RECRUITING Phase 3 ClinicalTrials.gov

A Study to Compare Standard Therapy to Treat Hodgkin Lymphoma to the Use of Two Drugs, Brentuximab Vedotin and Nivolumab

Sponsor: National Cancer Institute (NCI) • ClinicalTrials.gov ID: NCT05675410

Registry updated: 2026-10-20

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Description

This phase III trial compares the effect of adding immunotherapy (brentuximab vedotin and nivolumab) to standard treatment (chemotherapy with or without radiation) to the standard treatment alone in improving survival in patients with stage I and II classical Hodgkin lymphoma. Brentuximab vedotin is in a class of medications called antibody-drug conjugates. It is made of a monoclonal antibody called brentuximab that is linked to a cytotoxic agent called vedotin. Brentuximab attaches to CD30 positive lymphoma cells in a targeted way and delivers vedotin to kill them. A monoclonal antibody is a type of protein that can bind to certain targets in the body, such as molecules that cause the body to make an immune response (antigens). Immunotherapy with monoclonal antibodies, such as nivolumab, may help the body's immune system attack the cancer, and may interfere with the ability of tumor cells to grow and spread. Chemotherapy drugs such as doxorubicin hydrochloride, bleomycin sulfate, vinblastine sulfate, dacarbazine, and procarbazine hydrochloride 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. Cyclophosphamide is in a class of medications called alkylating agents. It works by damaging the cell's deoxyribonucleic acid (DNA) and may kill cancer cells. It may also lower the body's immune response. Etoposide is in a class of medications known as podophyllotoxin derivatives. It blocks a certain enzyme needed for cell division and DNA repair and may kill cancer cells. Vincristine is in a class of medications called vinca alkaloids. It works by stopping cancer cells from growing and dividing and may kill them. Prednisone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body's immune response to help lessen the side effects of chemotherapy drugs. Radiation therapy uses high energy x-rays to kill tumor cells and shrink tumors. Adding immunotherapy to the standard treatment of chemotherapy with or without radiation may increase survival and/or fewer short-term or long-term side effects in patients with classical Hodgkin lymphoma compared to the standard treatment alone.

Interventions

Biospecimen Collection (Procedure)
Undergo blood sample collection
Bleomycin Sulfate (Biological)
Given IV
Brentuximab Vedotin (Drug)
Given IV
Computed Tomography (Procedure)
Undergo CT and/or PET-CT
Cyclophosphamide (Drug)
Given IV
Dacarbazine (Drug)
Given IV
Doxorubicin Hydrochloride (Drug)
Given IV
Etoposide (Drug)
Given IV
Etoposide Phosphate (Drug)
Given IV
Fludeoxyglucose F-18 (Other)
Undergo FDG-PET
Involved-site Radiation Therapy (Radiation)
Undergo ISRT
Magnetic Resonance Imaging (Procedure)
Undergo MRI and/or PET-MRI
Nivolumab (Biological)
Given IV
Positron Emission Tomography (Procedure)
Undergo FDG-PET, PET, PET-CT, and/or PET-MRI
Prednisolone (Drug)
Given PO
Prednisone (Drug)
Given PO
Procarbazine Hydrochloride (Drug)
Given PO
Questionnaire Administration (Other)
Ancillary studies
Vinblastine Sulfate (Drug)
Given IV
Vincristine Sulfate (Drug)
Given IV

Eligibility criteria

Inclusion Criteria: * Patients must be 5 to 60 years of age at the time of enrollment * Patients with newly diagnosed untreated histologically confirmed classic Hodgkin lymphoma (cHL) (nodular sclerosis, mixed cellularity, lymphocyte-rich, or lymphocyte-depleted, or not otherwise specified \[NOS\]) with stage I or II disease * Patients must have bidimensionally measurable disease (at least one lesion with longest diameter \>= 1.5 cm) * Patients must have a whole body or limited whole body PET scan performed within 42 days prior to enrollment. PET-CT is strongly preferred. PET-MRI allowed if intravenous contrast enhanced CT is also obtained * Pediatric patients (age 5-17 years) with known or suspected mediastinal disease must have an upright posteroanterior (PA) chest X-ray (CXR) for assessment of bulky mediastinal disease. * Note: Pediatric patients who have received both a CT chest and upright PA CXR may meet the definition of bulk through either modality. * Patients \>= 18 years must have a performance status corresponding to Zubrod scores of 0, 1 or 2 * Patients =\< 17 years of age must have a Lansky performance score of \>= 50 * Pediatric patients (age 5-17 years): A serum creatinine based on age/sex as follows (within 28 days prior to enrollment): * 2 to \< 6 years (age): 0.8 mg/dL (male), 0.8 mg/dL (female) * 6 to \< 10 years (age): 1 mg/dL (male), 1 mg/dL (female) * 10 to \< 13 years (age): 1.2 mg/dL (male), 1.2 mg/dL (female) * 13 to \< 16 years (age): 1.5 mg/dL (male), 1.4 mg/dL (female) * \>= 16 years (age): 1.7 mg/dL (male), 1.4 mg/dL (female) OR a 24 hour urine creatinine clearance \>= 50 mL/min/1.73 m\^2 (within 28 days prior to enrollment) OR a glomerular filtration rate (GFR) \>= 50 mL/min/1.73 m\^2 (within 28 days prior to enrollment). GFR must be performed using direct measurement with a nuclear blood