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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03136445
Registration number
NCT03136445
Ethics application status
Date submitted
21/02/2017
Date registered
2/05/2017
Titles & IDs
Public title
TRial to EvaluAte Tranexamic Acid Therapy in Thrombocytopenia
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Scientific title
A Double-blind, Randomised Controlled Trial Evaluating the Safety and Efficacy of Antifibrinolytics (Tranexamic Acid) in Patients With Haematological Malignancies With Severe Thrombocytopenia
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Secondary ID [1]
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2014-001513-35
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Secondary ID [2]
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12-01-CSU
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Universal Trial Number (UTN)
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Trial acronym
TREATT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hematologic Neoplasms
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Hemorrhage
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Hematopoietic Stem Cell Transplantation
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Condition category
Condition code
Cancer
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Leukaemia - Acute leukaemia
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Cancer
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Leukaemia - Chronic leukaemia
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Blood
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Haematological diseases
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Blood
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tranexamic acid (TXA).
Treatment: Drugs - Placebo
Experimental: Intervention Arm - Tranexamic acid (TXA). Dose schedule TXA 1g every eight hours IV or 1.5g every eight hours PO.
Placebo comparator: Control Arm - Placebo (saline) if administration is IV. Placebo tablet matched for appearance to TXA if oral.
Treatment: Drugs: Tranexamic acid (TXA).
IV or oral preparation. IV tranexamic acid or Oral tablet of tranexamic acid.
Treatment: Drugs: Placebo
IV (saline) or oral placebo tablets
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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The proportion of patients who die or have bleeding of WHO grade 2 or above by WHO criteria during the first 30 days from the first dose of trial treatment, or planned first dose for those participants who do not receive treatment.
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Assessment method [1]
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The proportion of patients who die or have bleeding of WHO grade 2 or above by WHO criteria during the first 30 days from the first dose of trial treatment, or planned first dose for those participants who do not receive treatment.
A time-to-event analysis will be used to determine this proportion to ensure that all patients are included in the primary outcome analysis, not just those who are followed up for the full 30 days. Any patients lost to follow-up will be included in the analysis and censored at the time that they were lost.
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Timepoint [1]
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The first 30 days from first dose of trial treatment
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Secondary outcome [1]
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Proportion of days with bleeding (WHO grade 2 or above) up to Study Day 30.
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Assessment method [1]
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Number of days where WHO grade 2 or above bleeding has been recorded bleeding using WHO bleeding criteria.
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Timepoint [1]
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The first 30 days from first dose of trial treatment .
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Secondary outcome [2]
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Time to first episode of bleeding of WHO grade 2 or greater up to study day 30.
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Assessment method [2]
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Bleeding assessed using WHO bleeding criteria.
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Timepoint [2]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [3]
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Highest grade of bleeding a patient experiences up to study day 30.
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Assessment method [3]
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Measured using WHO bleeding criteria.
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Timepoint [3]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [4]
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Number of platelet transfusions per patient up to study day 30.
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Assessment method [4]
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Measured by number of recorded platelet transfusions per patient.
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Timepoint [4]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [5]
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Number of red cell transfusions per patient up to study day 30.
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Assessment method [5]
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Measured by number of recorded red cell transfusions per patient.
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Timepoint [5]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [6]
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Proportion of patients surviving at least 30 days without a platelet transfusion.
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Assessment method [6]
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Measured by calculating number of patients surviving at least 30 days without a platelet transfusion.
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Timepoint [6]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [7]
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Proportion of patients surviving at least 30 days without a red cell transfusion.
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Assessment method [7]
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Measured by calculating the number of patients surviving at least 30 days without a red cell transfusion.
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Timepoint [7]
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The first 30 days from first dose of trial treatment.
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Secondary outcome [8]
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Number of thrombotic events from first administration of trial treatment up to and including 120 days after the first dose of trial treatment is administered, per day at risk.
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Assessment method [8]
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Measured by calculating number of clinically diagnosed thrombotic events from Treatment Day 1 i.e the first day that the investigational medicinal product (IMP) is administered, up to and including the next 120 days.
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Timepoint [8]
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Up to and including 120 days from the first administration of investigational medicinal product (IMP).
