Dasatinib and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Lymphoblastic Leukemia

Phase 2

Completed

Conditions: Acute Lymphoblastic Leukemia
Adult B Acute Lymphoblastic Leukemia With t(9;22)(q34.1;q11.2); BCR-ABL1
Childhood B Acute Lymphoblastic Leukemia With t(9;22)(q34.1;q11.2); BCR-ABL1

Interventions: Drug: Asparaginase
Drug: Cyclophosphamide
Drug: Cytarabine
Drug: Dasatinib
Drug: Daunorubicin Hydrochloride
Drug: Dexamethasone
Drug: Etoposide
Biological: Filgrastim
Drug: Hydrocortisone Sodium Succinate
Drug: Ifosfamide
Other: Laboratory Biomarker Analysis
Drug: Leucovorin Calcium
Drug: Mercaptopurine
Drug: Methotrexate
Drug: Methylprednisolone
Drug: Pegaspargase
Drug: Prednisone
Radiation: Radiation Therapy
Drug: Vincristine Sulfate

Registration Number: NCT00720109

Lead Sponsor: National Cancer Institute (NCI)

Brief Summary: This phase II/III trial is studying the side effects and how well giving dasatinib together with combination chemotherapy works in treating young patients with newly diagnosed acute lymphoblastic leukemia (ALL). Dasatinib may stop the growth of cancer cells by blocking some of the enzymes needed for cell growth. Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving dasatinib together with combination chemotherapy may kill more cancer cells.

Detailed Description: PRIMARY OBJECTIVES:

I. To determine the feasibility and toxicity of an intensified chemotherapeutic regimen that incorporates dasatinib for treatment of children, adolescents, and young adults (up to age 30) with Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL).

II. To determine whether the intensification of tyrosine kinase inhibition through the addition of dasatinib in Induction (Days 15-28) and substitution of dasatinib for imatinib during post-Induction therapy, in the context of intensive cytotoxic therapy (according to AALL0031) and a good early response to therapy, will lead to a 3-year event-free survival (EFS) of at least 60% in patients with Ph+ ALL.

SECONDARY OBJECTIVES:

I. To determine whether the addition of dasatinib during Induction therapy (Days 15-28) will decrease levels of minimal residual disease (MRD) present at end of Induction therapy as compared with COG AALL0031.

II. To determine whether early intensified tyrosine kinase inhibitor (TKI) therapy will lower end-Consolidation MRD levels as compared to patients on COG AALL0031 that received imatinib in Consolidation Blocks 1 and 2 (Cohorts 3-5).

III. To determine the overall 3-year EFS rate for the whole cohort of Standard- and High-Risk patients treated with dasatinib.

IV. To determine the long-term effects of dasatinib on growth, development, and bone metabolism.

V. To assess BCR-ABL mutation status at time of diagnosis and progression/relapse.

OUTLINE: This is a multicenter study. Patients are stratified according to risk (standard risk vs high risk) at the end of consolidation therapy.

INDUCTION THERAPY (weeks 1-4): Patients receive initial induction therapy on days 1-14 prior to beginning the study. Patients then receive vincristine intravenously (IV) and daunorubicin hydrochloride\* IV over 15 minutes on days 15 and 22; dasatinib orally (PO) once daily (QD) and prednisone PO (or methylprednisolone IV) twice daily (BID) on days 15-28; methotrexate intrathecally (IT) on day 29; and some patients receive methotrexate, hydrocortisone, and cytarabine IT on days 15 and 22. After completion of induction therapy, patients undergo bone marrow aspiration for evaluation of disease. Patients with M1 bone marrow and minimal residual disease (MRD) \< 1% (standard-risk disease) proceed to block 1 consolidation therapy 1 week after completion of induction therapy or when blood counts recover (whichever occurs later). Patients with M2 or M3 bone marrow or MRD \>= 1% (high-risk disease) proceed immediately to block 1 consolidation therapy, regardless of blood counts. Patients with clinically evident or biopsy-proven testicular leukemia at diagnosis that persists at the end of induction therapy undergo 12 fractions of testicular radiotherapy beginning within 4 days prior to starting block 1 consolidation therapy.

