Optimization of Therapy in Adult Patients With Newly Diagnosed Acute Lymphoblastic Leukemia or Lymphoblastic Lymphoma by Individualised, Targeted and Intensified Treatment
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ClinicalTrials.gov Identifier: NCT02881086 |
Recruitment Status :
Active, not recruiting
First Posted : August 26, 2016
Last Update Posted : July 18, 2023
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Condition or disease | Intervention/treatment | Phase |
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Acute Lymphoblastic Leukemia Lymphoblastic Lymphoma | Drug: Rituximab Drug: Nelarabine Drug: PEG-Asparaginase Procedure: Cranial irradiation Drug: Imatinib Drug: Idarubicin Drug: Dexamethasone Drug: Cyclophosphamide Drug: Fludarabine Drug: Vincristine Drug: Mercaptopurine Drug: VP16 Drug: Daunorubicin (DNR) Drug: Methotrexate Procedure: Stem cell transplantation Drug: Cytarabine Drug: Vindesine Drug: Adriamycin Drug: Prednisolone | Phase 3 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 1000 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Treatment Optimization in Adult Patients With Newly Diagnosed Acute Lymphoblastic Leukemia (ALL) or Lymphoblastic Lymphoma by Individualised, Targeted and Intensified Treatment - a Phase IV-trial With a Phase III-part to Evaluate Safety and Efficacy of Nelarabine in T-ALL Patients |
Actual Study Start Date : | August 2016 |
Actual Primary Completion Date : | August 2022 |
Estimated Study Completion Date : | July 2025 |

Arm | Intervention/treatment |
---|---|
Stratification I - Standard Risk (SR)/ High Risk (HR)
Induction and consolidation I therapy for standard and high risk patients, PH/BCR-ABL-negative Chemotherapy, immunotherapy, intrathecal prophylaxis, CNS irradiation according to randomisation I Drugs: Rituximab, Vincristine, Daunorubicin, Dexamethasone, Cyclophosphamide, Cytarabine, Mercaptopurine, PEG-Asparaginase, Methotrexate, Vindesine, VP16
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Drug: Rituximab Drug: PEG-Asparaginase Drug: Dexamethasone Drug: Cyclophosphamide Drug: Vincristine Drug: Mercaptopurine Drug: VP16 Drug: Daunorubicin (DNR) Drug: Methotrexate Drug: Cytarabine Drug: Vindesine |
Stratification I - Philadelphia (PH)+
Induction and consolidation I therapy for PH+ patients Chemotherapy, immunotherapy, intrathecal prophylaxis Drugs: Rituximab, Vincristine, Imatinib, Dexamethasone, PEG-Asparaginase, Cytarabine, Methotrexate, Vindesine, VP16
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Drug: Rituximab Drug: PEG-Asparaginase Drug: Imatinib Drug: Dexamethasone Drug: Vincristine Drug: VP16 Drug: Methotrexate Drug: Cytarabine Drug: Vindesine |
Active Comparator: Rand I - B-Lin + CNS Rad + i.th. MTX
Chemotherapy according to Stratification I SR/HR CNS prophylaxis: CNS irradiation 24 Gy, intrathecal Methotrexate
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Procedure: Cranial irradiation Drug: Methotrexate |
Experimental: Rand I - B-Lin + i.th. MTX
Chemotherapy according to Stratification I SR/HR CNS prophylaxis: intrathecal Methotrexate
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Drug: Methotrexate |
Stratification II - SR + MRD-neg
Chemotherapy, immunotherapy, intrathecal prophylaxis, consolidation II, reinduction, consolidation III - VI, maintenance Drugs: Rituximab, PEG-Asparaginase, Cytarabine, Methotrexate, Vindesine, Adriamycin, Prednisolone, Cyclophosphamide, Nelarabine, Dexamethasone
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Drug: Rituximab Drug: Nelarabine Drug: PEG-Asparaginase Drug: Dexamethasone Drug: Cyclophosphamide Drug: Methotrexate Drug: Cytarabine Drug: Vindesine Drug: Adriamycin Drug: Prednisolone |
Stratification II - HR + MRD-neg
Chemotherapy or stem cell transplantation according to randomisation II
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Drug: Rituximab Drug: Nelarabine Drug: PEG-Asparaginase Drug: Cyclophosphamide Drug: Methotrexate Procedure: Stem cell transplantation Drug: Cytarabine Drug: Vindesine Drug: Adriamycin Drug: Prednisolone |
Stratification II - SR/HR/PH+ + MRD-pos
Chemotherapy or targeted therapy, followed by stem cell transplantation Drugs: Fludarabine, Idarubicin, Cytarabine, Nelarabine
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Drug: Nelarabine Drug: Idarubicin Drug: Fludarabine Drug: Cytarabine |
Active Comparator: Randomisation II - HR + MRD-neg-SCT
Stem cell transplantation
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Procedure: Stem cell transplantation |
Experimental: Randomisation II - HR + MRD-neg-SR-chemo
Chemotherapy, immunotherapy, intrathecal prophylaxis, consolidation II, reinduction, consolidation III - VI, maintenance Drugs: Rituximab, Dexamethasone, PEG-Asparaginase, Cytarabine, Methotrexate, Vindesine, Adriamycin, Prednisolone, Cyclophosphamide, Nelarabine
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Drug: Rituximab Drug: Nelarabine Drug: PEG-Asparaginase Drug: Dexamethasone Drug: Cyclophosphamide Drug: Methotrexate Drug: Cytarabine Drug: Vindesine Drug: Adriamycin Drug: Prednisolone |
- Event free survival [ Time Frame: 3.5 years ]
- Time until consolidation treatment I [ Time Frame: approximately 70 days ]
- Disease free survival [ Time Frame: 1 year ]
- Hematological remission rate [ Time Frame: after induction, approximately 6-8 weeks from diagnosis ]
- Molecular remission rate [ Time Frame: after induction and consolidation, approximately 6-8 weeks from diagnosis ]
- Results of the positron emission tomography (PET) based remission evaluation [ Time Frame: after consolidation, approximately 8-10 weeks ]
- Remission duration [ Time Frame: up to 10 years ]
- Relapse rate [ Time Frame: up to 10 years ]
- Overall survival [ Time Frame: up to 10 years ]
- Relapse location [ Time Frame: at timepoint of relapse (up to 10 years) ]
- Early death [ Time Frame: during induction, approximately 6-8 weeks from diagnosis ]
- Death in clinical remission (CR) [ Time Frame: during treatment, up to approximately 2.5 years from diagnosis ]
- Comorbidities according to Charlson Score [ Time Frame: up to 2.5 years ]
- Quality of life assessed by QLQ-C30 [ Time Frame: up to 2.5 years ]
- Eastern Cooperative Oncology Group (ECOG) under therapy [ Time Frame: up to 2.5 years ]
- Toxicity assessed by CTCAE v4.03 [ Time Frame: up to 2.5 years ]
- Results of the Dementia Detection (DemTect) test [ Time Frame: up to 2.5 years ]

