Combinatiechemotherapie met of zonder blinatumomab bij de behandeling van patiënten met nieuw gediagnosticeerde BCR-ABL-negatieve B-lineaire acute lymfoblastische leukemie
11 november 2026 bijgewerkt door: National Cancer Institute (NCI)
Een gerandomiseerde fase III-studie van blinatumomab voor nieuw gediagnosticeerde BCR-ABL-negatieve B-lijn acute lymfoblastische leukemie bij volwassenen
This randomized phase III trial studies combination chemotherapy with blinatumomab to see how well it works compared to induction chemotherapy alone in treating patients with newly diagnosed breakpoint cluster region (BCR)-c-abl oncogene 1, non-receptor tyrosine kinase (ABL)-negative B lineage acute lymphoblastic leukemia. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Immunotherapy with monoclonal antibodies, such as blinatumomab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. It is not yet known whether combination chemotherapy is more effective with or without blinatumomab in treating newly diagnosed acute lymphoblastic leukemia.
Studie Overzicht
Toestand
Actief, niet wervend
Conditie
Interventie / Behandeling
- Geneesmiddel: Cyclophosphamide
- Geneesmiddel: Prednisone
- Procedure: Bone Marrow Biopsy
- Procedure: Biospecimen Collection
- Biologisch: Rituximab
- Geneesmiddel: Vincristine
- Geneesmiddel: Vincristine Sulfate
- Geneesmiddel: Dexamethasone
- Procedure: Allogeneic Hematopoietic Stem Cell Transplantation
- Biologisch: Blinatumomab
- Procedure: Bone Marrow Aspiration
- Geneesmiddel: Cytarabine
- Geneesmiddel: Daunorubicin
- Geneesmiddel: Daunorubicin Hydrochloride
- Geneesmiddel: Etoposide
- Geneesmiddel: Leucovorin Calcium
- Procedure: Lumbar Puncture
- Geneesmiddel: Mercaptopurine
- Geneesmiddel: Methotrexate
- Geneesmiddel: Pegaspargase
- Procedure: X-Ray Imaging
Gedetailleerde beschrijving
PRIMARY OBJECTIVE:
I. To compare the overall survival (OS) of blinatumomab in conjunction with chemotherapy to chemotherapy alone in patients with BCR-ABL-negative B cell precursor acute lymphoblastic leukemia (ALL) who are minimal residual disease (MRD) negative after induction and intensification chemotherapy, based on multiparameter flow cytometric (MFC) assessment of residual blasts.
SECONDARY OBJECTIVES:
I. To compare the relapse-free survival (RFS) of blinatumomab in conjunction with chemotherapy to chemotherapy alone in MRD negative patients after induction and intensification chemotherapy.
II. To compare the OS and RFS of those patients who are MRD positive (+) at step 3 randomization/registration and then convert to MRD negative (-) after 2 cycles of blinatumomab to those patients who are MRD- at randomization and remain MRD- after 2 cycles of blinatumomab or consolidation chemotherapy.
III. To assess the toxicities of blinatumomab in this patient population. IV. To assess the toxicities of the modified E2993 chemotherapy regimen in this patient population.
V. To describe the outcome of patients who proceed to allogeneic blood or marrow transplant after treatment with or without blinatumomab.
LABORATORY OBJECTIVES:
I. To determine differences in MRD kinetics among patients with the BCR/ABL1-like B-lineage ALL, and to compare the OS (and RFS) of patients with BCR-ABL-like phenotype with those without BCR-ABL-like phenotype.
II. To evaluate the incidence of anti-blinatumomab antibody formation.
OUTLINE:
INDUCTION CHEMOTHERAPY: Patients receive cytarabine intrathecally (IT) on day 1; daunorubicin hydrochloride intravenously (IV) over 10-15 minutes on days 1, 8, 15, and 22; vincristine sulfate IV on days 1, 8, 15, and 22; dexamethasone orally (PO) daily on days 1-7 (and 15-21 for patients age < 55 years only); methotrexate IT on day 14; pegaspargase intramuscularly (IM) or IV on day 18 (patients age < 55 years); and CD20 positive patients may optionally receive rituximab IV on day 8 and 15. Beginning on day 29, patients with absolute neutrophil count (ANC) >= 0.75 x 10^9/L and platelets > 75 x 10^9/L (patients with delayed hematologic recovery) (patients with residual disease that is delaying count begin treatment immediately) receive cyclophosphamide IV over 30 minutes on days 1 and 29, cytarabine IV over 30 minutes or subcutaneously (SC) on days 1-4, 8-11, 29-32, and 36-39, mercaptopurine PO on days 1-14, 29-42, pegaspargase IM or IV on day 15 (patients age < 55 years), patients receiving treatment for central nervous system (CNS) 2 or 3 leukemia in cycle 1 receive methotrexate IT on days 1, 8, 15, and 22, and CD20 positive patients may optionally receive rituximab IV on days 8 and 15.
INTENSIFICATION THERAPY: Beginning 4 weeks after the completion of cycle 2 of induction therapy, patients receive intensification therapy comprising high-dose methotrexate IV over 2 hours on days 1 and 8, and pegaspargase IM or IV on day 9.
Patients are then randomized to 1 of 2 treatment arms.
Patients randomized to the blinatumomab group receive blinatumomab IV continuously on days 1-28. Treatment repeats every 6 weeks for 2 cycles in the absence of disease progression or unacceptable toxicity. Patients may then undergo allogeneic stem cell transplant (SCT) or proceed to consolidation therapy per investigator discretion.
CONSOLIDATION THERAPY: Beginning after the second cycle of blinatumomab (patients randomized to the blinatumomab group) or after intensification therapy (patients not randomized to blinatumomab), patients receive cytarabine IV over 30 minutes or SC on days 1-5, etoposide IV over 1 hour on days 1-5, methotrexate IT on day 1, and pegaspargase IM or IV on day 5, and CD20 positive patients may optionally receive rituximab IV on day 5. Beginning 4 weeks from day 1 of cycle 1, patients receive cytarabine, etoposide, methotrexate, and CD20 positive patients may receive rituximab as in cycle 1. Beginning 4 weeks from day 1 of cycle 2, patients receive daunorubicin hydrochloride IV over 10-15 minutes on day 1, 8, 15, and 22; vincristine sulfate IV on days 1, 8, 15, and 22; dexamethasone PO daily on days 1-7 (and 15-21 for patients age < 55 years); methotrexate IT on day 2; cyclophosphamide IV over 30 minutes on day 29; cytarabine IV over 30 minutes or SC on days 30-33 and 37-40; mercaptopurine PO on days 29-42 and CD20 positive patients may receive rituximab on day 8. Beginning 8 weeks from day 1 of cycle 3, patients receive cytarabine, etoposide, methotrexate, and CD20 positive patients may optionally receive rituximab as in cycle 1. Patients randomized to blinatumomab repeat cycle 4 and then receive blinatumomab IV continuously on days 1-28.
MAINTENANCE THERAPY: Within 6 weeks after beginning last cycle of consolidation therapy, patients receive mercaptopurine PO daily, methotrexate PO or IV over 2 hours once weekly for 2.5 years, vincristine sulfate IV on day 1 every 3 months, prednisone PO on days 1-5 every 3 months, and methotrexate IT on day 1 every 3 months. Treatment continues for up to 2.5 years in the absence of disease progression or unacceptable toxicity.
Patients undergo x-ray imaging during screening, lumbar puncture while on study, and bone marrow aspiration, bone marrow biopsy, and blood sample collection throughout the study.
After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years, and then every 12 months for 5 years.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
488
Fase
- Fase 3
Contacten en locaties
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Studie Locaties
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Alberta
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Calgary, Alberta, Canada, T2N 5G2
- Arthur J E Child Comprehensive Cancer Centre
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 3P1
- Clinical Research Unit at Vancouver Coastal Health Authority
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 2Y9
- QEII Health Sciences Centre/Nova Scotia Health Authority
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Ontario
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Kingston, Ontario, Canada, K7L 2V7
- Kingston Health Sciences Centre
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Quebec
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Montreal, Quebec, Canada, H1T 2M4
- CIUSSSEMTL-Hopital Maisonneuve-Rosemont
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Saskatchewan
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Regina, Saskatchewan, Canada, S4T 7T1
- Allan Blair Cancer Centre
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Haifa, Israël, 31096
- Rambam Medical Center
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Jerusalem, Israël, 91031
- Shaare Zedek Medical Center
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Bayamón, Puerto Rico, 00959-5060
- Cancer Center-Metro Medical Center Bayamon
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Manati, Puerto Rico, 00674
- Doctors Cancer Center
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San Juan, Puerto Rico, 00917
- San Juan Community Oncology Group
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San Juan, Puerto Rico, 00927
- Centro Comprensivo de Cancer de UPR
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San Juan, Puerto Rico, 00936
- San Juan City Hospital
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Alabama
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Birmingham, Alabama, Verenigde Staten, 35233
- University of Alabama at Birmingham Cancer Center
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Alaska
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Anchorage, Alaska, Verenigde Staten, 98508
- Anchorage Associates in Radiation Medicine
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Anchorage, Alaska, Verenigde Staten, 99508
- Alaska Breast Care and Surgery LLC
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Anchorage, Alaska, Verenigde Staten, 99508
- Alaska Oncology and Hematology LLC
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Anchorage, Alaska, Verenigde Staten, 99508
- Alaska Women's Cancer Care
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Anchorage, Alaska, Verenigde Staten, 99508
- Anchorage Oncology Centre
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Anchorage, Alaska, Verenigde Staten, 99508
- Katmai Oncology Group
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Anchorage, Alaska, Verenigde Staten, 99508
- Providence Alaska Medical Center
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Anchorage, Alaska, Verenigde Staten, 99504
- Anchorage Radiation Therapy Center
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Anchorage, Alaska, Verenigde Staten, 99508
- Alaska Regional Hospital
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Fairbanks, Alaska, Verenigde Staten, 99701
- Fairbanks Memorial Hospital
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Arizona
