knight Cancer Institute At Oregon Health and Science University
      • Portland, Oregon, Vereinigte Staaten, 97227
        • Legacy Emanuel Hospital and Health Center and Children's Hospital
    • Pennsylvania
      • Bethlehem, Pennsylvania, Vereinigte Staaten, 18017
        • Lehigh Valley Hospital - Muhlenberg
      • Danville, Pennsylvania, Vereinigte Staaten, 17822-0001
        • Geisinger Cancer Institute at Geisinger Health
      • Hershey, Pennsylvania, Vereinigte Staaten, 17033-0850
        • Penn State Children's Hospital
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19134-1095
        • St. Christopher's Hospital for Children
      • Philadelphia, Pennsylvania, Vereinigte Staaten, 19104-9786
        • Children's Hospital of Philadelphia
      • Pittsburgh, Pennsylvania, Vereinigte Staaten, 15213
        • Children's Hospital of Pittsburgh of UPMC
    • Rhode Island
      • Providence, Rhode Island, Vereinigte Staaten, 02903
        • Rhode Island Hospital Comprehensive Cancer Center
    • South Carolina
      • Charleston, South Carolina, Vereinigte Staaten, 29425
        • Hollings Cancer Center at Medical University of South Carolina
      • Greenville, South Carolina, Vereinigte Staaten, 29605
        • Greenville Hospital Cancer Center
    • South Dakota
      • Sioux Falls, South Dakota, Vereinigte Staaten, 57117-5039
        • Sanford Cancer Center at Sanford USD Medical Center
    • Tennessee
      • Chattanooga, Tennessee, Vereinigte Staaten, 37403
        • T.C. Thompson Children's Hospital
      • Knoxville, Tennessee, Vereinigte Staaten, 37901
        • East Tennessee Children's Hospital
      • Nashville, Tennessee, Vereinigte Staaten, 37232-6838
        • Vanderbilt-Ingram Cancer Center
    • Texas
      • Amarillo, Texas, Vereinigte Staaten, 79106
        • Texas Tech University Health Sciences Center School of Medicine - Amarillo
      • Corpus Christi, Texas, Vereinigte Staaten, 78411
        • Driscoll Children's Hospital
      • Dallas, Texas, Vereinigte Staaten, 75230
        • Medical City Dallas Hospital
      • Dallas, Texas, Vereinigte Staaten, 75390
        • Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas
      • Fort Worth, Texas, Vereinigte Staaten, 76104
        • Cook Children's Medical Center - Fort Worth
      • Houston, Texas, Vereinigte Staaten, 77030-2399
        • Baylor University Medical Center - Houston
      • San Antonio, Texas, Vereinigte Staaten, 78229-3993
        • Methodist Children's Hospital of South Texas
      • San Antonio, Texas, Vereinigte Staaten, 78207
        • University of Texas Health Science Center at San Antonio
    • Utah
      • Salt Lake City, Utah, Vereinigte Staaten, 84113-1100
        • Primary Children's Medical Center
    • Vermont
      • Burlington, Vermont, Vereinigte Staaten, 05401
        • Fletcher Allen Health Care - University Health Center Campus
    • Virginia
      • Falls Church, Virginia, Vereinigte Staaten, 22042-3300
        • Inova Fairfax Hospital
      • Roanoke, Virginia, Vereinigte Staaten, 24014
        • Carilion Medical Center for Children at Roanoke Community Hospital
    • Washington
      • Spokane, Washington, Vereinigte Staaten, 99220-2555
        • Providence Cancer Center at Sacred Heart Medical Center
    • West Virginia
      • Charleston, West Virginia, Vereinigte Staaten, 25302
        • West Virginia University Health Sciences Center - Charleston
      • Morgantown, West Virginia, Vereinigte Staaten, 26506
        • Mary Babb Randolph Cancer Center at West Virginia University Hospitals
    • Wisconsin
      • Green Bay, Wisconsin, Vereinigte Staaten, 54307-3508
        • St. Vincent Hospital Regional Cancer Center
      • La Crosse, Wisconsin, Vereinigte Staaten, 54601
        • Gundersen Lutheran Center for Cancer and Blood
      • Marshfield, Wisconsin, Vereinigte Staaten, 54449
        • Marshfield Clinic - Marshfield Center
      • Milwaukee, Wisconsin, Vereinigte Staaten, 53226
        • Midwest Children's Cancer Center at Children's Hospital of Wisconsin

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

1 Jahr bis 29 Jahre (Kind, Erwachsene)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

DISEASE CHARACTERISTICS:

  • Diagnosis of acute lymphoblastic leukemia (ALL)

    • B-precursor lineage (T-precursor lineage closed to accrual as of 05/20/10)
    • In first bone marrow remission (M1 by morphology) AND duration of first complete remission ≥ 18 months from time of initial diagnosis

  • First isolated CNS and/or testicular relapse

    • Isolated CNS relapse, as defined by 1 of the following:

      • WBC ≥ 5/mm^3 in cerebrospinal fluid (CSF) with blasts present on cytospin

      • Any number of WBC in CSF with immunophenotypic proof of leukemic relapse, defined by the following:

        • Identifiable blasts AND 1 of the following:

          • B-lineage (TdT OR CD-10-positive on 2 consecutive CSF samples obtained 4 weeks apart)
          • T-lineage (TdT AND CD-7 OR TdT positivity alone on 2 consecutive CSF samples obtained 4 weeks apart) (Closed to accrual as of 05/20/10)
    • Isolated testicular relapse, defined as biopsy proven testicular involvement
  • No Down syndrome
  • No T-cell ALL or T-cell non-Hodgkin lymphoma
  • No known optic nerve and/or retinal involvement

PATIENT CHARACTERISTICS:

Age

  • 18 months to 29 years at relapse

Performance status

  • Karnofsky 30-100% (for patients > 16 years of age) OR
  • Lansky 30-100% (for patients ≤ 16 years of age)

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Creatinine adjusted according to age as follows:

    • No greater than 0.4 mg/dL (≤ 5 months)
    • No greater than 0.5 mg/dL (6 months -11 months)
    • No greater than 0.6 mg/dL (1 year-23 months)
    • No greater than 0.8 mg/dL (2 years-5 years)
    • No greater than 1.0 mg/dL (6 years-9 years)
    • No greater than 1.2 mg/dL (10 years-12 years)
    • No greater than 1.4 mg/dL (13 years and over [female])
    • No greater than 1.5 mg/dL (13 years to 15 years [male])
    • No greater than 1.7 mg/dL (16 years and over [male]) OR
  • Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min

Cardiovascular

  • Shortening fraction ≥ 27% by echocardiogram OR
  • Ejection fraction ≥ 50% by MUGA

Other

  • Not pregnant or nursing

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • No prior bone marrow transplantation

Chemotherapy

  • Prior total anthracycline dosage ≤ 360 mg/m^2

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • No prior systemic therapy for concurrent extramedullary relapse