NOTE: \*Patients who receive initial induction therapy on a DFCI Childhood ALL Consortium trial do not receive daunorubicin hydrochloride during induction therapy on this study.

CONSOLIDATION THERAPY:

BLOCK 1 CONSOLIDATION THERAPY: (weeks 6-8) Patients receive etoposide IV over 1 hour and ifosfamide IV over 1 hour on days 1-5, dasatinib PO on days 1-14 OR on days 1-21, and some patients receive methotrexate, hydrocortisone, and cytarabine IT on days 8 and 15. Patients also receive filgrastim (G-CSF) subcutaneously (SC) or IV QD beginning on day 6 and continuing until blood counts recover.

After completion of block 1 consolidation therapy, patients proceed to block 2 consolidation therapy.

BLOCK 2 CONSOLIDATION THERAPY: (weeks 9-11) Patients receive high-dose methotrexate IV continuously over 24 hours on day 1; leucovorin calcium PO or IV every 6 hours for 3 doses on days 2-3; methotrexate, hydrocortisone, and cytarabine IT on day 1; cytarabine IV over 3 hours every 12 hours for 4 doses on days 2 and 3; and dasatinib PO on days 1-14 OR on days 1-21. Patients also receive G-CSF SC or IV QD beginning on day 4 and continuing until blood counts recover. After completion of block 2 consolidation therapy and recovery of blood counts, patients undergo bone marrow aspiration for evaluation of disease. Patients with MRD \< 0.01% (standard-risk disease) with a matched related donor and who are willing to undergo hematopoietic stem cell transplantation (HSCT) proceed to HSCT off study. Standard-risk patients without a suitable donor or those who elect not to undergo HSCT proceed to post-consolidation therapy. Patients with MRD \>= 0.01% (high-risk disease) with a matched related or unrelated donor proceed to HSCT off study. High-risk patients without a suitable donor proceed to post-consolidation therapy.

POST-CONSOLIDATION THERAPY:

REINDUCTION BLOCK 1 THERAPY: (weeks 12-14) Patients receive vincristine IV on days 1, 8, and 15; daunorubicin hydrochloride IV over 15 minutes on days 1 and 2; cyclophosphamide IV over 1 hour every 12 hours for 4 doses on days 3 and 4; pegaspargase intramuscularly (IM) on day 4; methotrexate, hydrocortisone, and cytarabine IT on days 1 and 15; dexamethasone PO or IV BID on days 1-7 and 15-21; and dasatinib PO on days 1-14 OR on days 1-21. Patients also receive G-CSF SC or IV QD beginning on day 5 and continuing until blood counts recover.

After completion of reinduction block 1 therapy, patients proceed to intensification block 1 therapy.

INTENSIFICATION BLOCK 1 THERAPY: (weeks 15-23) Patients receive high-dose methotrexate IV continuously over 24 hours on day 1; leucovorin calcium PO or IV every 6 hours for 3 doses on days 2-3; methotrexate, hydrocortisone, and cytarabine IT on days 1 and 22; etoposide IV over 1 hour and cyclophosphamide IV over 1 hour on days 22-26; cytarabine IV over 3 hours every 12 hours for 4 doses on days 43 and 44; asparaginase IM on day 44; and dasatinib PO on days 1-14, 22-35, and 43-56 OR on days 1-63. Patients also receive G-CSF SC or IV QD beginning on day 27 and continuing until blood counts recover. After completion of intensification block 1 therapy, patients proceed to reinduction block 2 therapy.

REINDUCTION BLOCK 2 THERAPY: (weeks 24-26) Patients receive reinduction block 2 therapy as per reinduction block 1 therapy. After completion of reinduction block 2 therapy, patients proceed to intensification block 2 therapy.

