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

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ClinicalTrials.gov Identifier: NCT01362595
Recruitment Status : Active, not recruiting
First Posted : May 30, 2011
Last Update Posted : April 11, 2018
Sponsor:
Information provided by (Responsible Party):
Adrianna Vlachos, Northwell Health

Study Description
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Brief Summary:

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 or disease Intervention/treatment Phase
Diamond Blackfan Anemia Blackfan Diamond Syndrome DBA Congenital Hypoplastic Anemia Pure Red Cell Aplasia Drug: leucine Phase 1 Phase 2

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.


Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Intervention Model: Single Group Assignment
Masking: None (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
Actual Study Start Date : June 2013
Estimated Primary Completion Date : June 30, 2018
Estimated Study Completion Date : June 30, 2018

Resource links provided by the National Library of Medicine

Drug Information available for: Leucine

Arms and Interventions
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Arm Intervention/treatment
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


Outcome Measures
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Primary Outcome Measures :
  1. 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. ]

    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 :
  1. Side effects of leucine in transfusion-dependent DBA patients [ Time Frame: Total study 12-15 months ]
    Secondary outcomes include safety parameters such as type, frequency, and severity of adverse events and relationship to leucine.


Eligibility Criteria
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Ages Eligible for Study:   2 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
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
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01362595


Locations
United States, Arizona
Phoenix Children's Hospital
Phoenix, Arizona, United States, 85016
United States, California
Stanford University Medical Center
Palo Alto, California, United States, 94304
United States, Indiana
Riley Hospital for Children
Indianapolis, Indiana, United States, 46202
United States, Kentucky
University of Louisville
Louisville, Kentucky, United States, 40202
United States, Massachusetts
Boston Children's Hospital
Boston, Massachusetts, United States, 02115
United States, Michigan
University of Michigan C.S. Mott Children's Hospital
Ann Arbor, Michigan, United States, 48109
United States, Missouri
University of Missouri-Columbia Women's and Children's Hospital
Columbia, Missouri, United States, 65201
United States, Nevada
Children's Specialty Center of Nevada
Las Vegas, Nevada, United States, 89109
United States, New York
Cohen Children's Medical Center of New York
New Hyde Park, New York, United States, 11040
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
United States, Texas
UT Southwestern Medical Center
Dallas, Texas, United States, 75390
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
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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
First Posted: May 30, 2011    Key Record Dates
Last Update Posted: April 11, 2018
Last Verified: April 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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

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