Imaging of Chemotherapy-induced Morphological and Functional Lung Changes in Childhood ALL and HD

NCT ID: NCT06093334

Last Updated: 2024-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-17

Study Completion Date

2024-12-09

Brief Summary

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With increasing cure rates of childhood cancer there is growing recognition of late effects of treatments. However, there is a lack of non-invasive and child-friendly procedures that can indicate possible late damage. This study uses morphologic and free-breathing phase-resolved functional low-field (PREFUL) magnetic resonance imaging (MRI) to identify persistent pulmonary toxicity after treatment for childhood acute lymphoblastic leukemia (ALL), Hodgkin's disease (HD) and allogeneic stem cell transplantation. Furthermore, cardiopulmonary testing is performed by means of a pulmonary function test, echocardiography with strain analysis and spiroergometry.

Detailed Description

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With increasing cure rates of childhood cancer there is growing recognition of late effects of treatments. However, there is a lack of non-invasive and child-friendly procedures that can indicate possible late damage.

This study uses morphologic and free-breathing phase-resolved functional low-field (PREFUL) magnetic resonance imaging (MRI) to identify persistent pulmonary toxicity after treatment for childhood acute lymphoblastic leukemia (ALL), Hodgkin's disease (HD) and allogeneic stem cell transplantation. The examination in the new 0.55 T MRI system does not differ in procedure and especially with regard to contraindications for an MRI examination from an examination in routinely used 1.5 or 3T devices. There is no intravenous administration of contrast medium. This method has already yielded relevant results in a previous study on the frequency of lung parenchymal changes in pediatric and adolescent patients with past SARS-CoV-2 infection detected by PCR. In addition, study participants will undergo cardiopilmonary testing by spirometry, spiroergometry and echocardiography with strain analysis to assess cardiac and pulmonary performance. For the individual patient, the duration of study participation is 120 minutes. This includes approximately 30 minutes for education and consent of study participants/parents/guardians, 30 minutes for lung function test and MRI, and 30 minutes for cardiopulmonary testing.

The purpose of this study is to assess early posttherapeutic changes as well as possible persistent pulmonary toxicity and change in cardiopulmonary performance.

Conditions

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Acute Lymphoblastic Leukemia Hodgkin Disease Allogeneic Stem Cell Transplantation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Early therapeutic effects

Diagnosed acute lymphatic leukemia or Hodgkin's disease (HD) and completed induction therapy or radiotherapy, from 5 years to \<18 years

Group Type EXPERIMENTAL

Low-field magnetic resonance imaging

Intervention Type DIAGNOSTIC_TEST

Imaging of lung parenchyma and function by LF-MRI

Cardiopulmonary testing

Intervention Type DIAGNOSTIC_TEST

Myocardial function (Strain-Analysis by echocardiography) and spiroergometry, capillary blood gases and lactate

Pulmonary testing

Intervention Type DIAGNOSTIC_TEST

Lung function (VC%, FEV1%)

Blood sample

Intervention Type DIAGNOSTIC_TEST

Standard procedures/parameters routinely available in follow-up care after oncological treatment

Late therapeutic effects

Diagnosed acute lymphatic leukemia or Hodgkin's disease (HD) and completed intensive therapy or radiotherapy, Patient in follow-up care, from 5 years to \<18 years

Group Type EXPERIMENTAL

Low-field magnetic resonance imaging

Intervention Type DIAGNOSTIC_TEST

Imaging of lung parenchyma and function by LF-MRI

Cardiopulmonary testing

Intervention Type DIAGNOSTIC_TEST

Myocardial function (Strain-Analysis by echocardiography) and spiroergometry, capillary blood gases and lactate

Pulmonary testing

Intervention Type DIAGNOSTIC_TEST

Lung function (VC%, FEV1%)

Blood sample

Intervention Type DIAGNOSTIC_TEST

Standard procedures/parameters routinely available in follow-up care after oncological treatment

Effects of hematopoietic stem cell transplantation

Diagnosed acute lymphatic leukemia, completed hematopoietic stem cell transplantation, from 5 years to \<18 years

Group Type EXPERIMENTAL

Low-field magnetic resonance imaging

Intervention Type DIAGNOSTIC_TEST

Imaging of lung parenchyma and function by LF-MRI

Cardiopulmonary testing

Intervention Type DIAGNOSTIC_TEST

Myocardial function (Strain-Analysis by echocardiography) and spiroergometry, capillary blood gases and lactate

Pulmonary testing

Intervention Type DIAGNOSTIC_TEST

Lung function (VC%, FEV1%)

