30 Participants Needed
McMaster University logo

Non-Identical Blood Type Transfusions for Patient Outcomes

(UD Trial)

Recruiting in Hamilton (>99 mi)
DA
NH
Overseen ByNancy Heddle
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: McMaster University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial is testing whether giving patients blood that exactly matches their own type can reduce complications and deaths. It focuses on patients who need transfusions and are at higher risk of problems when given non-matching blood. The goal is to prevent harmful immune reactions by using matching blood types.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications.

Is it safe to receive a blood transfusion with a non-identical blood type?

Blood transfusions, including those with red blood cells, can have risks such as adverse reactions and complications. Studies have shown that factors like storage duration and irradiation can increase these risks, and transfusions can lead to serious reactions like hemolysis (destruction of red blood cells). While transfusions are common, they are associated with various adverse effects, especially in specific populations like newborns and patients with heart conditions.12345

How is the treatment of non-identical blood type transfusions unique compared to other treatments?

Non-identical blood type transfusions are unique because they involve transfusing blood that doesn't match the recipient's blood type exactly, which is not standard practice. This approach may focus on matching other blood components or antigens to improve outcomes, unlike traditional transfusions that prioritize exact blood type matching.678910

What data supports the effectiveness of the treatment Non-Identical Blood Type Transfusions for Patient Outcomes?

Research shows that red blood cell (RBC) transfusion therapy has been effective in reducing mortality and morbidity in patients with cancer who receive multiple transfusions. This suggests that RBC transfusions, even with non-identical blood types, could potentially improve patient outcomes.610111213

Who Is on the Research Team?

DA

Donald Arnold

Principal Investigator

McMaster University

Are You a Good Fit for This Trial?

This trial is for adults over 18 with Myelodysplastic Syndrome (MDS) who don't have leukemia. They must need regular blood transfusions every 6 weeks or less, be stable according to their doctor's assessment, and not require special blood products due to reactions. People with blood group O or those unable to consent are excluded.

Inclusion Criteria

I have been diagnosed with MDS without leukemia, classified as low or intermediate-1 risk.
Blood group A, B, or AB
I need blood transfusions of 2 units at least every 6 weeks.
See 2 more

Exclusion Criteria

I am unable to understand and give consent for treatment.
My blood type is O.
I need special blood products due to reactions.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Transfusion Episode 1

Participants receive an ABO identical product during the first transfusion episode

1 day
1 visit (in-person)

Transfusion Episode 2

Participants receive an ABO non-identical product during the second transfusion episode

1 day
1 visit (in-person)

Follow-up

Participants are monitored for changes in biomarkers of inflammation and other safety parameters after transfusion

12-24 hours

What Are the Treatments Tested in This Trial?

Interventions

  • RBC transfusion
Trial Overview The study is examining if receiving Red Blood Cell (RBC) transfusions that aren't a perfect match for the patient's ABO blood type affects their health outcomes. It follows earlier research suggesting non-identical RBCs might increase in-hospital death risk.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: ABO non-identical transfusionExperimental Treatment1 Intervention
All study patients will participate in the study for two consecutive transfusion episodes (a transfusion episode is defined as a clinic visit where 2 RBC units are transfused) and will receive an ABO identical product at one transfusion episode and an ABO non-identical product for the other episode. Randomization will dictate the order of the transfusion. The number of RBCs given for each study transfusion episode will be identical 2 RBC units.
Group II: ABO identical transfusionActive Control1 Intervention
All study patients will participate in the study for two consecutive transfusion episodes (a transfusion episode is defined as a clinic visit where 2 RBC units are transfused) and will receive an ABO identical product at one transfusion episode and an ABO non-identical product for the other episode. Randomization will dictate the order of the transfusion. The number of RBCs given for each study transfusion episode will be identical 2 RBC units.

