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Trial registered on ANZCTR
Registration number
ACTRN12616001066471
Ethics application status
Approved
Date submitted
5/08/2016
Date registered
9/08/2016
Date last updated
29/06/2021
Date data sharing statement initially provided
21/01/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Do donor white blood cells survive in children who need a blood transfusion?
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Scientific title
Is there an incidence of donor white blood cell survival (microchimerism) in paediatric transfusion recipients?
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Secondary ID [1]
289857
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Blood Transfusion related outcomes
299796
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Microchimerism
299797
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Condition category
Condition code
Blood
299725
299725
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0
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Other blood disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This study is a pilot observational study only. A blood sample (1mL, 0.2 teaspoon) will be taken from any paediatric patients with any indication who requires a routine blood transfusion with at least one paediatric sized red blood cell unit as standard of care treatment. Since some patients will require multiple transfusions over the course of their treatment. The research samples will be taken before transfusion and during other routine standard of care samples that will be taken, this can mean samples will be taken every week or every few months depending on the clinical diagnosis of the patient. It is expected that each patient may provided up to, but not limited to, 10 samples over the 18 month study period and up to 12 months post transfusion.
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Intervention code [1]
295539
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Early Detection / Screening
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Comparator / control treatment
A comparative group will be found in the retrospective study where patients who were first transfused 5-15 years ago will provide a single (1mL, 0.2 teaspoon) research sample for microchimerism testing. If long-term donor white blood cell survival is found in these patients they can be compared with patients who are currently undergoing blood transfusion. Patients who are current patients are vital to study in addition to the retrospective cohort as transfusion manufacturing processes have changed over time, there is also the introduction of new white blood cell filters which may or may not have an effect on the current incidence of microchimerism and also trying to determine when microchimerism establishes in a patient may be found.
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Control group
Active
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Outcomes
Primary outcome [1]
299185
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To determine if donor white blood cells survive in paediatric patients who are transfused with red blood cell units. This will be achieved using a sensitive genetic real time polymerase chain reaction test on specific non-coding DNA sequences. This outcome is relevant for both the retrospective and prospective patient cohort
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Assessment method [1]
299185
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Timepoint [1]
299185
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For retrospective participants
a single research sample (1mL, 0.2 teaspoon volume) will be taken, this sample could be between 5-15 years since the commencement of their transfusion treatment.
For prospective participants
Samples will be taken before transfusion (baseline)
and before each red blood cell transfusion is administered at the same time as other routine standard of care testing (these will be patient dependent timepoints with up to but not limited to 10 samples collected over 18 month recruitment period).
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Secondary outcome [1]
326447
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None
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Assessment method [1]
326447
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Timepoint [1]
326447
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N/A
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Eligibility
Key inclusion criteria
For retrospective study
Male and female paediatric patients between the age of 0-16 years of age admitted for (but not limited to) haematology or oncology conditions which require chronic blood transfusion as part of treatment and who have received at least one blood transfusion between 5-15 years prior to enrollment into this study.
For prospective study
Male and female paediatric patients between the age of 0-16 years of age admitted for (but not limited to) haematology or oncology conditions which require chronic blood transfusion as part of treatment.
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Minimum age
No limit
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Maximum age
16
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
For both retrospective and prospective studies these exclusion criteria apply:
1)No blood transfusion given
2) Females who are pregnant, or have previously been pregnant
3) Mentally impaired or individuals in dependant relationships who are not sound of mind to consent to agree to participate in this study.
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Study design
Purpose
Screening
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Duration
Longitudinal
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Selection
Defined population
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Timing
Both
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Statistical methods / analysis
Directed measures outcomes. Patients will either have a positive or negative outcome for the test of microchimerism. The number of patients for recruitment is 200. This recruitment target will be achievable in the timeframe, will give a good indication of whether there is an incidence of microchimerism in this patient population, given that 10% incidence was found in the Australian major trauma study. This number of patients has also been funded where preliminary data could lead to a larger study in the area whereby more health related analyses could be performed.
