International Collaborative Treatment Protocol For Children And Adolescents With Acute Lymphoblastic Leukemia

Last updated: May 17, 2022
Sponsor: University Hospital Schleswig-Holstein
Overall Status: Completed

Phase

3

Condition

Leukemia

Treatment

N/A

Clinical Study ID

NCT01117441
AIEOP-BFM ALL 2009
  • Ages 1-18
  • All Genders

Study Summary

Rationale/Purpose: Drugs used in chemotherapy work in different ways to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Giving more than one drug (combination chemotherapy) may kill more cancer cells. It is not yet known which combination chemotherapy regimen is more effective in treating young patients with acute lymphoblastic leukemia (ALL).

This trial is studying several different combination chemotherapy regimens to compare how well they work in treating young patients with ALL.

Study objectives

Primary study questions:

  • Non high-risk (non-HR) precursor-B ALL (pB-ALL) patients with TEL/AML1-negative ALL or unknown TEL/AML1 status and flow cytometry minimal residual disease (MRD) in bone marrow on day 15 <0.1% or with TEL/AML1-positive ALL (randomized study question R1): Can the daunorubicin dose in Protocol IA be safely reduced by 50 % with a non-inferior EFS and a reduction of toxicity (treatment-related mortality and AE/SAE in Protocol I)?

  • Patients with pB-ALL and risk group medium risk (MR) (randomized study question R2): Can the clinical outcome be improved by protracted asparagine depletion achieved through application of intensified PEG-L-asparaginase during reintensification and early maintenance?

  • High-risk (HR) patients (as identified by day 33 - randomized study question RHR): Can the clinical outcome be improved by protracted exposure to PEG-L-asparaginase during Protocol IB?

Secondary study questions:

  • Standard risk (SR) patients identified by at least one sensitive marker: Is the clinical outcome comparable to that obtained in SR patients (identified with two sensitive markers) in AIEOP-BFM ALL 2000, or can the outcome even be improved with the use of PEG-L-asparaginase instead of native E. coli L-ASP?

  • T-ALL non-HR patients: Can the high level of outcome which was obtained for these patients in study AIEOP-BFM ALL 2000 be preserved or even improved with the use of PEG-L-ASP instead of native E. coli L-ASP?

  • HR patients with persisting high MRD levels despite the use of the HR blocks in the intensified consolidation phase "MRD Non-Responders": Is it possible to improve the outcome and to achieve a further reduction of leukemic cell burden by administration of an innovative treatment schedule (DNX-FLA)?

  • Patients participating in the randomized asparaginase studies (pB-ALL/MR, HR): Are asparaginase activity and asparaginase antibodies associated with development of allergic reactions, and do they have an effect on the outcome of the patients?

  • What is the relative value of different methods of MRD monitoring in the definition of alternative stratification systems within a BFM-oriented protocol?

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • newly diagnosed acute lymphoblastic leukemia
  • age ≥ 1 year (> 365 days) and < 18 years old (up to 17 years old and 365 days)
  • no Ph+ (BCR/ABL or t(9;22)-positive) ALL
  • no evidence of pregnancy or lactation period
  • no participation in another clinical study
  • patient enrolled in a participating center
  • written informed consent

Exclusion

Exclusion Criteria:

  • pre-treatment with cytostatic drugs
  • pre-treatment with cytostatic drugs
  • steroid pre-treatment with ≥ 1 mg/kg/d for more than two weeks during the last monthbefore diagnosis
  • treatment started according to another protocol
  • underlying diseases that prohibit treatment according to the protocol
  • ALL diagnosed as second malignancy steroid pre-treatment with ≥ 1 mg/kg/d for morethan two weeks during the last month before diagnosis

Study Design

Total Participants: 6136
Study Start date:
June 01, 2010
Estimated Completion Date:
December 31, 2021

Study Description

Risk Stratification

  • T/non-HR: T-ALL in absence of any HR criteria (see below)

  • pB/non-HR: pB-ALL in absence of any HR criteria (see below).

