International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia

NCT ID: NCT01117441

Last Updated: 2022-05-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE3
• Total Enrollment: 6136 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-06-30
• Study Completion Date: 2021-12-31

Brief Summary

Rationale/Purpose: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. It is not yet known which combination chemotherapy regimen is more effective in treating young patients with acute lymphoblastic leukemia (ALL).

This trial is studying several different combination chemotherapy regimens to compare how well they work in treating young patients with ALL.

Study objectives

Primary study questions:

• Non high-risk (non-HR) precursor-B ALL (pB-ALL) patients with TEL/AML1-negative ALL or unknown TEL/AML1 status and flow cytometry minimal residual disease (MRD) in bone marrow on day 15 <0.1% or with TEL/AML1-positive ALL (randomized study question R1): Can the daunorubicin dose in Protocol IA be safely reduced by 50 % with a non-inferior EFS and a reduction of toxicity (treatment-related mortality and AE/SAE in Protocol I)?
• Patients with pB-ALL and risk group medium risk (MR) (randomized study question R2): Can the clinical outcome be improved by protracted asparagine depletion achieved through application of intensified PEG-L-asparaginase during reintensification and early maintenance?
• High-risk (HR) patients (as identified by day 33 - randomized study question RHR): Can the clinical outcome be improved by protracted exposure to PEG-L-asparaginase during Protocol IB?

Secondary study questions:

• Standard risk (SR) patients identified by at least one sensitive marker: Is the clinical outcome comparable to that obtained in SR patients (identified with two sensitive markers) in AIEOP-BFM ALL 2000, or can the outcome even be improved with the use of PEG-L-asparaginase instead of native E. coli L-ASP?
• T-ALL non-HR patients: Can the high level of outcome which was obtained for these patients in study AIEOP-BFM ALL 2000 be preserved or even improved with the use of PEG-L-ASP instead of native E. coli L-ASP?
• HR patients with persisting high MRD levels despite the use of the HR blocks in the intensified consolidation phase "MRD Non-Responders": Is it possible to improve the outcome and to achieve a further reduction of leukemic cell burden by administration of an innovative treatment schedule (DNX-FLA)?
• Patients participating in the randomized asparaginase studies (pB-ALL/MR, HR): Are asparaginase activity and asparaginase antibodies associated with development of allergic reactions, and do they have an effect on the outcome of the patients?
• What is the relative value of different methods of MRD monitoring in the definition of alternative stratification systems within a BFM-oriented protocol?

Detailed Description

Risk Stratification

• T/non-HR: T-ALL in absence of any HR criteria (see below)
• pB/non-HR: pB-ALL in absence of any HR criteria (see below).

• SR (polymerase chain reaction(PCR)-MRD-SR (MRD-negative on day 33 and 78) or, if no PCR-MRD result available, FCM d15 < 0.1%)
• MR (no SR)
• HR: Prednisone poor-response (≥1000 blast cells/µl in peripheral blood on day 8), blast cells ≥10% in bone marrow on day 15 as measured by FCM, non-remission on day 33, positivity for MLL/AF4 or t(4;11), hypodiploidy (< 45 chromosomes), PCR-MRD-HR (MRD ≥10E-3 on day 78) or PCR-MRD-MR SER (only in pB-ALL, MRD ≥ 10-3 on day 33 and MRD positive at a level of < 10E-3 on day 78)

Chemotherapy

According to the risk group, patients receive the following chemotherapy elements:

T/non-HR: Protocol I, Protocol M, Protocol II and Maintenance pB/non-HR: Protocol I, Protocol M, Protocol II and Maintenance HR: Protocol I, HR-1', HR-2', HR-3', 3x Protocol III, Maintenance Patients of the HR group with PCR-MRD ≥10E-3 after element HR-3' are eligible for treatment with element DNX-FLA.

Protocol I Cytoreductive prephase: Prednisone (PDN) on days 1-7 and one dose of methotrexate (MTX) intrathecal (IT) on day 1 Protocol IA: Prednisone (PDN) on days 8 to 28 (21 days); vincristine (VCR) on days 8, 15, 22, 29 (4 doses); daunorubicin (DNR) on days 8, 15, 22 and 29 (4 doses); pegylated L-asparaginase (PEG-L-ASP) on days 12 and 26; MTX IT on days 12 and 33 and in case of blast cells in cerebrospinal fluid at diagnosis additional IT MTX is given on days 19 and 26.

