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Prevention of Osteoporosis in Bone Marrow Transplantation (BMT) Patients
This study is currently recruiting participants.
Verified by M.D. Anderson Cancer Center, September 2009
First Received: January 15, 2009   Last Updated: September 15, 2009   History of Changes
Sponsor: M.D. Anderson Cancer Center
Collaborator: Roche Pharma AG
Information provided by: M.D. Anderson Cancer Center
ClinicalTrials.gov Identifier: NCT00824993
  Purpose

This study plans to address the following hypotheses:

  1. The addition of Ibandronate initiated immediately after the transplantation will prevent bone loss in patients undergoing allogenic bone marrow transplantation (BMT) with underlying hematologic malignancies.
  2. BMT patients who require prolonged steroid and other immunosuppressive treatment for Graft versus Host Diseases(GVHD) have a higher rate of bone loss, which can be prevented or attenuated by Ibandronate.

Specific objectives to test these hypotheses are:

  1. Primary Objective:

    1. To prospectively compare the bone mineral density changes of lumbar spine, femoral neck and total hip between patients randomly assigned to ibandronate and control group over 12 months post bone marrow transplantation at the University of Texas MD Anderson Cancer Center.

  2. Secondary Objectives:

    1. To measure and compare the accumulated level of steroid used in both treatment and control groups.
    2. To collect and compare the level of serum C-terminal telopeptide (CTX) in both treatment and control groups to monitor the bone turnover rate for the duration of the study.
    3. To conduct a cost-effectiveness analysis of participating patients for both outcomes on bone mineral density (measured data) and skeletal-related events (modeled data).
    4. To record incidence of bone fractures and the graft rate in both treatment and control groups.

Condition Intervention Phase
Hematological Malignancies
Drug: Ibandronate
Drug: Vitamin Supplements
Phase III

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Parallel Assignment
Official Title: A Randomized, Controlled Study of Ibandronate for the Prevention of Bone Loss in Patients Who Have Received Allogeneic Bone Marrow Transplantation for Hematological Malignancies

Resource links provided by NLM:


Further study details as provided by M.D. Anderson Cancer Center:

Primary Outcome Measures:
  • Percent Reduction in Bone Mineral Density (BMD) of the lumbar spine, femoral neck, and total hip [ Time Frame: Baseline to 12 Months ] [ Designated as safety issue: No ]

Estimated Enrollment: 200
Study Start Date: December 2008
Estimated Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Group 1: Experimental
Ibandronate + Calcium + Vitamin D
Drug: Ibandronate
Infusion of 3 mg by vein over 15 to 30 seconds for 4 doses at 3-6 weeks after transplant, and at Months 3, 6, and 9 after the transplant.
Drug: Vitamin Supplements

Calcium 500 mg by mouth everyday for 12 months

Vitamin D 400 units by mouth 2 times a day for 12 months

Group 2: Experimental
Calcium + Viatmin D
Drug: Vitamin Supplements

Calcium 500 mg by mouth everyday for 12 months

Vitamin D 400 units by mouth 2 times a day for 12 months


  Show Detailed Description

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age greater than or equal to 18 years.
  2. Patients with the diagnosis of hematologic malignancies, who are immediately post- allogeneic bone marrow transplantation.
  3. Female patients of childbearing potential (i.e. no hysterectomy, no loss of menses for 12 consecutive months), must be willing to use contraception.
  4. Negative pregnancy test in premenopausal patients.
  5. Patients with GVHD or infections can be entered only if they respond to treatment and become controlled.
  6. Dental considerations: patients with negative dental screening for jaw osteonecrosis 0-3 months prior to their transplant and patients that do not have a plan for tooth extraction in the near future.

Exclusion Criteria:

  1. Patients with documented relapsed malignancy after the transplant, uncontrolled acute GVHD, or uncontrolled infection.
  2. Patients with hypocalcemia of less than 8.4 (corrected to account for the albumin level).
  3. Patients with hypercalcemia >12.2, due to a cause not related to their hematological malignancy (i.e. hyperparathyroidism, multiple myeloma).
  4. Hypersensitivity to Ibandronate or other bisphosphonates.
  5. Pre-existing osteoporosis, defined as a bone density T-score of -2.5 S.D. or less.
  6. Renal insufficiency (calculated creatinine clearance < 30 ml/min).
  7. Patients already on bisphosphonates (over the past two years), calcitonin, anabolic steroids, or daily oral fluoride supplement.
  8. Myeloma patients who have previously been on bisphosphonates over the past two years and/or have active bone lesions.
  9. If corrected calcium is above 10.3 and the iPTH is elevated or normal, the patient will be excluded from the study.
  10. Patients with a 25-hydroxyvitamin D concentration <20 ng/ml and evidence of osteomalacia (low ionized calcium and elevated intact PTH).
  11. Dental considerations: Patients with recent tooth extraction with signs of incomplete healing or significant infection will be excluded.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00824993

Contacts
Contact: Huifang Lu, MD, PHD 713-563-4462

Locations
United States, Texas
The University of Texas M.D. Anderson Cancer Center Recruiting
Houston, Texas, United States, 77030
Sponsors and Collaborators
M.D. Anderson Cancer Center
Roche Pharma AG
Investigators
Principal Investigator: Huifang Lu, MD, PHD UT MD Anderson Cancer Center
  More Information

Additional Information:
No publications provided

Responsible Party: U.T.M.D Anderson Cancer Center ( Huifang Lu, MD, PHD/Assistant Professor )
Study ID Numbers: 2006-0960
Study First Received: January 15, 2009
Last Updated: September 15, 2009
ClinicalTrials.gov Identifier: NCT00824993     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by M.D. Anderson Cancer Center:
Blood Cancer
Calcium
Vitamin D
Ibandronate
Boniva
Hematological Malignancies
Bone Marrow Transplantation
BMT
Osteoporosis
Bone Loss
Allogeneic Bone Marrow Transplantation

Additional relevant MeSH terms:
Neoplasms
Neoplasms by Site
Ibandronic acid
Hematologic Neoplasms
Hematologic Diseases
Growth Substances
Vitamins
Physiological Effects of Drugs
Bone Density Conservation Agents
Micronutrients
Pharmacologic Actions

ClinicalTrials.gov processed this record on February 08, 2010