NCT01317940

Brief Summary

Many adolescents with acute lymphoblastic leukemia (ALL) have been found to have low bone density by the end of treatment. This can lead to long-term suffering in survivors due to poor bone health. Vitamin D is known to be associated with bone health and previous research has established that Vitamin D insufficiency is very common at diagnosis of ALL and worsens over the course of treatment. Researchers have also learned that a relationship exists between both Vitamin D and fat tissue and ALL and fat tissue. In adolescents being treated for ALL as well as in early survivors, this randomized study will therefore examine the effect of Vitamin D and calcium supplementation on correcting Vitamin D insufficiency and on improving bone density in the context of changes in body composition and body fat. Bone density will be measured by a radiology exam called qCT (quantitative computed tomography) while body composition and body fat will be measured by a different radiology exam called a DXA (dual energy x-ray absorptiometry scan) . The study will also examine in depth the relationship between these three elements - Vitamin D insufficiency, obesity, and ALL - and their impact on bone density.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
76

participants targeted

Target at P50-P75 for phase_2

Timeline
Completed

Started Mar 2011

Longer than P75 for phase_2

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2011

Completed
16 days until next milestone

First Submitted

Initial submission to the registry

March 17, 2011

Completed
1 day until next milestone

First Posted

Study publicly available on registry

March 18, 2011

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2014

Completed
1.1 years until next milestone

Study Completion

Last participant's last visit for all outcomes

January 1, 2016

Completed
4.5 years until next milestone

Results Posted

Study results publicly available

July 8, 2020

Completed
Last Updated

July 8, 2020

Status Verified

June 1, 2020

Enrollment Period

3.8 years

First QC Date

March 17, 2011

Results QC Date

August 21, 2017

Last Update Submit

June 19, 2020

Conditions

Keywords

LeukemiaALLVitamin DBone DensityBody FatObesityAdipose

Outcome Measures

Primary Outcomes (1)

  • Change in Serum Vitamin D Level (Group A)

    Change in Vitamin D levels from baseline to study end (Group A: Consolidation through end of Delayed Intensification)

    +6 months

Secondary Outcomes (4)

  • Bone Mineral Density by Quantitative Computed Tomography (QCT) at Study End (Group A)

    +6 months

  • Change in Vitamin D Level (Group B)

    +6 months

  • Bone Mineral Density by QCT in Survivors at Study End (Group B)

    +6 months

  • Prevalence of Obesity and Vitamin D Insufficiency in Adolescents With Newly Diagnosed ALL and in Their Siblings

    1 timepoint

Study Arms (5)

Group A (Newly Diagnosed Subjects)

EXPERIMENTAL
Dietary Supplement: Vitamin D and Calcium Citrate

Standard of Care Group A

NO INTERVENTION

Group B (Early Survivors)

EXPERIMENTAL
Dietary Supplement: Vitamin D and Calcium Citrate

Observation Only - Group B

NO INTERVENTION

Group C (Siblings of Group A)

NO INTERVENTION

Interventions

Vitamin D (10,000 int.units/ml) 100,000 int. units (10ml) by mouth once every two months x 3 times (total treatment period approximately 6-7 months) Calcium Carbonate (1,000 mg/tab = 400 mg elemental calcium/tab) 2,000 mg (2 chewable tabs) by mouth every day for approximately 6-7 months

Also known as: 1,25-Dihydroxycholecalciferol, Calcitriol, Rocaltrol (Roche), Calcium carbonate
Group A (Newly Diagnosed Subjects)Group B (Early Survivors)

Eligibility Criteria

Age10 Years - 29 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • GROUP A: Patients with newly diagnosed ALL
  • Are greater than or equal to 10 years of age and less than or equal to 21 years of age at diagnosis of ALL
  • Have a new diagnosis of untreated ALL classified as "high risk" per NCI criteria (due to being greater than 10 years of age)
  • Are beginning treatment with a Children's Cancer Group/Children's Oncology Group "high risk" protocol with a 4-drug induction including steroids
  • Are not pregnant
  • GROUP B: Early survivors of ALL
  • Were treated for ALL and remain in first CR1 (complete remission)
  • Were equal to or greater than 10 years of age and less than or equal to 21 years of age at diagnosis of ALL
  • Have completed treatment on or as per a Children's Cancer Group/Children's Oncology Group "high risk" protocol between 12 and 48 months prior to enrollment in this study (consisting of a plan for a 4-drug induction including steroids in Induction, Delayed Intensification, and steroid pulses in Maintenance. Steroids are allowed to have been discontinued due to toxicity).
  • Are not pregnant
  • GROUP C: Siblings of Group A
  • Are either a full-sibling or a half-sibling of a patient in Group A
  • Are living at the same residence as the sibling/half-sibling from Group A
  • Are greater than or equal to 10 years of age and less than or equal to 21 years of age at the time of study entry, and within 3 years of the age diagnosis of ALL in the sibling/half-sibling from Group A
  • Are on the same Vitamin D supplementation regimen (if any) as the sibling from Group A at the time of his or her diagnosis

You may not qualify if:

  • Have a diagnosis of Down syndrome (Trisomy 21) or any genetic disease associated with abnormal bone development
  • Are undergoing treatment with other medicines that affect bones including chronic use of of steroids, bisphosphonate therapy, or Vitamin D at average dose greater than 400 international units (IU)/day
  • Have an underlying diseases altering body structure (i.e. missing a limb, severe dysmorphism) or severely affecting mobility (i.e. total or hemiparesis)
  • Have a history of chemotherapy or radiation for other cancers
  • Cannot complete the radiology exams/radiology exams uninterpretable (i.e. people with a hip replacement or prosthesis)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Children's Hospital Los Angeles

Los Angeles, California, 90027, United States

Location

Related Publications (1)

  • Orgel E, Framson C, Buxton R, Kim J, Li G, Tucci J, Freyer DR, Sun W, Oberley MJ, Dieli-Conwright C, Mittelman SD. Caloric and nutrient restriction to augment chemotherapy efficacy for acute lymphoblastic leukemia: the IDEAL trial. Blood Adv. 2021 Apr 13;5(7):1853-1861. doi: 10.1182/bloodadvances.2020004018.

Related Links

MeSH Terms

Conditions

Precursor Cell Lymphoblastic Leukemia-LymphomaVitamin D DeficiencyLeukemiaObesity

Interventions

Vitamin DCalcium CitrateCalcitriolCalcium Carbonate

Condition Hierarchy (Ancestors)

Leukemia, LymphoidNeoplasms by Histologic TypeNeoplasmsHematologic DiseasesHemic and Lymphatic DiseasesLymphoproliferative DisordersLymphatic DiseasesImmunoproliferative DisordersImmune System DiseasesAvitaminosisDeficiency DiseasesMalnutritionNutrition DisordersNutritional and Metabolic DiseasesOverweightOvernutritionBody WeightSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

SecosteroidsSteroidsFused-Ring CompoundsPolycyclic CompoundsCalcium CompoundsInorganic ChemicalsCitric AcidCitratesTricarboxylic AcidsAcids, AcyclicCarboxylic AcidsOrganic ChemicalsDihydroxycholecalciferolsHydroxycholecalciferolsCholecalciferolCholestenesCholestanesSterolsMembrane LipidsLipidsCarbonatesCarbonic AcidCarbon Compounds, InorganicMinerals

Results Point of Contact

Title
Dr. Etan Orgel
Organization
Children's Hospital Los Angeles

Study Officials

  • Etan Orgel, MD

    Children's Hospital Los Angeles

    PRINCIPAL INVESTIGATOR
  • Steven Mittelman, MD, PhD

    Children's Hospital Los Angeles

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Clinical Fellow

Study Record Dates

First Submitted

March 17, 2011

First Posted

March 18, 2011

Study Start

March 1, 2011

Primary Completion

December 1, 2014

Study Completion

January 1, 2016

Last Updated

July 8, 2020

Results First Posted

July 8, 2020

Record last verified: 2020-06

Locations