    • SR (polymerase chain reaction(PCR)-MRD-SR (MRD-negative on day 33 and 78) or, if no PCR-MRD result available, FCM d15 < 0.1%)

    • MR (no SR)

  • HR: Prednisone poor-response (≥1000 blast cells/µl in peripheral blood on day 8), blast cells ≥10% in bone marrow on day 15 as measured by FCM, non-remission on day 33, positivity for MLL/AF4 or t(4;11), hypodiploidy (< 45 chromosomes), PCR-MRD-HR (MRD ≥10E-3 on day 78) or PCR-MRD-MR SER (only in pB-ALL, MRD ≥ 10-3 on day 33 and MRD positive at a level of < 10E-3 on day 78)

Chemotherapy

According to the risk group, patients receive the following chemotherapy elements:

T/non-HR: Protocol I, Protocol M, Protocol II and Maintenance pB/non-HR: Protocol I, Protocol M, Protocol II and Maintenance HR: Protocol I, HR-1', HR-2', HR-3', 3x Protocol III, Maintenance Patients of the HR group with PCR-MRD ≥10E-3 after element HR-3' are eligible for treatment with element DNX-FLA.

Protocol I Cytoreductive prephase: Prednisone (PDN) on days 1-7 and one dose of methotrexate (MTX) intrathecal (IT) on day 1 Protocol IA: Prednisone (PDN) on days 8 to 28 (21 days); vincristine (VCR) on days 8, 15, 22, 29 (4 doses); daunorubicin (DNR) on days 8, 15, 22 and 29 (4 doses); pegylated L-asparaginase (PEG-L-ASP) on days 12 and 26; MTX IT on days 12 and 33 and in case of blast cells in cerebrospinal fluid at diagnosis additional IT MTX is given on days 19 and 26.

Protocol IA': Only two doses of DNR on days 8 and 15 given to patients eligible for randomization R1 and randomized into the experimental arm Protocol IA-CPM: additional cyclophosphamide (CPM) on day 10 only in T-ALL patients with prednisone poor-response Protocol IA-Dexa (IAD): Dexamethasone (DXM) instead of PDN is given to all patients with T-ALL without any high-risk criteria as identified by day 8.

Protocol IB: CPM on days 36 and 64; cytarabine (ARA-C) on days 38-41, 45-48, 52-55 and 59-62; 6-mercaptopurine (6-MP) on days 36 to 63 (28 days); MTX IT on day 45 and 59 Protocol IB-ASP+: additional PEG-L-ASP on days 40, 47, 54, and 61 (4 doses) are given to the patients eligible for randomization RHR and randomized into the experimental arm.

Protocol M 6-MP on days 1- 56, high-dose MTX (HD-MTX) on days 8, 22, 36, 50 and MTX IT on days 8, 22, 36 and 50 Protocol II Protocol IIA: DXM on days 1 to 21 (21 days); VCR on days 8, 15, 22, 29 (4 doses); doxorubicine (DOX) on days 8, 15, 22 and 29 (4 doses); PEG-L-ASP on day 8 (1 dose); MTX IT on days 1 and 18 only in patients with initial CNS involvement.

Protocol IIA-ASP+: additional PEG-L-ASP on day 22 for patients eligible for randomization R2 and randomized into the experimental arm.

Protocol IIB: CPM on day 36; ARA-C on days 38-41 and 45-48; thioguanine (TG) on days 36 to 49 (14 days) and MTX IT on days 38 and 45.

Protocol IIB-ASP+: additional PEG-L-ASP on days 36 and 50 for eligible for randomization R2 and randomized into the experimental arm.

Protocol III DXM on days 1-15; VCR on days 1 and 8; DOX on days 1 and 8; PEG-L-ASP on day 1; CPM on day 15; ARA-C on days 17-20 and 24-27; TG on days 15 - 28 and MTX IT on days 17 and 24, also on day 1 in patients with initial CNS involvement HR-1' DXM on days 1-5; VCR on days 1 and 6; HD-MTX on day 1; CPM every 12 hours on days 2-4 (5 doses); HD-ARA-C every 12 hours on day 5 (2 doses); PEG-L-ASP on day 6, MTX IT on day 1 HR-2' DXM on days 1 to 5; VDS on days 1 and 6; HD-MTX on day 1; IFO every 12 hours on days 2-4 (5 doses); DNR on day 5; PEG-L-ASP on day 6; MTX IT on day 1 and 1 in patients with initial CNS involvement also day 5 HR-3' DXM on days 1-5; ARA-C 4 x on days 1-2 in 12 h intervals; etoposide (VP-16) every 12 hours on days 3-5 (5 doses); PEG-L-ASP on day 6; MTX IT on day 1 DNX-FLA Flucytosine (FLU) on days 1-5 (5 doses); HD-ARA-C on days 1 to 5 (5 doses); liposomal daunorubicin (DNX) on days 1, 3 and 5 (3 doses); MTX IT on day 1

