Cytomegalovirus Disease Clinical Trial
— TT-CMVOfficial title:
Prevention of Transfusion-transmitted CMV (TT-CMV) in Lowbirth Weight Infants (LBWI; ≤1500 Grams) Using CMV Seronegative and Leukoreduced Transfusions.
Verified date | June 2015 |
Source | Emory University |
Contact | n/a |
Is FDA regulated | No |
Health authority | United States: Institutional Review Board |
Study type | Observational |
The spread of viruses through transfusions is the cause of serious illness and death in
recipients whose immune systems are unable to fight infection. Another group of patients
whose immune systems are underdeveloped and can be affected by a particular virus known as
cytomegalovirus (CMV) is low birthweight infants (LBWIs). CMV can be spread through the
placenta, during the birth process, through breast milk, while in the hospital or while
caring for someone carrying the virus as well as through a transfusion, known as
transfusion-transmitted (TT-CMV).
The spread of TT-CMV in LBWIs can be curtailed by transfusing blood products that are CMV
negative as well as to filter the white cells in blood that carry the virus
(leukoreduction). The purpose of this study is to see if the use of these two strategies can
lower the spread of CMV through a transfusion. How "safe" the blood actually is through
leukoreduction is not known and CMV still occurs in LBWIs. It is not clear whether this
approach is optimal or whether additional safety steps are needed to completely prevent
TT-CMV. Specific actions that could tell us when virus has reached the blood product or
breast milk is to test each of these to determine if virus slipped "unnoticed" and/or when
the product was not thoroughly filtered.
In this study, the investigators believe that the use of both prevention strategies will
result in a lower rate of TT-CMV, and that the "cause" of TT-CMV may be found in the
presence of CMV at the DNA level or by unfiltered white cells that remain in the blood
product. Thus, the most significant clinical question that remains to be addressed is
whether this double strategy for transfusion safety actually provides a "zero CMV-risk"
blood supply or whether further safety measures (DNA testing + 100% leukoreduction) must be
used to protect this extremely vulnerable patient group from CMV infection. This birth
cohort study will be done with 6 participating NICUs, and will study both CMV positive and
negative mothers in order to estimate the rate and pathway of CMV transmission to the LBWI
who receives a transfusion. Another study goal is to compare or link any CMV infection by
either transfused units where the virus was undetected, or filter failure. If CMV disease
occurs, the investigators will be able to describe the course and outcome in LBWIs who
develop TT-CMV.
Status | Completed |
Enrollment | 600 |
Est. completion date | April 2014 |
Est. primary completion date | April 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A to 5 Days |
Eligibility |
Inclusion Criteria: - All LBWIs whose weight is = 1500 grams at birth - LBWI is within first five days of life Exclusion Criteria: - LBWI not expected to live past first seven days of life - LBWI has a severe congenital abnormality - LBWI has received a RBC or platelet transfusion at another institution prior to transfer - LBWI has received an in-utero transfusion - LBWI is clinically suspected of having toxoplasmosis, rubella, herpes infection(s) at birth - Refusal by the mother to grant consent for herself and/or refusal to grant consent for her LBWI - If the mother of the child has previously participated in this study |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
United States | Emory University Hospital Midtown | Atlanta | Georgia |
United States | Grady Memorial Hospital | Atlanta | Georgia |
United States | Northside Hospital | Atlanta | Georgia |
Lead Sponsor | Collaborator |
---|---|
Emory University | National Heart, Lung, and Blood Institute (NHLBI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Estimate the incidence of TT-CMV in LBWIs who receive CMV-seronegative plus leukoreduced blood products. | The effectiveness of these two strategies coupled together will be assessed in the prevention of TT-CMV in at-risk LBWI born to CMV-negative and CMV-positive mothers. | 90 days study observation | Yes |
Status | Clinical Trial | Phase | |
---|---|---|---|
Terminated |
NCT02439957 -
A Phase 3 Study of Brincidofovir Versus Valganciclovir for the Prevention of Cytomegalovirus
|
Phase 3 | |
Terminated |
NCT02439970 -
A Phase 3 Study of Brincidofovir Versus Valganciclovir for the Prevention of Cytomegalovirus Disease
|
Phase 3 | |
Active, not recruiting |
NCT04904614 -
Letermovir Use in Heart Transplant Recipients
|
Phase 4 | |
Completed |
NCT01509404 -
Cytogam Administration in Abdominal Organ Transplant Recipients at High Risk for Cytomegalovirus Infection
|
Phase 4 | |
Completed |
NCT01573039 -
Cut Off for the Diagnosis of Cytomegalovirus (CMV) Disease in Serum-positive Kidney Transplant Recipients
|
N/A | |
Completed |
NCT04225923 -
A Study for Kidney Transplant Recipients at High-Risk of Cytomegalovirus Infection
|
Phase 2 | |
Completed |
NCT04129398 -
MK-8228 (Letermovir) in the Prevention of Human Cytomegalovirus (CMV) Infection and Disease in Adult Japanese Kidney Transplant Recipients (MK-8228-042)
|
Phase 3 | |
Recruiting |
NCT00828503 -
Certican® (Everolimus) Against Cytomegalovirus Disease in Renal Transplant Patients
|
Phase 2 |