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Inotuzumab Ozogamicin in Treating Younger Patients With B-Lymphoblastic Lymphoma or Relapsed or Refractory CD22 Positive B Acute Lymphoblastic Leukemia

NCT02981628 · Children's Oncology Group
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Official title
A Phase 2 Study of Inotuzumab Ozogamicin (NSC# 772518) in Children and Young Adults With Relapsed or Refractory CD22+ B-Acute Lymphoblastic Leukemia (B-ALL)
About this study
PRIMARY OBJECTIVE: I. To determine the morphologic response rate (complete response \[CR\] + complete response with incomplete hematologic recovery \[CRi\]) following one cycle of treatment with inotuzumab ozogamicin in children with relapsed or refractory CD22+ B acute lymphoblastic leukemia (B-ALL). (Cohort 1) SECONDARY OBJECTIVES: I. To determine the CR/CRi rate following 2 cycles of inotuzumab ozogamicin therapy. (Cohort 1) II. To determine the safety of single agent inotuzumab ozogamicin administered at the adult recommended phase 2 dose (RP2D) to pediatric patients with relapsed or refractory CD22+ B-ALL. (Cohort 1) III. To determine the level of minimal residual disease (MRD) by flow cytometry in responding patients. (Cohorts 1 and 2) IV. To determine the incidence, severity, and outcomes of sinusoidal obstruction syndrome (SOS) of the liver in patients during inotuzumab ozogamicin therapy and following subsequent treatment, including myeloablative hematopoietic stem cell transplantation (HSCT). (Cohorts 1 and 2) V. To estimate the 3-year event-free survival (EFS), 3-year overall survival (OS), and among responders, duration of CR/CRi for pediatric patients with relapsed or refractory B-ALL treated with inotuzumab ozogamicin. (Cohort 1) VI. To describe inotuzumab ozogamicin pharmacokinetics and immunogenicity in pediatric patients in the presence of overt leukemia and in remission. (Cohort 1) VII. To determine the safe and tolerable dose of inotuzumab ozogamicin in combination with the augmented modified Berlin-Frankfurt-Munster (mBFM) consolidation chemotherapy backbone. (Cohort 2) EXPLORATORY OBJECTIVES: I. To describe the levels of leukemic blast CD22 surface expression and site density, and to explore the correlation with cytogenetics and clinical outcomes after treatment with inotuzumab ozogamicin. (Cohorts 1 and 2) II. To explore potential mechanisms of resistance to inotuzumab ozogamicin therapy including CD22 splice variants and intracellular signaling pathways. (Cohorts 1 and 2) III. To explore the impact of inotuzumab ozogamicin on humoral immune function and peripheral B cell populations. (Cohorts 1 and 2) IV. To describe the level of MRD by next-generation high-throughput sequencing (HTS) techniques which may detect low level leukemic blast populations that have altered CD22 expression. (Cohorts 1 and 2) V. To prospectively explore candidate SOS biomarkers including the endothelial marker of inflammation Angiopoietin 2 (Ang2) and the hepatic specific complement marker L-ficolin. (Cohorts 1 and 2) VI. To explore the use of prophylactic ursodeoxycholic acid (UDCA) to prevent hepatic damage and SOS during inotuzumab ozogamicin therapy and subsequent HSCT. (Cohorts 1 and 2) VII. To describe the interaction between inotuzumab ozogamicin and chimeric antigen receptor (CAR) T cell therapy before or after treatment with inotuzumab ozogamicin. (Cohorts 1 and 2) VIII. To estimate the CR/CRi rate following one cycle of inotuzumab ozogamicin plus augmented mBFM consolidation chemotherapy (first 42 days) and following 2 cycles within the confines of a pilot study. (Cohort 2) OUTLINE: Patients are assigned to 1 of 2 cohorts. COHORT I: Patients receive inotuzumab ozogamicin intravenously (IV) over 60 minutes on days 1, 8, and 15 of each cycle. Treatment repeats every 28 days for up to 6 cycles in the absence of disease progression or unacceptable toxicity. (COMPLETE) COHORT II: Patients receive inotuzumab ozogamicin IV over 60 minutes on days 1, and 8. Patients also receive cyclophosphamide IV over 30-60 on day 1; cytarabine IV over 1-30 minutes or subcutaneously (SC) on days 1-4 and 8-11; leucovorin calcium orally (PO) or IV on days 2, 9, 16, 23 and 37 of cycle 1 and days 9 and 37 of cycle 2; pegaspargase or calaspargase pegol IV over 1-2 hours or pegaspargase intramuscularly (IM) on day 15; and vincristine IV on days 15 and 22. Patients receive methotrexate intrathecally (IT) on days 1, 8 and 36 of cycle 1 and day 36 of cycle 2 for CNS 1 patients, days 1, 8, 15, 22 and 36 of cycle 1, and day 36 of cycle 2 for CNS 2 patients. CNS 3 patients receive methotrexate intrathecal triple therapy (ITT) IT on days 1, 8, 15, 22 and 36 of cycle 1 and days 8 and 36 of cycle 2. There are 3 dose levels. If excessive toxicity is observed at dose level 1, the dosing of inotuzumab ozogamicin will be decreased for dose level -1 and 6-mercaptopurine omitted. If excessive toxicity is observed at this dose, then for dose level -2, the dosing of inotuzumab ozogamicin and cyclophosphamide will be decreased. Treatment repeats every 42 days for up to 2 cycles in the absence of disease progression or unacceptable toxicity. Patients undergo bone marrow aspiration or biopsy, lumbar puncture, and blood sample collection throughout the trial. Patients also undergo imaging on screening and on study. After completion of study treatment, patients are followed up at 30 days, every 3 months for 1 year, and then yearly for 4 years.
Eligibility criteria
Inclusion Criteria: * Patients must be \>= 1 year and \< 22 years of age at the time of enrollment * Patients must have B-ALL, or previously diagnosed B lymphoblastic lymphoma (B-LL), with \>= 5% (M2 or M3) bone marrow blasts with or without extramedullary disease * NOTE: Relapsed patients previously diagnosed with B-lymphoblastic lymphoma (B-LL) are eligible if they have an M2 or M3 marrow at the time of enrollment on this study * Patients with ALL or B-LL who have M2 morphology must have local confirmatory testing showing \>= 5% blasts by flow cytometry, fluorescence in situ hybridization (FISH) testing or other molecular method * Leukemic blasts must demonstrate surface expression of CD22 at the time of relapse by local/institutional flow cytometry of a bone marrow aspirate sample; (assessment of CD22 using a bright fluorophore such as phycoerythrin \[PE\] is strongly recommended) * In the case of an inadequate aspirate sample (dry tap) or if bone marrow aspirate is unable to be performed due to patient clinical status, flow cytometry of peripheral blood specimen may be substituted if the patient has at least 1,000/uL circulating blasts; alternatively, CD22 expression may be documented by immunohistochemistry of a bone marrow biopsy specimen * Patients with one of the following: * Second or greater relapse; * Primary refractory disease with at least 2 prior induction attempts; * First relapse refractory to at least one prior re-induction attempt * Any relapse after HSCT (Cohort 1 ONLY) Patients with Down syndrome are eligible ONLY for Cohort 1 with: * Any of above disease status, OR * First relapse with no prior re-induction attempt NOTE: Patients with Down syndrome or prior HSCT are NOT eligible for Cohort 2 combination therapy * Patients with Philadelphia chromosome (Ph)+ ALL must have had two prior therapy attempts including two different tyrosine kinase inhibitors (TKIs) * Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy, defined as resolution of all such toxicities to =\< grade 2 or lower per the inclusion/exclusion criteria prior to entering this study. Apply to Cohort 2: * Cytotoxic chemotherapy or other anti-cancer agents known to be myelosuppressive. For agents not listed, the duration of this interval must be discussed with the study chair and the study-assigned Research Coordinator prior to enrollment. * A waiting period prior to enrollment is not required for patients receiving standard cytotoxic maintenance chemotherapy (i.e., corticosteroid, vincristine, 6MP, and/or methotrexate). * A waiting period is not required for patients receiving a single dose of intrathecal methotrexate, hydrocortisone, and/or cytarabine within 7 days prior to enrollment * \>= 14 days must have elapsed after the completion of other cytotoxic therapy, with the exception of hydroxyurea, for patients not receiving standard maintenance therapy. For patients who previously received calaspargase pegol, \>= 21 days must have elapsed after the last dose. Additionally, patients must have fully recovered from all acute toxic effects of prior therapy. * Note: Cytoreduction with hydroxyurea must be discontinued \>= 24 hours prior to the start of protocol therapy. * Anti-cancer agents not known to be myelosuppressive (e.g., not associated with reduced platelet or absolute neutrophil count \[ANC\] counts): \>= 7 days after the last dose of agent. For agents not listed, the duration of this interval must be discussed with the study chair and the study-assigned research coordinator prior to enrollment. * Anti-cancer agents that are antibodies: \>= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade =\< 1. There is an exception for blinatumomab infusions, for which patients must have been off for at least 3 days and all drug related toxicity must have resolved to grade 2 or lower as outlined in the inclusion/exclusion criteria. * Corticosteroids: If used to modify immune adverse events related to prior therapy, \>= 14 days must have elapsed since last dose of corticosteroid. A waiting period prior to enrollment is not required for patients receiving corticosteroid for leukemia therapy/cytoreduction. * Radiotherapy: \>= 2 weeks must have elapsed since local palliative radiation therapy (XRT) (small port); \>= 3 months must have elapsed if prior cranial or craniospinal XRT was received, if \>= 50% of the pelvis was irradiated, or if total body irradiation (TBI) was received; \>= 6 weeks must have elapsed if other substantial bone marrow irradiation was given. * Stem cell transplant or rescue without TBI: For Cohort 1, at least 90 days must have elapsed since stem cell transplant and at least 30 days from donor lymphocyte infusion. Patient must have had no more than one previous HSCT and currently have no evidence of active graft vs. host disease (GVHD). For Cohort 2, no prior HSCT is allowed. * Chimeric antigen receptor (CAR) T cell therapy: At least 30 days must have elapsed from the last CAR-T cell infusion * Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1, or 2; use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age; patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score * Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 or * A serum creatinine based on age/gender as follows: * 1 to \< 2 years: maximum serum creatinine 0.6 mg/dL (both male and female) * 2 to \< 6 years: maximum serum creatinine 0.8 mg/dL (both male and female) * 6 to \< 10 years: maximum serum creatinine 1 mg/dL (both male and female) * 10 to \< 13 years: maximum serum creatinine 1.2 mg/dL (both male and female) * 13 to \< 16 years: maximum serum creatinine 1.5 mg/dL (male), 1.4 mg/dL (female) * \>= 16 years: maximum serum creatinine 1.7 mg/dL (male), 1.4 mg/dL (female) * Direct bilirubin =\< 1.5 x upper limit of normal (ULN) for age, and * Serum glutamic pyruvic transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 5 x ULN for age; for the purpose of this study, the ULN for ALT will be 45 U/L Exclusion Criteria: * Patients with any prior history of SOS irrespective of severity * Patients with isolated central nervous system (CNS), testicular, or any other extramedullary site of relapse * Patients who have been previously treated with inotuzumab ozogamicin * Patients who have previously received HSCT (Cohort 2 only) * Patients with Down syndrome (Cohort 2 only) * History of allergic reaction attributed to compounds of similar or biologic composition to inotuzumab ozogamicin or other agents in the study * Note: Patients with history of allergy to pegaspargase/calaspargase pegol are eligible for enrollment on Cohort 2 if Erwinia formulation of asparaginase can be obtained * Patients with active optic nerve and/or retinal involvement are not eligible; patients who are presenting with visual disturbances should have an ophthalmologic exam and, if indicated, a magnetic resonance imaging (MRI) to assess optic nerve or retinal involvement * Patients who are currently receiving another investigational drug * Patients who are currently receiving or plan to receive other anti-cancer agents (except hydroxyurea, which may be continued until 24 hours prior to start of protocol therapy, and intrathecal chemotherapy) * Anti-GVHD or agents to prevent organ rejection post-transplant; patients who are receiving cyclosporine, tacrolimus, or other agents to prevent either graft-versus-host disease post bone marrow transplant or organ rejection post-transplant are not eligible for this trial; at least 3 half-lives must have elapsed after the last dose of GVHD or anti-rejection medications * Patients who are currently receiving or plan to receive corticosteroids except as described below * Systemic corticosteroids may be administered