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Inotuzumab Ozogamicin and Chemotherapy in Treating Patients With Recurrent or Refractory B-cell Acute Lymphoblastic Leukemia

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03991884
Recruitment Status : Recruiting
First Posted : June 19, 2019
Last Update Posted : December 6, 2019
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
University of Washington

Brief Summary:
This phase I trial studies the best dose of inotuzumab ozogamicin in combination with chemotherapy in treating patients with B-cell acute lymphoblastic leukemia that has come back (recurrent) or that does not respond to treatment (refractory). Inotuzumab ozogamicin is a monoclonal antibody, called inotuzumab, linked to a toxic agent called ozogamicin. Inotuzumab attaches to CD22 positive cancer cells in a targeted way and delivers ozogamicin to kill them. Drugs used in chemotherapy, such as etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Giving inotuzumab ozogamicin in combination with chemotherapy may kill more cancer cells than with chemotherapy alone in treating patients with recurrent or refractory B-cell acute lymphoblastic leukemia.

Condition or disease Intervention/treatment Phase
Recurrent B Acute Lymphoblastic Leukemia Recurrent B Lymphoblastic Lymphoma Refractory B Acute Lymphoblastic Leukemia Refractory B Lymphoblastic Lymphoma Drug: Etoposide Drug: Doxorubicin Drug: Doxorubicin Hydrochloride Drug: Vincristine Drug: Vincristine Sulfate Drug: Prednisone Drug: Cyclophosphamide Biological: Inotuzumab Ozogamicin Phase 1

Detailed Description:

This is a dose-escalation study of inotuzumab ozogamicin.

Patients receive etoposide, doxorubicin, and vincristine intravenously (IV) via continuous infusion on days 1-4, prednisone orally (PO) or IV twice daily (BID) on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Patients also receive inotuzumab ozogamicin IV over 1 hour on days 8 and 15. Treatment repeats every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up at 30 days then annually for up to 5 years.


Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 36 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase I Study of Dose-Adjusted Etoposide, Prednisone, Vincristine, Cyclophosphamide, and Doxorubicin Plus Escalating Doses of Inotuzumab Ozogamicin (DA-EPOCH-InO) in Relapsed or Refractory B-Cell Acute Lymphoblastic Leukemia
Actual Study Start Date : September 24, 2019
Estimated Primary Completion Date : February 28, 2024
Estimated Study Completion Date : February 28, 2026


Arm Intervention/treatment
Experimental: Dose -1 (0.3 mg/m^2)
Patients receive etoposide, doxorubicin, and vincristine IV via continuous infusion on days 1-4, prednisone PO or IV BID on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Patients also receive inotuzumab ozogamicin IV over 1 hour on day 8. Treatment repeats approximately every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.
Drug: Etoposide
Given IV
Other Names:
  • 33419-42-0
  • Demethyl Epipodophyllotoxin Ethylidine Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • 141540

Drug: Doxorubicin
Given IV
Other Names:
  • 14-Hydroxydaunomycin
  • 23214-92-8
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin

Drug: Doxorubicin Hydrochloride
Given IV
Other Names:
  • 123127
  • 14-Hydroxydaunorubicin Hydrochloride
  • Adriacin
  • Adriamycin Hydrochloride
  • Adriamycin PFS
  • Adriamycin RDF
  • Adriamycine
  • Adriblastina
  • Adriblastine
  • Chloridrato de Doxorrubicina
  • Doxorubicin HCl
  • Farmiblastina
  • hydroxydaunorubicin
  • hydrochloride
  • Rubex

Drug: Vincristine
Given IV
Other Names:
  • 22-Oxovincaleukoblastine
  • LEUROCRISTINE
  • VCR
  • Vincrystine

Drug: Vincristine Sulfate
Given IV
Other Names:
  • 2068-78-2
  • 67574
  • Kyocristine
  • Leurocristine sulfate
  • Oncovin
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristine

Drug: Prednisone
Given PO or IV
Other Names:
  • 2-Dehydrocortisone
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-Cortisone
  • Delta-Dome
  • Metacortandracin
  • Ofisolona
  • Orasone
  • Paracort
  • Predicor
  • Predicorten
  • Prednicort
  • Prednidib
  • Prednilonga
  • Predniment
  • Prednisone Intensol
  • Prednisonum
  • Prednitone
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednisone

Drug: Cyclophosphamide
Given IV
Other Names:
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamide
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrate
  • CTX
  • Cycloblastin
  • Cycloblastine
  • Cyclophospham
  • Cyclophosphamid monohydrate
  • Cyclophosphamidum
  • Cyclophosphan
  • Cyclophosphane
  • Cyclostin
  • Cyclostine
  • Cytoxan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719

Biological: Inotuzumab Ozogamicin
Given IV
Other Names:
  • 635715-01-4
  • Besponsa
  • CMC-544
  • Way 207294
  • WAY-207294

Experimental: Dose 1 (0.3 mg/m^2)
Dose 1 patients receive etoposide, doxorubicin, and vincristine IV via continuous infusion on days 1-4, prednisone PO or IV BID on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Patients also receive inotuzumab ozogamicin IV over 1 hour on days 8 and 15. Treatment repeats approximately every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.
Drug: Etoposide
Given IV
Other Names:
  • 33419-42-0
  • Demethyl Epipodophyllotoxin Ethylidine Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • 141540

Drug: Doxorubicin
Given IV
Other Names:
  • 14-Hydroxydaunomycin
  • 23214-92-8
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin

Drug: Doxorubicin Hydrochloride
Given IV
Other Names:
  • 123127
  • 14-Hydroxydaunorubicin Hydrochloride
  • Adriacin
  • Adriamycin Hydrochloride
  • Adriamycin PFS
  • Adriamycin RDF
  • Adriamycine
  • Adriblastina
  • Adriblastine
  • Chloridrato de Doxorrubicina
  • Doxorubicin HCl
  • Farmiblastina
  • hydroxydaunorubicin
  • hydrochloride
  • Rubex

Drug: Vincristine
Given IV
Other Names:
  • 22-Oxovincaleukoblastine
  • LEUROCRISTINE
  • VCR
  • Vincrystine

Drug: Vincristine Sulfate
Given IV
Other Names:
  • 2068-78-2
  • 67574
  • Kyocristine
  • Leurocristine sulfate
  • Oncovin
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristine

Drug: Prednisone
Given PO or IV
Other Names:
  • 2-Dehydrocortisone
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-Cortisone
  • Delta-Dome
  • Metacortandracin
  • Ofisolona
  • Orasone
  • Paracort
  • Predicor
  • Predicorten
  • Prednicort
  • Prednidib
  • Prednilonga
  • Predniment
  • Prednisone Intensol
  • Prednisonum
  • Prednitone
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednisone

Drug: Cyclophosphamide
Given IV
Other Names:
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamide
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrate
  • CTX
  • Cycloblastin
  • Cycloblastine
  • Cyclophospham
  • Cyclophosphamid monohydrate
  • Cyclophosphamidum
  • Cyclophosphan
  • Cyclophosphane
  • Cyclostin
  • Cyclostine
  • Cytoxan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719

Biological: Inotuzumab Ozogamicin
Given IV
Other Names:
  • 635715-01-4
  • Besponsa
  • CMC-544
  • Way 207294
  • WAY-207294

Experimental: Dose 2 (0.6 mg/m^2, 0.3 mg/m^2)
Dose 2 patients receive etoposide, doxorubicin, and vincristine IV via continuous infusion on days 1-4, prednisone PO or IV BID on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Patients also receive inotuzumab ozogamicin IV over 1 hour on days 8 and 15. Treatment repeats approximately every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.
Drug: Etoposide
Given IV
Other Names:
  • 33419-42-0
  • Demethyl Epipodophyllotoxin Ethylidine Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • 141540

Drug: Doxorubicin
Given IV
Other Names:
  • 14-Hydroxydaunomycin
  • 23214-92-8
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin

Drug: Doxorubicin Hydrochloride
Given IV
Other Names:
  • 123127
  • 14-Hydroxydaunorubicin Hydrochloride
  • Adriacin
  • Adriamycin Hydrochloride
  • Adriamycin PFS
  • Adriamycin RDF
  • Adriamycine
  • Adriblastina
  • Adriblastine
  • Chloridrato de Doxorrubicina
  • Doxorubicin HCl
  • Farmiblastina
  • hydroxydaunorubicin
  • hydrochloride
  • Rubex

