Hemolysis Clinical Trial
Official title:
Elucidation of the Mechanism of IVIG-Associated Hemolysis
Verified date | March 2017 |
Source | Toronto Transfusion Medicine Collaborative |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Patients at high risk of IVIG-associated hemolysis (defined as receipt of a 28-day cumulative dose of ≥ 2 g/kg, adjusted for ideal body weight, and non-O blood group) will be prospectively monitored using a standardized protocol for signs of hemolysis, and will be undergo additional testing for variables that have been hypothesized to increase the risk of hemolysis. The goal of the study is to define the incidence and dynamics of IVIG-mediated hemolysis and identify patient and product-related factors that may predict which patients are especially at risk.
Status | Completed |
Enrollment | 144 |
Est. completion date | December 2016 |
Est. primary completion date | October 2016 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 3 Months and older |
Eligibility |
Inclusion Criteria: - cumulative dose within a 28-day period equal or greater to 2 g/kg body weight, adjusted for lean body mass - non-O blood group - willing to provide blood samples immediately prior to, immediately after the completion of, and 5-10 days after the course of IVIG therapy - Able to provide informed consent, either themselves or through a surrogate decision-maker Exclusion Criteria: - evidence of active bleeding or hemolytic anemia at time of enrolment (patients with chronic, stable anemia will be eligible following review by the principle investigator) - concurrently prescribed transfusion therapy |
Country | Name | City | State |
---|---|---|---|
Canada | Mount Sinai Hospital | Toronto | Ontario |
Canada | St. Michael's Hospital | Toronto | Ontario |
Canada | Sunnybrook Health Sciences Centre | Toronto | Ontario |
Canada | The Hospital for Sick Children | Toronto | Ontario |
Canada | University Health Network | Toronto | Ontario |
Canada | Women's College Hospital | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
Toronto Transfusion Medicine Collaborative | Mount Sinai Hospital, New York, St. Michael's Hospital, Toronto, Sunnybrook Health Sciences Centre, The Hospital for Sick Children, University Health Network, Toronto, Women's College Hospital |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Hemolysis | Definition and grading of hemolysis adopted from the Canadian IVIG Hemolysis Pharmacovigilance Group | From initiation of IVIG therapy to 5-10 days after the completion of last IVIG infusion | |
Secondary | Adverse transfusion reaction | Any patient symptom reported during or within 10 days of an IVIG infusion will be considered as a possible adverse transfusion reaction. Symptoms deemed to most likely indicate an adverse reaction include the development of fever, chills or rigours; allergic reactions (urticaria, angioedema or anaphylaxis); pain reactions (including headache); respiratory symptoms (cough, shortness of breath); and signs suggestive of anemia or hemolysis (pallor, fatigue, red-coloured urine, jaundice) | From initiation of IVIG therapy to 5-10 days after the completion of last IVIG infusion | |
Secondary | Descriptive analysis of risk factors | Additional secondary outcomes will include a descriptive analysis of information collected on the initial case report form such as patient demographics, medical history, dose and lot of IVIG administered, infusion rate, patient blood group, and concurrent medications. In addition, patient samples will be sent for additional testing aimed at elucidating the mechanism of IVIG-mediated hemolysis. These include: Cytokine panel profiling C3, C4, ferritin and CRP levels Monocyte monolayer assay using patient monocytes and implicated lot of IVIG against AET-treated group A1, B, and O red cells Tests of eluted IgG antibody for subtype. ABO zygosity (PCR) and/or by Flow FcR polymorphisms by PCR Secretor status by PCR |
From initiation of IVIG therapy to 5-10 days after the completion of last IVIG infusion |
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