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Secondary outcome [9]
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Number of patients developing Veno-occlusive Disease (VOD; Sinusoidal obstructive syndrome, SOS) within 60 days of first administration of trial treatment.
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Assessment method [9]
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Measured by calculating number of patients developing Veno-occlusive Disease (VOD; Sinusoidal obstructive syndrome, SOS) within 60 days of Treatment Day 1 i.e the first day that the IMP is administered.
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Timepoint [9]
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Up to and including 60 days from the first administration of IMP.
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Secondary outcome [10]
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All-cause mortality during the first 30 days and 120 days after the first dose of trial treatment is administered. All-cause mortality during the first 30 days and 120 days after the first dose of trial treatment is administered
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Assessment method [10]
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Measured by calculating number of deaths in first 30 days and 120 days after Treatment Day 1 i.e the first day that the IMP is administered.
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Timepoint [10]
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Up to and including 120 days from the first administration of IMP.
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Secondary outcome [11]
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Death due to thrombosis during the first 120 days after the first dose of trial treatment is administered.
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Assessment method [11]
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Measured by calculating number of deaths due to thrombosis during the first 120 days after Treatment Day 1 i.e the first day that the IMP is administered.
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Timepoint [11]
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Up to and including 120 days from the first administration of IMP.
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Secondary outcome [12]
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Death due to bleeding during the first 30 days after the first dose of trial treatment is administered.
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Assessment method [12]
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Measured by calculating number of deaths due to bleeding during the first 30 days
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Timepoint [12]
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Up to and including 30 days from the first administration of IMP.
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Secondary outcome [13]
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Number of serious adverse events (SAE) from first administration of trial treatment until 60 days after the first dose of trial treatment is administered.
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Assessment method [13]
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Measured by calculating the total number of SAE's reported from first administration of IMP.
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Timepoint [13]
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Up to and including 60 days from the first administration of IMP.
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Eligibility
Key inclusion criteria
Patients are eligible for this trial if:
1. Aged =18 years of age
2. Confirmed diagnosis of a haematological malignancy
3. Undergoing chemotherapy, or chemotherapy is planned, or haematopoietic stem cell transplantation
4. Anticipated to have a hypoproliferative thrombocytopenia resulting in a platelet count of =10x10?/L for = 5 days
5. Able to comply with treatment and monitoring
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Minimum age
18
Years
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Maximum age
No limit
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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
A patient will not be eligible for this trial if he/she fulfils one or more of the following criteria:
1. Patients with a past history or current diagnosis of arterial or venous thromboembolic disease including myocardial infarction, peripheral vascular disease and retinal arterial or venous thrombosis.
2. Diagnosis of acute promyelocytic leukaemia (APML) and undergoing induction chemotherapy
3. Patients with a diagnosis/previous history of veno-occlusive disease (also called sinusoidal obstruction syndrome)
4. Patients with known inherited or acquired prothrombotic disorders e.g.
1. Lupus anticoagulant
2. Positive antiphospholipids
5. Patients receiving any pro-coagulant agents (e.g. DDAVP, recombinant Factor VIIa or Prothrombin Complex Concentrates (PCC) within 48 hours of enrolment, or with known hypercoagulable state
6. Patients receiving L-asparaginase as part of their current cycle of treatment
7. History of immune thrombocytopenia (ITP), thrombotic thrombocytopenic purpura (TTP) or haemolytic uraemic syndrome (HUS)
8. Patients with overt disseminated intravascular coagulation (DIC) (See Appendix 3 in the protocol for definition)
9. Patients requiring a platelet transfusion threshold >10x10/?L at time of randomisation. (This refers to patients who require their platelet count to be maintained at a certain specified level on an ongoing basis, and excludes a transient rise in the threshold due to sepsis.)
10. Patients with a known inherited or acquired bleeding disorder e.g.
1. Acquired storage pool deficiency
2. Paraproteinaemia with platelet inhibition
11. Patients receiving anticoagulant therapy or anti-platelet therapy
12. Patients with visible haematuria at time of randomisation
13. Patients with anuria (defined as urine output < 10 mls/hr over 24 hours).
14. Patients with severe renal impairment (eGFR =30 ml/min/1.73m²)
15. Patients with a previous history of epilepsy, convulsions, fits or seizures
16. Patients who are pregnant or breast-feeding
17. Allergic to tranexamic acid.
18. Patients enrolled in other trials involving platelet transfusions, anti-fibrinolytics, platelet growth factors or other pro-coagulant agents.
