Childhood Acute Lymphoblastic Leukemia Treatment Protocol Moscow-Berlin 2015 (ALL-MB 2015)

Browse trials for

• Leukemia 5,446
• Precursor Cell Lymphoblastic Leukemia-Lymphoma 2,058
• Leukemia, Lymphoid 1,783

Keywords

• Acute lymphoblastic leukemia, children, adolescents, treatment

Study arms

• Experimental
  Dexa intermittent

  Induction therapy with intermittent Dexamethasone administration (1-15 days - 6 mg/m2, 15-22 day - pause, 22-29 days - 6 mg/m2).

  Drug: Dexamethasone intermittent

• Active comparator
  Dexa constant

  Induction therapy with continuous Dexamethasone administration (6 mg/m2 1-29 days).

  Drug: Dexamethasone continuous

• Active comparator
  Dexa

  Therapy with Dexamethasone (6 mg/m2) as basic glucocorticoid preparation.

  Drug: Dexamethasone

• Experimental
  Medrol

  Therapy with Methylprednisolone (60 mg/m2) as basic glucocorticoid preparation.

  Drug: Methylprednisolone

• Experimental
  IDA

  Induction and consolidation therapy with Idarubicin

  Drug: Idarubicin

• Active comparator
  DNR

  Induction and consolidation therapy with Daunorubicin

  Drug: Daunorubicin

• Experimental
  Protocol Ib+

  Two-phase induction therapy (additional second phase of induction - protocol Ib)

  Drug: Second phase of induction

• Active comparator
  Protocol Ib-

  Standard induction therapy (without second phase)

  Drug: Standard induction therapy

• Active comparator
  Bortezomib-

  Consolidation therapy without Bortezomib

  Drug: Standard consolidation therapy

• Experimental
  Bortezomib+

  Consolidation therapy with Bortezomib 1.3 mg/m2 N12 (N4 in each reinduction)

  Drug: Bortezomib

Interventions

• DrugDexamethasone continuous

  6 mg/m2, per os, in two divided doses per day q12 hours. 1-28 day (dose in the first few days is depending on the total tumor mass). From day 29 the dose of dexamethasone is reducing: days 29-31 - 3 mg/m2, days 32-34 - 1.5 mg/m2, days 35-36 - 0.75 mg/m2; then dexamethasone is discontinued completely.

• DrugDexamethasone intermittent

  6 mg/m2, per os, in two divided doses per day q12 hours. Days: 1-14 (dose in the first few days is depending on the total tumor mass) and 22-28; days 15-21 - pause. From day 29 the dose of dexamethasone is reducing: days 29-30 - 3 mg/m2, days 31-32 - 1.5 mg/m2, then dexamethasone is discontinued completely.

• DrugDexamethasone

  Induction: 6 mg/m2, per os, in two divided doses per day q12 hours. 1-28 day (dose in the first few days is depending on the total tumor mass). From day 29 the dose of dexamethasone is reducing: days 29-31 - 3 mg/m2, days 32-34 - 1.5 mg/m2, days 35-36 - 0.75 mg/m2; then dexamethasone is discontinued completely. Consolidation: 6 mg/m2 per os, in two divided doses per day q12 hours. Weeks 13-14 (days 85-98), weeks 21-22 (days 141-154), weeks 29-30 (days 197-210), weeks 37-38 (days 253-260), weeks 45-46 (days 309-316), weeks 53-54 (days 365-372). Maintenance therapy: 6 mg/m2, per os, in two divided doses per day q12 hours, for 10 days followed by quick discontinuation during 3 days. Weeks 61-62, 69-70, 77-78, 85-86, 93-94.

• DrugMethylprednisolone

  Induction: 60 mg/m2, per os, in two divided doses per day q12 hours. 1-28 day (dose in the first few days is depending on the total tumor mass). From day 29 the dose of dexamethasone is reducing: days 29-31 - 30 mg/m2, days 32-34 - 15 mg/m2, days 35-36 - 8 mg/m2; then methylprednisolone is discontinued completely. Consolidation: 60 mg/m2 per os, in two divided doses per day q12 hours. Weeks 13-14 (days 85-98), weeks 21-22 (days 141-154), weeks 29-30 (days 197-210), weeks 37-38 (days 253-260), weeks 45-46 (days 309-316), weeks 53-54 (days 365-372). Maintenance therapy: 60 mg/m2, per os, in two divided doses per day q12 hours, for 10 days followed by quick discontinuation during 3 days. Weeks 61-62, 69-70, 77-78, 85-86, 93-94.

• DrugDaunorubicin

  Induction: 45 mg/m2, intravenously, for 6 hours on days 8 and 22. Consolidation: 30 mg/m2, intravenously, for 6 hours on days 44, 65 (consolidation S1); 107, 121 (consolidation S2); and 163 (consolidation S3).

• DrugIdarubicin

  Induction: 10 mg/m2, intravenously, for 6 hours on days 8 and 22. Consolidation: 8 mg/m2, intravenously, for 6 hours on days 44, 65 (consolidation S1); 107, 121 (consolidation S2); and 163 (consolidation S3).

• DrugBortezomib

  1.3 mg/м2, intravenously, bolus injection. Days 85, 89, 92, 96 (consolidation S1); 141, 145, 148, 152 (consolidation S2) and 197, 201, 204, 208 (consolidation S3).

• DrugSecond phase of induction

  Cyclophosphamide (1,000 mg/m2, intravenously, for 1 hour - days 43 and 71); Cytarabine (75 mg/m2/day, intravenously, bolus injection. Four blocks of 4 days each, days 46-48, 52-55, 59-62, and 66-69); 6-mercaptopurine (60 mg/m2/day, per os, days 43-71); Triple intrathecal therapy (days 52 and 66)

• DrugStandard induction therapy

  Dexamethasone (6 mg/m2, p/o; 1-29 days); Daunorubicin (45 mg/m2, i.v.; day 8 and 22); Vincristine (1.5 mg/m2, i.v.; days 8, 15, 22, 29 and 36); Triple intrathecal therapy (Methotrexate/Cytarabine/Prednisone; days 0/1, 8, 15, 22, 29 and 36)

• DrugStandard consolidation therapy

  Consolidation consists of 3 phases: S1, S2 and S3. Each phase is a 6-week therapy with 6-mercaptopurine (50 mg/m2 per day, daily, orally), methotrexate (30 мг/м2, i.m., weekly) and L-asparaginase (10 000 U/m2, i.m., weekly), followed by 2 weeks of re-induction with Vincristine (1.5 mg/m2, i.v., days 1 and 8 of reinduction) plus Dexamethasone (6 mg/m2, p/o, daily, for 10 days followed by quick discontinuation during 3 days). Daunorubicin (30 mg/м2, i.v., N2 during S1, N2 during S2 and N1 during S3). Triple intrathecal therapy (Methotrexate/Cytarabine/Prednisone) N12 (4 injections per each phase)

Primary outcomes

1. Event-free survival

   Time frame: 3 years, 5 years and 10 years after study start

2. Overall survival

   Time frame: 3 years, 5 years and 10 years after study start

3. Cumulative incidence of relapse

   Time frame: 3 years, 5 years and 10 years after study start

Secondary outcomes

1. Early death rate

   Time frame: 3 years, 5 years and 10 years after study start

2. Remission death rate

   Time frame: 3 years, 5 years and 10 years after study start

Related links

• Study web-site ↗