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Trial registered on ANZCTR
Registration number
ACTRN12616000187448
Ethics application status
Approved
Date submitted
9/02/2016
Date registered
12/02/2016
Date last updated
1/02/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Bright light therapy to improve sleep and quality of life in children with acute lymphoblastic leukaemia
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Scientific title
Does bright light therapy improve sleep, reduce fatigue and improve quality of life in children (3-9 years old) with acute lymphoblastic leukaemia during maintenance therapy
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Secondary ID [1]
288502
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Nil Known
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Universal Trial Number (UTN)
U1111-1179-3707
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Lymphoblastic Leukaemia
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Sleep Disorders
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Fatigue
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Quality of Life
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Condition category
Condition code
Cancer
297768
297768
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0
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The participants (children 3-9 years of age with Acute Lymphoblastic Leukaemia) will be randomly assigned to the treatment group. They will wear a Feel Bright Light Visor (Physicians Engineered Products, Maine, USA) for 30 minutes as soon as awakening in the morning, for the 84 days of the second cycle of maintenance treatment. This device delivers 8,000 lux of light in the wavelength range of 460 nm to 550 nm. In addition to the light visor, the children will be asked to wear a small device attached to their clothing at the same time (HOBO Pendant (Registered Trademark) 8K Temperature/Light Data Logger (Onset Computer Corporation, Bourne, MA, USA), which measures light intensity and will be used to assess compliance.
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Intervention code [1]
293867
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Treatment: Devices
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Comparator / control treatment
Children 3-9 years of age with Acute Lymphoblastic Leukaemia) will be randomly assigned to the control group. They will have no light therapy intervention and will also be studied during the the 84 days of the second cycle of maintenance treatment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Composite outcome of sleep quantity and quality, using a combination of actigraphy, sleep diary and the Tayside Children’s Sleep Questionnaire.
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Assessment method [1]
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Timepoint [1]
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Primary outcome [2]
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Quality of life using the PedsQL - Cancer module and the Mood and Feelings Questionnaire
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Assessment method [2]
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Timepoint [2]
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Primary outcome [3]
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Daytime sleepiness using the Modified Epworth Sleepiness Scale
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Assessment method [3]
297298
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Timepoint [3]
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Secondary outcome [1]
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Parental stress using the Parenting Stress Index – short form
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Assessment method [1]
320651
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Timepoint [1]
320651
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Secondary outcome [2]
320652
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Composite outcome of sleep quantity and quality, using a combination of actigraphy, sleep diary and the Tayside Children’s Sleep Questionnaire.
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Assessment method [2]
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Timepoint [2]
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Six months after completion of 84 days of light therapy
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Secondary outcome [3]
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Fatigue using the Peds QL Multidimensional Fatigue Scale (Primary outcome)
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Assessment method [3]
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Timepoint [3]
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Secondary outcome [4]
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Family quality of life using the Peds QL Family Impact Module
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Assessment method [4]
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Timepoint [4]
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Comparing the five days before light therapy to the last five days of the second cycle of maintenance treatment
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Secondary outcome [5]
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Quality of life using the PedsQL - Cancer module and the Mood and Feelings Questionnaire
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Assessment method [5]
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Timepoint [5]
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Six months after completion of 84 days of light therapy
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Secondary outcome [6]
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Daytime sleepiness using the Modified Epworth Sleepiness Scale
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Assessment method [6]
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Timepoint [6]
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Six months after completion of 84 days of light therapy
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Secondary outcome [7]
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Fatigue using the Peds QL Multidimensional Fatigue Scale
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Assessment method [7]
320683
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Timepoint [7]
320683
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Six months after completion of 84 days of light therapy
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Secondary outcome [8]
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Family quality of life using the Peds QL Family Impact Module
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Assessment method [8]
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Timepoint [8]
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Six months after completion of 84 days of light therapy
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Secondary outcome [9]
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Parental Stress using the Parenting Stress Index – short form
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Assessment method [9]
320685
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Timepoint [9]
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Six months after completion of 84 days of light therapy
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Eligibility
Key inclusion criteria
Children 3 to 9 years of age
Undergoing maintenance treatment for acute lymphoblastic leukaemia
White cell count less than 50,000 cells per microliter
Favourable cytogenetics, i.e. no extreme hypodiploidy with < 44 chromosomes/cell; MLL gene rearrangement; Philadelphia chromosome positivity; Internal amplification of chromosome 21
No cerebrospinal disease
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Minimum age
3
Years
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Maximum age
9
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Children who are blind
Have a history of diagnosed retinal problems
On photo-sensitive medication, such as azole anti-fungal medication (risk of photosensitivity
On medications which alter/induce sleep
On psychotropic medications
Non-English speaking and/or non-English speaking parents
Have pre-existing developmental disabilities
Have epilepsy or migraines
Wear tinted glasses
Are in foster care or with documented protective services involvement.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Our primary aim is to determine whether light therapy significantly improves the quality of life in children with ALL Based on the number of children meeting the study criteria in 2016 from both MMC and RCH, and an 86% participation rate in our pilot study, we expect to recruit 80 children over the three years of the project from both sites. As there are no previous studies of light therapy in children with cancer upon which to base a power calculation, we have based our power calculation on a study that investigated the change in quality of life in children with ALL when being administered dexamethasone compared to no dexamethasone (Pound CM, et al. Corticosteroids, behavior, and quality of life in children treated for acute lymphoblastic leukemia; a multicentered trial. J Pediatr Hematol Oncol 2012;34:517-23). A mean difference in the pain and hurt scale of the PedsQL_cancer module of -17.4, SD 26.9 between the on-dexamethasone and off-dexamethasone time-points was significant (p<0.001). Using these data, our sample size of 40 children per group, will allow the detection of a significant difference between the light therapy and comparison groups with a power of 83% and alpha level of 0.05.
