ClinicalTrials.gg
RecruitingNCT03509961Updated May 4, 2025

The EndRAD Trial: Eliminating Total Body Irradiation (TBI) for NGS-MRD Negative Children, Adolescents, and Young Adults With B-ALL

A Phase 2 interventional study of NGS-MRD and Myeloablative allogeneic HCT with a non-TBI conditioning regimen in B-cell Acute Lymphoblastic Leukemia, sponsored by Pediatric Transplantation & Cellular Therapy Consortium. Recruiting at 24 sites in United States. Open to participants aged 1 Year to 25 Years. Per ClinicalTrials.gov, last updated 2025-05-04.

Sponsored by Pediatric Transplantation & Cellular Therapy Consortium · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jul 2025, 1 year 4 months ago, but the record still lists the study as recruiting.
  • Started Aug 2018; still recruiting 8 years 2 months later.

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Phase
Phase 2
Study type
Interventional
Enrollment
95
Allocation
Non-randomized
Ages
1 Year to 25 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 724 studies in Burkitt Lymphoma with a site in United States — 70 open to participants now, 117 under way, 9 of them phase 3. Burkitt Lymphoma · United States.

Planned enrollment
104th of 593
95 · median 36
Started
2018
with 14 others
Phase 2
237 of 724
19 open now
Primary completion
2025-07
later than 22 of 116 live
Registered
603rd of 724
by date

Among the 724 studies in Burkitt Lymphoma with a site in United States, this one is the 104th largest by planned enrollment of the 593 interventional ones that give a count, is one of 15 that started in 2018, is one of 237 in phase 2, reaches primary completion later than 22 of the 116 other live ones, and was the 603rd registered.

Burkitt Lymphoma

977 studies on the registry are indexed under Burkitt Lymphoma; 160 are open to participants now.

Browse Burkitt Lymphoma studies →

Open to participants now

70 of the 724 studies in Burkitt Lymphoma with a site in United States are open now. Recruiting first, the newest first:

65 more — sign in →

All 70 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 130 Burkitt Lymphoma studies recruiting now, 40 (31%) set no upper age limit and 77 (59%) stop at 75 or younger; 75 take children under 18; 2 take healthy volunteers.

This study: 1 Year to 25 Years · all sexes · no healthy volunteers.

The full table on the hub →

This tab as a report to print or save as PDF → With an account.

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Watch this landscapeDownload CSVNarrow it in search →With an account: a weekly mail of what changed among 724 studies in Burkitt Lymphoma with a site in United States, or all of them as a file.
02

Study summary

This study will evaluate the use of non- TBI (total body irradiation) conditioning for B-ALL patients with low risk of relapse as defined by absence of NGS-MRD (next generation sequencing minimal residual disease) before receiving a hematopoietic cell transplant (HCT). Patients diagnosed with B-ALL who are candidates for HCT will be screened by NGS-MRD on a test of bone marrow done before the HCT. Subjects who are pre-HCT NGS-MRD negative will be eligible to receive a non-TBI conditioning regimen as part of the treatment cohort of the study. Subjects who are pre-HCT NGS-MRD positive will be treated as per treating center standard and will be followed in an observational cohort (HCT center standard of care).

Read the detailed description

A Phase II pilot trial will estimate survival after a non-TBI based conditioning regimen in patients diagnosed with B-acute lymphoblastic leukemia (ALL) who are pre-allogeneic hematopoietic cell transplantation (HCT) next-generation-sequence (NGS) minimal residual disease (MRD) negative.

The relationship of NGS-MRD status to survival in children, adolescents, and young adults with B-ALL undergoing any approach to allogeneic HCT will be explored in a larger cohort (treatment [phase II] and observational arms of the study).

The primary objective is to estimate 2-year event free survival (EFS) in pre-HCT NGS-MRD negative patients with B-ALL undergoing a non-TBI based conditioning regimen through a multi-center prospective trial. The accrual period is 3 years.

Patients that are NGS-MRD negative with B-ALL may be eligible for the Treatment Arm, which is myeloablative non-TBI conditioning with busulfan, fludarabine, and thiotepa followed -matched related, unrelated, and umbilical cord blood transplants. Patients that are NGS-MRD positive will be followed on the observational arm for outcome.

