The GD-2008 ALL Protocol for Childhood Acute Lymphoblastic Leukemia
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The Guangdong work group of childhood acute lymphoblastic leukemia (ALL) therapy was set up in October 2002. The investigators treated the childhood ALL with a GZ2002 protocol since the year 2002, and the protocol was mainly derived from the ALLIC-BFM 2002 protocol. After summarizing the last six years' experience, our group revised the GZ2002 ALL protocol in the year 2008, which is named GD-2008 ALL protocol. The diagnosis and classified criteria is according to the ALLIC-BFM 2002 protocol, and the chemotherapy protocol consists all the therapeutic phases as the ALLIC-BFM 2002 protocol prescribed.
Condition | Intervention | Phase |
---|---|---|
Acute Lymphoblastic Leukemia |
Drug: 6-mercaptopurine, Methotrexate Drug: 6-mercaptopurine, Methotrexate, Vincristine, Dexamethasone |
Phase 4 |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Outcomes Assessor) Primary Purpose: Treatment |
Official Title: | Clinical Study of GD-2008 ALL Protocol for Childhood Acute Lymphoblastic Leukemia in Guangdong Province |
- The improvement of safety in the treatment protocol [ Time Frame: Two months ] [ Designated as safety issue: Yes ]
Estimated Enrollment: | 600 |
Study Start Date: | July 2008 |
Estimated Study Completion Date: | December 2018 |
Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Active Comparator: Protocol A (MM) |
Drug: 6-mercaptopurine, Methotrexate
6-mercaptopurine p.o. qd Methotrexate p.o. qw Other Name: For SR and IR patients (Group one)
|
Experimental: Protocol B (MM/VD) |
Drug: 6-mercaptopurine, Methotrexate, Vincristine, Dexamethasone
(1)6-mercaptopurine p.o. qd x 7w Methotrexate p.o. qd x 7w (2)Vincristine qw x 1w Dexamethasone p.o. qd x 7d Go to (1) and (2) Other Name: For SR and IR patients (Group two)
|
Detailed Description:
The modification includes:
- In the induction phase, the agent of dexamethasone 6 mg/m2 is used instead of prednisone after prednisone prophase.
- The phase "CAM" is 2 weeks for SR patients and 4 weeks for IR and HR patients,respectively.
- Both the SR and IR treatments involve the protocol mM /M (8 weeks) in the phase of consolidation. However, the folinic acid rescue starts at 36 hours instead of 42 hours. The type of HR enters the block treatment the same with the BFM protocol.
- There is not randomized study in delayed intensification. The GD-2008 ALL protocol uses the same protocol II with the BFM study.
- The randomized study focus on the phase of maintenance. The maintenance A is the same with the BFM protocol, while the maintenance B consists of 6mp/MTX and VCR/ dexamethasone. The cycle is 8 weeks: VCR at d1, Dexamethasone at d2 to d7, 6mp from d8 to d56, and MTX at d9,d16, d23, d30, d37,d44,d51.
- The GD-2008 ALL protocol for HR patients use the re-blocks and protocol II phases.
Ages Eligible for Study: | up to 16 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Cytologically proven acute lymphoblastic leukemia (ALL)
- No relapse of a previously unrecognized ALL
- Patients must meet one of the following risk criteria:
- Standard-risk (SR) group meeting all of the following criteria:
- Blasts < 1,000/μL in peripheral blood (PB) on day 8
- Aged 1 to < 6 years
- Initial WBC < 20,000/μL
- M1 (5%) or M2 (≥ 5% to < 25%) blasts in bone marrow on day 15;
- M1 marrow on day 33.
Intermediate-risk (IR) group meeting all of the following criteria:
- Aged < 1 or ≥ 6 years and/or WBC ≥ 20,000/μL
- Blasts < 1,000/μL in PB on day 8
- M1 or M2 marrow on day 15
- M3 (≥ 25%) marrow on day 15 OR meets SR criteria but M3 marrow on day 15 and *M1 marrow on day 33.
High-risk (HR) group meeting ≥ 1 of the following criteria:
- Meets IR criteria and M3 marrow on day 15 (not SR and M3 on day 15)
- Blasts ≥ 1,000/μL in PB on day 8
- M2 or M3 marrow on day 33
- Translocation t(9;22) [BCR/ABL+] (Philadelphia chromosome-positive) or t(4;11) [MLL/AF4+].
Exclusion Criteria:
- No Down syndrome
- No other major disease that prohibits study treatment (e.g., severe congenital heart disease)
- Not requiring significant therapy modification owing to study therapy associated complications
- No complications due to other interventions
- No one with missing data that are needed for the differential diagnosis, or for selection of the proper therapy arm
Contact: Shaoliang Huang, M.D. | +8620-81332003 | luhong.xu@yahoo.com |
China, Guangdong | |
The second affiliated hospital of Sun Yat-sen University | Recruiting |
Guangzhou, Guangdong, China, 510000 | |
Contact: Jianpei Fang, M.D. +8620-81332003 jpfang2005@163.com | |
Principal Investigator: Jianpei Fang, M.D. |
Study Director: | Jianpei Fang, M.D. | The second affiliated hospital of Sun Yat-sen University |
Principal Investigator: | Xuequn Luo, M.D. | First Affiliated Hospital, Sun Yat-Sen University |
Principal Investigator: | Jianliang Chen, M.D. | Third Affiliated Hospital, Sun Yat-Sen University |
Principal Investigator: | Xiaofei Sun | The cancer hospital of Sun Yat-sen University |
Principal Investigator: | Xuedong Wu | Nanfang hospital of Nanfang Medical University |
Principal Investigator: | Liming Tu, M.D. | Guangdong Provincial People's Hospital |
Principal Investigator: | Dongbo Lai, M.D. | Guangzhou children's hospital |
Principal Investigator: | Changgang Li, M.D. | Shenzhen Children's Hospital |
Principal Investigator: | Liyang Liu, M.D. | Huizhou People's Central Hospital |
No publications provided
Responsible Party: | Jianpei Fang,MD, Sun Yat-sen University |
ClinicalTrials.gov Identifier: | NCT00846703 History of Changes |
Other Study ID Numbers: | 2007016 |
Study First Received: | February 17, 2009 |
Last Updated: | March 5, 2010 |
Health Authority: | China: Ministry of Health |
Additional relevant MeSH terms:
Leukemia Leukemia, Lymphoid Precursor Cell Lymphoblastic Leukemia-Lymphoma Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases 6-Mercaptopurine Methotrexate Dexamethasone Vincristine BB 1101 Dexamethasone acetate |
Dexamethasone 21-phosphate Antimetabolites Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Antimetabolites, Antineoplastic Antineoplastic Agents Therapeutic Uses Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Nucleic Acid Synthesis Inhibitors Enzyme Inhibitors Anti-Inflammatory Agents Antiemetics Autonomic Agents |
ClinicalTrials.gov processed this record on September 26, 2012