Drug: Vincristine
Given IV
Other Names:
  • 22-Oxovincaleukoblastine
  • LEUROCRISTINE
  • VCR
  • Vincrystine

Drug: Vincristine Sulfate
Given IV
Other Names:
  • 2068-78-2
  • 67574
  • Kyocristine
  • Leurocristine sulfate
  • Oncovin
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristine

Drug: Prednisone
Given PO or IV
Other Names:
  • 2-Dehydrocortisone
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-Cortisone
  • Delta-Dome
  • Metacortandracin
  • Ofisolona
  • Orasone
  • Paracort
  • Predicor
  • Predicorten
  • Prednicort
  • Prednidib
  • Prednilonga
  • Predniment
  • Prednisone Intensol
  • Prednisonum
  • Prednitone
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednisone

Drug: Cyclophosphamide
Given IV
Other Names:
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamide
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrate
  • CTX
  • Cycloblastin
  • Cycloblastine
  • Cyclophospham
  • Cyclophosphamid monohydrate
  • Cyclophosphamidum
  • Cyclophosphan
  • Cyclophosphane
  • Cyclostin
  • Cyclostine
  • Cytoxan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719

Biological: Inotuzumab Ozogamicin
Given IV
Other Names:
  • 635715-01-4
  • Besponsa
  • CMC-544
  • Way 207294
  • WAY-207294

Experimental: Dose 3 (0.6 mg/m^2, 0.3 mg/m^2)
Dose 3 patients receive etoposide, doxorubicin, and vincristine IV via continuous infusion on days 1-4, prednisone PO or IV BID on days 1-5, and cyclophosphamide IV over 1 hour on day 5. Patients also receive inotuzumab ozogamicin IV over 1 hour on days 8 and 15. Treatment repeats approximately every 28 days for up to 4 cycles in the absence of disease progression or unacceptable toxicity.
Drug: Etoposide
Given IV
Other Names:
  • 33419-42-0
  • Demethyl Epipodophyllotoxin Ethylidine Glucoside
  • EPEG
  • Lastet
  • Toposar
  • Vepesid
  • VP 16
  • VP 16-213
  • VP-16
  • VP-16-213
  • VP16
  • 141540

Drug: Doxorubicin
Given IV
Other Names:
  • 14-Hydroxydaunomycin
  • 23214-92-8
  • Adriablastin
  • Hydroxydaunomycin
  • Hydroxyl Daunorubicin
  • Hydroxyldaunorubicin

Drug: Doxorubicin Hydrochloride
Given IV
Other Names:
  • 123127
  • 14-Hydroxydaunorubicin Hydrochloride
  • Adriacin
  • Adriamycin Hydrochloride
  • Adriamycin PFS
  • Adriamycin RDF
  • Adriamycine
  • Adriblastina
  • Adriblastine
  • Chloridrato de Doxorrubicina
  • Doxorubicin HCl
  • Farmiblastina
  • hydroxydaunorubicin
  • hydrochloride
  • Rubex

Drug: Vincristine
Given IV
Other Names:
  • 22-Oxovincaleukoblastine
  • LEUROCRISTINE
  • VCR
  • Vincrystine

Drug: Vincristine Sulfate
Given IV
Other Names:
  • 2068-78-2
  • 67574
  • Kyocristine
  • Leurocristine sulfate
  • Oncovin
  • Vincasar
  • Vincosid
  • Vincrex
  • Vincristine

Drug: Prednisone
Given PO or IV
Other Names:
  • 2-Dehydrocortisone
  • Adasone
  • Cortancyl
  • Dacortin
  • DeCortin
  • Decortisyl
  • Decorton
  • Delta 1-Cortisone
  • Delta-Dome
  • Metacortandracin
  • Ofisolona
  • Orasone
  • Paracort
  • Predicor
  • Predicorten
  • Prednicort
  • Prednidib
  • Prednilonga
  • Predniment
  • Prednisone Intensol
  • Prednisonum
  • Prednitone
  • Promifen
  • Rayos
  • Servisone
  • SK-Prednisone

Drug: Cyclophosphamide
Given IV
Other Names:
  • Carloxan
  • Ciclofosfamida
  • Ciclofosfamide
  • Cicloxal
  • Clafen
  • Claphene
  • CP monohydrate
  • CTX
  • Cycloblastin
  • Cycloblastine
  • Cyclophospham
  • Cyclophosphamid monohydrate
  • Cyclophosphamidum
  • Cyclophosphan
  • Cyclophosphane
  • Cyclostin
  • Cyclostine
  • Cytoxan
  • Fosfaseron
  • Genoxal
  • Genuxal
  • Ledoxina
  • Mitoxan
  • Neosar
  • Revimmune
  • Syklofosfamid
  • WR- 138719

Biological: Inotuzumab Ozogamicin
Given IV
Other Names:
  • 635715-01-4
  • Besponsa
  • CMC-544
  • Way 207294
  • WAY-207294




Primary Outcome Measures :
  1. Maximum tolerated dose (MTD) of inotuzumab ozogamicin (InO) [ Time Frame: Up to 5 years ]

    Will be defined as the highest dose of InO administered in which the incidence of dose limiting toxicities (DLTs) is < 33%, assuming at least 6 patients have been treated at this dose. DLTs assessed by:

    • Non-hematologic toxicities >= grade 4 evaluated using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version (v) 5.0 (except for febrile neutropenia/infection, unless felt to be a direct consequence of treatment-related toxicity [e.g., intestinal infection following mucosal barrier breakdown]).
    • Any instance of possible, probably, or definite SOS/VOD
    • Inability to complete 1 full cycle due to treatment-related adverse events
    • Any treatment delays > 3 weeks (i.e., to Day 50 of Cycle 1) for recovery of prolonged toxicity


Secondary Outcome Measures :
  1. Complete response (CR) rate [ Time Frame: Up to 5 years ]
    Rate of complete response (CR) by bone marrow morphology and/or imaging.

  2. Rate of complete minimal residual disease (MRD) response [ Time Frame: Up to 5 years ]
    Assessed by multiparameter flow cytometry (MFC).

  3. Progression-free survival [ Time Frame: Up to 5 years ]
  4. Relapse-free survival [ Time Frame: Up to 5 years ]
  5. Overall survival [ Time Frame: Up to 5 years ]
  6. Rate at which patients proceed to subsequent allogeneic hematopoietic cell transplantation (HCT) [ Time Frame: Up to 5 years ]


Information from the National Library of Medicine

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.


Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have a confirmed diagnosis of CD22-positive, Philadelphia chromosome (Ph)-positive or Ph-negative B-cell acute lymphoblastic leukemia or lymphoblastic lymphoma. CD22 expression will be determined by multiparameter flow cytometry (MFC) or immunohistochemistry.
  • Relapsed or refractory disease, as defined by any of the following:

    • Unable to achieve complete response (CR) despite >= 4 weeks of initial course of systemic therapy.
    • Recurrence of disease at any point after CR was achieved. (Note: patients with Ph-positive disease must have received >= 1 second- or third-generation ABL kinase inhibitor as part of their prior treatment to be eligible.)
  • Detectable disease, as defined by the following:

    • Presence of >= 5% abnormal blasts in the bone marrow or peripheral blood by morphology or MFC.
    • Patients with isolated extramedullary disease will be permitted if there is >= 1 site of disease that measures >= 1.5 cm in longest diameter on cross-sectional imaging.
  • Absolute neutrophil count (ANC) >= 1,000/uL.
  • Hemoglobin >= 8 g/dL.
  • Platelets >= 50,000/uL.
  • Note: Transfusions and growth factor support will be permitted within 3 days of initiation of study treatment to reach these thresholds. As patients with relapsed/refractory ALL frequently have cytopenias due to marrow infiltration by the disease, no hematologic parameters will be required for enrollment if cytopenias can be attributed to disease.
  • Total serum bilirubin =< 1.5 x upper limit of normal (ULN); (unless due to Gilbert syndrome or hemolysis; =< 2 x ULN for hepatic abnormalities considered disease-related).
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 2.5 x ULN.
  • Serum creatinine =< 1.5 x ULN or serum creatinine level associated with a measured or calculated creatinine clearance of >= 40 mL/min.
  • Corrected QT (QTc) interval =< 500 msec; if assessed, left ventricular ejection fraction >= 40%.
  • An Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2.
  • Must agree to the use of effective contraception while on study treatment, unless they are highly unlikely to conceive (defined as [1] surgically sterilized, or [2] women who are and men whose sexual partner[s] is/are postmenopausal [i.e., a woman who is > 50 years old or who has not had menses for >= 1 year], or [3] not heterosexually active for the duration of the study).

