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Hodgkin LymphomaNCT01820117

Brain Integrity in Survivors of Hodgkin Lymphoma Treated With Thoracic Radiation

An observational study of Hodgkin Lymphoma, run by St. Jude Children's Research Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

While thoracic radiation therapy (TRT) has been a primary component in successful treatment of a variety of childhood and adult cancers, the exposure to this treatment has been associated with significant cardiovascular and pulmonary morbidity in long-term survivors. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Hodgkin Lymphoma
What is being tested?
Neurocognitive Evaluation, Quantitative Brain Imaging and Neurologic Evaluation
Type of treatment
Surgery or procedure
How many people
416 participants
Where
1 siteUnited States
Study dates
26 Apr 2013to 20 Feb 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: SJLIFE is an institutional initiative to establish a lifetime survivor cohort to study physical and behavioral health outcomes in adult survivors of childhood cancer. This protocol includes individuals diagnosed and treated with a malignancy during childhood at SJCRH since 1962, who are now 10 or more years from diagnosis and over 18 years of age. The current study will recruit participants from the SJLIFE cohort who received thoracic radiation as part of their treatment for Hodgkin lymphoma. Potentially eligible comparison group participants will be recruited from the relative or friend population who accompany any After Completion of Therapy (ACT) or SJLIFE patient for follow-up at SJCRH.

Who may be able to join

  • Current St. Jude LIFE protocol Participant, treated with thoracic radiation
  • Currently ≥ 18 years of age
  • ≥ 10 years from original diagnosis
  • Research participant is a sibling, parent, relative or friend of a current or former St. Jude patient
  • Research participant must be at least 18 years of age at the time of the scheduled evaluation

Who cannot join

  • Has participated in the previous pilot study at St. Jude (HPP16)
  • History of cranial or total-body radiation therapy
  • History of intrathecal Methotrexate, high-dose Methotrexate or high-dose Cytarabine.
  • History of head injury or diagnosis of a genetic disorder associated with neurocognitive impairment
  • Pre-existing known neurocognitive impairment prior to diagnosis of Hodgkin lymphoma
  • History of congenital heart disease reported in the literature to be associated with neurocognitive status as determined by the principal investigators
Show all 15Show fewer
  • Currently pregnant
  • Secondary central nervous system neoplasm
  • History of cranial, total-body or thoracic radiation therapy
  • History of intrathecal Methotrexate, high-dose Methotrexate, or high-dose Cytarabine.
  • History of head injury or diagnosis of a genetic disorder associated with neurocognitive impairment
  • Known neurocognitive impairment
  • History of congenital heart disease reported in the literature to be associated with neurocognitive status as determined by the principal investigators
  • Currently pregnant
  • Central nervous system neoplasm

Trial locations and contacts

1 site in 1 country.

United States1 site
  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

Other trials in United States

About this study

Official title: Brain Integrity in Survivors of Hodgkin Lymphoma (HL) Treated With Thoracic Radiation

While thoracic radiation therapy (TRT) has been a primary component in successful treatment of a variety of childhood and adult cancers, the exposure to this treatment has been associated with significant cardiovascular and pulmonary morbidity in long-term survivors. Within non-cancer populations, cardiovascular and pulmonary morbidity is associated with increased risk for cerebral vascular accidents (CVAs), accelerated brain atrophy and neurocognitive impairment. Patients with chronic heart disease demonstrate problems with attention, processing speed, memory, and executive functions. Chronic pulmonary disease also increases the risk of stroke, leukoencephalopathy, and neurocognitive impairment in non-cancer populations. The investigators propose to examine indices of brain integrity, including neurocognitive performance and brain MRI/MRA, in long-term adult survivors of Hodgkin lymphoma (HL) treated with thoracic radiation and no direct central nervous system therapy.

OBJECTIVES:

  1. To evaluate brain integrity in adult survivors of childhood HL treated with thoracic radiation therapy.
  2. To identify therapeutic factors associated with brain integrity in adult survivors of childhood HL who are at risk for cardiac and pulmonary morbidity.
  3. To examine associations between cardiac, vascular and pulmonary health and brain integrity in adult survivors of childhood HL treated with thoracic radiation.
Read the detailed description

This is an observational study to collect health data from long-term survivors of Hodgkin lymphoma (HL). Data will be collected once at participant enrollment. The long-term effects of thoracic radiation therapy (TRT) given earlier as part of the treatment for HL will be examined in long-term survivors and compared to health data collected from normal volunteers.