Protocol IA': Only two doses of DNR on days 8 and 15 given to patients eligible for randomization R1 and randomized into the experimental arm Protocol IA-CPM: additional cyclophosphamide (CPM) on day 10 only in T-ALL patients with prednisone poor-response Protocol IA-Dexa (IAD): Dexamethasone (DXM) instead of PDN is given to all patients with T-ALL without any high-risk criteria as identified by day 8.

Protocol IB: CPM on days 36 and 64; cytarabine (ARA-C) on days 38-41, 45-48, 52-55 and 59-62; 6-mercaptopurine (6-MP) on days 36 to 63 (28 days); MTX IT on day 45 and 59 Protocol IB-ASP+: additional PEG-L-ASP on days 40, 47, 54, and 61 (4 doses) are given to the patients eligible for randomization RHR and randomized into the experimental arm.

Protocol M 6-MP on days 1- 56, high-dose MTX (HD-MTX) on days 8, 22, 36, 50 and MTX IT on days 8, 22, 36 and 50 Protocol II Protocol IIA: DXM on days 1 to 21 (21 days); VCR on days 8, 15, 22, 29 (4 doses); doxorubicine (DOX) on days 8, 15, 22 and 29 (4 doses); PEG-L-ASP on day 8 (1 dose); MTX IT on days 1 and 18 only in patients with initial CNS involvement.

Protocol IIA-ASP+: additional PEG-L-ASP on day 22 for patients eligible for randomization R2 and randomized into the experimental arm.

Protocol IIB: CPM on day 36; ARA-C on days 38-41 and 45-48; thioguanine (TG) on days 36 to 49 (14 days) and MTX IT on days 38 and 45.

Protocol IIB-ASP+: additional PEG-L-ASP on days 36 and 50 for eligible for randomization R2 and randomized into the experimental arm.

Protocol III DXM on days 1-15; VCR on days 1 and 8; DOX on days 1 and 8; PEG-L-ASP on day 1; CPM on day 15; ARA-C on days 17-20 and 24-27; TG on days 15 - 28 and MTX IT on days 17 and 24, also on day 1 in patients with initial CNS involvement HR-1' DXM on days 1-5; VCR on days 1 and 6; HD-MTX on day 1; CPM every 12 hours on days 2-4 (5 doses); HD-ARA-C every 12 hours on day 5 (2 doses); PEG-L-ASP on day 6, MTX IT on day 1 HR-2' DXM on days 1 to 5; VDS on days 1 and 6; HD-MTX on day 1; IFO every 12 hours on days 2-4 (5 doses); DNR on day 5; PEG-L-ASP on day 6; MTX IT on day 1 and 1 in patients with initial CNS involvement also day 5 HR-3' DXM on days 1-5; ARA-C 4 x on days 1-2 in 12 h intervals; etoposide (VP-16) every 12 hours on days 3-5 (5 doses); PEG-L-ASP on day 6; MTX IT on day 1 DNX-FLA Flucytosine (FLU) on days 1-5 (5 doses); HD-ARA-C on days 1 to 5 (5 doses); liposomal daunorubicin (DNX) on days 1, 3 and 5 (3 doses); MTX IT on day 1

Interim/Maintenance (until week 104):

6-MP p.o. daily; MTX p.o. once a week, doses adjusted to white blood cell count; PEG-L-ASP: every second week (6 doses), only for patients eligible for randomization R2 and randomized into the experimental arm; MTX IT every 6 weeks up to a total of 6 doses for the following subgroups (all CNS-negative):

• T-ALL (HR or non-HR) with < 2 years of age at start of maintenance,
• T-ALL, non-HR and initial WBC < 100 000/μl
• pB-ALL with PPR and/or FCM-MRD day 15 ≥ 10 % and/or PCR-MRDMR SER as only HR criteria

Radiotherapy Patients without CNS involvement and

• T-ALL/non-HR, WBC ≥ 100 000/μl, and age ≥ 2 years at start of pCRT or
• with risk group HR and age ≥ 2 years at start of pCRT except pB-ALL with PPR and/or FCM-MRD day 15 ≥ 10 % and/or PCR-MRD-MR SER as only HR criteria receive preventive cranial radiotherapy with 12 Gy

Patients with CNS involvement receive therapeutic cranial radiotherapy with 18 Gy (age 1 to <2 years 12 Gy).

