Liver shield: nutrient may prevent chemo side effect in young leukemia patients

NCT ID NCT05602194

Symptom relief Sponsor: Children's Oncology Group Source: ClinicalTrials.gov ↗

First seen Jun 27, 2026 · Last updated Aug 21, 2026 · Updated 3 times

Summary

This study tests whether adding levocarnitine, a natural nutrient, to standard chemotherapy can prevent severe liver damage in teens and young adults (ages 15-39) with leukemia or lymphoma. About 440 participants will receive either chemotherapy alone or chemotherapy plus levocarnitine. The goal is to help patients complete their planned treatment without liver problems.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Phase 3

Large-scale testing in a bigger group. Usually the last step before a treatment can be approved.

Participants

About 440 people

The number the study aims to enrol. It can still change while the study runs.

Started

Aug 2023

Expected to finish

Dec 2028

An estimate. End dates often move.

Lead sponsor

A research network

The lead sponsor is a research network or cooperative group.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

15 to 40 years

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * \>= 15 and \< 40 years at time of diagnosis * Newly diagnosed B-ALL, T-ALL, lymphoblastic lymphoma (LLy), or mixed-phenotype acute leukemia/lymphoma (MPAL) * Note: Philadelphia chromosome (PH)+ and PH-like acute leukemia are eligible (use of tyrosine kinase inhibitors \[TKI\] or CRLF2- targeted concomitant medication must be documented, if used) * Conjugated bilirubin =\< 1.5 x upper limit of normal (ULN) for age, regardless of baseline bilirubin (within 7 days prior to enrollment), and * Serum glutamate pyruvate transaminase (SGPT) (ALT) =\< 225 U/L (=\< 5x ULN) (within 7 days prior to enrollment), and * Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U/L and serum glutamic oxaloacetic transaminase (SGOT) (AST) to 50 U/L regardless of baseline * SGOT (AST) =\< 250 U/L (=\< 5x ULN) (within 7 days prior to enrollment) * Note: For the purpose of this study, the ULN for SGPT (ALT) has been set to the value of 45 U/L and SGOT (AST) to 50 U/L regardless of baseline * For patients receiving ursodiol prior to enrollment, laboratory values must meet above criteria off ursodiol for 7 days * PEDIATRIC PATIENTS (AGE 15-17 years): * A 24-hour urine creatinine clearance \>= 30 mL/min/1.73 m\^2 (within 7 days prior to enrollment) OR * A glomerular filtration rate (GFR) \>= 30 mL/min/1.73 m\^2. GFR must be performed using one of the following methods (within 7 days prior to enrollment): * Estimated GFR (eGFR) \>= 30 mL/min/1.73 m\^2. * An online calculator is available through the National Kidney Foundation at https://www.kidney.org/professionals/kdoqi/gfr\_calculatorped * Measured GFR \>= 30 mL/min/1.73 m\^2 (any age). If measured GFR is used, it must be performed using direct measurement with a nuclear blood sampling method or small molecule clearance method (iothalamate or other molecule per institutional standard) * ADULT PATIENTS (AGE 18 YEARS OR OLDER): Creatinine clearance \>= 30 mL/min, as estimated by the Cockcroft and Gault formula or a 24-hour urine collection (within 7 days prior to enrollment). Estimated creatinine clearance is based on actual body weight * An online calculator is available through the National Kidney Foundation at https://www.kidney.org/professionals/kdoqi/gfr\_calculatorcoc * Berlin-Frankfurt-Munich (BFM), Children's Oncology Group (COG), or C10403-based Induction regimen and must be inclusive of \>= 1 dose of pegaspargase or calaspargase pegol, and * First dose of asparaginase must be planned within the first week of induction therapy, and * Dose of pegaspargase or calaspargase pegol must be \>= 1,000 IU/ m\^2 (dose-capping permitted per primary regimen) * Note: Co-enrollment on a therapeutic consortia trial is not required * 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 Exclusion Criteria: * Down syndrome * Known inherited or autoimmune liver disease impacting conjugated bilirubin (e.g., Alagille syndrome, primary sclerosing cholangitis, other) * Known biopsy (or imaging) proven severe liver fibrosis (Batts-Ludwig \>= stage 3) * Unable to tolerate oral formulation of study drug at enrollment * Patients who received chemotherapy or treatment for a prior malignancy are not eligible * The following are permitted: steroid prophase, hydroxyurea, or other cytoreduction prior to initiation of Induction chemotherapy (must be documented) and chemotherapy for current diagnosis (i.e. initiation of Induction therapy within enrollment window). Chemotherapy prior to enrollment for treatment of a non-malignancy (e.g., steroid or methotrexate for autoimmune disease) is also permitted and must be documented * Female patients who are pregnant since fetal toxicities and teratogenic effects in humans are unknown for study drug. A pregnancy test is required for female patients of childbearing potential * Lactating females who plan to breastfeed their infants * Sexually active patients of reproductive potential who have not agreed to use an effective contraceptive method for the duration of their study participation

