Neurobehavioral Complications in Children Who Were Previously Treated With Steroids and Intrathecal Therapy for Acute Lymphoblastic Leukemia
Neurobehavioral Outcomes in Childhood Acute Lymphoblastic Leukemia. A Limited Non-Therapeutic Study
RATIONALE: Cancer therapies may affect the ability of a child's brain and central nervous system to function normally. Learning to identify which patients will develop complications may improve the ability of doctors to plan cancer treatment and improve patient quality of life.
PURPOSE: This clinical trial is studying neurobehavioral changes in children who have received steroid therapy or intrathecal therapy for acute lymphoblastic leukemia.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
- Compare neurobehavioral functioning, specifically memory, attention, executive function, visual-motor integration, and processing speed, in children previously treated with steroids (prednisone vs dexamethasone) and intrathecal therapy (methotrexate alone vs methotrexate, cytarabine, and hydrocortisone) for childhood acute lymphoblastic leukemia.
- Correlate non-treatment risk factors, such as gender, age at diagnosis, and time since termination of prior therapy, with impaired neurobehavioral function in these patients.
- Correlate neurobehavioral complications with quality-of-life of these patients.
OUTLINE: This is a multicenter, cohort study. Patients are assigned to 1 of 2 cohorts (prior treatment per CCG-1922 [prednisone vs dexamethasone] vs prior treatment per CCG-1952 [intrathecal (IT) methotrexate vs IT methotrexate, cytarabine, and hydrocortisone]). Patients in each cohort are stratified according to age at diagnosis, gender, and time since prior treatment termination.
- Cohort A (CCG-1922): Patients undergo physical and neurological examination, neurobehavioral evaluation, and quality of life assessment. Neurobehavioral evaluations assess memory, attention, and executive function.
- Cohort B (CCG-1952): Patients undergo evaluation as above. Neurobehavioral evaluations assess visual-motor integration and processing speed.
PROJECTED ACCRUAL: A total of 448 patients (224 per cohort) will be accrued for this study within 4 years.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
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Arizona
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Phoenix, Arizona, United States, 85016-7710
- Phoenix Children's Hospital
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California
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Loma Linda, California, United States, 92354
- Loma Linda University Cancer Institute at Loma Linda University Medical Center
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Long Beach, California, United States, 90801
- Jonathan Jaques Children's Cancer Center at Miller Children's Hospital
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Los Angeles, California, United States, 90095-1781
- Jonsson Comprehensive Cancer Center at UCLA
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Los Angeles, California, United States, 90027
- Childrens Hospital Los Angeles
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Oakland, California, United States, 94609
- Children's Hospital and Research Center Oakland
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Colorado
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Aurora, Colorado, United States, 80045
- Children's Hospital Center for Cancer and Blood Disorders
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Connecticut
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Farmington, Connecticut, United States, 06360-2875
- Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center
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New Haven, Connecticut, United States, 06520-8028
- Yale Cancer Center
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Delaware
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Wilmington, Delaware, United States, 19803
- Alfred I. DuPont Hospital for Children
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District of Columbia
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Washington, District of Columbia, United States, 20010-2970
- Children's National Medical Center
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Indiana
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Indianapolis, Indiana, United States, 46202-5289
- Indiana University Melvin and Bren Simon Cancer Center
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Iowa
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Des Moines, Iowa, United States, 50309
- Blank Children's Hospital
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Iowa City, Iowa, United States, 52242-1002
- Holden Comprehensive Cancer Center at University of Iowa
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Kentucky
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Lexington, Kentucky, United States, 40536-0093
- Lucille P. Markey Cancer Center at University of Kentucky
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Michigan
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Ann Arbor, Michigan, United States, 48109-0286
- C.S. Mott Children's Hospital at University of Michigan Medical Center
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Grand Rapids, Michigan, United States, 49503-2560
- Butterworth Hospital at Spectrum Health
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Minnesota
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Minneapolis, Minnesota, United States, 55404
- Children's Hospitals and Clinics of Minnesota - Minneapolis
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Minneapolis, Minnesota, United States, 55455
- Masonic Cancer Center at University of Minnesota
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Missouri
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Kansas City, Missouri, United States, 64108
- Children's Mercy Hospital
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New York
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New York, New York, United States, 10016
- NYU Cancer Institute at New York University Medical Center
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North Carolina
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Chapel Hill, North Carolina, United States, 27599-7295
- Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill
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Ohio
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Cincinnati, Ohio, United States, 45229-3039
- Cincinnati Children's Hospital Medical Center
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Columbus, Ohio, United States, 43205-2696
- Nationwide Children's Hospital
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Oregon
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Portland, Oregon, United States, 97239-3098
- Oregon Health and Science University Cancer Institute
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104-9786
- Children's Hospital of Philadelphia
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Pittsburgh, Pennsylvania, United States, 15213
- Children's Hospital of Pittsburgh
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Tennessee
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Nashville, Tennessee, United States, 37232-6838
- Vanderbilt-Ingram Cancer Center
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Texas
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Houston, Texas, United States, 77030-4009
- M. D. Anderson Cancer Center at University of Texas
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Utah
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Salt Lake City, Utah, United States, 84113-1100
- Primary Children's Medical Center
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Washington
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Seattle, Washington, United States, 98105
- Children's Hospital and Regional Medical Center - Seattle
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
DISEASE CHARACTERISTICS:
Diagnosis of standard-risk childhood acute lymphoblastic leukemia (ALL)
- In continuous first remission
- No history of CNS pathology requiring radiotherapy or surgery
Prior enrollment on one of the following Children's Cancer Group (CCG) protocols AND terminated therapy at least 1 year ago:
- CCG-1922 (prednisone vs dexamethasone)
CCG-1952 (intrathecal methotrexate vs triple intrathecal therapy)
- No prior enrollment on CCG-1952 arm III
- No history of pre-existing neurodevelopmental disorder before diagnosis of ALL (e.g., mental retardation, Down syndrome, seizure disorder, or traumatic brain injury)
- No neuropsychological assessment within the past 6 months
PATIENT CHARACTERISTICS:
Age
- 6.5 to 16 years
Performance status
- Not specified
Life expectancy
- Not specified
Hematopoietic
- Not specified
Hepatic
- Not specified
Renal
- Not specified
Other
- Reading, speaking, and listening comprehension of English by patient required (English and/or Spanish by parent)
- No history of very low birth weight (< 1,500 grams)
PRIOR CONCURRENT THERAPY:
Biologic therapy
- Not specified
Chemotherapy
- See Disease Characteristics
Endocrine therapy
- See Disease Characteristics
Radiotherapy
- See Disease Characteristics
Surgery
- See Disease Characteristics
Other
- Concurrent stimulants allowed
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Two-sided comparisons of various mean neurobehavioral scores between the two treatment arms within each study
Time Frame: length of study
|
Data analysis for each of the two clinical trials will be conducted separately.
The primary objectives will be two-sided comparisons of various mean neurobehavioral scores between the two treatment arms within each study.
|
length of study
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Nina S. Kadan-Lottick, MD, MSPH, Yale University
- Study Chair: Joseph P. Neglia, MD, MPH, Masonic Cancer Center, University of Minnesota
Publications and helpful links
General Publications
- Lindemulder SJ, Stork LC, Bostrom BC, et al.: Trends in body mass index (BMI) during and after treatment for standard risk (SR) acute lymphoblastic leukemia (ALL): A report from the Children's Oncology Group (COG). [Abstract] J Clin Oncol 30 (Suppl 15): A-9546, 2012.
- Kadan-Lottick NS, Brouwers P, Breiger D, Kaleita T, Dziura J, Liu H, Chen L, Nicoletti M, Stork L, Bostrom B, Neglia JP. A comparison of neurocognitive functioning in children previously randomized to dexamethasone or prednisone in the treatment of childhood acute lymphoblastic leukemia. Blood. 2009 Aug 27;114(9):1746-52. doi: 10.1182/blood-2008-12-186502. Epub 2009 Jun 22.
- Breiger D, Kaleita TA, Kadan-Lottick NS, et al.: Behavioral social adjustment in survivors of childhood acute lymphoblastic leukemia (ALL) treated without cranial radiation. [Abstract] Pediatr Blood Cancer 46 (6): A-3505.43, 690, 2006.
- Kadan-Lottick NS, Brouwers P, Kaleita TA, et al.: Preliminary findings of neurobehavioral outcomes in survivors of childhood acute lymphoblastic leukemia (ALL) treated without cranial radiation. [Abstract] Pediatr Blood Cancer 46 (6): A-3505.45, 691, 2006.
- Kadan-Lottick NS, Stork LC, Bostrom BC, et al.: Increased prevalence of overweight status in survivors of acute lymphoblastic leukemia (ALL) treated without cranial radiation . [Abstract] Pediatr Blood Cancer 46 (6): A-3505.44, 690, 2006.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Chemically-Induced Disorders
- Nervous System Diseases
- Immune System Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Lymphoproliferative Disorders
- Lymphatic Diseases
- Immunoproliferative Disorders
- Poisoning
- Leukemia
- Precursor Cell Lymphoblastic Leukemia-Lymphoma
- Leukemia, Lymphoid
- Neurotoxicity Syndromes
Other Study ID Numbers
Other Study ID Numbers
- ALTE02C2
- COG-ALTE02C2 (Other Identifier: Children's Oncology Group)
- CDR0000367480 (Other Identifier: Clinicaltrials.gov)
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