Combination Chemotherapy in Treating Patients With Non-Hodgkin's Lymphoma or Acute Lymphocytic Leukemia

NCT ID: NCT00005977

Last Updated: 2013-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

83 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-09-30

Study Completion Date

2006-09-30

Brief Summary

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RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. Combining more than one drug may kill more cancer cells.

PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy in treating patients who have non-Hodgkin's lymphoma or acute lymphocytic leukemia.

Detailed Description

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OBJECTIVES:

* Determine if increasing the methotrexate dose in combination with standard treatment is feasible in patients with advanced small noncleaved cell non-Hodgkin's lymphoma or B-cell acute lymphocytic leukemia.
* Assess the toxicity of this intensified therapy in these patients.
* Assess the feasibility of treating these patients that have CNS disease at diagnosis with this intensified therapy plus etoposide and ifosfamide.
* Assess toxicities and late effects of this intensive therapy on the central nervous system, cardiac function, and fertility in these patients.

OUTLINE: This is a multicenter study. Patients are stratified according to stage and disease (stage III non-Hodgkin's lymphoma (NHL) vs stage IV NHL with no CNS involvement vs stage IV NHL with CNS involvement vs B-cell acute lymphocytic leukemia (B-ALL) with no CNS involvement vs B-ALL with CNS involvement).

Patients receive methotrexate and cytarabine intrathecally on days 1, 4, 11, and 36 (on day 40 for patients with stage IV NHL or B-ALL only) in combination with alternating courses of: A) cyclophosphamide IV every 12 hours for a total of six doses on days 1-3, doxorubicin IV over 30 minutes on day 4, vincristine IV on days 4 and 11, dexamethasone IV or orally twice daily on days 1-5, and filgrastim (G-CSF) subcutaneously (SQ) or IV over 30 minutes beginning on day 5 and continuing until blood counts recover and B) methotrexate IV over 24 hours on day 18, methotrexate intrathecally on day 18, dexamethasone IV or orally twice daily on days 18-22, leucovorin calcium IV or orally every 6 hours for a total of 6 doses on days 20-21, cytarabine IV over 48 hours on days 20-21, and G-CSF SQ or IV over 30 minutes beginning on day 22 and continuing until blood counts recover. Patients with stage III NHL receive at total of 5 courses of treatment (A-B-A-B-A) and patients with stage IV NHL or B-ALL with no CNS involvement receive a total of 6 courses of treatment (A-B-A-B-A-B).

Patients with CNS involvement receive a third course of treatment: C) etoposide IV over 1 hour on days 36-40, ifosfamide IV over 1 hour on days 36-40, oral dexamethasone twice daily on days 36-40, and G-CSF SQ or IV over 30 minutes beginning on day 41 and continuing until blood counts recover. Patients with CNS involvement receive a total of 7 courses of treatment (A-B-C-A-B-A-B).

Patients are followed every 6 months for 4 years and then annually thereafter.

PROJECTED ACCRUAL: A total of 27-80 patients will be accrued for this study over 24 months.

Conditions

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Leukemia Lymphoma

Keywords

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childhood Burkitt lymphoma L3 childhood acute lymphoblastic leukemia B-cell childhood acute lymphoblastic leukemia L3 adult acute lymphoblastic leukemia B-cell adult acute lymphoblastic leukemia stage III adult Burkitt lymphoma stage IV adult Burkitt lymphoma stage III childhood small noncleaved cell lymphoma stage IV childhood small noncleaved cell lymphoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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STAGE III NHL (Trt 1)

A: Cyclophosphamide (CTX), Doxorubicin hydrochloride, Vincristine sulfate (VCR), Dexamethasone IT Therapy. B: HD-Methotrexate(MTX), Cytarabine(Ara-C), Dexamethasone IT Therapy.

Treatment ABABA

Group Type EXPERIMENTAL

filgrastim

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

methotrexate

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

STAGE IV NHL, -CNS (Trt 2)

A: Cyclophosphamide (CTX), Doxorubicin hydrochloride, Vincristine sulfate (VCR), Dexamethasone IT Therapy. B: HD-Methotrexate(MTX), Cytarabine(Ara-C), Dexamethasone IT Therapy.

Treatment ABABAB

Group Type EXPERIMENTAL

filgrastim

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

methotrexate

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

STAGE IV, +CNS (Trt 3)

A: Cyclophosphamide (CTX), Doxorubicin hydrochloride, Vincristine sulfate (VCR), Dexamethasone IT Therapy. B: HD-Methotrexate(MTX), Cytarabine(Ara-C), Dexamethasone IT Therapy. C: Etoposide, Ifosfamide, Dexamethasone IT Therapy.