Conditions

Leukemia

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: FACTORIAL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

R1 control arm

see detailed protocol description

Group Type: ACTIVE_COMPARATOR

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

R1 experimental arm

see detailed protocol description

Group Type: EXPERIMENTAL

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

R2 control arm

see detailed protocol description

Group Type: ACTIVE_COMPARATOR

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

R2 experimental arm

see detailed protocol description

Group Type: EXPERIMENTAL

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

R-HR control arm

see detailed protocol description

Group Type: ACTIVE_COMPARATOR

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

etoposide

Intervention Type: DRUG

see detailed protocol description

ifosfamide

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

vindesine

Intervention Type: DRUG

see detailed protocol description

daunoxome

Intervention Type: DRUG

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

fludarabine

Intervention Type: DRUG

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

R-HR experimental arm

see detailed protocol description

Group Type: EXPERIMENTAL

PEG-L-asparaginase

Intervention Type: DRUG

see detailed protocol description

cyclophosphamide

Intervention Type: DRUG

see detailed protocol description

cytarabine

Intervention Type: DRUG

see detailed protocol description

daunorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

dexamethasone

Intervention Type: DRUG

see detailed protocol description

doxorubicin hydrochloride

Intervention Type: DRUG

see detailed protocol description

etoposide

Intervention Type: DRUG

see detailed protocol description

ifosfamide

Intervention Type: DRUG

see detailed protocol description

mercaptopurine

Intervention Type: DRUG

see detailed protocol description

methotrexate

Intervention Type: DRUG

see detailed protocol description

prednisone

Intervention Type: DRUG

see detailed protocol description

thioguanine

Intervention Type: DRUG

see detailed protocol description

vincristine sulfate

Intervention Type: DRUG

see detailed protocol description

vindesine

Intervention Type: DRUG

see detailed protocol description

daunoxome

Intervention Type: DRUG

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

fludarabine

Intervention Type: DRUG

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

Radiation Therapy

Intervention Type: RADIATION

for eligibility for radiotherapy see detailed protocol description

Interventions

PEG-L-asparaginase

see detailed protocol description

Intervention Type: DRUG

cyclophosphamide

see detailed protocol description

Intervention Type: DRUG

cytarabine

see detailed protocol description

Intervention Type: DRUG

daunorubicin hydrochloride

see detailed protocol description

Intervention Type: DRUG

dexamethasone

see detailed protocol description

Intervention Type: DRUG

doxorubicin hydrochloride

see detailed protocol description

Intervention Type: DRUG

etoposide

see detailed protocol description

Intervention Type: DRUG

ifosfamide

see detailed protocol description

Intervention Type: DRUG

mercaptopurine

see detailed protocol description

Intervention Type: DRUG

methotrexate

see detailed protocol description

Intervention Type: DRUG

prednisone

see detailed protocol description

Intervention Type: DRUG

thioguanine

see detailed protocol description

Intervention Type: DRUG

vincristine sulfate

see detailed protocol description

Intervention Type: DRUG

vindesine

see detailed protocol description

Intervention Type: DRUG

daunoxome

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

Intervention Type: DRUG

fludarabine

see detailed protocol description; only given by patients with poor MRD-response during the high risk treatment

Intervention Type: DRUG

Radiation Therapy

for eligibility for radiotherapy see detailed protocol description

Intervention Type: RADIATION

Other Intervention Names

Oncaspar medac

Eligibility Criteria

Inclusion Criteria

• newly diagnosed acute lymphoblastic leukemia
• age ≥ 1 year (> 365 days) and < 18 years old (up to 17 years old and 365 days)
• no Ph+ (BCR/ABL or t(9;22)-positive) ALL
• no evidence of pregnancy or lactation period
• no participation in another clinical study
• patient enrolled in a participating center
• written informed consent

