Investigational Agents are new drugs being tested in this trial to see if they are safe and how well they work for children with certain blood cancers that have come back or are not responding to treatment. These agents are specifically chosen because they might work well against certain changes in the cancer cells. The trial aims to find out the best dose that can be given safely and to see if these drugs can help treat the cancer effectively.

Acute Lymphoblastic Leukemia, in Relapse – This is a type of cancer that affects the blood and bone marrow, characterized by the overproduction of immature white blood cells called lymphoblasts. In relapse, the disease returns after a period of improvement or remission. The abnormal cells can crowd out normal cells, leading to symptoms like fatigue, fever, and increased risk of infections. The disease progresses as these cancerous cells multiply rapidly, affecting the body’s ability to produce healthy blood cells. Over time, it can spread to other parts of the body, including the lymph nodes, liver, and spleen.

Lymphoblastic Lymphoma (Precursor B-Lymphoblastic Lymphoma/Leukemia) Recurrent – This is a type of non-Hodgkin lymphoma that originates from immature B-lymphocytes. In its recurrent form, the disease returns after treatment. It typically presents as a rapidly growing mass, often in the chest area, and can spread to other organs. The disease progresses as the abnormal lymphocytes multiply uncontrollably, potentially leading to symptoms such as swelling of lymph nodes, fever, and weight loss. It can also affect the bone marrow and central nervous system.

Lymphoblastic Lymphoma (Precursor T-Lymphoblastic Lymphoma/Leukemia) Recurrent – This is a type of aggressive non-Hodgkin lymphoma that arises from immature T-lymphocytes. When recurrent, the disease reappears after initial treatment. It often presents with a large mass in the chest and can spread to the bone marrow and central nervous system. The disease progresses as the cancerous T-cells proliferate rapidly, causing symptoms like chest pain, breathing difficulties, and swollen lymph nodes. It can also lead to complications due to the spread of cancerous cells.

Lymphoblastic Lymphoma (Precursor B-Lymphoblastic Lymphoma/Leukemia) Refractory – This condition refers to a type of non-Hodgkin lymphoma that does not respond to standard treatments. It originates from immature B-lymphocytes and can present as a rapidly growing mass. The disease progresses as the abnormal cells continue to multiply despite treatment efforts, leading to symptoms such as swollen lymph nodes, fever, and fatigue. It can spread to other parts of the body, including the bone marrow and central nervous system, complicating the clinical picture.

Lymphoblastic Lymphoma (Precursor T-Lymphoblastic Lymphoma/Leukemia) Refractory – This is a form of aggressive non-Hodgkin lymphoma that does not respond to conventional therapies. It arises from immature T-lymphocytes and often presents with a large mass in the chest. The disease progresses as the cancerous cells continue to grow and spread, causing symptoms like chest pain, difficulty breathing, and swollen lymph nodes. It can also affect the bone marrow and central nervous system, leading to further health complications.