sampling method OR direct small molecule clearance method (iothalamate or other molecule per institutional standard) * Note: Estimated GFR (eGFR) from serum or plasma creatinine, cystatin C or other estimates are not acceptable for determining eligibility * For adult patients (age 18 years or older) (within 28 days prior to enrollment): Creatinine clearance \>= 30 mL/min, as estimated by the Cockcroft and Gault formula or a 24-hour urine collection. The creatinine value used in the calculation must have been obtained within 28 days prior to registration. Estimated creatinine clearance is based on actual body weight * Total bilirubin =\< 2 x upper limit of normal (ULN) (within 28 days prior to enrollment) * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome * Aspartate aminotransferase (AST) =\< 3 x ULN (within 28 days prior to enrollment) * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome * Alanine aminotransferase (ALT) =\< 3 x ULN (within 28 days prior to enrollment) * Unless due to Gilbert's disease, lymphomatous involvement of liver or vanishing bile duct syndrome * Shortening fraction of \>= 27% by echocardiogram (ECHO), multigated acquisition scan (MUGA), or functional cardiac imaging scan (within 28 days prior to enrollment) or ejection fraction of \>= 50% by radionuclide angiogram, ECHO, MUGA, or cardiac imaging scan (within 28 days prior to enrollment) * Diffusion capacity of the lung for carbon monoxide (DLCO) \>= 50% of predicted value as corrected for hemoglobin by pulmonary function test (PFT) (within 28 days prior to enrollment). If unable to obtain PFTs, the criterion is: a pulse oximetry reading of \> 92% on room air * Known human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial * For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated. Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load Exclusion Criteria: * Patients with nodular lymphocyte predominant Hodgkin lymphoma * Patients with a history of active interstitial pneumonitis or interstitial lung disease * Patients with a diagnosis of inherited or acquired immunodeficiency that is poorly controlled or requiring active medications, such as primary immunodeficiency syndromes or organ transplant recipients * Patients with any known uncontrolled intercurrent illness that would jeopardize the patient's safety such as infection, autoimmune conditions, cardiac arrhythmias, angina pectoris, and gastrointestinal disorders affecting swallowing and/or absorption of pills * Patients with a condition requiring systemic treatment with either corticosteroids (defined as equivalent to \> 10 mg daily predniSONE for patients \>= 18 years or \> 0.5 mg/kg \[up to 10 mg/day\] for patients \< 18 years) or other immunosuppressive medications within 14 days prior to enrollment * Note: Replacement therapy such as thyroxine, insulin, or physiologic corticosteroid for adrenal or pituitary insufficiency is not considered a form of systemic treatment. Inhaled or topical steroids, and adrenal replacement doses (=\< 10 mg daily for patients \>= 18 years or =\< 0.5 mg/kg \[up to 10 mg/day\] predniSONE equivalents) are permitted in the absence of active autoimmune disease * Note: Steroid use for the control of Hodgkin lymphoma symptoms is allowable, but must be discontinued by cycle 1, day 1 * Short term use of corticosteroids for premedication or treatment of an allergy or hypersensitivity is considered an acceptable use of corticosteroids. * Patients with peripheral neuropathy \> grade 1 at the time of enrollment or patients with known Charcot-Marie-Tooth syndrome * Patients with a prior or concurrent malignancy whose natural history or treatment has the potential to interfere with the safety or efficacy assessment of the investigational regimen * Administration of prior chemotherapy, radiation, or antibody-based treatment for cHL * Prior solid organ transplant * Prior allogeneic stem cell transplantation * Live vaccine within 30 days prior to planned day 1 of protocol therapy (e.g., measles, mumps, rubella, varicella, yellow fever, rabies, bacillus Calmette Guerin \[BCG\], oral polio vaccine, and oral typhoid). Administration of messenger ribonucleic acid (mRNA) vaccines are permitted * Female patients who are pregnant since fetal toxicities and teratogenic effects have been noted for several of the study drugs. A pregnancy test within 28 days prior to enrollment is required for female patients of childbearing potential * Lactating females who plan to breastfeed their infants starting with the first dose of study therapy and for at least 6 months after the last treatment * Sexually active patients of reproductive potential who have not agreed to use a highly effective contraceptive method for the duration of their study drug therapy. Following therapy, patients will be advised to use contraception as per institutional practice or as listed below for investigational agents, whichever is longer * Men and women of childbearing potential (WOCBP) must use effective contraception during the study and for 2 months for WOCBP and 4 months for men, after last dose of brentuximab vedotin * WOCBP must continue contraception for a period of at least 5 months after the last dose of nivolumab * All patients and/or their parents or legal guardians must sign a written informed consent * All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Conditions

Lugano Classification Limited Stage Hodgkin Lymphoma AJCC v8

Locations

Children's Hospital of Alabama — Birmingham, Alabama, United States
USA Health Strada Patient Care Center — Mobile, Alabama, United States
Providence Alaska Medical Center — Anchorage, Alaska, United States
CTCA at Western Regional Medical Center — Goodyear, Arizona, United States
Banner Children's at Desert — Mesa, Arizona, United States
Cancer Center at Saint Joseph's — Phoenix, Arizona, United States
Phoenix Childrens Hospital — Phoenix, Arizona, United States
Arkansas Children's Hospital — Little Rock, Arkansas, United States
Mercy Cancer Center - Carmichael — Carmichael, California, United States
Mercy San Juan Medical Center — Carmichael, California, United States
City of Hope Corona — Corona, California, United States
UC Irvine Health Cancer Center-Newport — Costa Mesa, California, United States
Kaiser Permanente Downey Medical Center — Downey, California, United States
City of Hope Comprehensive Cancer Center — Duarte, California, United States
Kaiser Permanente Dublin — Dublin, California, United States
Mercy Cancer Center - Elk Grove — Elk Grove, California, United States
Kaiser Permanente-Fremont — Fremont, California, United States
Kaiser Permanente Fresno Orchard Plaza — Fresno, California, United States
Kaiser Permanente-Fresno — Fresno, California, United States
City of Hope Seacliff — Huntington Beach, California, United States
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care — Irvine, California, United States
City of Hope at Irvine Lennar — Irvine, California, United States
City of Hope Antelope Valley — Lancaster, California, United States
Loma Linda University Medical Center — Loma Linda, California, United States
Miller Children's and Women's Hospital Long Beach — Long Beach, California, United States
City of Hope at Long Beach Elm — Long Beach, California, United States
Children's Hospital Los Angeles — Los Angeles, California, United States
Cedars-Sinai Medical Center — Los Angeles, California, United States
Valley Children's Hospital — Madera, California, United States
Kaiser Permanente- Modesto MOB II — Modesto, California, United States
Kaiser Permanente-Modesto — Modesto, California, United States
City of Hope Newport Beach — Newport Beach, California, United States
Kaiser Permanente-Oakland — Oakland, California, United States
Children's Hospital of Orange County — Orange, California, United States
UC Irvine Health/Chao Family Comprehensive Cancer Center — Orange, California, United States
Mercy Cancer Center - Rocklin — Rocklin, California, United States
Kaiser Permanente Downtown Commons — Sacramento, California, United States
Mercy Cancer Center - Sacramento — Sacramento, California, United States
Sutter Medical Center Sacramento — Sacramento, California, United States
Kaiser Permanente-South Sacramento — Sacramento, California, United States
Rady Children's Hospital - San Diego — San Diego, California, United States
Naval Medical Center -San Diego — San Diego, California, United States
Kaiser Permanente-San Francisco — San Francisco, California, United States
Kaiser Permanente-Santa Teresa-San Jose — San Jose, California, United States
Kaiser Permanente San Leandro — San Leandro, California, United States
Kaiser San Rafael-Gallinas — San Rafael, California, United States
Santa Barbara Cottage Hospital — Santa Barbara, California, United States
Kaiser Permanente-Santa Rosa — Santa Rosa, California, United States
City of Hope South Pasadena — South Pasadena, California, United States
Kaiser Permanente-South San Francisco — South San Francisco, California, United States
City of Hope South Bay — Torrance, California, United States
City of Hope Upland — Upland, California, United States
Kaiser Permanente-Vallejo — Vallejo, California, United States
Kaiser Permanente-Walnut Creek — Walnut Creek, California, United States
Woodland Memorial Hospital — Woodland, California, United States
Children's Hospital Colorado — Aurora, Colorado, United States
UCHealth University of Colorado Hospital — Aurora, Colorado, United States
UCHealth Memorial Hospital Central — Colorado Springs, Colorado, United States
Memorial Hospital North — Colorado Springs, Colorado, United States
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center — Denver, Colorado, United States
Poudre Valley Hospital — Fort Collins, Colorado, United States
Cancer Care and Hematology-Fort Collins — Fort Collins, Colorado, United States
UCHealth Greeley Hospital — Greeley, Colorado, United States
Medical Center of the Rockies — Loveland, Colorado, United States
Smilow Cancer Hospital-Derby Care Center — Derby, Connecticut, United States
Smilow Cancer Hospital Care Center-Fairfield — Fairfield, Connecticut, United States
Smilow Cancer Hospital Care Center at Glastonbury — Glastonbury, Connecticut, United States
Smilow Cancer Hospital Care Center at Greenwich — Greenwich, Connecticut, United States
Smilow Cancer Hospital Care Center - Guilford — Guilford, Connecticut, United States
Smilow Cancer Hospital Care Center at Saint Francis — Hartford, Connecticut, United States
Connecticut Children's Medical Center — Hartford, Connecticut, United States
Yale University — New Haven, Connecticut, United States
Yale-New Haven Hospital North Haven Medical Center — North Haven, Connecticut, United States
Smilow Cancer Hospital Care Center at Long Ridge — Stamford, Connecticut, United States
Smilow Cancer Hospital-Torrington Care Center — Torrington, Connecticut, United States
Smilow Cancer Hospital Care Center-Trumbull — Trumbull, Connecticut, United States
Smilow Cancer Hospital-Waterbury Care Center — Waterbury, Connecticut, United States
Smilow Cancer Hospital Care Center - Waterford — Waterford, Connecticut, United States
Alfred I duPont Hospital for Children — Wilmington, Delaware, United States
MedStar Georgetown University Hospital — Washington D.C., District of Columbia, United States
Children's National Medical Center — Washington D.C., District of Columbia, United States
Broward Health Medical Center — Fort Lauderdale, Florida, United States
Golisano Children's Hospital of Southwest Florida — Fort Myers, Florida, United States
UF Health Cancer Institute - Gainesville — Gainesville, Florida, United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital — Hollywood, Florida, United States
Nemours Children's Clinic-Jacksonville — Jacksonville, Florida, United States
Mayo Clinic in Florida — Jacksonville, Florida, United States
University of Miami Miller School of Medicine-Sylvester Cancer Center — Miami, Florida, United States
Nicklaus Children's Hospital — Miami, Florida, United States
Mount Sinai Medical Center — Miami Beach, Florida, United States
AdventHealth Orlando — Orlando, Florida, United States
Arnold Palmer Hospital for Children — Orlando, Florida, United States
Nemours Children's Hospital — Orlando, Florida, United States
Nemours Children's Clinic - Pensacola — Pensacola, Florida, United States
Sacred Heart Hospital — Pensacola, Florida, United States
Johns Hopkins All Children's Hospital — St. Petersburg, Florida, United States
Tampa General Hospital — Tampa, Florida, United States
Saint Joseph's Hospital/Children's Hospital-Tampa — Tampa, Florida, United States
Saint Mary's Medical Center — West Palm Beach, Florida, United States
Grady Health System — Atlanta, Georgia, United States
Emory Proton Therapy Center — Atlanta, Georgia, United States
Emory University Hospital Midtown — Atlanta, Georgia, United States
Emory University Hospital/Winship Cancer Institute — Atlanta, Georgia, United States
Children's Healthcare of Atlanta - Arthur M Blank Hospital — Atlanta, Georgia, United States
Emory Saint Joseph's Hospital — Atlanta, Georgia, United States
Augusta University Medical Center — Augusta, Georgia, United States
Atrium Health Navicent — Macon, Georgia, United States
Memorial Health University Medical Center — Savannah, Georgia, United States
Kapiolani Medical Center for Women and Children — Honolulu, Hawaii, United States
Saint Alphonsus Cancer Care Center-Boise — Boise, Idaho, United States
Saint Luke's Cancer Institute - Boise — Boise, Idaho, United States
Saint Alphonsus Cancer Care Center-Caldwell — Caldwell, Idaho, United States
Saint Luke's Cancer Institute - Fruitland — Fruitland, Idaho, United States
Idaho Urologic Institute-Meridian — Meridian, Idaho, United States
Saint Luke's Cancer Institute - Meridian — Meridian, Idaho, United States
Saint Alphonsus Cancer Care Center-Nampa — Nampa, Idaho, United States
Saint Luke's Cancer Institute - Nampa — Nampa, Idaho, United States
Saint Luke's Cancer Institute - Twin Falls — Twin Falls, Idaho, United States
Rush-Copley Medical Center — Aurora, Illinois, United States
Advocate Good Shepherd Hospital — Barrington, Illinois, United States
Mount Sinai Hospital Medical Center — Chicago, Illinois, United States
Lurie Children's Hospital-Chicago — Chicago, Illinois, United States
Northwestern University — Chicago, Illinois, United States
University of Illinois — Chicago, Illinois, United States
Swedish Covenant Hospital — Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center — Chicago, Illinois, United States
Advocate Illinois Masonic Medical Center — Chicago, Illinois, United States
AMG Crystal Lake - Oncology — Crystal Lake, Illinois, United States
Carle at The Riverfront — Danville, Illinois, United States
Decatur Memorial Hospital — Decatur, Illinois, United States
Northwestern Medicine Cancer Center Kishwaukee — DeKalb, Illinois, United States
Advocate Good Samaritan Hospital — Downers Grove, Illinois, United States
Carle Physician Group-Effingham — Effingham, Illinois, United States
Crossroads Cancer Center — Effingham, Illinois, United States
Advocate Sherman Hospital — Elgin, Illinois, United States
Elmhurst Memorial Hospital — Elmhurst, Illinois, United States
NorthShore University HealthSystem-Evanston Hospital — Evanston, Illinois, United States
Northwestern Medicine Cancer Center Delnor — Geneva, Illinois, United States
NorthShore University HealthSystem-Glenbrook Hospital — Glenview, Illinois, United States
Northwestern Medicine Glenview Outpatient Center — Glenview, Illinois, United States
Northwestern Medicine Grayslake Outpatient Center — Grayslake, Illinois, United States
Advocate South Suburban Hospital — Hazel Crest, Illinois, United States
NorthShore University HealthSystem-Highland Park Hospital — Highland Park, Illinois, United States
Northwestern Medicine Lake Forest Hospital — Lake Forest, Illinois, United States
AMG Libertyville - Oncology — Libertyville, Illinois, United States
Condell Memorial Hospital — Libertyville, Illinois, United States
Carle Physician Group-Mattoon/Charleston — Mattoon, Illinois, United States
Loyola University Medical Center — Maywood, Illinois, United States
Edward Hospital/Cancer Center — Naperville, Illinois, United States
HSHS Saint Elizabeth's Hospital — O'Fallon, Illinois, United States
Advocate Christ Medical Center — Oak Lawn, Illinois, United States
Advocate Children's Hospital-Oak Lawn — Oak Lawn, Illinois, United States
Northwestern Medicine Orland Park — Orland Park, Illinois, United States
Advocate Children's Hospital-Park Ridge — Park Ridge, Illinois, United States
Advocate Lutheran General Hospital — Park Ridge, Illinois, United States
OSF Children's Hospital of Illinois — Peoria, Illinois, United States
Edward Hospital/Cancer Center?Plainfield — Plainfield, Illinois, United States
UW Health Carbone Cancer Center Rockford — Rockford, Illinois, United States
Memorial Hospital East — Shiloh, Illinois, United States
Southern Illinois University School of Medicine — Springfield, Illinois, United States
Carle Cancer Center — Urbana, Illinois, United States
Northwestern Medicine Cancer Center Warrenville — Warrenville, Illinois, United States
Rush-Copley Healthcare Center — Yorkville, Illinois, United States
Riley Hospital for Children — Indianapolis, Indiana, United States
Ascension Saint Vincent Indianapolis Hospital — Indianapolis, Indiana, United States
UI Health Care Mission Cancer and Blood - Ankeny Clinic — Ankeny, Iowa, United States
Saint Anthony Regional Hospital — Carroll, Iowa, United States
UI Health Care Mission Cancer and Blood - West Des Moines Clinic — Clive, Iowa, United States
Blank Children's Hospital — Des Moines, Iowa, United States
Iowa Methodist Medical Center — Des Moines, Iowa, United States
UI Health Care Mission Cancer and Blood - Des Moines Clinic — Des Moines, Iowa, United States
UI Health Care Mission Cancer and Blood - Laurel Clinic — Des Moines, Iowa, United States
University of Iowa/Holden Comprehensive Cancer Center — Iowa City, Iowa, United States
UI Health Care Mission Cancer and Blood - Waukee Clinic — Waukee, Iowa, United States
Wesley Medical Center — Wichita, Kansas, United States
University of Kentucky/Markey Cancer Center — Lexington, Kentucky, United States
Norton Children's Hospital — Louisville, Kentucky, United States
The James Graham Brown Cancer Center at University of Louisville — Louisville, Kentucky, United States
UofL Health Medical Center Northeast — Louisville, Kentucky, United States
Children's Hospital New Orleans — New Orleans, Louisiana, United States
Ochsner Medical Center Jefferson — New Orleans, Louisiana, United States
Eastern Maine Medical Center — Bangor, Maine, United States
MaineHealth Coastal Cancer Treatment Center — Bath, Maine, United States
MaineHealth Maine Medical Center - Portland — Portland, Maine, United States
MaineHealth Cancer Care Center of York County — Sanford, Maine, United States
Maine Children's Cancer Program — Scarborough, Maine, United States
MaineHealth Maine Medical Center- Scarborough — Scarborough, Maine, United States
MaineHealth Cancer Care and IV Therapy - South Portland — South Portland, Maine, United States
University of Maryland/Greenebaum Cancer Center — Baltimore, Maryland, United States
Sinai Hospital of Baltimore — Baltimore, Maryland, United States
Johns Hopkins University/Sidney Kimmel Cancer Center — Baltimore, Maryland, United States
Walter Reed National Military Medical Center — Bethesda, Maryland, United States
Dana-Farber Cancer Institute — Boston, Massachusetts, United States
UMass Memorial Medical Center - University Campus — Worcester, Massachusetts, United States
Trinity Health Saint Joseph Mercy Hospital Ann Arbor — Ann Arbor, Michigan, United States
C S Mott Children's Hospital — Ann Arbor, Michigan, United States
Bronson Battle Creek — Battle Creek, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Brighton — Brighton, Michigan, United States
Henry Ford Cancer Institute-Downriver — Brownstown, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Canton — Canton, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology - Chelsea Hospital — Chelsea, Michigan, United States
Henry Ford Macomb Hospital-Clinton Township — Clinton Township, Michigan, United States
Corewell Health Dearborn Hospital — Dearborn, Michigan, United States
Henry Ford Medical Center-Fairlane — Dearborn, Michigan, United States
Children's Hospital of Michigan — Detroit, Michigan, United States
Wayne State University/Karmanos Cancer Institute — Detroit, Michigan, United States
Henry Ford Hospital — Detroit, Michigan, United States
Michigan State University — East Lansing, Michigan, United States
Weisberg Cancer Treatment Center — Farmington Hills, Michigan, United States
Corewell Health Farmington Hills Hospital — Farmington Hills, Michigan, United States
Corewell Health Grand Rapids Hospitals - Butterworth Hospital — Grand Rapids, Michigan, United States
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital — Grand Rapids, Michigan, United States
Trinity Health Grand Rapids Hospital — Grand Rapids, Michigan, United States
Allegiance Health — Jackson, Michigan, United States
Bronson Methodist Hospital — Kalamazoo, Michigan, United States
West Michigan Cancer Center — Kalamazoo, Michigan, United States
Beacon Kalamazoo Cancer Center — Kalamazoo, Michigan, United States
Trinity Health Saint Mary Mercy Livonia Hospital — Livonia, Michigan, United States
Henry Ford Saint John Hospital - Macomb Medical — Macomb, Michigan, United States
Trinity Health Muskegon Hospital — Muskegon, Michigan, United States
Cancer and Hematology Centers of Western Michigan - Norton Shores — Norton Shores, Michigan, United States
Henry Ford Health Providence Novi Hospital — Novi, Michigan, United States
Henry Ford Medical Center-Columbus — Novi, Michigan, United States
Trinity Health Saint Joseph Mercy Oakland Hospital — Pontiac, Michigan, United States
Corewell Health Reed City Hospital — Reed City, Michigan, United States
Corewell Health Children's — Royal Oak, Michigan, United States
Corewell Health William Beaumont University Hospital — Royal Oak, Michigan, United States
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center — Saint Joseph, Michigan, United States
Henry Ford Health Providence Southfield Hospital — Southfield, Michigan, United States
Munson Medical Center — Traverse City, Michigan, United States
Corewell Health Beaumont Troy Hospital — Troy, Michigan, United States
Henry Ford West Bloomfield Hospital — West Bloomfield, Michigan, United States
Henry Ford Wyandotte Hospital — Wyandotte, Michigan, United States
University of Michigan Health - West — Wyoming, Michigan, United States
Trinity Health IHA Medical Group Hematology Oncology Ann Arbor Campus — Ypsilanti, Michigan, United States
Mercy Hospital — Coon Rapids, Minnesota, United States
Fairview Southdale Hospital — Edina, Minnesota, United States
Children's Hospitals and Clinics of Minnesota - Minneapolis — Minneapolis, Minnesota, United States
Abbott-Northwestern Hospital — Minneapolis, Minnesota, United States
University of Minnesota/Masonic Cancer Center — Minneapolis, Minnesota, United States
Mayo Clinic in Rochester — Rochester, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park — Saint Louis Park, Minnesota, United States
Regions Hospital — Saint Paul, Minnesota, United States
United Hospital — Saint Paul, Minnesota, United States
Minnesota Oncology Hematology PA-Woodbury — Woodbury, Minnesota, United States
University of Mississippi Medical Center — Jackson, Mississippi, United States
Saint Francis Medical Center — Cape Girardeau, Missouri, United States
Saint Luke's Hospital — Chesterfield, Missouri, United States
Siteman Cancer Center at Saint Peters Hospital — City of Saint Peters, Missouri, United States
University of Missouri Children's Hospital — Columbia, Missouri, United States
Siteman Cancer Center at West County Hospital — Creve Coeur, Missouri, United States
Children's Mercy Hospitals and Clinics — Kansas City, Missouri, United States
Cardinal Glennon Children's Medical Center — St Louis, Missouri, United States
Washington University School of Medicine — St Louis, Missouri, United States
Siteman Cancer Center-South County — St Louis, Missouri, United States
Siteman Cancer Center at Christian Hospital — St Louis, Missouri, United States
Mercy Hospital Saint Louis — St Louis, Missouri, United States
Nebraska Medicine-Bellevue — Bellevue, Nebraska, United States
Children's Hospital and Medical Center of Omaha — Omaha, Nebraska, United States
Nebraska Medicine-Village Pointe — Omaha, Nebraska, United States
University of Nebraska Medical Center — Omaha, Nebraska, United States
Alliance for Childhood Diseases/Cure 4 the Kids Foundation — Las Vegas, Nevada, United States
Renown Regional Medical Center — Reno, Nevada, United States
Dartmouth Hitchcock Medical Center/Dartmouth Cancer Center — Lebanon, New Hampshire, United States
Cooper Hospital University Medical Center — Camden, New Jersey, United States
Trinitas Hospital and Comprehensive Cancer Center - Williamson Street Campus — Elizabeth, New Jersey, United States
Hunterdon Medical Center — Flemington, New Jersey, United States
Hackensack University Medical Center — Hackensack, New Jersey, United States
Jersey City Medical Center — Jersey City, New Jersey, United States
Cooperman Barnabas Medical Center — Livingston, New Jersey, United States
Monmouth Medical Center — Long Branch, New Jersey, United States
Morristown Medical Center — Morristown, New Jersey, United States
Jersey Shore Medical Center — Neptune City, New Jersey, United States
Saint Peter's University Hospital — New Brunswick, New Jersey, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital — New Brunswick, New Jersey, United States
Rutgers Cancer Institute of New Jersey — New Brunswick, New Jersey, United States
Newark Beth Israel Medical Center — Newark, New Jersey, United States
Saint Joseph's Regional Medical Center — Paterson, New Jersey, United States
Community Medical Center — Toms River, New Jersey, United States
Presbyterian Hospital — Albuquerque, New Mexico, United States
University of New Mexico Cancer Center — Albuquerque, New Mexico, United States
Albany Medical Center — Albany, New York, United States
Roswell Park Cancer Institute — Buffalo, New York, United States
Hematology Oncology Associates of CNY at Camillus — Camillus, New York, United States
Hematology Oncology Associates of Central New York-East Syracuse — East Syracuse, New York, United States
Glens Falls Hospital — Glens Falls, New York, United States
NYU Langone Hospital - Long Island — Mineola, New York, United States
The Steven and Alexandra Cohen Children's Medical Center of New York — New Hyde Park, New York, United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone — New York, New York, United States
Mount Sinai Hospital — New York, New York, United States
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center — New York, New York, United States
Memorial Sloan Kettering Cancer Center — New York, New York, United States
NYP/Weill Cornell Medical Center — New York, New York, United States
University of Rochester — Rochester, New York, United States
Stony Brook University Medical Center — Stony Brook, New York, United States
State University of New York Upstate Medical University — Syracuse, New York, United States
Montefiore Medical Center - Moses Campus — The Bronx, New York, United States
Wilmot Cancer Institute at Webster — Webster, New York, United States
Roswell Park Amherst Center — Williamsville, New York, United States
Mission Hospital — Asheville, North Carolina, United States
UNC Lineberger Comprehensive Cancer Center — Chapel Hill, North Carolina, United States
Carolinas Medical Center/Levine Cancer Institute — Charlotte, North Carolina, United States
Novant Health Presbyterian Medical Center — Charlotte, North Carolina, United States
Duke University Medical Center — Durham, North Carolina, United States
East Carolina University — Greenville, North Carolina, United States
Wake Forest University Health Sciences — Winston-Salem, North Carolina, United States
Sanford Broadway Medical Center — Fargo, North Dakota, United States
Children's Hospital Medical Center of Akron — Akron, Ohio, United States
Cincinnati Children's Hospital Medical Center — Cincinnati, Ohio, United States
Rainbow Babies and Childrens Hospital — Cleveland, Ohio, United States
Cleveland Clinic Foundation — Cleveland, Ohio, United States
Nationwide Children's Hospital — Columbus, Ohio, United States
Dayton Children's Hospital — Dayton, Ohio, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital — Toledo, Ohio, United States
University of Oklahoma Health Sciences Center — Oklahoma City, Oklahoma, United States
Saint Francis Children's Hospital — Tulsa, Oklahoma, United States
Saint Alphonsus Cancer Care Center-Baker City — Baker City, Oregon, United States
Providence Newberg Medical Center — Newberg, Oregon, United States
Saint Alphonsus Cancer Care Center-Ontario — Ontario, Oregon, United States
Providence Willamette Falls Medical Center — Oregon City, Oregon, United States
Providence Portland Medical Center — Portland, Oregon, United States
Providence Saint Vincent Medical Center — Portland, Oregon, United States
Legacy Emanuel Children's Hospital — Portland, Oregon, United States
Oregon Health and Science University — Portland, Oregon, United States
Lehigh Valley Hospital-Cedar Crest — Allentown, Pennsylvania, United States
Geisinger Medical Center — Danville, Pennsylvania, United States
Penn State Children's Hospital — Hershey, Pennsylvania, United States
Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States
Thomas Jefferson University Hospital — Philadelphia, Pennsylvania, United States
Saint Christopher's Hospital for Children — Philadelphia, Pennsylvania, United States
Children's Hospital of Pittsburgh of UPMC — Pittsburgh, Pennsylvania, United States
Rhode Island Hospital — Providence, Rhode Island, United States
Smilow Cancer Hospital Care Center - Westerly — Westerly, Rhode Island, United States
Prisma Health Cancer Institute - Spartanburg — Boiling Springs, South Carolina, United States
Medical University of South Carolina — Charleston, South Carolina, United States
Prisma Health Richland Hospital — Columbia, South Carolina, United States
Saint Francis Hospital — Greenville, South Carolina, United States
BI-LO Charities Children's Cancer Center — Greenville, South Carolina, United States
Saint Francis Cancer Center — Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside — Greenville, South Carolina, United States
Sanford USD Medical Center - Sioux Falls — Sioux Falls, South Dakota, United States
T C Thompson Children's Hospital — Chattanooga, Tennessee, United States
East Tennessee Childrens Hospital — Knoxville, Tennessee, United States
The Children's Hospital at TriStar Centennial — Nashville, Tennessee, United States
Vanderbilt University/Ingram Cancer Center — Nashville, Tennessee, United States
Dell Children's Medical Center of Central Texas — Austin, Texas, United States
Driscoll Children's Hospital — Corpus Christi, Texas, United States
Medical City Dallas Hospital — Dallas, Texas, United States
UT Southwestern/Simmons Cancer Center-Dallas — Dallas, Texas, United States
El Paso Children's Hospital — El Paso, Texas, United States
Cook Children's Medical Center — Fort Worth, Texas, United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center — Houston, Texas, United States
UT MD Anderson Cancer Center — Houston, Texas, United States
Covenant Children's Hospital — Lubbock, Texas, United States
UMC Cancer Center / UMC Health System — Lubbock, Texas, United States
Children's Hospital of San Antonio — San Antonio, Texas, United States
Methodist Children's Hospital of South Texas — San Antonio, Texas, United States
University of Texas Health Science Center at San Antonio — San Antonio, Texas, United States
Scott and White Memorial Hospital — Temple, Texas, United States
Huntsman Cancer Institute/University of Utah — Salt Lake City, Utah, United States
Primary Children's Hospital — Salt Lake City, Utah, United States
University of Vermont and State Agricultural College — Burlington, Vermont, United States
University of Virginia Cancer Center — Charlottesville, Virginia, United States
Inova Fairfax Hospital — Falls Church, Virginia, United States
Children's Hospital of The King's Daughters — Norfolk, Virginia, United States
Naval Medical Center - Portsmouth — Portsmouth, Virginia, United States
VCU Massey Comprehensive Cancer Center — Richmond, Virginia, United States
Carilion Children's — Roanoke, Virginia, United States
Valley Medical Center — Renton, Washington, United States
Seattle Children's Hospital — Seattle, Washington, United States
Providence Sacred Heart Medical Center and Children's Hospital — Spokane, Washington, United States
Mary Bridge Children's Hospital and Health Center — Tacoma, Washington, United States
Vandalia Health/CAMC Institute for Academic Medicine — Charleston, West Virginia, United States
Edwards Comprehensive Cancer Center — Huntington, West Virginia, United States
Aurora Cancer Care-Southern Lakes VLCC — Burlington, Wisconsin, United States
Aurora Saint Luke's South Shore — Cudahy, Wisconsin, United States
Aurora Health Care Germantown Health Center — Germantown, Wisconsin, United States
Aurora Cancer Care-Grafton — Grafton, Wisconsin, United States
Saint Vincent Hospital Cancer Center Green Bay — Green Bay, Wisconsin, United States
Aurora BayCare Medical Center — Green Bay, Wisconsin, United States
Aurora Cancer Care-Kenosha South — Kenosha, Wisconsin, United States
Gundersen Lutheran Medical Center — La Crosse, Wisconsin, United States
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center — Madison, Wisconsin, United States
University of Wisconsin Carbone Cancer Center - University Hospital — Madison, Wisconsin, United States
Aurora Bay Area Medical Group-Marinette — Marinette, Wisconsin, United States
Marshfield Medical Center-Marshfield — Marshfield, Wisconsin, United States
Aurora Cancer Care-Milwaukee — Milwaukee, Wisconsin, United States
Aurora Saint Luke's Medical Center — Milwaukee, Wisconsin, United States
Children's Hospital of Wisconsin — Milwaukee, Wisconsin, United States
Aurora Sinai Medical Center — Milwaukee, Wisconsin, United States
ProHealth D N Greenwald Center — Mukwonago, Wisconsin, United States
ProHealth Oconomowoc Memorial Hospital — Oconomowoc, Wisconsin, United States
Vince Lombardi Cancer Clinic - Oshkosh — Oshkosh, Wisconsin, United States
Aurora Cancer Care-Racine — Racine, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Sheboygan — Sheboygan, Wisconsin, United States
Vince Lombardi Cancer Clinic-Sheboygan — Sheboygan, Wisconsin, United States
Saint Vincent Hospital Cancer Center at Sturgeon Bay — Sturgeon Bay, Wisconsin, United States
Aurora Medical Center in Summit — Summit, Wisconsin, United States
Vince Lombardi Cancer Clinic-Two Rivers — Two Rivers, Wisconsin, United States
UW Cancer Center at ProHealth Care — Waukesha, Wisconsin, United States
Aurora Cancer Care-Milwaukee West — Wauwatosa, Wisconsin, United States
Aurora West Allis Medical Center — West Allis, Wisconsin, United States
Alberta Children's Hospital — Calgary, Alberta, Canada
University of Alberta Hospital — Edmonton, Alberta, Canada
British Columbia Children's Hospital — Vancouver, British Columbia, Canada
CancerCare Manitoba — Winnipeg, Manitoba, Canada
IWK Health Centre — Halifax, Nova Scotia, Canada
McMaster Children's Hospital at Hamilton Health Sciences — Hamilton, Ontario, Canada
Children's Hospital — London, Ontario, Canada
Children's Hospital of Eastern Ontario — Ottawa, Ontario, Canada
Hospital for Sick Children — Toronto, Ontario, Canada
The Montreal Children's Hospital of the MUHC — Montreal, Quebec, Canada
Centre Hospitalier Universitaire Sainte-Justine — Montreal, Quebec, Canada
Centre Hospitalier Universitaire de Sherbrooke-Fleurimont — Sherbrooke, Quebec, Canada
Jim Pattison Children's Hospital — Saskatoon, Saskatchewan, Canada
CHU de Quebec-Centre Hospitalier de l'Universite Laval (CHUL) — Québec, Canada
University Pediatric Hospital — San Juan, Puerto Rico

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