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131 active trials for Myelodysplastic Syndrome

Study of Palifermin (Kepivance) in Persons Undergoing Unrelated Donor Allogeneic Hematopoietic Cell Transplantation

Background: - In allogeneic stem cell transplantation (SCT), stem cells are taken from a donor and given to a recipient. Sometimes the recipient s immune system destroys the donor s cells. Or donor immune cells attack the recipient s tissues, called graft-versus-host disease (GVHD). This is less likely when the recipient and donor have similar human leukocyte antigens (HLA). Researchers want to see if the drug palifermin improves the results of allogeneic SCT from HLA-matched unrelated donors. Objective: - To see if high doses of palifermin before chemotherapy are safe, prevent chronic GVHD, and improve immune function after transplant. Eligibility: - Adults 18 years of age or older with blood or bone marrow cancer with no HLA-matched sibling, but with a possible HLA-matched donor. Design: Participants will be screened with medical history, physical exam, and blood and urine tests. They will have scans and heart and lung exams. Before transplant, participants will: Have many tests and exams. These include blood tests throughout the study and bone marrow biopsy. Get a central line catheter if they do not have one. Have 1-3 rounds of chemotherapy. Take more tests to make sure they can have the transplant, including medical history, physical exam, and CT scan. Get palifermin by IV and more chemotherapy. They will get other drugs, some they will take for 6 months. Participants will get the SCT. After transplant, participants will: Be hospitalized at least 3-4 weeks. Have tests for GVHD at 60 days and 6 months. These include mouth and skin photos and biopsies. Stay near D.C. for 3 months. Visit NIH 5 times the first 2 years, then yearly. They may have scans and biopsies.

Start: September 2015
Revisiting the Universal Donor: Does Exposure to O Blood Products Affect Patient Outcomes?

In a recent analysis of a large transfusion database (Transfusion Research Utilization, Surveillance and Tracking database [TRUST]), the investigators found that the transfusion of ABO non-identical RBCs to group A individual was associated with an increased risk of death in-hospital compared to patients transfused with ABO identical RBCs (Red Blood Cells). Our finding was corroborated in a separate study of low birth weight neonates who received only group O RBCs (e.g., group O neonates received ABO identical RBCs but group A, B, and AB neonates received ABO non-identical RBCs). A subgroup of neonates who received ABO non-identical transfusions had higher mortality (Z. Sohl, personal communication, April 30th, 2020). Similar adverse clinical outcomes have been reported in a number of studies where patients have received ABO non-identical RBCs and/or platelets. Together, these findings raise the concern that the longstanding policy of transfusing group O non-identical RBCs and platelets may increase the risk of harm for some patients. In Hamilton, Ontario hospitals, approximately 20% of transfused patients receive ABO non-identical RBCs every year because of inventory shortages, urgent requests, and specific phenotype requirements. The negative impact of this practice could have widespread national and international implications for transfusion policy. The ability to undertake critical exploratory analyses in transfusion medicine is enabled by large research and administrative data sets that include all Hamilton hospitals. The initial finding of potential harm with ABO non-identical RBCs is hypothesis-generating and requires confirmation through external datasets and translational studies to support a biological mechanism. If confirmed, this hypothesis can then be tested in a clinical trial.

Start: August 2021