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Mucorales PCR Screening in At-risk Hematology Patients

Not Applicable
Recruiting
Conditions
Mucormycosis
Registration Number
NCT05925660
Lead Sponsor
Universitaire Ziekenhuizen KU Leuven
Brief Summary

Patients with leukemia are treated with intensive chemotherapy and often have to undergo a stem cell transplantation which makes their immune system extremely vulnerable. This puts them at risk for invasive fungal infections, of which invasive mucormycosis (IM) is one of the most dangerous ones. Treatment of IM is complex and mortality rates are still extremely high, ranging from 40% to 80% and sometimes even higher if the central nervous system is involved. Mucormycosis requires immediate intervention due to the rapidly progressive and destructive nature of the infection. But the diagnosis is often made too late...

Better survival can be achieved with a faster diagnosis. A new test has recently been developed for detection of Mucorales DNA by PCR. The polymerase chain reaction (PCR) is a method that allows to quickly make millions of copies of, for example, Mucorales DNA in order to detect it in the blood at an early stage. Because blood can easily be obtained, without an additional burden on the patient, the test could be interesting for screening for these infections, which then offers the opportunity to start an adequate treatment more quickly.

However, the test is now only performed if there is a clinical suspicion of IM. But at that point, precious time has already been lost, and often the patient can no longer be cured. In this study the utility of the Mucorales PCR as a possible screening test in at-risk patients is assessed. The participants, hospitalised patients with leukemia, will be screened twice weekly with a Mucorales PCR test during their most vulnerable period. If the study shows that the test helps in diagnosing IM faster, this could have an important impact on the treatment and survival of these at-risk patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Underlying disease:

    • Start of remission induction chemotherapy for acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) that is newly diagnosed or in first relapse after hematological remission lasting for a minimum duration of 6 months; OR
    • Start of myeloablative conditioning regimen to prepare for a first allogeneic hematopoietic cell transplantation (HCT).
  • Expected prolonged neutropenia (ANC< 0.5 x 109 /L for ≥ 7 days).

  • Planned hospital admission for the duration of the neutropenic phase.

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Incidence of a positive Mucorales PCR screening test3 months
Secondary Outcome Measures
NameTimeMethod
Incidence of invasive mucormycosis3 months
Outcome of patients with a positive Mucorales PCR versus these without: death or survival at 3 months3 months
Number of days antifungal therapy was given (amphotericin B, azoles)3 months
Was antifungal therapy started based on Mucorales PCR result? Y/N3 months
Incidence of invasive aspergillosis and invasive mucormycosis coinfections3 months
Was antifungal therapy stopped based on Mucorales PCR result? Y/N3 months

Trial Locations

Locations (1)

University Hospitals Leuven

🇧🇪

Leuven, Vlaams-Brabant, Belgium

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