ClinicalTrials.gg
RecruitingNCT03911128Updated Aug 13, 2026

A Treatment Protocol for Participants 0-45 Years With Acute Lymphoblastic Leukaemia

An observational study in Leukemia, Acute Lymphoblastic, sponsored by Mats Heyman. Recruiting at 57 sites in 8 countries. Open to participants aged 0 Years to 45 Years. Per ClinicalTrials.gov, last updated 2026-08-13.

Sponsored by Mats Heyman · Observational

From the registry’s dates

  • Started Aug 2019; still recruiting 7 years 2 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
500
Ages
0 Years to 45 Years
Sex
All
01

Study summary

The pilot study collects the experience of previously successful treatment of infants, children and young adults, with ALL from a number of well-renowned study groups into a new platform protocol, which is both a comprehensive system for stratification and treatment of ALL in this age-group as well as the basis for several randomised trials included in the study-design.

The pilot study is implemented as a master protocol without study specific interventions, thus as an observational study. The pilot study is for countries/study-groups who intend to join ALLTogether1 (including experimental interventions). For these countries the pilot study is crucial to optimise diagnostics, registration systems, collaborations with vendors, logistics and data-checks before starting the main study.

The study only includes "standard of care" treatment included in the master protocol.

Read the detailed description

The aims of the ALLTogether study are to improve survival and quality of survival for children and young adults with ALL. ALL in young people has excellent outcome with >90% survival in children and about 75% in young adults. However, patients still die of disease - after relapse as a result of under-treatment.

Furthermore, a considerable fraction of younger patients are over-treated: All patients risk treatment-related death and some suffer long-term side-effects or secondary cancer. The rates of death from disease and death from therapy are almost the same for children. To show improvement with such good survival, large populations are needed.

Study groups from the five Nordic countries, Estonia and Lithuania (NOPHO), the UK (UKALL), the Netherlands (DCOG), Germany (COALL), Belgium (BSPHO), Ireland (PHOAI), Portugal (SHOP) and France (SFCE) have designed a common treatment protocol as new standard of care for children and young adults with ALL. The risk-stratification is based on a novel, personalised algorithm using clinical characteristics, genetic changes in the leukaemia and response to therapy.

The protocol will, based on a personalised risk-approach, define a platform for diagnosis and treatment onto which randomized as well as non-randomised interventions and translational studies can be added. This platform can also be used by countries joining the collaboration at a later date to prepare for full participation.

High-risk B-lineage patients may be stratified to Chimeric Antigen Receptor T-cell (CAR-T) therapy as an alternative to high-risk blocks and stem-cell transplant to reduce the side-effects.

Translational and other therapy-related research will be promoted by the common master protocol.

02

Conditions studied

  • Leukemia, Acute Lymphoblastic

Keywords

  • Leukemia
  • Acute Lymphoblastic
  • ALL
  • ALLTogether
  • Leukaemia
03

In context

Precursor Cell Lymphoblastic Leukemia-Lymphoma

2,584 studies on the registry are indexed under Precursor Cell Lymphoblastic Leukemia-Lymphoma; 473 are open to participants now.

This study's planned enrollment of 500 is above the median of 108 across 400 observational studies indexed under Precursor Cell Lymphoblastic Leukemia-Lymphoma.

Browse Precursor Cell Lymphoblastic Leukemia-Lymphoma studies →

Lead sponsor

Mats Heyman is the lead sponsor of 2 studies on the registry; 2 are open to participants now.

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

04

Who can participate

Ages eligible
0 Years to 45 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Participants 0-45 years with newly diagnosed acute lymphoblastic leukaemia. The protocol has no gender-bias. The total estimated recruitment in the pilot study is 500 participants.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients newly diagnosed with T-lymphoblastic (T-cell) or B-lymphoblastic precursor (BCP) leukaemia (ALL) according to the WHO-classification of Tumours of Haematopoietic and Lymphoid Tissues (Revised 4th edition 2017) and with a diagnosis confirmed by an accredited laboratory at a participating paediatric oncology or adult haematology centre.
  • Age 0 - \< 46 years (one day before 46th birthday) at the time of diagnosis, with the exception of infants with KMT2A-r BCP ALL (see exclusion criteria below).
  • Patients with surface immunoglobulin negative (sIG-) BCP-ALL and an IG::MYC rearrangement, unless they have a concurrent BCL2/6 rearrangement. T-ALL patients with MYC translocations.
  • signed by the patient and/or parents/legal guardians according to country-specific age related guidelines
  • The ALL diagnosis should be confirmed by an accredited laboratory at a participating paediatric oncology or adult haematology centre.
  • The patient should be diagnosed and treated at a participating paediatric oncology or adult haematology centre in the participating countries.
  • The patient should be a resident in one of the participating countries on a permanent basis or should intend to settle in a participating country, for instance by an application for asylum. Patients who are visiting the country as tourists should not be included. However, returning expatriots and patients who intend to stay at least for the duration of the treatment with primary diagnosis abroad may be included if no treatment has been administered and the diagnostic procedures are repeated at a participating centre.
  • All women of (WOCBP) have to have a negative pregnancy test within 2 weeks prior to the start of treatment.