Blood sample

Intervention Type DIAGNOSTIC_TEST

Standard procedures/parameters routinely available in follow-up care after oncological treatment

Interventions

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Low-field magnetic resonance imaging

Imaging of lung parenchyma and function by LF-MRI

Intervention Type DIAGNOSTIC_TEST

Cardiopulmonary testing

Myocardial function (Strain-Analysis by echocardiography) and spiroergometry, capillary blood gases and lactate

Intervention Type DIAGNOSTIC_TEST

Pulmonary testing

Lung function (VC%, FEV1%)

Intervention Type DIAGNOSTIC_TEST

Blood sample

Standard procedures/parameters routinely available in follow-up care after oncological treatment

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Diagnosed acute lymphatic leukemia or Hodgkin's disease (HD)
* Completed induction therapy or radiotherapy


* Diagnosed acute lymphatic leukemia or Hodgkin's disease (HD)
* Completed intensive therapy or radiotherapy


* Diagnosed acute lymphatic leukemia
* Completed hematopoietic stem cell transplantation

Exclusion Criteria

* Pregnancy, Lactation
* Known pleural or pericardial effusion
* Critical condition (requiring respiratory support, ventilation, oxygen, shock, symptomatic heart failure)
* Marked thoracic deformities/malformations
* Previous lung surgery
* Injuries that do not allow physical stress diagnostics
* Rejection of MRI imaging
* General contraindications for MRI examinations (e.g. electrical implants such as cardiac pacemakers or perfusion pumps, etc.)

Study arm: "Late therapeutic effects"


* Pregnancy, Lactation
* Known pleural or pericardial effusion
* Critical condition (requiring respiratory support, ventilation, oxygen, shock, symptomatic heart failure)
* Marked thoracic deformities/malformations
* Previous lung surgery
* Injuries that do not allow physical stress diagnostics
* Rejection of MRI imaging
* General contraindications for MRI examinations (e.g. electrical implants such as cardiac pacemakers or perfusion pumps, etc.)

Study arm: "Effects of hematopoietic stem cell transplantation"


* Pregnancy, Lactation
* Known pleural or pericardial effusion
* Critical condition (requiring respiratory support, ventilation, oxygen, shock, symptomatic heart failure)
* Marked thoracic deformities/malformations
* Previous lung surgery
* Injuries that do not allow physical stress diagnostics
* Rejection of MRI imaging
* General contraindications for MRI examinations (e.g. electrical implants such as cardiac pacemakers or perfusion pumps, etc.)
Minimum Eligible Age

5 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Erlangen-Nürnberg Medical School

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Axel Karow, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen

Ferdinand Knieling, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen

Rafael Heiß, MD

Role: PRINCIPAL_INVESTIGATOR

Institute of Radiology, University Hospital Erlangen

Locations

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Department of Pediatrics and Adolescent Medicine

Erlangen, Bavaria, Germany

Site Status

Countries

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Germany

References

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Erdmann F, Frederiksen LE, Bonaventure A, Mader L, Hasle H, Robison LL, Winther JF. Childhood cancer: Survival, treatment modalities, late effects and improvements over time. Cancer Epidemiol. 2021 Apr;71(Pt B):101733. doi: 10.1016/j.canep.2020.101733. Epub 2020 May 24.

Reference Type BACKGROUND
PMID: 32461035 (View on PubMed)

Silverman LB. Balancing cure and long-term risks in acute lymphoblastic leukemia. Hematology Am Soc Hematol Educ Program. 2014 Dec 5;2014(1):190-7. doi: 10.1182/asheducation-2014.1.190. Epub 2014 Nov 18.

Reference Type BACKGROUND
PMID: 25696854 (View on PubMed)

Gebauer J, Baust K, Bardi E, Grabow D, Stein A, van der Pal HJ, Calaminus G, Langer T. Guidelines for Long-Term Follow-Up after Childhood Cancer: Practical Implications for the Daily Work. Oncol Res Treat. 2020;43(3):61-69. doi: 10.1159/000504200. Epub 2020 Jan 13.

Reference Type BACKGROUND
PMID: 31931503 (View on PubMed)

Huber F, Schoeffl I, Mueller N, Dierl A, Wild EM, Naumann-Bartsch N, Karow A, Knieling F, Woelfle J, Dittrich S, Anderheiden F. What about the heart - pediatric ALL survivors show cardiopulmonary limitations in the MinimALL Study. Eur J Pediatr. 2025 Jun 9;184(7):406. doi: 10.1007/s00431-025-06243-0.

Reference Type DERIVED
PMID: 40488780 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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23-47-B

Identifier Type: -

Identifier Source: org_study_id