Acute Lymphoblastic Leukemia Clinical Trial
Official title:
Therapeutic Interventions For Peripheral Neuropathy/Neuropathic Pain Induced By Vincristine Treatment For Childhood Acute Lymphoblastic Leukemia (ALL) On Total XVI Protocol
Neuropathic pain / peripheral neuropathy (NP/PN) is a known painful complication of vincristine (VCR) therapy; evidence supporting the best treatment plan for pediatric patients is limited. Gabapentin is frequently used for VCR-related NP/PN, with variable dosing and scheduling regimens, and with varying measures of success. The hypothesis of the study is that gabapentin will reduce the severity of NP/PN in patients receiving vincristine during treatment for ALL on the Total XVI protocol (or for those being treated "as per TOTXVI protocol"), as measured by two outcome measures: the daily dose of morphine used as needed for pain in addition to either gabapentin or placebo, as randomized, and the pain scores assessed daily.
Patients with ALL on Total XVI ((or for those being treated "as per TOTXVI protocol") who
experience NP/PN after specific doses of vincristine are eligible to enroll in the study as
soon as the diagnosis of NP/PN related to VCR is established. The qualifying doses of
vincristine have been selected because they fall in the schedule of weekly vincristine doses
as per Total XVI, and 2 additional weekly vincristine doses are anticipated according to the
protocol. Participants will be randomized to receive gabapentin or placebo upon enrollment.
Morphine will be available to both groups as needed for pain at any time on the study. At the
time of enrollment, and daily thereafter until completion of the study drug, data will be
collected for pain assessment, and the daily dose of oral morphine used will be collected.
Data regarding the pain type, quality, and location, as well as treatments used to manage
pain will be assessed on a daily basis for the diagnostic event and for the period following
the next two administrations of VCR treated with the study drug.
Primary Objective: To assess the analgesic efficacy of gabapentin in controlling VCR-related
NP/PN in participants with ALL, by comparing the morphine daily dose (mg/kg/day) used to
control NP/PN as a primary or a rescue regimen in the gabapentin vs. placebo groups.
Secondary Objective: To compare the pain scores in the gabapentin and placebo groups as
recorded by pain score right now and pain score average for previous 24 hours.
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