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Conditions

The condition(s) this trial relates to.

acute biphenotypic leukemia B-cell childhood acute lymphoblastic leukemia B-lymphoblastic leukemia/lymphoma with t(9;22)(q34.1;q11.2) B-lymphoblastic leukemia/lymphoma, BCR-ABL1–like Burkitt lymphoma lymphoblastic lymphoma mixed phenotype acute leukemia Precursor Cell Lymphoblastic Leukemia-Lymphoma Precursor T-Cell Lymphoblastic Leukemia-Lymphoma T-cell childhood acute lymphocytic leukemia

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

B acute lymphoblastic leukemia B acute lymphoblastic leukemia with T(9;22)(Q34.1;Q11.2); BCR-ABL1 B acute lymphoblastic leukemia, BCR-ABL1-like Lymphoblastic lymphoma Mixed phenotype acute leukemia T acute lymphoblastic leukemia

Contacts and locations

Locations

AdventHealth Orlando

Orlando, Florida, 32803, United States
Advocate Children's Hospital-Oak Lawn

Oak Lawn, Illinois, 60453, United States
Advocate Children's Hospital-Park Ridge

Park Ridge, Illinois, 60068, United States
Albany Medical Center

Albany, New York, 12208, United States
Alfred I duPont Hospital for Children

Wilmington, Delaware, 19803, United States
Alliance for Childhood Diseases/Cure 4 the Kids Foundation

Las Vegas, Nevada, 89135, United States
Ann M Wierman MD LTD

Las Vegas, Nevada, 89128, United States
Arkansas Children's Hospital

Little Rock, Arkansas, 72202-3591, United States
Ascension Saint Vincent Indianapolis Hospital

Indianapolis, Indiana, 46260, United States
Aurora Bay Area Medical Group-Marinette

Marinette, Wisconsin, 54143, United States
Aurora BayCare Medical Center

Green Bay, Wisconsin, 54311, United States
Aurora Cancer Care-Grafton

Grafton, Wisconsin, 53024, United States
Aurora Cancer Care-Kenosha South

Kenosha, Wisconsin, 53142, United States
Aurora Cancer Care-Milwaukee

Milwaukee, Wisconsin, 53209, United States
Aurora Cancer Care-Milwaukee West

Wauwatosa, Wisconsin, 53226, United States
Aurora Cancer Care-Racine

Racine, Wisconsin, 53406, United States
Aurora Cancer Care-Southern Lakes VLCC

Burlington, Wisconsin, 53105, United States
Aurora Health Care Germantown Health Center

Germantown, Wisconsin, 53022, United States
Aurora Medical Center in Summit

Summit, Wisconsin, 53066, United States
Aurora Saint Luke's Medical Center

Milwaukee, Wisconsin, 53215, United States
Aurora Saint Luke's South Shore

Cudahy, Wisconsin, 53110, United States
Aurora Sinai Medical Center

Milwaukee, Wisconsin, 53233, United States
Aurora West Allis Medical Center

West Allis, Wisconsin, 53227, United States
BI-LO Charities Children's Cancer Center

Greenville, South Carolina, 29605, United States
Banner University Medical Center - Tucson

Tucson, Arizona, 85719, United States
Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center

Houston, Texas, 77030, United States
Beacon Kalamazoo

Kalamazoo, Michigan, 49048, United States
Beacon Kalamazoo Cancer Center

Kalamazoo, Michigan, 49009, United States
Blank Children's Hospital

Des Moines, Iowa, 50309, United States
Bronson Battle Creek

Battle Creek, Michigan, 49017, United States
Bronson Methodist Hospital

Kalamazoo, Michigan, 49007, United States
C S Mott Children's Hospital

Ann Arbor, Michigan, 48109, United States
Cancer and Hematology Centers of Western Michigan - Norton Shores

Norton Shores, Michigan, 49444, United States
Carilion Children's

Roanoke, Virginia, 24014, United States
Carolinas Medical Center/Levine Cancer Institute

Charlotte, North Carolina, 28203, United States
Carson Tahoe Regional Medical Center

Carson City, Nevada, 89703, United States
Children's Healthcare of Atlanta - Arthur M Blank Hospital

Atlanta, Georgia, 30329, United States
Children's Hospital

London, Ontario, N6A 5W9, Canada
Children's Hospital Colorado

Aurora, Colorado, 80045, United States
Children's Hospital Los Angeles

Los Angeles, California, 90027, United States
Children's Hospital Medical Center of Akron

Akron, Ohio, 44308, United States
Children's Hospital New Orleans

New Orleans, Louisiana, 70118, United States
Children's Hospital and Medical Center of Omaha

Omaha, Nebraska, 68114, United States
Children's Hospital at Montefiore

The Bronx, New York, 10467, United States
Children's Hospital of Alabama

Birmingham, Alabama, 35233, United States
Children's Hospital of Michigan

Detroit, Michigan, 48201, United States
Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States
Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, 15224, United States
Children's Hospital of San Antonio

San Antonio, Texas, 78207, United States
Children's Hospital of The King's Daughters

Norfolk, Virginia, 23507, United States
Children's Hospital of Wisconsin

Milwaukee, Wisconsin, 53226, United States
Children's Mercy Hospitals and Clinics

Kansas City, Missouri, 64108, United States
Children's National Medical Center

Washington D.C., District of Columbia, 20010, United States
Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, 45229, United States
City of Hope Comprehensive Cancer Center

Duarte, California, 91010, United States
Cleveland Clinic Foundation

Cleveland, Ohio, 44195, United States
Comprehensive Cancer Centers of Nevada

Las Vegas, Nevada, 89148, United States
Comprehensive Cancer Centers of Nevada - Central Valley

Las Vegas, Nevada, 89169, United States
Comprehensive Cancer Centers of Nevada - Henderson

Henderson, Nevada, 89052, United States
Comprehensive Cancer Centers of Nevada - Northwest

Las Vegas, Nevada, 89128, United States
Comprehensive Cancer Centers of Nevada - Town Center

Las Vegas, Nevada, 89144, United States
Comprehensive Cancer Centers of Nevada-Horizon Ridge

Henderson, Nevada, 89052, United States
Comprehensive Cancer Centers of Nevada-Southeast Henderson

Henderson, Nevada, 89074, United States
Comprehensive Cancer Centers of Nevada-Summerlin

Las Vegas, Nevada, 89144, United States
Cook Children's Medical Center

Fort Worth, Texas, 76104, 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
Corewell Health Lakeland Hospitals - Marie Yeager Cancer Center

Saint Joseph, Michigan, 49085, United States
Corewell Health Lakeland Hospitals - Niles Hospital

Niles, Michigan, 49120, United States
Corewell Health Lakeland Hospitals - Saint Joseph Hospital

Saint Joseph, Michigan, 49085, United States
Corewell Health Reed City Hospital

Reed City, Michigan, 49677, United States
Covenant Children's Hospital

Lubbock, Texas, 79410, United States
Dayton Children's Hospital

Dayton, Ohio, 45404, United States
Dell Children's Medical Center of Central Texas

Austin, Texas, 78723, United States
Driscoll Children's Hospital

Corpus Christi, Texas, 78411, United States
East Tennessee Childrens Hospital

Knoxville, Tennessee, 37916, United States
El Paso Children's Hospital

El Paso, Texas, 79905, United States
Geisinger Medical Center

Danville, Pennsylvania, 17822, United States
Golisano Children's Hospital of Southwest Florida

Fort Myers, Florida, 33908, United States
Hackensack University Medical Center

Hackensack, New Jersey, 07601, United States
Hope Cancer Care of Nevada

Las Vegas, Nevada, 89103, United States
Hope Cancer Care of Nevada-Pahrump

Pahrump, Nevada, 89048, United States
Hospital for Sick Children

Toronto, Ontario, M5G 1X8, Canada
IWK Health Centre

Halifax, Nova Scotia, B3K 6R8, Canada
Inova Fairfax Hospital

Falls Church, Virginia, 22042, United States
Jersey Shore Medical Center

Neptune City, New Jersey, 07753, United States
Johns Hopkins All Children's Hospital

St. Petersburg, Florida, 33701, United States
Johns Hopkins University/Sidney Kimmel Cancer Center

Baltimore, Maryland, 21287, United States
Kaiser Permanente Downey Medical Center

Downey, California, 90242, United States
Kaiser Permanente Los Angeles Medical Center

Los Angeles, California, 90027, United States
Kaiser Permanente-Anaheim

Anaheim, California, 92806, United States
Kaiser Permanente-Bellflower

Bellflower, California, 90706, United States
Kaiser Permanente-Fontana

Fontana, California, 92335, United States
Kaiser Permanente-San Diego Mission

San Diego, California, 92108, United States
Kaiser Permanente-San Diego Zion

San Diego, California, 92120, United States
Kapiolani Medical Center for Women and Children

Honolulu, Hawaii, 96826, United States
Kingman Regional Medical Center

Kingman, Arizona, 86401, United States
Las Vegas Urology - Cathedral Rock

Las Vegas, Nevada, 89128, United States
Las Vegas Urology - Green Valley

Henderson, Nevada, 89074, United States
Las Vegas Urology - Pebble

Henderson, Nevada, 89074, United States
Las Vegas Urology - Pecos

Las Vegas, Nevada, 89074, United States
Las Vegas Urology - Smoke Ranch

Las Vegas, Nevada, 89128, United States
Las Vegas Urology - Sunset

Las Vegas, Nevada, 89113, United States
Laura and Isaac Perlmutter Cancer Center at NYU Langone

New York, New York, 10016, United States
Loma Linda University Medical Center

Loma Linda, California, 92354, United States
Lucile Packard Children's Hospital Stanford University

Palo Alto, California, 94304, United States
Madigan Army Medical Center

Tacoma, Washington, 98431, United States
Maimonides Medical Center

Brooklyn, New York, 11219, United States
Maine Children's Cancer Program

Scarborough, Maine, 04074, United States
Marshfield Medical Center-Marshfield

Marshfield, Wisconsin, 54449, United States
Mary Bridge Children's Hospital and Health Center

Tacoma, Washington, 98405, United States
Mayo Clinic in Rochester

Rochester, Minnesota, 55905, United States
Medical City Dallas Hospital

Dallas, Texas, 75230, United States
Memorial Health University Medical Center

Savannah, Georgia, 31404, United States
Memorial Regional Hospital/Joe DiMaggio Children's Hospital

Hollywood, Florida, 33021, United States
Mercy Hospital Saint Louis

St Louis, Missouri, 63141, United States
Methodist Children's Hospital of South Texas

San Antonio, Texas, 78229, United States
Miami Cancer Institute

Miami, Florida, 33176, United States
Michigan State University

East Lansing, Michigan, 48823, United States
Miller Children's and Women's Hospital Long Beach

Long Beach, California, 90806, United States
Montefiore Medical Center - Moses Campus

The Bronx, New York, 10467, United States
Montefiore Medical Center-Einstein Campus

The Bronx, New York, 10461, United States
Montefiore Medical Center-Weiler Hospital

The Bronx, New York, 10461, United States
Munson Medical Center

Traverse City, Michigan, 49684, United States
NYP/Weill Cornell Medical Center

New York, New York, 10065, United States
NYU Langone Hospital - Long Island

Mineola, New York, 11501, United States
Nationwide Children's Hospital

Columbus, Ohio, 43205, United States
Nemours Children's Clinic - Pensacola

Pensacola, Florida, 32504, United States
Nemours Children's Clinic-Jacksonville

Jacksonville, Florida, 32207, United States
Nemours Children's Hospital

Orlando, Florida, 32827, United States
New York Medical College

Valhalla, New York, 10595, United States
Newark Beth Israel Medical Center

Newark, New Jersey, 07112, United States
Nicklaus Children's Hospital

Miami, Florida, 33155, United States
North Star Lodge Cancer Center at Yakima Valley Memorial Hospital

Yakima, Washington, 98902, United States
Northwestern University

Chicago, Illinois, 60611, United States
Norton Children's Hospital

Louisville, Kentucky, 40202, United States
OSF Children's Hospital of Illinois

Peoria, Illinois, 61637, United States
Ochsner Medical Center Jefferson

New Orleans, Louisiana, 70121, United States
Oncology Las Vegas - Henderson

Henderson, Nevada, 89074, United States
Oncology Las Vegas - Tenaya

Las Vegas, Nevada, 89128, United States
OptumCare Cancer Care at Charleston

Las Vegas, Nevada, 89102, United States
OptumCare Cancer Care at Fort Apache

Las Vegas, Nevada, 89183, United States
OptumCare Cancer Care at MountainView

Las Vegas, Nevada, 89128, United States
Oregon Health and Science University

Portland, Oregon, 97239, United States
PCR Oncology

Arroyo Grande, California, 93420, United States
Penn State Children's Hospital

Hershey, Pennsylvania, 17033, United States
Phoenix Childrens Hospital

Phoenix, Arizona, 85016, United States
Presbyterian Hospital

Albuquerque, New Mexico, 87106, United States
Prisma Health Cancer Institute - Eastside

Greenville, South Carolina, 29615, United States
Prisma Health Greenville Memorial Hospital

Greenville, South Carolina, 29605, United States
Prisma Health Richland Hospital

Columbia, South Carolina, 29203, United States
ProMedica Toledo Hospital/Russell J Ebeid Children's Hospital

Toledo, Ohio, 43606, United States
Providence Alaska Medical Center

Anchorage, Alaska, 99508, United States
Providence Sacred Heart Medical Center and Children's Hospital

Spokane, Washington, 99204, United States
Radiation Oncology Associates

Reno, Nevada, 89509, United States
Radiation Oncology Centers of Nevada Central

Las Vegas, Nevada, 89106, United States
Radiation Oncology Centers of Nevada Southeast

Las Vegas, Nevada, 89119, United States
Rainbow Babies and Childrens Hospital

Cleveland, Ohio, 44106, United States
Renown Regional Medical Center

Reno, Nevada, 89502, United States
Riley Hospital for Children

Indianapolis, Indiana, 46202, United States
Rocky Mountain Hospital for Children-Presbyterian Saint Luke's Medical Center

Denver, Colorado, 80218, United States
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital

New Brunswick, New Jersey, 08903, United States
Sacred Heart Hospital

Pensacola, Florida, 32504, United States
Saint Francis Cancer Center

Greenville, South Carolina, 29607, United States
Saint Francis Children's Hospital

Tulsa, Oklahoma, 74136, United States
Saint Francis Hospital

Greenville, South Carolina, 29601, United States
Saint Joseph's Hospital/Children's Hospital-Tampa

Tampa, Florida, 33607, United States
Saint Joseph's Regional Medical Center

Paterson, New Jersey, 07503, United States
Saint Luke's Cancer Institute - Boise

Boise, Idaho, 83712, United States
Saint Luke's Cancer Institute - Fruitland

Fruitland, Idaho, 83619, United States
Saint Luke's Cancer Institute - Meridian

Meridian, Idaho, 83642, United States
Saint Luke's Cancer Institute - Nampa

Nampa, Idaho, 83687, United States
Saint Luke's Cancer Institute - Twin Falls

Twin Falls, Idaho, 83301, United States
Saint Mary's Regional Medical Center

Reno, Nevada, 89503, United States
Sanford Broadway Medical Center

Fargo, North Dakota, 58122, United States
Sanford USD Medical Center - Sioux Falls

Sioux Falls, South Dakota, 57117-5134, United States
Seattle Children's Hospital

Seattle, Washington, 98105, United States
Sinai Hospital of Baltimore

Baltimore, Maryland, 21215, United States
Southern Illinois University School of Medicine

Springfield, Illinois, 62702, United States
Stanford Cancer Institute Palo Alto

Palo Alto, California, 94304, United States
Stony Brook University Medical Center

Stony Brook, New York, 11794, United States
Summerlin Hospital Medical Center

Las Vegas, Nevada, 89144, United States
Sunrise Hospital and Medical Center

Las Vegas, Nevada, 89109, United States
Sutter Medical Center Sacramento

Sacramento, California, 95816, United States
Tampa General Hospital

Tampa, Florida, 33606, United States
The Children's Hospital at TriStar Centennial

Nashville, Tennessee, 37203, United States
The Steven and Alexandra Cohen Children's Medical Center of New York

New Hyde Park, New York, 11040, United States
Trinity Health Grand Rapids Hospital

Grand Rapids, Michigan, 49503, United States
Trinity Health Muskegon Hospital

Muskegon, Michigan, 49444, United States
UCSF Benioff Children's Hospital Oakland

Oakland, California, 94609, United States
UCSF Medical Center-Mission Bay

San Francisco, California, 94158, United States
UF Health Cancer Institute - Gainesville

Gainesville, Florida, 32610, United States
UMC Cancer Center / UMC Health System

Lubbock, Texas, 79415, United States
UNC Lineberger Comprehensive Cancer Center

Chapel Hill, North Carolina, 27599, United States
UT MD Anderson Cancer Center

Houston, Texas, 77030, United States
UT Southwestern/Simmons Cancer Center-Dallas

Dallas, Texas, 75390, United States
University Medical Center of Southern Nevada

Las Vegas, Nevada, 89102, United States
University of California Davis Comprehensive Cancer Center

Sacramento, California, 95817, United States
University of Chicago Comprehensive Cancer Center

Chicago, Illinois, 60637, United States
University of Illinois

Chicago, Illinois, 60612, United States
University of Iowa/Holden Comprehensive Cancer Center

Iowa City, Iowa, 52242, United States
University of Kansas Cancer Center

Kansas City, Kansas, 66160, United States
University of Kansas Hospital-Westwood Cancer Center

Westwood, Kansas, 66205, United States
University of Kentucky/Markey Cancer Center

Lexington, Kentucky, 40536, United States
University of Michigan Health - West

Wyoming, Michigan, 49519, United States
University of Michigan Rogel Cancer Center

Ann Arbor, Michigan, 48109, United States
University of Mississippi Medical Center

Jackson, Mississippi, 39216, United States
University of Nebraska Medical Center

Omaha, Nebraska, 68198, United States
University of New Mexico Cancer Center

Albuquerque, New Mexico, 87106, United States
University of Oklahoma Health Sciences Center

Oklahoma City, Oklahoma, 73104, United States
University of Texas Health Science Center at San Antonio

San Antonio, Texas, 78229, United States
University of Virginia Cancer Center

Charlottesville, Virginia, 22908, United States
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center

Madison, Wisconsin, 53718, United States
University of Wisconsin Carbone Cancer Center - University Hospital

Madison, Wisconsin, 53792, United States
Urology Specialists of Nevada - Central

Las Vegas, Nevada, 89106, United States
Urology Specialists of Nevada - Green Valley

Henderson, Nevada, 89074, United States
Urology Specialists of Nevada - Northwest

Las Vegas, Nevada, 89128, United States
Urology Specialists of Nevada - Southwest

Las Vegas, Nevada, 89113, United States
VCU Massey Comprehensive Cancer Center

Richmond, Virginia, 23298, United States
Valley Children's Hospital

Madera, California, 93636, United States
Valley Medical Center

Renton, Washington, 98055, United States
Vanderbilt University/Ingram Cancer Center

Nashville, Tennessee, 37232, United States
Vannie Cook Children's Clinic

McAllen, Texas, 78503, United States
Vince Lombardi Cancer Clinic - Oshkosh

Oshkosh, Wisconsin, 54904, United States
Vince Lombardi Cancer Clinic-Sheboygan

Sheboygan, Wisconsin, 53081, United States
Vince Lombardi Cancer Clinic-Two Rivers

Two Rivers, Wisconsin, 54241, United States
Wake Forest University Health Sciences

Winston-Salem, North Carolina, 27157, United States
West Michigan Cancer Center

Kalamazoo, Michigan, 49007, United States

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