Immunologic Features of Respiratory Failure in Pediatric Hematopoietic Cell Transplantation (HCT) Recipients and Pediatric Oncology Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- Feasibility of performing single cell gene expression analyses on tracheal aspirates
研究概览
简要总结
This study is being done because researchers want to learn more about genes that control the immune response in the participant's lungs and blood when the participant have lung disease leading to respiratory failure.
Primary Objective
To evaluate the feasibility of performing single cell gene expression analyses on tracheal aspirates from immunocompromised pediatric patients with immune compromising conditions, including HCT recipients.
Secondary Objectives
- To assess whether cell composition and activation states in longitudinally obtained tracheal aspirate and blood samples are able to distinguish unique immunopathology for each of the early post-HCT lung diseases.
- To assess whether cell composition and activation states in longitudinally obtained tracheal aspirate and blood samples are different between two immunodeficient patient populations (alloHCT vs non alloHCT) with lung disease and respiratory failure.
- To test the hypothesis that allogeneic T cell responses are implicated in the pathogenesis of early post-HCT lung diseases.
Exploratory Objectives
To correlate immune cell signaling in the lower respiratory tract and blood of patients with early post-HCT lung diseases with the presence or absence of pathogenic microbes at each site.
To explore HLA testing in Tracheal Aspirates in samples where enough cells are present.
详细描述
This study involves a Tracheal aspirate, Bronchoalveolar lavage (BAL), and blood samples. The tracheal aspirates and blood samples will be obtained within 24 hours of intubation, then twice more every 3 -4 days, and then once a week until the patient is extubated. If the primary treatment team performs bronchoscopy with BAL, then an aliquot of residual BAL fluid will be obtained.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- — 至 21 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participant is age 0 to 21 years old
- •Participant has acute respiratory failure due to primary pulmonary disease and is expected to receive invasive mechanical ventilation for more than 48 hours
排除标准
- •The primary etiology of respiratory failure is not related to primary pulmonary disease
- •Aspiration is present
- •The participant has a tracheostomy
- •If the patient has undergone HCT, they are more than 100 days removed from HCT
- •Has a diagnosis of severe combined immunodeficiency syndrome (SCIDS)
- •The primary on-service team feels obtaining a study sample would be unsafe for any reason.
- •Inability or unwillingness of research participant or legal guardian/representative to give written informed consent.
结局指标
主要结局
Feasibility of performing single cell gene expression analyses on tracheal aspirates
时间窗: 4 years
Feasibility is a qualitative binary outcome (Yes and No), based on the success of recovery of more than 100,000 live cells from a tracheal aspirate and blood sample from five of the first ten allo HCT patients enrolled on the study protocol.
次要结局
- Success of distinguishing unique immunopathology for each of the early post-HCT lung diseases(4 years)
- : Difference of cell composition and activation states between two immunodeficient patient populations (alloHCT vs non alloHCT) with lung disease and respiratory failure.(4 years)
- Whether allogeneic T cell responses are implicated in the pathogenesis of early post-HCT lung diseases.(4 years)