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Nicht randomisiert
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: CNS Patients-Treatment (combination chemotherapy)
All patients receive common induction (vincristine sulfate, dexamethasone, daunorubicin hydrochloride & intrathecal triple therapy (ITT: MTX, therapeutic hydrocortisone and cytarabine)), consolidation (cytarabine, pegaspargase, filgrastim, re-induction (vincristine, dexamethasone, daunorubicin), and intensification chemotherapy (MTX, leucovorin calcium, mercaptopurine, etoposide, cyclophosphamide & ITT.
Arzneimittel: therapeutisches Hydrocortison
Arzneimittel: Vincristinsulfat
gegeben IV
Andere Namen:
  • Videorecorder
  • Oncovin
  • LCR
  • NSC #67574
Biologisch: filgrastim
given subcutaneously (SC)
Andere Namen:
  • G-CSF
  • Granulozyten-Kolonie-stimulierender Faktor
  • r-metHuG-CSF
  • Neupogen
  • NSC 614629
Arzneimittel: cyclophosphamide
IV over 15-30 minutes
Andere Namen:
  • CYTOXAN
  • NSC #26271
Arzneimittel: cytarabine
IV over 3 hours twice daily
Andere Namen:
  • Ara-C
  • Cytosar
  • Cytosinarabinosid
  • NSC #6387
Arzneimittel: daunorubicin hydrochloride
IV over 15 minutes
Andere Namen:
  • Cerubidin
  • NSC #82151
  • Daunomycin
  • Rubidomycin
Arzneimittel: dexamethasone
oral twice daily
Andere Namen:
  • Dekadron
  • Dexameth
  • Dexon
  • Hexadrol
  • NSC-Nr. 34521
Arzneimittel: etoposide
IV over 1 hour
Andere Namen:
  • VP-16
  • Etopophos
  • VePesid
  • NSC-Nr. 141540
Arzneimittel: leucovorin calcium
rescue IV over 24 hours
Andere Namen:
  • LCV
  • Wellcovorin
  • Citrovorum-Faktor
  • Folinsäure
  • NSC 03590
Arzneimittel: mercaptopurine
oral
Andere Namen:
  • 6 MP
  • Purinethol
  • NSC-Nr. 000755
  • 6-Mercaptopurin
Arzneimittel: methotrexate
intramuscularly (IM)
Andere Namen:
  • Amethopterin
  • MTX
  • NSC-Nr. 000740
  • Trexall
Arzneimittel: pegaspargase
intramuscularly (IM)
Andere Namen:
  • Onkaspar
  • PEGLA
  • PEG-L-Asparaginase
  • PEG-Asparaginase
  • Polyethylenglykol-L-Asparaginase
  • NSC 624239
Strahlung: radiation therapy
Patients with isolated testicular relapse will start Induction with a single dose of high-dose methotrexate (HDMTX) and will not receive either testicular or cranial radiation. Patients with isolated CNS relapse will NOT receive the initial dose of HDMTX prior to Induction, but will receive 1200 cGy of cranial radiation after completing the initial 12 months of intensive systemic chemotherapy.
Experimental: Testicular Relapse Patients (Combination chemotherapy)
All patients receive common induction (vincristine sulfate, dexamethasone, daunorubicin hydrochloride & intrathecal triple therapy (ITT: MTX, therapeutic hydrocortisone and cytarabine)), consolidation (cytarabine, pegaspargase, filgrastim, testicular radiation therapy, re-induction (vincristine, dexamethasone, daunorubicin), and intensification chemotherapy (MTX, leucovorin calcium, mercaptopurine, etoposide, cyclophosphamide & ITT.
Arzneimittel: therapeutisches Hydrocortison
Arzneimittel: Vincristinsulfat
gegeben IV
Andere Namen:
  • Videorecorder
  • Oncovin
  • LCR
  • NSC #67574
Biologisch: filgrastim
given subcutaneously (SC)
Andere Namen:
  • G-CSF
  • Granulozyten-Kolonie-stimulierender Faktor
  • r-metHuG-CSF
  • Neupogen
  • NSC 614629
Arzneimittel: cyclophosphamide
IV over 15-30 minutes
Andere Namen:
  • CYTOXAN
  • NSC #26271
Arzneimittel: cytarabine
IV over 3 hours twice daily
Andere Namen:
  • Ara-C
  • Cytosar
  • Cytosinarabinosid
  • NSC #6387
Arzneimittel: daunorubicin hydrochloride
IV over 15 minutes
Andere Namen:
  • Cerubidin
  • NSC #82151
  • Daunomycin
  • Rubidomycin
Arzneimittel: dexamethasone
oral twice daily
Andere Namen:
  • Dekadron
  • Dexameth
  • Dexon
  • Hexadrol
  • NSC-Nr. 34521
Arzneimittel: etoposide
IV over 1 hour
Andere Namen:
  • VP-16
  • Etopophos
  • VePesid
  • NSC-Nr. 141540
Arzneimittel: leucovorin calcium
rescue IV over 24 hours
Andere Namen:
  • LCV
  • Wellcovorin
  • Citrovorum-Faktor
  • Folinsäure
  • NSC 03590
Arzneimittel: mercaptopurine
oral
Andere Namen:
  • 6 MP
  • Purinethol
  • NSC-Nr. 000755
  • 6-Mercaptopurin
Arzneimittel: methotrexate
intramuscularly (IM)
Andere Namen:
  • Amethopterin
  • MTX
  • NSC-Nr. 000740
  • Trexall
Arzneimittel: pegaspargase
intramuscularly (IM)
Andere Namen:
  • Onkaspar
  • PEGLA
  • PEG-L-Asparaginase
  • PEG-Asparaginase
  • Polyethylenglykol-L-Asparaginase
  • NSC 624239
Strahlung: radiation therapy
Patients with isolated testicular relapse will start Induction with a single dose of high-dose methotrexate (HDMTX) and will not receive either testicular or cranial radiation. Patients with isolated CNS relapse will NOT receive the initial dose of HDMTX prior to Induction, but will receive 1200 cGy of cranial radiation after completing the initial 12 months of intensive systemic chemotherapy.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Event-free Survival
Zeitfenster: 3 years
Monitoring of efficacy results will be performed in comparison with historical results.
3 years

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Children's Oncology Group

Mitarbeiter

National Cancer Institute (NCI)

Ermittler

  • Studienstuhl: Julio C. Barredo, MD, University of Miami Miller School of Medicine-Sylvester Cancer Center
  • Studienstuhl: Caroline A. Hastings, MD, UCSF Benioff Children's Hospital Oakland

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn

1. November 2004

Primärer Abschluss (Tatsächlich)

1. September 2013

Studienanmeldedaten

Zuerst eingereicht

9. November 2004

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

8. November 2004

Zuerst gepostet (Schätzen)

9. November 2004

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

21. März 2017

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

14. Februar 2017

Zuletzt verifiziert

1. Februar 2017

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • AALL02P2
  • COG-AALL02P2 (Andere Kennung: Children's Oncology Group)
  • NCI-2011-01623 (Andere Kennung: NCI Trial Identifier)

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .

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