Exclusion criteria

Exclusion Criteria:

  • Age \< 365 days and KMT2A-rearranged (KMT2A-r) BCP-ALL (documented presence of a KMT2A-split by FISH and/or a KMT2A fusion transcript). These patients will be transferred to an appropriate trial for infant KMT2A-r BCP-ALL, if available.
  • Age >45 years at diagnosis.
  • Patients with a previous malignant diagnosis (ALL as a second malignant neoplasm - SMN).
  • Relapse of ALL.
  • Patients with mature B-ALL (as defined by surface IG positivity) or any patients with IG::MYC and a concurrent BCL2/6 rearrangement.
  • Patients with Ph-positive ALL (documented presence of t(9;22)(q34;q11) and/or of the BCR::ABL1 fusion transcript). These patients will be transferred to an appropriate trial for t(9;22) if available.
  • Previously known ALL prone syndromes (e.g. Li-Fraumeni syndrome, germline ETV6 mutation), except for Down syndrome. Exploration for such ALL prone syndromes is not mandatory and patients in whom genetic work-up reveals a new germ-line mutation (index-cases) will remain in the study.
  • Treatment with systemic corresponding to (>10mg prednisolone/m2/day) for more than one week and/or other chemotherapeutic agents in a 4-week interval prior to diagnosis (pre-treatment).
  • Pre-existing to any treatment according to the ALLTogether protocol (constitutional or acquired disease prior to the diagnosis of ALL preventing adequate treatment).
  • Any other disease or condition, as determined by the investigator, which could interfere with the participation in the study according to the study protocol, or with the ability of the patients to cooperate and comply with the study procedures.
  • Women of who are pregnant at the time of diagnosis.
  • Women of childbearing potential and fertile men who are sexually active and are unwilling to use adequate during therapy. Efficient birth control is required, see section 18.9.
  • Female patients, who are breast-feeding.
  • Essential data missing from the registration of characteristics at diagnosis (in consultation with the protocol chair).
Terms in these criteria, in plain language(5)

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.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
500 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Participants with newly diagnosed ALL

    Other: Observational

Interventions

  • OtherObservational

    Observational study - no intervention

06

What researchers measure

Primary outcomes

  1. Event-free survival (EFS) compared to historical controls

    Time frame: 5 year

  2. Overall survival (OS) compared to historical controls

    Time frame: 5 year

07

Study locations

11 of 57 sites recruiting
  • Aalborg University Hospital, Dept of Paediatrics
    Aalborg, 9000, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Aarhus University Hospital
    Aarhus, 8000, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Aarhus University Hospital, Child and Adolescent Health
    Aarhus, 8200, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Rigshospitalet, Dept of Haematology
    Copenhagen, 2100, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Rigshospitalet, Dept of Paediatrics
    Copenhagen, 2100, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Odense University Hospital, Dept of Paediatrics
    Odense, 5000, Denmark
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • North Estonia Medical Centre, Dept of Haematology
    Tallinn, 13419, Estonia
    Not yet recruiting
    • Katrin Palk, M.D. · Principal investigator
  • Tallinn Children´s Hospital, Dept of Paediatrics
    Tallinn, 13419, Estonia
    Not yet recruiting
    • Kristi Lepik, M.D. · Principal investigator
  • Tartu University Hospital
    Tartu, 50406, Estonia
    Not yet recruiting
    • Mari Punab, M.D. · Principal investigator
  • Helsinki University Hospital, Dept of Haematology
    Helsinki, 00029, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Helsinki University Hospital, Dept of Paediatrics
    Helsinki, 00029, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Kuopio University Hospital, Dept of Haematology
    Kuopio, 70029, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Kuopio University Hospital, Dept of Paediatrics
    Kuopio, 70029, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Oulu University Hospital, Dept of Haematology, Dept of Medicine
    Oulu, 90029, Finland
    Not yet recruiting
    • Timo Siitonen, M.D. · Contact
    • Timo Siitonen, M.D. · Principal investigator
  • Oulu University Hospital, Dept of Paediatrics
    Oulu, 90029, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Tampere University Hospital, Dept of Haematology
    Tampere, 33521, Finland
    Not yet recruiting
    • Johanna Rimpiläinen, M.D. · Principal investigator
  • Tampere University Hospital, Dept of Paediatrics
    Tampere, 33521, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Turku University Hospital, Clinical Haematology and Stem Cell Transplantation Unit
    Turku, 20520, Finland
    Not yet recruiting
    • Urpu Salmenniemi, M.D. · Principal investigator
  • Turku University Hospital, Dept of Paediatrics
    Turku, 20520, Finland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Landspitali University Hospital, Children's Hospital
    Reykjavik, 101, Iceland
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Children's Hospital, Affiliate of Vilnius University Hospital
    Vilnius, 08406, Lithuania
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Vilnius University Hospital
    Vilnius, 08661, Lithuania
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Haukeland University Hospital, Dept of Haematology
    Bergen, 5021, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Haukeland University Hospital, Dept of Paediatrics
    Bergen, 5021, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Oslo University Hospital, Dept of Haematology
    Oslo, 0372, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Oslo University Hospital, Dept of paediatric haemato- and oncology
    Oslo, 0424, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Stavanger University Hospital, Dept of Haematology
    Stavanger, 4011, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • University Hospital North Norway, Dept of Haematology
    Tromsø, 9019, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • University Hospital of North Norway, Dept of Paediatrics
    Tromsø, 9038, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • St. Olavs University Hospital, Dept of Paediatrics
    Trondheim, 7006, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • St. Olavs University Hospital, Dept of Haematology
    Trondheim, 7030, Norway
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Hospital Universitario Dr.Balmis
    Alicante, Spain
    Recruiting
    • Laura Ureña Horno, M.D. · Principal investigator
  • Hospital Universitario de Cruces
    Barakaldo, Spain
    Recruiting
    • Rosa María Adán Pedroso, M.D. · Principal investigator
  • Hospital Universitario San Joan de Déu
    Barcelona, Spain
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Hospital Universitario Vall d'Hebron
    Barcelona, Spain
    Active, not recruiting

