Acute Lymphoblastic Leukemia (ALL)
Conditions
Brief summary
The overall objective of this study is to continue to improve the cure rate of childhood acute lymphoblastic leukemia (ALL) in Singapore and Malaysia in the context of a multi-centre cooperative trial using a risk-stratified therapy based primarily on early response to therapy utilizing a simplified minimal residual disease (MRD-lite) platform.
Detailed description
The study was designed on the premise that a risk classification strategy combining clinical and genetic presenting features with molecular assessment of MRD should reduce both treatment-related toxicities and relapse risk. The patient will be assigned to one of the 3 risk groups depending on his/her response to the treatment and special laboratory tests. There are no experimental drugs in this study. All the drugs used are standard established treatment for childhood ALL for the last 30 years. The difference in treatment is by changes in the frequency and dose of the chemotherapy drugs. The overall study treatment lasts for about 2 years.
Interventions
DRUGPrednisolone
Oral
DRUGDexamethasone
Oral
DRUGL-Asparaginase
Intramuscular injection
DRUGVincristine
Intravenous
DRUGMethotrexate
Intrathecal/ Intravenous/ Oral
DRUGDaunorubicin
Intravenous
DRUGDoxorubicin
Intravenous
DRUGCyclophosphamide
Intravenous
DRUGCytarabine
Intravenous/ Subcutaneous injection
DRUG6-Mercaptopurine
Oral
DRUGThioguanine
Oral
DRUGFludarabine
Intravenous
DRUGImatinib
Oral (For BCR-ABL ALL only)
Sponsors
National University Hospital, Singapore
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
1. Confirmed diagnosis of non-Burkitt B-lineage ALL 2. 1 to 17 years of age (before 18th birthday) 3. Renal function within normal range for age 4. Liver function within normal range for age 5. Able to participate in the full 2 years of treatment
Exclusion criteria
1. Age less than one year or age greater than/equals to 18 years 2. Previous treatment with cytotoxic agents or high-dose steroids 3. Mixed phenotype acute leukemia (MPAL) 4. ALL as secondary malignancy 5. Abnormal renal or liver function 6. Doubtful compliance or unable to afford full course of therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Event-free survival (EFS) | 5 years | EFS was estimated from time of diagnosis to time of first event or of patient's last follow-up. Failure to achieve complete remission (CR), relapse, death in continuous remission from whatever cause, secondary leukemia and abandonment (absence from scheduled therapy for more than 6 weeks) were considered as events. |
| Overall survival (OS) | 5 years | OS was determined from diagnosis to time of death from any cause. |
| Minimal residual disease (MRD) measurement | At time point of Day 33, week 8 and week 12 | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of participants with chemotherapy-related adverse events as assessed by CTCAE version 4.0 | Through study completion, an average of 2 years |
| Dose intensity of chemotherapy during various phases of therapy | Through study completion, an average of 2 years |
Countries
Malaysia, Singapore
Contacts
Primary ContactAllen Yeoh, MBBS
Outcome results
None listed