Exclusion Criteria

• pre-treatment with cytostatic drugs
• pre-treatment with cytostatic drugs
• steroid pre-treatment with ≥ 1 mg/kg/d for more than two weeks during the last month before diagnosis
• treatment started according to another protocol
• underlying diseases that prohibit treatment according to the protocol
• ALL diagnosed as second malignancy steroid pre-treatment with ≥ 1 mg/kg/d for more than two weeks during the last month before diagnosis

• Minimum Eligible Age: 1 Year
• Maximum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Deutsche Krebshilfe e.V., Bonn (Germany)

OTHER

Sponsor Role: collaborator

University Hospital Schleswig-Holstein

OTHER

Sponsor Role: lead

Responsible Party

Martin Schrappe

Prof. Dr. med.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Martin Schrappe, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Pediatrics, University Hospital of Schleswig-Holstein, Campus Kiel

Locations

The Sydney Children's Hospital, Centre for Children's Cancer and Blood Disorders

Randwick, , Australia

The Children's Hospital at Westmead, Department of Oncology

Westmead, , Australia

Krankenhaus Dornbirn, Abt. für Kinder- und Jugendheilkunde

Dornbirn, , Austria

Univ.-Kinderklinik Graz, Abt. Pädiatrische Hämato-Onkologie

Graz, , Austria

Department f. Kinder- u. Jugendheilkunde, Universitätsklinik f. Pädiatrie II

Innsbruck, , Austria

A.oe. Landeskrankenhaus Klagenfurt, Abt. für Kinder- und Jugendheilkunde

Klagenfurt, , Austria

A.oe. Landeskrankenhaus Leoben, Abt. für Kinder und Jugendliche

Leoben, , Austria

Landes-Kinderklinik Linz, Haematologie/Onkologie

Linz, , Austria

St. Johanns Spital / Landeskrankenhaus, Salzburg, Kinderspital Abt. Kinder u. Jugendheilkunde

Salzburg, , Austria

St. Anna Kinderspital, Zentrum für Kinder- und Jugendheilkunde

Vienna, , Austria

University Hospital Brno, Department of Pediatric Oncology

Brno, , Czechia

Regional Hospital České Budějovice, Department of Pediatrics

České Budějovice, , Czechia

University Hospital Hradec Králové, Department of Pediatrics

Hradec Králové, , Czechia

University Hospital Olomouc, Department of Pediatrics

Olomouc, , Czechia

Teaching Hospital Ostrava-Poruba, Department of Pediatrics

Ostrava-Poruba, , Czechia

University Hospital Plzeň, Department of Pediatrics

Pilsen, , Czechia

University Hospital Motol, Department of Pediatric Hematology and Oncology

Prague, , Czechia

Masaryk´s Hospital Ústí nad Labem, Department of Pediatrics

Ústí nad Labem, , Czechia

Kinderklinik der med. Fakultät der RWTH, Bereich Hämatologie/Onkologie

Aachen, , Germany

I. Klinik für Kinder u. Jugendliche, Klinikum Augsburg, Hämatologie/ Onkologie

Augsburg, , Germany

Klinikum Bayreuth, Kinderklinik

Bayreuth, , Germany

Klinikum Berlin-Buch II. Kinderklinik, Bereich Onkologie/Allg. Pädiatrie

Berlin, , Germany

Kinderklinik der Charité, Campus Virchow Klinikum (CVK), Abt.: Kinderhämatologie

Berlin, , Germany

Städtisches Krankenhaus, Kinderklinik

Braunschweig, , Germany

Klinikum Chemnitz gGmbH, Klinik für Kinder- und Jugendmedizin, Hämatologie / Onkologie

Chemnitz, , Germany

Kliniken der Stadt Köln GmbH, Kinderkrankenhaus Riehl

Cologne, , Germany

Med. Einrichtungen der Universität zu Köln, Klinik für Allg. Kinderheilkunde, Onkologisch-hämatologische Station