    Not enrolling at this site — choose another above.

  • Hospital Universitario La Paz
    Fuencarral-El Pardo, Spain
    Recruiting
    • Berta González Martínez, M.D. · Principal investigator
  • Hospital Infantil Universitario Nino Jesus
    Madrid, Spain
    Recruiting
    • Blanca Herrero Velasco, M.D. · Principal investigator
  • Hospital Clínico Universitario Virgen de la Arrixaca
    Murcia, Spain
    Recruiting
    • José Luis Fuster Soler, M.D. · Principal investigator
  • Hospital Universitario Son Espases
    Palma de Mallorca, Spain
    Recruiting
    • Elena Garcia Macias, M.D. · Principal investigator
  • Hospital Universitario Marqués de Valdecilla
    Santander, Spain
    Recruiting
    • Mónica López Duarte · Principal investigator
  • Hospital Clínico Universitario de Santiago
    Santiago de Compostela, Spain
    Recruiting
    • Sheila Torrado González, M.D. · Principal investigator
  • Hospital Universitario Virgen del Rocio
    Seville, Spain
    Recruiting
    • Águeda Molinos Quintana, M.D. · Principal investigator
  • Hospital Universitario Politécnico La Fe
    Valencia, Spain
    Recruiting
    • Carolina Fuentes Socorro, M.D. · Principal investigator
  • Hospital Universitario Miguel Servet
    Zaragoza, Spain
    Recruiting
    • Carmen Rodriguez-Vigil, M.D. · Principal investigator
  • Sahlgrenska University Hospital, Section for Haematology and coagulation
    Gothenburg, 41345, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Sahlgrenska University Hospital, Dept of Paediatric Haematology and Oncology
    Gothenburg, 41685, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Linköping University Hospital, Dept of Haematology
    Linköping, 58185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Linköping University Hospital, Dept of Paediatrics
    Linköping, 58185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Skåne University Hospital, Dept of Haematology
    Lund, 22185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Skåne University Hospital, Dept of Paediatrics
    Lund, 22185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Örebro University Hospital, Section for Haematology
    Örebro, 70185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Karolinska University Hospital, Dept of Paediatric Oncology and Haematology
    Stockholm, 17176, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Karolinska University Hospital, Patient area Haematology
    Stockholm, 17176, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Norrland University Hospital, Dept of Haematology
    Umeå, 90185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Norrland University Hospital, Dept of Paediatrics
    Umeå, 90185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Uppsala University Hospital, Dept of Haematology
    Uppsala, 75185, Sweden
    Completed

    Not enrolling at this site — choose another above.

  • Uppsala University Hospital, Dept of Paediatric Haematology and Oncology
    Uppsala, 75185, Sweden
    Completed

    Not enrolling at this site — choose another above.

