- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica 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)
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
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.
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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Queensland
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Herston, Queensland, Australia, 4029
- Royal Brisbane and Women's Hospital
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Herston, Queensland, Australia, 4029
- Royal Children's Hospital-Brisbane
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South Australia
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North Adelaide, South Australia, Australia, 5006
- Women's and Children's Hospital-Adelaide
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Victoria
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Parkville, Victoria, Australia, 3052
- Royal Children's Hospital
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Western Australia
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Perth, Western Australia, Australia, 6008
- Princess Margaret Hospital for Children
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Alberta
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Calgary, Alberta, Canada, T3B 6A8
- Alberta Children's Hospital
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Edmonton, Alberta, Canada, T6G 2B7
- University of Alberta Hospital
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British Columbia
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Vancouver, British Columbia, Canada, V6H 3V4
- British Columbia Children's Hospital
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Manitoba
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Winnipeg, Manitoba, Canada, R3E 0V9
- CancerCare Manitoba
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Newfoundland and Labrador
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Saint John's, Newfoundland and Labrador, Canada, A1B 3V6
- Janeway Child Health Centre
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3K 6R8
- IWK Health Centre
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Ontario
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Kingston, Ontario, Canada, K7L 2V7
- Kingston Health Sciences Centre
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London, Ontario, Canada, N6A 5W9
- Children's Hospital
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London, Ontario, Canada, N6K 1C2
- Victoria Hospital
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Ottawa, Ontario, Canada, K1H 8L1
- Children's Hospital of Eastern Ontario
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Toronto, Ontario, Canada, M5G 1X8
- Hospital for Sick Children
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Quebec
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Montreal, Quebec, Canada, H3H 1P3
- The Montreal Children's Hospital of the MUHC
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Sherbrooke, Quebec, Canada, J1H 5N4
- Centre Hospitalier Universitaire de Sherbrooke-Fleurimont
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Saskatchewan
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Regina, Saskatchewan, Canada, S4T 7T1
- Allan Blair Cancer Centre
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Saskatoon, Saskatchewan, Canada, S7N 4H4
- Saskatoon Cancer Centre
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Christchurch, Nuova Zelanda, 8011
- Christchurch Hospital
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Wellington, Nuova Zelanda, 6002
- Wellington Children's Hospital
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Auckland
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Grafton, Auckland, Nuova Zelanda, 1145
- Starship Children's Hospital
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Alabama
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Birmingham, Alabama, Stati Uniti, 35233
- University of Alabama at Birmingham Cancer Center
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Birmingham, Alabama, Stati Uniti, 35233
- Children's Hospital of Alabama
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Mobile, Alabama, Stati Uniti, 36604
- USA Health Strada Patient Care Center
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Arizona
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Mesa, Arizona, Stati Uniti, 85202
- Banner Children's at Desert
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Phoenix, Arizona, Stati Uniti, 85016
- Phoenix Childrens Hospital
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Tucson, Arizona, Stati Uniti, 85719
- Banner University Medical Center - Tucson
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Arkansas
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Little Rock, Arkansas, Stati Uniti, 72205
- University of Arkansas for Medical Sciences
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Little Rock, Arkansas, Stati Uniti, 72202-3591
- Arkansas Children's Hospital
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California
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Downey, California, Stati Uniti, 90242
