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Phase 3 N=114 Randomized Single-blind Treatment

Safety and Effectiveness of Granulocyte Transfusions in Resolving Infection in People With Neutropenia (The RING Study)

Neutropenia · Infection

Enrolled (actual)
114
Serious AEs
44.7%
Results posted
Dec 2014
Primary outcome: Primary: Percentage of Participants Who Are Alive at 42 Days After Treatment and Have Had Microbial Response — 42.9; 41.7 percentage of participants — p=0.73

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Standard antimicrobial therapy (Drug); Granulocyte transfusions (Biological); G-CSF/dexamethasone (Drug); Apheresis machine (Device)
Age
Pediatric, Adult, Older Adult
Sex
All
Sponsor
Carelon Research
Primary completion
Apr 2013

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants Who Are Alive at 42 Days After Treatment and Have Had Microbial Response
42.9; 41.7 0.73
SECONDARY
Alloimmunization, Defined as the Appearance of Anti-human Leukocyte Antigen (HLA) or Antineutrophil Antibodies
SECONDARY
Serious Granulocyte Transfusion Reactions, Including Febrile, Allergic, and Pulmonary Reactions (Transfusion Arm Only)
5; 19; 0; 7; 1; 14
SECONDARY
Graft Versus Host Disease Among Recipients of Allogeneic Stem Cell Transplantation
0.67; 0.40 0.43
SECONDARY
Overall Incidence of Adverse Effects
33; 30; 21; 20; 2; 5
SECONDARY
Fever Resolution
0.89; 0.94
SECONDARY
Time to Negative Test for Fungal Antigenemia (e.g., Galactomannan Antigenemia Among Participants With Invasive Aspergillosis)
SECONDARY
Time to Negative Blood Culture for Participants With Positive Blood Culture at Baseline
SECONDARY
Long-term Survival
30; 20 0.35
SECONDARY
Serious Adverse Events in Granulocyte Donors
1; 1
SECONDARY
Donor Availability (Proportion of Scheduled Granulocyte Transfusion Days on Which Granulocytes Were Available)
62.62
SECONDARY
Evaluation of Granulocyte Yield
174.75
SECONDARY
Discontinuation of Granulocyte Transfusions Due to Toxicity or Intolerance

Summary

Neutropenia, a condition characterized by an abnormally low number of infection-fighting white blood cells called neutrophils, commonly develops in people who have undergone chemotherapy or hematopoietic stem cell (HSC) transplantation. The severely reduced immunity of those with neutropenia can put them at risk of entry of life-threatening infections, making the implementation of treatments that increase white blood cell numbers important. Several studies have shown that the transfusion of donor granulocytes, a type of white blood cell that includes neutrophils, is effective in promoting the recovery of adequate numbers of granulocytes. However, granulocyte transfusions can cause side effects, and it is not known whether the success of the therapy outweighs the health risks of the side effects. This study will evaluate the safety and effectiveness of granulocyte transfusions in treating people with a bacterial or fungal infection during neutropenia.

Eligibility Criteria

Inclusion Criteria

  • Severe neutropenia (Absolute Neutrophil Count < 500/mm^3) due to marrow failure caused by underlying disease or therapy
  • Must have one of the following: fungemia; bacteremia; proven or presumptive invasive tissue bacterial infection; or proven, probable, or presumptive invasive fungal infection

Exclusion Criteria

  • Unlikely to survive 5 days
  • Evidence that patient will not be neutropenic at least 5 days
  • Previously enrolled in this study
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00627393). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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