Cologne, , Germany

Carl-Thiem-Klinikum, Kinderklinik, Abt. Hämatologie/Onkologie

Cottbus, , Germany

Vestische Kinder- u. Jugendklinik, Universitätsklinik Witten/Herdecke

Datteln, , Germany

Klinikum Lippe-Detmold, Kinder- und Jugendmedizin

Detmold, , Germany

Klinikum Dortmund, Klinik f. Kinder- und Jugendmedizin

Dortmund, , Germany

Uni.Klinik Carl Gustav Carus, Klinik f. Kinderheilkunde

Dresden, , Germany

Universitätskinderklinik

Düsseldorf, , Germany

Helios Klinikum Erfurt GmbH, Klinik für Kinderheilkunde

Erfurt, , Germany

Universitätsklinikum Erlangen, Kinder- und Jugendmedizin, Abt. für Onkologie/ Hämatologie/Immunologie

Erlangen, , Germany

Universitätsklinikum Essen, Kinderklinik, Hämatologie/Onkologie

Essen, , Germany

Universitäts-Kinderklinik, Klinik für Kinderheilkunde III, Pädiatrische Hämatologie/Onkologie

Frankfurt, , Germany

Universitäts-Kinderklinik, Haematologie/ Onkologie

Freiburg im Breisgau, , Germany

Klinikum der Justus-Liebig-Universität, Zentrum für Kinderheilkunde, Abt. Hämatologie/Onkologie

Giessen, , Germany

Universitäts-Kinderklinik Päd. I, Hämatologie/Onkologie

Göttingen, , Germany

Klinik und Poliklinik für Kinder und Jugendmedizin, Allgemeine Pädiatrie mit Poliklinik/Pädiatrische Onkologie und Hämatologie

Greifswald, , Germany

Uniklinikum d. Martin Luther Universität, Halle Wittenberg, Univ.-und Poliklinik für Kinder- und Jugendmedizin

Halle, , Germany

Medizinische Hochschule Hannover, Zentrum Kinderheilkunde u. Jugendmedizin

Hanover, , Germany

Universitäts-Kinderklinik, Päd. Onkologie, Hämatologie, und Immunologie

Heidelberg, , Germany

Klinikum Heilbronn GmbH, Klinik für Kinderheilkunde und Jugendmedizin/Perinatalzentrum

Heilbronn, , Germany

Gemeinschaftskrankenhaus Herdecke, Kinderabteilung

Herdecke, , Germany

Universitätsklinik für, Kinder- und Jugendmedizin, Päd. Hämatologie/ Onkologie

Homburg / Saar, , Germany

Klinikum, der Friedrich-Schiller-Universität, Klinik für Kinder- und Jugendmedizin

Jena, , Germany

Städtisches Klinikum Karlsruhe, Kinderklinik

Karlsruhe, , Germany

Klinikum Kassel, Kinderklinik

Kassel, , Germany

Klinik für Allgemeine Paediatrie, Univ.-Klinikum Schleswig-Holstein, Campus Kiel

Kiel, , Germany

Städtisches Krankenhaus Kemperhof, Kinderklinik

Koblenz, , Germany

Department für Frauen- und Kindermedizin, Abteilung für Pädiatrische Onkologie, Hämatologie und Hämostaseologie

Leipzig, , Germany

Universität zu Lübeck, Klinik für Kinder- u. Jugendmedizin, Abt. Hämatologie/ Onkologie/Immunologie

Lübeck, , Germany

Universitätsklinikum Magdeburg, Klinik für Päd. Hämatologie/Onkologie

Magdeburg, , Germany

Klinikum Mannheim gGmbH, Kinderklinik, Abt. Hämatologie/Onkologie

Mannheim, , Germany

Johannes Wesling Klinikum Minden

Minden, , Germany

Städt. Krankenhaus München GmbH, Krankenhaus München-Schwabingen, Kinderklinik d. TU

München, , Germany

Universitäts-Kinderklinik, Päd. Hämatologie und Onkologie

Münster, , Germany

Cnopf'sche Kinderklinik, Onkologie

Nuremberg, , Germany

Klinikum Oldenburg gGmbH, Zentrum für Kinder- u. Jugendmedizin, (Elisabeth Kinderkrankenhaus)

