Study of Stress Hormone Suppression After Glucocorticoid Treatment in Children with Leukemia and Lymphoblastic Lymphoma Tracking Recovery of Natural Hormone Production During and After Therapy

What this Trial Is About

Glucocorticoids are hormones that help control inflammation and regulate the immune system. In children with blood cancers like acute lymphoblastic leukemia ALL and lymphoblastic lymphoma LBL, these hormones are given as medications to quickly reduce cancer cells. However, this treatment can suppress the bodys natural glucocorticoid production, leading to a deficiency that increases infection risks and is hard to detect due to overlapping chemotherapy side effects. This study aims to understand how often and for how long this deficiency occurs in children with these cancers and to identify those at higher risk. The study observes children diagnosed with ALL or LBL who are treated with glucocorticoids for at least 21 consecutive days. Regular low-dose ACTH tests will be performed during and after treatment to assess the bodys natural glucocorticoid production. These tests are done only when children already have venous access and are hospitalized for treatment, minimizing extra burden. The study follows participants from enrollment until three months after their last glucocorticoid dose. Participants will be monitored through these ACTH tests to detect adrenal insufficiency and its duration. The main outcome measured is the occurrence of adrenal insufficiency, with a secondary focus on how long it lasts. The study involves children up to 18 years old and takes place at two childrens hospitals. The goal is to improve understanding and management of glucocorticoid deficiency during and after cancer treatment, with careful attention to the safety and comfort of the children involved.

A Swiss Assessment of Hypothalamic-pituitary-adrenal Axis Suppression After Glucocorticoid Therapy for Leukemia and Lymphoblastic Lymphoma in Children