The Implementation of the Automated Erythrocytapheresis in Egyptian Sickle Cell Disease Center
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|ClinicalTrials.gov Identifier: NCT03903289|
Recruitment Status : Recruiting
First Posted : April 4, 2019
Last Update Posted : April 4, 2019
|Condition or disease||Intervention/treatment||Phase|
|Sickle Cell Disease||Procedure: Automated red cell exchange Procedure: Manual red cell exchange Procedure: Simple red cell transfusion||Not Applicable|
There is a wide scoop for treatment of SCD ranging from medical treatment with hydroxyurea, simple transfusion with chelation therapy, exchange transfusion either manual or automated and stem cell transplantation which need highly equipped institutes.
The goals of treatment of SCD are symptom control with early detection and management of disease complications. Although several pharmacological agents have been studied for the treatment of SCD, the only drug currently approved by the US Food and Drug Administration (FDA) for the treatment of SCD is hydroxyurea. Allogeneic bone marrow transplantation (BMT) can cure SCD, but it is difficult to decide which patients should be offered BMT. Many risks are associated with BMT, and the risk-to-benefit ratio must be assessed carefully. The lack of availability of a matched donor may limit the utility of BMT. Transfusions are not needed for the usual anemia or episodes of pain associated with SCD. Urgent replacement of blood is often required for sudden severe anemia and regular blood transfusions are used for primary and secondary stroke prevention in children with SCD. With continued transfusion, iron overload inevitably develops and can result in heart and liver failure, and multiple other complications necessitate the use of chelation therapy.
Erythrocytapheresis is an automated red cell exchange procedure that removes blood that contains HbS from the patient while simultaneously replacing that same volume with packed red cells free of HbS. Transfusion usually consists of sickle-negative, leuco-reduced, and phenotypically matched blood for red cell antigens. Erythrocytapheresis thus has the advantage of controlling iron accumulation in patients with SCD who undergo long-term transfusion, as well as the ability to allow rapid reduction of HbS concentrations to less than 30% without significantly increasing total hemoglobin concentration post transfusion. This precision is achieved because, before the start of the transfusion, the computer in the pheresis machine calculates the expected amount of packed RBCs required to obtain a specific post-transfusion hemoglobin level, using various physiologic parameters (eg, height, weight, Hb level). Further, erythrocytapheresis requires less time than simple transfusion of similar blood volumes. Although erythrocytapheresis is more expensive than simple transfusion, the additional costs associated with simple transfusions (ie, those of chelation and organ damage due to iron overload) make erythrocytapheresis more cost-effective than simple transfusion programs. Central venous access devices can safely be used for long-term erythrocytapheresis in patients with SCD with a low rate of complications.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||20 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||None (Open Label)|
|Official Title:||Assessment of Implementation of the Automated Erythrocytapheresis in the Outcome of Egyptian Sickle Cell Disease Patients: Single Center Experience|
|Actual Study Start Date :||August 16, 2017|
|Estimated Primary Completion Date :||August 16, 2019|
|Estimated Study Completion Date :||January 1, 2020|
Experimental: Automated red cell exchange
Automated red cell exchange
Procedure: Automated red cell exchange
Erythrocytapheresis is an automated red cell exchange procedure that removes blood that contains HbS from the patient while simultaneously replacing that same volume with packed red cells free of HbS.
Other Name: Erythrocytapheresis
Active Comparator: Manual red cell exchange
Manual red cell exchange
Procedure: Manual red cell exchange
Active Comparator: Manual red cell exchange
Sham Comparator: Simple red cell transfusion
Simple red cell transfusion
Procedure: Simple red cell transfusion
Active Comparator: Simple red cell transfusion
- The change of health related quality of life (HRQoL) is being assessed [ Time Frame: assessed at enrollment and after one year of intervention ]The medical Outcome Study (MOS) short form (SF-36) is a 36- item tool for measuring health status and outcome from the patients' perceptions
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03903289
|Contact: Fatma SE Ebeid, MDfirstname.lastname@example.org|
|Faculty of Medicine, Ain Shams University||Recruiting|
|Cairo, Non-US, Egypt, 11556|
|Contact: Fatma SE Ebeid, MD 01095569596 email@example.com|
|Principal Investigator: Fatma SE Ebeid, MD|
|Principal Investigator:||Fatma Solima SE Ebeid, MD||Faculty of Medicine, Ain Shams university|