Oldenburg, , Germany

Universitäts-Kinderklinik

Rostock, , Germany

Asklepios-Klinik, Sankt Augustin GmbH

Sankt Augustin, , Germany

HELIOS Kliniken Schwerin, Klinik f. Kinder-u. Jugendmedizin

Schwerin, , Germany

Olga-Hospital, Kinderklinik, Pädiatrisches Zentrum, Abt. Hämatologie/Onkologie

Stuttgart, , Germany

Krankenanstalt Trier, Mutterhaus der Borromaeerinnen, Pädiatrische Abteilung

Trier, , Germany

Universitäts-Kinderklinik, Abt. Kinderheilkunde II, Hämatologie/Onkologie

Tübingen, , Germany

Universitäts-Kinderklinik

Ulm, , Germany

Stadtkrankenhaus, Kinderklinik

Wolfsburg, , Germany

Universitäts-Kinderklinik

Würzburg, , Germany

HaEmek Medical Center

Afula, , Israel

Soroka Medical Center

Beersheba, , Israel

Rambam Medical Center

Haifa, , Israel

Bnai-Zion Medical Center

Haifa, , Israel

Hadassah University Medical Center

Jerusalem, , Israel

Schneider Children Medical Center of Israel

Petah Tikva, , Israel

Dana children hospital

Tel Aviv, , Israel

Sheba Medical Center

Tel Litwinsky, , Israel

Centro Regionale Oncoematologia Pediatrica Ospedale dei Bambini "G. Salesi" Clinica Pediatrica

Ancona, , Italy

Dipartimento Biomedicina Età Evolutiva U.O Pediatrica I Policlinico

Bari, , Italy

U.O.C. Pediatria e Patologia Neonatale Ospedale San Martino

Belluno, , Italy

U.O. Pediatrica - OO.RR Bergamo

Bergamo, , Italy

Istituto Ortopedico Rizzoli Sez. di chemioterapia dei tumori dell'apparato locomotore

Bologna, , Italy

Oncologia ed Ematologia "Lalla Seràgnoli" Clinica Pediatrica Policlinico Sant'Orsola Malpighi

Bologna, , Italy

Pediatria Ospedale Regionale

Bolzano, , Italy

Clinica Pediatrica Oncoematologia pediatrica e TMO Ospedale dei Bambini

Brescia, , Italy

Istituto di Clinica Pediatrica Ospedale Regionale per le Microcitemie

Cagliari, , Italy

Divisione Ematologia - Oncologia Pediatrica Clinica Pediatrica

Catania, , Italy

Unità Operativa di Ematologia ed Oncologia Pediatrica Az. Osp. "Pugliese-Ciaccio"

Catanzaro, , Italy

Unità Operativa Pediatria Azienda Ospedaliera Annuziata

Cosenza, , Italy

Dipartimento di Medicina Clinica e Sperimentale Sezione di Pediatria Università di Ferrara

Ferrara, , Italy

Dipartimento A.I. Oncoematologia Pediatrica e Cure Domiciliari U.O. Oncoematologia Pediatrica Azienda Ospedaliero-Universitaria Meyer

Florence, , Italy

Dipartimento di Ematologia e Oncologia Pediatrica Instituto " G. Gaslini"

Genova, , Italy

Ospedale "Vito Fazzi" U.O. di Pediatria

Lecce, , Italy

Clinica Pediatrica II De Marchi

Milan, , Italy

Unità di Ricerca Clinica Pediatrica HSR TIGET - Istituto Scientifico San Raffaele

Milan, , Italy

Divisione di Oncologia Pediatrica Ist. Nazionale Studio e Cura Tumori

Milan, , Italy

Divisione Pediatria "Mariani" Ospedale "Niguarda Ca' Granda"

Milan, , Italy

U.O. di Ematologia, oncologia e trapianto Azienda Policlinico di Modena

Modena, , Italy

Clinica Pediatrica dell'Università Milano - Bicocca A.O. San Gerardo - Fondazione MBBM

Monza, , Italy

Dipartimento di Oncologia A.O. Santobono - Pausilipon

Napoli, , Italy

A.O. "A. Cardarelli", U.O.S. Talassemia pediatrica ed emoglobinopatie pediatriche

Napoli, , Italy

Servizio di Oncologia Pediatrica Dipartimento di Pediatria Seconda Università degli Studi di Napoli

