Acute lymphoblastic leukemia (ALL) is a type of cancer that occurs in the bone marrow. It is a disease in which there is an uncontrolled growth of abnormal white blood cells, called “blasts.” These blasts crowd out the normal cells in the bone marrow. Sometimes these blasts can be found in the brain, spinal cord, and/or other organs of the body.
A prior Children’s Oncology Group study developed a risk-based classification system for patients with newly diagnosed ALL. This phase III clinical trial is studying different combinations of risk-adapted chemotherapy regimens and their side effects and comparing how well they work in treating children with newly diagnosed ALL.
Treatment consists of chemotherapy delivered in three phases: induction, consolidation, and maintenance. In this study, patients will be assigned to different treatment regimens based on their risk status; that is, the likelihood of their leukemia returning after therapy is completed. Patients will be classified as low-risk, average risk, or standard risk with Down syndrome. (Children with Down syndrome have an increased risk for leukemia.) Each regimen will consist of different groups of drugs delivered according to different schedules, and investigators will compare the results between the patient groups.