Trial Outcomes & Findings for Age of Blood in Sickle Cell Transfusion (NCT NCT03704922)

NCT ID: NCT03704922

Last Updated: 2024-11-19

Results Overview

The investigators will compare the transfusions provided to the two groups (the proportion of biochemically old units when stored ≥30 days compared to when stored ≤10 days) using a Fisher exact test at an alpha of 0.05.

Recruitment status

COMPLETED

Study phase

PHASE2/PHASE3

Target enrollment

26 participants

Primary outcome timeframe

through third transfusion, an average of 18 weeks

Results posted on

2024-11-19

Participant Flow

Participant milestones

Participant milestones
Measure
≤10 Day Blood
Subjects in this group will receive only blood stored ≤10 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
≥30 Day Blood
Subjects in this group will receive only blood stored ≥30 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
Overall Study
STARTED
13
13
Overall Study
COMPLETED
10
10
Overall Study
NOT COMPLETED
3
3

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Age of Blood in Sickle Cell Transfusion

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
≤10 Day Blood
n=13 Participants
Subjects in this group will receive only blood stored ≤10 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
≥30 Day Blood
n=13 Participants
Subjects in this group will receive only blood stored ≥30 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
Total
n=26 Participants
Total of all reporting groups
Age, Continuous
30.2 years
STANDARD_DEVIATION 8.5 • n=99 Participants
29.8 years
STANDARD_DEVIATION 11.2 • n=107 Participants
30.0 years
STANDARD_DEVIATION 9.7 • n=206 Participants
Sex: Female, Male
Female
6 Participants
n=99 Participants
10 Participants
n=107 Participants
16 Participants
n=206 Participants
Sex: Female, Male
Male
7 Participants
n=99 Participants
3 Participants
n=107 Participants
10 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
13 Participants
n=99 Participants
13 Participants
n=107 Participants
26 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 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
13 Participants
n=99 Participants
13 Participants
n=107 Participants
26 Participants
n=206 Participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 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
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
13 Participants
n=99 Participants
13 Participants
n=107 Participants
26 Participants
n=206 Participants

PRIMARY outcome

Timeframe: through third transfusion, an average of 18 weeks

The investigators will compare the transfusions provided to the two groups (the proportion of biochemically old units when stored ≥30 days compared to when stored ≤10 days) using a Fisher exact test at an alpha of 0.05.

Outcome measures

Outcome measures
Measure
≤10 Day Blood
n=13 Participants
Subjects in this group will receive only blood stored ≤10 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
≥30 Day Blood
n=13 Participants
Subjects in this group will receive only blood stored ≥30 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
Proportion of Biochemically Old Red Cell Units
0.71 proportion biologically old units
0.86 proportion biologically old units

OTHER_PRE_SPECIFIED outcome

Timeframe: through third transfusion, an average of 18 weeks

Change in CD62Lcirculating monocyte/macrophage mean fluorescence intensity (MFI) at 2 hours post-transfusion compared to the subject pre-transfusion. The investigators will compare the two groups using a two sample two-sided t-test of the log at an alpha of 0.05. Power: In addition, we will use a generalized linear model to include biochemically old units transfused,regardless of unit age, as a covariate. Other co-variates will include free heme, cell free hemoglobin, and non-transferrin bound iron (NTBI) from the transfused unit. We will similarly compare secondary activation endpoints: activation markers for neutrophils and measured cytokine concentrations. When possible, donor and recipient red cells will be differentiated in S-antigen negative patients who are by chance provided S-positive heterozygous or homozygous donor red cells.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: through fourth transfusion, an average of 24 weeks

The primary endpoint is the percentage of infections in adults who receive ≥30 day-old units as compared to ≤10 day-old units. The presence of an indwelling catheter will be used as a key co-variate in this analysis. The investigators will further explore the relationship of blood age and transfusion of biochemically old red cell units on the change in hemoglobin (Hb) and hemoglobin S (HbS)% over time, daily pain scores, opioid use and dose, emergency department (ED) and hospitalization rate, infection symptoms, new alloantibody formation, and antibiotic use during the 3-month study period. The investigators will compare groups using a Fisher exact test. Power: A difference of 20% will be of clinical interest. The investigators do not expect to have adequate power for this pilot study but at an alpha of 0.05 with 20 subjects in each group the investigators will be able to detect a difference of 47% between the proportions.

Outcome measures

Outcome data not reported

Adverse Events

≤10 Day Blood

Serious events: 3 serious events
Other events: 4 other events
Deaths: 0 deaths

≥30 Day Blood

Serious events: 5 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
≤10 Day Blood
n=13 participants at risk
Subjects in this group will receive only blood stored ≤10 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
≥30 Day Blood
n=13 participants at risk
Subjects in this group will receive only blood stored ≥30 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Metabolism and nutrition disorders
Hyperkalemia
7.7%
1/13 • Number of events 2 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Infections and infestations
Sepsis
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
General disorders
Vaso-occlusive Pain
15.4%
2/13 • Number of events 5 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
23.1%
3/13 • Number of events 4 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Respiratory, thoracic and mediastinal disorders
Acute Chest Syndrome
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Skin and subcutaneous tissue disorders
Fistula Swelling
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.

Other adverse events

Other adverse events
Measure
≤10 Day Blood
n=13 participants at risk
Subjects in this group will receive only blood stored ≤10 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
≥30 Day Blood
n=13 participants at risk
Subjects in this group will receive only blood stored ≥30 days for 3 consecutive transfusion events. Transfusion: Red cell units for transfusion
General disorders
Vaso-occlusive pain
15.4%
2/13 • Number of events 2 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
30.8%
4/13 • Number of events 25 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
General disorders
Penile pain
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
7.7%
1/13 • Number of events 8 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
General disorders
Injury due to Fall
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Skin and subcutaneous tissue disorders
Fistula Swelling
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
Infections and infestations
Influenza
7.7%
1/13 • Number of events 1 • From the time of signing informed consent through study completion, a total of up to 24 weeks.
0.00%
0/13 • From the time of signing informed consent through study completion, a total of up to 24 weeks.

Additional Information

Matthew S. Karafin MD MS

University of North Carolina at Chapel Hill

Phone: 984-974-1583

Results disclosure agreements

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