HL survivors who were treated at St. Jude Children's Research Hospital (SJCRH) with TRT will be recruited to complete a comprehensive neurocognitive evaluation, brain MRI/MRA, a clinical neurological exam, peripheral pulse contour analysis, non-invasive central blood pressure monitoring, cardiopulmonary exercise testing, and serum biomarkers related to cardiac disease. As part of their standard St. Jude LIFE protocol evaluation, they also complete an echocardiogram, pulmonary function tests and questionnaires designed to evaluate broad health, psychological, socioeconomic and environmental factors that impact everyday life.

A comparison sample of healthy individuals, frequency-matched on age, sex and race will also be recruited. The comparison group will complete the comprehensive neurocognitive evaluation, brain MRI/MRA, clinical neurological exam, pulse contour analysis, non-invasive central blood pressure monitoring, and cardiopulmonary exercise testing. Through the St. Jude LIFE protocol, the comparison sample will also complete an echocardiogram, pulmonary function tests and questionnaires designed to evaluate broad health, psychological, socioeconomic and environmental factors that impact everyday life.

Being tested
Neurocognitive Evaluation, Quantitative Brain Imaging, Neurologic Evaluation, Health Questionnaire, Vascular Testing
Keywords
long-term health outcomes
Medical subject headings
Hodgkin Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Neurocognitive EvaluationOther

    The neurocognitive evaluation will include measures of academic achievement, intelligence, sustained attention, memory, processing speed, executive functions, functional behavior, and emotional functioning.

  • Quantitative Brain ImagingOther

    Imaging will include raw images to both quantify white matter hyperintensities and hemosiderin deposits, as well as cortical thickness and tissue segmentation. Brain imaging will be repeated on participants who are concurrently enrolled on BRIGHT and MIND protocols at St. Jude and who completed prior brain imaging during the BRIGHT clinic visit. The repeat MRI will be done at their 6 month MIND clinic visit.

  • Neurologic EvaluationOther

    Evaluation includes a complete review of neurologic symptoms, and interview and examination by the neurologist, assessment of neurologic symptoms and determination of their impact on day-to-day living, and quantified neurologic examination by the neurologist.

  • Health QuestionnaireOther

    Participants will be asked to complete an approximately 450-item survey to assess health history and status, social and demographic factors, health behaviors, and psychosocial constructs.

  • Vascular TestingOther

    Digital assessment of endothelial function will be studied, and central blood and pulse pressure and carotid-femoral pulse wave velocity will be non-invasively measured.

  • Cardiopulmonary Exercise TestingOther

    Study participants will undergo cardiopulmonary exercise testing by treadmill. Those participants whose physical performance does not permit walking safely on the treadmill (extreme deconditioning, lower extremity paralysis, balance disorder, acute lower extremity injury) will perform cardiopulmonary exercise testing on a bicycle or upper extremity ergometer using a comparable testing protocol.

  • EchocardiographyOther

    A complete 3D as well as 2D echocardiogram with Doppler and M-mode will be performed.

  • Pulmonary Function TestingOther

    Pulmonary function testing will include spirometry, lung volume measurements by body plethysmography, and single-breath carbon monoxide-diffusion capacity (DLCO).

  • Serum BiomarkersProcedure or surgery

    Blood for serum biomarkers associated with cardiovascular morbidity will be drawn, including high-sensitivity C-reactive protein, serum homocysteine.

  • Ophthalmology ExaminationOther

    Ophthalmology examination will include a review of symptoms, examination, and fundus imaging. The examination will consist of visual acuity testing, refraction testing, retinoscopy, ocular pressure, and examination under mydriasis. Fundus photography will be used to capture an image of the retina for examination of potential hypertensive retinopathy.

Study groups in NCT01820117
Study groupRoleWhat they receive
Hodgkin lymphomaParticipants previously treated at St. Jude Children's Research Hospital with thoracic radiation therapy for Hodgkin lymphoma. Interventions: Neurocognitive Evaluation, Quantitative Brain Imaging, Neurologic Evaluation, Comprehensive Health Questionnaire, Vascular Testing, Cardiopulmonary Exercise Testing, Echocardiography, Pulmonary Function Testing, Serum Biomarkers, and Ophthalmology Examination.
Receives: Other: Neurocognitive Evaluation; Other: Quantitative Brain Imaging; Other: Neurologic Evaluation; Other: Health Questionnaire; Other: Vascular Testing; Other: Cardiopulmonary Exercise Testing; Other: Echocardiography; Other: Pulmonary Function Testing; Procedure: Serum Biomarkers; Other: Ophthalmology Examination
Normal controlA group of healthy individuals matched for age, sex and race. Interventions: Neurocognitive Evaluation, Quantitative Brain Imaging, Neurologic Evaluation, Comprehensive Health Questionnaire, Vascular Testing, Cardiopulmonary Exercise Testing, Echocardiography, Pulmonary Function Testing, Serum Biomarkers, and Ophthalmology Examination.
Receives: Other: Neurocognitive Evaluation; Other: Quantitative Brain Imaging; Other: Neurologic Evaluation; Other: Health Questionnaire; Other: Vascular Testing; Other: Cardiopulmonary Exercise Testing; Other: Echocardiography; Other: Pulmonary Function Testing; Procedure: Serum Biomarkers; Other: Ophthalmology Examination