Study sampling will include NGS-MRD bone marrow (BM) aspirate and peripheral blood (PB) samples collected [same day when possible] pre-HCT (within 4 weeks), and post-HCT on days 42 ± 14, 100 ± 20, and 365 ± 60; PB samples only will also be collected day 180± 60 and 270± 60; day +30, day +100, and 1-year post-HCT. NGS-MRD peripheral blood sample only at 6 months and 9 months post-HCT; (Blast specimen at time of diagnosis or relapse is required for NGS-MRD testing).

03

Conditions studied

  • B-cell Acute Lymphoblastic Leukemia

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04

Who can participate

Ages eligible
1 Year to 25 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria for the Observational Arm:

Any patient with ALL who undergoes Myeloablative HCT including any of the following:

  • Patients who are pre-HCT NGS-MRD positive.
  • Patients \<1 year old who are pre-HCT NGS-MRD negative.
  • Patients who are pre-HCT NGS-MRD negative (CR1/CR2) who received inotuzumab ozogamicin therapy before proceeding to HCT.
  • Patients who are pre-HCT NGS-MRD negative and will be receiving haploidentical HCT.
  • Patients who are pre-HCT NGS-MRD negative in CR2 with history of CNS relapse.
  • Patients who have received blinatumomab, but are >CR2 prior to HCT.
  • Patients who have received CART-T cellular therapy, but are >CR2 prior to HCT.
  • Patients with pre-HCT NGS-MRD negative in ≥ CR3.
  • Any T-ALL and MPAL patients undergoing first HCT
  • Any patient who is pre-HCT NGS-MRD negative and eligible for participation in the treatment arm but family does not consent for treatment arm or treating physician believe it is in the patient best interest not to enroll on the treatment arm

Inclusion Criteria for the Treatment Arm:

  • Pre-HCT NGS-MRD negative
  • Age ≥ 1 year and ≤ 25 years
  • Disease status: B-ALL in first (CR1) or second remission (CR2)
  • No prior allogeneic hematopoietic stem cell transplant.
  • Patients in CR1 or CR2 after blinatumomab treatment.
  • Patients in CR1 or CR2 after CAR-T cellular therapy.
  • Index or Lansky Play-Performance Scale ≥ 60 % on pre-transplant evaluation. Karnofsky scores must be used for patients > 16 years of age and Lansky scores for patients \< 16 years of age.
  • Able to give if > 18 years, or with a legal guardian capable of giving informed consent if \< 18 years.
  • Adequate organ function (within 4 weeks of initiation of preparative regimen), defined as:
  • Pulmonary: , FVC, and corrected DLCO must all be ≥ 50% of predicted by pulmonary function tests (PFTs). For children who are unable to perform for PFTs due to age, the criteria are: no evidence of dyspnea at rest and no need for supplemental oxygen.
  • Renal: or radioisotope ≥ 60 mL/min/1.73 m2 or a serum creatinine based on age/gender.
  • Cardiac: Shortening fraction of ≥ 27% by echocardiogram or radionuclide scan () or ejection fraction of ≥ 50% by echocardiogram or radionuclide scan (MUGA), choice of test according to local standard of care.
  • Hepatic: (AST) or SGPT (ALT) \< 5 x (ULN) for age. Conjugated \< 2.5 mg/dL, unless attributable to Gilbert's Syndrome.

Exclusion Criteria:

  • CR2: exclude patients with history of CNS relapse (i.e. in CR2 with history of CNS isolated or combined relapse; CNS 2 will also be considered as CNS 3 for this purpose) from the treatment arm of study (can be enrolled on the observational arm).
  • Patients who have received inotuzumab treatment prior to allogeneic HCT are NOT eligible for the study treatment arm. Inotuzumab treatment may increase the risk of VOD/SOS for any allogeneic HCT recipient, but could potentiate the risk for with busulfan-based myeloablation (study-directed non-TBI conditioning). All inotuzumab-treated patients are eligible for the observational arm (HCT center standard of care).
  • Patients receiving non-myeloablative conditioning are not allowed on the observational arm (reduced toxicity conditioning with Flu/Mel/Thio is allowed on the observational arm).
  • Pregnant or lactating females are ineligible as many of the medications used in this protocol could be harmful to unborn children and infants.
  • Patients with or uncontrolled fungal, bacterial or viral infections are excluded. Patients with history of fungal disease during induction therapy may proceed if they have a significant response to antifungal therapy with no evidence or minimal evidence of non-progressive disease remaining by CT evaluation.
  • Patients with active CNS leukemia or any other active site of extramedullary disease at the time of enrollment are not permitted.
  • T-ALL and MPAL patients are only allowed on the observational arm.
  • Patients with genetic disorders (generally marrow failure syndromes) prone to secondary AML/ALL with known poor outcome are not eligible (Fanconi Anemia, Kostmann Syndrome, Dyskeratosis Congenita, etc).
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Karnofsky performance status (KPS)

A 0–100 scale of how well someone can carry out everyday activities. 100 is no complaints and no signs of illness; 70 is able to look after yourself but not to work or keep up normal activity; 50 is needing considerable help and frequent medical care.

