Status:

RECRUITING

A Study of Fludarabine Dosing in Children and Young Adults With B-cell Acute Lymphoblastic Leukemia

Lead Sponsor:

Memorial Sloan Kettering Cancer Center

Collaborating Sponsors:

Princess Maxima Center for Pediatric Oncology

Conditions:

B-cell Acute Lymphoblastic Leukemia

Eligibility:

All Genders

1+ years

Phase:

PHASE3

Brief Summary

The researchers are doing this study to find out whether PK-targeted fludarabine is an effective Lymphodepletion (LD) chemotherapy approach for people with relapsed/refractory B-cell acute lymphoblast...

Eligibility Criteria

Inclusion

  • Patients with B-ALL and eligible to receive commercial tisagenlecleucel.
  • Patient's weight \> 9 kg at time of lymphodepleting chemotherapy
  • Adequate organ function at time of LD is required and is defined:
  • Hepatic: Serum bilirubin ≤ 2 mg/dL, unless benign congenital hyperbilirubinemia
  • Hepatic: AST and ALT \< 5x the upper limit of normal for age, unless thought to be leukemic disease-related
  • Renal: Calculated glomerular filtration rate (GFR) ≥ 70 ml/min/1.73m\^2. (based on Schwartz formula GFR (mL/min/1.73 m²) = (36.2 × Height in cm) / Creatinine in μmol/L
  • Cardiac: LVEF ≥ 50% by multi-gated acquisition scan (MUGA), resting echocardiogram, or cardiac magnetic resonance imaging (MRI) within 6 weeks of screening
  • Pulmonary: Oxygen saturation as recorded by pulse oximetry of ≥ 90% on room air
  • Adequate performance status:
  • Age ≥ 16 years: ECOG ≤ 1 or Karnofsky \> 60% at treatment
  • Age \< 16 years: Lansky ≥ 60% at treatment
  • Willing to participate as research subject and provide written informed consent from parents/legal representative, patient, and age-appropriate assent as appropriate before any study specific screening procedures are conducted, according to local, regional or national law and legislation.

Exclusion

  • Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to the study drugs, or drugs chemically related to study treatment or excipients that contraindicate their participation, including fludarabine, cyclophosphamide and tisagenlecleucel.
  • Patients with tisagenlecleucel that is deemed out of specification (OOS) will be excluded from this protocol
  • Clinically significant active and uncontrolled infection confirmed by clinical evidence, imaging, or positive laboratory tests (e.g., blood cultures, PCR for DNA/RNA etc.)
  • Patient/parent/guardian unable to give informed consent or unable to comply with the treatment protocol.
  • Pregnant or lactating women

Key Trial Info

Start Date :

October 20 2025

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

October 1 2028

Estimated Enrollment :

130 Patients enrolled

Trial Details

Trial ID

NCT07223021

Start Date

October 20 2025

End Date

October 1 2028

Last Update

January 8 2026

Active Locations (1)

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1

Memorial Sloan Kettering Cancer Center

New York, New York, United States, 10065