Combination Chemotherapy in Treating Young Patients With Down Syndrome and Acute Myeloid Leukemia or Myelodysplastic Syndromes
Childhood Acute Basophilic Leukemia, Childhood Acute Eosinophilic Leukemia, Childhood Acute Erythroleukemia (M6)
About this trial
This is an interventional treatment trial for Childhood Acute Basophilic Leukemia
Eligibility Criteria
Inclusion Criteria: Diagnosis DS or DS mosaicism by karyotype or chromosomal analysis Diagnosis of myelodysplastic syndromes (MDS) with < 30% blasts or acute myeloid leukemia (AML) Newly diagnosed disease Patients with a history of transient myeloproliferative disorder (TMD) are eligible provided the patient is diagnosed with AML or MDS at > 90 days of age AND meets either of the following criteria: At least 30% blasts in the bone marrow regardless of time since resolution of TMD More than 8 weeks since resolution of TMD with ≥ 5% blasts in the bone marrow Immunophenotype required for study entry No promyelocytic leukemia Shortening fraction ≥ 27% by echocardiogram OR ejection fraction ≥ 50% by radionuclide angiogram Bilirubin ≤ 1.5 times upper limit of normal (ULN) AST or ALT < 2.5 times ULN Creatinine adjusted according to age as follows: No greater than 0.4 mg/dL (≤ 5 months) No greater than 0.5 mg/dL (6 months -11 months) No greater than 0.6 mg/dL (1 year-23 months) No greater than 0.8 mg/dL (2 years-5 years) No greater than 1.0 mg/dL (6 years-9 years) No greater than 1.2 mg/dL (10 years-12 years) No greater than 1.4 mg/dL (13 years and over [female]) No greater than 1.5 mg/dL (13 years to 15 years [male]) No greater than 1.7 mg/dL (16 years and over [male]) Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min No evidence of dyspnea at rest No exercise intolerance Pulse oximetry > 94% No prior chemotherapy, radiotherapy, or any antileukemic therapy Intrathecal cytarabine therapy given at diagnosis allowed Prior therapy for TMD allowed
Sites / Locations
- Phoenix Childrens Hospital
- Southern California Permanente Medical Group
- Miller Children's Hospital
- Children's Hospital Los Angeles
- Children's Hospital Central California
- Children's Hospital and Research Center at Oakland
- Kaiser Permanente-Oakland
- Childrens Hospital of Orange County
- Lucile Packard Children's Hospital Stanford University
- Rady Children's Hospital - San Diego
- University of California San Francisco Medical Center-Parnassus
- Children's Hospital Colorado
- Alfred I duPont Hospital for Children
- Children's National Medical Center
- Lombardi Comprehensive Cancer Center at Georgetown University
- Broward Health Medical Center
- Memorial Healthcare System - Joe DiMaggio Children's Hospital
- Nemours Children's Clinic - Jacksonville
- Florida Hospital
- All Children's Hospital
- Children's Healthcare of Atlanta - Egleston
- University of Hawaii
- Saint Luke's Mountain States Tumor Institute
- Lurie Children's Hospital-Chicago
- Loyola University Medical Center
- Advocate Lutheran General Hospital.
- Saint Jude Midwest Affiliate
- Southern Illinois University
- Indiana University Medical Center
- Riley Hospital for Children
- Saint Vincent Hospital and Health Services
- Kosair Children's Hospital
- Tulane University Health Sciences Center
- Eastern Maine Medical Center
- Sinai Hospital of Baltimore
- Johns Hopkins University-Sidney Kimmel Cancer Center
- Walter Reed National Military Medical Center
- C S Mott Children's Hospital
- Wayne State University-Karmanos Cancer Institute
- Saint John Hospital and Medical Center
- Hurley Medical Center
- Helen DeVos Children's Hospital at Spectrum Health
- Children's Hospitals and Clinics of Minnesota - Minneapolis
- University of Minnesota Medical Center-Fairview
- University of Mississippi Medical Center
- The Childrens Mercy Hospital
- Children's Hospital and Medical Center of Omaha
- University of Nebraska Medical Center
- Nevada Cancer Research Foundation CCOP
- Hackensack University Medical Center
- Saint Peter's University Hospital
- UMDNJ - Robert Wood Johnson University Hospital
- Newark Beth Israel Medical Center
- Roswell Park Cancer Institute
- Columbia University Medical Center
- Memorial Sloan-Kettering Cancer Center
- University of Rochester
- State University of New York Upstate Medical University
- Ny Cancer%
- University of North Carolina
- Carolinas Medical Center
- Duke University Medical Center
- Sanford Medical Center-Fargo
- Children's Hospital Medical Center of Akron
- Cleveland Clinic Foundation
- Nationwide Children's Hospital
- University of Oklahoma Health Sciences Center
- Legacy Emanuel Hospital and Health Center
- Oregon Health and Science University
- Penn State Hershey Children's Hospital
- Children's Hospital of Philadelphia
- Saint Christopher's Hospital for Children
- Children's Hospital of Pittsburgh of UPMC
- Rhode Island Hospital
- Palmetto Health Richland
- St. Jude Children's Research Hospital
- Vanderbilt-Ingram Cancer Center
- University of Texas Southwestern Medical Center
- Cook Children's Medical Center
- Baylor College of Medicine
- Covenant Children's Hospital
- University of Texas Health Science Center at San Antonio
- Primary Children's Hospital
- University of Vermont
- Childrens Hospital-King's Daughters
- Seattle Children's Hospital
- Mary Bridge Children's Hospital and Health Center
- Midwest Children's Cancer Center
- Princess Margaret Hospital for Children
- British Columbia Children's Hospital
- CancerCare Manitoba
- Janeway Child Health Centre
- Cancer Centre of Southeastern Ontario at Kingston General Hospital
- Children's Hospital
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- San Jorge Children's Hospital
Arms of the Study
Arm 1
Experimental
Treatment (combination chemotherapy)
INDUCTION THERAPY COURSE I: Patients receive cytarabine IT on day 1 and cytarabine IV continuously over 96 hours, daunorubicin hydrochloride IV continuously, and oral thioguanine BID on days 1-4. COURSE II: Patients receive high-dose cytarabine IV over 3 hours BID on days 1, 2, 8, and 9 and asparaginase (IM) on days 2 and 9. COURSE III: Patients receive treatment as in course I. COURSE IV: Patients receive cytarabine IV, daunorubicin hydrochloride IV, and oral thioguanine as in course I INTENSIFICATION THERAPY: Patients receive cytarabine IV continuously over 168 hours on days 1-7 and etoposide IV over 1 hour on days 1-3. Treatment repeats every 28 days for 2 courses in the absence of disease progression or unacceptable toxicity.