NCT01451515

Brief Summary

This is a phase II clinical trial using risk-adapted therapy. The treatment is acute lymphoblastic leukemia (ALL)-based therapy, using multi-agent regimens comprising of induction, consolidation, and continuation (maintenance) phases delivered over 24-30 months. Participants will be classified into 3 treatment stratums, based on bone marrow/peripheral blood lymphoma cells involvement at diagnosis and day 8 for T-lymphoblastic lymphoma and bone marrow/peripheral blood lymphoma cells involvement at diagnosis for B-lymphoblastic lymphoma. The Primary Objective of this study is: To improve the outcome of children with lymphoblastic lymphoma (LL) who have minimal disseminated disease (MDD) equal to or more than 1% at diagnosis by using MDD- and minimal residual disease (MRD)- based risk-adapted therapy. The Secondary Objectives of this study are:

  • To estimate the event-free survival and overall survival of children with lymphoblastic lymphoma who are treated with MDD- or MRD-based risk- directed therapy.
  • To evaluate the prognostic value of levels of MDD at diagnosis and MRD on day 8 of remission induction.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
23

participants targeted

Target at below P25 for phase_2

Timeline
Completed

Started May 2012

Longer than P75 for phase_2

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 17, 2011

Completed
2 months until next milestone

First Posted

Study publicly available on registry

October 13, 2011

Completed
8 months until next milestone

Study Start

First participant enrolled

May 25, 2012

Completed
9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 8, 2021

Completed
1 year until next milestone

Results Posted

Study results publicly available

May 23, 2022

Completed
8 days until next milestone

Study Completion

Last participant's last visit for all outcomes

May 31, 2022

Completed
Last Updated

June 28, 2022

Status Verified

June 1, 2022

Enrollment Period

9 years

First QC Date

August 17, 2011

Results QC Date

March 24, 2022

Last Update Submit

June 7, 2022

Conditions

Keywords

Lymphoblastic lymphoma

Outcome Measures

Primary Outcomes (1)

  • Probability of Event-free Survival (EFS)

    For EFS, relapse and second malignancies are considered as failures in addition to death in complete remission. The time to EFS will be set to 0 for patients who fail to achieve complete remission. Kaplan-Meier estimates of the OS and EFS curves are computed, along with estimates of standard errors by Peto's method. Please note the unit of measurement of probabilities are percentages.

    Two years post therapy.

Secondary Outcomes (3)

  • Probability of Overall Survival (OS)

    Two years post therapy.

  • Minimal Disseminated Disease (MDD)

    At Diagnosis

  • Minimal Residual Disease (MRD)

    Day 8

Study Arms (1)

Treatment

EXPERIMENTAL

Patients will undergo treatment as described in the intervention section. Interventions include: * Remission induction: prednisone, vincristine, daunorubicin, PEG-asparaginase (or Erwinia asparaginase), IT-MHA (Methotrexate, hydrocortisone, and cytarabine), cyclophosphamide, cytarabine, thioguanine * Consolidation: PEG-asparaginase, High-dose methotrexate (HD-MTX), mercaptopurine * Postremission continuation: Dexamethasone, doxorubicin, vincristine, mercaptopurine, PEG-asparaginase, cyclophosphamide, cytarabine, methotrexate * Reintensification: dexamethasone, cytarabine, etoposide, PEG-asparaginase, clofarabine, cyclophosphamide * All patients receive IT-MHA on days 1 and 15. Some patients also receive additional IT-MHA on days 8 and 22.

Drug: PrednisoneDrug: VincristineDrug: DaunorubicinDrug: PEG-asparaginaseDrug: Erwinia asparaginaseDrug: DoxorubicinDrug: CyclophosphamideDrug: CytarabineDrug: ThioguanineDrug: ClofarabineDrug: MethotrexateDrug: MercaptopurineDrug: DexamethasoneDrug: HydrocortisoneDrug: Etoposide

Interventions

Given orally (PO).

Also known as: Prednisolone
Treatment

Given intravenously (IV).

Also known as: Oncovin®, Vincristine sulfate
Treatment

Given IV.

Also known as: Daunomycin, Cerubidine®
Treatment

Given intramuscularly (IM) or IV.

Also known as: Pegaspargase, Oncaspar®
Treatment

Given IM or IV if allergy occurs with the first or second PEG-asparaginase dose.

Also known as: Erwinase®
Treatment

Given IV.

Also known as: Adriamycin®
Treatment

Given IV.

Also known as: Cytoxan®
Treatment

Given IV or IT.

Also known as: Ara-C, Cytosar-U®
Treatment

Given PO.

Also known as: Purine antimetabolite
Treatment

Given IV.

Also known as: Cl-F-Ara-A, CAFdA, 2-Chloro-9-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl)-9H-purin-6-amine, Clofarex, Clolar^TM
Treatment

Given IV, IM or IT.

Also known as: MTX, High-dose methotrexate (HD-MTX)
Treatment

Given PO.

Also known as: 6-MP, Purinethol®
Treatment

Given PO or IV.

Also known as: Decadron®
Treatment

Given IT.

Also known as: Cortef®
Treatment

Given IV.

Also known as: VP-16, Vepesid®
Treatment

Eligibility Criteria

AgeUp to 21 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • Diagnosis of newly diagnosed lymphoblastic lymphoma (patients must have \<25% tumor cells in bone marrow by morphology)
  • Age ≤ 21 years
  • Limited prior therapy, including systemic glucocorticoids for 1 week or less, 1 dose of vincristine, emergency radiation therapy to the mediastinum, and 1 dose of IT chemotherapy. Other circumstances must be cleared by PI or co-PI.
  • Written, informed consent and assent following guidelines of the Institutional Review Board, National Cancer Institute (NCI), Food and Drug Administration (FDA), and Office of Human Research Protections (OHRP).

You may not qualify if:

  • Participants with prior therapy, other than therapy specified in 3 above.
  • Participants who are pregnant or lactating.
  • Inability or unwillingness of research participant or legal guardian/representative to give written informed consent.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Rady Children's Hospital San Diego

San Diego, California, 92123, United States

Location

St. Jude Children's Research Hospital

Memphis, Tennessee, 38105, United States

Location

Related Links

MeSH Terms

Conditions

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Interventions

PrednisonePrednisoloneVincristineDaunorubicinpegaspargaseasparaginase erwinia chrysanthemi recombinantAsparaginaseDoxorubicinCyclophosphamideCytarabineThioguanineClofarabineMethotrexateMercaptopurineDexamethasoneCalcium DobesilateHydrocortisoneEtoposide

Condition Hierarchy (Ancestors)

Leukemia, LymphoidLeukemiaNeoplasms by Histologic TypeNeoplasmsHematologic DiseasesHemic and Lymphatic DiseasesLymphoproliferative DisordersLymphatic DiseasesImmunoproliferative DisordersImmune System Diseases

Intervention Hierarchy (Ancestors)

PregnadienediolsPregnadienesPregnanesSteroidsFused-Ring CompoundsPolycyclic CompoundsPregnadienetriolsVinca AlkaloidsSecologanin Tryptamine AlkaloidsIndole AlkaloidsAlkaloidsHeterocyclic CompoundsIndolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingIndolizidinesIndolizinesAnthracyclinesNaphthacenesPolycyclic Aromatic HydrocarbonsHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsAminoglycosidesGlycosidesCarbohydratesAmidohydrolasesHydrolasesEnzymesEnzymes and CoenzymesPhosphoramide MustardsNitrogen Mustard CompoundsMustard CompoundsHydrocarbons, HalogenatedPhosphoramidesOrganophosphorus CompoundsCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingArabinonucleosidesNucleosidesNucleic Acids, Nucleotides, and NucleosidesPurinesAdenine NucleotidesPurine NucleotidesNucleotidesRibonucleotidesAminopterinPterinsPteridinesSulfhydryl CompoundsSulfur CompoundsSteroids, FluorinatedBenzenesulfonatesBenzene DerivativesArylsulfonatesArylsulfonic AcidsSulfonic AcidsSulfur AcidsPregnenedionesPregnenes11-HydroxycorticosteroidsHydroxycorticosteroidsAdrenal Cortex HormonesHormonesHormones, Hormone Substitutes, and Hormone Antagonists17-HydroxycorticosteroidsPodophyllotoxinTetrahydronaphthalenesNaphthalenesGlucosides

Results Point of Contact

Title
Hiroto Inaba, MD, PhD
Organization
St. Jude Children's Research Hospital

Study Officials

  • Hiroto Inaba, MD,PhD

    St. Jude Children's Research Hospital

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 17, 2011

First Posted

October 13, 2011

Study Start

May 25, 2012

Primary Completion

May 8, 2021

Study Completion

May 31, 2022

Last Updated

June 28, 2022

Results First Posted

May 23, 2022

Record last verified: 2022-06

Locations