Basic Trial Information
Trial Description
     Summary
     Further Trial Information
     Eligibility Criteria
Trial Contact Information

Basic Trial Information

Trial Description

Summary

This phase II trial is studying the side effects of giving combination chemotherapy together with or without donor stem cell transplant and to see how well it works in treating patients with acute lymphoblastic leukemia. 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. Giving chemotherapy and total-body irradiation before a donor stem cell transplant helps stop the growth of cancer cells. It also stops the patient's immune system from rejecting the donor's stem cells. The donated stem cells may replace the patient's immune cells and help destroy any remaining cancer cells (graft-versus-tumor effect).

Further Study Information

PRIMARY OBJECTIVES:

I. To test whether the relapse-free survival after allogeneic stem cell transplantation among Philadelphia chromosome positive and/or BCR/ABL positive acute lymphoblastic leukemia (ALL) patients given an intensive short-term chemotherapy regimen of hyper-CVAD in combination with the tyrosine kinase inhibitor dasatinib is sufficiently high to warrant further investigation.

SECONDARY OBJECTIVES:

I. To test whether the continuous complete remission rate for previously untreated Philadelphia chromosome positive and/or BCR/ABL positive acute lymphoblastic leukemia (ALL) patients given an intensive short-term chemotherapy regimen of hyper-CVAD in combination with the tyrosine kinase inhibitor dasatinib is sufficiently high to warrant phase III investigation.

II. To investigate in a preliminary manner the relative effectiveness of minimal residual disease (MRD) detection using real-time quantitative polymerase chain reaction (PCR) for BCR/ABL versus flow cytometry to predict the outcome of patients treated by the hyper-CVAD + dasatinib regimen and/or allogeneic stem cell transplant.

TERTIARY OBJECTIVES:

I. To estimate the frequency and severity of toxicities of the intensive short-term chemotherapy regimen in these patients.

II. To estimate the overall survival of all patients on this study.

OUTLINE: This is a multicenter study.

Patients are stratified according to prior treatment and response (untreated vs achieved complete remission [CR] with or without [CRi] hematopoietic recovery vs treated, refractory, and no CR or CRi).

INDUCTION/CONSOLIDATION THERAPY: All patients receive both of the following regimens in alternating courses:

COURSES 1, 3, 5, 7 or 3, 5, 7, 9: Patients receive cyclophosphamide intravenously (IV) over 3 hours twice daily (BID) on days 1-3; doxorubicin hydrochloride IV over 24 hours on day 4; vincristine sulfate IV over 30 minutes on days 4 and 11; dexamethasone IV or orally (PO) once daily (QD) on days 1-4 and 11-14; dasatinib PO QD on days 1-14; cytarabine intrathecally (IT) on day 7; methotrexate IT on day 2; and filgrastim (G-CSF) subcutaneously (SC) QD or BID.

COURSES 2, 4, 6, 8: Patients receive high-dose methotrexate IV over 24 hours on day 1; methylprednisolone IV over 30 minutes BID on days 1-3; dasatinib PO QD on days 1-14; high-dose cytarabine IV over 2 hours BID on days 2-3; leucovorin calcium IV on days 2 or 3; methotrexate IT on day 2; cytarabine IT on day 7; and G-CSF SC QD or BID.

Treatment repeats every 14-21 days for 8 courses in the absence of disease progression, unacceptable toxicity, or if patient achieves CR or CRi.

MAINTENANCE THERAPY*: Patients receive vincristine sulfate IV over 30 minutes on day 1, prednisone PO QD on days 1-5, and dasatinib PO QD on days 1-28.

Treatment repeats every month for 24 courses in the absence of disease progression or unacceptable toxicity or until the transplant is ready.

INTENSIFICATION: For courses 6 and 13, patients receive cyclophosphamide IV over 3 hours BID on days 1-3; doxorubicin hydrochloride IV over 24 hours on day 4; vincristine sulfate IV over 30 minutes on days 4 and 11; dexamethasone IV or PO QD on days 1-4 and 11-14; dasatinib PO QD on days 1-14; and G-CSF SC QD or BID.

NOTE: *Only if transplantation is not ready after induction/consolidation therapy or patients are not undergoing a transplant.

ALLOGENEIC STEM CELL TRANSPLANTATION (FOR PATIENTS ACHIEVING CR OR CRi):

CONDITIONING REGIMEN: Patients receive 1 of the following regimens:

REGIMEN A: Patients receive total-body irradiation (TBI) QD on days -7 to -4 and cyclophosphamide IV on days -3 and -2.

REGIMEN B: Patients receive TBI BID on days -6 to -4 and cyclophosphamide IV on days -3 and -2.

REGIMEN C: Patients receive cyclophosphamide IV on days -7 and -6 and TBI QD on days -4 to -1.

REGIMEN D: Patients receive cyclophosphamide IV on days -6 and -5 and TBI BID on days -3 to -1.

REGIMEN E: Patients receive TBI QD on days -7 to -4 and etoposide IV on day -3.

REGIMEN F: Patients receive TBI BID on days -6 to -4 and etoposide IV on day -3.

ALLOGENEIC STEM CALL TRANSPLANTATION: Patients undergo allogeneic stem cell transplantation on day 0.

GRAFT-VS-HOST DISEASE (GVHD) PROPHYLAXIS: Patients receive 1 of the following regimens:

REGIMEN A: Patients receive sirolimus PO and tacrolimus IV continuously (changing to PO BID) beginning on day -3 and continuing for 6 months.

REGIMEN B: Patients receive tacrolimus IV continuously (changing to PO BID) and continuing for 6 months, and methotrexate IV on days 1, 3, 6, and 11.

SINGLE-AGENT THERAPY: After completion of maintenance therapy or beginning on day 100 post-transplantation, patients receive dasatinib PO QD for up to 5 years.

Bone marrow and blood samples are collected periodically for cytogenetic analysis by PCR and flow cytometry.

After completion of study therapy, patients are followed every 6 months for up to 5 years.

Eligibility Criteria

Inclusion Criteria:

• Patients must have a morphologic diagnosis of acute lymphoblastic leukemia (ALL), with evidence of ALL involvement in bone marrow and/or blood; patients with only extramedullary disease in the absence of bone marrow or blood involvement are not eligible; patients with M0 acute myeloid leukemia (AML) or mixed lineage leukemia are not eligible for this study; patients with L3 (Burkitts) are also not eligible

• For ALL in marrow or peripheral blood, immunophenotyping of the blood or marrow lymphoblasts must be performed to determine lineage (B cell, T-cell, or mixed B/T cell); NOTE: appropriate marker studies including CD19 (B cell), CD10, CD5, and CD7 (T cell) must be performed; co-expression of myeloid antigens (CD13 and CD33) will not exclude patients; if possible, the lineage specific markers cytoplasmic CD22 or CD79a (B cells), cytoplasmic CD3 (T cells) and cytoplasmic MPO (myeloid cells) must be determined

• Patients may have received no more than one course of remission induction therapy for ALL; patients who have received any post-remission therapy for ALL or who have relapsed from complete remission are not eligible; (patients with previously untreated ALL can be eligible, and patients who have received one course of remission induction therapy for ALL can be eligible, regardless of their response to therapy); patients may have received no more than 14 days of tyrosine kinase inhibitor therapy prior to registration; any prior induction chemotherapy must have been completed no more than 28 days prior to registration

• NOTE: If the patient has been initiated on the protocol defined regimen (i.e. the hyperCVAD regimen without a tyrosine kinase inhibitor) before the Philadelphia chromosome (Ph)/breakpoint cluster region (BCR)-Abelson murine leukemia viral oncogene (ABL) status was known, the patient may be registered on the protocol and start dasatinib; in this first course, dasatinib will be administered up to day 14 (i.e. if the patient is registered on day 5 and starts therapy on day 6, only 8 days of dasatinib will be administered and dasatinib will be completed on day 14)

• For patients who have received any prior therapy that was NOT remission induction therapy, one of the following must be true:

• At least 6 weeks must have elapsed since any monoclonal antibodies were given, at least 7 days must have elapsed since any other treatment was given, and all toxicities of the remission induction therapy must have resolved to grade =< 2

• The patient must have rapidly progressive disease (per institutional guidelines)

• For previously treated patients, the Study Chair must be contacted before registration, in order to determine the regimen to be given in the first course of induction/consolidation therapy, based on prior therapy

• Patients must be Ph positive and/or BCR/ABL positive as confirmed by standard cytogenetics, fluorescent in situ hybridization (FISH), and/or polymerase chain reaction (PCR) testing performed by local laboratory; NOTE: samples will be submitted centrally for verification of results

• Patients must have a bilirubin =< 3.0 x institutional upper limit of normal (IULN) within 14 days prior to registration

• Patients must have serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 3.0 x IULN and/or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 3.0 x IULN within 14 days prior to registration; if both tests are done then both values must be =< 3.0 x IULN

• Patients must have a serum creatinine =< 3.0 x IULN within 14 days prior to registration

• Patients must not have active pericardial effusion, ascites, or pleural effusion of any grade; exception: if the effusion is suspected to be related to the leukemia, the patient may have pericardial effusion of =< grade 2 or pleural effusion =< grade 1

• Patients may not have any clinically significant cardiovascular disease including the following:

• Myocardial infarction or ventricular tachyarrhythmia within 6 months

• Prolonged corrected QT (QTc) > 480 msec (Fridericia correction)

• Ejection fraction less than institutional normal

• Major conduction abnormality (unless a cardiac pacemaker is present)

• Patients with any cardiopulmonary symptoms of unknown cause (e.g. shortness of breath, chest pain, etc.) should be evaluated by a baseline echocardiogram with or without stress test as needed in addition to electrocardiogram (EKG) to rule out QTc prolongation; the patient may be referred to a cardiologist at the discretion of the principal investigator; patients with underlying cardiopulmonary dysfunction should be excluded from the study

• Patients must have Zubrod performance status of 0-2

• No other prior malignancy is allowed except for the following: adequately treated basal cell or squamous cell skin cancer, in situ cervical cancer, adequately treated stage I or II cancer from which the patient is currently in complete remission, or any other cancer from which the patient has been disease-free for 5 years

• Collection and submission of pre-treatment cytogenetic specimens must be completed within 28 days prior to registration on S0805

• Collection and submission of pretreatment marrow and/or peripheral blood specimens for cellular and molecular studies, including verification of BCR/ABL status must be completed within 28 days prior to registration

• Patients must not be pregnant or nursing because of the teratogenic potential of the drugs used in this study; women/men of reproductive potential must have agreed to use an effective contraceptive method; a woman is considered to be of "reproductive potential" if she has had menses at any time in the preceding 12 consecutive months; in addition to routine contraceptive methods, "effective contraception" also includes heterosexual celibacy and surgery intended to prevent pregnancy (or with a side-effect of pregnancy prevention) defined as a hysterectomy, bilateral oophorectomy or bilateral tubal ligation; however, if at any point a previously celibate patient chooses to become heterosexually active during the time period for use of contraceptive measures outlined in the protocol, he/she is responsible for beginning contraceptive measures

• Patients must not have prior history of known type I hypersensitivity or anaphylactic reactions to doxorubicin

• Patients or their legally authorized representative must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with institutional and federal guidelines

• At the time of patient registration, the treating institution's name and identification (ID) number must be provided to the Data Operations Center in Seattle in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered into the data base

Trial Contact Information

Trial Lead Organizations/Sponsors

National Cancer Institute

Farhad Ravandi-Kashani

Principal Investigator

U.S.A.
Arizona
	Tucson
	Arizona Cancer Center at University Medical Center North
		Andrew M. Yeager	Ph: 520-626-9008
	Arizona Cancer Center at University of Arizona Health Sciences Center
		Andrew M. Yeager	Ph: 520-626-9008
California
	Duarte
	City of Hope Comprehensive Cancer Center
		Margaret R. O'Donnell	Ph: 800-826-4673
			Email: becomingapatient@coh.org
	Sacramento
	University of California Davis Cancer Center
		Joseph M. Tuscano	Ph: 916-734-3089
Florida
	Gainesville
	University of Florida Shands Cancer Center
		John R Wingard	Ph: 352-273-8675
			Email: trials@cancer.ufl.edu
	Orlando
	Florida Hospital Cancer Institute at Florida Hospital Orlando
		Lee M. Zehngebot	Ph: 407-303-5623
Georgia
	Atlanta
	Winship Cancer Institute of Emory University
		Leonard Thompson Heffner	Ph: 404-778-1868
Illinois
	Chicago
	Robert H. Lurie Comprehensive Cancer Center at Northwestern University
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	University of Chicago Cancer Research Center
		Wendy Stock	Ph: 773-834-7424
	Highland Park
	Hematology Oncology Associates of Illinois-Highland Park
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	Kankakee
	Provena St. Mary's Regional Cancer Center - Kankakee
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	Libertyville
	North Shore Oncology and Hematology Associates, Limited - Libertyville
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	Maywood
	Cardinal Bernardin Cancer Center at Loyola University Medical Center
		Aileen Go	Ph: 708-226-4357
	Niles
	Cancer Care and Hematology Specialists of Chicagoland - Niles
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	Skokie
	Hematology Oncology Associates - Skokie
		Olga Frankfurt	Ph: 312-695-1301
			Email: cancer@northwestern.edu
	Springfield
	Regional Cancer Center at Memorial Medical Center
		James L. Wade	Ph: 217-876-4740
			Email: kcheek@dmhhs.org
Indiana
	Beech Grove
	St. Francis Hospital and Health Centers - Beech Grove Campus
		Howard M. Gross	Ph: 765-983-3000
	Fort Wayne
	Fort Wayne Medical Oncology and Hematology
		Sreenivasa Rao Nattam	Ph: 260-484-8830
			Email: ledgar@fwmoh.com
Iowa
	Sioux City
	Mercy Medical Center - Sioux City
		Donald Bruce Wender	Ph: 712-252-0088
	Siouxland Hematology-Oncology Associates, LLP
		Donald Bruce Wender	Ph: 712-252-0088
	St. Luke's Regional Medical Center
		Donald Bruce Wender	Ph: 712-252-0088
Kansas
	Chanute
	Cancer Center of Kansas, PA - Chanute
		Shaker R. Dakhil	Ph: 316-262-4467
	Dodge City
	Cancer Center of Kansas, PA - Dodge City
		Shaker R. Dakhil	Ph: 316-262-4467
	El Dorado
	Cancer Center of Kansas, PA - El Dorado
		Shaker R. Dakhil	Ph: 316-262-4467
	Fort Scott
	Cancer Center of Kansas - Fort Scott
		Shaker R. Dakhil	Ph: 316-262-4467
	Independence
	Cancer Center of Kansas-Independence
		Shaker R. Dakhil	Ph: 316-262-4467
	Kingman
	Cancer Center of Kansas, PA - Kingman
		Shaker R. Dakhil	Ph: 316-262-4467
	Lawrence
	Lawrence Memorial Hospital
		Shaker R. Dakhil	Ph: 316-262-4467
	Liberal
	Cancer Center of Kansas, PA - Liberal
		Shaker R. Dakhil	Ph: 316-262-4467
	Newton
	Cancer Center of Kansas, PA - Newton
		Shaker R. Dakhil	Ph: 316-262-4467
	Parsons
	Cancer Center of Kansas, PA - Parsons
		Shaker R. Dakhil	Ph: 316-262-4467
	Pratt
	Cancer Center of Kansas, PA - Pratt
		Shaker R. Dakhil	Ph: 316-262-4467
	Salina
	Cancer Center of Kansas, PA - Salina
		Shaker R. Dakhil	Ph: 316-262-4467
	Wellington
	Cancer Center of Kansas, PA - Wellington
		Shaker R. Dakhil	Ph: 316-262-4467
	Wichita
	Associates in Women's Health, PA - North Hillside
		Shaker R. Dakhil	Ph: 316-262-4467
	Cancer Center of Kansas, PA - Medical Arts Tower
		Shaker R. Dakhil	Ph: 316-262-4467
	Cancer Center of Kansas, PA - Wichita
		Shaker R. Dakhil	Ph: 316-262-4467
	CCOP - Wichita
		Shaker R. Dakhil	Ph: 316-262-4467
	Via Christi Cancer Center at Via Christi Regional Medical Center
		Shaker R. Dakhil	Ph: 316-262-4467
	Wesley Medical Center
		Shaker R. Dakhil	Ph: 316-262-4467
	Winfield
	Cancer Center of Kansas, PA - Winfield
		Shaker R. Dakhil	Ph: 316-262-4467
Kentucky
	Lexington
	University of Kentucky Chandler Medical Center
		Dianna S Howard	Ph: 859-257-3379
Louisiana
	Baton Rouge
	Hematology-Oncology Clinic
		Hana F Safah	Ph: 504-988-6121
	New Orleans
	Tulane Cancer Center at Tulane University Hospital and Clinic
		Hana F Safah	Ph: 504-988-6121
	Shreveport
	Feist-Weiller Cancer Center at Louisiana State University Health Sciences
		Glenn M. Mills	Ph: 318-813-1412
Maryland
	Baltimore
	Greenebaum Cancer Center at University of Maryland Medical Center
		Maria R. Baer	Ph: 800-888-8823
	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
		Hetty E Carraway	Ph: 410-955-8804
			Email: jhcccro@jhmi.edu
Michigan
	Ann Arbor
	University of Michigan Comprehensive Cancer Center
		Dale L Bixby	Ph: 800-865-1125
	Detroit
	Wayne State University
		Charles A. Schiffer	Ph: 313-576-9363
Minnesota
	Rochester
	Mayo Clinic Cancer Center
		Mark R. Litzow	Ph: 507-538-7623
Missouri
	Saint Louis
	Saint Louis University Cancer Center
		Mark J Fesler	Ph: 314-977-4440
	Siteman Cancer Center at Barnes-Jewish Hospital - Saint Louis
		Geoffrey L Uy	Ph: 800-600-3606
			Email: info@siteman.wustl.edu
Montana
	Billings
	Billings Clinic Cancer Center - 801 N 29th Street
		Benjamin Thomas Marchello	Ph: 800-648-6274
	CCOP - Montana Cancer Consortium
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Hematology-Oncology Centers of the Northern Rockies - Billings
		Benjamin Thomas Marchello	Ph: 800-648-6274
	St. Vincent Healthcare Cancer Care Services
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Bozeman
	Bozeman Deaconess Cancer Center
		Benjamin Thomas Marchello	Ph: 800-648-6274
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Butte
	St. James Healthcare Cancer Care
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Great Falls
	Benefis Sletten Cancer Institute
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Helena
	St. Peter's Hospital
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Kalispell
	Kalispell Regional Medical Center
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Missoula
	Montana Cancer Center at St. Patrick Hospital and Health Sciences Center
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Montana Cancer Specialists at Montana Cancer Center
		Benjamin Thomas Marchello	Ph: 800-648-6274
New York
	Buffalo
	Roswell Park Cancer Institute
		Meir Wetzler	Ph: 877-275-7724
	Rochester
	James P. Wilmot Cancer Center at University of Rochester Medical Center
		Jonathan W Friedberg	Ph: 585-275-5830
North Carolina
	Chapel Hill
	Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
		Matthew C Foster	Ph: 877-668-0683
Ohio
	Cincinnati
	Jewish Hospital Cancer Center
		James H. Essell	Ph: 513-585-2859
	Cleveland
	Cleveland Clinic Taussig Cancer Center
		Anjali S Advani	Ph: 866-223-8100
	Lima
	St. Rita's Medical Center
		Henry Gerad	Ph: 419-226-9617
Oklahoma
	Oklahoma City
	Oklahoma University Cancer Institute
		George B Selby	Ph: 405-271-4272
			Email: julie-traylor@ouhsc.edu
Pennsylvania
	Hershey
	Penn State Hershey Cancer Institute at Milton S. Hershey Medical Center
		David F Claxton	Ph: 717-531-3779
			Email: CTO@hmc.psu.edu
	Lewistown
	Lewistown Hospital
		David F Claxton	Ph: 717-531-3779
			Email: CTO@hmc.psu.edu
	Philadelphia
	Abramson Cancer Center of the University of Pennsylvania
		Selina M. Luger	Ph: 800-474-9892
	State College
	Mount Nittany Medical Center
		David F Claxton	Ph: 717-531-3779
			Email: CTO@hmc.psu.edu
South Carolina
	Charleston
	Hollings Cancer Center at Medical University of South Carolina
		Robert Kenneth Stuart	Ph: 843-792-9321
South Dakota
	Sioux Falls
	Avera Cancer Institute
		Addison R Tolentino	Ph: 800-657-4377
			Email: Jan.Healy@avera.org
Tennessee
	Nashville
	Vanderbilt-Ingram Cancer Center
		John P. Greer	Ph: 800-811-8480
Texas
	San Antonio
	Southwest Oncology Group
		Farhad Ravandi-Kashani
			Email: fravandi@mdanderson.org
		Farhad Ravandi-Kashani	Ph: 713-792-3245
			Email: fravandi@mdanderson.org
Utah
	American Fork
	American Fork Hospital
		Julie D Asch	Ph: 801-408-1347
	Cedar City
	Sandra L. Maxwell Cancer Center
		Julie D Asch	Ph: 801-408-1347
	Logan
	Logan Regional Hospital
		Julie D Asch	Ph: 801-408-1347
	Murray
	Jon and Karen Huntsman Cancer Center at Intermountain Medical Center
		Julie D Asch	Ph: 801-408-1347
	Ogden
	Val and Ann Browning Cancer Center at McKay-Dee Hospital Center
		Julie D Asch	Ph: 801-408-1347
	Provo
	Utah Valley Regional Medical Center - Provo
		Julie D Asch	Ph: 801-408-1347
	Saint George
	Dixie Regional Medical Center - East Campus
		Julie D Asch	Ph: 801-408-1347
	Salt Lake City
	Huntsman Cancer Institute at University of Utah
		Paul J. Shami	Ph: 801-581-4477
			Email: clinical.trials@hci.utah.edu
	LDS Hospital
		Julie D Asch	Ph: 801-408-1347
	Utah Cancer Specialists at UCS Cancer Center
		Julie D Asch	Ph: 801-408-1347
Washington
	Anacortes
	Cancer Care Center at Island Hogs
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Bellingham
	St. Joseph Cancer Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Bremerton
	Olympic Hematology and Oncology
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Burien
	Highline Medical Center Cancer Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Edmonds
	Swedish Cancer Institute at Stevens Hospital
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Issaquah
	Swedish Medical Center - Issaquah Campus
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Kennewick
	Columbia Basin Hematology
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Mount Vernon
	Skagit Valley Hospital Cancer Care Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Poulsbo
	Harrison Poulsbo Hematology and Onocology
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Seattle
	Fred Hutchinson Cancer Research Center/University of Washington Cancer Consortium
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Group Health Central Hospital
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Harborview Medical Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Minor and James Medical, PLLC
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Polyclinic First Hill
		Saul E. Rivkin	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Swedish Cancer Institute at Swedish Medical Center - First Hill Campus
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	University Cancer Center at University of Washington Medical Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Sedro-Woolley
	North Puget Oncology at United General Hospital
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Spokane
	Cancer Care Northwest - Spokane South
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Evergreen Hematology and Oncology, PS
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
	Wenatchee
	Wenatchee Valley Medical Center
		Gary E Goodman	Ph: 206-386-2323
			Email: patra.grevstad@swedish.org
West Virginia
	Morgantown
	Mary Babb Randolph Cancer Center at West Virginia University Hospitals
		Michael D Craig	Ph: 304-293-2745
			Email: sfilburn@hsc.wvu.edu
Wisconsin
	Milwaukee
	Froedtert Hospital and Medical College of Wisconsin
		Ehab L Atallah	Ph: 414-805-4380
Wyoming
	Casper
	Rocky Mountain Oncology
		Benjamin Thomas Marchello	Ph: 800-648-6274
	Sheridan
	Welch Cancer Center at Sheridan Memorial Hospital
		Benjamin Thomas Marchello	Ph: 800-648-6274

Link to the current ClinicalTrials.gov record.
NLM Identifer NCT00792948
ClinicalTrials.gov processed this data on June 17, 2013

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