Treatment ABCABAB

Group Type EXPERIMENTAL

filgrastim

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

etoposide

Intervention Type DRUG

Given IV

ifosfamide

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

methotrexate

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

B-ALL, -CNS (Trt 2)

A: Cyclophosphamide (CTX), Doxorubicin hydrochloride, Vincristine sulfate (VCR), Dexamethasone IT Therapy. B: HD-Methotrexate(MTX), Cytarabine(Ara-C), Dexamethasone IT Therapy.

Treatment ABABAB

Group Type EXPERIMENTAL

filgrastim

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

methotrexate

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

B-ALL, +CNS (Trt 3)

A: Cyclophosphamide (CTX), Doxorubicin hydrochloride, Vincristine sulfate (VCR), Dexamethasone IT Therapy. B: HD-Methotrexate(MTX), Cytarabine(Ara-C), Dexamethasone IT Therapy. C: Etoposide, Ifosfamide, Dexamethasone IT Therapy.

Treatment ABCABAB

Group Type EXPERIMENTAL

filgrastim

Intervention Type BIOLOGICAL

Given IV

cyclophosphamide

Intervention Type DRUG

Given IV

cytarabine

Intervention Type DRUG

Given IV

dexamethasone

Intervention Type DRUG

Given IV

doxorubicin hydrochloride

Intervention Type DRUG

Given IV

etoposide

Intervention Type DRUG

Given IV

ifosfamide

Intervention Type DRUG

Given IV

leucovorin calcium

Intervention Type DRUG

Given IV

methotrexate

Intervention Type DRUG

Given IV

vincristine sulfate

Intervention Type DRUG

Given IV

Interventions

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filgrastim

Given IV

Intervention Type BIOLOGICAL

cyclophosphamide

Given IV

Intervention Type DRUG

cytarabine

Given IV

Intervention Type DRUG

dexamethasone

Given IV

Intervention Type DRUG

doxorubicin hydrochloride

Given IV

Intervention Type DRUG

etoposide

Given IV

Intervention Type DRUG

ifosfamide

Given IV

Intervention Type DRUG

leucovorin calcium

Given IV

Intervention Type DRUG

methotrexate

Given IV

Intervention Type DRUG

vincristine sulfate

Given IV

Intervention Type DRUG

Other Intervention Names

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GRANULOCYTE COLONY-STIMULATING FACTOR r-metHuG-CSF G-CSF Neupogen NSC #614629 CTX Cytoxan NSC #26271 IND #7089 cytosine arabinoside Ara-C Cytosar NSC #638 DECADRON NSC #034521 Adriamycin NSC #123127 IND #7038 VP-16 VePesid NSC #141540 IND #9197 IFX IFOS NSC #109724 IND #7887 LCV Wellcovorin citrovorum factor folinic acid NSC #3590 MTX amethopterin NSC #740 IND #4291 VCR Oncovin NSC #67574 IND #7161

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* One of the following diagnoses:

* Histologically confirmed small noncleaved cell non-Hodgkin's lymphoma

* Stage III or IV
* Burkitt's or non-Burkitt's by the Working Formulation OR
* Burkitt's or Burkitt's-like by the REAL classification
* Histologically confirmed B-cell acute lymphocytic leukemia

* At least 25% blasts in bone marrow
* FAB L3 morphology
* FAB L1 morphology allowed if blasts show B-cell markers (CD19, 20, 22) and surface immunoglobulin positivity
* Must be registered on POG-9900 in past 8 days

PATIENT CHARACTERISTICS:

Age:

* Under 22 at time of diagnosis

Performance status:

* Not specified

Life expectancy:

* Not specified

Hematopoietic:

* Not specified

Hepatic:

* Not specified

Renal:

* Not specified

Other:

* Not pregnant or nursing
* Negative pregnancy test
* HIV positive allowed

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* Not specified

Chemotherapy:

* Not specified

Endocrine therapy:

* No concurrent use of dexamethasone as antiemetic

Radiotherapy:

* Not specified

Surgery:

* Prior surgery allowed

Other:

* No prior therapy except surgery
Maximum Eligible Age

22 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Children's Oncology Group

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hazem H. Mahmoud, MD

Role: STUDY_CHAIR

Carol G. Simon Cancer Center at Morristown Memorial Hospital

Locations

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University of Alabama at Birmingham Comprehensive Cancer Center

Birmingham, Alabama, United States

Site Status

University of South Alabama Medical Center

Mobile, Alabama, United States

Site Status

MBCCOP - Gulf Coast

Mobile, Alabama, United States

Site Status

Arizona Cancer Center

Tucson, Arizona, United States

Site Status

University of Arkansas for Medical Sciences

Little Rock, Arkansas, United States

Site Status

University of California San Diego Cancer Center

La Jolla, California, United States

Site Status

Lucile Packard Children's Hospital at Stanford

Palo Alto, California, United States

Site Status

Sutter Cancer Center

Sacramento, California, United States

Site Status

University of California Davis Medical Center

Sacramento, California, United States

Site Status

Kaiser Permanente-Southern California Permanente Medical Group

San Diego, California, United States

Site Status

Children's Hospital and Health Center

San Diego, California, United States

Site Status

Kaiser Permanente Medical Center - Santa Clara

Santa Clara, California, United States

Site Status

Yale Comprehensive Cancer Center

New Haven, Connecticut, United States

Site Status

Walter Reed Army Medical Center

Washington D.C., District of Columbia, United States

Site Status

Broward General Medical Center

Fort Lauderdale, Florida, United States

Site Status

Children's Hospital of Southwest Florida

Fort Myers, Florida, United States

Site Status

Shands Hospital and Clinics, University of Florida

Gainesville, Florida, United States

Site Status

Nemours Children's Clinic

Jacksonville, Florida, United States

Site Status

Sylvester Cancer Center, University of Miami

Miami, Florida, United States

Site Status

University of Miami-Jackson Memorial Hospital Medical Center

Miami, Florida, United States

Site Status

Miami Children's Hospital

Miami, Florida, United States

Site Status

Baptist Hospital of Miami

Miami, Florida, United States

Site Status

Florida Hospital Cancer Institute

Orlando, Florida, United States

Site Status

All Children's Hospital

St. Petersburg, Florida, United States

Site Status

CCOP - Florida Pediatric

Tampa, Florida, United States

Site Status

St. Mary's Hospital

West Palm Beach, Florida, United States

Site Status

Emory University Hospital - Atlanta

Atlanta, Georgia, United States

Site Status

Emory University School of Medicine

Atlanta, Georgia, United States

Site Status

Cancer Research Center of Hawaii

Honolulu, Hawaii, United States

Site Status

Tripler Army Medical Center

Honolulu, Hawaii, United States

Site Status

Rush-Presbyterian-St. Luke's Medical Center

Chicago, Illinois, United States

Site Status

Children's Memorial Hospital, Chicago

Chicago, Illinois, United States

Site Status

Hope Children's Hospital

Oak Lawn, Illinois, United States

Site Status

CCOP - Illinois Oncology Research Association

Peoria, Illinois, United States

Site Status

Saint Jude Midwest Affiliate

Peoria, Illinois, United States

Site Status

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status

CCOP - Wichita

Wichita, Kansas, United States

Site Status

Via Christi Regional Medical Center

Wichita, Kansas, United States

Site Status

MBCCOP - LSU Health Sciences Center

New Orleans, Louisiana, United States

Site Status

Tulane University School of Medicine

New Orleans, Louisiana, United States

Site Status

CCOP - Ochsner

New Orleans, Louisiana, United States

Site Status

Eastern Maine Medical Center

Bangor, Maine, United States

Site Status

Maine Children's Cancer Program

Portland, Maine, United States

Site Status

Marlene & Stewart Greenebaum Cancer Center, University of Maryland

Baltimore, Maryland, United States

Site Status

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Baltimore, Maryland, United States

Site Status

Boston Floating Hospital Infants and Children

Boston, Massachusetts, United States

Site Status

Massachusetts General Hospital Cancer Center

Boston, Massachusetts, United States

Site Status

Dana-Farber Cancer Institute

Boston, Massachusetts, United States

Site Status

University of Massachusetts Memorial Medical Center

Worcester, Massachusetts, United States

Site Status

Children's Hospital of Michigan

Detroit, Michigan, United States

Site Status

St. John Hospital and Medical Center

Detroit, Michigan, United States

Site Status

Hurley Medical Center

Flint, Michigan, United States

Site Status

University of Mississippi Medical Center

Jackson, Mississippi, United States

Site Status

Keesler Medical Center - Keesler AFB

Keesler Air Force Base, Mississippi, United States

Site Status

University of Missouri-Columbia Hospital and Clinics

Columbia, Missouri, United States

Site Status

Cardinal Glennon Children's Hospital

St Louis, Missouri, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Norris Cotton Cancer Center