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Kingman, Arizona, Verenigde Staten, 86401
- Kingman Regional Medical Center
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Tucson, Arizona, Verenigde Staten, 85719
- Banner University Medical Center - Tucson
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Tucson, Arizona, Verenigde Staten, 85719
- University of Arizona Cancer Center-North Campus
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Arkansas
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Fort Smith, Arkansas, Verenigde Staten, 72903
- Mercy Hospital Fort Smith
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Little Rock, Arkansas, Verenigde Staten, 72205
- University of Arkansas for Medical Sciences
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California
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Arroyo Grande, California, Verenigde Staten, 93420
- PCR Oncology
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Burbank, California, Verenigde Staten, 91505
- Providence Saint Joseph Medical Center/Disney Family Cancer Center
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Clovis, California, Verenigde Staten, 93611
- Community Cancer Institute
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Clovis, California, Verenigde Staten, 93611
- University Oncology Associates
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La Jolla, California, Verenigde Staten, 92093
- UC San Diego Moores Cancer Center
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Orange, California, Verenigde Staten, 92868
- UC Irvine Health/Chao Family Comprehensive Cancer Center
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Palo Alto, California, Verenigde Staten, 94304
- Stanford Cancer Institute Palo Alto
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Colorado
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Aurora, Colorado, Verenigde Staten, 80012
- Rocky Mountain Cancer Centers-Aurora
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Aurora, Colorado, Verenigde Staten, 80012
- The Medical Center of Aurora
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Boulder, Colorado, Verenigde Staten, 80303
- Boulder Community Foothills Hospital
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Boulder, Colorado, Verenigde Staten, 80304
- Rocky Mountain Cancer Centers-Boulder
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Denver, Colorado, Verenigde Staten, 80218
- Presbyterian - Saint Lukes Medical Center - Health One
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Denver, Colorado, Verenigde Staten, 80220
- Rose Medical Center
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Denver, Colorado, Verenigde Staten, 80218
- Rocky Mountain Cancer Centers-Midtown
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Denver, Colorado, Verenigde Staten, 80220
- Rocky Mountain Cancer Centers-Rose
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Denver, Colorado, Verenigde Staten, 80218
- Colorado Blood Cancer Institute
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Denver, Colorado, Verenigde Staten, 80204
- Cancer Center of Colorado at Sloan's Lake
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Denver, Colorado, Verenigde Staten, 80209
- The Women's Imaging Center
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Denver, Colorado, Verenigde Staten, 80206
- National Jewish Health-Main Campus
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Denver, Colorado, Verenigde Staten, 80220
- Western Surgical Care
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Denver, Colorado, Verenigde Staten, 80218
- Saint Joseph Hospital - Cancer Centers of Colorado
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Englewood, Colorado, Verenigde Staten, 80113
- Mountain Blue Cancer Care Center - Swedish
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Englewood, Colorado, Verenigde Staten, 80113
- Swedish Medical Center
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Golden, Colorado, Verenigde Staten, 80401
- National Jewish Health-Western Hematology Oncology
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Grand Junction, Colorado, Verenigde Staten, 81501
- Saint Mary's Hospital and Regional Medical Center
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Grand Junction, Colorado, Verenigde Staten, 81505
- Grand Valley Oncology
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Greeley, Colorado, Verenigde Staten, 80631
- Banner North Colorado Medical Center
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Lafayette, Colorado, Verenigde Staten, 80026
- Good Samaritan Hospital - Cancer Centers of Colorado
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Littleton, Colorado, Verenigde Staten, 80120
- Rocky Mountain Cancer Centers-Littleton
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Lone Tree, Colorado, Verenigde Staten, 80124
- Sky Ridge Medical Center
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Lone Tree, Colorado, Verenigde Staten, 80124
- Rocky Mountain Cancer Centers-Sky Ridge
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Loveland, Colorado, Verenigde Staten, 80539
- Banner North Colorado Medical Center - Loveland Campus
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Thornton, Colorado, Verenigde Staten, 80260
- National Jewish Health-Northern Hematology Oncology
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Wheat Ridge, Colorado, Verenigde Staten, 80401
- Intermountain Health Lutheran Hospital
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Connecticut
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Hartford, Connecticut, Verenigde Staten, 06105
- Smilow Cancer Hospital Care Center at Saint Francis
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New Haven, Connecticut, Verenigde Staten, 06520
- Yale University
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Torrington, Connecticut, Verenigde Staten, 06790
- Smilow Cancer Hospital-Torrington Care Center
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District of Columbia
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Washington D.C., District of Columbia, Verenigde Staten, 20016
- Sibley Memorial Hospital
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Florida
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Coral Springs, Florida, Verenigde Staten, 33065
- UM Sylvester Comprehensive Cancer Center at Coral Springs
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Deerfield Beach, Florida, Verenigde Staten, 33442
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
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Hollywood, Florida, Verenigde Staten, 33021
- UM Sylvester Comprehensive Cancer Center at Hollywood
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Jacksonville, Florida, Verenigde Staten, 32207
- Baptist MD Anderson Cancer Center
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Miami, Florida, Verenigde Staten, 33136
- University of Miami Miller School of Medicine-Sylvester Cancer Center
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Miami, Florida, Verenigde Staten, 33176
- UM Sylvester Comprehensive Cancer Center at Kendall
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Plantation, Florida, Verenigde Staten, 33324
- UM Sylvester Comprehensive Cancer Center at Plantation
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Weston, Florida, Verenigde Staten, 33331
- Cleveland Clinic-Weston
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30322
- Emory University Hospital/Winship Cancer Institute
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Atlanta, Georgia, Verenigde Staten, 30342
- Northside Hospital
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Idaho
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Boise, Idaho, Verenigde Staten, 83706
- Saint Alphonsus Cancer Care Center-Boise
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Boise, Idaho, Verenigde Staten, 83712
- Saint Luke's Cancer Institute - Boise
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Caldwell, Idaho, Verenigde Staten, 83605
- Saint Alphonsus Cancer Care Center-Caldwell
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Coeur d'Alene, Idaho, Verenigde Staten, 83814
- Kootenai Health - Coeur d'Alene
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Emmett, Idaho, Verenigde Staten, 83617
- Walter Knox Memorial Hospital
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Fruitland, Idaho, Verenigde Staten, 83619
- Saint Luke's Cancer Institute - Fruitland
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Meridian, Idaho, Verenigde Staten, 83642
- Idaho Urologic Institute-Meridian
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Meridian, Idaho, Verenigde Staten, 83642
- Saint Luke's Cancer Institute - Meridian
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Nampa, Idaho, Verenigde Staten, 83687
- Saint Alphonsus Cancer Care Center-Nampa
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Nampa, Idaho, Verenigde Staten, 83687
- Saint Luke's Cancer Institute - Nampa
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Post Falls, Idaho, Verenigde Staten, 83854
- Kootenai Clinic Cancer Services - Post Falls
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Sandpoint, Idaho, Verenigde Staten, 83864
- Kootenai Clinic Cancer Services - Sandpoint
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Twin Falls, Idaho, Verenigde Staten, 83301
- Saint Luke's Cancer Institute - Twin Falls
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Illinois
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Bloomington, Illinois, Verenigde Staten, 61704
- Illinois CancerCare-Bloomington
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Bloomington, Illinois, Verenigde Staten, 61701
- OSF Saint Joseph Medical Center
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Canton, Illinois, Verenigde Staten, 61520
- Illinois CancerCare-Canton
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Carbondale, Illinois, Verenigde Staten, 62902
- Memorial Hospital of Carbondale
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Carterville, Illinois, Verenigde Staten, 62918
- SIH Cancer Institute
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Carthage, Illinois, Verenigde Staten, 62321
- Illinois CancerCare-Carthage
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Centralia, Illinois, Verenigde Staten, 62801
- Centralia Oncology Clinic
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Chicago, Illinois, Verenigde Staten, 60611
- Northwestern University
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Chicago, Illinois, Verenigde Staten, 60637
- University of Chicago Comprehensive Cancer Center
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Chicago, Illinois, Verenigde Staten, 60612
- University of Illinois