INTENSIFICATION BLOCK 2 THERAPY: (weeks 27-35) Patients receive intensification block 2 therapy as per intensification block 1 therapy. After completion of intensification block 2 therapy, patients proceed to maintenance therapy.

MAINTENANCE THERAPY:

MAINTENANCE COURSES 1-4: (weeks 36-67) Patients receive high-dose methotrexate IV continuously over 24 hours on day 1; leucovorin calcium PO or IV every 6 hours for 3 doses on days 2-3; methotrexate, hydrocortisone, and cytarabine IT and vincristine IV on days 1 and 29; prednisone PO or IV BID on days 1-5 and 29-33; mercaptopurine PO on days 8-28; methotrexate PO on days 8, 15, and 22; etoposide IV over 1 hour and cyclophosphamide IV over 1 hour on days 29-33; and dasatinib PO on days 1-14 and 29-42 OR on days 1-56. Patients also receive G-CSF SC or IV QD beginning on day 34 and continuing until blood counts recover. Courses repeat every 56 days. After completion of maintenance courses 1-4, patients proceed to maintenance course 5.

MAINTENANCE COURSE 5: (weeks 68-75) Patients receive vincristine IV on days 1 and 29; prednisone PO or IV BID on maintenance courses 6-12.

MAINTENANCE COURSES 6-12: (weeks 76-131) Patients receive vincristine IV on days 1 and 29; prednisone PO or IV BID on days 1-5 and 29-33; mercaptopurine PO on days 1-56; methotrexate PO on days 1, 8, 15, 22, 29, 36, 43, and 50; and dasatinib PO on days 1-14 and 29-42 OR on days 1-56.

Courses repeat every 56 days. Patients long-term growth, development, and bone metabolism are assessed after completion of study therapy and then annually for 5 years.

After completion of study therapy, patients are followed up periodically for up to 10 years.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 63

Inclusion Criteria

Newly diagnosed acute lymphoblastic leukemia (ALL)
- Definitive evidence of BCR-ABL fusion (Philadelphia chromosome positive [PH+]) from an approved Children's Oncology Group (COG) cytogenetics laboratory
Meets one of the following criteria:
- Concurrent enrollment on Clusters of Orthologous Groups (COG)-AALL03B1 (or a successor trial) AND COG-AALL0232, COG-AALL0331, COG-AALL0434 or other front-line COG ALL clinical trial
- Concurrent enrollment on COG-AALL03B1 (or a successor trial) AND scheduled to receive a 3 or 4-drug standard induction regimen
- Concurrent enrollment on a Dana-Farber Cancer Institute (DFCI) Childhood ALL Consortium trial (or scheduled to be treated as per a DFCI Childhood ALL Consortium induction regimen)
All patients must have definitive evidence of BCR-ABL fusion from an approved COG cytogenetics laboratory; patients may NOT have received Day 15 of Induction chemotherapy (or day 18 vincristine if enrolled on a DFCI Childhood ALL Consortium trial) prior to enrollment on AALL0622
Patients must have a performance status of 0, 1 or 2 at completion of two weeks of Induction; use Karnofsky for patients > 16 years of age and Lansky for patients =< 16 years of age
Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70mL/min/1.73 m^2 or maximum serum creatinine based on age and gender as follows:
- 0.4 mg/dL (for patients 1 to 5 months of age)
- 0.5 mg/dL (for patients 6 to 11 months of age)
- 0.6 mg/dL (for patients 1 year of age)
- 0.8 mg/dL (for patients 2 to 5 years of age)
- 1.0 mg/dL (for patients 6 to 9 years of age)
- 1.2 mg/dL (for patients 10 to 12 years of age)
- 1.5 mg/dL (males) or 1.4 mg/dL (females) (for patients 13 to 15 years of age)
- 1.7 mg/dL (males) or 1.4 mg/dL (females) (for patients >= 16 years of age)
Total bilirubin =< 1.5 times upper limit of normal (ULN) for age
Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) < 2.5 times ULN for age
Shortening fraction >= 27% by echocardiogram or ejection fraction >= 50% by gated radionuclide study
No evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry > 94% at sea level if there is clinical indication for determination
Patients with seizure disorder may be enrolled if on anticonvulsants and well controlled; however, drugs that induce CYP3A4/5 (carbamazepine, oxcarbazepine, phenytoin, primidone, phenobarbital) should be avoided
Patients will start AALL0622 therapy on day 15 of induction therapy (or day 18 if enrolled on a DFCI Childhood ALL Consortium trial); patients must have received the first 2 weeks of Induction therapy

