CClinicalTrials.gg
Sign In
CompletedNCT01700946Updated Sep 28, 2022Results posted

Therapy for Pediatric Relapsed or Refractory Precursor B-Cell Acute Lymphoblastic Leukemia and Lymphoma

A Phase 2 interventional study of dexamethasone and vincristine sulfate in Recurrent B-Cell Childhood Acute Lymphoblastic Leukemia and Recurrent Childhood B-Lymphoblastic Lymphoma, sponsored by St. Jude Children's Research Hospital. Completed at 3 sites in United States. Open to participants aged Up to 21 Years. Per ClinicalTrials.gov, last updated 2022-09-28.

Sponsored by St. Jude Children's Research Hospital · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
80
Allocation
Non-randomized
Ages
Up to 21 Years
Sex
All
01

Study summary

The overall objective of this protocol is to improve the cure rate of relapsed precursor B-cell acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma.

This phase II trial is studying risk-directed therapy for B-lymphoblastic leukemia or lymphoma in first relapse. Standard risk (SR) and high risk (HR) participants will receive different therapy. Treatment will consist of chemotherapy for SR participants, and chemotherapy followed by hematopoietic stem cell transplant (HSCT) for HR in first relapse. Induction therapy consists of three blocks of chemotherapy. The first block is a novel immunotherapy regimen that includes chemotherapy, rituximab and infusion of haploidentical natural killer (NK) cells. SR participants will continue to receive chemotherapy for a total duration of approximately 2 years. HR participants will be candidates for HSCT and will proceed to transplant once a suitable donor is found and their minimal residual disease (MRD) is negative.

Read the detailed description

Primary objective

  • To estimate the 3-year survival rate of participants with first relapse or primary refractory precursor B-cell ALL and lymphoblastic lymphoma treated with risk-directed therapy.

Secondary objectives

  • To determine minimal residual disease (MRD) levels at the end of remission induction therapy for participants with relapsed precursor B-cell ALL and compare the results with those in protocol ALLR17
  • To estimate levels of CD20 expression at baseline, during treatment with dexamethasone-containing chemotherapy and following rituximab treatment in Block 1 of remission induction therapy for relapsed precursor B-cell ALL.

STUDY DESCRIPTION:

The general treatment plan will consist of chemotherapy for standard-risk participants and chemotherapy followed by HSCT for high risk participants in first relapse of B-precursor ALL or lymphoblastic lymphoma. Remission induction for all participants consists of three blocks of therapy, wherein the first block is a novel immunotherapy regimen that includes cytotoxic chemotherapy, rituximab and infusion of haploidentical natural killer (NK) cells. Standard-risk patients will continue to receive chemotherapy for a total duration of approximately 2 years. High-risk patients will be candidates for HSCT and will proceed to transplant once a suitable donor is found and the patient achieves negative MRD.

Participants will be assigned to the standard arm if they experience late relapse (> or = 6 months after completion of frontline therapy) AND maximum residual disease (MRD) is \<0.01% at the end of Block II of remission induction therapy. Provisional standard risk participants (i.e., late relapse) will be re-assigned to high risk if MRD is > or = 0.01% at the end of Block II. Participants with lymphoma must be in complete remission at the end of Block III.

High risk participants will meet one of the following criteria:

  • Early relapse (on therapy or \<6 months after completion of frontline therapy), OR
  • Any relapse after hematopoietic stem cell transplant, OR
  • MRD > or = 0.01% at the end of Block II of remission induction therapy, OR
  • Re-emergence of MRD at any time after attaining negative MRD on this clinical trial.

Natural killer (NK) cell collection: Donors who meet eligibility criteria will undergo apheresis once. The cells obtained will be purified for CD56+ cells utilizing the CliniMACS selection system. The NK cell product will undergo quality control testing following standard operating procedures of the St. Jude Human Applications Laboratory.

OUTLINE (STANDARD RISK):

REMISSION INDUCTION:

BLOCK I: Patients receive dexamethasone orally (PO) or intravenously (IV) thrice daily (TID) on days 1-8 and 21-28; vincristine sulfate IV on days 1, 21, 28, and 35; rituximab IV on days 4, 13, 20, and 27; clofarabine, cyclophosphamide, and etoposide IV on days 6-10; aldesleukin subcutaneously (SC) once every other day (QOD) on days 11-19; and pegaspargase IV on days 21 and 35. Patients also undergo natural killer (NK) cell infusion on day 12. Patients may receive triple intrathecal therapy comprising methotrexate, therapeutic hydrocortisone, and cytarabine on days 1, 5, 8, 11, 21, and 28. Patients continue on to Block II after count recovery.

BLOCK II: Patients receive methotrexate IV over 24 hours on days 1 and 8 and mercaptopurine PO on days 1-21. Patients also receive triple intrathecal therapy on day 1. High-risk patients with negative MRD continue on to transplantation. All patients with positive MRD continue on to Block III after count recovery.

BLOCK III: Patients receive cytarabine IV over 2 hours twice daily (BID) on days 1-4 and mitoxantrone hydrochloride IV over 1 hour on days 3-5. Patients also receive triple intrathecal therapy on day 7.

INTERIM CONTINUATION (for patients unable to tolerate dose intensive chemotherapy): Patients receive etoposide and cyclophosphamide IV on day 1, methotrexate IV on day 8, mercaptopurine PO on days 8-14, teniposide and cytarabine IV on day 15, dexamethasone PO TID on days 22-26, and vinblastine IV on day 22.

RE-INDUCTION THERAPY: Patients receive clofarabine, cyclophosphamide, and etoposide IV on days 1-5; dexamethasone PO on days 1-6; and pegaspargase on days 6 and 20 and vincristine sulfate IV on days 6, 13, and 20. Patients may also receive triple intrathecal therapy on days 1 and 15. Patients continue on to continuation treatment after count recovery.

CONTINUATION TREATMENT: Patients receive methotrexate IV over 2 hours on day 1 and mercaptopurine PO on days 1-7 of weeks 1, 2, 5, and 6; teniposide and cytarabine IV on day 1 of weeks 3 and 7; vincristine sulfate IV on day 1 of week 4; dexamethasone PO TID on days 1-5 of weeks 4 and 8; and vinblastine IV on day 1 of week 8. Treatment repeats every 8 weeks for up to 10 courses in the absence of disease progression or unacceptable toxicity. Patients may also receive triple intrathecal therapy on day 1 of week 1 of all courses and day 1 of week 5, courses 1-5.

Due to the unavailability of the drug Teniposide (VM-26), etoposide (VP-16) will be substituted for the remaining doses for patients currently on this study. The protocol Section 5.1.3 allows this substitution.

OUTLINE: GROUP 2 (high risk defined as participants not meeting the standard risk criteria noted above):

Patients receive Remission Induction (Blocks I, II, and III) treatment as described above for Group 1. Patients then undergo allogeneic hematopoietic stem cell transplantation (HSCT) as soon as they have negative MRD. Patients with negative MRD may continue chemotherapy until a suitable donor is found.

After completion of study treatment, patients are followed up every 4 months for 1 year, every 6 months for 1 year, and then yearly for up to 10 years.

02

Conditions studied

  • Recurrent B-Cell Childhood Acute Lymphoblastic Leukemia
  • Recurrent Childhood B-Lymphoblastic Lymphoma

Keywords

  • leukemia
  • lymphoma
  • Non-Hodgkins
03

In context

Lymphoma

5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.

This study's enrollment of 80 is above the median of 40 across 4,508 interventional studies indexed under Lymphoma.

Browse Lymphoma studies →

Lead sponsor

St. Jude Children's Research Hospital is the lead sponsor of 434 studies on the registry; 99 are open to participants now.