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years to 55 Years (Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Acute lymphoblastic leukemia (pro-B, common, pre-B, early T, thymic T, mature T)
- Lymphoblastic lymphoma (B or T-lineage)
- Age 18-55 yrs
- Written informed consent
- Adequate contraception as specified per protocol
Exclusion Criteria:
- Severe comorbidity or leukemia associated complications
- Late relapse of pediatric ALL or ALL as second malignancy
- Cytostatic pre-treatment
- Pregnancy or breast feeding
- Severe psychiatric illness or other circumstances which may compromise cooperation of the patient
- Participation in other clinical trials interfering with the study therapy

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02881086
Germany | |
University Hospital of Frankfurt (Main) | |
Frankfurt (Main), Germany, 60590 |
Principal Investigator: | Nicola Gökbuget, Dr. med. | University Hospital of Frankfurt (Main) |
Responsible Party: | Nicola Goekbuget, GMALL Head, Goethe University |
ClinicalTrials.gov Identifier: | NCT02881086 |
Other Study ID Numbers: |
GMALL08_2013 |
First Posted: | August 26, 2016 Key Record Dates |
Last Update Posted: | July 18, 2023 |
Last Verified: | July 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Acute lymphoblastic leukemia Lymphoblastic lymphoma Nelarabine BCR-ABL |
MRD PEG-Asparaginase Rituximab |
Lymphoma Leukemia Precursor Cell Lymphoblastic Leukemia-Lymphoma Leukemia, Lymphoid Lymphoma, Non-Hodgkin Neoplasms by Histologic Type Neoplasms Lymphoproliferative Disorders Lymphatic Diseases Immunoproliferative Disorders Immune System Diseases Cytarabine Dexamethasone Prednisolone Cyclophosphamide |
Rituximab Methotrexate Fludarabine Vincristine Doxorubicin Daunorubicin Asparaginase Mercaptopurine Idarubicin Pegaspargase Vindesine Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antirheumatic Agents |