Exclusion Criteria

Females of childbearing potential must have a negative pregnancy test; patients of childbearing potential must agree to use an effective birth control method
Female patients who are lactating must agree to stop breast-feeding
Patients with Down syndrome
Patients with any clinically significant cardiovascular disease including the following:
- Myocardial infarction or ventricular tachyarrhythmia within 6 months
- Ejection fraction less than institutional normal
- Major conduction abnormality (unless a cardiac pacemaker is present)

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Asparaginase	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Cytarabine	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Daunorubicin Hydrochloride	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Dexamethasone	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Etoposide	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Laboratory Biomarker Analysis	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Filgrastim	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Ifosfamide	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Methotrexate	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Methylprednisolone	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Pegaspargase	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Radiation Therapy	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Vincristine Sulfate	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Leucovorin Calcium	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Cyclophosphamide	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Dasatinib	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Mercaptopurine	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Prednisone	See Detailed Description
Treatment (enzyme inhibitor therapy and chemotherapy)	Hydrocortisone Sodium Succinate	See Detailed Description

Primary Outcome Measures

Name	Time	Method
Event-Free Survival (EFS) of Patients With Standard-risk Disease Treated With Dasatinib in Combination With Intensified Chemotherapy	At 3 years	Event-Free Survival (EFS) curves will be constructed using the Kaplan-Meier life table method with standard errors computed using the method of Peto and Peto. A 1-sided 95% confidence interval for EFS will be constructed.
Feasibility and Toxicity of an Intensified Chemotherapeutic Regimen Incorporating Dasatinib for Treatment of Children and Adolescents With Ph+ ALL Assessed by Examining Adverse Events	Weeks 3 through 23 of treatment (From week 3 Induction through Intensification Block 1)	Number of patients in safety cohort with dose limiting toxicity (DLT)(including treatment delay)

Secondary Outcome Measures

Name	Time	Method
Contribution of Dasatinib on Minimal Residual Disease (MRD) After Induction Therapy	At the end of induction therapy (at 5 weeks)	Percent of patients MRD Positive (MRD \> 0.01%) at End of Induction.
Percent of Patients MRD Positive (MRD > 0.01%) at End of Consolidation	At end of consolidation (at 11 weeks)	A 1-sample Z-test of proportions (alpha=5%, 1-sided test) will be used.
Overall EFS Rate for the Combined Cohort of Standard- and High-Risk Patients (Who Receive the Final Chosen Dose of Dasatinib)	From the time entry on study to first event or date of last follow-up, assessed up to 7 years	An event is defined as: Induction failure, relapse at any site, secondary malignancy, or death.

