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Lymphoblastic LeukemiaPhase 2IAMFITNCT05194397

Exercise Training and NR Supplementation Trial to Improve Fitness in AYA HCT Survivors

A Phase 2 study testing Nicotinamide Riboside and Exercise Intervention in people with Lymphoblastic Leukemia and Cancer Survivors, run by Children's Hospital of Philadelphia at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This will be a randomized, placebo-controlled trial with a 2x2 factorial design testing the effects of an NAD+ precursor (NR) and exercise on skeletal muscle quality and VO2max in AYA HCT survivors. The primary outcome is the change in muscle strength (isometric knee extension) from baseline to 16 weeks. Read more about this study

Who is it for?
Ages 10 to 30 years
What is being tested?
Nicotinamide Riboside and Exercise Intervention
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
80 participants
Where
3 sitesUnited States
Study dates
23 Feb 2023to 30 Jun 2026
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 10 to 30 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Males and females, ages 10-30 years at enrollment
  • Able to understand and speak English
  • Diagnosis of leukemia (myeloid, lymphoid), aplastic anemia, bone marrow failure syndrome, or myelodysplastic syndrome requiring allogeneic HCT
  • 6-48 months from allogeneic HCT
  • Females must have a negative urine/serum pregnancy test and must use an acceptable method of contraception, including abstinence, a barrier method (diaphragm or condom), Depo-Provera, or an oral contraceptive, for the duration of the study.
  • Subject's informed consent or parental/guardian permission (informed consent) and if appropriate, child assent
  • Minimum weight of 24 kg

Who cannot join

  • Known sensitivity to NR
  • Concurrent use of any medications, including statins, likely to increase risk of NR toxicity
  • Active malignancy, investigational agent(s) within 4 wks, or supraphysiological glucocorticoids at the baseline visit
  • Currently meeting public health exercise guidelines
  • Use of NAD+ precursors (supra-physiologic) within 4 weeks
  • Hemoglobin < 10 g/dL
Show all 25Show fewer
  • Platelets < 50K
  • Diabetes Mellitus requiring insulin or insulin secretagogue
  • HbA1C ≥ 8% or fasting glucose > 125 mg/dL; However if the participant is diabetic, both fasting glucose level and HbA1C must meet the criteria to be deemed eligible.
  • Kidney disease (eGFR < 60 ml/min/1.73 m2)
  • Liver disease Alanine aminotransferase (ALT)/Aspartate aminotransferase (AST) (ALT/AST > 3 x ULN)
  • Limitations in physical function preventing exercise testing/training
  • Unstable angina or history of acute myocardial infarction (<5 days of planned study procedures)
  • Recurrent syncope
  • Symptomatic severe aortic stenosis
  • Uncontrolled arrhythmia causing symptoms
  • Pulmonary embolus <3 months of study procedures
  • Thrombosis of lower extremities
  • Symptomatic moderate or severe persistent asthma based on Forced Expiratory Volume (FEV) from pre-HCT pulmonary function testing
  • Room air desaturation at rest ≤85%
  • Females: Pregnant or planning pregnancy
  • Non-cardiopulmonary disorders that may affect exercise performance or be aggravated by exercise (e.g. infection, renal failure, thyrotoxicosis, >moderate Graft versus host disease (GVHD) resulting in physical or functional impairment)
  • Parents/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
  • For MRI procedure: Contraindications to MRI. Individuals will be screened to ensure they can safely complete the MRI. *participants who cannot complete the MRI will not be excluded from participation in the remainder of the study procedures if they meet those inclusion and exclusion criteria.
  • Current weight precludes safe completion of study procedures

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Katherine Cambareri, MPH contact

445-942-7801

cambarerik@chop.edu

Kristin Wade contact

267-398-5761

wadekl@chop.edu

United States3 sites, 3 recruiting
  • City of Hope Medical Center

    Duarte, California, 91010

    Lanie Lindenfeld, MA, CCRP, 626-218-1150, llindenfeld@coh.org

    Saro H Armenian, DO, MPH

    Recruiting
  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

    Sarah Terrell, MS, 901-595-4466, sarah.terrell@stjude.org

    Kirsten K. Ness, PhD

    Recruiting
  • Children's Hospital of Philadelphia

    Philadelphia, Pennsylvania, 19104

    Susan Lee, 267-602-4603, leess@chop.edu

    Kristin Wade, 267-398-5761, wadekl@chop.edu

    Recruiting

Other trials in United States

About this study

Official title: Intensive Tailored Exercise Training With NAD+ Precursor Supplementation to Improve Muscle Mass and Fitness in Adolescent and Young Adult Hematopoietic Cell Transplant Survivors

This will be a randomized, placebo-controlled trial with a 2x2 factorial design testing the effects of an NAD+ precursor (NR) and exercise on skeletal muscle quality and VO2max in AYA HCT survivors.

The primary outcome is the change in muscle strength (isometric knee extension) from baseline to 16 weeks. Key secondary outcomes are the change in muscle strength (ankle plantarflexion) from baseline to 16 weeks, the change in grip strength from baseline to 16 weeks, the change in lower extremity muscle mass from baseline to 16 weeks, the change in muscle OXPHOS capacity from baseline to 16 weeks, and the change in aerobic capacity (VO2 max) from baseline to 16 weeks.

Read the detailed description

Adolescents and young adults (AYAs) who undergo hematopoietic cell transplantation (HCT) are at an especially high risk of developing sarcopenia (loss of skeletal muscle mass), which occurs earlier than would be expected from advancing age alone. This is important as not only it doubles their risk for non-relapse mortality, but it also leads to premature cardiovascular disease. The investigators propose a mechanistic randomized controlled trial of home-based remotely supervised exercise (aerobic and resistance) training and supplementation with nicotinamide riboside, a precursor of NAD+, a metabolite that is critical for muscle metabolism, in AYA survivors of HCT. The findings will lay the critical groundwork for future trials to prevent or mitigate the myriad downstream adverse effects of low muscle mass in AYA HCT survivors.

Being tested
Nicotinamide Riboside, Placebo, Exercise Intervention
Keywords
Sarcopenia, NAD+, Exercise Intervention, OXPHOS Capacity, VO2 Max, Adolescent young adults, Cancer Survivors, Hematopoietic Stem Cell Transplantation (HCT)
Medical subject headings
Precursor Cell Lymphoblastic Leukemia-Lymphoma, Anemia, Aplastic, Myelodysplastic Syndromes, Leukemia, Myeloid, Sarcopenia

What participants receive

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

  • Nicotinamide RibosideDietary supplement

    Investigators will use (Good Manufacturing Process) GMP-grade 300 mg capsules of the dietary supplement nicotinamide riboside (ChromaDex, Irvine CA).

    NR is distributed by ChromaDex, Inc., Irvine, CA. NR is available as 300 mg capsules.

    The dietary supplement will be re-labeled by the Hospital of the University of Pennsylvania (HUP) Investigational Drug Service according to FDA regulations, including subject and physician name and NR or Placebo 300 mg capsules.

  • PlaceboDietary supplement

    The matched placebo will contain the same excipients without the active supplement and is generally recognized as safe. The placebo will be covered in an identical capsule (NR will be covered in the same capsule)

  • Exercise InterventionOther

    The exercise program consists of at-home training sessions and will include aerobic and strengthening components designed to progress persons gradually to 150-300 minutes of the equivalent of moderate aerobic activity, and twice weekly strengthening over 16 weeks. For aerobic training, the eventual intensity and duration goal (adapted for each person as necessary) will be for persons to train at 70-80% of peak 2MSPT heart rate 20-45 minutes 3-5 days/week. For resistance exercises the goal will be a load/weight that results in fatigue after 3 sets of 10-12 repetitions on 8-10 exercises 2 days/week.

Study groups in NCT05194397
Study groupRoleWhat they receive
Nicotinamide Riboside (NR)ExperimentalInvestigators will use Good Manufacturing Process (GMP)-grade 300 mg capsules of the dietary supplement nicotinamide riboside (ChromaDex, Irvine CA). Investigators dose based on body weight, and monitor for adverse effects (AEs). For individuals with weight > 72 kg: 900 mg po qd x 16 wks. For individuals with weight > 48 kg and ≤ 72 kg: 600 mg po qd x 16 wks. For individuals with weight 24 ≤ 48 kg: 300 mg po qd x 16 wks.
Receives: Dietary Supplement: Nicotinamide Riboside
PlaceboPlacebo comparatorMatched placebo will contain the same excipients without the active supplement and is generally recognized as safe. The placebo will be covered in an identical capsule (NR will be covered in the same capsule). Doses of placebo will match the body weight schema for dosing of NR. Investigators dose based on body weight, and monitor for adverse effects (AEs). For individuals with weight > 72 kg: 900 mg po qd x 16 wks. For individuals with weight > 48 kg and ≤ 72 kg: 600 mg po qd x 16 wks. For individuals with weight 24 ≤ 48 kg: 300 mg po qd x 16 wks.
Receives: Dietary Supplement: Placebo
Exercise Intervention and NRExperimentalThe exercise program consists of at-home training sessions including: aerobic and strengthening components designed to progress persons gradually to 150-300 minutes of the equivalent of moderate aerobic activity, and twice weekly strength training exercises. Participants in this arm will receive both the Exercise Intervention and the NR.
Receives: Dietary Supplement: Nicotinamide Riboside; Other: Exercise Intervention
Exercise Intervention and PlaceboExperimentalThe exercise program consists of at-home training sessions including: aerobic and strengthening components designed to progress persons gradually to 150-300 minutes of the equivalent of moderate aerobic activity, and twice weekly strength training exercises. Participants in this arm will receive both the Exercise Intervention and the Placebo
Receives: Dietary Supplement: Placebo; Other: Exercise Intervention

