Hypoxic Red Blood Cells for Burns and Hematological Malignancies at Haukeland University Hospital

Burns Clinical Trial

Official title:

A Single Center, Pilot Clinical Investigation of Surgical Bleeding in Burn Patients, and Chronically Transfused Patients With Haematologic Malignancies, Who Are Transfused With Hypoxic Red Blood Cells Manufactured With Hemanext ONE System

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05549232
• Other study ID #: PRO-CLIN-0012
• Status: Recruiting
• Start date: August 24, 2022
• Est. completion date: March 31, 2024

Study information

• Verified date: September 2023
• Source: Hemanext
• Contact: Kimberly Dorsch
• Phone: +1.781.301.7443
• Email: kim.dorsch[@]hemanext.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The overall objective of this study is to collect preliminary safety data on the transfusion of hypoxic RBCs, manufactured with the Hemanext ONE device, in patients with burns and patients with hematological malignancies. The Hemanext ONE device received CE mark in April 2021.

Description:

The primary objective is to assess hypoxic RBCs safety and tolerance assessment up to 24 hours following the transfusion initiation and overall up to 7 days (+/- 1 day) after the transfusion episode (single transfusion course).

Secondary objectives include the following.

1. Assessment of pre and post transfusion hemoglobin levels

2. Assessment of hemoglobin level before the following transfusion, if applicable

3. Assessment of AEs occurrence:

i. Up to 7 days (+/- 1 day) post transfusion, in comparison with historical control (including but not limited to infection, deep vein thrombosis, acute respiratory distress syndrome, transfusion-related acute lung injury, transfusion associated circulatory overload, anaphylactic shock, acute hemolytic transfusion reaction).

ii. Up to the subsequent transfusion episode or up to 28 days (+/- 1 day) after the initial transfusion, whichever comes first.

iii. From enrollment, up to their subsequent transfusion or 28 days (+/- 1 day) post transfusion, whichever comes first, through the assessment of patient's diary.

4. Assessment of the vital signs during and up to 15 minutes after the transfusion.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: March 31, 2024
• Est. primary completion date: December 31, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

A. Hematological malignancies patients group:

1. Male or female patients at least 18 years of age

2. Patients expected to require > 2 units of red blood cells in a single transfusion event

3. Patients who have the capacity to consent to participate and are willing to comply with the study procedures.

4. Patients identified by a Transfusion hemoglobin trigger of less than 9 g/dL

5. Patients with a documented diagnosis of leukemia, myelomatosis or MDS requiring chronic transfusions

B. Burn patients group:

1. Male or female patients at least 18 years of age

2. Patients who have the capacity to consent by themselves to participate to the clinical investigation

3. Smaller burn patients, hospitalized with a Total Body Surface Area (TBSA%) burn = 10% and = 50%

4. Patients expected to require > 2 unit of red blood cells in a single transfusion event

Exclusion Criteria:

A. Both patients groups

1. Patients with any positive antibody screening test

2. Patients for whom consent has not been obtained

3. Patients with a known hemolytic anemia (congenital or acquired)

4. Patients < 18 years old

5. Patients with a known or suspected pregnancy

6. Patients with a history of major transfusion reactions

7. Patients whom the Investigator deems clinical trial participation is not in their best interest.

B. Burn patients specific exclusion criteria :

1. Patients who do not have the capacity to consent by themselves to participate to the clinical investigation

2. Patients hospitalized with a Total body surface area (TBSA%) burn more than 50%

3. Patients with combined trauma in need of blood transfusions for treatment other than the burn excision

Related Conditions & MeSH terms

• Burns
• Hematologic Neoplasms

Intervention

Device:
• Hypoxic Red Blood Cells
Hypoxic Red Blood Cells manufactured with the Hemanext ONE device- CPD/PAGGSM Red Blood Cells, Leukocytes Reduced, and O2/CO2 Reduced

Locations

Country	Name	City	State
Norway	Haukeland University Hospital	Bergen

Sponsors (1)

Lead Sponsor	Collaborator
Hemanext

Country where clinical trial is conducted

Norway, 

References & Publications (3)

