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A Pilot, Phase I/II Study of the Amino Acid Leucine in the Treatment of Patients With Transfusion-Dependent Diamond Blackfan Anemia (LeucineDBA)

This study is currently recruiting participants. (see Contacts and Locations)
Verified June 2016 by Northwell Health
Sponsor:
Information provided by (Responsible Party):
Adrianna Vlachos, Northwell Health
ClinicalTrials.gov Identifier:
NCT01362595
First received: May 20, 2011
Last updated: June 15, 2016
Last verified: June 2016
History of Changes
  Purpose

This study will determine the safety and possibility of giving the amino acid, leucine, in patients with Diamond Blackfan anemia(DBA)who are on dependent on red blood cell transfusions.

The leucine is expected to produce a response in patients with DBA to the point where red blood cell production is increased. Red cell transfusions can then be less frequent or possibly discontinued.

The investigators will study the side effects, if any, of giving leucine to DBA patients. Leucine levels of leucine will be obtained at baseline and during the study.

The drug leucine will be provided in capsule form and taken 3 times a day for a total of 9 months.


Condition Intervention Phase
Diamond Blackfan Anemia
Blackfan Diamond Syndrome
DBA
Congenital Hypoplastic Anemia
Pure Red Cell Aplasia
 Drug: leucine
 Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: The Use of Novel Therapies to Reconstitute Blood Cell Production and Promote Organ Performance Using Bone Marrow Failure as a Model: a Pilot, Phase I/II Study of the Amino Acid Leucine in the Treatment of Patients With Transfusion-dependent Diamond Blackfan Anemia

Resource links provided by NLM:

Drug Information available for: Leucine
U.S. FDA Resources

Further study details as provided by Northwell Health:

Primary Outcome Measures:
  • Response to Leucine in Transfusion dependent patients with Diamond Blackfan Anemia [ Time Frame: Patients will take leucine for 9 months. The study is expected to take 12-15 months to complete. ] [ Designated as safety issue: Yes ]

    The primary outcome is the type of response observed at 9 months (and 6 months). Response to treatment can be one of the following:

    1. Complete response (CR): Hb > 9 gm/dL and transfusion-independence as defined in DBA
    2. Partial response (PR): Hb < 9 gm/dL and increased reticulocyte count to greater than 1% and any increase in transfusion interval from baseline. (Baseline reticulocytes range from 0.1 to 0.5 and transfusions are usually performed every 3 weeks. An increase of reticulocyte counts to over 1 to 1.5% and any increase in transfusion interval will be considered a PR.)
    3. No response (NR): no change in transfusion requirements and no significant change in Hb or reticulocytes (or any response that does not satisfy the conditions of either a PR or CR)
    4. Progression: worsening of disease as defined by the need for more frequent transfusions


Secondary Outcome Measures:
  • Side effects of leucine in transfusion-dependent DBA patients [ Time Frame: Total study 12-15 months ] [ Designated as safety issue: Yes ]
    Secondary outcomes include safety parameters such as type, frequency, and severity of adverse events and relationship to leucine.
Estimated Enrollment: 50
Study Start Date: June 2013
Estimated Study Completion Date: January 2017
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Leucine
No alternative treatment arm
 Drug: leucine

Dosage of leucine will be dependent on body surface area (BSA):

leucine 700 mg/m2/dose by mouth three times a day

Other Name: leucine, L-leucine

Detailed Description:

Leucine will be provided to participants in the form of a capsule and will be taken three times daily.

Blood hemoglobin levels will be monitored every 3-4 weeks for 9 months.

The entire study will last 12-15 months in length.

Subjects must be two years of age or older and on transfusion for more than six months prior to enrollment.

  Eligibility
Ages Eligible for Study:   2 Years and older   (Child, Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • diagnosed with Diamond Blackfan anemia as published in British Journal of Hematology
  • transfusion dependent
  • age 2 years and older
  • adequate renal function
  • adequate liver function
  • negative B-HCG if patient is a menstruating female and documentation of adequate contraception
  • signed informed consent

Exclusion Criteria:

  • Known hypersensitivity to branched chain amino acids
  • Diagnosis of an inborn error of amino acid metabolism disorder
  • Prior hematopoietic stem cell transplantation
  • Pregnancy, or plans to become pregnant during duration of trial
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01362595

Contacts
Contact: Eva Atsidaftos, MA 516-562-1504 eatsidaf@nshs.edu
Contact: Jessica Kang, BS 516-562-1505 jkang4@nshs.edu