for cytoreduction up to 24 hours prior to the start of protocol therapy, (Cohort 1 only) for all patients, corticosteroids may be administered as a premedication for inotuzumab ozogamicin and as treatment for allergic reactions or for physiologic replacement/stress dosing of hydrocortisone for documented adrenal insufficiency; corticosteroids are not allowed for other indications * Patients with known human immunodeficiency virus (HIV), hepatitis B or C infections; testing to prove negative status is not required for enrollment unless it is deemed necessary for usual medical care of the patient * Patients who have an active uncontrolled infection defined as: * Positive bacterial blood culture within 48 hours of study enrollment; * Fever above 38.2 degree Celsius (C) within 48 hours of study enrollment with clinical signs of infection; fever that is determined to be due to tumor burden is allowed if patients have documented negative blood cultures for at least 48 hours prior to enrollment and no concurrent signs or symptoms of active infection or hemodynamic instability * A positive fungal culture within 30 days of study enrollment or active therapy for presumed invasive fungal infection * Patients may be receiving IV or oral antibiotics to complete a course of therapy for a prior documented infection as long as cultures have been negative for at least 48 hours and signs or symptoms of active infection have resolved; for patients with clostridium (C.) difficile diarrhea, at least 72 hours of antibacterial therapy must have elapsed and stools must have normalized to baseline * Active viral or protozoal infection requiring IV treatment * Patients known to have one of the following concomitant genetic syndromes: Bloom syndrome, ataxia-telangiectasia, Fanconi anemia, Kostmann syndrome, Schwachman (Schwachman-Diamond-Blackfan) syndrome or any other known bone marrow failure syndrome * There have been no human studies of inotuzumab ozogamicin in pregnant women and no reports of exposure in utero; based on nonclinical safety studies, inotuzumab ozogamicin has the potential to impair human male and female fertility and to adversely affect human embryo fetal development; women of childbearing potential should be advised to avoid becoming pregnant while receiving inotuzumab ozogamicin; there is no information regarding the presence of inotuzumab ozogamicin in human milk, the effects on the breast-fed infant, or the effects on milk production; because of the potential for adverse reactions in breast-fed infants, women should not breast-feed during treatment with inotuzumab ozogamicin and for at least 2 months after the final dose * Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained within 7 days prior to enrollment * Female patients who are sexually active and of reproductive potential are not eligible unless they agree to use an effective contraceptive method for the duration of their study participation and for 8 months after the last dose of inotuzumab ozogamicin * Men with female partners of childbearing potential should use effective contraception during treatment with inotuzumab ozogamicin and for at least 5 months after the last dose of inotuzumab ozogamicin * Lactating females are not eligible unless they agree not to breastfeed their infants
Study design
Enrollment target: 80 participants
Allocation: non_randomized
Masking: none
Age groups: child, adult
Timeline
Starts: 2017-06-19
Estimated completion: 2026-12-31
Last updated: 2026-02-23
Interventions
Drug: Asparaginase Erwinia chrysanthemiProcedure: Biospecimen CollectionProcedure: Bone Marrow Aspiration and BiopsyDrug: Calaspargase PegolDrug: CyclophosphamideDrug: CytarabineProcedure: Diagnostic Imaging TestingBiological: Inotuzumab OzogamicinDrug: Leucovorin CalciumProcedure: Lumbar PunctureDrug: MethotrexateDrug: PegaspargaseDrug: Vincristine
Primary outcomes
  • Morphologic response (complete response [CR]+ incomplete hematologic recovery [CRi]) following one cycle of treatment with inotuzumab ozogamicin (Cohort 1) (Up to 28 days)
Sponsor
Children's Oncology Group · network
With: National Cancer Institute (NCI)
Contacts & investigators
InvestigatorMaureen M O'Brien · principal_investigator, Children's Oncology Group
All locations (157)
Children's Hospital of AlabamaRecruiting
Birmingham, Alabama, United States
Providence Alaska Medical CenterRecruiting
Anchorage, Alaska, United States