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Chicago, Illinois, Verenigde Staten, 60608
- Mount Sinai Hospital Medical Center
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Decatur, Illinois, Verenigde Staten, 62526
- Decatur Memorial Hospital
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Decatur, Illinois, Verenigde Staten, 62526
- Cancer Care Specialists of Illinois - Decatur
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Dixon, Illinois, Verenigde Staten, 61021
- Illinois CancerCare-Dixon
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Effingham, Illinois, Verenigde Staten, 62401
- Crossroads Cancer Center
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Eureka, Illinois, Verenigde Staten, 61530
- Illinois CancerCare-Eureka
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Evanston, Illinois, Verenigde Staten, 60201
- NorthShore University HealthSystem-Evanston Hospital
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Galesburg, Illinois, Verenigde Staten, 61401
- Western Illinois Cancer Treatment Center
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Galesburg, Illinois, Verenigde Staten, 61401
- Illinois CancerCare-Galesburg
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Glenview, Illinois, Verenigde Staten, 60026
- NorthShore University HealthSystem-Glenbrook Hospital
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Highland Park, Illinois, Verenigde Staten, 60035
- NorthShore University HealthSystem-Highland Park Hospital
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Highland Park, Illinois, Verenigde Staten, 60035
- Hematology Oncology Associates of Illinois-Highland Park
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Kankakee, Illinois, Verenigde Staten, 60901
- Presence Saint Mary's Hospital
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Kewanee, Illinois, Verenigde Staten, 61443
- Illinois CancerCare-Kewanee Clinic
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Libertyville, Illinois, Verenigde Staten, 60048
- AMG Libertyville - Oncology
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Macomb, Illinois, Verenigde Staten, 61455
- Illinois CancerCare-Macomb
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Maywood, Illinois, Verenigde Staten, 60153
- Loyola University Medical Center
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Mount Vernon, Illinois, Verenigde Staten, 62864
- SSM Health Good Samaritan
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Niles, Illinois, Verenigde Staten, 60714
- Illinois Cancer Specialists-Niles
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O'Fallon, Illinois, Verenigde Staten, 62269
- Cancer Care Center of O'Fallon
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Ottawa, Illinois, Verenigde Staten, 61350
- Illinois CancerCare-Ottawa Clinic
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Ottawa, Illinois, Verenigde Staten, 61350
- Radiation Oncology of Northern Illinois
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Pekin, Illinois, Verenigde Staten, 61554
- Illinois CancerCare-Pekin
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Pekin, Illinois, Verenigde Staten, 61554
- OSF Saint Francis Radiation Oncology at Pekin
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Peoria, Illinois, Verenigde Staten, 61636
- Methodist Medical Center of Illinois
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Peoria, Illinois, Verenigde Staten, 61637
- OSF Saint Francis Medical Center
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Peoria, Illinois, Verenigde Staten, 61615
- Illinois CancerCare-Peoria
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Peoria, Illinois, Verenigde Staten, 61615
- OSF Saint Francis Radiation Oncology at Peoria Cancer Center
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Peru, Illinois, Verenigde Staten, 61354
- Illinois CancerCare-Peru
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Peru, Illinois, Verenigde Staten, 61354
- Valley Radiation Oncology
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Princeton, Illinois, Verenigde Staten, 61356
- Illinois CancerCare-Princeton
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Skokie, Illinois, Verenigde Staten, 60076
- Hematology Oncology Associates of Illinois - Skokie
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Skokie, Illinois, Verenigde Staten, 60076
- North Shore Medical Center
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Springfield, Illinois, Verenigde Staten, 62702
- Southern Illinois University School of Medicine
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Springfield, Illinois, Verenigde Staten, 62702
- Springfield Clinic
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Springfield, Illinois, Verenigde Staten, 62702
- Central Illinois Hematology Oncology Center
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Springfield, Illinois, Verenigde Staten, 62781
- Springfield Memorial Hospital
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Swansea, Illinois, Verenigde Staten, 62226
- Southwest Illinois Health Services LLP
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Indiana
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Fort Wayne, Indiana, Verenigde Staten, 46805
- Parkview Hospital Randallia
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Fort Wayne, Indiana, Verenigde Staten, 46845
- Parkview Regional Medical Center
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Indianapolis, Indiana, Verenigde Staten, 46237
- Franciscan Health Indianapolis
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Mooresville, Indiana, Verenigde Staten, 46158
- Franciscan Health Mooresville
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Richmond, Indiana, Verenigde Staten, 47374
- Reid Health
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Iowa
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Ames, Iowa, Verenigde Staten, 50010
- Mary Greeley Medical Center
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Ames, Iowa, Verenigde Staten, 50010
- McFarland Clinic - Ames
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Boone, Iowa, Verenigde Staten, 50036
- McFarland Clinic - Boone
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Fort Dodge, Iowa, Verenigde Staten, 50501
- McFarland Clinic - Trinity Cancer Center
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Jefferson, Iowa, Verenigde Staten, 50129
- McFarland Clinic - Jefferson
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Marshalltown, Iowa, Verenigde Staten, 50158
- McFarland Clinic - Marshalltown
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Kansas
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Chanute, Kansas, Verenigde Staten, 66720
- Cancer Center of Kansas - Chanute
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Dodge City, Kansas, Verenigde Staten, 67801
- Cancer Center of Kansas - Dodge City
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El Dorado, Kansas, Verenigde Staten, 67042
- Cancer Center of Kansas - El Dorado
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Fort Scott, Kansas, Verenigde Staten, 66701
- Cancer Center of Kansas - Fort Scott
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Garden City, Kansas, Verenigde Staten, 67846
- Central Care Cancer Center - Garden City
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Great Bend, Kansas, Verenigde Staten, 67530
- Central Care Cancer Center - Great Bend
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Independence, Kansas, Verenigde Staten, 67301
- Cancer Center of Kansas-Independence
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Kansas City, Kansas, Verenigde Staten, 66160
- University of Kansas Cancer Center
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Kingman, Kansas, Verenigde Staten, 67068
- Cancer Center of Kansas-Kingman
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Lawrence, Kansas, Verenigde Staten, 66044
- Lawrence Memorial Hospital
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Lenexa, Kansas, Verenigde Staten, 66219
- Kansas Institute of Medicine Cancer and Blood Center
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Lenexa, Kansas, Verenigde Staten, 66219
- Minimally Invasive Surgery Hospital
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Liberal, Kansas, Verenigde Staten, 67905
- Cancer Center of Kansas-Liberal
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Manhattan, Kansas, Verenigde Staten, 66502
- Cancer Center of Kansas-Manhattan
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McPherson, Kansas, Verenigde Staten, 67460
- Cancer Center of Kansas - McPherson
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Newton, Kansas, Verenigde Staten, 67114
- Cancer Center of Kansas - Newton
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Olathe, Kansas, Verenigde Staten, 66061
- The University of Kansas Cancer Center - Olathe
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Overland Park, Kansas, Verenigde Staten, 66209
- Menorah Medical Center
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Overland Park, Kansas, Verenigde Staten, 66213
- Saint Luke's South Hospital
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Parsons, Kansas, Verenigde Staten, 67357
- Cancer Center of Kansas - Parsons
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Pratt, Kansas, Verenigde Staten, 67124
- Cancer Center of Kansas - Pratt
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Salina, Kansas, Verenigde Staten, 67401
- Cancer Center of Kansas - Salina
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Wellington, Kansas, Verenigde Staten, 67152
- Cancer Center of Kansas - Wellington
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Westwood, Kansas, Verenigde Staten, 66205
- University of Kansas Hospital-Westwood Cancer Center
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Wichita, Kansas, Verenigde Staten, 67214
- Ascension Via Christi Hospitals Wichita
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Wichita, Kansas, Verenigde Staten, 67208
- Cancer Center of Kansas-Wichita Medical Arts Tower
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Wichita, Kansas, Verenigde Staten, 67214
- Cancer Center of Kansas - Wichita
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Wichita, Kansas, Verenigde Staten, 67208
- Associates In Womens Health
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Wichita, Kansas, Verenigde Staten, 67214
- Wesley Medical Center
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Winfield, Kansas, Verenigde Staten, 67156
- Cancer Center of Kansas - Winfield
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Kentucky
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Crestview Hills, Kentucky, Verenigde Staten, 41017
- Oncology Hematology Care Inc-Crestview
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Louisville, Kentucky, Verenigde Staten, 40202
- The James Graham Brown Cancer Center at University of Louisville
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Louisiana
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Baton Rouge, Louisiana, Verenigde Staten, 70809
- Ochsner Health Center-Summa
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Baton Rouge, Louisiana, Verenigde Staten, 70816
- Medical Center of Baton Rouge
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Baton Rouge, Louisiana, Verenigde Staten, 70836
- Ochsner High Grove
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Monroe, Louisiana, Verenigde Staten, 71202
- Ochsner LSU Health Monroe Medical Center
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New Orleans, Louisiana, Verenigde Staten, 70121
- Ochsner Medical Center Jefferson
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Shreveport, Louisiana, Verenigde Staten, 71103
- LSU Health Sciences Center at Shreveport
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Maine
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Bangor, Maine, Verenigde Staten, 04401
- Eastern Maine Medical Center
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Brewer, Maine, Verenigde Staten, 04412
- Lafayette Family Cancer Center-EMMC
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Maryland
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Baltimore, Maryland, Verenigde Staten, 21287
- Johns Hopkins University/Sidney Kimmel Cancer Center
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Baltimore, Maryland, Verenigde Staten, 21201
- University of Maryland/Greenebaum Cancer Center
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Bethesda, Maryland, Verenigde Staten, 20889-5600
- Walter Reed National Military Medical Center
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Massachusetts
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Boston, Massachusetts, Verenigde Staten, 02215
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, Verenigde Staten, 02215
- Dana-Farber Cancer Institute
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Boston, Massachusetts, Verenigde Staten, 02114
- Massachusetts General Hospital Cancer Center
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Michigan
-
Adrian, Michigan, Verenigde Staten, 49221
- Bixby Medical Center
-
Adrian, Michigan, Verenigde Staten, 49221
- Hickman Cancer Center
-
Ann Arbor, Michigan, Verenigde Staten, 48106
- Trinity Health Saint Joseph Mercy Hospital Ann Arbor
-
Battle Creek, Michigan, Verenigde Staten, 49017
- Bronson Battle Creek
-
Brownstown, Michigan, Verenigde Staten, 48183
- Henry Ford Cancer Institute-Downriver
-
Clinton Township, Michigan, Verenigde Staten, 48038
- Henry Ford Macomb Hospital-Clinton Township
-
Dearborn, Michigan, Verenigde Staten, 48126
- Henry Ford Medical Center-Fairlane
-
Dearborn, Michigan, Verenigde Staten, 48124
- Corewell Health Dearborn Hospital
-
Detroit, Michigan, Verenigde Staten, 48202
- Henry Ford Hospital
-
Detroit, Michigan, Verenigde Staten, 48201
- Wayne State University/Karmanos Cancer Institute
-
Detroit, Michigan, Verenigde Staten, 48236
- Henry Ford Health Saint John Hospital
-
Escanaba, Michigan, Verenigde Staten, 49829
- OSF Saint Francis Hospital and Medical Group
-
Farmington Hills, Michigan, Verenigde Staten, 48334
- Weisberg Cancer Treatment Center
-
Farmington Hills, Michigan, Verenigde Staten, 48336
- Corewell Health Farmington Hills Hospital
-
Flint, Michigan, Verenigde Staten, 48503
- Hurley Medical Center
-
Flint, Michigan, Verenigde Staten, 48503
- Genesys Hurley Cancer Institute
-
Grand Rapids, Michigan, Verenigde Staten, 49503
- Trinity Health Grand Rapids Hospital
-
Grand Rapids, Michigan, Verenigde Staten, 49503
- Corewell Health Grand Rapids Hospitals - Butterworth Hospital
-
Grand Rapids, Michigan, Verenigde Staten, 49503
- Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
-
Grosse Pointe, Michigan, Verenigde Staten, 48230
- William Beaumont Hospital-Grosse Pointe
-
Jackson, Michigan, Verenigde Staten, 49201
- Allegiance Health
-
Kalamazoo, Michigan, Verenigde Staten, 49007
- West Michigan Cancer Center
-
Kalamazoo, Michigan, Verenigde Staten, 49007
- Bronson Methodist Hospital
-
Kalamazoo, Michigan, Verenigde Staten, 49048
- Beacon Kalamazoo
-
Lansing, Michigan, Verenigde Staten, 48912
- University of Michigan Health - Sparrow Lansing
-
Livonia, Michigan, Verenigde Staten, 48154
- Trinity Health Saint Mary Mercy Livonia Hospital
-
Monroe, Michigan, Verenigde Staten, 48162
- Mercy Memorial Hospital
-
Monroe, Michigan, Verenigde Staten, 48162
- Toledo Clinic Cancer Centers-Monroe
-
Muskegon, Michigan, Verenigde Staten, 49444
- Trinity Health Muskegon Hospital
-
Niles, Michigan, Verenigde Staten, 49120
- Corewell Health Lakeland Hospitals - Niles Hospital
-
Norton Shores, Michigan, Verenigde Staten, 49444
- Cancer and Hematology Centers of Western Michigan - Norton Shores
-
Novi, Michigan, Verenigde Staten, 48377
- Henry Ford Medical Center-Columbus
-
Pontiac, Michigan, Verenigde Staten, 48341
- Trinity Health Saint Joseph Mercy Oakland Hospital
-
Port Huron, Michigan, Verenigde Staten, 48060
- Lake Huron Medical Center
-
Port Huron, Michigan, Verenigde Staten, 48060
- Huron Medical Center PC
-
Reed City, Michigan, Verenigde Staten, 49677
- Corewell Health Reed City Hospital
-
Roseville, Michigan, Verenigde Staten, 48066
- Michigan Cancer Specialists
-
Royal Oak, Michigan, Verenigde Staten, 48073
- Cancer Care Associates PC
-
Royal Oak, Michigan, Verenigde Staten, 48073
- Comprehensive Medical Center PLLC
-
Royal Oak, Michigan, Verenigde Staten, 48073
- Oakland Medical Group
-
Royal Oak, Michigan, Verenigde Staten, 48067
- Oakland Colon Rectal Associates
-
Royal Oak, Michigan, Verenigde Staten, 48073
- Hematology Oncology Consultants PC-Royal Oak
-
Royal Oak, Michigan, Verenigde Staten, 48073
- Corewell Health William Beaumont University Hospital
-
Saginaw, Michigan, Verenigde Staten, 48601
- MyMichigan Medical Center Saginaw
-
Saint Joseph, Michigan, Verenigde Staten, 49085
- Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
-
Saint Joseph, Michigan, Verenigde Staten, 49085
- Corewell Health Lakeland Hospitals - Saint Joseph Hospital
-
Sterling Heights, Michigan, Verenigde Staten, 48312
- Premier Hematology Oncology Care
-
Sterling Heights, Michigan, Verenigde Staten, 48314
- Mitchell Folbe MD PC
-
Traverse City, Michigan, Verenigde Staten, 49684
- Munson Medical Center
-
Troy, Michigan, Verenigde Staten, 48084
- Michigan Institute of Urology-Town Center
-
Troy, Michigan, Verenigde Staten, 48085
- Claudia BR Herke MD PC
-
Troy, Michigan, Verenigde Staten, 48098
- Hematology Oncology Consultants PC-Troy
-
Troy, Michigan, Verenigde Staten, 48085
- Corewell Health Beaumont Troy Hospital
-
Warren, Michigan, Verenigde Staten, 48093
- Henry Ford Health Warren Hospital
-
West Bloomfield, Michigan, Verenigde Staten, 48322
- Henry Ford West Bloomfield Hospital
-
Wyoming, Michigan, Verenigde Staten, 49519
- University of Michigan Health - West
-
-
Minnesota
-
Rochester, Minnesota, Verenigde Staten, 55905
- Mayo Clinic in Rochester
-
-
Missouri
-
Ballwin, Missouri, Verenigde Staten, 63011
- Mercy Oncology and Hematology - Clayton-Clarkson
-
Bolivar, Missouri, Verenigde Staten, 65613
- Central Care Cancer Center - Bolivar
-
Bonne Terre, Missouri, Verenigde Staten, 63628
- Parkland Health Center-Bonne Terre
-
Branson, Missouri, Verenigde Staten, 65616
- Cox Cancer Center Branson
-
Cape Girardeau, Missouri, Verenigde Staten, 63703
- Saint Francis Medical Center
-
Cape Girardeau, Missouri, Verenigde Staten, 63703
- Mercy Cancer Center - Cape Girardeau
-
City of Saint Peters, Missouri, Verenigde Staten, 63376
- Siteman Cancer Center at Saint Peters Hospital
-
Creve Coeur, Missouri, Verenigde Staten, 63141
- Siteman Cancer Center at West County Hospital
-
Farmington, Missouri, Verenigde Staten, 63640
- Parkland Health Center - Farmington
-
Independence, Missouri, Verenigde Staten, 64057
- Centerpoint Medical Center LLC
-
Jefferson City, Missouri, Verenigde Staten, 65109
- MU Health Care Goldschmidt Cancer Center
-
Joplin, Missouri, Verenigde Staten, 64804
- Freeman Health System
-
Joplin, Missouri, Verenigde Staten, 64804
- Mercy Hospital Joplin
-
Kansas City, Missouri, Verenigde Staten, 64111
- Saint Luke's Hospital of Kansas City
-
Kansas City, Missouri, Verenigde Staten, 64132
- Research Medical Center
-
Kansas City, Missouri, Verenigde Staten, 64118
- Heartland Hematology and Oncology Associates Incorporated
-
Lee's Summit, Missouri, Verenigde Staten, 64086
- Saint Luke's East - Lee's Summit
-
Liberty, Missouri, Verenigde Staten, 64068
- Liberty Hospital
-
Rolla, Missouri, Verenigde Staten, 65401
- Mercy Clinic-Rolla-Cancer and Hematology
-
Rolla, Missouri, Verenigde Staten, 65401
- Phelps Health Delbert Day Cancer Institute
-
Saint Joseph, Missouri, Verenigde Staten, 64506
- Heartland Regional Medical Center
-
Sainte Genevieve, Missouri, Verenigde Staten, 63670
- Sainte Genevieve County Memorial Hospital
-
Springfield, Missouri, Verenigde Staten, 65807
- CoxHealth South Hospital
-
Springfield, Missouri, Verenigde Staten, 65804
- Mercy Hospital Springfield
-
St Louis, Missouri, Verenigde Staten, 63110
- Washington University School of Medicine
-
St Louis, Missouri, Verenigde Staten, 63129
- Siteman Cancer Center-South County
-
St Louis, Missouri, Verenigde Staten, 63131
- Missouri Baptist Medical Center
-
St Louis, Missouri, Verenigde Staten, 63109
- Mercy Infusion Center - Chippewa
-
St Louis, Missouri, Verenigde Staten, 63141
- Mercy Hospital Saint Louis
-
St Louis, Missouri, Verenigde Staten, 63128
- Mercy Hospital South
-
Sullivan, Missouri, Verenigde Staten, 63080
- Missouri Baptist Sullivan Hospital
-
Washington, Missouri, Verenigde Staten, 63090
- Mercy Hospital Washington
-
-
Montana
-
Anaconda, Montana, Verenigde Staten, 59711
- Community Hospital of Anaconda
-
Billings, Montana, Verenigde Staten, 59101
- Billings Clinic Cancer Center
-
Billings, Montana, Verenigde Staten, 59101
- Saint Vincent Healthcare
-
Billings, Montana, Verenigde Staten, 59102
- Saint Vincent Frontier Cancer Center
-
Bozeman, Montana, Verenigde Staten, 59715
- Bozeman Health Deaconess Hospital
-
Butte, Montana, Verenigde Staten, 59701
- Saint James Community Hospital and Cancer Treatment Center
-
Great Falls, Montana, Verenigde Staten, 59405
- Great Falls Clinic
-
Great Falls, Montana, Verenigde Staten, 59405
- Benefis Sletten Cancer Institute
-
Helena, Montana, Verenigde Staten, 59601
- Saint Peter's Community Hospital
-
Kalispell, Montana, Verenigde Staten, 59901
- Logan Health Medical Center
-
Missoula, Montana, Verenigde Staten, 59802
- Saint Patrick Hospital - Community Hospital
-
Missoula, Montana, Verenigde Staten, 59804
