Clinical Trials Logo

Clinical Trial Summary

The investigators aim to give an overview of Iron overload(IOL) of patients with AA and low and int-1 risk MDS and their sequelae under different chelation treatment. And the investigators also aim to evaluate the relationship of LIC and T2*/R2*.


Clinical Trial Description

Long-term transfusion therapy, a supporting treatment for patients with intractable chronic anemia is currently the most frequent cause of secondary iron overload. Both Aplastic anemia (AA) and low risk (low and intermediate-1 risk) myelodysplastic syndromes (MDS) are classified into bone marrow failure syndromes (BMFs) as they have a lot of characters in common. Iron overload (IOL) can then become a significant problem in regularly transfused patients, leading to organ damage, particularly in the liver and heart. Iron overload also has a suppressive effect on erythroid progenitors and may increase transfusion requirements. In those cases, iron chelation therapy may help to improve their quality of life and prolong their survival.

Because of the importance of iron chelation in patients with AA and low and intermediate-1(int-1) risk MDS complicated with iron overload, it is necessary to monitor their iron overload status to find the suitable patients to be chelated and follow up the effectiveness of therapy. Using quantitative Magnetic resonance imaging (MRI) T2* to detect the iron deposit of different organs has been introduce to China since 5 years ago. Compared to the traditional methods for evaluating iron overload like clinical manifestations, serum ferritin (SF) level, transferrin saturation (TS), CT and echocardiography (UCG) etc., which are widely used so far in China, MRI T2* provides an more accurate, convenient and affordable non-invasive way of monitoring iron overload. More important, it is very reliable to monitor the improvement of iron chelation therapy since the variation of MRI detection between different detections is very low. Few reports have been focused on IOL of MDS and AA in China so far.

Measurement of liver iron concentration (LIC) by MRI yields similar results to those coming from liver biopsy analysis, and is a validated tool for detection of iron overload. Data has been published from a multi-center trial evaluating the efficacy and safety of deferasirox (DFX) in low and intermediate-1 risk MDS patients with transfusion-dependent IOL and showed DFX yields sufficient reduction of excess iron indicated by serum ferritin levels and most importantly by liver MRI. But the median duration of DFX treatment is only 354 days and no data of Chinese patients was included. Most of the studies for MDS lack data of long term follow-up and there is scarcely any data on AA so far.

In China, more and more patients with iron overload can afford adequate iron chelation therapies, although there are still some patients who cannot afford at all or can only be chelated irregularly. And some patients can only accept deferoxamine instead of deferasirox because of the medical insurance policies. It is important to include patients with different situations and monitor their iron change in their major organs based on different chelation level.

In this study, it is anticipated to evaluate prospectively 80 patients with AA and low or int-1 risk MDS with IOL, by the traditional methods and MRI T2*. Clinical parameters and T2*values will be monitored every 12 months for 3 years. Other parameters like clinical follow-ups ( rate of infection, liver disease, cardiac disorders, endocrine function and other co-morbidities associated with MDS/AAs, etc.), SF, liver and kidney function, UCG tests will be monitored as well at the interval of every 6 months. At the end of the study, patients will be classified as well chelated groups (defined as those received deferasirox 20mg/kg or deferoxamine 40 mg/kg for more than 255 days/year) or poor chelated groups (defined as those received iron chelation therapy dose less than above) and compared the differences of their outcome and change of iron status. The investigators aim to give an overview of IOL of patients with AA and low and int-1 risk MDS and their sequelae under different chelation treatment. And the investigators also aim to evaluate the relationship of LIC and T2*/R2*. It is the first and longest prospective clinical trial on AA and low risk MDS and will give us a better understanding of the value of proper chelation treatment for the organ function. ;


Study Design

Observational Model: Case-Only, Time Perspective: Prospective


Related Conditions & MeSH terms


NCT number NCT02833493
Study type Observational
Source Peking Union Medical College Hospital
Contact
Status Not yet recruiting
Phase N/A
Start date September 2016
Completion date October 2019

See also
  Status Clinical Trial Phase
Active, not recruiting NCT03025698 - A Phase II Dose-escalation Study Characterizing the PK of Eltrombopag in Pediatric Patients With Previously Untreated or Relapsed Severe Aplastic Anemia or Recurrent Aplastic Anemia Phase 2
Completed NCT00987480 - Hematopoietic Stem Cell Transplantation for the Treatment of Patients With Fanconi Anemia Lacking a Genotypically Identical Donor, Using a Chemotherapy Only Cytoreduction With Busulfan, Cyclophosphamide and Fludarabine Phase 2
Completed NCT00767650 - Neuropsychological Effects of Immunosuppressive Treatment in Subjects With Aplastic Anemia N/A
Completed NCT02833805 - NMA Haplo or MUD BMT for Newly Diagnosed Severe Aplastic Anemia Phase 2
Recruiting NCT02028416 - Comparison of Two Different Doses of Rabbit ATG-Fresenius With Cyclosporin in the Treatment of Acquired Aplastic Anaemia N/A
Completed NCT00004474 - Phase III Randomized Study of Cyclophosphamide With or Without Antithymocyte Globulin Before Bone Marrow Transplantation in Patients With Aplastic Anemia Phase 3
Recruiting NCT05031897 - Reduced-Intensity Conditioning for the Prevention of Treatment-Related Mortality in Patients Who Undergo a Hematopoietic Stem Cell Transplant Phase 2
Completed NCT04439006 - Ibrutinib for the Treatment of COVID-19 in Patients Requiring Hospitalization Phase 1
Not yet recruiting NCT05996393 - CsA+ATG+AVA vs. CsA+AVA for the Treatment of Newly-diagnosed SAA in the Elderly Phase 4
Completed NCT02462252 - Phase IIA Open Label Study to Evaluate Efficacy and Safety of BL-8040 Followed by (hATG), Cyclosporine and Methyprednisolone in Adult Subjects With Aplastic Anemia or Hypoplastic Myelodysplastic Syndrome Phase 2
Completed NCT00513175 - Non-Myeloablative Allogeneic Stem Cell Transplantation With Matched Unrelated Donors for Treatment of Hematologic Malignancies, Renal Cell Carcinoma, and Aplastic Anemia N/A
Completed NCT01272817 - Nonmyeloablative Allogeneic Transplant N/A
Completed NCT00001398 - Stem Cell Factor Medication for Aplastic Anemia Phase 1
Recruiting NCT01861093 - Safety Study of Cord Blood Units for Stem Cell Transplants Phase 2
Not yet recruiting NCT05018936 - Efficacy and Safety of Hetrombopag in Non-severe Aplastic Anemia Phase 2/Phase 3
Completed NCT00065260 - Rabbit Antithymocyte Globulin Versus Campath-1H for Treating Severe Aplastic Anemia Phase 2
Recruiting NCT02007811 - Open-label Clinical Trial to Investigate the Safety and Tolerability of Allogeneic B-cell Concentrates for Immune Reconstitution After Allogeneic Stem Cell Transplantation Measured as Response to a Antedated Single Vaccination Phase 1/Phase 2
Recruiting NCT01758042 - Bone Marrow and Kidney Transplant for Patients With Chronic Kidney Disease and Blood Disorders N/A
Terminated NCT01500161 - Pooled Unrelated Donor Umbilical Cord Blood Transplant For Hematologic Malignancy Needing Allogeneic Stem Cell Transplant Without Related HLA-Match Phase 2
Recruiting NCT00881933 - Study of Fludarabine + Cyclophosphamide + TBI Conditioning Regimen for Double Units Cord Blood Transplantation(CBT)in Severe Aplastic Anemia(SAA) Phase 1/Phase 2