Banner Children's at DesertRecruiting
Mesa, Arizona, United States
Phoenix Childrens HospitalRecruiting
Phoenix, Arizona, United States
Banner University Medical Center - TucsonActive Not Recruiting
Tucson, Arizona, United States
Arkansas Children's HospitalRecruiting
Little Rock, Arkansas, United States
Kaiser Permanente Downey Medical CenterRecruiting
Downey, California, United States
City of Hope Comprehensive Cancer CenterActive Not Recruiting
Duarte, California, United States
Loma Linda University Medical CenterRecruiting
Loma Linda, California, United States
Children's Hospital Los AngelesRecruiting
Los Angeles, California, United States
Cedars Sinai Medical CenterRecruiting
Los Angeles, California, United States
Valley Children's HospitalActive Not Recruiting
Madera, California, United States
UCSF Benioff Children's Hospital OaklandRecruiting
Oakland, California, United States
Kaiser Permanente-OaklandRecruiting
Oakland, California, United States
Children's Hospital of Orange CountyRecruiting
Orange, California, United States
Lucile Packard Children's Hospital Stanford UniversityRecruiting
Palo Alto, California, United States
Sutter Medical Center SacramentoRecruiting
Sacramento, California, United States
University of California Davis Comprehensive Cancer CenterActive Not Recruiting
Sacramento, California, United States
Rady Children's Hospital - San DiegoActive Not Recruiting
San Diego, California, United States
UCSF Medical Center-Mission BayRecruiting
San Francisco, California, United States
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical CenterActive Not Recruiting
Torrance, California, United States
Children's Hospital ColoradoRecruiting
Aurora, Colorado, United States
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical CenterRecruiting
Denver, Colorado, United States
Connecticut Children's Medical CenterRecruiting
Hartford, Connecticut, United States
Yale UniversityActive Not Recruiting
New Haven, Connecticut, United States
Alfred I duPont Hospital for ChildrenRecruiting
Wilmington, Delaware, United States
Children's National Medical CenterRecruiting
Washington D.C., District of Columbia, United States
Golisano Children's Hospital of Southwest FloridaRecruiting
Fort Myers, Florida, United States
UF Health Cancer Institute - GainesvilleActive Not Recruiting
Gainesville, Florida, United States
Memorial Regional Hospital/Joe DiMaggio Children's HospitalRecruiting
Hollywood, Florida, United States
Nemours Children's Clinic-JacksonvilleRecruiting
Jacksonville, Florida, United States
Nicklaus Children's HospitalRecruiting
Miami, Florida, United States
AdventHealth OrlandoRecruiting
Orlando, Florida, United States
Nemours Children's HospitalRecruiting
Orlando, Florida, United States
Nemours Children's Clinic - PensacolaRecruiting
Pensacola, Florida, United States
Johns Hopkins All Children's HospitalActive Not Recruiting
St. Petersburg, Florida, United States
Tampa General HospitalRecruiting
Tampa, Florida, United States
Saint Joseph's Hospital/Children's Hospital-TampaRecruiting
Tampa, Florida, United States
Saint Mary's Medical CenterRecruiting
West Palm Beach, Florida, United States
Children's Healthcare of Atlanta - Arthur M Blank HospitalRecruiting
Atlanta, Georgia, United States
Memorial Health University Medical CenterRecruiting
Savannah, Georgia, United States
Kapiolani Medical Center for Women and ChildrenRecruiting
Honolulu, Hawaii, United States
Saint Luke's Cancer Institute - BoiseRecruiting
Boise, Idaho, United States
Lurie Children's Hospital-ChicagoRecruiting
Chicago, Illinois, United States
University of Chicago Comprehensive Cancer CenterRecruiting
Chicago, Illinois, United States
Loyola University Medical CenterRecruiting
Maywood, Illinois, United States
Saint Jude Midwest AffiliateRecruiting
Peoria, Illinois, United States
Southern Illinois University School of MedicineRecruiting
Springfield, Illinois, United States
Riley Hospital for ChildrenRecruiting
Indianapolis, Indiana, United States
Ascension Saint Vincent Indianapolis HospitalActive Not Recruiting
Indianapolis, Indiana, United States
Blank Children's HospitalRecruiting
Des Moines, Iowa, United States
University of Iowa/Holden Comprehensive Cancer CenterRecruiting
Iowa City, Iowa, United States
University of Kentucky/Markey Cancer CenterRecruiting
Lexington, Kentucky, United States
Norton Children's HospitalRecruiting
Louisville, Kentucky, United States
Children's Hospital New OrleansRecruiting
New Orleans, Louisiana, United States
Ochsner Medical Center JeffersonRecruiting
New Orleans, Louisiana, United States
Eastern Maine Medical CenterRecruiting
Bangor, Maine, United States
Maine Children's Cancer ProgramRecruiting
Scarborough, Maine, United States
Sinai Hospital of BaltimoreRecruiting
Baltimore, Maryland, United States
Johns Hopkins University/Sidney Kimmel Cancer CenterRecruiting
Baltimore, Maryland, United States
National Institutes of Health Clinical CenterActive Not Recruiting
Bethesda, Maryland, United States
Tufts Children's HospitalActive Not Recruiting
Boston, Massachusetts, United States
Dana-Farber Cancer InstituteRecruiting
Boston, Massachusetts, United States
UMass Memorial Medical Center - University CampusRecruiting
Worcester, Massachusetts, United States
C S Mott Children's HospitalRecruiting
Ann Arbor, Michigan, United States
Michigan State UniversityActive Not Recruiting
East Lansing, Michigan, United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's HospitalRecruiting
Grand Rapids, Michigan, United States
Corewell Health Children'sRecruiting
Royal Oak, Michigan, United States
Children's Hospitals and Clinics of Minnesota - MinneapolisRecruiting
Minneapolis, Minnesota, United States
University of Minnesota/Masonic Cancer CenterRecruiting
Minneapolis, Minnesota, United States
Mayo Clinic in RochesterRecruiting
Rochester, Minnesota, United States
University of Mississippi Medical CenterRecruiting
Jackson, Mississippi, United States
University of Missouri Children's HospitalRecruiting
Columbia, Missouri, United States
Children's Mercy Hospitals and ClinicsRecruiting
Kansas City, Missouri, United States
Cardinal Glennon Children's Medical CenterRecruiting
St Louis, Missouri, United States
Washington University School of MedicineRecruiting
St Louis, Missouri, United States
Mercy Hospital Saint LouisRecruiting
St Louis, Missouri, United States
Children's Hospital and Medical Center of OmahaRecruiting
Omaha, Nebraska, United States
University of Nebraska Medical CenterRecruiting
Omaha, Nebraska, United States
Sunrise Hospital and Medical CenterRecruiting
Las Vegas, Nevada, United States
Alliance for Childhood Diseases/Cure 4 the Kids FoundationRecruiting
Las Vegas, Nevada, United States
Summerlin Hospital Medical CenterRecruiting
Las Vegas, Nevada, United States
Renown Regional Medical CenterRecruiting
Reno, Nevada, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer CenterRecruiting
Lebanon, New Hampshire, United States
Hackensack University Medical CenterRecruiting
Hackensack, New Jersey, United States
Morristown Medical CenterRecruiting
Morristown, New Jersey, United States
Saint Peter's University HospitalRecruiting
New Brunswick, New Jersey, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University HospitalRecruiting
New Brunswick, New Jersey, United States
Newark Beth Israel Medical CenterRecruiting
Newark, New Jersey, United States
Saint Joseph's Regional Medical CenterRecruiting
Paterson, New Jersey, United States
Albany Medical CenterRecruiting
Albany, New York, United States
Maimonides Medical CenterRecruiting
Brooklyn, New York, United States
Roswell Park Cancer InstituteRecruiting
Buffalo, New York, United States
NYU Langone Hospital - Long IslandRecruiting
Mineola, New York, United States
The Steven and Alexandra Cohen Children's Medical Center of New YorkRecruiting
New Hyde Park, New York, United States
Laura and Isaac Perlmutter Cancer Center at NYU LangoneRecruiting
New York, New York, United States
Mount Sinai HospitalRecruiting
New York, New York, United States
Memorial Sloan Kettering Cancer CenterRecruiting
New York, New York, United States
University of RochesterActive Not Recruiting
Rochester, New York, United States
Stony Brook University Medical CenterRecruiting
Stony Brook, New York, United States
State University of New York Upstate Medical UniversityRecruiting
Syracuse, New York, United States
Montefiore Medical Center - Moses CampusRecruiting
The Bronx, New York, United States
New York Medical CollegeActive Not Recruiting
Valhalla, New York, United States
Mission HospitalRecruiting
Asheville, North Carolina, United States
UNC Lineberger Comprehensive Cancer CenterActive Not Recruiting
Chapel Hill, North Carolina, United States
Duke University Medical CenterRecruiting
Durham, North Carolina, United States
