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Study of Late-Occurring Complications in Childhood Cancer Survivors
This study is currently recruiting participants.
Verified by National Cancer Institute (NCI), January 2009
Sponsors and Collaborators: Children's Oncology Group
National Cancer Institute (NCI)
Information provided by: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT00082745
  Purpose

RATIONALE: A patient's genes may affect the risk of developing complications, such as congestive heart failure, heart attack, stroke, and second cancer, years after undergoing cancer treatment. Genetic studies may help doctors identify survivors of childhood cancer who are more likely to develop late complications.

PURPOSE: This clinical trial is studying cancer survivors to identify those who are at increased risk of developing late-occurring complications after undergoing treatment for childhood cancer.


Condition Intervention
Cancer
Procedure: cytogenetic analysis
Procedure: mutation analysis
Procedure: polymorphism analysis
Procedure: questionnaire administration

Genetics Home Reference related topics: retinoblastoma
MedlinePlus related topics: Cancer Hodgkin's Disease Leukemia, Adult Acute Leukemia, Adult Chronic Leukemia, Childhood Lymphoma Neuroblastoma Soft Tissue Sarcoma Wilms' Tumor
U.S. FDA Resources
Study Type: Observational
Official Title: Key Adverse Events After Childhood Cancer

Further study details as provided by National Cancer Institute (NCI):

Estimated Enrollment: 6900
Study Start Date: March 2004
Estimated Primary Completion Date: March 2005 (Final data collection date for primary outcome measure)
Detailed Description:

OBJECTIVES:

  • Identify key late-occurring complications, specifically, cardiac dysfunction, myocardial infarction (closed to accrual as of 6/5/06), ischemic stroke, avascular necrosis, and subsequent malignant neoplasm, in childhood cancer survivors.
  • Correlate key late-occurring complications with pathology and staging of the primary malignancy and therapeutic treatment protocol details in these patients.
  • Identify treatment-related and demographic risk factors by comparing patients who develop late-occurring complications (case group) vs those with the same primary malignancy who do not develop late-occurring complications (control group).
  • Compare the frequency of mutations or polymorphisms in specific candidate genes in both the case and control groups using constitutional DNA and RNA from both groups.
  • Explore the role and nature of gene-environment interaction in the development of late-occurring complications in these patients.

OUTLINE: This is a multicenter study.

DNA from peripheral blood or buccal sample of patients is analyzed for the presence of polymorphisms in candidate genes associated with an increased risk of late-occurring complications, such as cardiac dysfunction, myocardial infarction (closed to accrual as of 6/5/06), ischemic stroke, avascular necrosis, and subsequent malignant neoplasms.

Patients also complete a questionnaire detailing family history and health history.

PROJECTED ACCRUAL: A total of 6,900 patients (1,725 with late-occurring complications [case group] and 5,175 without late-occurring complications [control group] [myocardial infarction patients closed to accrual as of 6/5/06]) will be accrued for this study.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

DISEASE CHARACTERISTICS:

  • Diagnosis of primary cancer at age 21 or younger
  • In active follow-up by a Children's Oncology Group (COG) institution

    • Date of last visit or contact by a COG institution within the past 24 months
  • Case group

    • Development of one of the following key adverse events after initiation of prior cancer therapy:

      • Cardiac dysfunction, meeting 1 of the following criteria:

        • Symptomatic cardiac dysfunction, including current or previous diagnosis of congestive heart failure based on any of the following clinical criteria:

          • Pulmonary and/or peripheral edema
          • Dyspnea
          • Orthopnea
          • Fatigue
          • Hepatomegaly
        • Asymptomatic cardiac dysfunction

          • Ejection fraction < 40% on echocardiogram OR MUGA and/or fractional shortening < 28% on echocardiogram without clinical symptoms
      • Myocardial infarction, meeting 1 of the following criteria (closed to accrual as of 6/5/06):

        • Definite ECG changes
        • Typical, atypical, or inadequately described symptoms AND probable ECG, AND abnormal enzymes, including creatine kinase MB
        • Typical symptoms AND abnormal enzymes, including creatine kinase MB, AND ischemic ECG, non-codable ECG, or ECG not available
      • Ischemic stroke, meeting the following criteria:

        • Fixed neurological deficit lasting more than 24 hours
        • Confirmed by CT scan or MRI within 7 days of onset of symptoms
        • No subarachnoid or intracerebral hemorrhage, transient ischemic attacks, or amaurosis fugax
      • Avascular necrosis, meeting the following criteria:

        • Clinical symptoms of joint pain, joint stiffness, or decreased range of motion
        • Confirmed by plain radiographs, CT scan, MRI, or bone scan
      • Subsequent malignant neoplasm, meeting the following criteria:

        • Histologically distinct neoplasm developing in patients treated for a primary cancer
        • Confirmed by an institutional pathology report
  • Control group

    • No clinical evidence of any of the following:

      • Cardiac dysfunction
      • Myocardial infarction (closed to accrual as of 6/5/06)
      • Ischemic stroke
      • Avascular necrosis
      • Subsequent malignant neoplasm

PATIENT CHARACTERISTICS:

Age

  • 21 and under at diagnosis, any age at study entry

Performance status

  • Not specified

Life expectancy

  • Not specified

Hematopoietic

  • Not specified

Hepatic

  • Not specified

Renal

  • Not specified

Cardiovascular

  • See Disease Characteristics

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • Not specified

Endocrine therapy

  • Not specified

Radiotherapy

  • Not specified

Surgery

  • Not specified

Other

  • No prior allogeneic (non-autologous) hematopoietic cell transplant
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00082745

  Show 132 Study Locations
Sponsors and Collaborators
Children's Oncology Group
  More Information

Clinical trial summary from the National Cancer Institute's PDQ® database  This link exits the ClinicalTrials.gov site

Study ID Numbers: CDR0000360708, COG-ALTE03N1
Study First Received: May 14, 2004
Last Updated: January 9, 2009
ClinicalTrials.gov Identifier: NCT00082745  
Health Authority: Unspecified

Keywords provided by National Cancer Institute (NCI):
unspecified childhood solid tumor, protocol specific
long-term effects secondary to cancer therapy in children
recurrent/refractory childhood Hodgkin lymphoma
stage I childhood Hodgkin lymphoma
stage II childhood Hodgkin lymphoma
stage III childhood Hodgkin lymphoma
stage IV childhood Hodgkin lymphoma
childhood acute lymphoblastic leukemia in remission
childhood acute lymphoblastic leukemia
recurrent childhood acute lymphoblastic leukemia
de novo myelodysplastic syndromes
previously treated childhood rhabdomyosarcoma
previously treated myelodysplastic syndromes
secondary myelodysplastic syndromes
childhood acute myeloid leukemia in remission
childhood acute myeloid leukemia/other myeloid malignancies
recurrent childhood acute myeloid leukemia
childhood grade III lymphomatoid granulomatosis
recurrent childhood grade III lymphomatoid granulomatosis
recurrent childhood large cell lymphoma
stage I childhood large cell lymphoma
stage II childhood large cell lymphoma
stage III childhood large cell lymphoma
stage IV childhood large cell lymphoma
recurrent childhood lymphoblastic lymphoma
stage I childhood lymphoblastic lymphoma
stage II childhood lymphoblastic lymphoma
stage III childhood lymphoblastic lymphoma
stage IV childhood lymphoblastic lymphoma
Burkitt lymphoma

Study placed in the following topic categories:
Juvenile myelomonocytic leukemia
Neuroectodermal Tumors, Primitive
Histiocytoma, Benign Fibrous
Malignant mesenchymal tumor
Lymphoma, small cleaved-cell, diffuse
Retinoblastoma
Small non-cleaved cell lymphoma
Osteogenic sarcoma
Lymphoma, large-cell, immunoblastic
Lymphomatoid granulomatosis
Ewing's sarcoma
Preleukemia
Neoplasm Metastasis
Neuroepithelioma
Glioma
Hodgkin Disease
Rhabdomyosarcoma
Myelodysplastic syndromes
Lymphoma, Large B-Cell, Diffuse
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Astrocytoma
Myeloproliferative Disorders
Acute myelogenous leukemia
Renal cancer
Leukemia, Myeloid
Neuroectodermal Tumors
Brain Neoplasms
Histiocytoma
Hodgkin lymphoma, childhood
Sarcoma

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Histologic Type
Neoplasms, Nerve Tissue
Neoplasms, Neuroepithelial

ClinicalTrials.gov processed this record on January 15, 2009