- Kaiser Permanente Downey Medical Center
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Duarte, California, Stati Uniti, 91010
- City of Hope Comprehensive Cancer Center
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Loma Linda, California, Stati Uniti, 92354
- Loma Linda University Medical Center
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Long Beach, California, Stati Uniti, 90806
- Miller Children's and Women's Hospital Long Beach
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Los Angeles, California, Stati Uniti, 90027
- Children's Hospital Los Angeles
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Los Angeles, California, Stati Uniti, 90095
- UCLA / Jonsson Comprehensive Cancer Center
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Los Angeles, California, Stati Uniti, 90048
- Cedars Sinai Medical Center
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Los Angeles, California, Stati Uniti, 90095
- Mattel Children's Hospital UCLA
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Madera, California, Stati Uniti, 93636
- Valley Children's Hospital
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Oakland, California, Stati Uniti, 94609
- UCSF Benioff Children's Hospital Oakland
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Oakland, California, Stati Uniti, 94611
- Kaiser Permanente-Oakland
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Orange, California, Stati Uniti, 92868
- Children's Hospital of Orange County
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Palo Alto, California, Stati Uniti, 94304
- Lucile Packard Children's Hospital Stanford University
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Sacramento, California, Stati Uniti, 95816
- Sutter Medical Center Sacramento
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Sacramento, California, Stati Uniti, 95817
- University of California Davis Comprehensive Cancer Center
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San Diego, California, Stati Uniti, 92123
- Rady Children's Hospital - San Diego
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San Francisco, California, Stati Uniti, 94143
- UCSF Medical Center-Parnassus
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Santa Barbara, California, Stati Uniti, 93102
- Santa Barbara Cottage Hospital
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- Children's Hospital Colorado
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Denver, Colorado, Stati Uniti, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
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Denver, Colorado, Stati Uniti, 80218
- Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center
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Connecticut
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Farmington, Connecticut, Stati Uniti, 06030
- University of Connecticut
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Hartford, Connecticut, Stati Uniti, 06106
- Connecticut Children's Medical Center
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New Haven, Connecticut, Stati Uniti, 06520
- Yale University
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Delaware
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Wilmington, Delaware, Stati Uniti, 19803
- Alfred I duPont Hospital for Children
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District of Columbia
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Washington, District of Columbia, Stati Uniti, 20010
- Children's National Medical Center
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Washington, District of Columbia, Stati Uniti, 20007
- MedStar Georgetown University Hospital
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Florida
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Fort Lauderdale, Florida, Stati Uniti, 33316
- Broward Health Medical Center
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Fort Myers, Florida, Stati Uniti, 33908
- Golisano Children's Hospital of Southwest Florida
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Fort Myers, Florida, Stati Uniti, 33901
- Lee Memorial Health System
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Gainesville, Florida, Stati Uniti, 32610
- University of Florida Health Science Center - Gainesville
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Hollywood, Florida, Stati Uniti, 33021
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
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Jacksonville, Florida, Stati Uniti, 32207
- Nemours Children's Clinic-Jacksonville
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Miami, Florida, Stati Uniti, 33155
- Nicklaus Children's Hospital
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Miami, Florida, Stati Uniti, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Stati Uniti, 33176
- Miami Cancer Institute
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Orlando, Florida, Stati Uniti, 32806
- Orlando Health Cancer Institute
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Orlando, Florida, Stati Uniti, 32806
- Nemours Children's Clinic - Orlando
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Orlando, Florida, Stati Uniti, 32827
- Nemours Children's Hospital