Interim/Maintenance (until week 104):

6-MP p.o. daily; MTX p.o. once a week, doses adjusted to white blood cell count; PEG-L-ASP: every second week (6 doses), only for patients eligible for randomization R2 and randomized into the experimental arm; MTX IT every 6 weeks up to a total of 6 doses for the following subgroups (all CNS-negative):

  • T-ALL (HR or non-HR) with < 2 years of age at start of maintenance,

  • T-ALL, non-HR and initial WBC < 100 000/μl

  • pB-ALL with PPR and/or FCM-MRD day 15 ≥ 10 % and/or PCR-MRDMR SER as only HR criteria

Radiotherapy Patients without CNS involvement and

  • T-ALL/non-HR, WBC ≥ 100 000/μl, and age ≥ 2 years at start of pCRT or

  • with risk group HR and age ≥ 2 years at start of pCRT except pB-ALL with PPR and/or FCM-MRD day 15 ≥ 10 % and/or PCR-MRD-MR SER as only HR criteria receive preventive cranial radiotherapy with 12 Gy

Patients with CNS involvement receive therapeutic cranial radiotherapy with 18 Gy (age 1 to <2 years 12 Gy).

Connect with a study center

  • The Sydney Children's Hospital, Centre for Children's Cancer and Blood Disorders

    Randwick, NSW 2031
    Australia

    Site Not Available

  • The Children's Hospital at Westmead, Department of Oncology

    Westmead, NSW 2145
    Australia

    Site Not Available

  • Krankenhaus Dornbirn, Abt. für Kinder- und Jugendheilkunde

    Dornbirn, 6850
    Austria

    Site Not Available

  • Univ.-Kinderklinik Graz, Abt. Pädiatrische Hämato-Onkologie

    Graz, 8036
    Austria

    Site Not Available

  • Department f. Kinder- u. Jugendheilkunde, Universitätsklinik f. Pädiatrie II

    Innsbruck, 6020
    Austria

    Site Not Available

  • A.oe. Landeskrankenhaus Klagenfurt, Abt. für Kinder- und Jugendheilkunde

    Klagenfurt, 9026
    Austria

    Site Not Available

  • A.oe. Landeskrankenhaus Leoben, Abt. für Kinder und Jugendliche

    Leoben, 8700
    Austria

    Site Not Available

  • Landes-Kinderklinik Linz, Haematologie/Onkologie

    Linz, 4020
    Austria

    Site Not Available

  • St. Johanns Spital / Landeskrankenhaus, Salzburg, Kinderspital Abt. Kinder u. Jugendheilkunde

