NOPHO ALL-2008 Pilot Study on Consolidation Therapy for Children and Adolescents With Acute Lymphoblastic Leukemia

This study has been completed.
Information provided by (Responsible Party):
Kjeld Schmiegelow, Rigshospitalet, Denmark Identifier:
First received: October 23, 2007
Last updated: June 30, 2013
Last verified: June 2013

October 23, 2007
June 30, 2013
December 2007
January 2009   (final data collection date for primary outcome measure)
Toxicity of Treatment in Terms of Number of Participants With Serious Adverse Events or Adverse Events, Reported [ Time Frame: 3 months ( 79 days ) ] [ Designated as safety issue: Yes ]
Number of participants following the protocol treatment for the full consolidation therapy with toxicity in this pilot study trying to individually titrate 6-mercaptopurine to the highest tolerable level during Consolidation.
Reduction in leukemia burden (minimal residual disease) and DNA-incorporation of thioguanine nucleotides in nucleated blood cells. [ Time Frame: At the end of consolidation (3 months) ]
Complete list of historical versions of study NCT00548431 on Archive Site
Incorporation of 6-thioguanine Nucleotides (6TGN) Into Leukocyte DNA, Development of Asparaginase Antibody Production [ Time Frame: During the 3 months consolidation therapy ] [ Designated as safety issue: No ]
Biweekly bloodsamples during the 3 months are analyzed for 6TGN incorporation into leucocyte DNA. In addition Methylated Mercaptopurin (MeMP) and Erythrocyte-Methotrexate level is measured
Asparaginase antibody production [ Time Frame: Within 3 months from therapy ]
Not Provided
Not Provided
NOPHO ALL-2008 Pilot Study on Consolidation Therapy for Children and Adolescents With Acute Lymphoblastic Leukemia
Phase II Study of Individual 6-mercaptopurine(6MP) Dose Increments in Children With Acute Lymphoblastic Leukemia (ALL) Receiving High-dose Methotrexate (HDM) and PEG-asparaginase
The present pharmacokinetic (PK)-pharmacodynamic (PD) study will explore the toxicity and antileukemic response during the initial 3 months of individualised therapy of children and young adults with acute lymphoblastic leukemia (ALL). The investigators will on an individual toxicity-titrated basis attempt to increase the dose intensity of the 6-mercaptopurine used in the two-months post-remission treatment phase of lower risk childhood ALL. This will be performed together with continuous PEG-ASP (every 2nd week) and interspersed HD-MTX (5 g/m^2) every 3rd week. Thus, the trial will also test the feasibility of this particular drug combination.

In addition to the details above we will also explore

  • the relationship of the post-HD-MTX MRD-levels with the dose of 6MP, TPMT-activity, DNA-6TGN, E-6TGN, E-MeMP, E-MTX, and presence of ASP-antibodies,
  • the early development of anti-ASP antibodies during continuous PEG-ASP therapy.

The study could improve the understanding of the pharmacodynamics of the 6MP/HD-MTX interaction in combination with PEG-ASP.

Phase 2
Endpoint Classification: Pharmacokinetics/Dynamics Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Leukemia, Lymphocytic, Acute
Drug: 6-mercaptopurine
Standard dose 25 mg/m^2/day. Can be increased up to 75 mg/m^2/day if the myelosuppression is acceptable (ANC>0.5 T-count >50)
Experimental: 6 mercaptopurine arm
All patients received basic daily 6MP (6-mercaptopurine) (25 mg/m^2) and in addition high-dose methotrexate(HDM) every 3rd week (3 times HDM in total) and PEG-asparaginase every 14th day. Patients increased the dose of 6MP 2 weeks after each HDM if if the myelotoxicity had been acceptable. This means 2 increments since the study stopped 2 weeks after the last HDM
Intervention: Drug: 6-mercaptopurine
Not Provided

*   Includes publications given by the data provider as well as publications identified by Identifier (NCT Number) in Medline.
May 2009
January 2009   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • B-lineage ALL
  • 1-17.9 years
  • WBC <100, clinical remission obtained day 2
  • Written consent to participation.

Exclusion Criteria:

  • t(9;22)
  • Hypodiploidy
  • 11q23-aberrations
  • TPMT-deficiency
  • Intolerance to MTX or 6MP
1 Year to 18 Years
Contact information is only displayed when the study is recruiting subjects
Denmark,   Sweden
NOPHO HDM-6MP pilot study
Not Provided
Not Provided
Kjeld Schmiegelow, Rigshospitalet, Denmark
Rigshospitalet, Denmark
Not Provided
Study Chair: Kjeld Schmiegelow, M.D. Pediatric Clinic II, RIgshospitalet, Copenhagen, DK-2100
Rigshospitalet, Denmark
June 2013

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP