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Biomarkers in Patients With Anemia-Induced Thrombocytopenic Bleeding (BAIT)

D

Donald Arnold

Status

Enrolling

Conditions

Acute Leukemia
Acute Myeloid Leukemia (AML)
Acute Lymphocytic Leukaemia

Treatments

Procedure: RBC transfusion strategy

Study type

Interventional

Funder types

Other

Identifiers

Details and patient eligibility

About

This pilot study aims to gather preliminary evidence on how different hemoglobin levels impact blood biomarkers related to bleeding. The feasibility of conducting a future larger clinical trial will also be assessed. Red blood cell transfusions are part of the standard of care for patients with leukemia. This study evaluates two transfusion strategies: one that maintains hemoglobin levels above the standard-of-care threshold, reflecting current routine practice; and another that maintains hemoglobin levels above 110 g/L, which is closer to the normal hemoglobin range. The normal hemoglobin range is 120-160 g/L for females and 140-180 g/L for males. Raising hemoglobin levels closer to normal values may reduce bleeding risk.

Enrollment

60 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  1. ≥18 years old.
  2. Inpatient
  3. Diagnosis of acute myeloid leukemia or acute lymphocytic leukemia.
  4. Less than 5 days have elapsed since the start of induction chemotherapy treatment.
  5. Hemoglobin at enrolment is under 130 g/L.

Exclusion criteria

  1. Failure to provide informed consent.
  2. Unwilling to receive blood transfusions.
  3. Life expectancy <72 hours.
  4. Undergoing palliative chemotherapy.
  5. Requires specialized blood products (e.g., antigen-matched, irradiation, etc.).
  6. Diagnosis of acute promyelocytic leukemia.
  7. Diagnosis of hyperleukocytosis (a white blood cell count exceeding 100 × 10^9/L).
  8. Diagnosed with coagulopathies or ongoing treatment with therapeutic anticoagulants, aspirin or nonsteroidal anti-inflammatory drugs (history of inherited or acquired coagulation disorder, known hemolytic disease, INR > 1.5)
  9. Evidence of iron overload (ferritin >800 ng/mL, transferrin saturation >80%) .

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

60 participants in 2 patient groups

RBC transfusion strategy to maintain a hemoglobin level of at least 110 g/LL
Experimental group
Description:
Participants randomized to this arm will be assigned to a liberal RBC transfusion strategy to maintain a hemoglobin level of at least 110 g/L.
Treatment:
Procedure: RBC transfusion strategy
Standard-of-care RBC transfusion strategy
No Intervention group
Description:
Participants randomized to this arm will be assigned to a restrictive RBC transfusion strategy of standard-of-care, which is typically to maintain a hemoglobin level of at least 70-80 g/L.

Trial contacts and locations

1

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Central trial contact

Dimpy Modi

Data sourced from clinicaltrials.gov

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