19. Patients previously randomised into this trial at any stage of their treatment.
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Study design
Purpose of the study
Other
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/06/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
18/06/2022
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Sample size
Target
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Accrual to date
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Final
616
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Royal Adelaide Hospital - Adelaide
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Recruitment hospital [2]
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Royal Brisbane - Brisbane
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Recruitment hospital [3]
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Canberra Hospital - Canberra
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Recruitment hospital [4]
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Andrew Love Cancer Centre - Geelong
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Recruitment hospital [5]
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Alfred Hospital - Melbourne
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Recruitment hospital [6]
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Monash Health - Melbourne
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Recruitment hospital [7]
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St Vincent's Hospital - Melbourne
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Recruitment hospital [8]
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Victorian Comprehensive Cancer Centre - Melbourne
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Recruitment hospital [9]
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Royal North Shore Hospital - St Leonards
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Recruitment hospital [10]
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St Vincent's Hospital - Sydney
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Recruitment hospital [11]
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
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- Adelaide
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Recruitment postcode(s) [2]
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- Brisbane
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Recruitment postcode(s) [3]
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- Canberra
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Recruitment postcode(s) [4]
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- Geelong
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Recruitment postcode(s) [5]
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- Melbourne
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Recruitment postcode(s) [6]
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- St Leonards
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Recruitment postcode(s) [7]
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- Sydney
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Recruitment postcode(s) [8]
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- Westmead
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Recruitment outside Australia
Country [1]
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United Kingdom
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State/province [1]
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Bath
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Country [2]
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United Kingdom
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State/province [2]
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Belfast
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Country [3]
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United Kingdom
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State/province [3]
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Birmingham
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Country [4]
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United Kingdom
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State/province [4]
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Bristol
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Country [5]
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United Kingdom
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State/province [5]
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Coventry
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Country [6]
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United Kingdom
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State/province [6]
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Exeter
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Country [7]
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United Kingdom
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State/province [7]
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Glasgow
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Country [8]
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United Kingdom
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State/province [8]
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Leeds
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Country [9]
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United Kingdom
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State/province [9]
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Lincoln
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Country [10]
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United Kingdom
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State/province [10]
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London
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Country [11]
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United Kingdom
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State/province [11]
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Newcastle
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Country [12]
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United Kingdom
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State/province [12]
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Oxford
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Country [13]
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United Kingdom
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State/province [13]
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Plymouth
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Country [14]
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United Kingdom
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State/province [14]
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Salisbury
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Funding & Sponsors
Primary sponsor type
Government body
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Name
NHS Blood and Transplant
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Monash University
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to test whether giving tranexamic acid to patients receiving treatment for blood cancers reduces the risk of bleeding or death, and the need for platelet transfusions. Patients will be randomised to receive tranexamic acid (given intravenously through a drip, or orally) or a placebo.
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Trial website
https://clinicaltrials.gov/study/NCT03136445
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Trial related presentations / publications
Estcourt LJ, McQuilten Z, Powter G, Dyer C, Curnow E, Wood EM, Stanworth SJ; TREATT Trial Collaboration (provisional). The TREATT Trial (TRial to EvaluAte Tranexamic acid therapy in Thrombocytopenia): safety and efficacy of tranexamic acid in patients with haematological malignancies with severe thrombocytopenia: study protocol for a double-blind randomised controlled trial. Trials. 2019 Oct 15;20(1):592. doi: 10.1186/s13063-019-3663-2.
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Public notes
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Contacts
Principal investigator
Name
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Lise J Estcourt, MBBChir MSc DPhil MRCP FRCPath
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Address
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NHS Blood and Transplant
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
The datasets generated during and/or analysed during the current study will be available upon request from the NHSBT Clinical Trials Unit after de-identification (text, tables, figures and appendices) 9 months after publication and ending 5 years following article publication.
Supporting document/s available: Study protocol
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When will data be available (start and end dates)?
9 months after publication and ending 5 years following article publication.
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Available to whom?
Data will be shared with investigators whose use of the data has been assessed and approved by an NHSBT review committee as a methodologically sound proposal.
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03136445