D'Alessandro A, Yoshida T, Nestheide S, Nemkov T, Stocker S, Stefanoni D, Mohmoud F, Rugg N, Dunham A, Cancelas JA. Hypoxic storage of red blood cells improves metabolism and post-transfusion recovery. Transfusion. 2020 Apr;60(4):786-798. doi: 10.1111/trf.15730. Epub 2020 Feb 27. — View Citation

Williams AT, Jani VP, Nemkov T, Lucas A, Yoshida T, Dunham A, D'Alessandro A, Cabrales P. Transfusion of Anaerobically or Conventionally Stored Blood After Hemorrhagic Shock. Shock. 2020 Mar;53(3):352-362. doi: 10.1097/SHK.0000000000001386. — View Citation

Yoshida T, Prudent M, D'alessandro A. Red blood cell storage lesion: causes and potential clinical consequences. Blood Transfus. 2019 Jan;17(1):27-52. doi: 10.2450/2019.0217-18. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of participants who experienced an adverse event (all types/grades) within a time frame up to 24 hours following the transfusion and overall up to 7 days (+/- 1 day) after the transfusion.	The type and the grade of each adverse event will be categorized according to: Association for the Advancement of Blood and Biotherapies (AABB) technical manual, 20th edition (2020); Biomedical Excellence for Safer Transfusion (BEST) Collaborative review - Lancet 2016; 388: 2825-36; Local AEs database (for reference); ISO 14155-2020 definitions	7 days
Secondary	Evolution of the hemoglobin level before and after the transfusion.	The difference in measured hemoglobin (grams/dL) between pre-transfusion and up to 30 minutes post-transfusion.	1 days
Secondary	Calculation of the Hemoglobin increment after transfusion corrected for patient blood volume and hemoglobin dose	The hemoglobin increment from each transfusion will be determined by calculating the difference between the subject's post-transfusion and pre-transfusion hemoglobin (g/dL). It will then be corrected for estimated subject blood volume and the amount of Hb transfused.; The following equation used for the hemoglobin increment calculation: HgB Increment = (Subject's HgB level post-transfusion - Subject's HgB pre-transfusion)/ (total HgB transfused x Subject's BloodVolume); Equations for calculating the hemoglobin increment may be found in the following publication: Wendelbo Ø, Opheim EN, Hervig T, Felli Lunde TH, Bruserud Ø, Mollnes TE, Reikvam H. Cytokine profiling and post-transfusion haemoglobin increment in patients with haematological diseases. Vox Sang. 2018 Oct;113(7):657-668. doi: 10.1111/vox.12703. Epub 2018 Aug 29. PMID: 30159896.	28 days
Secondary	Comparison of the Hemoglobin level before the index transfusion to that prior to the subsequent transfusion (hematologic malignancy group only)	The difference in measured hemoglobin (grams/dL) between the pre-transfusion hemoglobin level for the study transfusion and the pre-transfusion hemoglobin level for the next scheduled transfusion.	28 days
Secondary	Evaluation of AEs from enrollment, up to prior to the subsequent transfusion or up to Day 28, whichever occurs first	The type and the grade of each adverse event will be categorized according to: Association for the Advancement of Blood and Biotherapies (AABB) technical manual, 20th edition (2020); Biomedical Excellence for Safer Transfusion (BEST) Collaborative review - Lancet 2016; 388: 2825-36; Local AEs database (for reference); ISO 14155-2020 definitions	28 days
Secondary	Evaluation of subject's blood pressure over the course of the transfusion and up to 15 minutes post-transfusion	Review of blood pressure (systolic/diastolic; mmHg) throughout the study transfusion.	1 day
Secondary	Evaluation of subject's respiratory rate over the course of the transfusion and up to 15 minutes post-transfusion	Review of respiratory rate (breaths per minute) throughout the study transfusion.	1 day
Secondary	Evaluation of subject's SO2 level over the course of the transfusion and up to 15 minutes post-transfusion	Review of amount of oxygen in the body (% S02 level) measured with a pulse oximeter throughout the study transfusion.	1 day
Secondary	Evaluation of subject's pulse over the course of the transfusion and up to 15 minutes post-transfusion	Review of heart rate (beats per minute) throughout the study transfusion.	1 day