Remote Ischemic Conditioning in Oncology

Children's Hospital Medical Center, Cincinnati1 enrolled

Overview

This is a feasibility study at a single site, Cincinnati Children's Hospital Medical Center. Patients undergoing anthracycline chemotherapy for Hodgkin disease and soft-tissue and bone sarcoma who meet eligibility requirements will be approached to participate in the study. The purpose of the study is to determine if performing remote ischemic conditioning (RIC) is feasible in children and young adults receiving anthracycline chemotherapy. The secondary purpose is to describe differences in markers of myocardial injury and stress in children and young adults that receive RIC prior to anthracycline chemotherapy compared to control subjects that receive sham therapy prior to chemotherapy.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DEVICE_FEASIBILITY

Masking

NONE

Enrollment

Conditions

Participants Undergoing Anthracycline Chemotherapy

Interventions

With the patient sitting upright in bed or a chair, the remote ischemic conditioning intervention will consist of 4 automatic cycles of upper arm blood pressure cuff inflation to 200 mm Hg for 5 minutes to induce transient, noninjurious, limb ischemia, followed by cuff deflation for 5 minutes, for a total of 35 minutes (autoRIC®, Cellaegis Devices, Mississauga, ON, Canada).17 The remote ischemic preconditioning cycles will be performed by trained research personnel prior to each cycle of chemotherapy (total treatments variable based on chemotherapy protocol

Eligibility

Sex: ALLMin age: 11 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Pediatric, adolescent, or young adult patients, 11 years of age or above. 2. Able to tolerate upper arm blood pressure inflation. Exclusion Criteria: 1. Previous diagnosis of cardiomyopathy (dilated, hypertrophic, restrictive, myocarditis) or congenital heart disease other than bicuspid aortic valve. 2. Chronic kidney disease as defined as a pre-transplant GFR \<80 3. Central line in both upper extremities. 4. Known peripheral vascular disease or vasculitis. 5. Platelet count less than 30,000. 6. Known clotting disorder or hypercoagulability 7. Non-English-speaking patients.

Outcomes

Primary Outcomes

Adverse Effects

Patients with intra-thoracic disease may also receive consolidative radiation that includes portions of the myocardium within the radiation field and thus further increase their risk of developing therapy-related cardiomyopathy. Thus, the development of cardioprotective strategies during therapy for these malignancies is of primary interest to minimize the potential late adverse effects of anthracyclines among the long term survivors of these conditions.

Time frame: 18-24 months from start of enrollment