- Community Medical Center
-
-
Nebraska
-
Bellevue, Nebraska, Verenigde Staten, 68123
- Nebraska Medicine-Bellevue
-
Omaha, Nebraska, Verenigde Staten, 68198
- University of Nebraska Medical Center
-
Omaha, Nebraska, Verenigde Staten, 68118
- Nebraska Medicine-Village Pointe
-
-
Nevada
-
Carson City, Nevada, Verenigde Staten, 89703
- Carson Tahoe Regional Medical Center
-
Henderson, Nevada, Verenigde Staten, 89052
- Comprehensive Cancer Centers of Nevada - Henderson
-
Henderson, Nevada, Verenigde Staten, 89052
- Cancer and Blood Specialists-Henderson
-
Henderson, Nevada, Verenigde Staten, 89052
- Las Vegas Cancer Center-Henderson
-
Henderson, Nevada, Verenigde Staten, 89074
- Comprehensive Cancer Centers of Nevada-Southeast Henderson
-
Henderson, Nevada, Verenigde Staten, 89052
- Comprehensive Cancer Centers of Nevada-Horizon Ridge
-
Henderson, Nevada, Verenigde Staten, 89074
- Las Vegas Urology - Green Valley
-
Henderson, Nevada, Verenigde Staten, 89074
- Las Vegas Urology - Pebble
-
Henderson, Nevada, Verenigde Staten, 89074
- Urology Specialists of Nevada - Green Valley
-
Henderson, Nevada, Verenigde Staten, 89074
- Oncology Las Vegas - Henderson
-
Las Vegas, Nevada, Verenigde Staten, 89144
- Summerlin Hospital Medical Center
-
Las Vegas, Nevada, Verenigde Staten, 89109
- Sunrise Hospital and Medical Center
-
Las Vegas, Nevada, Verenigde Staten, 89102
- OptumCare Cancer Care at Charleston
-
Las Vegas, Nevada, Verenigde Staten, 89106
- Radiation Oncology Centers of Nevada Central
-
Las Vegas, Nevada, Verenigde Staten, 89119
- Radiation Oncology Centers of Nevada Southeast
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Comprehensive Cancer Centers of Nevada - Northwest
-
Las Vegas, Nevada, Verenigde Staten, 89128
- OptumCare Cancer Care at MountainView
-
Las Vegas, Nevada, Verenigde Staten, 89135
- Alliance for Childhood Diseases/Cure 4 the Kids Foundation
-
Las Vegas, Nevada, Verenigde Staten, 89144
- Comprehensive Cancer Centers of Nevada - Town Center
-
Las Vegas, Nevada, Verenigde Staten, 89144
- Comprehensive Cancer Centers of Nevada-Summerlin
-
Las Vegas, Nevada, Verenigde Staten, 89148
- Comprehensive Cancer Centers of Nevada
-
Las Vegas, Nevada, Verenigde Staten, 89169
- Comprehensive Cancer Centers of Nevada - Central Valley
-
Las Vegas, Nevada, Verenigde Staten, 89102
- University Medical Center of Southern Nevada
-
Las Vegas, Nevada, Verenigde Staten, 89106
- Cancer and Blood Specialists-Shadow
-
Las Vegas, Nevada, Verenigde Staten, 89109
- HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
-
Las Vegas, Nevada, Verenigde Staten, 89113
- HealthCare Partners Medical Group Oncology/Hematology-San Martin
-
Las Vegas, Nevada, Verenigde Staten, 89121
- Cancer Therapy and Integrative Medicine
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Cancer and Blood Specialists-Tenaya
-
Las Vegas, Nevada, Verenigde Staten, 89128
- HealthCare Partners Medical Group Oncology/Hematology-Tenaya
-
Las Vegas, Nevada, Verenigde Staten, 89148-2405
- Las Vegas Cancer Center-Medical Center
-
Las Vegas, Nevada, Verenigde Staten, 89149
- HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Ann M Wierman MD LTD
-
Las Vegas, Nevada, Verenigde Staten, 89074
- Las Vegas Urology - Pecos
-
Las Vegas, Nevada, Verenigde Staten, 89102
- Desert West Surgery
-
Las Vegas, Nevada, Verenigde Staten, 89103
- Hope Cancer Care of Nevada
-
Las Vegas, Nevada, Verenigde Staten, 89106
- Urology Specialists of Nevada - Central
-
Las Vegas, Nevada, Verenigde Staten, 89113
- Las Vegas Prostate Cancer Center
-
Las Vegas, Nevada, Verenigde Staten, 89113
- Las Vegas Urology - Sunset
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Las Vegas Urology - Cathedral Rock
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Las Vegas Urology - Smoke Ranch
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Urology Specialists of Nevada - Northwest
-
Las Vegas, Nevada, Verenigde Staten, 89169
- University Cancer Center
-
Las Vegas, Nevada, Verenigde Staten, 89113
- Urology Specialists of Nevada - Southwest
-
Las Vegas, Nevada, Verenigde Staten, 89128
- Oncology Las Vegas - Tenaya
-
Las Vegas, Nevada, Verenigde Staten, 89183
- OptumCare Cancer Care at Fort Apache
-
Pahrump, Nevada, Verenigde Staten, 89048
- Hope Cancer Care of Nevada-Pahrump
-
Reno, Nevada, Verenigde Staten, 89502
- Renown Regional Medical Center
-
Reno, Nevada, Verenigde Staten, 89503
- Saint Mary's Regional Medical Center
-
Reno, Nevada, Verenigde Staten, 89509
- Radiation Oncology Associates
-
-
New Hampshire
-
Lebanon, New Hampshire, Verenigde Staten, 03756
- Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center
-
-
New Jersey
-
Basking Ridge, New Jersey, Verenigde Staten, 07920
- Memorial Sloan Kettering Basking Ridge
-
Middletown, New Jersey, Verenigde Staten, 07748
- Memorial Sloan Kettering Monmouth
-
Montvale, New Jersey, Verenigde Staten, 07645
- Memorial Sloan Kettering Bergen
-
New Brunswick, New Jersey, Verenigde Staten, 08903
- Rutgers Cancer Institute of New Jersey
-
-
New York
-
Buffalo, New York, Verenigde Staten, 14263
- Roswell Park Cancer Institute
-
Commack, New York, Verenigde Staten, 11725
- Memorial Sloan Kettering Commack
-
Harrison, New York, Verenigde Staten, 10604
- Memorial Sloan Kettering Westchester
-
Lake Success, New York, Verenigde Staten, 11042
- Northwell Health/Center for Advanced Medicine
-
Manhasset, New York, Verenigde Staten, 11030
- North Shore University Hospital
-
New Hyde Park, New York, Verenigde Staten, 11040
- Long Island Jewish Medical Center
-
New York, New York, Verenigde Staten, 10065
- Memorial Sloan Kettering Cancer Center
-
Rochester, New York, Verenigde Staten, 14642
- University of Rochester
-
Stony Brook, New York, Verenigde Staten, 11794
- Stony Brook University Medical Center
-
The Bronx, New York, Verenigde Staten, 10461
- Montefiore Medical Center-Einstein Campus
-
The Bronx, New York, Verenigde Staten, 10467
- Montefiore Medical Center - Moses Campus
-
The Bronx, New York, Verenigde Staten, 10461
- Montefiore Medical Center-Weiler Hospital
-
Uniondale, New York, Verenigde Staten, 11553
- Memorial Sloan Kettering Nassau
-
-
North Carolina
-
Asheville, North Carolina, Verenigde Staten, 28803
- AdventHealth Infusion Center Asheville
-
Chapel Hill, North Carolina, Verenigde Staten, 27599
- UNC Lineberger Comprehensive Cancer Center
-
Clyde, North Carolina, Verenigde Staten, 28721
- AdventHealth Infusion Center Haywood
-
Hendersonville, North Carolina, Verenigde Staten, 28792
- AdventHealth Hendersonville
-
Winston-Salem, North Carolina, Verenigde Staten, 27157
- Wake Forest University Health Sciences
-
-
Ohio
-
Beavercreek, Ohio, Verenigde Staten, 45431
- Indu and Raj Soin Medical Center
-
Boardman, Ohio, Verenigde Staten, 44512
- Saint Elizabeth Boardman Hospital
-
Bowling Green, Ohio, Verenigde Staten, 43402
- Toledo Clinic Cancer Centers-Bowling Green
-
Centerville, Ohio, Verenigde Staten, 45459
- Miami Valley Hospital South
-
Centerville, Ohio, Verenigde Staten, 45459
- Dayton Physicians LLC-Miami Valley South
-
Cincinnati, Ohio, Verenigde Staten, 45219
- University of Cincinnati Cancer Center-UC Medical Center
-
Cincinnati, Ohio, Verenigde Staten, 45242
- Oncology Hematology Care Inc-Blue Ash
-
Cincinnati, Ohio, Verenigde Staten, 45202
- Oncology Hematology Care Inc-Eden Park
-
Cincinnati, Ohio, Verenigde Staten, 45211
- Oncology Hematology Care Inc-Mercy West
-
Cincinnati, Ohio, Verenigde Staten, 45230
- Oncology Hematology Care Inc-Anderson
-
Cincinnati, Ohio, Verenigde Staten, 45236
- Oncology Hematology Care Inc-Kenwood
-
Cleveland, Ohio, Verenigde Staten, 44106
- Case Western Reserve University
-
Cleveland, Ohio, Verenigde Staten, 44195
- Cleveland Clinic Foundation
-
Columbus, Ohio, Verenigde Staten, 43210
- Ohio State University Comprehensive Cancer Center
-
Dayton, Ohio, Verenigde Staten, 45406
- Good Samaritan Hospital - Dayton
-
Dayton, Ohio, Verenigde Staten, 45409
- Miami Valley Hospital
-
Dayton, Ohio, Verenigde Staten, 45415
- Miami Valley Hospital North
-
Dayton, Ohio, Verenigde Staten, 45415
- Dayton Physician LLC - Englewood
-
Fairfield, Ohio, Verenigde Staten, 45014
- Oncology Hematology Care Inc-Healthplex
-
Findlay, Ohio, Verenigde Staten, 45840
- Blanchard Valley Hospital
-
Findlay, Ohio, Verenigde Staten, 45840
- Armes Family Cancer Center
-
Findlay, Ohio, Verenigde Staten, 45840
- Orion Cancer Care
-
Franklin, Ohio, Verenigde Staten, 45005-1066
- Atrium Medical Center-Middletown Regional Hospital
-
Franklin, Ohio, Verenigde Staten, 45005
- Dayton Physicians LLC-Atrium
-
Greenville, Ohio, Verenigde Staten, 45331
- Wayne Hospital
-
Greenville, Ohio, Verenigde Staten, 45331
- Dayton Physicians LLC-Wayne
-
Kettering, Ohio, Verenigde Staten, 45429
- Kettering Medical Center
-
Kettering, Ohio, Verenigde Staten, 45409
- Greater Dayton Cancer Center
-
Kettering, Ohio, Verenigde Staten, 45420
- First Dayton Cancer Care
-
Lima, Ohio, Verenigde Staten, 45804
- Lima Memorial Hospital
-
Maumee, Ohio, Verenigde Staten, 43537
- Toledo Clinic Cancer Centers-Maumee
-
Maumee, Ohio, Verenigde Staten, 43537
- Toledo Radiation Oncology at Northwest Ohio Onocolgy Center
-
Middletown, Ohio, Verenigde Staten, 45042
- Dayton Physicians LLC-Signal Point
-
Oregon, Ohio, Verenigde Staten, 43616
- Saint Charles Hospital
-
Oregon, Ohio, Verenigde Staten, 43616
- Toledo Clinic Cancer Centers-Oregon
-
Sidney, Ohio, Verenigde Staten, 45365
- Dayton Physicians LLC-Wilson
-
Springfield, Ohio, Verenigde Staten, 45504
- Springfield Regional Cancer Center
-
Springfield, Ohio, Verenigde Staten, 45504
- Springfield Regional Medical Center
-
Sylvania, Ohio, Verenigde Staten, 43560
- ProMedica Flower Hospital
-
Tiffin, Ohio, Verenigde Staten, 44883
- Mercy Hospital of Tiffin
-
Toledo, Ohio, Verenigde Staten, 43606
- ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
-
Toledo, Ohio, Verenigde Staten, 43623
- Mercy Health - Saint Anne Hospital
-
Toledo, Ohio, Verenigde Staten, 43623
- Toledo Clinic Cancer Centers-Toledo
-
Toledo, Ohio, Verenigde Staten, 43614
- University of Toledo
-
Toledo, Ohio, Verenigde Staten, 43617
- Toledo Community Hospital Oncology Program CCOP
-
Toledo, Ohio, Verenigde Staten, 43608
- Mercy Health - Saint Vincent Hospital
-
Troy, Ohio, Verenigde Staten, 45373
- Upper Valley Medical Center
-
Troy, Ohio, Verenigde Staten, 45373
- Dayton Physicians LLC - Troy
-
Warren, Ohio, Verenigde Staten, 44484
- Saint Joseph Warren Hospital
-
Wauseon, Ohio, Verenigde Staten, 43567
- Fulton County Health Center
-
West Chester, Ohio, Verenigde Staten, 45069
- University of Cincinnati Cancer Center-West Chester
-
Wright-Patterson Air Force Base, Ohio, Verenigde Staten, 45433
- Wright-Patterson Medical Center
-
Youngstown, Ohio, Verenigde Staten, 44501
- Saint Elizabeth Youngstown Hospital
-
-
Oklahoma
-
Oklahoma City, Oklahoma, Verenigde Staten, 73104