Of its 60 completed or terminated interventional studies of FDA-regulated products, 35 (58%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Up to 21 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

INCLUSION CRITERIA:

  • Must have relapsed or refractory precursor B-cell acute lymphoblastic leukemia or acute lymphoblastic lymphoma.

  • Participants with leukemia must meet one of the following:

    1. In first hematologic relapse, defined as the reappearance (in a patient who has previously achieved remission) of leukemia blasts in the bone marrow or peripheral blood, OR
    2. Refractory to one or two courses of frontline induction therapy (≥ 5% blasts in the bone marrow or peripheral blood confirmed by flow cytometric analysis).

  • Participant with lymphoma must meet one of the following:

    1. In first relapse, OR

    2. Refractory to one or two courses of frontline induction therapy with measurable disease

      • Should flow cytometric analyses suggest relapse (by the reappearance of a similar immunophenotype to the original leukemia) in the presence of \<5% blasts morphologically, a repeat bone marrow test is recommended to confirm relapse.
      • Molecular or genetic relapse is characterized by the reappearance of a cytogenetic or molecular abnormality.
      • Early relapse is defined as relapse on therapy or \< 6 months after completion of frontline therapy. Late relapse is defined as relapse occurring ≥ 6 months after completion of frontline therapy.
  • Participant's age is \< 22 years at time of enrollment (e.g. participant is eligible until 22nd birthday).

  • Prior therapy:

    1. There is no waiting period for participants who relapse while receiving frontline therapy and are free from side effects attributable to such therapy.
    2. Emergent radiation therapy, one dose of intrathecal chemotherapy, and up to 7 days of steroids for treatment of relapse are permitted before start of treatment in participants who relapse after completion of frontline therapy.
    3. At least 90 days have elapsed since bone marrow transplant and participant is off immune suppression for a minimum of 2 weeks, if applicable. Participants with ALL or NHL who were transplanted in first remission are eligible for this study.

Organ function requirements

  • Hepatic: Total bilirubin ≤ upper limit of normal (ULN) for age, or if total bilirubin is > ULN, direct bilirubin ≤ 1.4 mg/dl
  • Cardiac: Shortening fraction ≥ 28%

  • Renal: Glomerular filtration rate >50cc/min/1.73 m\^2, OR maximum serum creatinine (SC) based on age as follows:

    • If age is 1 to 2 years, then maximum SC is 0.6 mg/dL
    • If age is 2 to 6 years, then maximum SC is 0.8 mg/dL
    • If age is 6 to 10 years, then maximum SC is 1 mg/dL
    • If age is 10 to \<13 years, then maximum SC is 1.2 mg/dL
    • If age is 13 to 16 years, then maximum SC is 1.5 mg/dL for males and 1.4 mg/dL for females
    • If age is >16 years, then maximum SC is 1.7 mg/dL for males and 1.4 mg/dL for females

EXCLUSION CRITERIA:

  • Leukemia participants ages 1 to 5 years with induction failure AND favorable cytogenetics (i.e., hyperdiploidy defined as DNA index ≥1.16 or modal chromosome number ≥51, or ETV6-RUNXI).
  • Hepatitis B or HIV infection.
  • Pregnant or breast-feeding
  • Inability or unwillingness or research participant or legal guardian/representative to give written informed consent.

INCLUSION CRITERIA FOR NK CELL DONORS:

  • Donor is at least 18 years of age.
  • Donor is a family member.
05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
80 participants (actual)

Study arms

  • Active comparator
    Standard Risk

    Interventions: dexamethasone, vincristine sulfate, rituximab, clofarabine, cyclophosphamide, etoposide, aldesleukin, pegaspargase, methotrexate, mercaptopurine, cytarabine, mitoxantrone, teniposide, vinblastine, natural killer cell infusion, laboratory biomarker analysis, therapeutic hydrocortisone Cells for infusion are prepared using the CliniMACS System.

