Purpose

The goal of this study is to provide sufficient therapy during the time a patients' B-cell Acute Lymphoblastic Leukemia (ALL) or Lymphoblastic Lymphoma (LLy) risk category is being determined. The term "risk" refers to the chance of the ALL or LLy coming back after treatment. Primary Objectives - To provide sufficient therapy to enable testing of newly diagnosed acute lymphoblastic leukemia/lymphoma and mixed phenotype acute leukemia/lymphoma tumor samples to determine eligibility and appropriate risk stratification for SJALL therapeutic studies. - To develop a central database of genomic and clinical findings. Secondary Objectives - To assess event free and overall survival data of patients enrolled on this study.

Conditions

Eligibility

Eligible Ages
Between 1 Year and 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Age 1-18.99 years - Diagnosis of acute leukemia / lymphoma as below: - Acute lymphoblastic leukemia (ALL) with at least 25% bone marrow blasts or definitive evidence of ALL in peripheral blood (in those without an available bone marrow sample). - Lymphoblastic lymphoma (LLy) with immunophenotypic evidence of a lymphoblastic population and <25% bone marrow blasts and less than 1,000 circulating blasts/ microL. - Mixed phenotype acute leukemia (MPAL) with or without 25% bone marrow involvement (i.e. patients with either leukemia or lymphoma are eligible).

Exclusion Criteria

  • Pregnant or breastfeeding - Receipt of prior cancer directed therapy with the exclusion of up to 1 dose of intrathecal chemotherapy, 1 dose of vincristine, or emergency radiotherapy due to organ compromising malignant mass. There is no exclusion for prior steroid therapy. - Known to be currently ineligible for available SJALL therapeutic studies (e.g. receipt of prohibited therapy, no appropriate SJALL therapeutic study available, enrolled on competing trial, etc.). Note: The intention of this exclusion criterion is to enroll all newly diagnosed ALL/ LLy/ MPAL patients. If participant is screened as a potential participant for subsequent SJALL and later found to be ineligible due to information obtained during INITIALL, this will not make the participant ineligible for INITIALL. - Inability or unwillingness of research participant or legal guardian/representative to give written informed consent. - Major pre-existing abnormalities such as ataxia telangiectasia, Fanconi anemia, Charcot Marie Tooth, etc.

Study Design

Phase
Phase 4
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Newly diagnosed ALL, LLy, and MPAL patients
All eligible patients receive the following intervention: Dexamethasone, Vincristine, Daunorubicin, Intrathecal triple therapy (methotrexate + hydrocortisone + cytarabine)
  • Drug: Dexamethasone
    Per mouth (PO) or intravenously (IV) once on Day 1 and PO or IV divided BID (every 12 hours) days 2-7
    Other names:
    • Decadron
  • Drug: Vincristine
    Intravenously (IV) for 1 dose on Day 1 or 2
    Other names:
    • Vincristine Sulfate
    • Oncovin
  • Drug: Daunorubicin
    Intravenously (IV) for 1 dose on Day 2 or 3 (T-ALL/ T-LLy/ MPAL only)
    Other names:
    • Daunomycin
  • Drug: Intrathecal triple therapy (methotrexate + hydrocortisone + cytarabine)
    Intrathecal (Age adjusted) for 1 dose on Day 4 or 5 or 6
    Other names:
    • ITMHA
  • Drug: Methotrexate
    Given IT as part of Intrathecal triple therapy.
    Other names:
    • MTX
    • Trexall®
  • Drug: Cytarabine
    Given IT as part of Intrathecal triple therapy.
    Other names:
    • Cytosine arabinoside
    • Ara-C

Recruiting Locations

Rady Children's Hospital
San Diego, California 92123
Contact:
Victor Wong, MD
858-966-5811
vwong@rchsd.org

Our Lady of the Lakes Regional Medical Center
Baton Rouge, Louisiana 70809
Contact:
Sakshi Bami, MD
901-595-0341
sakshi.bami@fmolhs.org

Novant Health Presbyterian Hemby Children's Hospital
Charlotte, North Carolina 28204
Contact:
Jessica Bell, MD
704-384-1900
jbell@novanthealth.org

Saint Francis Children's Hospital
Tulsa, Oklahoma 74136
Contact:
Ashraf Mohamed, MD
918-502-6720
ammohamed@saintfrancis.com

St. Jude Children's Research Hospital
Memphis, Tennessee 38105
Contact:
Seth E. Karol, MD
888-226-4343
referralinfo@stjude.org

More Details

Status
Recruiting
Sponsor
St. Jude Children's Research Hospital

Study Contact

Seth E. Karol, MD
888-226-4343
referralinfo@stjude.org

Detailed Description

Patients with newly diagnosed acute lymphoblastic leukemia/lymphoma (ALL/LLy) and mixed phenotype acute leukemia/lymphoma (MPAL) will undergo diagnostic procedures either during screening or on Day 1. They will receive 7 days of chemotherapy including 13 doses of dexamethasone, 1 dose of vincristine, and 1 dose of daunorubicin (for patients with T-ALL/LLy or MPAL only). Patients will also undergo their initial lumbar puncture with intrathecal chemotherapy on Days 4 or 5 or 6 of therapy. After the completion of 7 days of chemotherapy, patients will begin therapy on either a SJALL therapeutic trial or will receive non-protocol therapy.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.