成熟 B 细胞淋巴瘤和白血病研究 III
This is a phase III clinical trial using risk-adapted therapy. Treatment outcomes for children with B-cell NHL are excellent. Further improvements in outcome will likely be achieved through more focused study of the biology of the tumors and prospective studies of the late effects of treatment. Toward this end, this study features a spectrum of prospective biologic and late effect studies performed in patients treated with a modified regimen derived from the very successful LMB-96 regimen.
研究概览
详细说明
- This study will perform analysis of newly diagnosed mature B-cell lymphomas (e.g. Burkitt lymphoma/leukemia, DLBCL, and MLBCL) obtained from participants in different parts of the world.
- This study will describe the types and frequency of mutations in the ARF-HDM2-TP53 pathway, in B-cell lymphomas in the United States and that found in selected geographic regions of the world.
- This study will describe the expression of ARF-HDM2-TP53 and PUMA-associated pathways in B-cell lymphomas in the United States and that found in B-cell lymphomas of other selected geographic regions of the world.
- This study will describe the pattern and frequency of XLP gene mutations presenting with B-cell lymphomas in the United States and selected geographic regions.
- This study will describe the frequency of EBV-positive B-cell lymphomas in the United States and selected geographic regions of the world: and will describe the pattern of EBV protein and gene expression (e.g., EBNA 3) in EBV-positive lymphomas and the study will compare patterns of EBV protein and gene expression with clinical, laboratory and outcome data.
Exploratory Aims:
To estimate the complete response rate, event-free survival, and overall survival rates in patients with Burkitt lymphoma (BL), Burkitt leukemia/B-cell acute leukemia (B-ALL) and diffuse large B-cell lymphoma (DLBCL) treated with a stage-adapted regimen based on the St. Jude B-cell II protocol.
研究类型
注册 (实际的)
阶段
- 阶段2
- 第三阶段
联系人和位置
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
St. Jude participants and collaborating sites participating in therapeutic and biological objectives:
-
Participant must have a histologic diagnosis of a mature B cell lymphoma (e.g., Burkitt lymphoma/leukemia, atypical Burkitt lymphoma, diffuse large B-cell lymphoma, mediastinal large B-cell lymphoma, mature B-cell lymphoma NOS) as defined in the WHO classification.
-
Participant must be previously untreated, (no more than 72 hours of steroids, one intrathecal chemotherapy treatment, and/or emergency radiation).
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Participant must be < 22 years of age at the time of diagnosis
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For selected higher-risk CD20+ Group B and all CD20+ Group C participants receiving rituximab only (e.g., those with MLBLC, Stage III with LDH ≥ 2 times upper limit of normal (ULN), and/or bone marrow/CNS involvement: All participants who will receive rituximab must have hepatitis screening prior to enrollment. Participants whose results indicate that they are carrier of hepatitis B can still be treated per Group B or C but will NOT receive rituximab. This screening must be done for eligibility for participants who will receive rituximab, BUT the results are not needed prior to enrollment:
- Hepatitis B immunization status (vaccination Yes or No)
- HBsAg
- Anti-HBs antibody
- Anti-HBc antibody.
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All participants must have screening prior to enrollment; participants whose results indicate that they are carrier of hepatitis B can still be treated per group B and C but will NOT receive rituximab
-
HIV test has been obtained within 42 days. Participants who test positive for HIV cannot be enrolled on therapeutic part of study, but are still eligible for biology studies.
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Informed consent must be obtained according to St. Jude guidelines before enrollment into study.
Participants from Collaborating Sites Participating in Biological Objectives Only:
- Participant must have a histologic diagnosis of a mature B cell lymphoma (e.g., Burkitt lymphoma/leukemia, atypical Burkitt lymphoma, diffuse large B-cell lymphoma, mediastinal large B-cell lymphoma, mature B-cell lymphoma NOS) as defined in the WHO classification.
- Participant must be < 22 years of age at the time of diagnosis.
- Participant must be previously untreated (no more than 72 hours of steroids, one intrathecal chemotherapy treatment, and/or emergency radiation) at the time of the diagnostic biopsy.
- Informed consent must be obtained by local PI or his/her designee according to ICH/Good Clinical Practice and local guidelines before enrollment into study.
Exclusion Criteria:
Participants from Collaborating Sites Participating in Therapeutic and Biological Objectives:
- Participants known to be HIV positive (for therapeutic part of protocol, HIV participants are eligible for biology studies).
- Participants who are pregnant or lactating.
- Inability or unwillingness of research participant or legal guardian to consent.
Participants from Collaborating Sites Participating in Biological Objectives Only:
- Inability or unwillingness of research participant or legal guardian to consent.
- Histologic diagnosis other than a mature B-cell lymphoma as defined in the WHO classification.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他:Group A
Completely resected stage I or completely resected abdominal stage II lesions. Group A will include: COPAD x 2 cycles. |
Vincristine Prednis(ol)one, Cyclophosphamide, Doxorubicin, G-CSF In the event the patient cannot receive G-CSF, Pegfilgrastim can be substituted.
其他名称:
|
|
其他:Group B
All cases not eligible for Group A or Group C. (Murphy Stage III and non-CNS Stage IV) Group B will include the intervention COP, COPD M3, CYM as follows: Pre-Phase: COP Induction: COPAD M3 x 2 cycles Consolidation: CYM x 2 cycles. |
GROUP B Treatment Details Intravenous fluids should be given at a rate of 3000 mL/m2/day. Use of rasburicase may preclude the need for HCO3 Pre-Phase: Cyclophosphamide, Vincristine, Prednis(ol)one, IT medications Induction (2 cycles): Vincristine, Prednis(ol)one, Methotrexate, Leucovorin, Cyclophosphamide, Doxorubicin, IT medications, G-CSF, Rituximab Consolidation (2 cycles): Methotrexate, Leucovorin, Cytarabine, IT medications, G-CSF, Rituximab In the event the patient cannot receive G-CSF, Pegfilgrastim can be substituted.
其他名称:
|
|
其他:Group C
Any CNS involvement and/or bone marrow involvement ≥ 25% blasts. For CNS involvement one or more of the following applies:
Group C will include the intervention COP, COPADM8, CYVE as follows: Pre-Phase: COP Induction: COPADM8 cycle 1 Induction: COPADM8 Cycle 2 Consolidation: CYVE x 2 cycles and Maintenance |
Treatment: Intravenous fluids should be given at a rate of 3000 mL/m2/day. Use of rasburicase may preclude the need for HCO3. COP Pre-Phase: Cyclophosphamide, Vincristine, Prednis(ol)one, IT medications, Leucovorin. COPADM8 Induction (2 cycles): Vincristine, Prednis(ol)one, Methotrexate, Leucovorin, Cyclophosphamide, Doxorubicin, Rituximab, IT medications, G-CSF CYVE Consolidation (2 cycles): Cytarabine, High-Dose Ara-C, Etoposide, Rituximab, G-CSF. Maintenance No.1: Vincristine, Prednis(ol)one, Cyclophosphamide, Methotrexate, Leucovorin, Doxorubicin, IT medications, G-CSF. Maintenance No.2: Cytarabine, Etoposide, G-CSF, IT Medications. Maintenance No.3: Vincristine, Prednis(ol)one, Cyclophosphamide, Doxorubicin, G-CSF, IT Medications. Maintenance No. 4: Cytarabine, Etoposide, G-CSF, IT Medications. In the event the patient cannot receive G-CSF, Pegfilgrastim can be substituted.