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Orlando, Florida, Stati Uniti, 32803
- AdventHealth Orlando
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Pensacola, Florida, Stati Uniti, 32504
- Sacred Heart Hospital
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Pensacola, Florida, Stati Uniti, 32504
- Nemours Children's Clinic - Pensacola
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Saint Petersburg, Florida, Stati Uniti, 33701
- Johns Hopkins All Children's Hospital
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Tampa, Florida, Stati Uniti, 33607
- Saint Joseph's Hospital/Children's Hospital-Tampa
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West Palm Beach, Florida, Stati Uniti, 33407
- Saint Mary's Hospital
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Georgia
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Atlanta, Georgia, Stati Uniti, 30322
- Emory University Hospital/Winship Cancer Institute
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Atlanta, Georgia, Stati Uniti, 30322
- Children's Healthcare of Atlanta - Egleston
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Augusta, Georgia, Stati Uniti, 30912
- Augusta University Medical Center
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Savannah, Georgia, Stati Uniti, 31404
- Memorial Health University Medical Center
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Hawaii
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Honolulu, Hawaii, Stati Uniti, 96813
- University of Hawaii Cancer Center
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Honolulu, Hawaii, Stati Uniti, 96859
- Tripler Army Medical Center
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Idaho
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Boise, Idaho, Stati Uniti, 83712
- Saint Luke's Cancer Institute - Boise
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Illinois
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Chicago, Illinois, Stati Uniti, 60612
- Rush University Medical Center
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Chicago, Illinois, Stati Uniti, 60637
- University of Chicago Comprehensive Cancer Center
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Chicago, Illinois, Stati Uniti, 60612
- University of Illinois
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Chicago, Illinois, Stati Uniti, 60611
- Lurie Children's Hospital-Chicago
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Maywood, Illinois, Stati Uniti, 60153
- Loyola University Medical Center
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Oak Lawn, Illinois, Stati Uniti, 60453
- Advocate Children's Hospital-Oak Lawn
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Park Ridge, Illinois, Stati Uniti, 60068
- Advocate Lutheran General Hospital
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Springfield, Illinois, Stati Uniti, 62702
- Southern Illinois University School of Medicine
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Indiana
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Indianapolis, Indiana, Stati Uniti, 46202
- Indiana University/Melvin and Bren Simon Cancer Center
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Indianapolis, Indiana, Stati Uniti, 46202
- Riley Hospital for Children
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Indianapolis, Indiana, Stati Uniti, 46260
- Saint Vincent Hospital and Health Care Center
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Iowa
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Des Moines, Iowa, Stati Uniti, 50309
- Blank Children's Hospital
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Iowa City, Iowa, Stati Uniti, 52242
- University of Iowa/Holden Comprehensive Cancer Center
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Kansas
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Kansas City, Kansas, Stati Uniti, 66160
- University of Kansas Cancer Center
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Kentucky
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Lexington, Kentucky, Stati Uniti, 40536
- University of Kentucky/Markey Cancer Center
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Louisville, Kentucky, Stati Uniti, 40202
- Norton Children's Hospital
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Louisiana
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New Orleans, Louisiana, Stati Uniti, 70112
- Tulane University Health Sciences Center
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New Orleans, Louisiana, Stati Uniti, 70118
- Children's Hospital New Orleans
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Maine
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Bangor, Maine, Stati Uniti, 04401
- Eastern Maine Medical Center
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Scarborough, Maine, Stati Uniti, 04074
- Maine Children's Cancer Program
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Maryland
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Baltimore, Maryland, Stati Uniti, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Baltimore, Maryland, Stati Uniti, 21215
- Sinai Hospital of Baltimore
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Baltimore, Maryland, Stati Uniti, 21201
