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.
Study Type
OBSERVATIONAL
Enrollment
130
Alberta Children's Hospital
Calgary, Alberta, Canada
NOT_YET_RECRUITINGStollery Children's Hospital
Edmonton, Alberta, Canada
NOT_YET_RECRUITINGBC Children's Hospital
Vancouver, British Columbia, Canada
NOT_YET_RECRUITINGWinnipeg Children's Hospital
Winnipeg, Manitoba, Canada
NOT_YET_RECRUITINGIWK Health Centre
Halifax, Nova Scotia, Canada
NOT_YET_RECRUITINGChildren's Hospital of Western Ontario
London, Ontario, Canada
NOT_YET_RECRUITINGChildrens Hospital of Eastern Ontario
Ottawa, Ontario, Canada
RECRUITINGHospital for Sick Children
Toronto, Ontario, Canada
NOT_YET_RECRUITINGHopital Sainte-Justine
Montreal, Quebec, Canada
NOT_YET_RECRUITINGMontreal Children's Hospital
Montreal, Quebec, Canada
NOT_YET_RECRUITINGosteonecrosis 1 year post leukemia therapy
Each participant will undergo MRI of hip, knee, ankle and shoulder to look for ON
Time frame: One year after completion of therapy for leukemia
Bone mass density and Osteonecrosis
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
Time frame: One year post therapy for leukemia
Is Bone loss/failure to accure bone mineral and ON
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
Time frame: One year post leukemia therapy
Glucocorticoid dose and ON
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.
Time frame: One year post Leukemia therapy
Methotrexate dose and ON
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.
Time frame: One year post leukemia therpy
Obesity and ON
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.
Time frame: One year post leukemia therapy
Weight bearing and non weight bearing activities and ON
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.
Time frame: One year post leukrmia therapy
Hyperlipidemia and On
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.
Time frame: One year post leukemia therapy
Thrombophilia and ON
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.
Time frame: One year post leukemia therapy
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