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National Prospective Cohort for Monitoring Children With Severe Autoimmune Cytopenia.

Completed
Conditions
Autoimmune Haemolytic Anaemia
Cytopenia
Thrombocytopenic Purpura, Immune
Interventions
Other: Blood sample
Registration Number
NCT04070612
Lead Sponsor
University Hospital, Bordeaux
Brief Summary

This study aims to study prospectively the clinical and paraclinical evolution and prognostic factors of autoimmune haemolytic anemias, Evans syndromes and chronic immunological thrombocytopenic purpura of children in France.

Detailed Description

These autoimmune haematological diseases are rare diseases affecting the child, often very young, and serious and potentially life-threatening. International literature data are scarce, and include individual cases or small series.

They do not allow to determine an optimal therapeutic strategy in case of escape from the first-line treatments. Existing treatments (long-term corticosteroid therapy, immunoglobulins, splenectomy, immunosuppressants, chemotherapies, and more recently anti-CD20 antibodies) are inconsistently effective, and often associated with serious side effects.

The seriousness of these diseases, the therapeutic difficulties, and the absence of a targeted research project in France, led to the implementation of this study.

This study aims to study prospectively the clinical and paraclinical evolution and prognostic factors of autoimmune haemolytic anemias, Evans syndromes and chronic immunological thrombocytopenic purpura of children in France.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
122
Inclusion Criteria
  • Age strictly below 18 years of age at initial diagnosis
  • Affiliate child or beneficiary of a social security scheme
  • Child residing in metropolitan France
  • Diagnosis of autoimmune haemolytic anemias, Evans syndrome and / or chronic Immune thrombocytopenic purpura
  • Free, informed, written and signed consent
Exclusion Criteria
  • Diagnosis of constitutional haemolytic anemia
  • Diagnosis of platelet constitutional disease

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Children with Immune thrombocytopenic purpuraBlood sampleA blood sample of 2 times 2 to 5 ml additional maximum
children with autoimmune haemolytic anemiaBlood sampleA blood sample of 2 times 2 to 5 ml additional maximum
Children with Evans syndromeBlood sampleA blood sample of 2 times 2 to 5 ml additional maximum
Primary Outcome Measures
NameTimeMethod
no response (yes/no) for children with autoimmune haemolytic anemiasAt the screening

Clinical Signs of Severe Anemia (Grade 3 or More) Or Hemoglobin \<7 g / dl

deceased patient (yes/no) for children with autoimmune haemolytic anemiasAt the screening

Death yes/no

partial remission (yes/no) for children with chronic immunologic thrombocytopenic purpuraAt the screening

Clinical Signs of Hemorrhage (Grade 1 or 2) Or platelets between 30,000 and 100,000 / mm3

Complete sustainable remission (yes/no) for children with autoimmune haemolytic anemiasAt the screening

Absence of clinical signs of anemia (grade 0) And Hemoglobin \> 11 g / dl And reticulocytes \<120,000 / mm3 And haptoglobin\> 10 mg / dl And bilirubin \<10 mg / l or 17 μmol / l And no specific treatment for at least 12 months

partial remission (yes/no) for children with autoimmune haemolytic anemiasAt the screening

Clinical Signs of Anemia (Grade 1 or 2) Or Hemoglobin from 7 to 11 g / dl Or reticulocytes\> 120,000 / mm3 Regardless of the level of haptoglobin or bilirubin

complete remission (yes/no) for children with chronic immunologic thrombocytopenic purpuraAt the screening

Absence of clinical signs of haemorrhage (grade 0) And platelets\> 100,000 / mm3 And specific treatment in progress or interrupted for less than 12 months

no response (yes/no) for children with chronic immunologic thrombocytopenic purpuraAt the screening

Clinical Signs of Severe Hemorrhage (Grade 3 or Greater) Or Platelets \<30,000 / mm3

deceased patient (yes/no) for children with chronic immunologic thrombocytopenic purpuraAt the screening

Death yes/no

complete remission (yes/no) for children with autoimmune haemolytic anemiasAt the screening

Absence of clinical signs of anemia (grade 0) And Hemoglobin\> 11 g / dl And reticulocytes \<120,000 / mm3 Regardless of the level of haptoglobin or bilirubin And specific treatment in progress or interrupted for less than 12 months

Complete sustainable remission (yes/no) for children with chronic immunologic thrombocytopenic purpuraAt the screening

Absence of clinical signs of haemorrhage (grade 0) And platelets\> 100,000 / mm3 And no specific treatment for at least 12 months

Secondary Outcome Measures
NameTimeMethod
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