- REGISTRATION ELIGIBILITY CRITERIA (STEP 1)
Newly diagnosed patients with CD-22 positive B-cell acute lymphoblastic leukemia (WHO criteria) are eligible. Patients with Burkitt type ALL are NOT eligible
Patients who have BCR-ABL fusion transcript determined by fluorescence in situ hybridization (FISH) or real time-polymerase chain reaction (RT-PCR) or t(9
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- q11) by cytogenetics are not eligible and should be considered for enrollment on studies that incorporate imatinib during induction, please note: flow cytometry is to be performed at the local reference lab and must include assessment of CD20 and CD22 positivity, as well as CD29 and CD22 anti-positivity
Single-dose intrathecal cytarabine is allowed prior to registration or prior to initiation of systematic therapy for patient convenience
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- systemic chemotherapy must begin within 72 hours of this intrathecal therapy
Patients receiving prior steroid therapy are eligible for study, the dose and duration of previous steroid therapy should be carefully documented on case report forms
Not pregnant and not nursing
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- for women of childbearing potential only, a negative urine or serum pregnancy test done =\< 7 days prior to registration is required
Eastern Cooperative Oncology Group (ECOG) performance status 0-2
Patients with down syndrome are excluded from this study
Aspartate aminotransferase (AST), alanine aminotransferase (ALT) =\< 3 x upper limit of normal (ULN), unless suspected leukemic involvement of the liver
Direct bilirubin =\< 3 x upper limit of normal (ULN), unless suspected leukemic involvement of the liver
Calculated (calc.) creatinine clearance \>= 50 mL/min by Cockcroft-Gault
RANDOMIZATION ELIGIBILITY CRITERIA (STEP 2)
Completion of remission induction therapy
Patients with M2 marrow or better are eligible
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- patients with M3 or M4 marrow (greater than 25% lymphoblasts) will not be eligible to be randomized
Rating: M0, M1
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- Blast Cells (%): 0-5.0
Rating: M2
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- Blast Cells (%): 5.1-25.0
Rating: M3
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- Blast Cells (%): \> 25-50
Rating: M4
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- Blast Cells (%): \> 50.0
The term "blast cell" includes any cell that cannot be classified as a more mature normal element, and includes "leukemic cells," pathologic lymphocytes, and stem cells
No ascites, effusions or significant edema
Absolute neutrophil count (ANC) \>= 1,000/mm\^3
Platelet count \>= 100,000/mm\^3
Total bilirubin =\< 1.5 x upper limit of normal (ULN), except for patients with known Gilbert's syndrome
Aspartate aminotransferase (AST) =\< 8 x upper limit of normal (ULN)
Completion of first 12 weeks (12+ weeks) of maintenance therapy (Course V)
Patient has at least 24 weeks (24+ weeks) remaining before end of maintenance therapy (Course V)
Patient is in complete continuous first remission at entry into A041501-HO1
Patient is receiving oral anti-metabolite chemotherapy during the maintenance phase of therapy, treatment plan must call for the following doses of antimetabolites: 6MP 75 mg/m2/day orally, methotrexate (MTX) 20 mg/m2/week orally (modification of 6 MP or MTX dosing based on laboratory or clinical parameters is acceptable)
Patient is able and willing to use the Medication Event Monitoring System (MEMS) TrackCap (e.g. not using a pillbox)
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