Lebanon, New Hampshire, United States

Site Status

CCOP - Northern New Jersey

Hackensack, New Jersey, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

University of New Mexico School of Medicine

Albuquerque, New Mexico, United States

Site Status

Roswell Park Cancer Institute

Buffalo, New York, United States

Site Status

Schneider Children's Hospital

New Hyde Park, New York, United States

Site Status

Mount Sinai School of Medicine

New York, New York, United States

Site Status

University of Rochester Cancer Center

Rochester, New York, United States

Site Status

State University of New York Health Sciences Center - Stony Brook

Stony Brook, New York, United States

Site Status

State University of New York - Upstate Medical University

Syracuse, New York, United States

Site Status

Mission Saint Joseph's Health System

Asheville, North Carolina, United States

Site Status

Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Presbyterian Healthcare

Charlotte, North Carolina, United States

Site Status

Duke Comprehensive Cancer Center

Durham, North Carolina, United States

Site Status

East Carolina University School of Medicine

Greenville, North Carolina, United States

Site Status

Comprehensive Cancer Center at Wake Forest University

Winston-Salem, North Carolina, United States

Site Status

Oklahoma Memorial Hospital

Oklahoma City, Oklahoma, United States

Site Status

Natalie Warren Bryant Cancer Center

Tulsa, Oklahoma, United States

Site Status

CCOP - Columbia River Program

Portland, Oregon, United States

Site Status

Legacy Emanuel Hospital and Health Center

Portland, Oregon, United States

Site Status

St. Christopher's Hospital for Children

Philadelphia, Pennsylvania, United States

Site Status

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status

Children's Hospital of Greenville Hospital System

Greenville, South Carolina, United States

Site Status

James H. Quillen College of Medicine

Johnson City, Tennessee, United States

Site Status

Saint Jude Children's Research Hospital

Memphis, Tennessee, United States

Site Status

Driscoll Children's Hospital

Corpus Christi, Texas, United States

Site Status

Texas Oncology P.A.

Dallas, Texas, United States

Site Status

Medical City Dallas Hospital

Dallas, Texas, United States

Site Status

Simmons Cancer Center - Dallas

Dallas, Texas, United States

Site Status

Cook Children's Medical Center - Fort Worth

Fort Worth, Texas, United States

Site Status

University of Texas Medical Branch

Galveston, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

San Antonio Military Pediatric Cancer and Blood Disorders Center

Lackland Air Force Base, Texas, United States

Site Status

MBCCOP - South Texas Pediatric

San Antonio, Texas, United States

Site Status

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status

Scott and White Clinic

Temple, Texas, United States

Site Status

Vermont Cancer Center

Burlington, Vermont, United States

Site Status

Cancer Center at the University of Virginia

Charlottesville, Virginia, United States

Site Status

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status

Naval Medical Center, Portsmouth

Portsmouth, Virginia, United States

Site Status

Massey Cancer Center

Richmond, Virginia, United States

Site Status

Carilion Roanoke Community Hospital

Roanoke, Virginia, United States

Site Status

Madigan Army Medical Center

Tacoma, Washington, United States

Site Status

West Virginia University Medical School-Charleston

Charleston, West Virginia, United States

Site Status

West Virginia University Hospitals

Morgantown, West Virginia, United States

Site Status

St. Vincent Hospital

Green Bay, Wisconsin, United States

Site Status

Midwest Children's Cancer Center

Milwaukee, Wisconsin, United States

Site Status

Royal Children's Hospital

Parkville, Victoria, Australia

Site Status

Alberta Children's Hospital

Calgary, Alberta, Canada

Site Status

Cross Cancer Institute

Edmonton, Alberta, Canada

Site Status

Children's Hospital

Hamilton, Ontario, Canada

Site Status

Children's Hospital of Eastern Ontario

Ottawa, Ontario, Canada

Site Status

Hospital for Sick Children

Toronto, Ontario, Canada

Site Status

McGill University Health Center - Montreal Children's Hospital

Montreal, Quebec, Canada

Site Status

Hopital Sainte Justine

Montreal, Quebec, Canada

Site Status

Laval University Medical Center

Sainte-Foy, Quebec, Canada

Site Status

Centre Hospitalier de L'Universite Laval

Sainte-Foy, Quebec, Canada

Site Status

Academisch Ziekenhuis Groningen

Groningen, , Netherlands

Site Status

San Jorge Childrens Hospital

Santurce, , Puerto Rico

Site Status

Swiss Pediatric Oncology Group Bern

Bern, , Switzerland

Site Status

Clinique de Pediatrie

Geneva, , Switzerland

Site Status

Centre Hospitalier Universitaire Vaudois

Lausanne, , Switzerland

Site Status

Countries

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United States Australia Canada Netherlands Puerto Rico Switzerland

Other Identifiers

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COG-9917

Identifier Type: OTHER

Identifier Source: secondary_id

CDR0000067965

Identifier Type: OTHER

Identifier Source: secondary_id

9917

Identifier Type: -

Identifier Source: org_study_id