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Safety and Efficacy of Iron Reduction by Phlebotomy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00689182
Recruitment Status : Completed
First Posted : June 3, 2008
Last Update Posted : January 31, 2017
Information provided by (Responsible Party):
Andrea Kew, Nova Scotia Health Authority

Brief Summary:

Hypothesis: The reduction of total body iron by phlebotomy will be safe and feasible in the post-HSCT setting

Iron overload is common after hematopoietic stem cell transplantation. It is associated with chronic liver disease, with increased rates of infection and decreased survival.

Eligible, consenting patients will have once monthly phlebotomy procedures (500ml) for 12 months.

SAFETY: At each visit, patients will have a comprehensive assessment prior to starting and after completing the phlebotomy. This assessment will include determination of pain at phlebotomy site, local infection and an assessment of symptoms of anemia including presyncope, fatigue and dyspnea. The patient's pulse, blood pressure, respiratory rate and temperature will also be determined before and following the phlebotomy.

EFFICACY: Iron stores will be measured serially in each patient. Measurements will be performed prior to the start of phlebotomy, and at 6 months and 12 months following the start of the series of 12 phlebotomies. These evaluations will be undertaken regardless of the number of phlebotomies which the patient actually undergoes. Iron stores will be estimated by measuring serum ferritin and transferrin saturation levels. Total body iron will be estimated from hepatic and cardiac iron concentration as measured by magnetic resonance imaging (MRI). Gandon et al. (12) described a non-invasive technique using MRI to measure hepatic iron stores. Iron is a paramagnetic substance which causes local magnetic field inhomogeneities leading to dephasing and signal loss in MRI. Gradient echo sequences are most susceptible to their effects because they do not use a 180° refocusing pulse, unlike conventional spin-echo sequences. Gandon et al. used multiple gradient echo sequences, compared the signal in liver to adjacent muscle and used this ratio to correlate with hepatic iron levels measured on tissue biopsy samples using spectrophotometric analysis. Multiple sequences were used because the nomogram comparing the L/M signal ratio is linear over only a small concentration of tissue iron.

Condition or disease Intervention/treatment Phase
Iron Overload Procedure: monthly phlebotomy x 12 months Phase 2

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 23 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase II Trial of the Safety and Efficacy of Iron Reduction by Phlebotomy in Recipients of Hematopoietic Stem Cell Transplants
Study Start Date : May 2007
Actual Primary Completion Date : December 2012
Actual Study Completion Date : December 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Iron

Arm Intervention/treatment
Experimental: A
All patients will receive phlebotomy
Procedure: monthly phlebotomy x 12 months
All patients will receive monthly phlebotomies.

Primary Outcome Measures :
  1. Iron stores, total body iron [ Time Frame: 1 year ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • consecutive patients who have undergone autologous or allogeneic HSCT
  • who are red-cell transfusion-independent
  • at least 60 days post-transplant
  • serum ferritin of at least 1000ug/L
  • ECOG less than or equal to 2.0

Exclusion Criteria:

  • pregnancy
  • breast-feeding
  • serious infection
  • HIV antibody positive
  • renal failure (creatinine < 30ml/min)
  • sever obstructive lung disease
  • have a pacemaker, cerebral aneurysm or metal prosthesis
  • evidence of disease relapse

Information from the National Library of Medicine

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 identifier (NCT number): NCT00689182

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Canada, Nova Scotia
QEII Health Sciences Centre
Halifax, Nova Scotia, Canada, B3h 2Y9
Sponsors and Collaborators
Andrea Kew
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Principal Investigator: Andrea Kew, MD Queen Elizabeth II Health Sciences Centre
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Responsible Party: Andrea Kew, Dr., Nova Scotia Health Authority Identifier: NCT00689182    
Other Study ID Numbers: CDHA017
First Posted: June 3, 2008    Key Record Dates
Last Update Posted: January 31, 2017
Last Verified: January 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided
Keywords provided by Andrea Kew, Nova Scotia Health Authority:
iron reduction
iron overload
hematopoietic stem cell transplant
Additional relevant MeSH terms:
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Iron Overload
Iron Metabolism Disorders
Metabolic Diseases