Quality of Life-Guided Transfusion in Refractory MDS or AML (Q-TRANS)
Quality of Life-based Transfusion in Refractory MDS or AML Under Advanced Palliative Care and Supportive Treatment.
Patients with refractory myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) in exclusive palliative care frequently receive red blood cell transfusions based on hemoglobin thresholds, despite limited evidence of clinical benefit in this setting.
This prospective randomized study compares a standard hemoglobin-based transfusion strategy to a quality-of-life-guided strategy using the EQ-5D-5L questionnaire, with the aim of reducing transfusion burden while maintaining patient safety and quality of life.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is a prospective, single-center, randomized interventional study conducted in patients with transfusion-dependent refractory MDS or AML receiving exclusive palliative care. Palliative Care
Patients are randomized to either a standard transfusion strategy based on hemoglobin thresholds or a quality-of-life-guided strategy in which red blood cell transfusions are triggered by a clinically significant deterioration in EQ-5D-5L score.
The study aims to evaluate whether a quality-of-life-guided transfusion strategy can safely reduce the number of red blood cell transfusions without negatively impacting patient-reported outcomes.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Thomas Cluzeau, Professor
- Phone Number: 0492039025
- Email: cluzeau.t@chu-nice.fr
Study Contact Backup
- Name: Lydia Cherfaoui
- Phone Number: 0492039025
- Email: cherfaoui.l@chu-nice.fr
Study Locations
-
-
-
Nice, France, 06000
- Recruiting
- CHU de Nice
-
Contact:
- Lydia Cherfaoui
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults aged 18 years and older.
- Diagnosis of refractory MDS or AML, receiving palliative care only.
- Anaemia with haemoglobin ≤ 8 g/dl at inclusion (or ≤ 9 g/dl if associated with cardiovascular disease).
- Transfusion dependency, defined as requiring more than 2 GR transfusions every 8 weeks.
- No vitamin B9, vitamin B12 or iron deficiency.
- Ability to understand and sign the informed consent form.
- Ability to comply with the schedule of visits and other protocol requirements.
Non inclusion Criteria:
- Previous malignant disease other than MDS or AML (except basal cell or squamous cell carcinoma or carcinoma in situ of the cervix or breast).
- Active uncontrolled infection (hepatitis B or C, HIV).
- Use of G-CSF.
- Confirmed neurocognitive disorders (based on prior diagnosis or clinical assessment by the investigator) impairing comprehension, consent or the ability to reliably complete the EQ-5D-5L questionnaire.
- Active uncontrolled heart disease.
- Active haemolytic anaemia.
- Recent major surgery.
- Life-threatening complications of MDS/AML.
- Presence of another serious or unstable disease which, in the investigators' opinion, would make participation in the study inappropriate or risky for the patient's safety.
- Vulnerable individuals.
Exclusion Criteria:
- Immediate severe complications related to MDS/AML, such as uncontrolled bleeding, pneumonia with hypoxia or shock, or severe disseminated intravascular coagulopathy.
- Withdrawal of the patient's voluntary informed consent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Hemoglobin-Based Transfusion Strategy
Red blood cell transfusions are performed according to standard hemoglobin thresholds (Hb <7 g/dL, or <8 g/dL in patients with cardiovascular comorbidities).
Standard of care arm
|
|
|
Experimental: Quality of Life-Guided Transfusion Strategy
Red blood cell transfusions are performed when a clinically significant deterioration (≥1 level decrease in at least one EQ-5D-5L domain compared to baseline) is observed
|
Red blood cell transfusions are administered based on patient-reported quality-of-life assessments using the EQ-5D-5L questionnaire, collected weekly.
A transfusion is performed when a deterioration of at least one level in any EQ-5D-5L dimension is observed.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Red Blood Cell Transfusions
Time Frame: 2 months
|
Total number of red blood cell units transfused during the 2-month follow-up period.
|
2 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quality of Life (EQ-5D-5L)
Time Frame: from baseline to 1 month and 2 months.
|
Change in quality-of-life scores
|
from baseline to 1 month and 2 months.
|
|
Overall Survival
Time Frame: from inclusion to 2 months
|
Survival status
|
from inclusion to 2 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Thomas Cluzeau, Centre Hospitalier Universitaire de Nice
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 25-AOI-02
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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