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- Klinische proef 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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
- Geneesmiddel: cyclofosfamide
- Geneesmiddel: leucovorine calcium
- Straling: bestralingstherapie
- Geneesmiddel: prednison
- Geneesmiddel: cytarabine
- Geneesmiddel: daunorubicine hydrochloride
- Geneesmiddel: etoposide
- Geneesmiddel: methotrexaat
- Geneesmiddel: vincristine sulfaat
- Geneesmiddel: thioguanine
- Geneesmiddel: doxorubicine hydrochloride
- Biologisch: filgrastim
- Geneesmiddel: pegaspargase
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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Western Australia
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Perth, Western Australia, Australië, 6001
- Princess Margaret Hospital for Children
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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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Nova Scotia
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Halifax, Nova Scotia, Canada, B3J 3G9
- IWK Grace Health Centre
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California
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Long Beach, California, Verenigde Staten, 90806
- Long Beach Memorial Medical Center
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Los Angeles, California, Verenigde Staten, 90095-1781
- Jonsson Comprehensive Cancer Center, UCLA
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Los Angeles, California, Verenigde Staten, 90027-0700
- Children's Hospital Los Angeles
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Orange, California, Verenigde Staten, 92668
- Children's Hospital of Orange County
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San Francisco, California, Verenigde Staten, 94115-0128
- UCSF Cancer Center and Cancer Research Institute
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Colorado
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Denver, Colorado, Verenigde Staten, 80218
- Children's Hospital of Denver
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District of Columbia
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Washington, District of Columbia, Verenigde Staten, 20010-2970
- Children's National Medical Center
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Illinois
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Chicago, Illinois, Verenigde Staten, 60637
- University of Chicago Cancer Research Center
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Indiana
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Indianapolis, Indiana, Verenigde Staten, 46202-5265
- Indiana University Cancer Center
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Iowa
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Iowa City, Iowa, Verenigde Staten, 52242
- University of Iowa Hospitals and Clinics
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Michigan
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Ann Arbor, Michigan, Verenigde Staten, 48109-0752
- University Of Michigan Comprehensive Cancer Center
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Minnesota
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Rochester, Minnesota, Verenigde Staten, 55905
- Mayo Clinic Cancer Center
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Missouri
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Kansas City, Missouri, Verenigde Staten, 64108
- Children's Mercy Hospital
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68198-3330
- University of Nebraska Medical Center
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New Jersey
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Paterson, New Jersey, Verenigde Staten, 07503
- St. Joseph's Hospital and Medical Center
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New York
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New York, New York, Verenigde Staten, 10021
- Memorial Sloan-Kettering Cancer Center
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New York, New York, Verenigde Staten, 10016
- NYU School of Medicine's Kaplan Comprehensive Cancer Center
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New York, New York, Verenigde Staten, 10032
- Herbert Irving Comprehensive Cancer Center
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North Carolina
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Chapel Hill, North Carolina, Verenigde Staten, 27599-7295
- Lineberger Comprehensive Cancer Center, UNC
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Ohio
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Cincinnati, Ohio, Verenigde Staten, 45229-3039
- Children's Hospital Medical Center - Cincinnati
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Cleveland, Ohio, Verenigde Staten, 44106-5065
- Ireland Cancer Center
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Columbus, Ohio, Verenigde Staten, 43205-2696
- Children's Hospital of Columbus
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Oregon
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Portland, Oregon, Verenigde Staten, 97201-3098
- Doernbecher Children's Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, Verenigde Staten, 19104
- Children's Hospital of Philadelphia
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Pittsburgh, Pennsylvania, Verenigde Staten, 15213
- Children's Hospital of Pittsburgh
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Tennessee
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Nashville, Tennessee, Verenigde Staten, 37232-6838
- Vanderbilt Cancer Center
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Texas
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Houston, Texas, Verenigde Staten, 77030-4009
- University of Texas - MD Anderson Cancer Center
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Utah
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Salt Lake City, Utah, Verenigde Staten, 84132
- Huntsman Cancer Institute
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Washington
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Seattle, Washington, Verenigde Staten, 98105
- Children's Hospital and Regional Medical Center - Seattle
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Wisconsin
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Madison, Wisconsin, Verenigde Staten, 53792
- University of Wisconsin Comprehensive Cancer Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Regime A
Zie gedetailleerde beschrijving.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
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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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
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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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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Studie stoel: Minnie Abromowitch, MD, Children's Hospital Medical Center, Cincinnati
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Ziekten van het immuunsysteem
- Neoplasmata per histologisch type
- Neoplasmata
- Lymfoproliferatieve aandoeningen
- Lymfatische ziekten
- Immunoproliferatieve aandoeningen
- Lymfoom
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Anti-infectieuze middelen
- Antivirale middelen
- Nucleïnezuursyntheseremmers
- Enzymremmers
- Ontstekingsremmende middelen
- Antireumatische middelen
- Antimetabolieten, antineoplastische
- Antimetabolieten
- Antineoplastische middelen
- Immunosuppressieve middelen
- Immunologische factoren
- Tubuline-modulatoren
- Antimitotische middelen
- Mitose modulatoren
- Glucocorticoïden
- Hormonen
- Hormonen, hormoonvervangers en hormoonantagonisten
- Antineoplastische middelen, hormonaal
- Beschermende middelen
- Antineoplastische middelen, alkylering
- Alkyleringsmiddelen
- Myeloablatieve agonisten
- Antineoplastische middelen, fytogeen
- Topoisomerase II-remmers
- Topoisomeraseremmers
- Dermatologische middelen
- Micronutriënten
- Antibiotica, antineoplastiek
- Vitaminen
- Reproductieve controlemiddelen
- Tegengif
- Vitamine B-complex
- Afbrekende middelen, niet-steroïde
- Abortieve agenten
- Foliumzuurantagonisten
- Cyclofosfamide
- Etoposide
- Leucovorin
- Levoleucovorine
- Prednison
- Doxorubicine
- Liposomale doxorubicine
- Cytarabine
- Methotrexaat
- Vincristine
- Daunorubicine
- Asparaginase
- Thioguanine
- Pegaspargase
Andere studie-ID-nummers
- 5941
- CCG-5941 (Andere identificatie: Children's Cancer Group)
- CDR0000063751 (Andere identificatie: NCI)
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