RBC transfusion is already approved in European Union, United States, Canada for the following indications:

🇪🇺
Approved in European Union as Red Blood Cell transfusion for:
  • Anemia
  • Blood loss
  • Surgical procedures
🇺🇸
Approved in United States as RBC transfusion for:
  • Anemia
  • Blood loss
  • Surgical procedures
  • Trauma
🇨🇦
Approved in Canada as Red Blood Cell transfusion for:
  • Anemia
  • Blood loss
  • Surgical procedures

Find a Clinic Near You

Who Is Running the Clinical Trial?

McMaster University logo

McMaster University

Lead Sponsor

Trials
936
Recruited
2,630,000+

CBS

Collaborator

Trials
2
Recruited
280+

Published Research Related to This Trial

A study analyzing 732 cases of red blood cell alloimmunization in patients with oncological malignancies found that transfusion significantly increases the risk of developing antibodies against Rh blood group antigens, particularly the E antigen.
To minimize the risk of alloimmunization in these high-risk patients, the study recommends implementing a policy for extended RBC phenotyping and providing antigen-matched blood, especially for the E antigen.
RBC Transfusion Strategy in Oncological Patients with Chronic RBC Transfusion Therapy.Fang, W., Pang, C., Zhang, F., et al.[2023]
In a study of 10,069 critically ill patients across 730 ICUs worldwide, 26.3% received red blood cell (RBC) transfusions, with significant variations in practice based on geographic regions.
While transfusions were associated with higher hospital mortality rates overall (30.0% for transfused vs. 19.6% for non-transfused), they showed a slightly lower relative risk of in-hospital death in the most severely ill patients, suggesting that transfusion decisions should consider the severity of illness.
Worldwide audit of blood transfusion practice in critically ill patients.Vincent, JL., Jaschinski, U., Wittebole, X., et al.[2018]
In a study of 6124 cardiac surgical patients, receiving 1-2 units of leukocyte-depleted red blood cells (RBCs) did not increase the risk of long-term mortality compared to those who received no transfusion, with a hazard ratio of 1.00, indicating no significant difference.
Preoperative anemia was not found to be a risk factor for increased postoperative mortality, even among patients who received transfusions, suggesting that transfusion practices may not need to change based on anemia status.
No Significant Association Between the Transfusion of Small Volumes of Leukocyte-Depleted Red Blood Cells and Mortality Over 7 Years of Follow-up in Patients Undergoing Cardiac Surgery: A Propensity Score Matched Analysis.Koster, A., Zittermann, A., Börgermann, J., et al.[2019]

Citations

RBC Transfusion Strategy in Oncological Patients with Chronic RBC Transfusion Therapy. [2023]
Worldwide audit of blood transfusion practice in critically ill patients. [2018]
No Significant Association Between the Transfusion of Small Volumes of Leukocyte-Depleted Red Blood Cells and Mortality Over 7 Years of Follow-up in Patients Undergoing Cardiac Surgery: A Propensity Score Matched Analysis. [2019]
Predicting red blood cell transfusion in hospitalized patients: role of hemoglobin level, comorbidities, and illness severity. [2021]
Storage time of transfused red blood cells and impact on clinical outcomes in hematopoietic stem cell transplantation. [2011]
In vitro lysis and acute transfusion reactions with hemolysis caused by inappropriate storage of canine red blood cell products. [2021]
Induction of platelet white blood cell (WBC) aggregate formation by platelets and WBCs in red blood cell units. [2008]
Irradiation and prolonged storage of red cells are associated with increased adverse events. [2019]
Adverse effects of small-volume red blood cell transfusions in the neonatal population. [2021]
Adverse Outcomes of Perioperative Red Blood Cell Transfusions in Coronary Artery Bypass Grafting in Hospital Universiti Sains Malaysia. [2023]
11.United Statespubmed.ncbi.nlm.nih.gov
Signs and symptoms associated with the transfusion of WBC-reduced RBCs and non-WBC-reduced RBCs in patients with anemia and HIV infection: results from the Viral Activation Transfusion Study. [2019]
Red blood cell alloimmunization in sickle cell disease and in thalassaemia: current status, future perspectives and potential role of molecular typing. [2022]
Single versus double-unit transfusion: Safety and efficacy for patients with hematologic malignancies. [2020]
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