其他名称:
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Gene Differential Expression Profiling of Burkitt Lymphoma (BL) vs. Non-BL in the US and Other Selected Geographic Regions of the World
大体时间:1 year after the participant is enrolled
|
Gene expression levels in BL vs. non-BL will be analyzed through approximately 22,000 probesets on the Affymetrix U133A GeneChip by using two-factor analysis of variance model for each gene. |
1 year after the participant is enrolled
|
|
Catalog and Estimate Frequencies of Copy Number Variations in Childhood Lymphomas
大体时间:1 year after the participant is enrolled
|
The prevalence of CNVs between different subtypes of childhood lymphomas and geographic regions will be reported and compared with exact chi-square or Fisher's test. The CNVs are derived from Affymetrix SNP arrays. |
1 year after the participant is enrolled
|
|
Integrated Analysis of CNVs and Gene Expressions in the US and Other Selected Geographic Regions of the World
大体时间:1 year after the participant is enrolled
|
The association between the identified CNVs and gene expressions in the study cohort will be examined by using general linear models, and multiple tests will be considered. Gene expressions are measured by Affymetrix U133A arrays and CNVs are derived from Affymetrix SNP arrays. |
1 year after the participant is enrolled
|
|
Pattern and Frequency of XLP Gene Mutations Presenting With B-cell Lymphomas in the United States and Selected Geographic Regions
大体时间:1 year after the participant enrollment
|
Frequency of XLP mutation among boys will be calculated in each geographical region as well as in all regions pooled. The frequency is reported here as the number of boys with XLP gene mutations found in B-cell lymphomas boys. |
1 year after the participant enrollment
|
|
Frequency of EBV Protein Expression (e.g., EBNA 3) in EBV-positive Lymphomas
大体时间:1 year after the participant is enrolled
|
Frequency of EBV-positive BL will be calculated for each geographical region. |
1 year after the participant is enrolled
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Overall Survival
大体时间:Up to 5 years after completion of therapy
|
Overall survival (OS) will be estimated among eligible patients treated at SJCRH by the Kaplan-Meier estimator. |
Up to 5 years after completion of therapy
|
|
Event-free Survival
大体时间:Up to 5 years after completion of therapy
|
Event-free survival (EFS) will be estimated among eligible patients treated at SJCRH by the Kaplan-Meier estimator. The events will include: (1) death while in continuous CR, (2) relapse, (3) secondary malignancy, and (4) failure to achieve complete response (CR). |
Up to 5 years after completion of therapy
|
|
Complete Response Rate
大体时间:Up to 5 years after completion of therapy
|
Complete response rate will be estimated with exact 95% CI based on the binomial distribution, and it will be reported as the percentage of patients who reached complete remission among eligible patients treated at SJCRH |
Up to 5 years after completion of therapy
|
合作者和调查者
调查人员
- 首席研究员:Raul Ribeiro, MD、St. Jude Children's Research Hospital
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
- 肿瘤
- 免疫系统疾病
- 组织学类型的肿瘤
- 血液病
- 淋巴系统疾病
- 淋巴增生性疾病
- 免疫增生性疾病
- 半身和淋巴疾病
- 白血病
- 淋巴瘤
- 淋巴瘤,非霍奇金
- 肽
- 氨基酸,肽和蛋白质
- 蛋白质
- 有机化学品
- 杂环化合物,1形
- 杂环化合物
- 杂环化合物,2环
- 杂环化合物,融合环
- 核酸,核苷酸和核苷
- 碳氢化合物
- 碳氢化合物,循环
- 生物因素
- 碳水化合物
- Podophyllotoxin
- 四氢乙烯甲烯烃
- 萘
- 多环芳烃
- 碳氢化合物,芳香族
- 多环化合物
- 葡萄糖剂
- 糖苷
- 酶和辅酶
- 抗体,单克隆
- 抗体
- 免疫球蛋白
- 免疫蛋白
- 血蛋白
- 血清球蛋白
- 球蛋白
- 胞苷
- 嘧啶核苷
- 嘧啶
- 怀孕
- 怀孕
- 类固醇
- 融合环化合物
- 磷酰胺芥末
- 氮芥末化合物
- 芥末化合物
- 碳氢化合物,卤素
- 磷酰胺
- 有机磷化合物
- 核苷
- 甲基四氢胶酸盐
- 四氢胶质
- 叶酸
- 翼
- 翼状
- 细胞间信号肽和蛋白质
- 妊娠二培养子
- 阿拉伯核苷
- 蒽环类动物
- 萘烯
- 氨基糖苷
- 辅酶
- 糖蛋白
- 糖缀合物
- 抗体,单克隆,鼠的衍生
- Daunorubicin
- 菌落刺激因素
- 造血细胞生长因子
- 细胞因子
- 粒细胞群刺激因子
- 利妥昔单抗
- 强的松
- 环磷酰胺
- 阿糖胞苷
- 依托泊苷
- 亚叶酸
- 阿霉素
- Filgrastim
- Pegfilgrastim
- 拉布立酶
其他研究编号
- SJBC3
- NCI-2011-01251 (注册表标识符:NCI Clinical Trial Registration Program)
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