East Carolina UniversityRecruiting
Greenville, North Carolina, United States
Wake Forest University Health SciencesRecruiting
Winston-Salem, North Carolina, United States
Sanford Broadway Medical CenterRecruiting
Fargo, North Dakota, United States
Children's Hospital Medical Center of AkronRecruiting
Akron, Ohio, United States
Cincinnati Children's Hospital Medical CenterRecruiting
Cincinnati, Ohio, United States
Cleveland Clinic FoundationActive Not Recruiting
Cleveland, Ohio, United States
Nationwide Children's HospitalRecruiting
Columbus, Ohio, United States
Dayton Children's HospitalRecruiting
Dayton, Ohio, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's HospitalRecruiting
Toledo, Ohio, United States
University of Oklahoma Health Sciences CenterRecruiting
Oklahoma City, Oklahoma, United States
Legacy Emanuel Children's HospitalRecruiting
Portland, Oregon, United States
Oregon Health and Science UniversityRecruiting
Portland, Oregon, United States
Lehigh Valley Hospital-Cedar CrestRecruiting
Allentown, Pennsylvania, United States
Geisinger Medical CenterRecruiting
Danville, Pennsylvania, United States
Penn State Children's HospitalRecruiting
Hershey, Pennsylvania, United States
Children's Hospital of PhiladelphiaRecruiting
Philadelphia, Pennsylvania, United States
Saint Christopher's Hospital for ChildrenRecruiting
Philadelphia, Pennsylvania, United States
Children's Hospital of Pittsburgh of UPMCRecruiting
Pittsburgh, Pennsylvania, United States
Rhode Island HospitalRecruiting
Providence, Rhode Island, United States
Medical University of South CarolinaRecruiting
Charleston, South Carolina, United States
Prisma Health Richland HospitalRecruiting
Columbia, South Carolina, United States
BI-LO Charities Children's Cancer CenterRecruiting
Greenville, South Carolina, United States
Sanford USD Medical Center - Sioux FallsRecruiting
Sioux Falls, South Dakota, United States
T C Thompson Children's HospitalRecruiting
Chattanooga, Tennessee, United States
East Tennessee Childrens HospitalRecruiting
Knoxville, Tennessee, United States
Saint Jude Children's Research HospitalRecruiting
Memphis, Tennessee, United States
The Children's Hospital at TriStar CentennialRecruiting
Nashville, Tennessee, United States
Vanderbilt University/Ingram Cancer CenterRecruiting
Nashville, Tennessee, United States
Dell Children's Medical Center of Central TexasRecruiting
Austin, Texas, United States
Driscoll Children's HospitalRecruiting
Corpus Christi, Texas, United States
Medical City Dallas HospitalRecruiting
Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-DallasRecruiting
Dallas, Texas, United States
El Paso Children's HospitalRecruiting
El Paso, Texas, United States
Cook Children's Medical CenterRecruiting
Fort Worth, Texas, United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer CenterRecruiting
Houston, Texas, United States
Covenant Children's HospitalRecruiting
Lubbock, Texas, United States
UMC Cancer Center / UMC Health SystemRecruiting
Lubbock, Texas, United States
Children's Hospital of San AntonioRecruiting
San Antonio, Texas, United States
Methodist Children's Hospital of South TexasRecruiting
San Antonio, Texas, United States
University of Texas Health Science Center at San AntonioRecruiting
San Antonio, Texas, United States
Primary Children's HospitalSuspended
Salt Lake City, Utah, United States
University of Vermont and State Agricultural CollegeRecruiting
Burlington, Vermont, United States
University of Virginia Cancer CenterRecruiting
Charlottesville, Virginia, United States
Inova Fairfax HospitalRecruiting
Falls Church, Virginia, United States
Children's Hospital of The King's DaughtersRecruiting
Norfolk, Virginia, United States
Seattle Children's HospitalRecruiting
Seattle, Washington, United States
Providence Sacred Heart Medical Center and Children's HospitalRecruiting
Spokane, Washington, United States
West Virginia University HealthcareRecruiting
Morgantown, West Virginia, United States
Marshfield Medical Center-MarshfieldActive Not Recruiting
Marshfield, Wisconsin, United States
Children's Hospital of WisconsinActive Not Recruiting
Milwaukee, Wisconsin, United States
HIMA San Pablo Oncologic HospitalActive Not Recruiting
Caguas, Puerto Rico
Inotuzumab Ozogamicin in Treating Younger Patients With B-Lymphoblastic Lymphoma or Relapsed or Refractory CD22 Positive B Acute Lymphoblastic Leukemia · TrialPath