CiproPAL (Ciprofloxacin Prophylaxis in Acute Leukaemia)

This study is particularly for children and teenagers between 1 and 17 years old who have recently been diagnosed with Acute Lymphoblastic Leukaemia (ALL). They must be receiving their ALL treatment as part of another main study called ALLTogether-1 in the UK.

Your child can participate if they are starting their ALL treatment within the first five days, though up to 14 days is also acceptable. Most importantly, you, as their parent or guardian, must agree for your child to take part in both the ALLTogether-1 study and the CiproPAL study.

There are a few reasons why a child might not be able to join. For example, if they have Down syndrome (because they usually receive ciprofloxacin already) or if they have certain conditions that mean they can't take antibiotics like ciprofloxacin. They also cannot join if they are not part of the main ALLTogether-1 study.

If your child takes part in the CiproPAL study, they will be randomly assigned to one of two groups: either receiving daily ciprofloxacin or continuing with standard care. This will happen during the initial 'induction' phase of their ALL treatment, which is when they are most vulnerable to infections. Ciprofloxacin would be given either by mouth or through a drip, twice a day.

Throughout the first year, doctors will take small samples, like stool (poo) or swabs from around the bottom, at five different times. These samples help check how bacteria in your child's body are responding to antibiotics. If your child gets an infection, doctors will also test the bacteria from that infection to see which antibiotics work against it. All these checks are part of your child's regular ALL treatment and hospital visits. The study itself won't add many extra appointments, but it will involve specific monitoring and, for one group, taking the study medication. The overall monitoring for antibiotic resistance will continue for the duration of the main ALLTogether-1 trial.