08

References and documents

Publications

  • Toft N, Birgens H, Abrahamsson J, Griskevicius L, Hallbook H, Heyman M, Klausen TW, Jonsson OG, Palk K, Pruunsild K, Quist-Paulsen P, Vaitkeviciene G, Vettenranta K, Asberg A, Frandsen TL, Marquart HV, Madsen HO, Noren-Nystrom U, Schmiegelow K. Results of NOPHO ALL2008 treatment for patients aged 1-45 years with acute lymphoblastic leukemia. Leukemia. 2018 Mar;32(3):606-615. doi: 10.1038/leu.2017.265. Epub 2017 Aug 18. PubMed 28819280 ↗
  • Schramm F, Zimmermann M, Jorch N, Pekrun A, Borkhardt A, Imschweiler T, Christiansen H, Faber J, Feuchtinger T, Schmid I, Beron G, Horstmann MA, Escherich G. Daunorubicin during delayed intensification decreases the incidence of infectious complications - a randomized comparison in trial CoALL 08-09. Leuk Lymphoma. 2019 Jan;60(1):60-68. doi: 10.1080/10428194.2018.1473575. Epub 2018 Jul 3. PubMed 29966458 ↗
  • Mondelaers V, Suciu S, De Moerloose B, Ferster A, Mazingue F, Plat G, Yakouben K, Uyttebroeck A, Lutz P, Costa V, Sirvent N, Plouvier E, Munzer M, Poiree M, Minckes O, Millot F, Plantaz D, Maes P, Hoyoux C, Cave H, Rohrlich P, Bertrand Y, Benoit Y; Children-s Leukemia Group (CLG) of the European Organization for Research and Treatment of Cancer (EORTC). Prolonged versus standard native E. coli asparaginase therapy in childhood acute lymphoblastic leukemia and non-Hodgkin lymphoma: final results of the EORTC-CLG randomized phase III trial 58951. Haematologica. 2017 Oct;102(10):1727-1738. doi: 10.3324/haematol.2017.165845. Epub 2017 Jul 27. PubMed 28751566 ↗
  • Vora A, Goulden N, Wade R, Mitchell C, Hancock J, Hough R, Rowntree C, Richards S. Treatment reduction for children and young adults with low-risk acute lymphoblastic leukaemia defined by minimal residual disease (UKALL 2003): a randomised controlled trial. Lancet Oncol. 2013 Mar;14(3):199-209. doi: 10.1016/S1470-2045(12)70600-9. Epub 2013 Feb 7. PubMed 23395119 ↗
  • Pieters R, de Groot-Kruseman H, Van der Velden V, Fiocco M, van den Berg H, de Bont E, Egeler RM, Hoogerbrugge P, Kaspers G, Van der Schoot E, De Haas V, Van Dongen J. Successful Therapy Reduction and Intensification for Childhood Acute Lymphoblastic Leukemia Based on Minimal Residual Disease Monitoring: Study ALL10 From the Dutch Childhood Oncology Group. J Clin Oncol. 2016 Aug 1;34(22):2591-601. doi: 10.1200/JCO.2015.64.6364. Epub 2016 Jun 6. PubMed 27269950 ↗
  • Fermer J, van Bunningen H, Zhou O, Abrahamsson J, Borssen M, Donner I, Heyman M, Holmqvist AS, Valind A, Vogt H, Ranta S, Harila A. Early Toxicity in Childhood Acute Lymphoblastic Leukemia: A Comparison of NOPHO ALL2008 and ALLTogether Protocols in Sweden. Pediatr Blood Cancer. 2026 Feb;73(2):e32168. doi: 10.1002/pbc.32168. Epub 2025 Nov 20. PubMed 41262029 ↗

Individual participant data

Plan to share: Undecided — Individual participant data will be entered into the study database. The data will be used to inform the coming main study regarding safety and overall outcomes of the master protocol. As such, these outcomes may be published in the context of a comparison with the ALLTogether1 protocol (the master protocol including experimental interventions, NCT 04307576, or compared with legacy protocols of the participating study-groups, The data of the pilot protocol will be shared according to the same principles as ALLTogether1 data.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03911128
Lead sponsor
Mats Heyman
Collaborators
Nordic Society for Pediatric Hematology and Oncology, The Swedish Childhood Cancer Foundation, NordForsk
Responsible party
Mats Heyman (MD, Associate Professor, Karolinska University Hospital) — Sponsor-investigator
First posted
Apr 10, 2019
Start date
Aug 29, 2019
Primary completion
Jun 2033 (estimated)
Completion
Jun 2033 (estimated)
Last update
Aug 13, 2026

Study contacts

Trial Central Office
Contact
alltogether.karolinska@regionstockholm.se
+46812370000
Mats Heyman, M.D. PhD
study chair · Karolinska University Hospital

Oversight

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

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