RECRUITING

Study to Test OBI-3424 in Patients With T-Cell Acute Lymphoblastic Leukemia (T-ALL) or T-Cell Lymphoblastic Lymphoma (T-LBL)

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This phase I/II trial studies the safety, side effects and best dose of OBI-3424 and how well it works in treating patients with T-cell acute lymphoblastic leukemia or T-cell lymphoblastic lymphoma that has come back (relapsed) or does not respond to treatment (refractory). Chemotherapy drugs, such as OBI-3424, 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. OBI-3424 may reduce the amount of leukemia in the body.

Official Title

A Phase I/II Study of AKR1C3-Activated Prodrug OBI-3424 (OBI-3424) In Patients With Relapsed/Refractory T-Cell Acute Lymphoblastic Leukemia (T-ALL)/T-Cell Lymphoblastic Lymphoma (T-LBL)

Quick Facts

Study Start:2021-02-08
Study Completion:2028-08-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04315324

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:12 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:CHILD, ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Patients must have a diagnosis of relapsed or refractory T-cell acute lymphoblastic leukemia (T-ALL) based on World Health Organization (WHO) classification. Patients with relapsed/refractory T-cell lymphoblastic lymphoma are eligible if lymphoblasts are \>= 5% in the bone marrow or in the peripheral blood by morphology or flow cytometry
  2. * Patients must have evidence of acute leukemia in their peripheral blood or bone marrow. Patients must have \>= 5% lymphoblasts in the peripheral blood or bone marrow within 14 days prior to registration. Patients with only extramedullary disease are not eligible
  3. * Patients ≥ 18 years of age must be refractory to or have relapsed following a standard induction chemotherapy. Patients \< 18 years of age must have relapsed or must be refractory after 2 or more chemotherapy cycles (example: induction and consolidation)
  4. * A standard chemotherapy induction regimen is defined as any program of treatment that includes:
  5. * Vincristine and corticosteroids plus at least one more chemotherapy agent
  6. * Cytarabine and anthracycline, or
  7. * High dose cytarabine (defined as at least 1 gr/m\^2 per individual dose unless adjustments were required for renal/liver function)
  8. * Patients must have no evidence of central nervous system disease within 28 days prior to registration based on cerebrospinal fluid (CSF) studies. Patients with clinical signs or symptoms consistent with central nervous system (CNS) involvement must have a lumbar puncture which is negative for CNS involvement; the lumbar puncture must be completed within 28 days prior to registration. Patients with CNS1 or CNS2 are eligible; however patients with CNS3 are not eligible
  9. * Note that the patients may receive intrathecal chemotherapy with the initial lumbar puncture. This may count as the first dose of intrathecal therapy required as part of the study
  10. * Prior nelarabine therapy is not required. In addition, for patients ≥ 18 years of age who received nelarabine during initial induction or post-remission treatment are eligible only if the physician does not feel they would benefit from other, multi-agent chemotherapy
  11. * Patients must not have had chemotherapy or investigational agents within 14 days prior to registration except for corticosteroids, oral 6-mercaptopurine, oral methotrexate, vincristine, intrathecal chemotherapy, or hydroxyurea. For participants who have received radiation therapy, at least 7 days must have elapsed from the end of radiation prior to registration and participants must not currently be experiencing toxicities from radiation therapy
  12. * Patients must not have undergone allogeneic hematopoietic transplant within 90 days prior to registration
  13. * Patients must have no evidence of active \>= grade 2 acute graft versus host disease (GVHD) or moderate or severe limited chronic GVHD. Patients must have no history of extensive GVHD of any severity within 90 days prior to registration. Patients who are post-transplant must be off calcineurin inhibitors for at least 21 days to be eligible. Extensive GVHD is defined as 1) generalized skin involvement or 2) localized skin involvement and/or hepatic dysfunction plus liver histology or cirrhosis or involvement of eye or minor salivary organ or oral mucosa or any other target organ
  14. * Patients must be \>= 12 years of age
  15. * Patients ≥ 16 years of age must have a Zubrod Performance Status of 0-3. Patients \< 16 years of age must have a Lansky score of ≥ 50
  16. * Patients must not have systemic fungal, bacterial, viral or other infection that is not controlled (defined as exhibiting ongoing signs/symptoms related to the infection and without improvement, despite appropriate antibiotics or other treatment) within 14 days prior to registration
  17. * Patients ≥ 18 years of age must have creatinine clearance \> 30 mL/min within 14 days prior to registration according to the Cockcroft Gault equation
  18. * Patients 12-17 years of age must have adequate renal function within 14 days prior to registration defined as serum creatinine ≤ 1.5 x institutional upper limit of normal (ULN) according to age or a calculated estimated glomerular filtration rate (eGFR) (based on Schwartz formula) or radioisotope glomerular filtration rate (GFR) ≥ 50ml/min/1.73 m\^2
  19. * Patients must have direct bilirubin =\< 1.5 x institutional upper limit of normal (ULN) within 14 days prior to registration
  20. * Patients must have alanine aminotransferase (ALT) =\< 3.0 x institutional upper limit of normal (ULN) or =\< 5.0 x ULN (if thought to be related to leukemic involvement) within 14 days prior to registration
  21. * Prothrombin time (PT)/partial thromboplastin time (PTT)/ fibrinogen (as clinically indicated for example but not limited to history of bleeding or active bleeding, concern for disseminated intravascular coagulation) (within 14 days prior to registration to obtain baseline measurements)
  22. * From metabolic panel (comprehensive or basic): sodium, potassium, chloride, carbon dioxide (CO2), and blood urea nitrogen (BUN) (within 14 days prior to registration to obtain baseline measurements)
  23. * Patients must be able to safely discontinue use of strong inhibitors/inducers of CYP3A4 or PgP-g-p and must be able to safely discontinue use of naproxen for 48 hours before and after each dose of OBI-3424
  24. * Patients with known human immunodeficiency virus (HIV)-infection are eligible providing they are on effective anti-retroviral therapy and have undetectable viral load at their most recent viral load test within 6 months prior to registration. (HIV viral load testing is required only for patients with known HIV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
  25. * Patients with evidence of chronic hepatitis B virus (HBV) infection may be eligible provided that they have an undetectable HBV viral load within 28 days prior to registration. Patients may be currently receiving HBV treatment. (HBV viral load testing is required only for patients with known HBV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
  26. * Patients with known history of hepatitis C virus (HCV) infection may be eligible provided that they have an undetectable HCV viral load within in 28 days prior to registration. Patients may be currently receiving treatment. (HCV viral load testing is required only for patients with known HCV infection). Patients must not be receiving antiviral therapies that are known strong inhibitors or inducers of CYP3A4
  27. * Patients must not have a known history of prolonged QT interval by Fridericia (QTcF) (interval \> 450 msec for males; \> 470 msec for females). Patients that had transient prolongation of QTc secondary to medications or electrolyte abnormalities are not excluded if the QTc normalized and remain within acceptable QTcF range (interval \> 450 msec for males; \> 470 msec for females). Additionally, suspected medications should be no longer required or used, and electrolyte abnormalities must have normalized
  28. * Patients must not be pregnant or nursing due to the teratogenic potential of the drug used on this study. Females of reproductive potential must have a negative serum pregnancy test within 14 days prior to registration. Women/men of reproductive potential must have agreed to use an effective contraceptive method during and up to 6 months after treatment. 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
  29. * Patients must not have other active malignancies for which they have received treatments within 6 months prior to registration excluding localized malignancies that do not require systemic treatment
  30. * Patients must agree to have bone marrow and blood specimens submitted for MRD testing
  31. * Patients must be offered the opportunity to participate in specimen banking. With patient consent, residuals from specimens submitted will be retained and banked for future research
  32. * Patients must be informed of the investigational nature of this study and must sign and give written informed consent in accordance with fedral, local, institutional and Central Institutional Review Board (CIRB) guidelines unless they are unable to provide consent based on age (\< 18 years) or based on impaired decision-making capabilities. For patients \< 18 years of age or with impaired decision making capabilities, parents or other legally authorized representatives must sign and give informed consent on behalf of study participants in accordance with applicable federal, local, institutional and CIRB regulations
  33. * As a part of the Oncology Patient Enrollment Network (OPEN) registration process the treating institution's identity is provided in order to ensure that the current (within 365 days) date of institutional review board approval for this study has been entered in the system
  34. * This trial will use a slot reservation system to enroll the Phase I portion of the study. Patients planning to enroll at this phase of the study must first have a slot reserved in advance of the registration. All site staff will use OPEN to create a slot reservation
  1. Pregnancy or breastfeeding
  2. Severe psychiatric disorders
  3. Active substance abuse
  4. Unstable medical conditions
  5. Inability to comply with study requirements

Contacts and Locations

Principal Investigator

Anjali S Advani
PRINCIPAL_INVESTIGATOR
SWOG Cancer Research Network

Study Locations (Sites)

University of Alabama at Birmingham Cancer Center
Birmingham, Alabama, 35233
United States
Kingman Regional Medical Center
Kingman, Arizona, 86401
United States
Arkansas Children's Hospital
Little Rock, Arkansas, 72202-3591
United States
PCR Oncology
Arroyo Grande, California, 93420
United States
City of Hope Comprehensive Cancer Center
Duarte, California, 91010
United States
Loma Linda University Medical Center
Loma Linda, California, 92354
United States
Children's Hospital of Orange County
Orange, California, 92868
United States
Children's Hospital Colorado
Aurora, Colorado, 80045
United States
Alfred I duPont Hospital for Children
Wilmington, Delaware, 19803
United States
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, 33908
United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital
Hollywood, Florida, 33021
United States
Johns Hopkins All Children's Hospital
Saint Petersburg, Florida, 33701
United States
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, 30322
United States
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, 30329
United States
Augusta University Medical Center
Augusta, Georgia, 30912
United States
Loyola Center for Health at Burr Ridge
Burr Ridge, Illinois, 60527
United States
Lurie Children's Hospital-Chicago
Chicago, Illinois, 60611
United States
Northwestern University
Chicago, Illinois, 60611
United States
University of Illinois
Chicago, Illinois, 60612
United States
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, 60637
United States
Loyola Medicine Homer Glen
Homer Glen, Illinois, 60491
United States
Northwestern Medicine Lake Forest Hospital
Lake Forest, Illinois, 60045
United States
Loyola University Medical Center
Maywood, Illinois, 60153
United States
Marjorie Weinberg Cancer Center at Loyola-Gottlieb
Melrose Park, Illinois, 60160
United States
UC Comprehensive Cancer Center at Silver Cross
New Lenox, Illinois, 60451
United States
University of Chicago Medicine-Orland Park
Orland Park, Illinois, 60462
United States
Southern Illinois University School of Medicine
Springfield, Illinois, 62702
United States
Mary Greeley Medical Center
Ames, Iowa, 50010
United States
McFarland Clinic - Ames
Ames, Iowa, 50010
United States
McFarland Clinic - Boone
Boone, Iowa, 50036
United States
McFarland Clinic - Trinity Cancer Center
Fort Dodge, Iowa, 50501
United States
McFarland Clinic - Jefferson
Jefferson, Iowa, 50129
United States
McFarland Clinic - Marshalltown
Marshalltown, Iowa, 50158
United States
Norton Children's Hospital
Louisville, Kentucky, 40202
United States
LSU Health Baton Rouge-North Clinic
Baton Rouge, Louisiana, 70805
United States
Our Lady of the Lake Physician Group
Baton Rouge, Louisiana, 70808
United States
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, 21287
United States
Bronson Battle Creek
Battle Creek, Michigan, 49017
United States
Wayne State University/Karmanos Cancer Institute
Detroit, Michigan, 48201
United States
Weisberg Cancer Treatment Center
Farmington Hills, Michigan, 48334
United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital
Grand Rapids, Michigan, 49503
United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, 49503
United States
Trinity Health Grand Rapids Hospital
Grand Rapids, Michigan, 49503
United States
Bronson Methodist Hospital
Kalamazoo, Michigan, 49007
United States
West Michigan Cancer Center
Kalamazoo, Michigan, 49007
United States
Beacon Kalamazoo Cancer Center
Kalamazoo, Michigan, 49009
United States
Beacon Kalamazoo
Kalamazoo, Michigan, 49048
United States
Trinity Health Muskegon Hospital
Muskegon, Michigan, 49444
United States
Corewell Health Lakeland Hospitals - Niles Hospital
Niles, Michigan, 49120
United States
Cancer and Hematology Centers of Western Michigan - Norton Shores
Norton Shores, Michigan, 49444
United States
Corewell Health Reed City Hospital
Reed City, Michigan, 49677
United States
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center
Saint Joseph, Michigan, 49085
United States
Corewell Health Lakeland Hospitals - Saint Joseph Hospital
Saint Joseph, Michigan, 49085
United States
Munson Medical Center
Traverse City, Michigan, 49684
United States
University of Michigan Health - West
Wyoming, Michigan, 49519
United States
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
United States
Minnesota Oncology - Burnsville
Burnsville, Minnesota, 55337
United States
Cambridge Medical Center
Cambridge, Minnesota, 55008
United States
Mercy Hospital
Coon Rapids, Minnesota, 55433
United States
Fairview Southdale Hospital
Edina, Minnesota, 55435
United States
Unity Hospital
Fridley, Minnesota, 55432
United States
Fairview Clinics and Surgery Center Maple Grove
Maple Grove, Minnesota, 55369
United States
Minnesota Oncology Hematology PA-Maplewood
Maplewood, Minnesota, 55109
United States
Saint John's Hospital - Healtheast
Maplewood, Minnesota, 55109
United States
Abbott-Northwestern Hospital
Minneapolis, Minnesota, 55407
United States
Hennepin County Medical Center
Minneapolis, Minnesota, 55415
United States
Health Partners Inc
Minneapolis, Minnesota, 55454
United States
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, 55455
United States
Monticello Cancer Center
Monticello, Minnesota, 55362
United States
New Ulm Medical Center
New Ulm, Minnesota, 56073
United States
Fairview Northland Medical Center
Princeton, Minnesota, 55371
United States
North Memorial Medical Health Center
Robbinsdale, Minnesota, 55422
United States
Park Nicollet Clinic - Saint Louis Park
Saint Louis Park, Minnesota, 55416
United States
Regions Hospital
Saint Paul, Minnesota, 55101
United States
United Hospital
Saint Paul, Minnesota, 55102
United States
Saint Francis Regional Medical Center
Shakopee, Minnesota, 55379
United States
Lakeview Hospital
Stillwater, Minnesota, 55082
United States
Ridgeview Medical Center
Waconia, Minnesota, 55387
United States
Rice Memorial Hospital
Willmar, Minnesota, 56201
United States
Minnesota Oncology Hematology PA-Woodbury
Woodbury, Minnesota, 55125
United States
Fairview Lakes Medical Center
Wyoming, Minnesota, 55092
United States
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
United States
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, 68114
United States
University of Nebraska Medical Center
Omaha, Nebraska, 68198
United States
Carson Tahoe Regional Medical Center
Carson City, Nevada, 89703
United States
Cancer and Blood Specialists-Henderson
Henderson, Nevada, 89052
United States
Comprehensive Cancer Centers of Nevada - Henderson
Henderson, Nevada, 89052
United States
Comprehensive Cancer Centers of Nevada-Horizon Ridge
Henderson, Nevada, 89052
United States
Las Vegas Cancer Center-Henderson
Henderson, Nevada, 89052
United States
OptumCare Cancer Care at Seven Hills
Henderson, Nevada, 89052
United States
Comprehensive Cancer Centers of Nevada-Southeast Henderson
Henderson, Nevada, 89074
United States
GenesisCare USA - Henderson
Henderson, Nevada, 89074
United States
Las Vegas Urology - Green Valley
Henderson, Nevada, 89074
United States
Las Vegas Urology - Pebble
Henderson, Nevada, 89074
United States
Urology Specialists of Nevada - Green Valley
Henderson, Nevada, 89074
United States
Las Vegas Urology - Pecos
Las Vegas, Nevada, 89074
United States
Desert West Surgery
Las Vegas, Nevada, 89102
United States
OptumCare Cancer Care at Charleston
Las Vegas, Nevada, 89102
United States
University Medical Center of Southern Nevada
Las Vegas, Nevada, 89102
United States
Hope Cancer Care of Nevada
Las Vegas, Nevada, 89103
United States
Radiation Oncology Centers of Nevada Central
Las Vegas, Nevada, 89106
United States
Urology Specialists of Nevada - Central
Las Vegas, Nevada, 89106
United States
GenesisCare USA - Las Vegas
Las Vegas, Nevada, 89109
United States
HealthCare Partners Medical Group Oncology/Hematology-Maryland Parkway
Las Vegas, Nevada, 89109
United States
Sunrise Hospital and Medical Center
Las Vegas, Nevada, 89109
United States
HealthCare Partners Medical Group Oncology/Hematology-San Martin
Las Vegas, Nevada, 89113
United States
Las Vegas Prostate Cancer Center
Las Vegas, Nevada, 89113
United States
Las Vegas Urology - Sunset
Las Vegas, Nevada, 89113
United States
Urology Specialists of Nevada - Southwest
Las Vegas, Nevada, 89113
United States
Radiation Oncology Centers of Nevada Southeast
Las Vegas, Nevada, 89119
United States
Ann M Wierman MD LTD
Las Vegas, Nevada, 89128
United States
Comprehensive Cancer Centers of Nevada - Northwest
Las Vegas, Nevada, 89128
United States
GenesisCare USA - Vegas Tenaya
Las Vegas, Nevada, 89128
United States
HealthCare Partners Medical Group Oncology/Hematology-Tenaya
Las Vegas, Nevada, 89128
United States
Las Vegas Urology - Cathedral Rock
Las Vegas, Nevada, 89128
United States
Las Vegas Urology - Smoke Ranch
Las Vegas, Nevada, 89128
United States
OptumCare Cancer Care at MountainView
Las Vegas, Nevada, 89128
United States
Urology Specialists of Nevada - Northwest
Las Vegas, Nevada, 89128
United States
Alliance for Childhood Diseases/Cure 4 the Kids Foundation
Las Vegas, Nevada, 89135
United States
Comprehensive Cancer Centers of Nevada - Town Center
Las Vegas, Nevada, 89144
United States
Comprehensive Cancer Centers of Nevada-Summerlin
Las Vegas, Nevada, 89144
United States
Summerlin Hospital Medical Center
Las Vegas, Nevada, 89144
United States
Las Vegas Cancer Center-Medical Center
Las Vegas, Nevada, 89148-2405
United States
Comprehensive Cancer Centers of Nevada
Las Vegas, Nevada, 89148
United States
GenesisCare USA - Fort Apache
Las Vegas, Nevada, 89148
United States
OptumCare Cancer Care at Fort Apache
Las Vegas, Nevada, 89148
United States
HealthCare Partners Medical Group Oncology/Hematology-Centennial Hills
Las Vegas, Nevada, 89149
United States
Comprehensive Cancer Centers of Nevada - Central Valley
Las Vegas, Nevada, 89169
United States
University Cancer Center
Las Vegas, Nevada, 89169
United States
Hope Cancer Care of Nevada-Pahrump
Pahrump, Nevada, 89048
United States
Renown Regional Medical Center
Reno, Nevada, 89502
United States
Saint Mary's Regional Medical Center
Reno, Nevada, 89503
United States
Radiation Oncology Associates
Reno, Nevada, 89509
United States
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87106
United States
Roswell Park Cancer Institute
Buffalo, New York, 14263
United States
University of Rochester
Rochester, New York, 14642
United States
Duke University Medical Center
Durham, North Carolina, 27710
United States
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, 45219
United States
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, 45229
United States
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
United States
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, 45069
United States
Oregon Health and Science University
Portland, Oregon, 97239
United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, 19104
United States
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, 15224
United States
Rhode Island Hospital
Providence, Rhode Island, 02903
United States
Prisma Health Richland Hospital
Columbia, South Carolina, 29203
United States
The Children's Hospital at TriStar Centennial
Nashville, Tennessee, 37203
United States
Dell Children's Medical Center of Central Texas
Austin, Texas, 78723
United States
El Paso Children's Hospital
El Paso, Texas, 79905
United States
Methodist Children's Hospital of South Texas
San Antonio, Texas, 78229
United States
University of Texas Health Science Center at San Antonio
San Antonio, Texas, 78229
United States
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, 84112
United States
University of Virginia Cancer Center
Charlottesville, Virginia, 22908
United States
Children's Hospital of The King's Daughters
Norfolk, Virginia, 23507
United States
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, 23298
United States
Overlake Medical Center
Bellevue, Washington, 98004
United States
Valley Medical Center
Renton, Washington, 98055
United States
Fred Hutchinson Cancer Center
Seattle, Washington, 98109
United States
University of Washington Medical Center - Montlake
Seattle, Washington, 98195
United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital
Yakima, Washington, 98902
United States
West Virginia University Healthcare
Morgantown, West Virginia, 26506
United States
Gundersen Lutheran Medical Center
La Crosse, Wisconsin, 54601
United States
Cancer Center of Western Wisconsin
New Richmond, Wisconsin, 54017
United States

Collaborators and Investigators

Sponsor: SWOG Cancer Research Network

  • Anjali S Advani, PRINCIPAL_INVESTIGATOR, SWOG Cancer Research Network

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-02-08
Study Completion Date2028-08-01

Study Record Updates

Study Start Date2021-02-08
Study Completion Date2028-08-01

Terms related to this study

Additional Relevant MeSH Terms

  • Recurrent T Acute Lymphoblastic Leukemia
  • Refractory T Acute Lymphoblastic Leukemia
  • Refractory T Lymphoblastic Lymphoma
  • T Lymphoblastic Lymphoma