Combination Chemotherapy in Treating Young Patients With Relapsed or Refractory Acute Lymphoblastic Leukemia
Recruitment status was Recruiting
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Purpose
RATIONALE: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It is not yet known which combination chemotherapy regimen is more effective in treating young patients with acute lymphoblastic leukemia.
PURPOSE: This partially randomized phase III trial is studying how well combination chemotherapy works in treating young patients with relapsed or refractory acute lymphoblastic leukemia.
| Condition | Intervention | Phase |
|---|---|---|
|
Leukemia |
Drug: asparaginase Drug: dexamethasone Drug: idarubicin Drug: methotrexate Drug: mitoxantrone hydrochloride Drug: pegaspargase Drug: vincristine sulfate |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Primary Purpose: Treatment |
| Official Title: | ALLR3: An International Collaborative Trial for Relapsed and Refractory Acute Lymphoblastic Leukaemia (ALL) |
- Progression-free survival (PFS) of United Kingdom (UK) patients stratified by risk groups [ Designated as safety issue: No ]
- Evaluation of whether a minimal residual disease (MRD) level of 10(-4) is a suitable criterion at the end of induction therapy on which to decide whether chemotherapy or stem cell transplantation will be most beneficial to patients with intermediate- ... [ Designated as safety issue: No ]
- MRD as a surrogate marker for treatment response and PFS [ Designated as safety issue: No ]
- Comparison of PFS, MRD level at day 35, and toxicity as response variables in patients randomized to receive induction therapy with mitoxantrone hydrochloride or idarubicin [ Designated as safety issue: No ]
- PFS of all patients (UK, Dutch, Australian, and New Zealand) stratified by risk groups [ Designated as safety issue: No ]
- Comparison of PFS and overall survival between patients enrolled in this study and patients enrolled in R2 or I-BFM [ Designated as safety issue: No ]
- Evaluation of whether pre-stem cell transplantation cytoreduction (FLAD) reduces tumor load and how it affects outcome following transplant [ Designated as safety issue: No ]
| Estimated Enrollment: | 470 |
| Study Start Date: | October 2002 |
| Estimated Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm I (induction therapy)
Patients receive idarubicin IV over 1 hour on days 1 and 2; oral dexamethasone twice daily on days 1-5 and 15-19; intrathecal (IT) methotrexate on days 1 and 8; vincristine sulfate IV on days 3, 10, 17, and 24; and pegaspargase intramuscularly (IM) on days 3 and 17 or asparaginase IM on days 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, and 25.
|
Drug: asparaginase
Given intramuscularly
Drug: dexamethasone
Given orally
Drug: idarubicin
Given IV
Drug: methotrexate
Given intrathecally
Drug: pegaspargase
Given intramuscularly
Drug: vincristine sulfate
Given IV
|
|
Experimental: Arm II (induction therapy)
Patients receive mitoxantrone IV over 1 hour on days 1 and 2. Patients also receive dexamethasone, methotrexate, vincristine sulfate, and pegaspargase or asparaginase as in arm I.
|
Drug: asparaginase
Given intramuscularly
Drug: dexamethasone
Given orally
Drug: methotrexate
Given intrathecally
Drug: mitoxantrone hydrochloride
Given IV
Drug: pegaspargase
Given intramuscularly
Drug: vincristine sulfate
Given IV
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 1 Year to 18 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
Diagnosis of acute lymphoblastic leukemia (ALL) meeting 1 of the following criteria:
In first relapse after treatment
- Has not yet received chemotherapy or radiotherapy for the first relapse
- Primary refractory disease
- No mature B-cell ALL
Meets criteria for one of the following risk groups:
- Standard-risk disease: non-T-cell or T-cell ALL with late isolated extramedullary relapse
- Intermediate-risk disease: non-T-cell ALL with early isolated extramedullary relapse or combined marrow and extramedullary relapse; non-T-cell ALL with late combined marrow and extramedullary relapse or isolated marrow relapse; or T-cell ALL with early isolated extramedullary relapse
- High-risk disease: non-T-cell ALL with very early isolated extramedullary relapse, combined marrow and extramedullary relapse, or isolated marrow relapse; non-T-cell ALL with early isolated marrow relapse; T-cell ALL with very early isolated extramedullary relapse, combined marrow and extramedullary relapse, or isolated marrow relapse; T-cell ALL with early combined marrow and extramedullary relapse or isolated marrow relapse; or T-cell ALL with late combined marrow and extramedullary relapse or isolated marrow relapse
PATIENT CHARACTERISTICS:
- Not specified
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
- No prior bone marrow transplant
Contacts and Locations| Australia, South Australia | |
| Women's and Children's Hospital | Recruiting |
| North Adelaide, South Australia, Australia, 5006 | |
| Contact: Contact Person 61-8-8161-7000 | |
| United Kingdom | |
| Birmingham Children's Hospital | Recruiting |
| Birmingham, England, United Kingdom, B4 6NH | |
| Contact: Contact Person 44-121-333-9999 | |
| Bristol Royal Hospital for Children | Recruiting |
| Bristol, England, United Kingdom, BS2 8BJ | |
| Contact: Contact Person 44-117-342-8520 | |
| Great Ormond Street Hospital for Children | Recruiting |
| London, England, United Kingdom, WC1N 3JH | |
| Contact: Contact Person 44-20-7405-9200 | |
| Christie Hospital | Recruiting |
| Manchester, England, United Kingdom, M20 4BX | |
| Contact: Vaskar Saha, MD 44-161-446-3094 | |
| Southampton General Hospital | Recruiting |
| Southampton, England, United Kingdom, SO16 6YD | |
| Contact: Contact Person 44-23-8079-8751 | |
| Principal Investigator: | Vaskar Saha, MD | Christie Hospital NHS Foundation Trust |
More Information
Additional Information:
Publications:
| ClinicalTrials.gov Identifier: | NCT00967057 History of Changes |
| Other Study ID Numbers: | CDR0000642221, CCLG-ALLR3, ISCRTN-45724312, EUDRACT-2004-000052-16, EU-20938 |
| Study First Received: | August 26, 2009 |
| Last Updated: | January 27, 2011 |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
|
recurrent childhood acute lymphoblastic leukemia T-cell childhood acute lymphoblastic leukemia |
Additional relevant MeSH terms:
|
Leukemia Leukemia, Lymphoid Precursor Cell Lymphoblastic Leukemia-Lymphoma Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Pegaspargase Asparaginase Dexamethasone Idarubicin Methotrexate Mitoxantrone |
Vincristine Dexamethasone acetate Dexamethasone 21-phosphate BB 1101 Antineoplastic Agents Therapeutic Uses Pharmacologic Actions Anti-Inflammatory Agents Antiemetics Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Central Nervous System Agents Gastrointestinal Agents Glucocorticoids |
ClinicalTrials.gov processed this record on June 18, 2013