- University of Maryland/Greenebaum Cancer Center
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Bethesda, Maryland, Stati Uniti, 20889-5600
- Walter Reed National Military Medical Center
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02114
- Massachusetts General Hospital Cancer Center
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Boston, Massachusetts, Stati Uniti, 02111
- Tufts Children's Hospital
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Springfield, Massachusetts, Stati Uniti, 01199
- Baystate Medical Center
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Worcester, Massachusetts, Stati Uniti, 01655
- UMass Memorial Medical Center - University Campus
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Michigan
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Ann Arbor, Michigan, Stati Uniti, 48109
- C S Mott Children's Hospital
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Detroit, Michigan, Stati Uniti, 48201
- Wayne State University/Karmanos Cancer Institute
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Detroit, Michigan, Stati Uniti, 48236
- Ascension Saint John Hospital
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East Lansing, Michigan, Stati Uniti, 48824-7016
- Michigan State University Clinical Center
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Flint, Michigan, Stati Uniti, 48503
- Hurley Medical Center
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Grand Rapids, Michigan, Stati Uniti, 49503
- Spectrum Health at Butterworth Campus
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Grand Rapids, Michigan, Stati Uniti, 49503
- Helen DeVos Children's Hospital at Spectrum Health
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Kalamazoo, Michigan, Stati Uniti, 49007
- Bronson Methodist Hospital
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Kalamazoo, Michigan, Stati Uniti, 49008
- Kalamazoo Center for Medical Studies
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Royal Oak, Michigan, Stati Uniti, 48073
- William Beaumont Hospital-Royal Oak
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Royal Oak, Michigan, Stati Uniti, 48073
- Beaumont Children's Hospital-Royal Oak
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Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
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Minneapolis, Minnesota, Stati Uniti, 55455
- University of Minnesota/Masonic Cancer Center
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Rochester, Minnesota, Stati Uniti, 55905
- Mayo Clinic in Rochester
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Saint Paul, Minnesota, Stati Uniti, 55102
- Children's Hospital and Clinic-Saint Paul
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Mississippi
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Jackson, Mississippi, Stati Uniti, 39216
- University of Mississippi Medical Center
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Missouri
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Columbia, Missouri, Stati Uniti, 65201
- Columbia Regional
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Columbia, Missouri, Stati Uniti, 65212
- University of Missouri - Ellis Fischel
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Kansas City, Missouri, Stati Uniti, 64108
- Children's Mercy Hospitals and Clinics
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Saint Louis, Missouri, Stati Uniti, 63110
- Washington University School of Medicine
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Saint Louis, Missouri, Stati Uniti, 63104
- Cardinal Glennon Children's Medical Center
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Nebraska
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Omaha, Nebraska, Stati Uniti, 68198
- University of Nebraska Medical Center
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Omaha, Nebraska, Stati Uniti, 68114
- Children's Hospital and Medical Center of Omaha
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Nevada
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Las Vegas, Nevada, Stati Uniti, 89169
- Nevada Cancer Research Foundation NCORP
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New Hampshire
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Lebanon, New Hampshire, Stati Uniti, 03756
- Dartmouth Hitchcock Medical Center
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New Jersey
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Hackensack, New Jersey, Stati Uniti, 07601
- Hackensack University Medical Center
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Livingston, New Jersey, Stati Uniti, 07039
- Saint Barnabas Medical Center
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Morristown, New Jersey, Stati Uniti, 07960
- Morristown Medical Center
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New Brunswick, New Jersey, Stati Uniti, 08901
- Saint Peter's University Hospital
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New Brunswick, New Jersey, Stati Uniti, 08903
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
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Newark, New Jersey, Stati Uniti, 07112
- Newark Beth Israel Medical Center