- University of Oklahoma Health Sciences Center
-
Oklahoma City, Oklahoma, Verenigde Staten, 73120
- Mercy Hospital Oklahoma City
-
-
Oregon
-
Baker City, Oregon, Verenigde Staten, 97814
- Saint Alphonsus Cancer Care Center-Baker City
-
Bend, Oregon, Verenigde Staten, 97701
- Saint Charles Health System
-
Clackamas, Oregon, Verenigde Staten, 97015
- Clackamas Radiation Oncology Center
-
Clackamas, Oregon, Verenigde Staten, 97015
- Providence Cancer Institute Clackamas Clinic
-
Coos Bay, Oregon, Verenigde Staten, 97420
- Bay Area Hospital
-
Newberg, Oregon, Verenigde Staten, 97132
- Providence Newberg Medical Center
-
Ontario, Oregon, Verenigde Staten, 97914
- Saint Alphonsus Cancer Care Center-Ontario
-
Oregon City, Oregon, Verenigde Staten, 97045
- Providence Willamette Falls Medical Center
-
Portland, Oregon, Verenigde Staten, 97213
- Providence Portland Medical Center
-
Portland, Oregon, Verenigde Staten, 97225
- Providence Saint Vincent Medical Center
-
Redmond, Oregon, Verenigde Staten, 97756
- Saint Charles Health System-Redmond
-
-
Pennsylvania
-
Danville, Pennsylvania, Verenigde Staten, 17822
- Geisinger Medical Center
-
Hershey, Pennsylvania, Verenigde Staten, 17033-0850
- Penn State Milton S Hershey Medical Center
-
Philadelphia, Pennsylvania, Verenigde Staten, 19111
- Fox Chase Cancer Center
-
Philadelphia, Pennsylvania, Verenigde Staten, 19107
- Thomas Jefferson University Hospital
-
Philadelphia, Pennsylvania, Verenigde Staten, 19104
- University of Pennsylvania/Abramson Cancer Center
-
Pittsburgh, Pennsylvania, Verenigde Staten, 15232
- UPMC Hillman Cancer Center
-
Scranton, Pennsylvania, Verenigde Staten, 18510
- Community Medical Center
-
-
South Carolina
-
Anderson, South Carolina, Verenigde Staten, 29621
- AnMed Health Cancer Center
-
Boiling Springs, South Carolina, Verenigde Staten, 29316
- Prisma Health Cancer Institute - Spartanburg
-
Easley, South Carolina, Verenigde Staten, 29640
- Prisma Health Cancer Institute - Easley
-
Gaffney, South Carolina, Verenigde Staten, 29341
- Gibbs Cancer Center-Gaffney
-
Greenville, South Carolina, Verenigde Staten, 29605
- Prisma Health Cancer Institute - Faris
-
Greenville, South Carolina, Verenigde Staten, 29607
- Saint Francis Cancer Center
-
Greenville, South Carolina, Verenigde Staten, 29615
- Prisma Health Cancer Institute - Eastside
-
Greenville, South Carolina, Verenigde Staten, 29605
- Prisma Health Cancer Institute - Butternut
-
Greenville, South Carolina, Verenigde Staten, 29601
- Saint Francis Hospital
-
Greenville, South Carolina, Verenigde Staten, 29605
- Prisma Health Greenville Memorial Hospital
-
Greenville, South Carolina, Verenigde Staten, 29601
- Greenville Health System Cancer Institute-Andrews
-
Greer, South Carolina, Verenigde Staten, 29650
- Prisma Health Cancer Institute - Greer
-
Greer, South Carolina, Verenigde Staten, 29651
- Gibbs Cancer Center-Pelham
-
Lancaster, South Carolina, Verenigde Staten, 29720
- Carolina Blood and Cancer Care Associates PA-Lancaster
-
Rock Hill, South Carolina, Verenigde Staten, 29732
- Carolina Blood and Cancer Care Associates PA
-
Seneca, South Carolina, Verenigde Staten, 29672
- Prisma Health Cancer Institute - Seneca
-
Spartanburg, South Carolina, Verenigde Staten, 29303
- Spartanburg Medical Center
-
-
Tennessee
-
Franklin, Tennessee, Verenigde Staten, 37067
- Vanderbilt-Ingram Cancer Center Cool Springs
-
Nashville, Tennessee, Verenigde Staten, 37232
- Vanderbilt University/Ingram Cancer Center
-
Nashville, Tennessee, Verenigde Staten, 37204
- Vanderbilt Breast Center at One Hundred Oaks
-
-
Texas
-
Dallas, Texas, Verenigde Staten, 75235
- Parkland Memorial Hospital
-
Dallas, Texas, Verenigde Staten, 75390
- UT Southwestern/Simmons Cancer Center-Dallas
-
Houston, Texas, Verenigde Staten, 77030
- Houston Methodist Hospital
-
Houston, Texas, Verenigde Staten, 77030
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Houston, Texas, Verenigde Staten, 77030
- Ben Taub General Hospital
-
-
Utah
-
American Fork, Utah, Verenigde Staten, 84003
- American Fork Hospital / Huntsman Intermountain Cancer Center
-
Cedar City, Utah, Verenigde Staten, 84720
- Sandra L Maxwell Cancer Center
-
Farmington, Utah, Verenigde Staten, 84025
- Farmington Health Center
-
Logan, Utah, Verenigde Staten, 84321
- Logan Regional Hospital
-
Murray, Utah, Verenigde Staten, 84107
- Intermountain Medical Center
-
Ogden, Utah, Verenigde Staten, 84403
- McKay-Dee Hospital Center
-
Provo, Utah, Verenigde Staten, 84604
- Utah Valley Regional Medical Center
-
Riverton, Utah, Verenigde Staten, 84065
- Riverton Hospital
-
Salt Lake City, Utah, Verenigde Staten, 84112
- Huntsman Cancer Institute/University of Utah
-
Salt Lake City, Utah, Verenigde Staten, 84106
- Utah Cancer Specialists-Salt Lake City
-
Salt Lake City, Utah, Verenigde Staten, 84143
- LDS Hospital
-
South Jordan, Utah, Verenigde Staten, 84009
- South Jordan Health Center
-
St. George, Utah, Verenigde Staten, 84770
- Saint George Regional Medical Center
-
-
Virginia
-
Fredericksburg, Virginia, Verenigde Staten, 22401
- Fredericksburg Oncology Inc
-
Richmond, Virginia, Verenigde Staten, 23235
- VCU Massey Cancer Center at Stony Point
-
Richmond, Virginia, Verenigde Staten, 23298
- VCU Massey Comprehensive Cancer Center
-
-
Washington
-
Aberdeen, Washington, Verenigde Staten, 98520
- Providence Regional Cancer System-Aberdeen
-
Anacortes, Washington, Verenigde Staten, 98221
- Cancer Care Center at Island Hospital
-
Auburn, Washington, Verenigde Staten, 98001
- MultiCare Auburn Medical Center
-
Bellevue, Washington, Verenigde Staten, 98004
- Overlake Medical Center
-
Bellevue, Washington, Verenigde Staten, 98005
- Swedish Cancer Institute-Eastside Oncology Hematology
-
Bellingham, Washington, Verenigde Staten, 98225
- PeaceHealth Saint Joseph Medical Center
-
Centralia, Washington, Verenigde Staten, 98531
- Providence Regional Cancer System-Centralia
-
Edmonds, Washington, Verenigde Staten, 98026
- Swedish Cancer Institute-Edmonds
-
Everett, Washington, Verenigde Staten, 98201
- Providence Regional Cancer Partnership
-
Gig Harbor, Washington, Verenigde Staten, 98335
- MultiCare Gig Harbor Medical Park
-
Issaquah, Washington, Verenigde Staten, 98029
- Swedish Cancer Institute-Issaquah
-
Kennewick, Washington, Verenigde Staten, 99336
- Kadlec Clinic Hematology and Oncology
-
Lacey, Washington, Verenigde Staten, 98503
- Providence Regional Cancer System-Lacey
-
Longview, Washington, Verenigde Staten, 98632
- PeaceHealth Saint John Medical Center
-
Port Townsend, Washington, Verenigde Staten, 98368
- Jefferson Healthcare
-
Puyallup, Washington, Verenigde Staten, 98372
- MultiCare Good Samaritan Hospital
-
Renton, Washington, Verenigde Staten, 98055
- Valley Medical Center
-
Seattle, Washington, Verenigde Staten, 98107
- Swedish Medical Center-Ballard Campus
-
Seattle, Washington, Verenigde Staten, 98122
- Swedish Medical Center-First Hill
-
Seattle, Washington, Verenigde Staten, 98112
- Kaiser Permanente Washington
-
Seattle, Washington, Verenigde Staten, 98104
- Minor and James Medical PLLC
-
Seattle, Washington, Verenigde Staten, 98104
- Pacific Gynecology Specialists
-
Seattle, Washington, Verenigde Staten, 98122-5711
- Swedish Medical Center-Cherry Hill
-
Sedro-Woolley, Washington, Verenigde Staten, 98284
- PeaceHealth United General Medical Center
-
Shelton, Washington, Verenigde Staten, 98584
- Providence Regional Cancer System-Shelton
-
Spokane, Washington, Verenigde Staten, 99218
- Evergreen Hematology and Oncology PS
-
Spokane, Washington, Verenigde Staten, 99204
- MultiCare Deaconess Cancer and Blood Specialty Center - Downtown
-
Spokane, Washington, Verenigde Staten, 99218
- MultiCare Deaconess Cancer and Blood Specialty Center - North
-
Spokane Valley, Washington, Verenigde Staten, 99216
- MultiCare Deaconess Cancer and Blood Specialty Center - Valley
-
Tacoma, Washington, Verenigde Staten, 98405
- Mary Bridge Children's Hospital and Health Center
-
Tacoma, Washington, Verenigde Staten, 98405
- MultiCare Tacoma General Hospital
-
Vancouver, Washington, Verenigde Staten, 98664
- PeaceHealth Southwest Medical Center
-
Walla Walla, Washington, Verenigde Staten, 99362
- Providence Saint Mary Regional Cancer Center
-
Yakima, Washington, Verenigde Staten, 98902
- North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
-
Yelm, Washington, Verenigde Staten, 98597
- Providence Regional Cancer System-Yelm
-
-
Wisconsin
-
Eau Claire, Wisconsin, Verenigde Staten, 54701
- Marshfield Medical Center-EC Cancer Center
-
Eau Claire, Wisconsin, Verenigde Staten, 54701
- Marshfield Clinic Cancer Center at Sacred Heart
-
Green Bay, Wisconsin, Verenigde Staten, 54301
- Saint Vincent Hospital Cancer Center Green Bay
-
Green Bay, Wisconsin, Verenigde Staten, 54303
- Saint Vincent Hospital Cancer Center at Saint Mary's
-
La Crosse, Wisconsin, Verenigde Staten, 54601
- Gundersen Lutheran Medical Center
-
Madison, Wisconsin, Verenigde Staten, 53792
- University of Wisconsin Carbone Cancer Center - University Hospital
-
Manitowoc, Wisconsin, Verenigde Staten, 54221
- Holy Family Memorial Hospital
-
Marinette, Wisconsin, Verenigde Staten, 54143
- Saint Vincent Hospital Cancer Center at Marinette
-
Marshfield, Wisconsin, Verenigde Staten, 54449
- Marshfield Medical Center-Marshfield
-
Marshfield, Wisconsin, Verenigde Staten, 54449
- Marshfield Medical Center
-
Milwaukee, Wisconsin, Verenigde Staten, 53226
- Medical College of Wisconsin
-
Minocqua, Wisconsin, Verenigde Staten, 54548
- Marshfield Medical Center - Minocqua
-
Oconto Falls, Wisconsin, Verenigde Staten, 54154
- Saint Vincent Hospital Cancer Center at Oconto Falls
-
Rice Lake, Wisconsin, Verenigde Staten, 54868
- Marshfield Medical Center-Rice Lake
-
Sheboygan, Wisconsin, Verenigde Staten, 53081
- HSHS Saint Nicholas Hospital
-
Stevens Point, Wisconsin, Verenigde Staten, 54482
- Marshfield Medical Center-River Region at Stevens Point
-
Sturgeon Bay, Wisconsin, Verenigde Staten, 54235-1495
- Saint Vincent Hospital Cancer Center at Sturgeon Bay
-
Wausau, Wisconsin, Verenigde Staten, 54401
- Marshfield Clinic-Wausau Center
-
Weston, Wisconsin, Verenigde Staten, 54476
- Marshfield Medical Center - Weston
-
-
Wyoming
-
Casper, Wyoming, Verenigde Staten, 82609
- Rocky Mountain Oncology
-
Cheyenne, Wyoming, Verenigde Staten, 82001
- Cheyenne Regional Medical Center-West
-
Cody, Wyoming, Verenigde Staten, 82414
- Big Horn Basin Cancer Center
-
Cody, Wyoming, Verenigde Staten, 82414
- Billings Clinic-Cody
-
Sheridan, Wyoming, Verenigde Staten, 82801
- Welch Cancer Center
-
-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
30 jaar tot 70 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Ja
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria:
-
PRE-REGISTRATION
-
