Combination Chemotherapy in Treating Children With Acute Lymphoblastic Leukemia
Leukemia
About this trial
This is an interventional treatment trial for Leukemia focused on measuring childhood acute lymphoblastic leukemia in remission, B-cell childhood acute lymphoblastic leukemia
Eligibility Criteria
DISEASE CHARACTERISTICS: Diagnosis of B-cell precursor acute lymphoblastic leukemia Registered on POG-9900 Classification Study Registered within 7 days of documenting complete response (CR) after induction therapy on day 29 or, if 2 more weeks of induction are required, within 7 days of CR determination Classified as low-risk: WBC less than 50,000/mm^3 Age 1 to 9 No adverse translocations [E2A-PBX1, t(1;19) or BCR/ABL, t(9;22); and MLL rearrangements] No CNS 3 disease (CSF WBC at least 5/mm^3 with blasts present) No testicular disease At least one of the following present: TEL/AML1, t(12;21) Simultaneous trisomy of chromosomes 4 and 10 PATIENT CHARACTERISTICS: Age: 1 to 9 Performance status: Not specified Life expectancy: Not specified Hematopoietic: See Disease Characteristics Hepatic: Not specified Renal: Not specified Other: Not pregnant or nursing Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy Not specified Chemotherapy Not specified Endocrine therapy Not specified Radiotherapy Not specified Surgery Not specified
Sites / Locations
- Comprehensive Cancer Center at University of Alabama at Birmingham
- University of South Alabama Cancer Research Institute
- Arizona Cancer Center at University of Arizona Health Sciences Center
- Arkansas Cancer Research Center at University of Arkansas for Medical Sciences
- Rebecca and John Moores UCSD Cancer Center
- Stanford Cancer Center at Stanford University Medical Center
- Sutter Cancer Center
- University of California Davis Cancer Center
- Kaiser Permanente Medical Center/Kaiser Foundation Hospital - San Diego
- Children's Hospital and Health Center - San Diego
- Kaiser Permanente Medical Center - Santa Clara Kiely Campus
- Yale Comprehensive Cancer Center
- Broward General Medical Center
- Children's Hospital of Southwest Florida
- University of Florida Shands Cancer Center
- Joe DiMaggio Children's Hospital at Memorial
- Nemours Children's Clinic
- University of Miami Sylvester Comprehensive Cancer Center
- Miami Children's Hospital
- Baptist-South Miami Regional Cancer Program
- Florida Hospital Cancer Institute
- Nemours Children's Clinic-Orlando
- Sacred Heart Children's Hospital
- All Children's Hospital
- St. Joseph's Children's Hospital of Tampa
- Kaplan Cancer Center at St. Mary's Medical Center
- AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Scottish Rite Campus
- MBCCOP-Medical College of Georgia Cancer Center
- Cancer Research Center of Hawaii
- Tripler Army Medical Center
- Rush University Medical Center
- Children's Memorial Hospital - Chicago
- Advocate Hope Children's Hospital
- Saint Jude Midwest Affiliate
- Kansas Masonic Cancer Research Institute at the University of Kansas Medical Center
- CCOP - Wichita
- Via Christi Cancer Center at Via Christi Regional Medical Center
- Wesley Medical Center
- MBCCOP - LSU Health Sciences Center
- Tulane Cancer Center at Tulane University Hospital and Clinic
- Children's Hospital of New Orleans
- Ochsner Cancer Institute at Ochsner Clinic Foundation
- Pediatric Specialty Clinic at Eastern Maine Medical Center
- Maine Children's Cancer Program
- Greenebaum Cancer Center at University of Maryland Medical Center
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
- Walter Reed Army Medical Center
- Floating Hospital for Children
- Massachusetts General Hospital Cancer Center
- Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute
- UMASS Memorial Cancer Center - University Campus
- Children's Hospital of Michigan
- Van Elslander Cancer Center at St. John Hospital and Medical Center
- Hurley Medical Center
- University of Mississippi Medical Center
- Keesler Medical Center - Keesler Air Force Base
- University of Missouri - Columbia
- Cardinal Glennon Children's Hospital
- St. Louis Children's Hospital
- Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
- Hackensack University Medical Center
- University of New Mexico Cancer Research and Treatment Center
- Roswell Park Cancer Institute
- Schneider Children's Hospital
- Mount Sinai Medical Center
- Beth Israel Medical Center - Singer Division
- James P. Wilmot Cancer Center at University of Rochester Medical Center
- Long Island Cancer Center at Stony Brook University Hospital
- SUNY Upstate Medical University Hospital
- Mission Hospitals - Memorial Campus
- Blumenthal Cancer Center at Carolinas Medical Center
- Presbyterian Cancer Center at Presbyterian Hospital
- Duke Comprehensive Cancer Center
- Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital
- Comprehensive Cancer Center at Wake Forest University
- Oklahoma University Medical Center
- Natalie Warren Bryant Cancer Center at St. Francis Hospital
- CCOP - Columbia River Oncology Program
- Legacy Emanuel Hospital and Health Center & Children's Hospital
- St. Christopher's Hospital for Children
- Rhode Island Hospital
- Hollings Cancer Center at Medical University of South Carolina
- Children's Hospital of Greenville Hospital System
