Document Detail


Design of the silent cerebral infarct transfusion (SIT) trial.
MedLine Citation:
PMID:  20201689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Silent cerebral infarct (SCI) is the most common cause of serious neurological disease in sickle cell anemia (SCA), affecting approximately 22% of children. The goal of this trial is to determine whether blood transfusion therapy will reduce further neurological morbidity in children with SCI, and if so, the magnitude of this benefit.
PROCEDURE: The Silent Cerebral Infarct Transfusion (SIT) Trial includes 29 clinical sites and 3 subsites, a Clinical Coordinating Center, and a Statistical and Data Coordinating Center, to test the following hypothesis: prophylactic blood transfusion therapy in children with SCI will result in at least an 86% reduction in the rate of subsequent overt strokes or new or progressive cerebral infarcts as defined by magnetic resonance imaging (MRI) of the brain. The intervention is blood transfusion versus observation. Two hundred and four participants (102 in each treatment assignment) will ensure 85% power to detect the effect necessary to recommend transfusion therapy (86% reduction), after accounting for 10% drop out and 19% crossover rates. MRI examination of the brain is done at screening, immediately before randomization and study exit. Each randomly assigned participant receives a cognitive test battery at study entry, 12-18 months later, and study exit and an annual neurological examination. Blood is obtained from all screened participants for a biologic repository containing serum and a renewable source of DNA.
CONCLUSION: The SIT Trial could lead to a change in standard care practices for children affected with SCA and SCI, with a consequent reduction in neurological morbidity.
Authors:
James F Casella; Allison A King; Bruce Barton; Desiree A White; Michael J Noetzel; Rebecca N Ichord; Cindy Terrill; Deborah Hirtz; Robert C McKinstry; John J Strouse; Thomas H Howard; Thomas D Coates; Caterina P Minniti; Andrew D Campbell; Bruce A Vendt; Harold Lehmann; Michael R Debaun
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Pediatric hematology and oncology     Volume:  27     ISSN:  1521-0669     ISO Abbreviation:  Pediatr Hematol Oncol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-05-24     Revised Date:  2011-01-31    
Medline Journal Info:
Nlm Unique ID:  8700164     Medline TA:  Pediatr Hematol Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-89     Citation Subset:  IM    
Affiliation:
Pediatric Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. jcasella@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Anemia, Sickle Cell / complications*
Blood Transfusion*
Cerebral Infarction / complications*,  prevention & control,  therapy*
Child
Humans
Magnetic Resonance Imaging
Research Design
Stroke / complications,  prevention & control,  therapy
Grant Support
ID/Acronym/Agency:
K23 HL078819-03/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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