Locations
United States, Arizona
Phoenix Children's Hospital Recruiting
Phoenix, Arizona, United States, 85016
Contact: Erica Olson, RN    602-933-0171    eolson1@phoenixchildrens.com   
Principal Investigator: Christine Knoll, MD         
Sub-Investigator: Sanjay Shah, MD         
United States, California
Stanford University Medical Center Recruiting
Palo Alto, California, United States, 94304
Contact: Kirsten Mouradian, RN, FNP    650-724-2448    KMouradian@stanfordchildrens.org   
Contact: Anu Narla, MD    650-725-7349    anunarla@stanford.edu   
Principal Investigator: Bertil Glader, MD, PhD         
Sub-Investigator: Anu Narla, MD         
United States, Indiana
Riley Hospital for Children Recruiting
Indianapolis, Indiana, United States, 46202
Contact: Anne Bubnick, CCRP    317-948-0101    abubnick@iu.edu   
Principal Investigator: Gregorz Nalepa, MD, PhD         
United States, Kentucky
University of Louisville Recruiting
Louisville, Kentucky, United States, 40202
Contact: Helen Anderkin    502-629-7180    helen.anderkin@louisville.edu   
Principal Investigator: Arun Panigrahi, MD         
United States, Massachusetts
Boston Children's Hospital Recruiting
Boston, Massachusetts, United States, 02115
Contact: Krystle K Benedict    617-355-3748    Krystle.Benedict@childrens.harvard.edu   
Principal Investigator: Colin Sieff, MBBCh         
Sub-Investigator: Ellis Neufeld, MD, PhD         
Sub-Investigator: Vijay Sankaran, MD, PhD         
United States, Michigan
University of Michigan C.S. Mott Children's Hospital Active, not recruiting
Ann Arbor, Michigan, United States, 48109
United States, Missouri
University of Missouri-Columbia Women's and Children's Hospital Recruiting
Columbia, Missouri, United States, 65201
Contact: Mihaela Popescu, MS, CCRP    573-882-1960    popescumi@health.missouri.edu   
Principal Investigator: Thomas W Loew, MD         
Sub-Investigator: Barbara Gruner, MD         
United States, Nevada
Children's Specialty Center of Nevada Recruiting
Las Vegas, Nevada, United States, 89109
Contact: Daniel Crosier, BS, CRA    702-732-1493 ext 131    dcrosier@cure4thekids.org   
Principal Investigator: Jonathan Bernstein, MD         
United States, New York
Cohen Children's Medical Center of New York Recruiting
New Hyde Park, New York, United States, 11040
Contact: Eva Atsidaftos, MA, CCRC    516-562-1504    eatsidaf@nshs.edu   
Contact: Jessica Kang, BS    516-562-1505    jkang4@nshs.edu   
Sub-Investigator: Jeffrey M Lipton, MD, PhD         
Sub-Investigator: Johnson Liu, MD         
Sub-Investigator: Eva Atsidaftos, MA, CCRC         
Sub-Investigator: Lawrence C Wolfe, MD         
Sub-Investigator: Ellen Muir, MSN, RN, CNS         
Principal Investigator: Adrianna Vlachos, MD         
United States, Pennsylvania
Children's Hospital of Philadelphia Recruiting
Philadelphia, Pennsylvania, United States, 19104
Contact: Shanna Cross    267-426-6765    cross@email.chop.edu   
Principal Investigator: Helge Hartung, MD         
United States, Texas
UT Southwestern Medical Center Recruiting
Dallas, Texas, United States, 75390
Contact: Zora R Rogers, MD    214-648-3896    Zora.Rogers@UTSouthwestern.edu   
Contact: Leah M Adix, CCRP    214-456-2888    leah.adix@childrens.com   
Principal Investigator: Zora R Rogers, MD         
Sub-Investigator: George R Buchanan, MD         
Sub-Investigator: Timothy L McCavit, MD         
Sponsors and Collaborators
Northwell Health
Investigators
Principal Investigator: Adrianna Vlachos, MD North Shore- Long Island Jewish Medical Center; Cohen Children's Medical Center of NY
  More Information

Additional Information:
Diamond Blackfan Anemia Registry - a registry for patients with DBA in North America  This link exits the ClinicalTrials.gov site
Daniella Maria Arturi Foundation is a family sponsored group which facilitates research for DBA.  This link exits the ClinicalTrials.gov site
The DBA foundation is a family sponsored organization who raise funds for research and provides emotional support to families.  This link exits the ClinicalTrials.gov site

Publications:
Lab Advisor(TM); Leucine Measurements in Micromedex (R) Healthcare Series. 2010Thomson Reuters
Jellin JM, Gregory P, Batz F. Pharmacist's letter/ Prescriber's Letter Natural Medicines Comprehensive Database, 3rd ed, Therapeutic Research Faculty, Stockton, CA, 2000.
Braverman ER. The Healing Nutrients Within. New Canaan, CT: Keats Publishing, Inc. 1997; 339
Gilman AG, Rall JW, Nies AD et al (eds): Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed. Pergamon Press, New York, NY, 1990.
AMA Department of Drugs; AMA Drug Evaluations, 6th ed. American Medical Association, Chicago, IL,1986.
Tietz NE (Ed); Clinical Guide to Laboratory Tests, 3rd ed W. B. Saunders, Philadelphia, PA, 1995.
Henry JB: Clinical Diagnosis and Management by Laboratory Methods, 20th ed. Saunders 2001.

Responsible Party: Adrianna Vlachos, MD, Principal Investigator, Northwell Health
ClinicalTrials.gov Identifier: NCT01362595     History of Changes
Other Study ID Numbers: 12-375B 
Study First Received: May 20, 2011
Last Updated: June 15, 2016
Health Authority: United States: Food and Drug Administration

Keywords provided by Northwell Health:
leucine administration
red blood cell transfusion
Diamond Blackfan anemia

Additional relevant MeSH terms:
Anemia
Anemia, Diamond-Blackfan
Red-Cell Aplasia, Pure
Anemia, Aplastic
 Anemia, Hypoplastic, Congenital
Hematologic Diseases
Bone Marrow Diseases
Genetic Diseases, Inborn

ClinicalTrials.gov processed this record on September 27, 2016