Exclusion Criteria:

  • Patients with a circulating blast count of > 50,000/uL; systemic therapy with either hydroxyurea, vincristine, and/or corticosteroids will be permitted within 3 days of initiation of study treatment to reduce the blast count.
  • Except for management of circulating blasts noted above, adequate duration from prior therapy must be achieved before initiation of study treatment, as defined below:

    • No cytotoxic or targeted systemic therapy < 2 weeks.
    • No blinatumomab < 2 weeks.
    • No radiation therapy < 4 weeks.
    • No monoclonal antibody therapy < 6 weeks (except for prior InO, as discussed below).
  • Patients previously treated with InO will be eligible, unless they meet ANY of the following criteria:

    • > 6 individual doses (e.g., > 2 standard cycles) were administered.
    • Any documented hepatic toxicity observed was grade 3 or higher.
    • The most recent dose was administered < 3 months from the initiation of study treatment.
  • For patients that have received prior allogeneic HCT, they must be >= 4 months from the date of stem cell infusion, with no prior history of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD), and off all treatment for graft-vs-host disease (GVHD) for >= 2 weeks. Patients with minimal active symptoms that can be controlled with topical therapies and/or the equivalent of prednisone =< 10 mg/day will be eligible.
  • For patients that have received other forms of cellular immunotherapy (e.g., chimeric antigen receptor-modified [CAR] T cells), they must be >= 21 days from cell infusion, and any specific manifestations of cytokine release syndrome or neurologic toxicity attributable to the cellular therapy have completely resolved (i.e., < grade 1)
  • Patients with a known history of chronic liver disease, including but not limited to cirrhosis, steatohepatitis, and chronic viral hepatitis. Patients with a history of GVHD of the liver will be permitted, provided they meet all of the other eligibility criteria.
  • Patients with isolated testicular or central nervous system disease.
  • Known hypersensitivity or intolerance to any of the agents under investigation.
  • May not be pregnant or nursing.

Information from the National Library of Medicine

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): NCT03991884


Contacts
Layout table for location contacts
Contact: Ryan Cassaday 206-606-1202 cassaday@seattlecc.org

Locations
Layout table for location information
United States, Washington
Fred Hutch/University of Washington Cancer Consortium Recruiting
Seattle, Washington, United States, 98109
Contact: Ryan Cassaday         
Sponsors and Collaborators
University of Washington
National Cancer Institute (NCI)
Investigators
Layout table for investigator information
Principal Investigator: Ryan Cassaday Fred Hutch/University of Washington Cancer Consortium

Layout table for additonal information
Responsible Party: University of Washington
ClinicalTrials.gov Identifier: NCT03991884     History of Changes
Other Study ID Numbers: RG1004854
NCI-2019-03811 ( Registry Identifier: NCI / CTRP )
8786 ( Other Identifier: Fred Hutch/University of Washington Cancer Consortium )
P30CA015704 ( U.S. NIH Grant/Contract )
First Posted: June 19, 2019    Key Record Dates
Last Update Posted: December 6, 2019
Last Verified: December 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
Layout table for MeSH terms
Burkitt Lymphoma
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
Epstein-Barr Virus Infections
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Tumor Virus Infections
Lymphoma, B-Cell
Prednisone
Cyclophosphamide
Doxorubicin
Liposomal doxorubicin
Etoposide
Etoposide phosphate
Vincristine
Inotuzumab Ozogamicin
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Antirheumatic Agents