nutrition and body composition in acute lymphoblastic leukemia

Conditions: Precursor Cell Lymphoblastic Leukemia-Lymphoma; Vitamin D Deficiency

Summary: many adolescents with acute lymphoblastic leukemia (all) have been found to have low bone density by the end of treatment. this can lead to long-term suffering in survivors due to poor bone health. vitamin d is known to be associated with bone health and previous research has established that vitamin d insufficiency is very common at diagnosis of all and worsens over the course of treatment. researchers have also learned that a relationship exists between both vitamin d and fat tissue and all and fat tissue. in adolescents being treated for all as well as in early survivors, this randomized study will therefore examine the effect of vitamin d and calcium supplementation on correcting vitamin d insufficiency and on improving bone density in the context of changes in body composition and body fat. bone density will be measured by a radiology exam called qct (quantitative computed tomography) while body composition and body fat will be measured by a different radiology exam called a dxa (dual energy x-ray absorptiometry scan) . the study will also examine in depth the relationship between these three elements - vitamin d insufficiency, obesity, and all - and their impact on bone density.


Eligibility criteria:
inclusion criteria: group a: patients with newly diagnosed all * are greater than or equal to 10 years of age and less than or equal to 21 years of age at diagnosis of all * have a new diagnosis of untreated all classified as "high risk" per nci criteria (due to being greater than 10 years of age) * are beginning treatment with a children's cancer group/children's oncology group "high risk" protocol with a 4-drug induction including steroids * are not pregnant group b: early survivors of all * were treated for all and remain in first cr1 (complete remission) * were equal to or greater than 10 years of age and less than or equal to 21 years of age at diagnosis of all * have completed treatment on or as per a children's cancer group/children's oncology group "high risk" protocol between 12 and 48 months prior to enrollment in this study (consisting of a plan for a 4-drug induction including steroids in induction, delayed intensification, and steroid pulses in maintenance. steroids are allowed to have been discontinued due to toxicity). * are not pregnant group c: siblings of group a * are either a full-sibling or a half-sibling of a patient in group a * are living at the same residence as the sibling/half-sibling from group a * are greater than or equal to 10 years of age and less than or equal to 21 years of age at the time of study entry, and within 3 years of the age diagnosis of all in the sibling/half-sibling from group a * are on the same vitamin d supplementation regimen (if any) as the sibling from group a at the time of his or her diagnosis exclusion criteria (all groups): * have a diagnosis of down syndrome (trisomy 21) or any genetic disease associated with abnormal bone development * are undergoing treatment with other medicines that affect bones including chronic use of of steroids, bisphosphonate therapy, or vitamin d at average dose greater than 400 international units (iu)/day * have an underlying diseases altering body structure (i.e. missing a limb, severe dysmorphism) or severely affecting mobility (i.e. total or hemiparesis) * have a history of chemotherapy or radiation for other cancers * cannot complete the radiology exams/radiology exams uninterpretable (i.e. people with a hip replacement or prosthesis)

Keywords: leukemia all vitamin d bone density body fat obesity adipose