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Malaysia-Singapore Acute Lymphoblastic Leukemia 2010 Study

Registration Number
NCT02894645
Lead Sponsor
National University Hospital, Singapore
Brief Summary

The overall objective of this study is to continue to improve the cure rate of childhood acute lymphoblastic leukemia (ALL) in Singapore and Malaysia in the context of a multi-centre cooperative trial using a risk-stratified therapy based primarily on early response to therapy utilizing a simplified minimal residual disease (MRD-lite) platform.

Detailed Description

The study was designed on the premise that a risk classification strategy combining clinical and genetic presenting features with molecular assessment of MRD should reduce both treatment-related toxicities and relapse risk.

The patient will be assigned to one of the 3 risk groups depending on his/her response to the treatment and special laboratory tests. There are no experimental drugs in this study. All the drugs used are standard established treatment for childhood ALL for the last 30 years. The difference in treatment is by changes in the frequency and dose of the chemotherapy drugs.

The overall study treatment lasts for about 2 years.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
500
Inclusion Criteria
  1. Confirmed diagnosis of non-Burkitt B-lineage ALL
  2. 1 to 17 years of age (before 18th birthday)
  3. Renal function within normal range for age
  4. Liver function within normal range for age
  5. Able to participate in the full 2 years of treatment
Exclusion Criteria
  1. Age less than one year or age greater than/equals to 18 years
  2. Previous treatment with cytotoxic agents or high-dose steroids
  3. Mixed phenotype acute leukemia (MPAL)
  4. ALL as secondary malignancy
  5. Abnormal renal or liver function
  6. Doubtful compliance or unable to afford full course of therapy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
High risk (HR)Imatinib-
High risk (HR)Cytarabine-
High risk (HR)Fludarabine-
Standard Risk (SR)Methotrexate-
Intermediate Risk (IR)L-Asparaginase-
High risk (HR)Cyclophosphamide-
Standard Risk (SR)Cytarabine-
Standard Risk (SR)6-Mercaptopurine-
Standard Risk (SR)Thioguanine-
Intermediate Risk (IR)Doxorubicin-
Intermediate Risk (IR)Thioguanine-
Standard Risk (SR)Prednisolone-
Standard Risk (SR)L-Asparaginase-
Standard Risk (SR)Dexamethasone-
Standard Risk (SR)Vincristine-
Standard Risk (SR)Cyclophosphamide-
Intermediate Risk (IR)Prednisolone-
Intermediate Risk (IR)Dexamethasone-
Intermediate Risk (IR)Methotrexate-
Intermediate Risk (IR)Vincristine-
Intermediate Risk (IR)Cyclophosphamide-
Intermediate Risk (IR)Cytarabine-
Intermediate Risk (IR)6-Mercaptopurine-
High risk (HR)Dexamethasone-
High risk (HR)Prednisolone-
High risk (HR)Vincristine-
High risk (HR)L-Asparaginase-
High risk (HR)Methotrexate-
High risk (HR)Daunorubicin-
High risk (HR)Doxorubicin-
High risk (HR)6-Mercaptopurine-
High risk (HR)Thioguanine-
Primary Outcome Measures
NameTimeMethod
Event-free survival (EFS)5 years

EFS was estimated from time of diagnosis to time of first event or of patient's last follow-up. Failure to achieve complete remission (CR), relapse, death in continuous remission from whatever cause, secondary leukemia and abandonment (absence from scheduled therapy for more than 6 weeks) were considered as events.

Overall survival (OS)5 years

OS was determined from diagnosis to time of death from any cause.

Minimal residual disease (MRD) measurementAt time point of Day 33, week 8 and week 12
Secondary Outcome Measures
NameTimeMethod
Number of participants with chemotherapy-related adverse events as assessed by CTCAE version 4.0Through study completion, an average of 2 years
Dose intensity of chemotherapy during various phases of therapyThrough study completion, an average of 2 years

Trial Locations

Locations (4)

University of Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

Subang Jaya Medical Centre

🇲🇾

Subang Jaya, Malaysia

National University Hospital

🇸🇬

Singapore, Singapore

KK Women's and Children's Hospital

🇸🇬

Singapore, Singapore

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