Docetaxel in Treating Children With Relapsed or Refractory Acute Lymphoblastic or Acute Myeloid Leukemia

Sponsor

Children's Oncology Group (Other)

Overall Status

Completed

CT.gov ID

NCT00021242

Collaborator

National Cancer Institute (NCI) (NIH)

Enrollment

228

Locations

Arm

Duration (Months)

0.1

Patients Per Site

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

RATIONALE: Drugs used in chemotherapy, such as docetaxel, work in different ways to stop cancer cells from dividing so they stop growing or die.

PURPOSE: Phase II trial to study the effectiveness of docetaxel in treating children who have relapsed or refractory acute lymphoblastic or acute myeloid leukemia.

Condition or Disease	Intervention/Treatment	Phase
Leukemia	Drug: docetaxel	Phase 2

Detailed Description

OBJECTIVES:

Determine the response rate in pediatric patients with relapsed or refractory acute lymphoblastic or acute myeloid leukemia treated with docetaxel.
Determine the toxicity of this regimen in these patients.

OUTLINE: Patients receive docetaxel IV over 1 hour on days 1, 8, and 15. Treatment repeats every 28 days for a maximum of 12 courses in the absence of disease progression or unacceptable toxicity.

PROJECTED ACCRUAL: A total of 10-20 patients will be accrued for this study within 1 year.

Study Design

Study Type:

Interventional

Actual Enrollment :

12 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Phase II Study of Docetaxel (Taxotere) (NSC# 628503, IND# 59,761) in Children With Refractory Leukemias

Study Start Date :

Aug 1, 2002

Actual Primary Completion Date :

Mar 1, 2006

Actual Study Completion Date :

Sep 1, 2006

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Relapsed or Refractory ALL, AML Docetaxel 60 mg/m^2 per dose weekly (Days 1,8,15) for 3 weeks followed by 1 week of rest.	Drug: docetaxel Continuous IV infusion Other Names: Taxotere® NSC #628503

Arm

Intervention/Treatment

Experimental: Relapsed or Refractory ALL, AML

Docetaxel 60 mg/m^2 per dose weekly (Days 1,8,15) for 3 weeks followed by 1 week of rest.

Drug: docetaxel

Continuous IV infusion

Other Names:

Taxotere®

NSC #628503

Outcome Measures

Primary Outcome Measures

Response to therapy [At any time during protocol therapy]
The levels of pro- and anti-apoptotic proteins will be evaluated in specimens taken before and after administration of docetaxel, at the end of therapy and at the time of relapse. The average values and variance of these levels will be used to design further investigations. The pre- and post- docetaxel levels will be compared using the difference of these two values for each patient. The change in level will be assessed using a paired t-test with an appropriate transformation for normality.

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A to 21 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

DISEASE CHARACTERISTICS:

Histologically confirmed acute lymphoblastic or acute myeloid leukemia
M3 bone marrow relapse required
Refractory to conventional chemotherapy
No extramedullary disease at relapse

PATIENT CHARACTERISTICS:

Age:

21 and under at time of initial diagnosis

Performance status:

ECOG 0-2

Life expectancy:

At least 2 months

Hematopoietic:

Not specified

Hepatic:

Bilirubin no greater than 1.5 mg/dL
AST and ALT no greater than 1.5 times normal
Alkaline phosphatase no greater than 2.5 times normal

Renal:

Creatinine no greater than 1.5 times normal OR
Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min

Other:

Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy:

At least 7 days since prior biologic therapy and recovered
At least 6 months since prior allogeneic stem cell transplantation
No concurrent immunomodulating agents during first 2 courses of therapy
No concurrent routine filgrastim (G-CSF)

Chemotherapy:

See Disease Characteristics
At least 2 weeks since prior chemotherapy (4 weeks for nitrosoureas) and recovered
No prior paclitaxel or docetaxel
No other concurrent chemotherapy during first 2 courses of therapy

Endocrine therapy:

No concurrent corticosteroid therapy except dexamethasone, low-dose hydrocortisone to treat allergic reactions, or treatment for adrenal crisis

Radiotherapy:

Recovered from prior radiotherapy
At least 2 weeks since prior palliative local radiotherapy
At least 6 months since prior craniospinal radiotherapy or radiotherapy to at least 50% of the pelvis
At least 6 weeks since prior substantial bone marrow radiotherapy
No concurrent radiotherapy

Surgery:

Not specified

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Comprehensive Cancer Center at University of Alabama at Birmingham	Birmingham	Alabama	United States	35233
2	University of South Alabama Cancer Research Institute	Mobile	Alabama	United States	36604
3	Phoenix Children's Hospital	Phoenix	Arizona	United States	85016
4	Arizona Cancer Center at University of Arizona Health Sciences Center	Tucson	Arizona	United States	85724
5	Arkansas Cancer Research Center at University of Arkansas for Medical Sciences	Little Rock	Arkansas	United States	72205
6	Southern California Permanente Medical Group	Downey	California	United States	90242
7	City of Hope Comprehensive Cancer Center	Duarte	California	United States	91010-3000
8	Rebecca and John Moores UCSD Cancer Center	La Jolla	California	United States	92093-0658
9	Loma Linda University Cancer Institute at Loma Linda University Medical Center	Loma Linda	California	United States	92354
10	Jonathan Jaques Children's Cancer Center at Miller Children's Hospital	Long Beach	California	United States	90801-1428
11	Children's Hospital Los Angeles	Los Angeles	California	United States	90027-0700
12	Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center	Los Angeles	California	United States	90048
13	Jonsson Comprehensive Cancer Center at UCLA	Los Angeles	California	United States	90095-1781
14	Children's Hospital Central California	Madera	California	United States	93638-8762
15	Children's Hospital and Research Center - Oakland	Oakland	California	United States	94609-1809
16	Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center	Orange	California	United States	92868
17	Children's Hospital of Orange County	Orange	California	United States	92868
18	Lucile Packard Children's Hospital at Stanford University Medical Center	Palo Alto	California	United States	94304
19	Sutter Cancer Center	Sacramento	California	United States	95816
20	University of California Davis Cancer Center	Sacramento	California	United States	95817
21	Kaiser Permanente Medical Center - Sacramento	Sacramento	California	United States	95825
22	Kaiser Permanente Medical Center - Kaiser Foundation Hospital - San Diego	San Diego	California	United States	92120
23	Children's Hospital and Health Center - San Diego	San Diego	California	United States	92123-4282
24	UCSF Comprehensive Cancer Center	San Francisco	California	United States	94143
25	Santa Barbara Cottage Children's Hospital	Santa Barbara	California	United States	93102
26	Kaiser Permanente Medical Center - Santa Clara Kiely Campus	Santa Clara	California	United States	95051
27	General Robert Huyser Cancer Center at David Grant Medical Center	Travis Air Force Base	California	United States	94535
28	Children's Hospital Cancer Center	Denver	Colorado	United States	80218
29	Presbyterian - St. Luke's Medical Center	Denver	Colorado	United States	80218
30	Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center	Farmington	Connecticut	United States	06360-7106
31	Yale Comprehensive Cancer Center at Yale University School of Medicine	New Haven	Connecticut	United States	06520-8064
32	Alfred I. duPont Hospital for Children	Wilmington	Delaware	United States	19899
33	Lombardi Cancer Center at Georgetown University Medical Center	Washington	District of Columbia	United States	20007
34	Children's National Medical Center	Washington	District of Columbia	United States	20010-2970
35	Broward General Medical Center Cancer Center	Fort Lauderdale	Florida	United States	33316
36	Children's Hospital of Southwest Florida	Fort Myers	Florida	United States	33908
37	University of Florida Shands Cancer Center	Gainesville	Florida	United States	32610-0296
38	Joe DiMaggio Children's Hospital at Memorial	Hollywood	Florida	United States	33021
39	Nemours Children's Clinic	Jacksonville	Florida	United States	32207
40	Jackson Memorial Hospital	Miami	Florida	United States	33136
41	Miami Children's Hospital	Miami	Florida	United States	33155
42	Baptist-South Miami Regional Cancer Program	Miami	Florida	United States	33176-2197
43	Florida Hospital Cancer Institute	Orlando	Florida	United States	32804
44	Nemours Children's Clinic - Orlando	Orlando	Florida	United States	32806
45	Sacred Heart Children's Hospital	Pensacola	Florida	United States	32504
46	All Children's Hospital	St. Petersburg	Florida	United States	33701
47	St. Joseph's Children's Hospital of Tampa	Tampa	Florida	United States	33677-4227
48	Kaplan Cancer Center at St. Mary's Medical Center	West Palm Beach	Florida	United States	33407
49	AFLAC Cancer Center and Blood Disorders Service of Children's Healthcare of Atlanta - Scottish Rite Campus	Atlanta	Georgia	United States	30342
50	MBCCOP-Medical College of Georgia Cancer Center	Augusta	Georgia	United States	30912-4000
51	Medical Center of Central Georgia	Macon	Georgia	United States	31201
52	Curtis & Elizabeth Anderson Cancer Institute at Memorial Health University Medical Center	Savannah	Georgia	United States	31405
53	Cancer Research Center of Hawaii	Honolulu	Hawaii	United States	96813
54	Tripler Army Medical Center	Honolulu	Hawaii	United States	96859-5000
55	St. Luke's Mountain States Tumor Institute - Boise	Boise	Idaho	United States	83712
56	University of Chicago Cancer Research Center	Chicago	Illinois	United States	60601
57	Rush University Medical Center	Chicago	Illinois	United States	60612
58	University of Illinois at Chicago Cancer Center	Chicago	Illinois	United States	60612
59	Children's Memorial Hospital - Chicago	Chicago	Illinois	United States	60614
60	Advocate Hope Children's Hospital	Oak Lawn	Illinois	United States	60453
61	Lutheran General Cancer Care Center	Park Ridge	Illinois	United States	60068-1174
62	Saint Jude Midwest Affiliate	Peoria	Illinois	United States	61637
63	Southern Illinois University School of Medicine	Springfield	Illinois	United States	62794-9658
64	Riley's Children Cancer Center at Riley Hospital for Children	Indianapolis	Indiana	United States	46202-5225
65	St. Vincent Indianapolis Hospital	Indianapolis	Indiana	United States	46260
66	Blank Children's Hospital	Des Moines	Iowa	United States	50309
67	Holden Comprehensive Cancer Center at University of Iowa	Iowa City	Iowa	United States	52242-1009
68	Wesley Medical Center	Wichita	Kansas	United States	67214
69	Markey Cancer Center at University of Kentucky Chandler Medical Center	Lexington	Kentucky	United States	40536-0284
70	Kosair Children's Hospital	Louisville	Kentucky	United States	40202-3830
71	MBCCOP - LSU Health Sciences Center	New Orleans	Louisiana	United States	70112
72	Tulane Cancer Center at Tulane University Hospital and Clinic	New Orleans	Louisiana	United States	70112
73	Children's Hospital of New Orleans	New Orleans	Louisiana	United States	70118
74	Ochsner Cancer Institute at Ochsner Clinic Foundation	New Orleans	Louisiana	United States	70121
75	Pediatric Specialty Clinic at Eastern Maine Medical Center	Bangor	Maine	United States	04401
76	Maine Children's Cancer Program	Scarborough	Maine	United States	04074-9308
77	Greenebaum Cancer Center at University of Maryland Medical Center	Baltimore	Maryland	United States	21201-1595
78	Alvin and Lois Lapidus Cancer Institute at Sinai Hospital	Baltimore	Maryland	United States	21215
79	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins	Baltimore	Maryland	United States	21231-7223
80	Walter Reed Army Medical Center	Silver Spring	Maryland	United States	20910
81	Floating Hospital for Children	Boston	Massachusetts	United States	02111
82	Dana-Farber/Harvard Cancer Center at Dana Farber Cancer Institute	Boston	Massachusetts	United States	02115
83	Baystate Regional Cancer Program at D'Amour Center for Cancer Care	Springfield	Massachusetts	United States	01107
84	UMASS Memorial Cancer Center - University Campus	Worcester	Massachusetts	United States	01655
85	University of Michigan Comprehensive Cancer Center	Ann Arbor	Michigan	United States	48109-0914
86	Children's Hospital of Michigan	Detroit	Michigan	United States	48201
87	Van Elslander Cancer Center at St. John Hospital and Medical Center	Detroit	Michigan	United States	48236
88	Hurley Medical Center	Flint	Michigan	United States	48503
89	DeVos Children's Hospital	Grand Rapids	Michigan	United States	49503
90	Bronson Methodist Hospital	Kalamazoo	Michigan	United States	49007-5364
91	Breslin Cancer Center at Ingham Regional Medical Center	Lansing	Michigan	United States	48910
92	William Beaumont Hospital - Royal Oak Campus	Royal Oak	Michigan	United States	48073-6769
93	St. Mary's - Duluth Clinic Cancer Center	Duluth	Minnesota	United States	55805
94	Children's Hospitals and Clinics - Minneapolis/St. Paul	Minneapolis	Minnesota	United States	55404
95	Mayo Clinic Cancer Center	Rochester	Minnesota	United States	55905
96	University of Mississippi Medical Center	Jackson	Mississippi	United States	39216-4505
97	Children's Mercy Hospital	Kansas City	Missouri	United States	64108
98	Cardinal Glennon Children's Hospital	Saint Louis	Missouri	United States	63104
99	St. Louis Children's Hospital	Saint Louis	Missouri	United States	63110
100	Children's Hospital of Omaha	Omaha	Nebraska	United States	68114
101	UNMC Eppley Cancer Center at the University of Nebraska Medical Center	Omaha	Nebraska	United States	68198-2168
102	Sunrise Hospital and Medical Center	Las Vegas	Nevada	United States	89109
103	Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center	Lebanon	New Hampshire	United States	03756
104	Hackensack University Medical Center	Hackensack	New Jersey	United States	07601
105	Cancer Institute of New Jersey at UMDNJ - Robert Wood Johnson Medical School	New Brunswick	New Jersey	United States	08903
106	Newark Beth Israel Medical Center	Newark	New Jersey	United States	07112-2094
107	St. Joseph's Hospital and Medical Center	Paterson	New Jersey	United States	07503
108	Valerie Fund Children's Center at Atlantic Health System	Summit	New Jersey	United States	07901
109	University of New Mexico Cancer Research and Treatment Center	Albuquerque	New Mexico	United States	87131
110	Children's Hospital at Albany Medical Center	Albany	New York	United States	12208
111	Albert Einstein Cancer Center at Albert Einstein College of Medicine	Bronx	New York	United States	10461
112	Brooklyn Hospital Center	Brooklyn	New York	United States	11201-5493
113	SUNY Downstate Medical Center	Brooklyn	New York	United States	11203
114	Brookdale University Hospital and Medical Center	Brooklyn	New York	United States	11212
115	Maimonides Medical Center	Brooklyn	New York	United States	11219
116	Schneider Children's Hospital	New Hyde Park	New York	United States	11040
117	Memorial Sloan-Kettering Cancer Center	New York	New York	United States	10021
118	New York Weill Cornell Cancer Center at Cornell University	New York	New York	United States	10021
119	Mount Sinai Medical Center	New York	New York	United States	10029
120	Herbert Irving Comprehensive Cancer Center at Columbia University	New York	New York	United States	10032
121	James P. Wilmot Cancer Center at University of Rochester Medical Center	Rochester	New York	United States	14642
122	Long Island Cancer Center at Stony Brook University Hospital	Stony Brook	New York	United States	11794-8174
123	SUNY Upstate Medical University Hospital	Syracuse	New York	United States	13210
124	New York Medical College	Valhalla	New York	United States	10595
125	Mission Hospitals - Memorial Campus	Asheville	North Carolina	United States	28801
126	Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill	Chapel Hill	North Carolina	United States	27599
127	Blumenthal Cancer Center at Carolinas Medical Center	Charlotte	North Carolina	United States	28232-2861
128	Presbyterian Cancer Center at Presbyterian Hospital	Charlotte	North Carolina	United States	28233
129	Duke Comprehensive Cancer Center	Durham	North Carolina	United States	27710
130	Leo W. Jenkins Cancer Center at Pitt County Memorial Hospital	Greenville	North Carolina	United States	27858-4354
131	Dakota Cancer Institute at Innovis Health - Dakota Clinic	Fargo	North Dakota	United States	58103-4940
132	Children's Hospital Medical Center of Akron	Akron	Ohio	United States	44308-1062
133	Cincinnati Children's Hospital Medical Center	Cincinnati	Ohio	United States	45229-3039
134	Ireland Cancer Center at University Hospitals of Cleveland and Case Western Reserve University	Cleveland	Ohio	United States	44106-5065
135	Cleveland Clinic Taussig Cancer Center	Cleveland	Ohio	United States	44195
136	Columbus Children's Hospital	Columbus	Ohio	United States	43205-2696
137	Children's Medical Center - Dayton	Dayton	Ohio	United States	45404
138	Toledo Children's Hospital	Toledo	Ohio	United States	43601
139	St. Vincent Mercy Medical Center	Toledo	Ohio	United States	43608
140	Tod Children's Hospital - Forum Health	Youngstown	Ohio	United States	44501
141	Children's Hospital at Oklahoma University Medical Center	Oklahoma City	Oklahoma	United States	73104
142	Natalie Warren Bryant Cancer Center at St. Francis Hospital	Tulsa	Oklahoma	United States	74136
143	CCOP - Columbia River Oncology Program	Portland	Oregon	United States	97225
144	Legacy Emanuel Hospital and Health Center & Children's Hospital	Portland	Oregon	United States	97227
145	Doernbecher Children's Hospital at Oregon Health & Science University	Portland	Oregon	United States	97239-3098
146	Geisinger Medical Center	Danville	Pennsylvania	United States	17822-1320
147	Penn State Children's Hospital	Hershey	Pennsylvania	United States	17033
148	Children's Hospital of Philadelphia	Philadelphia	Pennsylvania	United States	19104
149	St. Christopher's Hospital for Children	Philadelphia	Pennsylvania	United States	19134-1095
150	Children's Hospital of Pittsburgh	Pittsburgh	Pennsylvania	United States	15213
151	Rhode Island Hospital	Providence	Rhode Island	United States	02903
152	Hollings Cancer Center at Medical University of South Carolina	Charleston	South Carolina	United States	29425-0721
153	Palmetto Health South Carolina Cancer Center	Columbia	South Carolina	United States	29203
154	Children's Hospital of Greenville Hospital System	Greenville	South Carolina	United States	29605
155	Avera Cancer Institute	Sioux Falls	South Dakota	United States	57105-1080
156	Sioux Valley Hospital and University of South Dakota Medical Center	Sioux Falls	South Dakota	United States	57117-5039
157	East Tennessee State University Cancer Center at Johnson City Medical Center	Johnson City	Tennessee	United States	37614-0622
158	East Tennessee Children's Hospital	Knoxville	Tennessee	United States	37901
159	St. Jude Children's Research Hospital	Memphis	Tennessee	United States	38105
160	Vanderbilt Children's Hospital	Nashville	Tennessee	United States	37232-6310
161	Texas Tech University Health Sciences Center School of Medicine	Amarillo	Texas	United States	79106
162	Children's Hospital of Austin	Austin	Texas	United States	78701
163	Medical City Dallas Hospital	Dallas	Texas	United States	75230
164	Simmons Comprehensive Cancer Center at University of Texas Southwestern Medical Center - Dallas	Dallas	Texas	United States	75390-9063
165	Cook Children's Medical Center - Fort Worth	Fort Worth	Texas	United States	76104
166	University of Texas Medical Branch	Galveston	Texas	United States	77555-0209
167	M.D. Anderson Cancer Center at University of Texas	Houston	Texas	United States	77030-4009
168	Cancer Center at Baylor College of Medicine	Houston	Texas	United States	77030
169	Wilford Hall Medical Center	Lackland Air Force Base	Texas	United States	78236-5300
170	Covenant Children's Hospital	Lubbock	Texas	United States	79410
171	University of Texas Health Science Center at San Antonio	San Antonio	Texas	United States	78207
172	MBCCOP - South Texas Pediatrics	San Antonio	Texas	United States	78229-3900
173	Methodist Cancer Center at Methodist Specialty and Transplant Hospital	San Antonio	Texas	United States	78229-3902
174	CCOP - Scott and White Hospital	Temple	Texas	United States	76508
175	Center for Cancer Prevention and Care at Scott and White Clinic	Temple	Texas	United States	76508
176	Huntsman Cancer Institute at University of Utah	Salt Lake City	Utah	United States	84112
177	Vermont Cancer Center at University of Vermont	Burlington	Vermont	United States	05401-3498
178	University of Virginia Cancer Center	Charlottesville	Virginia	United States	22908
179	INOVA Fairfax Hospital	Falls Church	Virginia	United States	22042-3300
180	Children's Hospital of the King's Daughters	Norfolk	Virginia	United States	23507
181	Naval Medical Center - Portsmouth	Portsmouth	Virginia	United States	23708-5100
182	Massey Cancer Center at Virginia Commonwealth University	Richmond	Virginia	United States	23298-0121
183	Carilion Medical Center for Children at Roanoke Community Hospital	Roanoke	Virginia	United States	24029
184	Children's Hospital and Regional Medical Center - Seattle	Seattle	Washington	United States	98105
185	Fred Hutchinson Cancer Research Center	Seattle	Washington	United States	98109-1024
186	Group Health Central Hospital	Seattle	Washington	United States	98112
187	Deaconess Medical Center	Spokane	Washington	United States	99210-0248
188	Mary Bridge Children's Hospital and Health Center - Tacoma	Tacoma	Washington	United States	98415-0299
189	Madigan Army Medical Center	Tacoma	Washington	United States	98431-0001
190	West Virginia University - Robert C. Byrd Health Sciences Center - Charleston Division	Charleston	West Virginia	United States	25302
191	Cabell Huntington Hospital	Huntington	West Virginia	United States	25701
192	Mary Babb Randolph Cancer Center at West Virginia University Hospitals	Morgantown	West Virginia	United States	26506-9300
193	Bellin Memorial Hospital	Green Bay	Wisconsin	United States	54301
194	CCOP - St. Vincent Hospital Cancer Center, Green Bay	Green Bay	Wisconsin	United States	54301
195	St. Vincent Hospital Regional Cancer Center	Green Bay	Wisconsin	United States	54307-9070
196	Gundersen Lutheran Cancer Center at Gundersen Lutheran Medical Center	La Crosse	Wisconsin	United States	54601
197	University of Wisconsin Comprehensive Cancer Center	Madison	Wisconsin	United States	53792-6164
198	Marshfield Clinic - Marshfield Center	Marshfield	Wisconsin	United States	54449-5772
199	CCOP - Marshfield Clinic Research Foundation	Marshfield	Wisconsin	United States	54449
200	Midwest Children's Cancer Center	Milwaukee	Wisconsin	United States	53226
201	Sydney Children's Hospital	Randwick	New South Wales	Australia	2031
202	Children's Hospital at Westmead	Westmead	New South Wales	Australia	2145
203	Royal Children's Hospital	Brisbane	Queensland	Australia	4029
204	Women's and Children's Hospital	North Adelaide	South Australia	Australia	5006
205	Royal Children's Hospital	Parkville	Victoria	Australia	3052
206	Princess Margaret Hospital for Children	Perth	Western Australia	Australia	6001
207	Alberta Children's Hospital	Calgary	Alberta	Canada	T2T 5C7
208	Cross Cancer Institute at University of Alberta	Edmonton	Alberta	Canada	T6G 1Z2
209	Children's & Women's Hospital of British Columbia	Vancouver	British Columbia	Canada	V6H 3V4
210	CancerCare Manitoba	Winnipeg	Manitoba	Canada	R3E 0V9
211	Janeway Children's Health and Rehabilitation Centre	St. John's	Newfoundland and Labrador	Canada	A1B 3V6
212	IWK Health Centre	Halifax	Nova Scotia	Canada	NS B3J 3G9
213	McMaster Children's Hospital at Hamilton Health Sciences	Hamilton	Ontario	Canada	L8S 4J9
214	Children's Hospital of Western Ontario	London	Ontario	Canada	N6C 2V5
215	Children's Hospital of Eastern Ontario	Ottawa	Ontario	Canada	K1H 8L1
216	Hospital for Sick Children	Toronto	Ontario	Canada	M5G 1X8
217	Montreal Children's Hospital at McGill University Health Center	Montreal	Quebec	Canada	H3H 1P3
218	Hopital Sainte Justine	Montreal	Quebec	Canada	H3T 1C5
219	Centre de Recherche du Centre Hospitalier de l'Universite Laval	Sainte Foy	Quebec	Canada	GIV 4G2
220	Allan Blair Cancer Centre at Pasqua Hospital	Regina	Saskatchewan	Canada	S4T 7T1
221	Saskatoon Cancer Centre at the University of Saskatchewan	Saskatoon	Saskatchewan	Canada	S7N 4H4
222	University Medical Center Groningen	Groningen		Netherlands	9700 RB
223	Starship Children's Health	Auckland		New Zealand
224	Puerto Rico Cancer Center at University of Puerto Rico - Medical Sciences Campus	San Juan		Puerto Rico	00936-5067
225	San Jorge Children's Hospital	Santurce		Puerto Rico	00912
226	Swiss Pediatric Oncology Group Bern	Bern		Switzerland	CH 3010
227	Swiss Pediatric Oncology Group Geneva	Geneva		Switzerland	CH 1211
228	Swiss Pediatric Oncology Group Lausanne	Lausanne		Switzerland	CH 1011