CCG 1952

Note: this outline was patched together from the NCI online protocol and input from parents of kids with ALL. It is summarized here for our convenience, so that we can quickly compare our protocols. We do not guarantee the accuracy of this outline - it is not an official document. You can contact your child's oncologist and ask for the complete protocol document if you are interested in the details of your child's protocol.


Note: the cancer.gov pdq includes a bibliography of articles about this trial.

(for abbreviations, see CCG 1961 document)

Treatment for standard risk ALL defined as presenting features of:

Notes:

Protocol initiated, # patients: (date?) 3 years, 590 patients

Specific aims:

Also:

4 arms of treatment:

Following Induction, patients who achieve remission are randomly assigned to Regimen A1, A2, B1, or B2. Patients with M3 marrow after 2 weeks or M2 marrow after 4 weeks of Induction or with the following cytogenetic abnormalities proceed to Regimen C.

If a child has leukemic cells in the spinal fluid at the time of diagnosis (CNS involvement), the child receives radiation therapy to the head and spine. Patients with testicular involvement at diagnosis receive radiation to the testes.

CCG 1952 (A1, A2, B1, B2)

CCG 1952 C

A child with 25 percent leukemic cells on day 14 of the bone marrow test or the bone marrow test done at diagnosis shows unfavorable characteristics will be assigned to this treatment plan to start on day 14 of induction. Thus, induction then becomes 5 weeks, days 0 to 34:

CCG 1952 D


Notes

Treatment is based on CCG 1891, regimen B in which delint was admin 2X and found to be favorable.

Thioguanine is being tried because theoretical and in vitro pharmokinetic data suggest that TG is better.

A comment from Becky, the mom of a child on this protocol:

"It is designed to determine if 6TG is a better agent than 6MP. We are on the arm that NEVER gets 6MP. I researched this topic and learned how these to different agents worked (the chemistry side of things). It seems that when 6MP metabolizes through the liver it turns into the same makeup as 6TG, BUT sometimes does not produce the higher levels of RBC thioguanine nucleotides that is necessary to get those little remaining stubborn cells. By giving 6TG they hypothesize that these levels will be higher and thus help the outcome of higher levels of RBC TGN. So far according to Taylor's dr. this is proving to be the case. NOW having said that, 6MP is still a terrific agent and patients that are getting that are still being cured everyday.....and 4% of some of the patients that are on the arm getting 6TG have had what appears to be liver problems; therefore they are adjusting the dose on the study."

Triple ITs are being tried based on low CNS relapse in POG studies that utilize TIT.

No prior treatment for ALL is allowed on this trial.

Comments

Interesting to note that CCG1952A, B never gives methotrexate via IV or IM, it is either oral or IT. IV methotrexate is common in the POG protocols.

They only get doxorubicin and cytoxin in the delints. CCG 1961, for higher risk patients, includes these two drugs in the initial induction/consolidation.

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Last Updated 3/06

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