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Paterson, New Jersey, Stati Uniti, 07503
- Saint Joseph's Regional Medical Center
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Summit, New Jersey, Stati Uniti, 07902
- Overlook Hospital
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New Mexico
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Albuquerque, New Mexico, Stati Uniti, 87102
- University of New Mexico Cancer Center
-
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New York
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Albany, New York, Stati Uniti, 12208
- Albany Medical Center
-
Bronx, New York, Stati Uniti, 10467
- Montefiore Medical Center - Moses Campus
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Brooklyn, New York, Stati Uniti, 11219
- Maimonides Medical Center
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Brooklyn, New York, Stati Uniti, 11201
- Brooklyn Hospital Center
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Brooklyn, New York, Stati Uniti, 11212
- Brookdale Hospital Medical Center
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Buffalo, New York, Stati Uniti, 14263
- Roswell Park Cancer Institute
-
Mineola, New York, Stati Uniti, 11501
- NYU Winthrop Hospital
-
New Hyde Park, New York, Stati Uniti, 11040
- The Steven and Alexandra Cohen Children's Medical Center of New York
-
New York, New York, Stati Uniti, 10029
- Mount Sinai Hospital
-
New York, New York, Stati Uniti, 10065
- NYP/Weill Cornell Medical Center
-
New York, New York, Stati Uniti, 10016
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Stony Brook, New York, Stati Uniti, 11794
- Stony Brook University Medical Center
-
Syracuse, New York, Stati Uniti, 13210
- State University of New York Upstate Medical University
-
Valhalla, New York, Stati Uniti, 10595
- New York Medical College
-
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North Carolina
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Asheville, North Carolina, Stati Uniti, 28801
- Mission Hospital
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Chapel Hill, North Carolina, Stati Uniti, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Charlotte, North Carolina, Stati Uniti, 28203
- Carolinas Medical Center/Levine Cancer Institute
-
Charlotte, North Carolina, Stati Uniti, 28204
- Novant Health Presbyterian Medical Center
-
Durham, North Carolina, Stati Uniti, 27710
- Duke University Medical Center
-
Greenville, North Carolina, Stati Uniti, 27834
- East Carolina University
-
Winston-Salem, North Carolina, Stati Uniti, 27157
- Wake Forest University Health Sciences
-
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North Dakota
-
Fargo, North Dakota, Stati Uniti, 58122
- Sanford Broadway Medical Center
-
-
Ohio
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Akron, Ohio, Stati Uniti, 44308
- Children's Hospital Medical Center of Akron
-
Cincinnati, Ohio, Stati Uniti, 45229
- Cincinnati Children's Hospital Medical Center
-
Cleveland, Ohio, Stati Uniti, 44195
- Cleveland Clinic Foundation
-
Cleveland, Ohio, Stati Uniti, 44106
- Rainbow Babies and Childrens Hospital
-
Columbus, Ohio, Stati Uniti, 43205
- Nationwide Children's Hospital
-
Dayton, Ohio, Stati Uniti, 45404
- Dayton Children's Hospital
-
Toledo, Ohio, Stati Uniti, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Toledo, Ohio, Stati Uniti, 43614
- University of Toledo
-
Toledo, Ohio, Stati Uniti, 43608
- Mercy Children's Hospital
-
Youngstown, Ohio, Stati Uniti, 44501
- Tod Children's Hospital - Forum Health
-
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Oklahoma
-
Oklahoma City, Oklahoma, Stati Uniti, 73104
- University of Oklahoma Health Sciences Center
-
Tulsa, Oklahoma, Stati Uniti, 74136
- Natalie Warren Bryant Cancer Center at Saint Francis
-
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Oregon
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Portland, Oregon, Stati Uniti, 97239
- Oregon Health and Science University
-
Portland, Oregon, Stati Uniti, 97227
- Legacy Emanuel Children's Hospital
-
Portland, Oregon, Stati Uniti, 97227
- Legacy Emanuel Hospital and Health Center
-
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Pennsylvania
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Bethlehem, Pennsylvania, Stati Uniti, 18017
- Lehigh Valley Hospital - Muhlenberg
-
Danville, Pennsylvania, Stati Uniti, 17822
- Geisinger Medical Center
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Hershey, Pennsylvania, Stati Uniti, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Hershey, Pennsylvania, Stati Uniti, 17033
- Penn State Children's Hospital
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Philadelphia, Pennsylvania, Stati Uniti, 19104
- Children's Hospital of Philadelphia
-
Philadelphia, Pennsylvania, Stati Uniti, 19134
- Saint Christopher's Hospital for Children
-
Philadelphia, Pennsylvania, Stati Uniti, 19104
- Children's Oncology Group
-
Pittsburgh, Pennsylvania, Stati Uniti, 15224
- Children's Hospital of Pittsburgh of UPMC
-
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Rhode Island
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Providence, Rhode Island, Stati Uniti, 02903
- Rhode Island Hospital
-