- East Tennessee State University Cancer Center at Johnson City Medical Center
- St. Jude Children's Research Hospital
- Driscoll Children's Hospital
- Medical City Dallas Hospital
- Simmons Cancer Center at University of Texas Southwestern Medical Center at Dallas
- Cook Children's Medical Center - Fort Worth
- University of Texas Medical Branch
- Texas Children's Cancer Center and Hematology Service at Texas Children's Hospital
- San Antonio Military Pediatric Cancer and Blood Disorders Center
- University of Texas Health Science Center at San Antonio
- MBCCOP - South Texas Pediatrics
- CCOP - Scott and White Hospital
- Center for Cancer Prevention and Care at Scott and White Clinic
- Vermont Cancer Center at University of Vermont
- University of Virginia Cancer Center
- INOVA Fairfax Hospital
- Naval Medical Center - Portsmouth
- Massey Cancer Center at Virginia Commonwealth University
- Carilion Medical Center for Children at Roanoke Community Hospital
- Madigan Army Medical Center
- West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division
- Mary Babb Randolph Cancer Center at West Virginia University Hospitals
- St. Vincent Hospital
- CCOP - Marshfield Clinic Research Foundation
- Midwest Children's Cancer Center
- Children's Hospital at Westmead
- Royal Children's Hospital
- Royal Children's Hospital
- Alberta Children's Hospital
- Cross Cancer Institute at University of Alberta
- McMaster Children's Hospital at Hamilton Health Sciences
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- Montreal Children's Hospital at McGill University Health Center
- Hopital Sainte Justine
- Centre de Recherche du Centre Hospitalier de l'Universite Laval
- University Medical Center Groningen
- San Jorge Children's Hospital
- Swiss Pediatric Oncology Group Bern
- Swiss Pediatric Oncology Group Geneva
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Experimental
Arm I: (combination chemotherapy)
Arm II (combination chemotherapy)
Arm III (combination chemotherapy)
.Arm IV (combination chemotherapy)
CONSOLIDATION: Pts receive Methotrexate(MTX) IV over 24 hrs on day 1 and oral leucovorin calcium (CF) every 6 hrs for 3 doses at 42 hours after initiation of MTX infusion during weeks 7, 10, 13, 16, and 19. Pts also receive MTX IT on wks 7, 10, 13, 16, 19, and 22; oral mercaptopurine(6-MP) daily wks 5-24; oral dexamethasone (DM) 2x on days 1-7 of wks 8 and 17; and vincristine sulfate (VCR) IV on day 1 of wks 8, 9, 17, and 18. CONTINUATION: Pts receive oral 6-MP daily on wks 25-130; oral DM twice a day on days 1-7 and vincristine sulfate (VCR) IV on days 1 and 8 during wks 25, 41, 57, 73, 89, and 105; oral MTX on wks 25-130 (except during wks of IT MTX); and MTX IT on wks 25, 37, 49, 61, 73, 85, 97, and 109.
CONSOLIDATION: Pts receive methotrexate (MTX) IV over 4 hrs on day 1 and oral leucovorin calcium (CF) during wks 7, 10, 13, 16, and 19. Pts also receive MTX IT on wks 7, 10, 13, 16, 19, and 22; oral mercaptopurine (6-MP) daily on wks 5-24; oral dexamethasone (DM) 2x on days 1-7 of wks 8 and 17; and vincristine sulfate (VCR) IV on day 1 of wks 8, 9, 17, and 18. CONTINUATION: Pts receive oral 6-MP daily on wks 25-130; oral DM 2x on days 1-7 and vincristine sulfate (VCR) IV on days 1 and 8 during wks 25, 41, 57, 73, 89, and 105; oral MTX weekly on wks 25-130 (except during wks of IT MTX); and MTX IT on wks 25, 37, 49, 61, 73, 85, 97, and 109.
CONSOLIDATION: Pts receive methotrexate (MTX) IV and leucovorin calcium (CF) as in arm I on wks 7, 10, 13, 24, 27, and 30. Pts also receive oral mercaptopurine (6-MP) daily on wks 5-13 and then on wk 24 and continuing until the end of consolidation; MTX IT on wks 7, 10, 13, 16, 20, 21, and 30; oral dexamethasone (DM) twice daily on days 1-7 of wks 8, 16-18, and 28; vincristine sulfate (VCR) IV on day 1 of wks 8, 9, 16-18, 28, and 29; pegaspargase intramuscularly on wk 16; daunorubicin hydrochloride IV on day 1 of wks 16-18; cyclophosphamide IV on day 1 of wk 20; cytarabine IV or subcutaneously on days 2-5 of wks 20 and 21; and oral thioguanine daily on days 1-14 of wks 20 and 21. CONTINUATION: Pts receive oral 6-MP daily on wks 33-130; oral dexamethasone (DM) twice a day on days 1-7 and VCR IV on days 1 and 8 during wks 41, 57, 73, 89, and 105; oral MTX weekly on wks 33-130 (except during wks of IT MTX); and MTX IT on wks 37, 49, 61, 73, 85, 97, and 109.
CONSOLIDATION: Pts receive methotrexate (MTX) and leucovorin calcium (CF) on wks 7, 10, 13, 24, 27, and 30. Pts receive mercaptopurine(6-MP) daily weeks 5-13 then beginning wk 24 and continuing until end of consolidation; MTX on wks 7, 10, 13, 16, 20, 21, and 30; dexamethasone (DM) 2x daily on days 1-7 of wks 8, 16-18, and 28; vincristine sulfate (VCR) day 1 of wks 8, 9, 16-18, 28, and 29; pegaspargase on wk 16; daunorubicin hydrochloride on day 1 of wks 16-18; cyclophosphamide on day 1 of wk 20; cytarabine on days 2-5 of wks 20 and 21; thioguanine daily on days 1-14 of wks 20 and 21. CONTINUATION: Pts receive mercaptopurine(6-MP) daily on weeks 33-130; oral dexamethasone (DM) twice a day on days 1-7 and VCR IV on days 1 and 8 during weeks 41, 57, 73, 89, and 105; oral MTX weekly on weeks 33-130 (except during weeks of IV MTX); and IV MTX on weeks 37, 49, 61, 73, 85, 97, and 109.