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
5/09/2016
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Actual
5/12/2016
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Date of last participant enrolment
Anticipated
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Actual
31/12/2020
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Date of last data collection
Anticipated
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Actual
31/12/2020
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Sample size
Target
200
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Accrual to date
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Final
44
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
6416
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Lady Cilento Children's Hospital - South Brisbane
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Recruitment hospital [2]
6417
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John Hunter Children's Hospital - New Lambton
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Recruitment postcode(s) [1]
13956
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4101 - South Brisbane
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Recruitment postcode(s) [2]
13957
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2305 - New Lambton
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Funding & Sponsors
Funding source category [1]
294234
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Government body
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Name [1]
294234
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Australian Red Cross Blood Service
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Address [1]
294234
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Research and Development
17 O'Riordan Street
Alexandria, Sydney NSW 2015
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Country [1]
294234
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Australia
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Primary sponsor type
Government body
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Name
Australian Red Cross Blood Service
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Address
Research and Development
17 O'Riordan Street
Alexandria, Sydney NSW 2015
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Country
Australia
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Secondary sponsor category [1]
293063
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None
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Name [1]
293063
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Address [1]
293063
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Country [1]
293063
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Other collaborator category [1]
279145
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Hospital
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Name [1]
279145
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Lady Cilento Children's hospital
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Address [1]
279145
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Department of Haematology
501 Stanley St
South Brisbane QLD 4101
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Country [1]
279145
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Australia
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Other collaborator category [2]
279146
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Hospital
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Name [2]
279146
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John Hunter Children's Hospital
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Address [2]
279146
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Department of oncology
Kookaburra Circuit
New Lambton Heights NSW 2305
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Country [2]
279146
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
295653
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Hunter New England Local Health District HREC
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Ethics committee address [1]
295653
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Hunter New England Research Support & Development office Locked bag 1 New Lambton NSW 2305
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Ethics committee country [1]
295653
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Australia
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Date submitted for ethics approval [1]
295653
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20/04/2016
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Approval date [1]
295653
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02/05/2016
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Ethics approval number [1]
295653
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16/04/20/4.08
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Summary
Brief summary
Some adverse transfusion-related reactions are hypothesised to be primarily mediated by donor white blood cells (leucocytes) present in red blood cell (RBC) units. Leucodepletion (removal of leucocytes via filtration) has successfully reduced transfusion related reactions, however current clinical data suggests that RBC transfusion can still result in poor patient outcomes. One such undesirable outcome is the development of microchimerism, where genetically distinct donor leucocytes are detected within a transfused patient. Transfusion-associated microchimerism has primarily been reported in trauma patients who receive multiple blood units and often have an underlying disruption of their immune response. In Australia, we reported that despite the use of leucodepleted blood components 10% of trauma patients showed an incidence of microchimerism. However, it is still unknown whether there is an incidence of microchimerism in other Australian transfusion recipients. This study aims to gather preliminary data on the incidence of microchimerism in chronically transfused paediatric patients. These patients were chosen since they receive multiple RBC units and may be immunosuppressed at the time of transfusion. It is currently unknown whether chronic red blood cell treatment results in long term donor white cell survival (microchimerism) within this patient group and whether the use of gamma-irradiated blood components can affect any potential incidence found. To test for the presence of surviving donor cells in chronically transfused paediatric cases both a retrospective (look-back) and prospective (current) study will be collected. For the retrospective study, a single blood samples (1mL) will be analysed for an incidence of microchimerism. These patients will have been transfused 5-15 years ago and will enable data to be gathered on whether there is a long-term donor cell survival. For the prospective study, a blood sample (1mL) will be collected before transfusion, routinely before each red blood cell unit transfusion during the course of their treatment and at 12-18 months following treatment completion. Genomic DNA will be isolated from the blood sample which will undergo a sensitive genetic test for a series of insertion/deletion sequences which are diagnostic for the presence of microchimerism.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
68022
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Dr Rena Hirani
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Address
68022
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Australian Red Cross Blood Service
Research and Development
17 O'Riordan Street
Alexandria NSW 2015
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Country
68022
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Australia
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Phone
68022
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+61292342454
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Fax
68022
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+61292342411
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Email
68022
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[email protected]
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Contact person for public queries
Name
68023
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Rena Hirani
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Address
68023
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Australian Red Cross Blood Service
Research and Development
17 O'Riordan Street
Alexandria NSW 2015
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Country
68023
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Australia
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Phone
68023
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+61292342454
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Fax
68023
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+61292342411
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Email
68023
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[email protected]
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Contact person for scientific queries
Name
68024
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Rena Hirani
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Address
68024
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Australian Red Cross Blood Service
Research and Development
17 O'Riordan Street
Alexandria NSW 2015
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Country
68024
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Australia
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Phone
68024
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+61292342454
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Fax
68024
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+61292342411
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Email
68024
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Individual data will not be provided as consent for this has not been provided by the participants
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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