    Drug: dexamethasone · Drug: vincristine sulfate · Biological: rituximab · Drug: clofarabine · Drug: cyclophosphamide · Drug: etoposide · Biological: aldesleukin · Drug: pegaspargase · Drug: methotrexate · Drug: mercaptopurine · Drug: cytarabine · Drug: mitoxantrone · Drug: teniposide · Drug: vinblastine · Biological: natural killer cell infusion · Other: laboratory biomarker analysis · Drug: therapeutic hydrocortisone · Device: CliniMACS

  • Active comparator
    High Risk

    Interventions: dexamethasone, vincristine, rituximab, clofarabine, cyclophosphamide, etoposide, aldesleukin, pegaspargase, methotrexate, mercaptopurine, cytarabine, mitoxantrone, natural killer cell infusion, allogeneic hematopoietic stem cell transplantation, laboratory biomarker analysis, therapeutic hydrocortisone Cells for infusion are prepared using the CliniMACS System.

    Drug: dexamethasone · Drug: vincristine sulfate · Biological: rituximab · Drug: clofarabine · Drug: cyclophosphamide · Drug: etoposide · Biological: aldesleukin · Drug: pegaspargase · Drug: methotrexate · Drug: mercaptopurine · Drug: cytarabine · Drug: mitoxantrone · Biological: natural killer cell infusion · Other: laboratory biomarker analysis · Drug: therapeutic hydrocortisone · Procedure: allogeneic hematopoietic stem cell transplantation · Device: CliniMACS

Interventions

  • Drugdexamethasone

    given intravenously or orally

    Also known as: Decadron(R)

  • Drugvincristine sulfate

    given intravenously

    Also known as: Oncovin(R)

  • Biologicalrituximab

    given intravenously

    Also known as: Rituxan(R)

  • Drugclofarabine

    given intravenously

    Also known as: Clolar(TM), clofarex

  • Drugcyclophosphamide

    given intravenously

    Also known as: Cytoxan(R)

  • Drugetoposide

    given intravenously

    Also known as: VP-16, Vepesid(R)

  • Biologicalaldesleukin

    given subcutaneously

    Also known as: IL-2, interleukin-2, Proleukin (R)

  • Drugpegaspargase

    given intravenously

    Also known as: PEG-ASP, Peg-L-asparaginase, PEG-asparaginase, Oncaspar(R)

  • Drugmethotrexate

    given intrathecally or intravenously

    Also known as: MTX, HDMTX

  • Drugmercaptopurine

    given orally

    Also known as: 6-MP, Purinethol(R)

  • Drugcytarabine

    given intrathecally or intravenously

    Also known as: Ara-C, Cytosar-U(R)

  • Drugmitoxantrone

    given intravenously

    Also known as: Novantrone(R)

  • Drugteniposide

    given intravenously

    Also known as: VM-26, Vumon(R)

  • Drugvinblastine

    given intravenously

    Also known as: Velban(R)

  • Biologicalnatural killer cell infusion

    undergo allogeneic natural killer cell infusion

    Also known as: NK cell infusion

  • Otherlaboratory biomarker analysis

    correlative studies

  • Drugtherapeutic hydrocortisone

    given intrathecally

    Also known as: Cortef

  • Procedureallogeneic hematopoietic stem cell transplantation

    undergo allogeneic HSCT

    Also known as: HSCT

  • DeviceCliniMACS

    The mechanism of action of the CliniMACS Cell Selection System is based on magnetic-activated cell sorting (MACS). The CliniMACS device is a powerful tool for the isolation of many cell types from heterogeneous cell mixtures, (e.g. apheresis products). These can then be separated in a magnetic field using an immunomagnetic label specific for the cell type of interest, such as CD3+ human T cells.

    Also known as: Cell Selection System

06

What researchers measure

Primary outcomes

  1. 3-year Overall Survival Rate of Patients With Relapsed ALL

    Estimate the 3-year survival rate of participants with first relapse or primary refractory precursor B-cell ALL treated with risk-directed therapy.

    Time frame: 3 years of follow-up since the on-study date

  2. 3-year Event-free Survival Rates in Patients With Relapsed ALL

    Estimate the 3-year event-free survival rate of participants with first relapse or primary refractory precursor B-cell ALL treated with risk-directed therapy.

