Identification of Necessary Information for Treatment Induction in Newly Diagnosed Acute Lymphoblastic Leukemia/Lymphoma

NCT ID: NCT06289673

Last Updated: 2025-09-23

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

850 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-26

Study Completion Date

2039-05-31

Brief Summary

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The goal of this study is to provide sufficient therapy during the time a patients' B-cell Acute Lymphoblastic Leukemia (ALL) or Lymphoblastic Lymphoma (LLy) risk category is being determined. The term "risk" refers to the chance of the ALL or LLy coming back after treatment.

Primary Objectives

* To provide sufficient therapy to enable testing of newly diagnosed acute lymphoblastic leukemia/lymphoma and mixed phenotype acute leukemia/lymphoma tumor samples to determine eligibility and appropriate risk stratification for SJALL therapeutic studies.
* To develop a central database of genomic and clinical findings.

Secondary Objectives

* To assess event free and overall survival data of patients enrolled on this study.

Detailed Description

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Patients with newly diagnosed acute lymphoblastic leukemia/lymphoma (ALL/LLy) and mixed phenotype acute leukemia/lymphoma (MPAL) will undergo diagnostic procedures either during screening or on Day 1. They will receive 7 days of chemotherapy including 13 doses of dexamethasone, 1 dose of vincristine, and 1 dose of daunorubicin (for patients with T-ALL/LLy or MPAL only). Patients will also undergo their initial lumbar puncture with intrathecal chemotherapy on Days 4 or 5 or 6 of therapy. After the completion of 7 days of chemotherapy, patients will begin therapy on either a SJALL therapeutic trial or will receive non-protocol therapy.

Conditions

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Acute Lymphoblastic Leukemia Lymphoblastic Lymphoma Mixed Phenotype Acute Leukemia

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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Newly diagnosed ALL, LLy, and MPAL patients

All eligible patients receive the following intervention:

Dexamethasone, Vincristine, Daunorubicin, Intrathecal triple therapy (methotrexate + hydrocortisone + cytarabine)

Group Type EXPERIMENTAL

Dexamethasone

Intervention Type DRUG

Per mouth (PO) or intravenously (IV) once on Day 1 and PO or IV divided BID (every 12 hours) days 2-7

Vincristine

Intervention Type DRUG

Intravenously (IV) for 1 dose on Day 1 or 2

Daunorubicin

Intervention Type DRUG

Intravenously (IV) for 1 dose on Day 2 or 3 (T-ALL/ T-LLy/ MPAL only)

Intrathecal triple therapy (methotrexate + hydrocortisone + cytarabine)

Intervention Type DRUG

Intrathecal (Age adjusted) for 1 dose on Day 4 or 5 or 6

Methotrexate

Intervention Type DRUG

Given IT as part of Intrathecal triple therapy.

Cytarabine

Intervention Type DRUG

Given IT as part of Intrathecal triple therapy.

Interventions

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Dexamethasone

Per mouth (PO) or intravenously (IV) once on Day 1 and PO or IV divided BID (every 12 hours) days 2-7

Intervention Type DRUG

Vincristine

Intravenously (IV) for 1 dose on Day 1 or 2

Intervention Type DRUG

Daunorubicin

Intravenously (IV) for 1 dose on Day 2 or 3 (T-ALL/ T-LLy/ MPAL only)

Intervention Type DRUG

Intrathecal triple therapy (methotrexate + hydrocortisone + cytarabine)

Intrathecal (Age adjusted) for 1 dose on Day 4 or 5 or 6

Intervention Type DRUG

Methotrexate

Given IT as part of Intrathecal triple therapy.

Intervention Type DRUG

Cytarabine

Given IT as part of Intrathecal triple therapy.

Intervention Type DRUG

Other Intervention Names

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Decadron Vincristine Sulfate Oncovin Daunomycin ITMHA MTX Trexall® Cytosine arabinoside Ara-C

Eligibility Criteria

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Inclusion Criteria

* Age 1-18.99 years
* Diagnosis of acute leukemia / lymphoma as below:

* Acute lymphoblastic leukemia (ALL) with at least 25% bone marrow blasts or definitive evidence of ALL in peripheral blood (in those without an available bone marrow sample).
* Lymphoblastic lymphoma (LLy) with immunophenotypic evidence of a lymphoblastic population and \<25% bone marrow blasts and less than 1,000 circulating blasts/ microL.
* Mixed phenotype acute leukemia (MPAL) with or without 25% bone marrow involvement (i.e. patients with either leukemia or lymphoma are eligible).

Exclusion Criteria

* Pregnant or breastfeeding
* Receipt of prior cancer directed therapy with the exclusion of up to 1 dose of intrathecal chemotherapy, 1 dose of vincristine, or emergency radiotherapy due to organ compromising malignant mass. There is no exclusion for prior steroid therapy.
* Known to be currently ineligible for available SJALL therapeutic studies (e.g. receipt of prohibited therapy, no appropriate SJALL therapeutic study available, enrolled on competing trial, etc.).

Note: The intention of this exclusion criterion is to enroll all newly diagnosed ALL/ LLy/ MPAL patients. If participant is screened as a potential participant for subsequent SJALL and later found to be ineligible due to information obtained during INITIALL, this will not make the participant ineligible for INITIALL.

* Inability or unwillingness of research participant or legal guardian/representative to give written informed consent.
* Major pre-existing abnormalities such as ataxia telangiectasia, Fanconi anemia, Charcot Marie Tooth, etc.
Minimum Eligible Age

1 Year

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Jude Children's Research Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Seth E. Karol, MD

Role: PRINCIPAL_INVESTIGATOR

St. Jude Children's Research Hospital

Locations

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Rady Children's Hospital

San Diego, California, United States

Site Status RECRUITING

Saint Francis Children's Hospital

Tulsa, Oklahoma, United States

Site Status RECRUITING

St. Jude Children's Research Hospital

Memphis, Tennessee, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Seth E. Karol, MD

Role: CONTACT

866-278-5833

Facility Contacts

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Victor Wong, MD

Role: primary

858-966-5811

Ashraf Mohamed, MD

Role: primary

918-502-6720

Seth E. Karol, MD

Role: primary

866-278-5833

Related Links

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http://www.stjude.org

St. Jude Children's Research Hospital

http://www.stjude.org/protocols

Clinical Trials Open at St. Jude

Other Identifiers

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NCI-2024-01659

Identifier Type: REGISTRY

Identifier Source: secondary_id

INITIALL

Identifier Type: -

Identifier Source: org_study_id

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