Diagnostic bone marrow and/or peripheral blood specimens must be submitted for immunophenotyping and selected molecular testing, and the establishment of BCR/ABL status; testing will be performed by the Eastern Cooperative Oncology Group (ECOG)-American College of Radiation Imaging Network (ACRIN) Leukemia Translational Research Laboratory (LTRL) and reported to the institution
- NOTE: IT IS ESSENTIAL THAT A SAMPLE CONTAINING SUFFICIENT BLAST CELLS BE SUBMITTED TO THE ECOG-ACRIN LTRL AT BASELINE SO THAT SUBSEQUENT BONE MARROW ASSESSMENTS OF MRD CAN BE DONE; IN ADDITION TO ALLOWING THE LTRL TO CONFIRM ELIGIBILITY BASED ON BLAST CELL IMMUNOPHENOTYPE AND BCR/ABL STATUS, IT IS ALSO IMPERATIVE THAT AN ADEQUATE NUMBER OF BLASTS BE BANKED FOR ANALYSIS BY DRS MULLIGHAN/WILLMAN. WITHOUT ADEQUATE BASELINE SAMPLES, PATIENTS WILL NOT BE ABLE TO BE TREATED AND RANDOMIZED ON THIS PROTOCOL; IF A BONE MARROW ASPIRATE IS NOT AVAILABLE FOR LTRL SUBMISSION AT BASELINE, IT IS IMPERATIVE THAT DR PAIETTA FROM THE LTRL IS CALLED TO DISCUSS THE PERIPHERAL BLOOD WHITE BLOOD CELL (WBC) AND BLAST COUNT BEFORE BLOOD ONLY IS SUBMITTED
- NOTE: Hydroxyurea can be given for up to 5 days prior to initiation of protocol therapy for control of leukocyte count and/or other symptoms or signs; corticosteroids can be given after pre-registration to the protocol and submission of baseline marrow and blood samples for control of leukocyte count and/or other symptoms or signs prior to initiation of protocol therapy if needed; if corticosteroids are given prior to pre-registration, contact the study chair as the patient may still be eligible to participate
-
INDUCTION ELIGIBILITY CRITERIA-STEP 1
-
Age >= 30 years and =< 70 years
-
New diagnosis of B lineage ALL must be made upon bone marrow or peripheral blood immunophenotyping; cases with myeloid antigen expression, but unequivocal lymphoid immunophenotype, are eligible
-
Negativity for the Philadelphia chromosome must be established by conventional cytogenetics, fluorescence in situ hybridization (FISH) and/or polymerase chain reaction (PCR); patients who are negative for the Philadelphia chromosome by conventional cytogenetics must have FISH or PCR performed for BCR/ABL to exclude occult translocations
-
Cytogenetic analysis must be performed from diagnostic bone marrow (preferred) or if adequate number of circulating blasts from peripheral blood; FISH testing for common B-lineage ALL abnormalities including t(9;22) (BCR/ABL1), t(12;21) (ETS-variant gene 6 [ETV6]/runt-related transcription factor 1 [RUNX1]), t(1;19) (pre-B-cell leukemia homeobox 1 [PBX1]/transcription factor 3 [TCF3]), +4,+10,+17, (centromeric [Cen]4/Cen10/Cen17), t(11q23;var), (myeloid/lymphoid or mixed lineage leukemia [MLL]), deletion (del)(9p) (cyclin-dependent kinase inhibitor 2A [CDKN2A]/Cen9), and t(14;var) (immunoglobulin heavy chain [IGH] is encouraged); if there are few or no circulating blasts and an adequate marrow sample cannot be obtained for cytogenetic analysis, the patient may still enroll on the trial
-
Serum direct bilirubin < 2 mg/dl or serum total bilirubin =< 3 (obtained =< 48 hours prior to registration); NOTE: the above stipulation for normal hepatic function does not apply if liver dysfunction is due to leukemia infiltration
-
Serum creatinine < 2 mg/dl (obtained =< 48 hours prior to registration); NOTE: the above stipulation for normal hepatic function does not apply if liver dysfunction is due to leukemia infiltration
-
Patient should be human leukocyte antigen (HLA) typed (A, B, C, DR and DQ) during induction therapy phase or a written explanation for not undergoing HLA typing on the flow sheet
-
Patients with known human immunodeficiency virus (HIV) infection are eligible if they meet all of the following criteria:
- No history of acquired immune deficiency syndrome (AIDS)-related complications other than a history of low CD4+ T-cell count (< 200/mm^3) prior to initiation of combination antiretroviral therapy; on study CD4+ T-cell count may not be informative due to leukemia and should not be used as an exclusion criterion if low
- Patient must be healthy on the basis of HIV disease with high likelihood of near normal life span were it not for the leukemia
- Patient must have serum HIV viral load of < 200 copies/mm^3
- Patient must be on combination antiretroviral therapy with minimal pharmacokinetic interactions with study therapy and minimal overlapping clinical toxicity with protocol therapy
- Patient must not be receiving protease inhibitors or once daily formulations containing cobicistat, stavudine, or on regimens containing stavudine or zidovudine
- It is recommended to utilize a regimen of the integrase inhibitor, dolutegravir, combined with either disoproxil fumarate/emtricitabine or dolutegravir combined with tenofovir alafenamide/emtricitabine
-
Patient must have no history of recent myocardial infarction (within three months), uncontrolled congestive heart failure, or uncontrolled cardiac arrhythmia
-
Patient must have a normal cardiac ejection fraction by pretreatment multigated acquisition scan (MUGA) or echocardiogram within 4 weeks prior to registration (resting ejection fraction >= 40% or >= 5% increase with exercise), shortening fraction by echocardiogram >= 24%, or to within the normal range of values for the institution
-
Women must not be pregnant or breast-feeding due to administration of teratogenic chemotherapy and must not become pregnant or breastfeed during protocol therapy and for at least 3 months after protocol therapy; woman of childbearing potential must abstain from sexual activity or be willing to use 2 highly effective forms of contraception throughout protocol therapy and for at least an additional 3 months after the last dose of protocol-specified therapy; all females of childbearing potential must have a blood test or urine study within 2 weeks prior to registration to rule out pregnancy; a female of childbearing potential is any woman, regardless of whether they have undergone tubal ligation, who meets the following criteria: has not undergone a hysterectomy or bilateral oophorectomy; or has not been naturally postmenopausal for at least 24 consecutive months (i.e., has had menses at any time in the preceding 24 consecutive months)
-
Men who have a female partner of childbearing potential must be willing to use 2 highly effective forms of contraception throughout protocol therapy and for at least an additional 3 months after the last dose of protocol-specified therapy; men who have a pregnant partner must be willing to use a condom during sexual activity throughout protocol therapy and for 3 months after the last dose of protocol-specified therapy
-
ECOG performance score 0-3
-
Patient must have given written informed consent
-
POST-INDUCTION THERAPY ELIGIBILITY CRITERIA (PRIOR TO INTENSIFICATION-STEP 2)
-
ECOG performance status 0-2
-
Patients must have achieved a CR or CRi
-
Patients who have achieved a CR or CRi must have maintained peripheral blood evidence of a CR or CRi
-
Patient must be CNS (cerebrospinal fluid [CSF]) negative for leukemia
-
Patients must have resolved any serious infectious complications related to induction
-
Any significant medical complications related to induction must have resolved
-
Serum creatinine =< 2.0 mg/dl (obtained =< 48 hours prior to registration)
-
Serum direct bilirubin < 2 mg/dL or serum total bilirubin =< 3 (obtained =< 48 hours prior to registration)
-
Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x upper limit of normal (ULN) (obtained =< 48 hours prior to registration)
-
RANDOMIZATION OR ASSIGNMENT TO BLINATUMOMAB OR NO BLINATUMOMAB-STEP 3
-
Patients must have an ECOG performance status of 0-2
-
Patients must have maintained peripheral blood evidence of a remission and must have a CR or CRi, confirmed on restaging bone marrow (BM) aspirate and biopsy
-
Patients must have resolved any serious infectious complications related to therapy
-
Any significant medical complications related to therapy must have resolved
-
Direct or total bilirubin < 1.5 x ULN (unless related to Gilbert's or Meulengracht's syndrome); the values must be obtained within 48 hours prior to randomization
-
Serum creatinine < 1.5 x ULN; the values must be obtained within 48 hours prior to randomization
-
Bone marrow aspirates must be submitted for centralized minimal residual disease (MRD) assessment performed by the ECOG-ACRIN Leukemia Translational Research Laboratory
-
MRD results will be reported to the submitting institution
-
NOTE: FOR MRD ASSESSMENTS, AN ASPIRATE FROM A SEPARATE BONE MARROW ASPIRATION SITE MUST BE SUBMITTED (THE NEEDLE CAN BE RE-DIRECTED THROUGH THE SAME SKIN PUNCTURE SITE); ONLY SUBMIT ASPIRATES FROM THE FIRST PULL OF AN ASPIRATION SITE FOR MRD TESTING; DO NOT SUBMIT SAMPLES FROM THE SECOND OR THIRD PULL OF THE SAME ASPIRATION SITE
-
In B-lineage ALL, MRD levels in peripheral blood or from a dilute marrow aspiration can be 300% lower, on average, than those in bone marrow at a given time point; submitting a first pull from a separate aspiration site will ensure that MRD determinations used in randomization and trial interpretation are accurate
- NOTE: failure to submit bone marrow aspirates will result in a major violation at the time of an audit
-
-
CRITERIA FOR ALLOGENEIC TRANSPLANTATION
-
A suitable donor must be identified; there are no restrictions on donor type and can include a matched sibling, a matched or mismatched unrelated donor, a family haplotype matched donor or a cord blood donor (single or double)
-
Patients should meet the eligibility criteria for RANDOMIZATION OR ASSIGNMENT TO BLINATUMOMAB OR NO BLINATUMOMAB-STEP 3
-
Patients must be considered reliable enough to comply with the medication regimen and follow-up, and have social support necessary to allow this compliance
-
CRITERIA FOR MAINTENANCE THERAPY-STEP 4: Patients must have an ECOG performance status of 0-3
-
CRITERIA FOR MAINTENANCE THERAPY-STEP 4: Patients must have maintained peripheral blood evidence of a remission and must have a CR or CRi, confirmed on restaging BM aspirate and biopsy
-
CRITERIA FOR MAINTENANCE THERAPY-STEP 4: Patients must have resolved any serious infectious complications related to therapy
-
CRITERIA FOR MAINTENANCE THERAPY-STEP 4: Any significant medical complications related to therapy must have resolved
Exclusion Criteria:
- Mature B ALL (Burkitt's-like leukemia) is excluded from enrollment in this trial; pre-study bone marrow biopsy and aspirate must be completed =< 1 week prior to registration
- Patient must not have a concurrent active malignancy for which they are receiving treatment
- Patient must not have intercurrent organ damage or medical problems that will jeopardize the outcome of therapy (i.e., psychiatric disorder, drug abuse, pregnancy)
- Patient must not have an antecedent hematologic disorder