    Time frame: 3 years of follow-up since the on-study date

Secondary outcomes

  1. Proportion of Participants With Positive Minimal Residual Disease

    To determine minimal residual disease (MRD) levels at the end of remission induction therapy for participants with relapsed precursor B-cell ALL and compare the results with those in protocol ALLR17 (NCT00186875).

    Time frame: At end of induction (approximately 3 months)

  2. Mean of CD20 Expression Levels

    To estimate mean levels of CD20 expression at baseline, during treatment with dexamethasone-containing chemotherapy and following rituximab treatment in Block I of remission induction therapy for relapsed precursor B-cell ALL.

    Time frame: Baseline and at the end of Block I (approximately 5 weeks after the on-study date)

  3. Median CD20 Expression Levels

    To estimate median levels of CD20 expression at baseline, during treatment with dexamethasone-containing chemotherapy and following rituximab treatment in Block I of remission induction therapy for relapsed precursor B-cell ALL.

    Time frame: Baseline and at the end of Block I (approximately 5 weeks after the on-study date)

07

Results

Posted Sep 28, 2022

Participant flow

Eighty (80) participants were enrolled on study. Forty-two (42) participants for the outcome measures and thirty-eight (38) donors who are not included in the analysis.

Participant flow — Overall Study
MilestoneSTANDARD RISKHIGH RISK
Started1824
Completed77
Not completed1117
Withdrew: Lost to follow-up10
Withdrew: Physician decision712
Withdrew: Withdrawal by subject02
Withdrew: Failed to achieve complete remission after induction block iii02
Withdrew: Relapse21
Withdrew: Unacceptable toxicity10

Outcome measures

Primary3-year Overall Survival Rate of Patients With Relapsed ALL

Estimate the 3-year survival rate of participants with first relapse or primary refractory precursor B-cell ALL treated with risk-directed therapy.

Time frame:
3 years of follow-up since the on-study date
Reported as:
Number · percentage of participants
3-year Overall Survival Rate of Patients With Relapsed ALL
percentage of participantsSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
3-year Overall Survival Rate of Patients With Relapsed ALL94.4 (66.6 to 99.2)55.5 (33.0 to 73.2)72.63 (55.95 to 83.85)
Statistical analysis
  • STANDARD RISK vs HIGH RISK · Log Rank · p = 0.035
Primary3-year Event-free Survival Rates in Patients With Relapsed ALL

Estimate the 3-year event-free survival rate of participants with first relapse or primary refractory precursor B-cell ALL treated with risk-directed therapy.

Time frame:
3 years of follow-up since the on-study date
Reported as:
Number · percentage of participants
3-year Event-free Survival Rates in Patients With Relapsed ALL
percentage of participantsSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
3-year Event-free Survival Rates in Patients With Relapsed ALL83.3 (56.8 to 94.3)55.7 (33.2 to 73.4)67.83 (51.04 to 79.9)
Statistical analysis
  • STANDARD RISK vs HIGH RISK · Log Rank · p = 0.105
SecondaryProportion of Participants With Positive Minimal Residual Disease

To determine minimal residual disease (MRD) levels at the end of remission induction therapy for participants with relapsed precursor B-cell ALL and compare the results with those in protocol ALLR17 (NCT00186875).

Time frame:
At end of induction (approximately 3 months)
Reported as:
Count of participants · Participants
Proportion of Participants With Positive Minimal Residual Disease
ParticipantsSTANDARD RISKHIGH RISKALLR18ALLR17
MRD end-induction: Negative1462022
MRD end-induction: Positive04410
Statistical analysis
  • ALLR18 vs ALLR17 · Fisher Exact · p = 0.1181
SecondaryMean of CD20 Expression Levels

To estimate mean levels of CD20 expression at baseline, during treatment with dexamethasone-containing chemotherapy and following rituximab treatment in Block I of remission induction therapy for relapsed precursor B-cell ALL.