    Salzburg, 5020
    Austria

    Site Not Available

  • St. Anna Kinderspital, Zentrum für Kinder- und Jugendheilkunde

    Wien, 1090
    Austria

    Site Not Available

  • University Hospital Hradec Králové, Department of Pediatrics

    Hradec Králové, 500 12
    Czech Republic

    Site Not Available

  • University Hospital Plzeň, Department of Pediatrics

    Plzeň, 304 60
    Czech Republic

    Site Not Available

  • Masaryk´s Hospital Ústí nad Labem, Department of Pediatrics

    Ústí nad Labem, 401 13
    Czech Republic

    Site Not Available

  • Regional Hospital ÄŒeské BudÄ›jovice, Department of Pediatrics

    České Budějovice, 370 01
    Czech Republic

    Site Not Available

  • University Hospital Brno, Department of Pediatric Oncology

    Brno, 662 63
    Czechia

    Site Not Available

  • University Hospital Hradec Králové, Department of Pediatrics

    Hradec Králové, 500 12
    Czechia

    Site Not Available

  • University Hospital Olomouc, Department of Pediatrics

    Olomouc, 770 00
    Czechia

    Site Not Available

  • Teaching Hospital Ostrava-Poruba, Department of Pediatrics

    Ostrava-Poruba, 708 52
    Czechia

    Site Not Available

  • University Hospital Plzeň, Department of Pediatrics

    Plzeň, 304 60
    Czechia

    Site Not Available

  • University Hospital Motol, Department of Pediatric Hematology and Oncology

    Praha 5, 150 06
    Czechia

    Site Not Available

  • Masaryk´s Hospital Ústí nad Labem, Department of Pediatrics

    Ústí nad Labem, 401 13
    Czechia

    Site Not Available

  • Regional Hospital České Budějovice, Department of Pediatrics

    České Budějovice, 370 01
    Czechia

    Site Not Available

  • Kinderklinik der med. Fakultät der RWTH, Bereich Hämatologie/Onkologie

    Aachen, 52074
    Germany

    Site Not Available

  • I. Klinik für Kinder u. Jugendliche, Klinikum Augsburg, Hämatologie/ Onkologie

    Augsburg, 86156
    Germany

    Site Not Available

  • Klinikum Bayreuth, Kinderklinik

    Bayreuth, 95445
    Germany

    Site Not Available

  • Kinderklinik der Charité, Campus Virchow Klinikum (CVK), Abt.: Kinderhämatologie

    Berlin, 13353
    Germany

    Site Not Available

  • Klinikum Berlin-Buch II. Kinderklinik, Bereich Onkologie/Allg. Pädiatrie

    Berlin, 13125
    Germany

    Site Not Available

  • Zentrum für Kinderheilkunde der Universität Bonn, Päd. Hämatologie / Onkologie

    Bonn, 53113
    Germany

    Site Not Available

  • Städtisches Krankenhaus, Kinderklinik

    Braunschweig, 38118
    Germany

    Site Not Available

  • Klinikum Chemnitz gGmbH, Klinik für Kinder- und Jugendmedizin, Hämatologie / Onkologie

    Chemnitz, 09009
    Germany

    Site Not Available

  • Carl-Thiem-Klinikum, Kinderklinik, Abt. Hämatologie/Onkologie

    Cottbus, 03048
    Germany

    Site Not Available

  • Vestische Kinder- u. Jugendklinik, Universitätsklinik Witten/Herdecke

    Datteln, 45711
    Germany

    Site Not Available

  • Klinikum Lippe-Detmold, Kinder- und Jugendmedizin

    Detmold, 32756
    Germany

    Site Not Available

  • Klinikum Dortmund, Klinik f. Kinder- und Jugendmedizin

    Dortmund, 44137
    Germany

    Site Not Available

  • Uni.Klinik Carl Gustav Carus, Klinik f. Kinderheilkunde

    Dresden, 01307
    Germany

    Site Not Available

  • Universitätskinderklinik

    Düsseldorf, 40225
    Germany

    Site Not Available

  • Helios Klinikum Erfurt GmbH, Klinik für Kinderheilkunde

    Erfurt, 99089
    Germany

    Site Not Available

  • Universitätsklinikum Erlangen, Kinder- und Jugendmedizin, Abt. für Onkologie/ Hämatologie/Immunologie

    Erlangen, 91054
    Germany

    Site Not Available

  • Universitätsklinikum Essen, Kinderklinik, Hämatologie/Onkologie

    Essen, 45122
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Klinik für Kinderheilkunde III, Pädiatrische Hämatologie/Onkologie

    Frankfurt, 60590
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Haematologie/ Onkologie

    Freiburg, 79106
    Germany

    Site Not Available

  • Klinikum der Justus-Liebig-Universität, Zentrum für Kinderheilkunde, Abt. Hämatologie/Onkologie

    Gießen, 35385
    Germany

    Site Not Available

  • Klinikum der Justus-Liebig-Universität, Zentrum für Kinderheilkunde, Abt. Hämatologie/Onkologie

    Gießen, 35385
    Germany

    Site Not Available

  • Klinik und Poliklinik für Kinder und Jugendmedizin, Allgemeine Pädiatrie mit Poliklinik/Pädiatrische Onkologie und Hämatologie

    Greifswald, 17475
    Germany

    Site Not Available

  • Universitäts-Kinderklinik Päd. I, Hämatologie/Onkologie

    Göttingen, 37099
    Germany

    Site Not Available

  • Universitäts-Kinderklinik Päd. I, Hämatologie/Onkologie

    Göttingen, 37099
    Germany

    Site Not Available

  • Uniklinikum d. Martin Luther Universität, Halle Wittenberg, Univ.-und Poliklinik für Kinder- und Jugendmedizin

    Halle, 06120
    Germany

    Site Not Available

  • Medizinische Hochschule Hannover, Zentrum Kinderheilkunde u. Jugendmedizin

    Hannover, 30625
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Päd. Onkologie, Hämatologie, und Immunologie

    Heidelberg, 69120
    Germany

    Site Not Available

  • Klinikum Heilbronn GmbH, Klinik für Kinderheilkunde und Jugendmedizin/Perinatalzentrum

    Heilbronn, 74078
    Germany

    Site Not Available

  • Gemeinschaftskrankenhaus Herdecke, Kinderabteilung

    Herdecke, 58313
    Germany

    Site Not Available

  • Universitätsklinik für, Kinder- und Jugendmedizin, Päd. Hämatologie/ Onkologie

    Homburg / Saar, 66421
    Germany

    Site Not Available

  • Klinikum, der Friedrich-Schiller-Universität, Klinik für Kinder- und Jugendmedizin

    Jena, 7740
    Germany

    Site Not Available

  • Städtisches Klinikum Karlsruhe, Kinderklinik

    Karlsruhe, 76133
    Germany

    Site Not Available

  • Klinikum Kassel, Kinderklinik

    Kassel, 34125
    Germany

    Site Not Available

  • Klinik für Allgemeine Paediatrie, Univ.-Klinikum Schleswig-Holstein, Campus Kiel

    Kiel, 24105
    Germany

    Site Not Available

  • Städtisches Krankenhaus Kemperhof, Kinderklinik

    Koblenz, 56073
    Germany

    Site Not Available

  • Med. Einrichtungen der Universität zu Köln, Klinik für Allg. Kinderheilkunde, Onkologisch-hämatologische Station

    Köln, 50937
    Germany

    Site Not Available

  • Kliniken der Stadt Köln GmbH, Kinderkrankenhaus Riehl

    Köln, 50735
    Germany

    Site Not Available

  • Med. Einrichtungen der Universität zu Köln, Klinik für Allg. Kinderheilkunde, Onkologisch-hämatologische Station

    Köln, 50937
    Germany

    Site Not Available

  • Department für Frauen- und Kindermedizin, Abteilung für Pädiatrische Onkologie, Hämatologie und Hämostaseologie

    Leipzig, 04103
    Germany

    Site Not Available

  • Universität zu Lübeck, Klinik für Kinder- u. Jugendmedizin, Abt. Hämatologie/ Onkologie/Immunologie

    Lübeck, 23538
    Germany

    Site Not Available

  • Universität zu Lübeck, Klinik für Kinder- u. Jugendmedizin, Abt. Hämatologie/ Onkologie/Immunologie

    Lübeck, 23538
    Germany

    Site Not Available

  • Universitätsklinikum Magdeburg, Klinik für Päd. Hämatologie/Onkologie

    Magdeburg, 39120
    Germany

    Site Not Available

  • Klinikum Mannheim gGmbH, Kinderklinik, Abt. Hämatologie/Onkologie

    Mannheim, 68167
    Germany

    Site Not Available

  • Universitätskliniken, Giessen und Marburg GmbH

    Marburg, 35033
    Germany

    Site Not Available

  • Johannes Wesling Klinikum Minden

    Minden, 32429
    Germany

    Site Not Available

  • Städt. Krankenhaus München GmbH, Krankenhaus München-Schwabingen, Kinderklinik d. TU

    München, 80804
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Päd. Hämatologie und Onkologie

    Münster, 48149
    Germany

    Site Not Available

  • Städt. Krankenhaus München GmbH, Krankenhaus München-Schwabingen, Kinderklinik d. TU

    München, 80804
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Päd. Hämatologie und Onkologie

    Münster, 48149
    Germany

    Site Not Available

  • Cnopf'sche Kinderklinik, Onkologie

    Nürnberg, 90419
    Germany

    Site Not Available

  • Cnopf'sche Kinderklinik, Onkologie

    Nürnberg, 90419
    Germany

    Site Not Available

  • Klinikum Oldenburg gGmbH, Zentrum für Kinder- u. Jugendmedizin, (Elisabeth Kinderkrankenhaus)

    Oldenburg, 26133
    Germany

    Site Not Available

  • Universitäts-Kinderklinik

    Rostock, 18055
    Germany

    Site Not Available

  • Asklepios-Klinik, Sankt Augustin GmbH

    Sankt Augustin, 53757
    Germany

    Site Not Available

  • HELIOS Kliniken Schwerin, Klinik f. Kinder-u. Jugendmedizin

    Schwerin, 19049
    Germany

    Site Not Available

  • Deutsches Rotes Kreuz, Kinderklinik

    Siegen, 57072
    Germany

    Site Not Available

  • Olga-Hospital, Kinderklinik, Pädiatrisches Zentrum, Abt. Hämatologie/Onkologie

    Stuttgart, 70176
    Germany

    Site Not Available

  • Krankenanstalt Trier, Mutterhaus der Borromaeerinnen, Pädiatrische Abteilung

    Trier, 54290
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Abt. Kinderheilkunde II, Hämatologie/Onkologie

    Tübingen, 72076
    Germany

    Site Not Available

  • Universitäts-Kinderklinik, Abt. Kinderheilkunde II, Hämatologie/Onkologie

    Tübingen, 72076
    Germany

    Site Not Available

  • Universitäts-Kinderklinik

    Ulm, 89075
    Germany

    Site Not Available

  • Stadtkrankenhaus, Kinderklinik

    Wolfsburg, 38440
    Germany

    Site Not Available

  • Universitäts-Kinderklinik

    Würzburg, 97080
    Germany

    Site Not Available

  • Universitäts-Kinderklinik

    Würzburg, 97080
    Germany

    Site Not Available

  • HaEmek Medical Center

    Afula, 18101
    Israel

    Site Not Available

  • Soroka Medical Center

    Beer-Sheva, 84101
    Israel

    Site Not Available

  • Bnai-Zion Medical Center

    Haifa, 33394
    Israel

    Site Not Available

  • Rambam Medical Center

    Haifa, 31096
    Israel

    Site Not Available

  • Hadassah University Medical Center

    Jerusalem, 91120
    Israel

    Site Not Available

  • Schneider Children Medical Center of Israel

    Petach Tikva, 49202
    Israel

    Site Not Available

  • Dana children hospital

    Tel-Aviv, 64239
    Israel

    Site Not Available

  • Sheba Medical Center

    Tel-Hashomer,
    Israel

    Site Not Available

  • Centro Regionale Oncoematologia Pediatrica Ospedale dei Bambini "G. Salesi" Clinica Pediatrica

    Ancona, 60123
    Italy

    Site Not Available

  • Dipartimento Biomedicina Età Evolutiva U.O Pediatrica I Policlinico

    Bari, 70124
    Italy

    Site Not Available

  • U.O.C. Pediatria e Patologia Neonatale Ospedale San Martino

    Belluno, 32100
    Italy

    Site Not Available

  • U.O. Pediatrica - OO.RR Bergamo

    Bergamo, 24100
    Italy

    Site Not Available

  • Istituto Ortopedico Rizzoli Sez. di chemioterapia dei tumori dell'apparato locomotore

    Bologna, 40136
    Italy

    Site Not Available

  • Oncologia ed Ematologia "Lalla Seràgnoli" Clinica Pediatrica Policlinico Sant'Orsola Malpighi

    Bologna, 40138
    Italy

    Site Not Available

  • Pediatria Ospedale Regionale

    Bolzano, 39100
    Italy

    Site Not Available

  • Clinica Pediatrica Oncoematologia pediatrica e TMO Ospedale dei Bambini

    Brescia, 25123
    Italy

    Site Not Available

  • Istituto di Clinica Pediatrica Ospedale Regionale per le Microcitemie

    Cagliari, 09121
    Italy

    Site Not Available

  • Divisione Ematologia - Oncologia Pediatrica Clinica Pediatrica

    Catania, 95123
    Italy

    Site Not Available

  • Unità Operativa di Ematologia ed Oncologia Pediatrica Az. Osp. "Pugliese-Ciaccio"

    Catanzaro, 88100
    Italy

    Site Not Available

  • Unità Operativa Pediatria Azienda Ospedaliera Annuziata

    Cosenza, 87100
    Italy

    Site Not Available

  • Dipartimento di Medicina Clinica e Sperimentale Sezione di Pediatria Università di Ferrara

    Ferrara, 41100
    Italy

    Site Not Available

  • Dipartimento A.I. Oncoematologia Pediatrica e Cure Domiciliari U.O. Oncoematologia Pediatrica Azienda Ospedaliero-Universitaria Meyer

    Firenze, 50139
    Italy

    Site Not Available

  • Dipartimento di Ematologia e Oncologia Pediatrica Instituto " G. Gaslini"

    Genova, 16148
    Italy

    Site Not Available

  • Dipartimento di Ematologia e Oncologia Pediatrica Instituto " G. Gaslini"

    Genova Quarto, 16148
    Italy

    Site Not Available

  • Ospedale "Vito Fazzi" U.O. di Pediatria

    Lecce, 73100
    Italy

    Site Not Available

  • Clinica Pediatrica II De Marchi

    Milano, 20122
    Italy

    Site Not Available

  • Divisione Pediatria "Mariani" Ospedale "Niguarda Ca' Granda"

    Milano, 20162
    Italy

    Site Not Available

  • Divisione di Oncologia Pediatrica Ist. Nazionale Studio e Cura Tumori

    Milano, 20133
    Italy

    Site Not Available

  • Unità di Ricerca Clinica Pediatrica HSR TIGET - Istituto Scientifico San Raffaele

    Milano, 20132
    Italy

    Site Not Available

  • U.O. di Ematologia, oncologia e trapianto Azienda Policlinico di Modena

    Modena, 41100
    Italy

    Site Not Available

  • Clinica Pediatrica dell'Università Milano - Bicocca A.O. San Gerardo - Fondazione MBBM

    Monza, 20052
    Italy

    Site Not Available

  • A.O. "A. Cardarelli", U.O.S. Talassemia pediatrica ed emoglobinopatie pediatriche

    Napoli, 80131
    Italy

    Site Not Available

  • Dipartimento di Oncologia A.O. Santobono - Pausilipon

    Napoli, 80123
    Italy

    Site Not Available

  • Servizio di Oncologia Pediatrica Dipartimento di Pediatria Seconda Università degli Studi di Napoli

    Napoli, 80138
    Italy

    Site Not Available

  • U.O.C. Pediatria - TIN, Ospedale "Umberto Primo" ASL SA - 1

    Nocera Inferiore, 84014
    Italy

    Site Not Available

  • U.O.C. Pediatria - TIN, Ospedale "Umberto Primo" ASL SA - 1

    Nocera Inferiore - SA, 84014
    Italy

    Site Not Available

  • S.C.D.U. Azienda Ospedaliera "Maggiore della carità"

    Novara, 28100
    Italy

    Site Not Available

  • Dipartimento di Pediatria Università di Padova Cattedra Di Oncoematologia Pediatrica

    Padova, 35128
    Italy

    Site Not Available

  • Oncoematologia Pediatrica Ospedale dei Bambini G. di Cristina

    Palermo, 90134
    Italy

    Site Not Available

  • U.O. di Pediatria e Oncoematologia Pediatrica Az. Osp. Di Parma Ospedali Riuniti

    Parma, 43100
    Italy

    Site Not Available

  • Oncoematologia Pediatrica IRCCS, Policlinico San Matteo

    Pavia, 27100
    Italy

    Site Not Available

  • S.C. di Oncoematologia Pediatrica con Trapianto di CSE, Ospedale "S.M. della Misericordia" A.O. Perugia

    Perugia, 06156
    Italy

    Site Not Available

  • Ematologia, Ospedale di Muraglia

    Pesaro, 61100
    Italy

    Site Not Available

  • U.O. Pediatrica Azienda Ospedaliera San Salvatore

    Pesaro, 61100
    Italy

    Site Not Available

  • Dipartimento di Ematologia Ospedale Civile

    Pescara, 65123
    Italy

    Site Not Available

  • Centro di Oncoematologia Pediatrica e Trapianto Midollo Osseo Azienda Ospedaliero Universitaria Pisana Ospedale S. Chiara

    Pisa, 56126
    Italy

    Site Not Available

  • Centro Integrato di Emato-oncologia e dell'adolescenza A.O. S. Maria degli Angeli - Pordenone e IRCCS Centro di Riferimento Oncologico - Aviano

    Pordenone, 33170
    Italy

    Site Not Available

  • Divisione Ematologia Ospedali Riuniti

    Reggio Calabria, 89100
    Italy

    Site Not Available

  • U.O Pediatria Ospedale Infermi Azienda USL Rimini

    Rimini, 47900
    Italy

    Site Not Available

  • Divisione Oncologia Pediatrica Ospedale "Bambin Gesù"

    Roma, 00165
    Italy

    Site Not Available

  • Divisione Oncologia Pediatrica Università Cattolica di Roma

    Roma, 00168
    Italy

    Site Not Available

  • Divisione di Ematologia Pediatrica Ospedale "Bambin Gesù"Istituto di Ricerca Scientifica

    Roma, 00165
    Italy

    Site Not Available

  • Oncoematologia pediatrica Università "La Sapienza" Roma

    Roma, 00161
    Italy

    Site Not Available

  • Ospedale Sant'Eugenio clinica pediatrica Univ. Tor Vergata

    Roma, 00144
    Italy

    Site Not Available

  • Sezione Ematologia Dipart. di biotecnologie Cellulari ed Ematologia Università "La Sapienza"

    Roma, 00161
    Italy

    Site Not Available

  • U.O. Oncoematologia Pediatrica Ospedale "Casa Sollievo della Sofferenza"

    San Giovanni Rotondo, 71013
    Italy

    Site Not Available

  • Clinica Pediatrica Università

    Sassari, 07100
    Italy

    Site Not Available

  • Dipartimento di Pediatria Ostetricia e Medicina della Riproduzione Università degli Studi di Siena

    Siena, 53100
    Italy

    Site Not Available

  • Ospedale Infantile Regina Margherita

    Torino, 10126
    Italy

    Site Not Available

  • Unità Operativa di Pediatria - U.T.I.N. Az.Osp. "Card. G. Panico"

    Tricase, 73039
    Italy

    Site Not Available

  • U.O. Emato-Oncologia Pediatrica Università degli studi di Trieste Ospedale Infantile Burlo Garofolo

    Trieste, 34137
    Italy

    Site Not Available

  • SOS Oncologia Pediatrica Policlinico Universitario

    Udine, 33100
    Italy

    Site Not Available

  • Clinica Pediatrica Università degli Studi dell'Insubria di Varese Ospedale "Filippo del Ponte"

    Varese, 21100
    Italy

    Site Not Available

  • U.O.C Oncoematologia Pediatrica Policlinico "G.B: Rossi"

    Verona, 37134
    Italy

    Site Not Available

  • Ospedale San Bortolo, U.O. di Pediatria e patologia Neonatale

    Vicenza, 36100
    Italy

    Site Not Available

  • Kinderklinik, Hämatologie/Onkologie

    Aarau, 5000
    Switzerland

    Site Not Available

  • Baseler Kinderspital, Hämatologische Poliklinik

    Basel, 4005
    Switzerland

    Site Not Available

  • Repartio di Pediatria

    Bellinzona, 6500
    Switzerland

    Site Not Available

  • Pädiatrische Klinik, Kinderspital Luzern, Kinderonkologie

    Luzern, 6000
    Switzerland

    Site Not Available

  • Hämatologie/Onkologie, Ostschweizer Kinderspital, FMH Pädiatrie, Hämatologie

    St. Gallen, 9006
    Switzerland

    Site Not Available

  • Kinderspital Zürich, Universitäts-Kinderklinik

    Zürich, 8032
    Switzerland

    Site Not Available

  • Kinderspital Zürich, Universitäts-Kinderklinik

    Zürich, 8032
    Switzerland

    Site Not Available

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