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South Carolina
-
Charleston, South Carolina, Stati Uniti, 29425
- Medical University of South Carolina
-
Columbia, South Carolina, Stati Uniti, 29203
- Prisma Health Richland Hospital
-
Greenville, South Carolina, Stati Uniti, 29605
- BI-LO Charities Children's Cancer Center
-
Greenville, South Carolina, Stati Uniti, 29605
- Greenville Cancer Treatment Center
-
-
South Dakota
-
Sioux Falls, South Dakota, Stati Uniti, 57117-5134
- Sanford USD Medical Center - Sioux Falls
-
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Tennessee
-
Chattanooga, Tennessee, Stati Uniti, 37403
- T C Thompson Children's Hospital
-
Knoxville, Tennessee, Stati Uniti, 37916
- East Tennessee Childrens Hospital
-
Nashville, Tennessee, Stati Uniti, 37232
- Vanderbilt University/Ingram Cancer Center
-
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Texas
-
Amarillo, Texas, Stati Uniti, 79106
- Texas Tech University Health Sciences Center-Amarillo
-
Austin, Texas, Stati Uniti, 78723
- Dell Children's Medical Center of Central Texas
-
Corpus Christi, Texas, Stati Uniti, 78411
- Driscoll Children's Hospital
-
Dallas, Texas, Stati Uniti, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Dallas, Texas, Stati Uniti, 75230
- Medical City Dallas Hospital
-
Fort Worth, Texas, Stati Uniti, 76104
- Cook Children's Medical Center
-
Galveston, Texas, Stati Uniti, 77555-0565
- University of Texas Medical Branch
-
Houston, Texas, Stati Uniti, 77030
- M D Anderson Cancer Center
-
Houston, Texas, Stati Uniti, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Lubbock, Texas, Stati Uniti, 79410
- Covenant Children's Hospital
-
San Antonio, Texas, Stati Uniti, 78229
- University of Texas Health Science Center at San Antonio
-
San Antonio, Texas, Stati Uniti, 78229
- Methodist Children's Hospital of South Texas
-
Temple, Texas, Stati Uniti, 76508
- Scott and White Memorial Hospital
-
-
Utah
-
Salt Lake City, Utah, Stati Uniti, 84113
- Primary Children's Hospital
-
-
Vermont
-
Burlington, Vermont, Stati Uniti, 05405
- University of Vermont and State Agricultural College
-
-
Virginia
-
Charlottesville, Virginia, Stati Uniti, 22908
- University of Virginia Cancer Center
-
Falls Church, Virginia, Stati Uniti, 22042
- Inova Fairfax Hospital
-
Norfolk, Virginia, Stati Uniti, 23507
- Children's Hospital of The King's Daughters
-
Portsmouth, Virginia, Stati Uniti, 23708-2197
- Naval Medical Center - Portsmouth
-
Richmond, Virginia, Stati Uniti, 23298
- Virginia Commonwealth University/Massey Cancer Center
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Roanoke, Virginia, Stati Uniti, 24014
- Carilion Children's
-
-
Washington
-
Seattle, Washington, Stati Uniti, 98105
- Seattle Children's Hospital
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Spokane, Washington, Stati Uniti, 99204
- Providence Sacred Heart Medical Center and Children's Hospital
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Tacoma, Washington, Stati Uniti, 98405
- Mary Bridge Children's Hospital and Health Center
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Tacoma, Washington, Stati Uniti, 98431
- Madigan Army Medical Center
-
-
West Virginia
-
Charleston, West Virginia, Stati Uniti, 25304
- West Virginia University Charleston Division
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Morgantown, West Virginia, Stati Uniti, 26506
- West Virginia University Healthcare
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-
Wisconsin
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Green Bay, Wisconsin, Stati Uniti, 54301
- Saint Vincent Hospital Cancer Center Green Bay
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La Crosse, Wisconsin, Stati Uniti, 54601
- Gundersen Lutheran Medical Center
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Madison, Wisconsin, Stati Uniti, 53792
- University of Wisconsin Hospital and Clinics
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Marshfield, Wisconsin, Stati Uniti, 54449
- Marshfield Medical Center-Marshfield
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Milwaukee, Wisconsin, Stati Uniti, 53226
- Children's Hospital of Wisconsin
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-
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Bern, Svizzera, 3010
- Swiss Pediatric Oncology Group - Bern
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Geneva, Svizzera, 1205
- Swiss Pediatric Oncology Group - Geneva
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Lausanne, Svizzera, 1011
- Swiss Pediatric Oncology Group - Lausanne
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
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
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione di gruppo singolo
- Mascheramento: Nessuno (etichetta aperta)
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
|
Comparatore attivo: 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.
|
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO
Altri nomi:
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO o IV
Altri nomi:
Dato PO
Altri nomi:
Sottoponiti a radioterapia
Altri nomi:
Dato IM
Altri nomi:
Dato IT o IV
Altri nomi:
Given IT, SC, or IV
Altri nomi:
|
|
Comparatore attivo: 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.
|
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO
Altri nomi:
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO o IV
Altri nomi:
Dato PO
Altri nomi:
Sottoponiti a radioterapia
Altri nomi:
Dato IV
Altri nomi:
Dato IM
Altri nomi:
Dato IT o IV
Altri nomi:
Given IT, SC, or IV
Altri nomi:
|
|
Sperimentale: 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. |
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO
Altri nomi:
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO o IV
Altri nomi:
Dato PO
Altri nomi:
Sottoponiti a radioterapia
Altri nomi:
Dato PO o IV
Altri nomi:
Dato IM
Altri nomi:
Dato IT o IV
Altri nomi:
Given IT, SC, or IV
Altri nomi:
|
|
Sperimentale: 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. |
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO
Altri nomi:
Dato IV
Altri nomi:
Dato IV
Altri nomi:
Dato PO o IV
Altri nomi:
Dato PO
Altri nomi:
Sottoponiti a radioterapia
Altri nomi:
Dato PO o IV
Altri nomi:
Dato IV
Altri nomi:
Dato IM
Altri nomi:
Dato IT o IV
Altri nomi:
Given IT, SC, or IV
Altri nomi:
|
Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Comparison of the Increase in Cure Rate of High Risk ALL Without Causing More Serious Side Effects Between Interventions
Lasso di tempo: 5 years
|
Event Free Probability.
|
5 years
|
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Correlation of Minimal Residual Disease (MRD) Positive With Overall Survival (OS)
Lasso di tempo: 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).
Lasso di tempo: 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.
Lasso di tempo: 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.
Lasso di tempo: 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)
Lasso di tempo: 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).
Lasso di tempo: 5 years
|
Bone marrow MRD status is defined as negative with < 0.1 detectable leukemia cells.
|
5 years
|
Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Eric C Larsen, Children's Oncology Group
Pubblicazioni e link utili
Pubblicazioni generali
- 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.
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Stima)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattie del sistema immunitario
- Neoplasie per tipo istologico
- Neoplasie
- Malattie linfoproliferative
- Malattie linfatiche
- Disturbi immunoproliferativi
- Leucemia
- Leucemia-linfoma linfoblastico a cellule precursori
- Leucemia, linfoide
- Effetti fisiologici delle droghe
- Meccanismi molecolari dell'azione farmacologica
- Agenti antinfettivi
- Agenti autonomi
- Agenti del sistema nervoso periferico
- Agenti antivirali
- Inibitori della sintesi degli acidi nucleici
- Inibitori enzimatici
- Agenti antinfiammatori
- Agenti antireumatici
- Antimetaboliti, Antineoplastici
- Antimetaboliti
- Agenti antineoplastici
- Agenti immunosoppressivi
- Fattori immunologici
- Modulatori della tubulina
- Agenti antimitotici
- Modulatori della mitosi
- Antiemetici
- Agenti gastrointestinali
- Glucocorticoidi
- Ormoni
- Ormoni, sostituti ormonali e antagonisti ormonali
- Agenti antineoplastici, ormonali
- Inibitori della proteasi
- Agenti protettivi
- Agenti Antineoplastici, Alchilanti
- Agenti Alchilanti
- Agonisti mieloablativi
- Agenti antineoplastici, fitogenici
- Inibitori della topoisomerasi II
- Inibitori della topoisomerasi
- Agenti dermatologici
- Micronutrienti
- Antibiotici, Antineoplastici
- Vitamine
- Agenti di conservazione della densità ossea
- Ormoni e agenti regolatori del calcio
- Agenti di controllo riproduttivo
- Antidoti
- Complesso di vitamina B
- Ematinici
- Agenti abortivi, non steroidei
- Agenti abortivi
- Antagonisti dell'acido folico
- Desametasone
- Desametasone acetato
- BB 1101
- Ciclofosfamide
- Leucovorin
- Calcio
- Levoleucovorin
- Prednisone
- Doxorubicina
- Doxorubicina liposomiale
- Citarabina
- Metotrexato
- Vincristina
- Daunorubicina
- Asparaginasi
- Mercaptopurina
- Acido folico
- Calcio, dietetico
- Cortisone
- Tioguanina
- Pegaspargasi
- 2-amminopurina
Altri numeri di identificazione dello studio
- AALL0232 (Altro identificatore: CTEP)
- U10CA098543 (Sovvenzione/contratto NIH degli Stati Uniti)
- 11723 (DAIDS ES Registry Number)
- NCI-2009-00301 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
- COG-AALL0232
- CDR0000349182
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .