Acute Myeloid Leukemia Clinical Trial
Official title:
Transfusional Iron Overload Among Leukemia Survivors
Verified date | May 2017 |
Source | St. Jude Children's Research Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Red cell transfusions are an important part of supportive cancer therapy. The iron in the
transfused blood may build up in the body since the human body has no way to get rid of
extra iron. Iron tends to build up in the liver and the heart muscle. It is unknown if iron
build-up is present many years after completing cancer therapy. It is also not known if
extra iron causes harm to internal organs. Researchers at St. Jude Children's Research
Hospital (SJCRH) want to understand if iron build-up (called "iron overload") exists in
survivors of leukemia. They also want to know if iron overload can cause injury to your
organs if it is present.
Liver iron accumulation has been documented in childhood cancer survivors, however, it is
not known if iron associated organ toxicity is contributing to the long-term morbidity that
has been well documented among these survivors. This study will investigate the prevalence
of iron overload and the association of tissue iron burden with markers of organ dysfunction
in leukemia survivors. This study will determine the prevalence of iron overload among
long-term leukemia survivors that underwent blood transfusion. This study will use blood and
magnetic resonance imaging (MRI) testing to determine iron overload of specified organs.
Understanding the prevalence of iron overload could impact surveillance practices in
leukemia survivors.
PRIMARY OBJECTIVE:
- To determine the prevalence of iron overload in the liver [liver iron concentration
(LIC) >3mg/g using R2* MRI measurements] and in the heart (T2* <20 ms) among long-term
leukemia survivors transfused with ≥50ml/kg of packed red blood cells.
SECONDARY OBJECTIVES:
- To examine the relationship between hepatic, cardiac, and endocrine dysfunction and
transfusionally acquired iron overload as defined by R2* and T2* MRI among survivors of
pediatric leukemias.
- To investigate the association between serum ferritin, transferrin saturation,
non-transferrin-bound iron, and hepcidin measurements with R2* and T2* MRI-defined iron
overload.
Status | Completed |
Enrollment | 24 |
Est. completion date | May 2017 |
Est. primary completion date | May 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 5 Years and older |
Eligibility |
Inclusion Criteria: - A diagnosis of ALL or AML that was treated at SJCRH with conventional chemotherapy. - At time of enrollment survivors should be > 5 and < 10 years from diagnosis of primary cancer. - A packed red blood cell transfusion history of =50 ml/kg. Exclusion Criteria: - Undergoing active cancer therapy for relapse or subsequent malignant neoplasm - History of hematopoietic stem cell transplant (HSCT) - A known disorder of iron regulation such as hereditary hemochromatosis - Any contraindication to undergoing an MRI, such as the presence of ferromagnetic material in the body - If patient is an adult (18 years or over), does require IV sedation or anxiolytic to undergo MRI - Positive pregnancy test, or known ongoing pregnancy |
Country | Name | City | State |
---|---|---|---|
United States | St. Jude Children's Research Hospital | Memphis | Tennessee |
Lead Sponsor | Collaborator |
---|---|
St. Jude Children's Research Hospital | Baylor College of Medicine |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Proportion of iron overload | Iron overload will be measured by R2*MRI in the liver and T2* in the heart and is defined as R2*MRI value > 3 mg/g and/or T2* MRI <20ms. | On day of enrollment | |
Secondary | Relationship between hepatic, cardiac, and endocrine dysfunction and transfusionally-acquired iron overload | Fisher's Exact test will be performed to examine the relationship of organ dysfunction and iron overload. Then the logistic regression model will be built to evaluate the effect of the iron overload defined by R2* and T2* MRI on the risk of organ dysfunction, respectively, while controlling for the effects of craniospinal radiation and chemotherapeutic agents. | On day of enrollment | |
Secondary | Association between serum ferritin, transferrin saturation, non-transferrin-bound iron, and hepcidin measurements with R2* and T2* MRI-defined iron overload | Logistic regression model will be used to evaluate the association of iron overload status and the above four iron test measurements. | On day of enrollment |
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