What is being measured

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

  1. Within participant changes in muscle strength (Isometric knee extension, Z-score)

    Muscle Strength will be assessed by completion of isometric contractions using a Biodex dynamometer.

    Measured: Baseline to 16 Weeks

Secondary outcomes (5)
  1. Within participant change in muscle strength (Ankle Plantarflexion)

    Muscle Strength will be assessed by completion of isometric contractions using a Biodex dynamometer.

    Measured: Baseline to 16 Weeks

  2. Within participant change in grip strength (Hand Grip Dynamometry)

    Grip Strength will be assessed using a hand grip dynamometry device.

    Measured: Baseline to 16 Weeks

  3. Within participant changes in muscle mass (lower leg lean muscle mass by DXA)

    Muscle mass will be assessed by completion of whole body DXA scanning.

    Measured: Baseline to 16 Weeks

  4. Within participant changes in post-exercise oxidative phosphorylation capacity (OXPHOS).

    OXPHOS capacity will be assessed by completion of non-invasive MRI scanning using creatine chemical exchange saturation transfer (CrCEST).

    Measured: Baseline to 16 Weeks

  5. Within participant change in aerobic capacity (VO2 max, Maximal Oxygen Uptake on Cardiopulmonary Exercise Testing).

    VO2 Max will be assessed by completion of an incremental cardio-pulmonary Exercise Stress Test (EST) on an upright leg cycle ergometer

    Measured: Baseline to 16 Weeks

Timeline

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

  1. First posted18 Jan 2022
  2. Study start23 Feb 2023
  3. Primary completion30 Jun 2026 (estimated)
  4. Study completion30 Jun 2026 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Factorial
Model description
Randomized, placebo-controlled trial with a 2x2 factorial design testing the effects of an NAD+ precursor (NR) and exercise.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05194397
Sponsor's protocol ID
20-017320
Other IDs
1R01CA254955-01A1
Acronym
IAMFIT
Status last verified
Dec 2025
First submitted
9 Dec 2021
Last updated
4 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: No identifiable data will be used for future study without first obtaining IRB approval. The investigator will obtain a fully executed data use agreement between the provider (the PI) of the data and any recipient researchers \[(including others at CHOP) before sharing a limited dataset (or the data will only be provided to users under a fully executed data use (or data sharing) agreement approved by the Children's Hospital of Philadelphia (CHOP) Institutional Review Board (IRB)\]. The execution of the agreement will require approval by the Children's Hospital of Philadelphia (CHOP) Institutional Review Board (IRB) or a demonstration of IRB exemption per institutional policy.

Publications

  • Song M, Armenian SH, Bhandari R, Lee K, Ness K, Putt M, Lindenfeld L, Manoukian S, Wade K, Dedio A, Guzman T, Hampton I, Lin K, Baur J, McCormack S, Mostoufi-Moab S. Exercise training and NR supplementation to improve muscle mass and fitness in adolescent and young adult hematopoietic cell transplant survivors: a randomized controlled trial 1. BMC Cancer. 2022 Jul 19;22(1):795. doi: 10.1186/s12885-022-09845-1.

    PubMed 35854224

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nicotinamide Riboside and Exercise Intervention in people with Lymphoblastic Leukemia and Cancer Survivors, run by Children's Hospital of Philadelphia at 3 sites 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 7 inclusion and 25 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: looking for participants now, as of the sponsor's last update on 4 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Katherine Cambareri, MPH (445-942-7801, cambarerik@chop.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Within participant changes in muscle strength (Isometric knee extension, Z-score) (time frame: Baseline to 16 Weeks). 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 NCT05194397, 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 4 Dec 2025.

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