Time frame:
Baseline and at the end of Block I (approximately 5 weeks after the on-study date)
Reported as:
Mean · percentage of CD20 Antigen
Mean of CD20 Expression Levels
percentage of CD20 AntigenSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
At Baseline31.10 ± 9.8239.82 ± 7.936.23 ± 6.11
At Block I18.54 ± 4.9320.10 ± 3.4419.43 ± 2.85
SecondaryMedian CD20 Expression Levels

To estimate median levels of CD20 expression at baseline, during treatment with dexamethasone-containing chemotherapy and following rituximab treatment in Block I of remission induction therapy for relapsed precursor B-cell ALL.

Time frame:
Baseline and at the end of Block I (approximately 5 weeks after the on-study date)
Reported as:
Median · percentage of CD20 Antigen
Median CD20 Expression Levels
percentage of CD20 AntigenSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
At Baseline16.40 (3.30 to 36.8)23.13 (8.75 to 67.25)22.0 (4.30 to 61.20)
At Block 111.83 (1.50 to 22.15)19.58 (2.6 to 30.67)15.58 (1.50 to 30.13)

Adverse events

Collected over Through one month after therapy completion, approximately 22 months. If participant proceeds to transplant, until the first day of conditioning therapy.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
STANDARD RISK3/18 (16.7%)1/18 (5.6%)18/18 (100%)
HIGH RISK10/24 (41.7%)0/24 (0%)23/24 (95.8%)
All Patients Enrolled on the Study13/42 (31%)1/42 (2.4%)41/42 (97.6%)
Most frequent serious events
Most frequent serious events
EventSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
Aspartate aminotransferase increasedInvestigations1/180/241/42
Most frequent other events
Showing 10 of 134
Most frequent other events
EventSTANDARD RISKHIGH RISKAll Patients Enrolled on the Study
HyperglycemiaMetabolism and nutrition disorders18/1822/2440/42
Alanine aminotransferase increasedInvestigations18/1821/2439/42
HypoalbuminemiaMetabolism and nutrition disorders17/1823/2440/42
Aspartate aminotransferase increasedInvestigations17/1821/2438/42
HypocalcemiaMetabolism and nutrition disorders17/1817/2434/42
Febrile neutropeniaBlood and lymphatic system disorders16/1819/2435/42
HypokalemiaMetabolism and nutrition disorders15/1820/2435/42
HypophosphatemiaMetabolism and nutrition disorders15/1820/2435/42
NauseaGastrointestinal disorders15/1819/2434/42
HyponatremiaMetabolism and nutrition disorders15/1818/2433/42

Baseline characteristics

All participants enrolled on study.

Age, Customized
Age, Customized(Participants)STANDARD RISKHIGH RISKTotal
1 to 9 years61622
>=10 years12820
Sex: Female, Male
Sex: Female, Male(Participants)STANDARD RISKHIGH RISKTotal
Female7512
Male111930
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)STANDARD RISKHIGH RISKTotal
Black235
White131730
Other347
08

Study locations

3 sites
  • Rady Children's Hospital and Health Center
    San Diego, California 92123, United States
  • St. Jude Children's Research Hospital
    Memphis, Tennessee 38105, United States
  • Cook Children's Medical Center
    Fort Worth, Texas 76104, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Mar 18, 2019

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 28, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01700946
Lead sponsor
St. Jude Children's Research Hospital
Collaborators
Cookies for Kids' Cancer, Assisi Foundation
Responsible party
Sponsor
First posted
Oct 4, 2012
Start date
Apr 15, 2013
Primary completion
Jul 24, 2021
Completion
Jul 24, 2021
Results posted
Sep 28, 2022
Last update
Sep 28, 2022

Study contacts

Sima Jeha, MD
principal investigator · St. Jude Children's Research Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2022. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Other studies in this condition

Lymphoma→

Other studies from this sponsor

St. Jude Children's Research Hospital

Start the discussion