- Patient must not have a history or presence of clinically relevant central nervous system (CNS) pathology such as epilepsy, seizure, paresis, aphasia, stroke, severe brain injuries, dementia; Parkinson's disease, cerebellar disease, organic brain syndrome, psychosis, or other significant CNS abnormalities
- Patient must not have an active uncontrolled infection
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Experimenteel: Arm I (blinatumomab, chemotherapy)
See Detailed Description |
Given IV
Andere namen:
Given PO
Andere namen:
Undergo bone marrow biopsy
Andere namen:
Undergo blood sample collection
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given PO
Andere namen:
Undergo allogeneic hematopoietic SCT
Andere namen:
Given IV
Andere namen:
Undergo bone marrow aspiration Given IT, IV, or SC
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV or PO
Andere namen:
Undergo lumbar puncture
Andere namen:
Given PO
Andere namen:
Given PO, IT or IV
Andere namen:
Given IM or IV
Andere namen:
Undergo x-ray imaging
Andere namen:
|
|
Actieve vergelijker: Arm II (chemotherapy)
See Detailed Description |
Given IV
Andere namen:
Given PO
Andere namen:
Undergo bone marrow biopsy
Andere namen:
Undergo blood sample collection
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given PO
Andere namen:
Undergo allogeneic hematopoietic SCT
Andere namen:
Undergo bone marrow aspiration Given IT, IV, or SC
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV
Andere namen:
Given IV or PO
Andere namen:
Undergo lumbar puncture
Andere namen:
Given PO
Andere namen:
Given PO, IT or IV
Andere namen:
Given IM or IV
Andere namen:
Undergo x-ray imaging
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Overall Survival (OS) Among Patients Who Were MRD Negative After Induction and Intensification Chemotherapy
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
Overall survival is defined as the time from randomization to death of any cause. |
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Relapse-free Survival (RFS) Among Patients Who Were MRD Negative After Induction and Intensification Chemotherapy
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
RFS was defined as time from randomization to relapse or to death without documentation of relapse. Patients without events were censored at the date of last disease assessment. Relapse/Persistent Disease Persistent disease/Relapse following complete remission (CR)/complete remission incomplete (CRi) is defined as:
|
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
|
RFS Among of Those Who Are MRD+ at Randomization and Then Convert to MRD- After 2 Cycles of Blinatumomab to Those Patients Who Are MRD- at Randomization and Remain MRD- After 2 Cycles of Blinatumomab or Consolidation Chemotherapy
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
RFS was defined as time from end of 2 cycles of blinatumomab to relapse or to death without documentation of relapse. Patients without events were censored at the date of last disease assessment. Relapse/Persistent Disease Persistent disease/Relapse following complete remission (CR)/complete remission incomplete (CRi) is defined as:
|
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
|
OS Among of Those Who Are MRD+ at Randomization and Then Convert to MRD- After 2 Cycles of Blinatumomab to Those Patients Who Are MRD- at Randomization and Remain MRD- After 2 Cycles of Blinatumomab or Consolidation Chemotherapy
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
OS was defined as time from end of 2 cycles of blinatumomab to death of any cause |
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
|
OS Among MRD Negative Patients Who Proceed to Allogeneic Transplant on Study
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
OS was defined as time from allogeneic transplant to death of any cause. |
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
To Determine Differences in MRD Kinetics Among Patients With the BCR/ABL1-like B-lineage ALL, and to Compare the OS (and RFS) of Patients With BCR-ABL-like Phenotype With Those Without BCR-ABLlike Phenotype
Tijdsspanne: Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
To determine differences in MRD kinetics among patients with the BCR/ABL1-like B-lineage ALL, and to compare the OS (and RFS) of patients with BCR-ABL-like phenotype with those without BCR-ABLlike phenotype |
Assessed every 3 months for 2 years, then every 6 months for 3 years, then annually for 5 years
|
|
Incidence of Anti-blinatumomab Antibody Formation
Tijdsspanne: Assessed at baseline, end of 2 cycles of blinatumomab, end of 4 cycles of blinatumomab, and end of blinatumomab treatment
|
To evaluate the incidence of anti-blinatumomab antibody formation |
Assessed at baseline, end of 2 cycles of blinatumomab, end of 4 cycles of blinatumomab, and end of blinatumomab treatment
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Onderzoekers
- Hoofdonderzoeker: Mark R Litzow, ECOG-ACRIN Cancer Research Group
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Seftel MD. Hyper-CVAD: a regimen for all seasons. Lancet Haematol. 2020 Jul;7(7):e501-e502. doi: 10.1016/S2352-3026(20)30179-4. No abstract available.
- Litzow MR, Sun Z, Mattison RJ, Paietta EM, Roberts KG, Zhang Y, Racevskis J, Lazarus HM, Rowe JM, Arber DA, Wieduwilt MJ, Liedtke M, Bergeron J, Wood BL, Zhao Y, Wu G, Chang TC, Zhang W, Pratz KW, Dinner SN, Frey N, Gore SD, Bhatnagar B, Atallah EL, Uy GL, Jeyakumar D, Lin TL, Willman CL, DeAngelo DJ, Patel SB, Elliott MA, Advani AS, Tzachanis D, Vachhani P, Bhave RR, Sharon E, Little RF, Erba HP, Stone RM, Luger SM, Mullighan CG, Tallman MS. Blinatumomab for MRD-Negative Acute Lymphoblastic Leukemia in Adults. N Engl J Med. 2024 Jul 25;391(4):320-333. doi: 10.1056/NEJMoa2312948.
- Zhong X, Roberts KG, Wei H, Sun Z, Montefiori LE, Kumar A, Iacobucci I, Baviskar P, Gao Q, Polonen P, Pruett-Miller SM, Schreiber RM, Chang TC, Zhang W, Lei S, Rampersaud E, Fan Y, Wu G, Mattison RJ, Zhang Y, Racevskis J, Lazarus HM, Rowe JM, Arber DA, Wieduwilt MJ, Abou Mourad Y, Shami PJ, Baer MR, Asch AS, O'Dwyer KM, Hall A, Liedtke M, Bergeron J, Wood BL, Pratz KW, Dinner SN, Frey NV, Gore SD, Bhatnagar B, Atallah EL, Uy GL, Jeyakumar D, Lin TL, Willman CL, Podoltsev NA, DeAngelo DJ, Patel S, Elliott MA, Advani AS, Tzachanis D, Vachhani P, Bhave RR, Sharon E, Little RF, Erba HP, Stone RM, Tallman MS, Yang JJ, Luger SM, Paietta E, Litzow MR, Mullighan CG. Genomic drivers of leukemia and blinatumomab response in adult acute lymphoblastic leukemia - the ECOG-ACRIN E1910 study. Blood. 2026 Oct 5:blood.2026033793. doi: 10.1182/blood.2026033793. Online ahead of print.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
19 mei 2014
Primaire voltooiing (Werkelijk)
23 juni 2023
Studie voltooiing (Geschat)
25 februari 2027
Studieregistratiedata
Eerst ingediend
2 december 2013
Eerst ingediend dat voldeed aan de QC-criteria
2 december 2013
Eerst geplaatst (Geschat)
6 december 2013
Updates van studierecords
Laatste update geplaatst (Werkelijk)
13 november 2026
Laatste update ingediend die voldeed aan QC-criteria
11 november 2026
Laatst geverifieerd
1 september 2026
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Neoplasmata
- Ziekten van het immuunsysteem
- Infecties
- Virusziekten
- Neoplasmata per histologisch type
- Hematologische ziekten
- DNA-virusinfecties
- Lymfatische ziekten
- Lymfoproliferatieve aandoeningen
- Immunoproliferatieve aandoeningen
- Lymfoom, non-Hodgkin
- Lymfoom, B-cel
- Lymfoom
- Leukemie, Lymfoïde
- Leukemie
- Epstein-Barr-virusinfecties
- Herpesviridae-infecties
- Tumorvirusinfecties
- Hemische en lymfatische ziekten
- Voorlopercel lymfoblastische leukemie-lymfoom
- Burkitt lymfoom
- Aminozuren, peptiden en eiwitten
- Eiwitten
- Zwavelverbindingen
- Organische chemicaliën
- Heterocyclische verbindingen, 1-ring
- Heterocyclische verbindingen
- Heterocyclische verbindingen, 2-ring
- Heterocyclische verbindingen, gefuseerd ring
- Onderzoekstechnieken
- Therapeutica
- Klinische laboratoriumtechnieken
- Diagnostische technieken en procedures
- Diagnose
- Buren
- Chirurgische procedures, operatief
- Cytologische technieken
- Nucleïnezuren, nucleotiden en nucleosiden
- Cytodiagnose
- Koolwaterstoffen
- Koolwaterstoffen, cyclisch
- Koolhydraten
- Fysieke fenomeen
- Alkaloïden
- Podophyllotoxine
- Tetrahydronaftalenes
- Naftalenen
- Polycyclische aromatische koolwaterstoffen
- Koolwaterstoffen, aromatisch
- Polycyclische verbindingen
- Glucosiden
- Glycosiden
- Transplantatie
- Apparatuur en benodigdheden
- Enzymen en co -enzymen
- Indolen
- Antilichamen, monoklonaal
- Antilichamen
- Immunoglobulinen
- Immunoproteïnen
- Bloedeiwitten
- Serum -globulines
- Globulines
- Purines
- Cytidine
- Pyrimidine -nucleosiden
- Pyrimidines
- Zwangerschap
- Zwangere
- Steroïden
- Verbindingen met gefuseerde ring
- Steroïden, gefluoreerd
- Benzeenderivaten
- Diagnostische technieken, chirurgisch
- Sulfonzuren
- Zwavelzuren
- Fosforamide mosterd
- Stikstofmosterdverbindingen
- Mosterdverbindingen
- Koolwaterstoffen, gehalogeneerd
- Fosforamides
- Organofosforverbindingen
- Nucleosiden
- Formyltetrahydrofolates
- Tetrahydrofolaten
- Foliumzuur
- Pterins
- Pteridines
- Zwangerschap
- Zwangerschap
- Vinca -alkaloïden
- Secologanin tryptamine alkaloïden
- Indol alkaloïden
- Indolizidines
- Indolizines
- Arabinonucleosides
- Aminopterine
- Antracyclines
- Naftacenes
- Aminoglycosides
- Co -enzymen
- Elektromagnetische fenomenen
- Magnetische fenomenen
- Antilichamen, monoklonaal, van murine afgeleid
- Celtransplantatie
- Op cellen en weefsel gebaseerde therapie
- Biologische therapie
- Diagnostische technieken, neurologisch
- Elektromagnetische straling
- Bestraling
- Straling, ionisatie
- Benzenesulfonaten
- Arylsulfonaten
- Arylsulfonzuren
- Sulfhydrylverbindingen
- Rituximab
- Dexamethason
- Methotrexaat
- Prednison
- Cyclofosfamide
- Cytarabine
- Etoposide
- Leucovorin
- Vincristine
- Daunorubicine
- Mercaptopurine
- Calciumdobesilaat
- Biopsie
- Exemplaarbehandeling
- blinatumomab
- Stamceltransplantatie
- Spinale punctie
- Dexamethason 21-fosfaat
- Röntgenstralen
- CT-P10
- deltacorteen
- prednylidene
- N, N-dicyclohexyl-isoborneol-10-sulfonamide
- azathiopurine
- Merphos
- pegaspargase
- Fantomen, beeldvorming
- auricularum
- Dexamethason acetaat
Andere studie-ID-nummers
- NCI-2013-02229
- U10CA180820 (Subsidie/contract van de Amerikaanse NIH)
- U24CA196172 (Subsidie/contract van de Amerikaanse NIH)
- U10CA021115 (Subsidie/contract van de Amerikaanse NIH)
- NCI-2013-02229 (Register-ID: CTRP (Clinical Trial Reporting Program))
- ECOG-E1910
- E1910 (Andere identificatie: CTEP)
- PE1910_A08PAMDREVW01
- E1910 (Andere identificatie: ECOG-ACRIN Cancer Research Group)
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Ja
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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