Studies often ask for 60 or 70 and above. Your doctor gives the score.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

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

Study arms

  • Other
    Observational Arm

    Patients are enrolled to the observational arm to proceed with NGS-MRD testing pre-HCT. If NGS-MRD negative, eligible patients may be considered for the Treatment Arm to receive a myeloablative non-TBI conditioning regimen prior to HCT. If NGS-MRD positive, patients may continue in the observational arm and receive HCT under the direction of their transplant physician and followed on the study for outcome.

    Diagnostic Test: NGS-MRD

  • Other
    Treatment Arm

    Patients enrolled to the observational arm that are NGS-MRD pre-HCT are considered for the Treatment Arm. Patients will receive a myeloablative non-TBI conditioning regimen prior to the transplant consisting on busulfan, fludarabine and thiotepa. Patients will be followed for outcome for up to 5 years.

    Diagnostic Test: NGS-MRD · Drug: Myeloablative allogeneic HCT with a non-TBI conditioning regimen

Interventions

  • Diagnostic testNGS-MRD

    Next generation sequencing minimal residual disease (NGS-MRD) is a test that has increased sensitivity over multichannel flow cytometry to better identify risk of key outcomes after HCT. Patients that have a pre-HCT negative NGS-MRD results may be eligible to proceed to the treatment arm of the study that uses a non-TBI conditioning regimen.

  • DrugMyeloablative allogeneic HCT with a non-TBI conditioning regimen

    Myeloablative study regimen will consist of busulfan, fludarabine and thiotepa. day -7: Fludarabine and Busulfan day -6: Fludarabine and Busulfan day -5: Fludarabine and Busulfan day -4: Fludarabine and Busulfan day -3: Fludarabine day -2: Thiotepa day -1: Rest Day 0: Transplant

06

What researchers measure

Primary outcomes

  1. Two Year Event-free Survival

    The primary objective of this study is the two Year Event-free Survival for patients with high-risk or recurrent B-ALL who proceed to HCT and who are NGS-MRD negative when treated with a non-TBI preparative regimen.

    Time frame: Two years

07

Study locations

24 of 24 sites recruiting
08

References and documents

Publications

  • Andolina JR, Fries C, Boulware R, Vargas A, Fraint E, Barth M, Ambrusko S, Comito M, Monteleone P. Successful Bone Marrow Transplantation With Intensive Post-transplant Intrathecal Chemotherapy for CNS Relapsed AML in 2 Infants. J Pediatr Hematol Oncol. 2022 Jan 1;44(1):e264-e267. doi: 10.1097/MPH.0000000000002151. PubMed 33843815 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Aug 2018 (actual). Primary completion is estimated for Jul 2025, 82 months after the start.

Of 83 non-industry phase 2 interventional studies under Burkitt Lymphoma, half reached primary completion within 83 months of starting (the median), counting those still running; a quarter within 42 and three quarters within 120. This study's planned 82 months is close to that.

Counting every sponsor, half of 91 studies reached it within 81 months; a quarter within 41 and three quarters within 119.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 19, 2018
First posted
Apr 27, 2018
StartActual
Aug 29, 2018
Primary completionEst.
Jul 1, 2025
CompletionEst.
Jul 1, 2026
Last update
May 4, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 4, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03509961
Lead sponsor
Pediatric Transplantation & Cellular Therapy Consortium
Responsible party
Michael Pulsipher (Principal Investigator, Children's Hospital Los Angeles) — Principal investigator
First posted
Apr 27, 2018
Start date
Aug 29, 2018
Primary completion
Jul 1, 2025 (estimated)
Completion
Jul 1, 2026 (estimated)
Last update
May 4, 2025

Study contacts

Liz Gourdine
Contact
EndRAD@chla.usc.edu
323-361-6652
Abdel-Azim Hisham, MD
principal investigator · Loma Linda University
Troy Quigg, DO, MS
principal investigator · Helen DeVos Children's Hospital

Oversight

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

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