Mirasol-Treated Platelets - (Pathogen Reduction Extended Storage Study) (PRESS)

PRESS Pathogen Reduction Extended Storage Study PRESS (Pathogen Reduction Extended Storage Study) A Pilot Study of Mirasol Platelets Treated in Platelet Additive Solution in Thrombocytopenic Patients

The PRESS trial is a single-center, two-part, randomized cross-over pilot study in Copenhagen that will evaluate 1) the safety and performance of Mirasol-treated and untreated platelet products stored for 2-4 days and for 7-days in Platelet Additive Solution (PAS) and 2) the correlation between the TEG® parameters and platelet count increments after platelet transfusions in thrombocytopenic subjects.

Study Overview

• Status: Terminated
• Conditions: Thrombocytopenia
• Intervention / Treatment: Biological: 2-4-day-old Mirasol-treated Platelets Transfusion; Biological: 2-4-day-old Untreated Platelets Transfusion

Detailed Description

1. To evaluate in thrombocytopenic subjects the efficacy and safety of platelets treated with Mirasol Pathogen Reduction Technology (PRT) in Platelet Additive Solution. The following safety and efficacy measures will be compared between Mirasol treated and untreated platelets stored for 2-4 days and stored for 7 days:

   • Thrombelastography (TEG®) parameters: reaction time R, alpha angle α and maximal amplitude (MA)
   • Platelet Count Increment and Corrected Count Increment
   • Time to next platelet transfusion
   • Incidence of transfusion related (serious) adverse events
   • Incidence and severity of bleedings
2. To evaluate the use of the TEG® parameters as a measure for platelet transfusion efficacy and to evaluate the correlation between the TEG® parameters and the platelet Corrected Count Increments after platelet transfusions in thrombocytopenic subjects.

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Phase 2; Phase 3

Contacts and Locations

Study Locations

• Denmark
  • Blegdamsvej
    • Copenhagen, Blegdamsvej, Denmark, 2100
      • Hematology Service Rigshospitalet

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male or female of age of 18 years or older.
• Have thrombocytopenia or expected to develop thrombocytopenia requiring at least 3 platelet transfusions.
• Woman of child bearing potential must have a negative serum or urine pregnancy test within 72 hours before randomization.
• Subjects must have signed and dated the Informed Consent Form before performing any protocol related procedure.

Exclusion Criteria:

• History of any hypersensitivity reaction to riboflavin or metabolites.
• History of refractoriness to platelet transfusions (defined as 2 successive CCI1hr<5000) or presence of human leukocyte antigen (HLA) antibodies or positive lymphocytotoxicity or previously documented alloimmunization.
• Previous exposure to PRT-treated platelet concentrates.
• Active bleeding requiring one or more red cells concentrate transfusions (i.e. grade 3 or 4 bleeding according to the WHO bleeding assessment scale in Appendix 1).
• Exposure to an investigational product, within 30 days before randomization.
• Splenomegaly (presence of a palpable spleen whose border could be felt more than 4 cm below the costal margin) or splenectomy.
• History or diagnosis of Immune/Idiopathic Thrombocytopenic Purpura (ITP), Thrombotic Thrombocytopenia Purpura (TTP), or Haemolytic Uremic Syndrome (HUS).
• Use of prohibited medication (see section 5.5).
• Pregnant or lactating females.
• Any medical condition or treatment that would be expected to compromise the effectiveness of a platelet transfusion or that would interfere with an expected platelet count increment.
• Any other medical condition that would compromise the participation of the subject in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Mirasol first, then Reference; This study arm will receive first a 2-4-day-old Mirasol-treated platelets transfusion and then a reference 2-4-day-old untreated platelets transfusion (Mirasol-Reference sequence).	Biological: 2-4-day-old Mirasol-treated Platelets Transfusion; 2-4-day-old Mirasol-treated Platelets Units with: Platelet yield between 2.4x10e11 and 4.5x10e11; Plasma carryover of >32%; Cell count > 800x103/µL; Other Names: PRT; Mirasol; Pathogen Reduction; Biological: 2-4-day-old Untreated Platelets Transfusion; 2-4-day-old Untreated Platelets Units with: Platelet yield between 2.4x10e11 and 4.5x10e11; Plasma carryover of >32%; Cell count > 800x103/µL
Active Comparator: Reference first, then Mirasol; This study arm will receive first a reference 2-4-day-old untreated platelets transfusion and then a 2-4-day-old Mirasol-treated platelets transfusion (Reference-Mirasol sequence).	Biological: 2-4-day-old Mirasol-treated Platelets Transfusion; 2-4-day-old Mirasol-treated Platelets Units with: Platelet yield between 2.4x10e11 and 4.5x10e11; Plasma carryover of >32%; Cell count > 800x103/µL; Other Names: PRT; Mirasol; Pathogen Reduction; Biological: 2-4-day-old Untreated Platelets Transfusion; 2-4-day-old Untreated Platelets Units with: Platelet yield between 2.4x10e11 and 4.5x10e11; Plasma carryover of >32%; Cell count > 800x103/µL

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Maximum Amplitude at 1-hour Post-transfusion	Thromboelastography (TEG) Parameter: Pre- to post-transfusional modification of Maximum Amplitude at 1-hour post-transfusion	pre-transfusion, 1-hour post transfusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Maximum Amplitude at 24-hours Post-transfusion	Thromboelastography parameter: Pre- to post-transfusional modification in Maximum Amplitude at 24-hours post-transfusion	pre-transfusion, 24-hour post transfusion

Collaborators and Investigators

• Sponsor: Terumo BCTbio
• Investigators: Principal Investigator: Pär Johansson, MD, Transfusion Service Rigshospitalet - Dept of Immunology, Copenhagen Denmark; Principal Investigator: Lene Udby, MD, Hematology Service Rigshospitalet, Copenhagen Denmark

Publications and helpful links

General Publications

• Johansson PI, Simonsen AC, Brown PN, Ostrowski SR, Deberdt L, Van Hoydonck P, Yonemura SS, Goodrich RP. A pilot study to assess the hemostatic function of pathogen-reduced platelets in patients with thrombocytopenia. Transfusion. 2013 Sep;53(9):2043-52. doi: 10.1111/trf.12055. Epub 2012 Dec 24.

Study record dates

Study Major Dates

• Study Start: September 1, 2010
• Primary Completion (Actual): April 1, 2011
• Study Completion (Actual): May 1, 2011

Study Registration Dates

• First Submitted: June 6, 2011
• First Submitted That Met QC Criteria: June 6, 2011
• First Posted (Estimate): June 7, 2011

Study Record Updates

• Last Update Posted (Estimate): June 28, 2016
• Last Update Submitted That Met QC Criteria: May 23, 2016
• Last Verified: May 1, 2016

More Information

Terms related to this study

• Keywords: Platelets; Thromboelastography; Corrected Count Increment; Thrombocytopenic; Mirasol; CCI; Pathogen reduction
• Additional Relevant MeSH Terms: Hematologic Diseases; Blood Platelet Disorders; Thrombocytopenia
• Other Study ID Numbers: CTS-0063