Napoli, , Italy

U.O.C. Pediatria - TIN, Ospedale "Umberto Primo" ASL SA - 1

Nocera Inferiore, , Italy

S.C.D.U. Azienda Ospedaliera "Maggiore della carità"

Novara, , Italy

Dipartimento di Pediatria Università di Padova Cattedra Di Oncoematologia Pediatrica

Padua, , Italy

Oncoematologia Pediatrica Ospedale dei Bambini G. di Cristina

Palermo, , Italy

U.O. di Pediatria e Oncoematologia Pediatrica Az. Osp. Di Parma Ospedali Riuniti

Parma, , Italy

Oncoematologia Pediatrica IRCCS, Policlinico San Matteo

Pavia, , Italy

S.C. di Oncoematologia Pediatrica con Trapianto di CSE, Ospedale "S.M. della Misericordia" A.O. Perugia

Perugia, , Italy

Ematologia, Ospedale di Muraglia

Pesaro, , Italy

U.O. Pediatrica Azienda Ospedaliera San Salvatore

Pesaro, , Italy

Dipartimento di Ematologia Ospedale Civile

Pescara, , Italy

Centro di Oncoematologia Pediatrica e Trapianto Midollo Osseo Azienda Ospedaliero Universitaria Pisana Ospedale S. Chiara

Pisa, , Italy

Centro Integrato di Emato-oncologia e dell'adolescenza A.O. S. Maria degli Angeli - Pordenone e IRCCS Centro di Riferimento Oncologico - Aviano

Pordenone, , Italy

Divisione Ematologia Ospedali Riuniti

Reggio Calabria, , Italy

U.O Pediatria Ospedale Infermi Azienda USL Rimini

Rimini, , Italy

Ospedale Sant'Eugenio clinica pediatrica Univ. Tor Vergata

Roma, , Italy

Oncoematologia pediatrica Università "La Sapienza" Roma

Roma, , Italy

Sezione Ematologia Dipart. di biotecnologie Cellulari ed Ematologia Università "La Sapienza"

Roma, , Italy

Divisione di Ematologia Pediatrica Ospedale "Bambin Gesù"Istituto di Ricerca Scientifica

Roma, , Italy

Divisione Oncologia Pediatrica Ospedale "Bambin Gesù"

Roma, , Italy

Divisione Oncologia Pediatrica Università Cattolica di Roma

Roma, , Italy

U.O. Oncoematologia Pediatrica Ospedale "Casa Sollievo della Sofferenza"

San Giovanni Rotondo, , Italy

Clinica Pediatrica Università

Sassari, , Italy

Dipartimento di Pediatria Ostetricia e Medicina della Riproduzione Università degli Studi di Siena

Siena, , Italy

Ospedale Infantile Regina Margherita

Torino, , Italy

Unità Operativa di Pediatria - U.T.I.N. Az.Osp. "Card. G. Panico"

Tricase, , Italy

U.O. Emato-Oncologia Pediatrica Università degli studi di Trieste Ospedale Infantile Burlo Garofolo

Trieste, , Italy

SOS Oncologia Pediatrica Policlinico Universitario

Udine, , Italy

Clinica Pediatrica Università degli Studi dell'Insubria di Varese Ospedale "Filippo del Ponte"

Varese, , Italy

U.O.C Oncoematologia Pediatrica Policlinico "G.B: Rossi"

Verona, , Italy

Ospedale San Bortolo, U.O. di Pediatria e patologia Neonatale

Vicenza, , Italy

Kinderklinik, Hämatologie/Onkologie

Aarau, , Switzerland

Baseler Kinderspital, Hämatologische Poliklinik

Basel, , Switzerland

Repartio di Pediatria

Bellinzona, , Switzerland

Pädiatrische Klinik, Kinderspital Luzern, Kinderonkologie

Lucerne, , Switzerland

Hämatologie/Onkologie, Ostschweizer Kinderspital, FMH Pädiatrie, Hämatologie

Sankt Gallen, , Switzerland

Kinderspital Zürich, Universitäts-Kinderklinik

Zurich, , Switzerland

Countries

Australia; Austria; Czechia; Germany; Israel; Italy; Switzerland

References

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Other Identifiers

AIEOP-BFM ALL 2009

Identifier Type: -

Identifier Source: org_study_id