Status:

COMPLETED

Preventing Acute Chest Syndrome by Transfusion Feasibility Study

Lead Sponsor:

Carelon Research

Collaborating Sponsors:

National Heart, Lung, and Blood Institute (NHLBI)

Conditions:

Sickle Cell Disease

Eligibility:

All Genders

2+ years

Phase:

NA

Brief Summary

Acute chest syndrome (ACS) is similar to severe pneumonia and is a common cause of hospitalizations for people with sickle cell disease (SCD). Blood transfusions are one treatment option for ACS. High...

Detailed Description

SCD is an inherited blood disorder, and symptoms include anemia, infections, organ damage, and intense episodes of pain, which are called "sickle cell crises." ACS, characterized by fever, respiratory...

Eligibility Criteria

Inclusion

  • Inclusion Criteria for the Observational and Trial Cohorts:
  • Hemoglobin diagnosis of SS (two copies of the hemoglobin S gene), SC (one copy of the hemoglobin S gene and one copy of the hemoglobin C gene), or S-β thalassemia (β+ or β0)
  • No clinically apparent ACS
  • No prior participation in either part of the study
  • Inclusion Criteria for the Trial Cohort, in addition to the above criteria:
  • sPLA2 level greater than 100 ng/mL within the same 24-hour window that coincides with fever and chest radiograph negative for new pulmonary infiltrate within the last 12 hours of the 24-hour window
  • Fever greater than 38.0º C within the same 24-hour window that coincides with elevated sPLA2 level (greater than 100 ng/mL) and chest radiograph negative for new pulmonary infiltrate within the last 12 hours of the 24-hour window
  • Chest radiograph negative for new pulmonary infiltrate within the last 12 hours of the 24-hour window of an abnormal sPLA2 level and fever
  • Hemoglobin levels equal or less than 10 g/dL at time of study entry
  • Informed consent of parent(s) or legal guardian; informed consent or assent of participant as applicable
  • Exclusion Criteria for Observational and Trial Cohorts:
  • Existing diagnosis of a new pulmonary infiltrate diagnosed by chest radiography (pleural effusion not obscuring lung parenchyma will not exclude the person from the study)
  • Any coexisting medical condition for which the physician feels that a transfusion may be needed within 24 hours (e.g., severe anemia, stroke)
  • Red Blood Cell (RBC) transfusion in the 60 days before study entry
  • Unwillingness to sign consent form, or if a minor, unwillingness of parent/guardian to sign consent form
  • Treatment with any investigational drug or device in the 30 days before study entry (hydroxyurea is allowable)
  • History of alloimmunization that would prevent the participant from receiving blood within 8 hours of eligibility for study entry or history of a life-threatening transfusion reaction
  • Objection to transfusion for religious or other reasons from either the participant or guardian
  • History of treatment with systemic steroids within 1 week of study entry (inhaled steroids are acceptable)
  • Pregnant

Exclusion

    Key Trial Info

    Start Date :

    July 1 2009

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    July 1 2010

    Estimated Enrollment :

    237 Patients enrolled

    Trial Details

    Trial ID

    NCT00951808

    Start Date

    July 1 2009

    End Date

    July 1 2010

    Last Update

    April 24 2013

    Active Locations (24)

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    Page 1 of 6 (24 locations)

    1

    Children's Hospital and Research Center

    Oakland, California, United States

    2

    A.I. duPont Hospital for Children

    Wilmington, Delaware, United States

    3

    Children's National Medical Center

    Washington D.C., District of Columbia, United States

    4

    Howard University Hospital

    Washington D.C., District of Columbia, United States