Long-term Comparative Cerebrovascular Outcome After Transplantation vs Standard Care in Sickle Cell Anemia

Recruiting

• Conditions: Stenosis; Sickle Cell Disease; Cerebral Ischemia
• Interventions: Other: blood collection

• Registration Number: NCT05053932
• Lead Sponsor: Centre Hospitalier Intercommunal Creteil

Brief Summary

The purpose of the present observational study is to remotely reevaluate the cohort of 67 sickle cell patients with transcranial Doppler-detected cerebral vasculopathy included in the national "Sickle Cell Transplant" protocol and whose 1- and 3-year results were published in JAMA (Journal of the American Medical Association) in 2019 and in BHJ in 2020.

Detailed Description

The present observational study has the objective to reevaluate at distance the cohort of 67 children with sickle cell anemia enrolled in the "Drepagreffe"trial because of cerebral vasculopathy detected by transcranial Doppler. Results at 1 and 3 years were reported in JAMA in 2019 in BHJ in 2020. This trial was the first worldwide prospective study comparing transplantation to standard care in sickle cell disease. Velocities were highly significantly more reduced with a higher proportion of patients with normalized velocities and better quality of life after transplantation than on standard care. Despite a trend to a better ischemic lesions outcome at 3 years, the difference was not significant and cognitive performances were not different between both groups. The biologic study only assessed at enrollment and 1-year showed lower levels of Ang-2 and HGF (hepatocyte growth factor) after transplant and a significant and independent association between Doppler normalization probability with low Ang-2 and BDNF (brain-derived neurotrophic factor) levels.The aim of the present study is to reassess at 9-10 years this cohort with grants allowing to reevaluate cognitive functioning and hypoxia/angiogenic factors not realized in the systematic cohort follow-up

Study Timeline

• Study First Submitted: 2021-05-12
• Study First Submitted QC: 2021-09-13
• Study First Posted: 2021-09-23
• Study Start: 2022-10-07
• Status Verified: 2023-08
• Last Update Submitted: 2023-08-22
• Last Update Posted: 2023-08-23
• Primary Completion: 2024-06
• Study Completion: 2025-06

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 67

Inclusion Criteria

• Patient of legal age or minor who participated in the DREPAGREFFE research protocol [NCT 01340404] between December 2010 and June 2013,
• Having read and understood the information letter

Exclusion Criteria

• Refusal to participate
• Patient deceased

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Patients included in Drepagreffe 1 study (NCT01340404)	blood collection	biological collection

Primary Outcome Measures

Name	Time	Method
Long term evolution (at 9-10 years) of Ischemic lesion on brain magnetic resonance imaging 10-year measurement of ischemic lesion on magnetic resonance imaging	within 6 months of inclusion	The MRI-scores, ranging from 0 (best outcome) to 10 (worst outcome), are obtained by adding up the ischemic lesion scores from the left and right sides, i.e., 3 for territorial or 2 for border zone (cortical and subcortical), 1 for white matter and 1 for basal ganglia infarcts and 0 if absent on each side.
Long term evolution (at 9-10 years) of arterial stenosis on cerebral and cervical magnetic resonance angiography	within 6 months of inclusion	The MRA stenosis-scores, ranging from 0 (best outcome) to 32 (worst outcome) are defined as the weighted sums over the 8 assessed cerebral arteries, as 0 if no stenosis, 1 if mild stenosis (25-49%), 2 if moderate stenosis (50-74%), 3 if severe stenosis (75-99%), and 4 if occlusion.

Secondary Outcome Measures

Name	Time	Method
Long term evolution (at 9-10 years) of cognitive performance	within 6 months of inclusion	Full Scale Intelligence Quotient (40= worst outcome, 160= best outcome) is measured by Wechsler Intelligence Scale for Children -Fourth Edition (WISC-4) for children 7-16 years of age and by WAIS-3 (Weschler Adult Intelligence Scale-3) for patients older than 16 years
Long term evolution (at 9-10 years) of quality of life	within 6 months of inclusion	Quality of life assessment is collected using the French version of the Pediatric Quality of Life Inventory Generic Core Scale (PedsQLTM 4.0 generic core scales) (physical, emotional, social, school items) (0= worst outcome, 100= best outcome) via self-report and parent proxy-report
Evolution at 9-10 years of factors of hypoxia and oxidative stress	within 6 months of inclusion	Assessment on plasma Phosphatidyl-serine expression VEGF, Angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2),EPO, HIF-1, BDNF, PDGF-AA

Trial Locations

Locations (14)

Groupe hospitalier Pellegrin; 🇫🇷 Bordeaux, France

Centre Hospitalier Intercommunal de Créteil; 🇫🇷 Créteil, France

Hôpital Bicêtre AP-HP; 🇫🇷 Le Kremlin-Bicêtre, France

CH de Pau; 🇫🇷 PAU, France

CHU de Rennes; 🇫🇷 Rennes, France

Hôpital Necker - AP-HP; 🇫🇷 Paris, France

IHOPe; 🇫🇷 Lyon, France

CHU de la Guadeloupe; 🇫🇷 La Guadeloupe, France

Hôpital Hautepierre; 🇫🇷 Strasbourg, France

CHU de Lyon; 🇫🇷 Lyon, France

Hôpital Robert Debré AP-HP; 🇫🇷 Paris, IDF, France

Hôpital Henri Monr - APHP; 🇫🇷 Créteil, France

Hôpital de la Timone; 🇫🇷 Marseille, France

CHU de Montpellier; 🇫🇷 Montpellier, France