In this study, the effect of light therapy on sleep parameters (sleep pattern, total sleep time, sleep onset latency, wake after sleep onset), and scores from the Tayside Children’s Sleep Questionnaire, Epworth Sleepiness Scale, PedsQL-Cancer module, PedsQl-Fatigue module, Mood and Feelings Questionnaire, PedsQL-Family Impact module and the Parenting Stress Index will be analysed using linear mixed model analyses to allow for random effects over repeated observations. Group and time will be entered as fixed effects. Age and SES will be entered as covariates. Subject code will be used as the random factor. When there is a significant interaction between group and time in the mixed model analyses, post-hoc one-way-ANOVAs with Bonferroni adjustments will be used. Separate analysis at six month follow-up will compare sleep parameters and questionnaire scores between the groups using Student’s T-tests with Bonferroni correction to account for multiple tests.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/03/2016
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Actual
8/06/2016
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Date of last participant enrolment
Anticipated
1/03/2020
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
80
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment hospital [2]
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The Royal Childrens Hospital - Parkville
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Recruitment postcode(s) [1]
12717
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3168 - Clayton
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Recruitment postcode(s) [2]
15218
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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The Ritchie Centre, Hudson Institute of Medical Research
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Address [1]
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27-31 Wright St,
Clayton
Victoria 3168
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Country [1]
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Australia
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Funding source category [2]
295484
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Charities/Societies/Foundations
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Name [2]
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Children's Cancer Foundation
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Address [2]
295484
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Level 4,
4 Freshwater Place,
Southbank
VIC 3006
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Country [2]
295484
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Australia
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Primary sponsor type
Individual
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Name
Lisa Walter
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Address
The Ritchie Centre,
Hudson Institute of Medical Research
27-31 Wright St,
Clayton
Victoria 3168
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
291599
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Address [1]
291599
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Country [1]
291599
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
294356
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Monash Health Human Research Ethics Committee
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Ethics committee address [1]
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Research Support Services Monash Health Monash Medical Centre 246 Clayton Rd Clayton Victoria 3168
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Ethics committee country [1]
294356
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Australia
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Date submitted for ethics approval [1]
294356
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04/02/2016
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Approval date [1]
294356
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15/02/2016
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Ethics approval number [1]
294356
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16047A
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Ethics committee name [2]
296813
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Royal Children's Hospital, Research Ethics and Governance
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Ethics committee address [2]
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50 Flemington Rd, Parkville VIC 3052
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Ethics committee country [2]
296813
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Australia
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Date submitted for ethics approval [2]
296813
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21/12/2016
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Approval date [2]
296813
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Ethics approval number [2]
296813
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Summary
Brief summary
The primary purpose of this study is to evaluate the efficacy of bright light therapy for improving sleep and quality of life in children undergoing treatment for acute lymphoblastic leukaemia. Who is it for? You may be eligible to participate in this study if you are aged 3 to 9 years of age, and undergoing maintenance treatment for acute lymphoblastic leukaemia. Study details All participants enrolled in this study will be randomly allocated (by chance) to receive either bright light therapy or standard leukaemia care with no bright light therapy. Participants allocated to the bright light therapy group will be asked to wear a bright light visor for 30 minutes immediately after waking up each morning for the 84 days of the second maintenance treatment cycle. To assess sleep, fatigue, mood, and quality of life measures, researchers will use a combination of home-based assessment of sleep (actigraphy), a detailed sleep diary and questionnaires. The questionnaires will be completed by both the child and the parents at the beginning and the end of the light therapy, and six months after therapy, and will take approximately 30 minutes to complete at each time point. It is hoped that bright light therapy will provide a cost-effective method of improving sleep and quality of life for children undergoing treatment for acute lymphoblastic leukaemia who are a group at risk of development of potentially long-term sleep problems, increased psychological distress, poor treatment resilience and low quality of life.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Lisa Walter
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Address
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The Ritchie Centre
Hudson Institute of Medical Research
27-31 Wright St
Clayton
Victoria 3168
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Country
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Australia
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Phone
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+61 385722834
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Fax
63402
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+61 395946811
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Email
63402
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[email protected]
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Contact person for public queries
Name
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Lisa Walter
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Address
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The Ritchie Centre
Hudson Institute of Medical Research
27-31 Wright St
Clayton
Victoria 3168
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Country
63403
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Australia
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Phone
63403
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+61 385722834
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Fax
63403
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+61 395946811
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Email
63403
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[email protected]
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Contact person for scientific queries
Name
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Lisa Walter
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Address
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The Ritchie Centre
Hudson Institute of Medical Research
27-31 Wright St
Clayton
Victoria 3168
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Country
63404
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Australia
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Phone
63404
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+61 385722834
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Fax
63404
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+61 395946811
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Email
63404
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF