The British Osteonecrosis Study

Overview

The aim of this research is to examine the natural history of osteonecrosis in older children, teenagers and young adults with acute lymphoblastic leukaemia and lymphoblastic lymphoma within the UK. In addition to using and validating new, internationally agreed, standard definitions for osteonecrosis, this study will provide the data needed to develop a radiological classification which correlates with clinical status.

Full Title of Study: “The British Osteonecrosis Study: A Prospective Multi-centre Study to Examine the Natural History of Osteonecrosis in Older Children, Teenagers and Young Adults With Acute Lymphoblastic Leukaemia and Lymphoblastic Lymphoma”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 10, 2022

Detailed Description

Children, teenagers or young adults between the age of 10 (including the day of the 10th birthday) and 24 years 364 days (at the time of diagnosis) with a first diagnosis of acute lymphoblastic leukaemia or lymphoblastic lymphoma (T-NHL or SmIg negative precursor B-NHL) diagnosed under standard criteria are eligible for BONES. The recruitment target is 50 over a 2 year period, which is based on an anticipated ascertainment target of 75%. Information will be collected on basic demographics, presenting features and diagnosis at initial recruitment. Further data will be collected at the end of induction to ascertain treatment and response, along with results of relevant investigations performed in induction detailed below. Clinical information collected will include height, weight and puberty stage. At the four subsequent time points when MRI imagine is performed further data will also be collected, including a physiotherapy assessment using a structured assessment tool and child health assessment questionnaire, and biochemical information. Investigations The results of the following investigations, usually performed as part of the routine assessment, will be collected: 1. At diagnosis – highest white cell count, immunophenotype, cytogenetics, molecular results; albumin; lipid profile; vitamin D level, PTH, bone profile 2. At the end of induction – MRD result, flow cytometry from end of induction bone marrow; albumin; lipid profile plus results of additional investigations of vitamin D, PTH and bone profile if performed. DEXA scans should be performed on all children >10y old and on treatment for ALL. It is recommended that a DEXA scan is performed at diagnosis and then annually. The results of these DEXA scans will be collected. MRI of the hips, knees and ankles should comprise of unenhanced coronal T1 and STIR images as a minimum protocol. Knees and ankles can be imaged together. Where further information of a specific joint is needed pre-treatment additional sequences in different planes could be performed at the discretion of the participating centre. MRI will be performed at the following time points: 1. Within 4 weeks of diagnosis 2. At the end of delayed intensification 3. One year after the start of maintenance 4. Two years after the start of maintenance 5. Three years after the start of maintenance In the event of the development of osteonecrosis the patient should be managed according to local protocols and at the discretion of their own consultant. Information on treatment will be collected. Radiological review: A central review panel consisting of Paediatric Radiologists with an interest in paediatric haematology will meet quarterly to review each MRI in order to agree the grade of osteonecrosis and noting specific features according to the study radiology proforma.

Interventions

  • Other: observation
    • Observational study with no intervention

Clinical Trial Outcome Measures

Primary Measures

  • Incidence of osteonecrosis
    • Time Frame: 5 years
    • The incidence of osteonecrosis in older children, teenagers and young adults being treated for acute lymphoblastic leukaemia (ALL) in the UK at different time points in their treatment.

Secondary Measures

  • Risk factors for development of osteonecrosis.
    • Time Frame: 5 years
    • The risk factors for progression and the development of symptomatic osteonecrosis in this population.
  • Radiological features for prediction of progression of osteonecrosis
    • Time Frame: 5 years
    • specific radiological features that predict for either progression or regression in those with asymptomatic osteonecrosis

Participating in This Clinical Trial

Inclusion Criteria

  • first diagnosis of acute lymphoblastic leukaemia or lymphoblastic lymphoma (T-NHL or SmIg negative precursor B-NHL) Exclusion Criteria:

  • inability to have MRI scans of lower limbs

Gender Eligibility: All

Minimum Age: 10 Years

Maximum Age: 25 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Leeds
  • Provider of Information About this Clinical Study
    • Principal Investigator: Nadia laila Amin, Chief Investigator – University of Leeds
  • Overall Official(s)
    • Nadia L Amin, MBChB, Principal Investigator, University of Leeds
  • Overall Contact(s)
    • Nadia L Amin, MBChB, 0113 343 2596, nadia.amin3@nhs.net

Clinical trials entries are delivered from the US National Institutes of Health and are not reviewed separately by this site. Please see the identifier information above for retrieving further details from the government database.

At TrialBulletin.com, we keep tabs on over 200,000 clinical trials in the US and abroad, using medical data supplied directly by the US National Institutes of Health. Please see the About and Contact page for details.