Acute Lymphoblastic Leukemia, Osteonecrosis
Conditions
Keywords
bone health, Osteonecrosis, acute lymphoblastic leukemia
Brief summary
Acute lymphoblastic leukemia is the most common form of childhood cancer with current treatment survival rates approaching 80%. Improved outcomes show an increased number of survivors at risk for long-term treatment related side effects including osteonecrosis. Osteonecrosis, or bone death, is caused by blood supply loss to the bone causing pain and poor quality of life. The hips, shoulders, knees and ankles may be affected. Pain is the usual presenting symptom and may become severe requiring surgical decompression or replacement of the affected joint. Long-term effects including arthritis and progressive joint difficulties will not be known for decades. This study aims to determine the risk factors for developing osteonecrosis that will lead to information for earlier detection and prevention. The study will be the basis for future intervention and prevention trials.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Enrollment in the STOPP-CIS study * Informed consent of patient or care givers * \>5 years of age at MRI assessment
Exclusion criteria
* Individuals with a history of claustrophobia precluding MRI assessment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| osteonecrosis 1 year post leukemia therapy | One year after completion of therapy for leukemia | Each participant will undergo MRI of hip, knee, ankle and shoulder to look for ON |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Is Bone loss/failure to accure bone mineral and ON | One year post leukemia therapy | Is bone loss/failure to accrue bone mineral at a normal rate during chemotherapy is/are associated with the development of ON.These patients are a subset of a lagre study where Bone mass is being measured by DEXA. We will be able to access this data to look for bone loss |
| Glucocorticoid dose and ON | One year post Leukemia therapy | Is there a glucocorticoid threshold dose, above which patients are more likely to develop ON. These patients are a subset of a lagre study where glucocorticoid dose is recorded. We will be able to access this data. |
| Methotrexate dose and ON | One year post leukemia therpy | Is there a methotrexate threshold dose, above which patients are more likely to develop ON. These patients are a subset of a lagre study where Methotrexate dose is recorded. We will be able to access this data. |
| Bone mass density and Osteonecrosis | One year post therapy for leukemia | Is reductions in bone mass density at diagnosis of leukemia associated with the development of ON. These patients are a subset of a lagre study where Bone mass is being measured by DEXA. We will be able to access this data to look for bone mass density |
| Weight bearing and non weight bearing activities and ON | One year post leukrmia therapy | Does weight bearing and non-weight bearing activities play a role in the development of ON. These patients are a subset of a larger study. They are recording these activities. We will be able to use this data. |
| Hyperlipidemia and On | One year post leukemia therapy | Is hyperlipidemia associated with the development of ON. Statins (cholesterol lowering medications) have been suggested as a therapeutic intervention to prevent ON. Fasting blood will be tested for lipids at at least one year post chemtherapy. |
| Thrombophilia and ON | One year post leukemia therapy | Is thrombophilia associated with the development of ON. Blood will be tested at study entry following one year completion of chemotherapy.Blood will be drawn for protein C, protein S, antithrombin, activated protein C resistance, Factor V Leiden, prothrombin gene complex, MTHFR, lupus anticoagulant and antiphospholipid antibodies and Lipoprotein A. |
| Obesity and ON | One year post leukemia therapy | Is obesity either at diagnosis or during therapy associated with ON. These patients are a subset of a larger group in a larger study. They are recording height weight and BMI. We will be able to access this data. |
Countries
Canada