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neurocognitive measures of sustained attention and memory between HL survivor group and control group.

    To evaluate brain integrity in adult survivors of childhood cancer treated with thoracic radiation therapy.

    Two-sided two-sample t test will be conducted to compare the difference of neurocognitive impairment in area of sustained attention and memory in the HL survivors and matched controls.

    Measured: Once, at or near enrollment

  2. Rate of leukoencephalopathy and hemosiderin deposits on quantitative MRI between HL survivor group and control group.

    To evaluate brain integrity in adult survivors of childhood cancer treated with thoracic radiation therapy.

    Two-sided two-sample proportional test will be used to compare the rates of leukoencephalopathy and hemosiderin deposits between in the HL survivors and matched controls.

    Measured: Once, at or near enrollment

  3. Rate of neurologic symptoms between HL survivor group and control group.

    To evaluate brain integrity in adult survivors of childhood cancer treated with thoracic radiation therapy.

    Two-sided two-sample proportional test will be used to compare the rates of neurologic symptoms between the HL survivors and matched controls.

    Measured: Once, at or near enrollment

Secondary outcomes (2)
  1. Association between thoracic radiation dose and sustained attention and memory scores and rate of leukoencephalopathy and hemosiderin deposits in HL survivors.

    In HL survivors only, outcome variables will be: sustained attention (continuous), memory (continuous), leukoencephalopathy (dichotomous) and hemosiderin deposits (dichotomous). Independent variables are radiation dose to cardiopulmonary structures. Covariates will include chemotherapy exposures, particularly anthracycline exposure. For each continuous response variable, linear regression model will be used to see its association with these independent variables, adjusted for race/age/sex. Other possible covariates include educational attainment, employment and occupation, current physical activity, and alcohol and tobacco. For each dichotomous response variable, logistic regression model will be used to see its association with these independent variables, adjusted for race/age/sex. AIC criteria will be used to select the final model.

    Measured: Once, at or near enrollment

  2. Association between cardiac, vascular and pulmonary health and sustained attention and memory scores and rate of leukoencephalopathy and hemosiderin deposits.

    In HL survivors only, outcome variables will be: sustained attention (continuous), memory (continuous), leukoencephalopathy (dichotomous) and hemosiderin deposits (dichotomous). Independent variables are cardiac, vascular and pulmonary health. For each continuous response variable, linear regression model will be used to see its association with these independent variables, adjusted for race/age/sex. Other possible covariates include educational attainment, employment and occupation, current physical activity, and alcohol and tobacco. For each dichotomous response variable, logistic regression model will be used to see its association with these independent variables, adjusted for race/age/sex. AIC criteria will be used to select the final model.

    Measured: Once, at or near enrollment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Mar 2013 (estimated)
  2. Study start26 Apr 2013
  3. Primary completion20 Feb 2018
  4. Study completion20 Feb 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Other
Enrolment
416 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01820117
Sponsor's protocol ID
BRIGHT
Other IDs
R01CA174794
Status last verified
Feb 2018
First submitted
21 Mar 2013
Last updated
1 Mar 2018
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Khan RB, Hanzlik E, Deokumar S, Xie L, Hudson MM, Krull KR, Sabin ND. Neurologic Morbidity in Survivors of Childhood Hodgkin Lymphoma Treated With Radiation. Pediatr Blood Cancer. 2026 Aug;73(8):e70398. doi: 10.1002/1545-5017.70398. Epub 2026 May 12.

    PubMed 42116823

Questions about this trial

What is this clinical trial studying?

An observational study of Hodgkin Lymphoma, run by St. Jude Children's Research Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Mar 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neurocognitive measures of sustained attention and memory between HL survivor group and control group. (time frame: Once, at or near enrollment). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01820117, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Mar 2018.

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