The Impact of Oxidative Stress on Erythrocyte Biology (RBC Survival)

University of North Carolina (UNC)

Status and phase: Enrolling; Phase 2

Conditions: Sickle Cell Disease Without Crisis

Treatments: Biological: Non-G6PD deficient Red Blood Cell Transfusion; Biological: G6PD Deficient Red Blood Cell Transfusion

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04028700

R01HL148151-01 (U.S. NIH Grant/Contract)

21-0587

Details and patient eligibility

About

This study will address if red blood cells transfused to a sickle cell patient from a donor with a glucose-6-phosphate-dehydrogenase (G6PD) enzyme deficiency have a different lifespan as measured by the percentage of red blood cells that survive post-transfusion compared to red blood cells transfused to a sickle cell patient from a donor without a G6PD enzyme deficiency.

Full description

This prospective, phase II, crossover, single-blind, randomized transfusion order study will address if red blood cells from donors with a G6PD enzyme deficiency have a different lifespan once transfused into a patient with sickle cell disease than red blood cells from an otherwise normal donor. Results of this critical study will guide future research and donor testing policies to ensure that patients receive the most appropriate units of blood for their condition. Each patient randomized to the study will receive 2 blood transfusions, one from a G6PD deficient donor and one from an otherwise normal donor. Half the patients (8) will receive G6PD deficient blood first while the other half (8) will receive non-G6PD deficient blood first. Patients will have a wash-out period of at least 4 months before receiving the opposite type of blood transfusion. The blood transfusion order will be randomized. There is currently no standard of testing in place to screen blood donations for G6PD enzyme deficiency. It is believed that up to 10% of the antigen-matched donors for patients with sickle cell disease are G6PD deficient, and the lifespan is unknown in the sickle cell population.

Enrollment: 16 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18-60 years
• Has diagnosis of sickle cell disease
• Steady state (no pain or baseline pain and ≥1 month from any hospital admission)
• Receiving chronic transfusions (i.e., regular transfusion every 4-8 weeks).

Exclusion criteria

• History of transfusion reactions not adequately managed by antihistamines
• Does not have crossmatch compatible red cells
• Known G6PD deficiency
• Hepato- or splenomegaly
• Participation in another therapeutic trial
• Pregnant or nursing
• HIV positive
• At investigator discretion for uncontrolled inter-current illness or social situation limiting compliance with study requirements.
• Inability to speak and/or read English

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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16 participants in 2 patient groups

G6PD Deficient Red Blood Cell Transfusion, then Non-G6PD deficient Red Blood Cell Transfusion

Experimental group

Description:

Transfusion of a red blood cell unit that has been identified by local laboratory procedures to be deficient in G6PD enzyme activity followed after 4 months by transfusion of a red blood cell unit that has been identified by local laboratory procedures to not be deficient in G6PD enzyme activity.

Treatment:

Biological: G6PD Deficient Red Blood Cell Transfusion

Biological: Non-G6PD deficient Red Blood Cell Transfusion

Non-G6PD deficient Red Blood Cell Transfusion, then G6PD Deficient Red Blood Cell Transfusion,

Active Comparator group

Description:

Transfusion of a red blood cell unit that has been identified by local laboratory procedures to not be deficient in G6PD enzyme activity followed after 4 months by transfusion of a red blood cell unit that has been identified by local laboratory procedures to be deficient in G6PD enzyme activity

Treatment:

Biological: G6PD Deficient Red Blood Cell Transfusion

Biological: Non-G6PD deficient Red Blood Cell Transfusion