Trial Locations

Locations (134): New York Medical College
🇺🇸
Valhalla, New York, United States
UCLA / Jonsson Comprehensive Cancer Center
🇺🇸
Los Angeles, California, United States
Valley Children's Hospital
🇺🇸
Madera, California, United States
Johns Hopkins University/Sidney Kimmel Cancer Center
🇺🇸
Baltimore, Maryland, United States
Sinai Hospital of Baltimore
🇺🇸
Baltimore, Maryland, United States
Lurie Children's Hospital-Chicago
🇺🇸
Chicago, Illinois, United States
University of Illinois
🇺🇸
Chicago, Illinois, United States
Rainbow Babies and Childrens Hospital
🇺🇸
Cleveland, Ohio, United States
Dana-Farber Cancer Institute
🇺🇸
Boston, Massachusetts, United States
Indiana University/Melvin and Bren Simon Cancer Center
🇺🇸
Indianapolis, Indiana, United States
Riley Hospital for Children
🇺🇸
Indianapolis, Indiana, United States
Nevada Cancer Research Foundation CCOP
🇺🇸
Las Vegas, Nevada, United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
🇺🇸
Houston, Texas, United States
Rady Children's Hospital - San Diego
🇺🇸
San Diego, California, United States
University of Arkansas for Medical Sciences
🇺🇸
Little Rock, Arkansas, United States
University of Connecticut
🇺🇸
Farmington, Connecticut, United States
Banner University Medical Center - Tucson
🇺🇸
Tucson, Arizona, United States
Advocate Children's Hospital-Oak Lawn
🇺🇸
Oak Lawn, Illinois, United States
Harbor-University of California at Los Angeles Medical Center
🇺🇸
Torrance, California, United States
Miller Children's and Women's Hospital Long Beach
🇺🇸
Long Beach, California, United States
Saint Mary's Hospital
🇺🇸
West Palm Beach, Florida, United States
Children's National Medical Center
🇺🇸
Washington, District of Columbia, United States
Alfred I duPont Hospital for Children
🇺🇸
Wilmington, Delaware, United States
University of Missouri - Ellis Fischel
🇺🇸
Columbia, Missouri, United States
Lee Memorial Health System
🇺🇸
Fort Myers, Florida, United States
Advocate Christ Medical Center
🇺🇸
Oak Lawn, Illinois, United States
University of Kentucky/Markey Cancer Center
🇺🇸
Lexington, Kentucky, United States
Kaiser Permanente-Oakland
🇺🇸
Oakland, California, United States
Memorial Health University Medical Center
🇺🇸
Savannah, Georgia, United States
Lucile Packard Children's Hospital Stanford University
🇺🇸
Palo Alto, California, United States
University of Hawaii Cancer Center
🇺🇸
Honolulu, Hawaii, United States
Mattel Children's Hospital UCLA
🇺🇸
Los Angeles, California, United States
Saint Luke's Mountain States Tumor Institute
🇺🇸
Boise, Idaho, United States
Sacred Heart Hospital
🇺🇸
Pensacola, Florida, United States
Kaiser Permanente Downey Medical Center
🇺🇸
Downey, California, United States
Loyola University Medical Center
🇺🇸
Maywood, Illinois, United States
Emory University Hospital/Winship Cancer Institute
🇺🇸
Atlanta, Georgia, United States
University of Florida Health Science Center - Gainesville
🇺🇸
Gainesville, Florida, United States
Johns Hopkins All Children's Hospital
🇺🇸
Saint Petersburg, Florida, United States
Spectrum Health at Butterworth Campus
🇺🇸
Grand Rapids, Michigan, United States
Cleveland Clinic Foundation
🇺🇸
Cleveland, Ohio, United States
Saint Vincent Hospital and Health Care Center
🇺🇸
Indianapolis, Indiana, United States
Sanford Broadway Medical Center
🇺🇸
Fargo, North Dakota, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
🇺🇸
New Brunswick, New Jersey, United States
University of Mississippi Medical Center
