Trial Outcomes & Findings for Silent Cerebral Infarct Transfusion Multi-Center Clinical Trial (NCT NCT00072761)

NCT ID: NCT00072761

Last Updated: 2016-02-08

Results Overview

The primary end point was the recurrence of infarct or hemorrhage as determined by neuroimaging, clinical evidence of permanent neurologic injury, or both. A new infarct had to meet the criteria for a silent cerebral infarction; an enlarged silent cerebral infarct was defined as a previously identified silent cerebral infarct that increased by at least 3 mm along any linear dimension in any plane on MRI.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

196 participants

Primary outcome timeframe

From study entry to study exit

Results posted on

2016-02-08

Participant Flow

Recruitment began in December, 2004 and ended May, 2010. Among the 1074 children screened with a MRI of the brain, 1.9% (20 of 1074) had strokes and 35.2% (379 of 1074) had infarct-like lesions. 196 participants completed all pre-randomization procedures and were successfully randomly allocated.

Participant milestones

Participant milestones
Measure
Transfusion Group
The transfusion group received blood transfusion therapy every 4-6 weeks for 36 months.
Observation Group
The observation group received standard care therapy and quarterly physical examination by a study hematologist for 36 months.
Overall Study
STARTED
99
97
Overall Study
COMPLETED
90
95
Overall Study
NOT COMPLETED
9
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Silent Cerebral Infarct Transfusion Multi-Center Clinical Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Transfusion Group
n=99 Participants
The transfusion Group received blood transfusion therapy every 4-6 weeks for 36 months.
Observation Group
n=97 Participants
The observation group received standard care therapy and quarterly physical examination by a study hematologist for 36 months.
Total
n=196 Participants
Total of all reporting groups
Age, Categorical
<=18 years
99 Participants
n=99 Participants
97 Participants
n=107 Participants
196 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
10 years
n=99 Participants
10 years
n=107 Participants
10 years
n=206 Participants
Sex: Female, Male
Female
40 Participants
n=99 Participants
45 Participants
n=107 Participants
85 Participants
n=206 Participants
Sex: Female, Male
Male
59 Participants
n=99 Participants
52 Participants
n=107 Participants
111 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
91 Participants
n=99 Participants
90 Participants
n=107 Participants
181 Participants
n=206 Participants
Race (NIH/OMB)
White
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants
n=99 Participants
7 Participants
n=107 Participants
13 Participants
n=206 Participants

PRIMARY outcome

Timeframe: From study entry to study exit

Population: Randomization assignments were provided by the statistical data coordinating center with the use of a permuted block design, with stratification according to site, age, and sex. Participants were assigned in a 1:1 ratio to the observation or transfusion group and were followed until study exit or study endpoint.

The primary end point was the recurrence of infarct or hemorrhage as determined by neuroimaging, clinical evidence of permanent neurologic injury, or both. A new infarct had to meet the criteria for a silent cerebral infarction; an enlarged silent cerebral infarct was defined as a previously identified silent cerebral infarct that increased by at least 3 mm along any linear dimension in any plane on MRI.

Outcome measures

Outcome measures
Measure
Transfusion Group
n=99 Participants
The transfusion Group received blood transfusion therapy every 4-6 weeks for 36 months.
Observation Group
n=97 Participants
The observation group received standard care therapy and quarterly physical examination by a study hematologist for 36 months.
Recurrence of an Infarct, Defined as a Stroke or a New or Enlarged Silent Cerebral Infarct
2.0 infarct recurrence per 100 person years
4.8 infarct recurrence per 100 person years

Adverse Events

Transfusion Group

Serious events: 6 serious events
Other events: 99 other events
Deaths: 0 deaths

Observation Group

Serious events: 16 serious events
Other events: 97 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Transfusion Group
n=99 participants at risk
The transfusion Group received blood transfusion therapy every 4-6 weeks for 36 months.
Observation Group
n=97 participants at risk
The observation Group received standard care therapy and quarterly physical examination by a study hematologist for 36 months.
General disorders
Stroke
1.0%
1/99
7.2%
7/97
General disorders
Silent Cerebral Infarct
5.1%
5/99
7.2%
7/97
General disorders
Transient Ischemic Attack
0.00%
0/99
2.1%
2/97

Other adverse events

Other adverse events
Measure
Transfusion Group
n=99 participants at risk
The transfusion Group received blood transfusion therapy every 4-6 weeks for 36 months.
Observation Group
n=97 participants at risk
The observation Group received standard care therapy and quarterly physical examination by a study hematologist for 36 months.
General disorders
Vaso-Occlusive Pain
32.3%
32/99 • Number of events 126
57.7%
56/97 • Number of events 295
Respiratory, thoracic and mediastinal disorders
Acute Chest Syndrome
5.1%
5/99 • Number of events 5
24.7%
24/97 • Number of events 41
General disorders
Priapism
1.7%
1/59 • Number of events 1
13.5%
7/52 • Number of events 10
General disorders
Symptomatic avascular necrosis of the hip
1.0%
1/99 • Number of events 1
6.2%
6/97 • Number of events 6
General disorders
Headache
24.2%
24/99 • Number of events 76
30.9%
30/97 • Number of events 93
General disorders
Blood-transfusion reaction
16.7%
15/90 • Number of events 24
3.2%
1/31 • Number of events 1
General disorders
Ferritin > 1500 ng/ml
84.4%
76/90 • Number of events 1479
9.7%
3/31 • Number of events 33

Additional Information

Michael R. DeBaun, MD, MPH

Vanderbilt University School of Medicine

Phone: 615-875-3040

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place