🇺🇸
Jackson, Mississippi, United States
University of New Mexico Cancer Center
🇺🇸
Albuquerque, New Mexico, United States
Christchurch Hospital
🇳🇿
Christchurch, New Zealand
Cook Children's Medical Center
🇺🇸
Fort Worth, Texas, United States
Nationwide Children's Hospital
🇺🇸
Columbus, Ohio, United States
Children's Hospital of Pittsburgh of UPMC
🇺🇸
Pittsburgh, Pennsylvania, United States
UMass Memorial Medical Center - University Campus
🇺🇸
Worcester, Massachusetts, United States
Saskatoon Cancer Centre
🇨🇦
Saskatoon, Saskatchewan, Canada
Hackensack University Medical Center
🇺🇸
Hackensack, New Jersey, United States
Penn State Children's Hospital
🇺🇸
Hershey, Pennsylvania, United States
Saint Vincent Hospital Cancer Center Green Bay
🇺🇸
Green Bay, Wisconsin, United States
Medical City Dallas Hospital
🇺🇸
Dallas, Texas, United States
West Virginia University Charleston Division
🇺🇸
Charleston, West Virginia, United States
Marshfield Medical Center-Marshfield
🇺🇸
Marshfield, Wisconsin, United States
Carolinas Medical Center/Levine Cancer Institute
🇺🇸
Charlotte, North Carolina, United States
Roswell Park Cancer Institute
🇺🇸
Buffalo, New York, United States
Newark Beth Israel Medical Center
🇺🇸
Newark, New Jersey, United States
Overlook Hospital
🇺🇸
Summit, New Jersey, United States
Geisinger Medical Center
🇺🇸
Danville, Pennsylvania, United States
Driscoll Children's Hospital
🇺🇸
Corpus Christi, Texas, United States
Mercy Children's Hospital
🇺🇸
Toledo, Ohio, United States
UT Southwestern/Simmons Cancer Center-Dallas
🇺🇸
Dallas, Texas, United States
CancerCare Manitoba
🇨🇦
Winnipeg, Manitoba, Canada
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
🇺🇸
New York, New York, United States
State University of New York Upstate Medical University
🇺🇸
Syracuse, New York, United States
Cincinnati Children's Hospital Medical Center
🇺🇸
Cincinnati, Ohio, United States
Dayton Children's Hospital
🇺🇸
Dayton, Ohio, United States
Centre Hospitalier Universitaire Sainte-Justine
🇨🇦
Montreal, Quebec, Canada
Saint Joseph's Regional Medical Center
🇺🇸
Paterson, New Jersey, United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone
🇺🇸
New York, New York, United States
Hospital for Sick Children
🇨🇦
Toronto, Ontario, Canada
The Montreal Children's Hospital of the MUHC
🇨🇦
Montreal, Quebec, Canada
Providence Sacred Heart Medical Center and Children's Hospital
🇺🇸
Spokane, Washington, United States
Scott and White Memorial Hospital
🇺🇸
Temple, Texas, United States
British Columbia Children's Hospital
🇨🇦
Vancouver, British Columbia, Canada
Texas Tech University Health Sciences Center-Amarillo
🇺🇸
Amarillo, Texas, United States
Royal Brisbane and Women's Hospital
🇦🇺
Herston, Queensland, Australia
Royal Children's Hospital-Brisbane
🇦🇺
Herston, Queensland, Australia
San Jorge Children's Hospital
🇵🇷
San Juan, Puerto Rico
Centre Hospitalier Universitaire de Quebec
🇨🇦
Quebec, Canada
Women's and Children's Hospital-Adelaide
🇦🇺
North Adelaide, South Australia, Australia
Starship Children's Hospital
🇳🇿
Grafton, Auckland, New Zealand
Children's Hospitals and Clinics of Minnesota - Minneapolis
🇺🇸
Minneapolis, Minnesota, United States
Methodist Children's Hospital of South Texas
🇺🇸
San Antonio, Texas, United States
University of Texas Health Science Center at San Antonio
🇺🇸
San Antonio, Texas, United States
Princess Margaret Hospital for Children
🇦🇺
Perth, Western Australia, Australia
Children's Hospital of Orange County
🇺🇸
Orange, California, United States
UCSF Medical Center-Mount Zion
🇺🇸
San Francisco, California, United States
UCSF Medical Center-Parnassus
🇺🇸
San Francisco, California, United States
Primary Children's Hospital
🇺🇸
Salt Lake City, Utah, United States
Children's Hospital Los Angeles
🇺🇸
Los Angeles, California, United States
Children's Hospital of Alabama
🇺🇸
Birmingham, Alabama, United States
University of Alabama at Birmingham Cancer Center
🇺🇸
Birmingham, Alabama, United States
Phoenix Childrens Hospital
🇺🇸
Phoenix, Arizona, United States
Wayne State University/Karmanos Cancer Institute
🇺🇸
Detroit, Michigan, United States
University of Oklahoma Health Sciences Center
🇺🇸
Oklahoma City, Oklahoma, United States
Legacy Emanuel Hospital and Health Center
🇺🇸
Portland, Oregon, United States
Oregon Health and Science University
🇺🇸
Portland, Oregon, United States
McMaster Children's Hospital at Hamilton Health Sciences
🇨🇦
Hamilton, Ontario, Canada
Mayo Clinic
🇺🇸
Rochester, Minnesota, United States
Children's Hospital and Medical Center of Omaha
🇺🇸
Omaha, Nebraska, United States
Children's Hospital of Wisconsin
🇺🇸
Milwaukee, Wisconsin, United States
NYP/Weill Cornell Medical Center
🇺🇸
New York, New York, United States
Nemours Children's Clinic-Jacksonville
🇺🇸
Jacksonville, Florida, United States
Helen DeVos Children's Hospital at Spectrum Health
🇺🇸
Grand Rapids, Michigan, United States
Children's Hospital Colorado
🇺🇸
Aurora, Colorado, United States
Saint Joseph's Hospital/Children's Hospital-Tampa
🇺🇸
Tampa, Florida, United States
Walter Reed National Military Medical Center
🇺🇸
Bethesda, Maryland, United States
Connecticut Children's Medical Center
🇺🇸
Hartford, Connecticut, United States
Children's Healthcare of Atlanta - Egleston
🇺🇸
Atlanta, Georgia, United States
Michigan State University Clinical Center
🇺🇸
East Lansing, Michigan, United States
Children's Hospital of Philadelphia
🇺🇸
Philadelphia, Pennsylvania, United States
Nemours Children's Clinic - Pensacola
🇺🇸
Pensacola, Florida, United States
Southern Illinois University School of Medicine
🇺🇸
Springfield, Illinois, United States
Kalamazoo Center for Medical Studies
🇺🇸
Kalamazoo, Michigan, United States
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital
🇺🇸
Toledo, Ohio, United States
East Tennessee Childrens Hospital
🇺🇸
Knoxville, Tennessee, United States
Children's Hospital of The King's Daughters
🇺🇸
Norfolk, Virginia, United States
AdventHealth Orlando
🇺🇸
Orlando, Florida, United States
Nemours Children's Clinic - Orlando
🇺🇸
Orlando, Florida, United States
UF Cancer Center at Orlando Health
🇺🇸
Orlando, Florida, United States
Norton Children's Hospital
🇺🇸
Louisville, Kentucky, United States
Seattle Children's Hospital
🇺🇸
Seattle, Washington, United States
IWK Health Centre
🇨🇦
Halifax, Nova Scotia, Canada
Yale University
🇺🇸
New Haven, Connecticut, United States
Children's Mercy Hospitals and Clinics
🇺🇸
Kansas City, Missouri, United States
UNC Lineberger Comprehensive Cancer Center
🇺🇸
Chapel Hill, North Carolina, United States
Tulane University Health Sciences Center
🇺🇸
New Orleans, Louisiana, United States
Rhode Island Hospital
🇺🇸
Providence, Rhode Island, United States

Dasatinib and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Lymphoblastic Leukemia

Recruitment & Eligibility

Study & Design

Trial Locations

Instant Trial Alerts

Instant Trial Alerts