- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02064933
Patients Treated for Wiskott-Aldrich Syndrome (WAS) Since 1990
Analysis of Patients Treated for Wiskott-Aldrich Syndrome Since January 1, 1990 (RDCRN PIDTC-6904)
Wiskott - Aldrich syndrome (WAS) is a rare serious medical condition that causes problems both with the immune system and with easy bruising and bleeding. The immune abnormalities cause patients with WAS to be very susceptible to infections. Depending on the specific type of primary immune deficiency diseases, there are effective treatments, including antibiotics, cellular therapy and gene therapy, but studies of large numbers of patients are needed to determine the full range of causes, natural history, or the best methods of treatment for long term success.
This multicenter study combines retrospective, prospective and cross-sectional analyses of the transplant experiences for patients with WAS who have already received HCT since 1990, or who will undergo Hematopoietic cell transplant (HCT) during the study period. The retrospective and prospective portions of the study will address the impact of a number of pre and post-transplant factors on post-transplant disease correction and ultimate benefit from HCT and the cross-sectional portion of the study will assess the benefit of HCT 2 years post-HCT in consenting surviving patients.
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Alberta
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Calgary, Alberta, Canada, T3B 6A8
- Alberta Children's Hospital
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British Columbia
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Vancouver, British Columbia, Canada, V6H 3V4
- Children's & Women's Health Centre of British Columbia
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Manitoba
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Winnipeg, Manitoba, Canada, R3E 0V9
- Cancer Care Manitoba, University of Manitoba
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Ontario
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Toronto, Ontario, Canada, M5G 1XB
- The Hospital for Sick Children
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Quebec
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Montreal, Quebec, Canada, H3T 1C5
- CHU Sainte-Justine, Department of Pediatrics, University of Montreal
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Alabama
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Birmingham, Alabama, United States, 35233
- Department of Pediatrics, University of Alabama at Birmingham
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Arizona
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Phoenix, Arizona, United States, 85016
- Phoenix Children's Hospital
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California
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Los Angeles, California, United States, 90027
- Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California
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Los Angeles, California, United States, 90095-1752
- Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles,
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Palo Alto, California, United States, 94304
- Lucile Salter Packard Children's Hospital at Stanford
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San Francisco, California, United States, 94143-1278
- University of California, San Francisco Benioff Children's Hospital
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Colorado
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Denver, Colorado, United States, 80220
- Children's Hospital Denver, University of Colorado
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Delaware
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Wilmington, Delaware, United States, 19803
- Nemours Alfred I. Dupont Hospital for Children
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District of Columbia
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Washington, District of Columbia, United States, 20010-2970
- Children's National Hospital-George Washington University School of Medicine and Health Sciences
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Florida
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Saint Petersburg, Florida, United States, 33701
- Blood and Marrow Transplant Program, Johns Hopkins All Children's Hospital
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Georgia
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Atlanta, Georgia, United States, 30322
- Aflac Cancer and Blood Disorders Center, Emory/Children's Healthcare of Atlanta
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Illinois
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Chicago, Illinois, United States, 60614
- Ann & Robert H. Lurie Children's Hospital of Chicago
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Louisiana
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New Orleans, Louisiana, United States, 70118
- Center for Cancer and Blood Disorders, Children's Hospital/Louisiana State University
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Massachusetts
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Boston, Massachusetts, United States, 02115
- Boston Children's Hospital
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Michigan
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Ann Arbor, Michigan, United States, 48109
- Department of Pediatrics, C. S. Mott Children's Hospital, University of Michigan
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Minnesota
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Minneapolis, Minnesota, United States, 55455
- Division of Pediatric Blood and Marrow Transplantation, University of Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic Children's Center
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Missouri
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Saint Louis, Missouri, United States, 63104
- Cardinal Glennon Children's Hospital, Saint Louis University
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Saint Louis, Missouri, United States, 63110
- Saint Louis Children's Hospital, Washington University
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New Jersey
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Hackensack, New Jersey, United States, 07601
- Institute for Pediatric Cancer and Blood Disorders, Hackensack University Medical Center
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New York
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New York, New York, United States, 10065
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center
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Rochester, New York, United States, 14642
- Department of Pediatrics, Golisano Children's Hospital, University of Rochester
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Valhalla, New York, United States, 10595
- Maria Fareri Children's Hospital, New York Medical College
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University Medical Center
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Ohio
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Cincinnati, Ohio, United States, 45229-3039
- Cincinnati Children's Hospital Medical Center, University of Cincinnati
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Cleveland, Ohio, United States, 44106
- Rainbow Babies and Children's Hospital
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Columbus, Ohio, United States, 43205
- Nationwide Children's Hospital
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Oregon
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Portland, Oregon, United States, 97239
- Division of Pediatric Hematology/Oncology, Oregon Health and Science University
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Children's Hospital of Philadelphia, University of Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15224
- University of Pittsburgh Children's Hospital of Pittsburgh
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Tennessee
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Memphis, Tennessee, United States, 38105
- St. Jude Children's Research Hospital
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Texas
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Dallas, Texas, United States, 75390-9263
- Pediatrics, University of Texas Southwestern Medical Center
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Houston, Texas, United States, 77030-2399
- Baylor College of Medicine Section of Immunology, Allergy, and Retrovirology, Texas Children's Hospital
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San Antonio, Texas, United States, 78229
- Texas Transplant Institute, Methodist Children's Hospital
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Utah
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Salt Lake City, Utah, United States, 84113
- Primary Children's Hospital, University of Utah
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Washington
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Seattle, Washington, United States, 98109
- Fred Hutchinson Cancer Research Center and University of Washington-Seattle Children's Hospital
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Wisconsin
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Madison, Wisconsin, United States, 53705-2275
- American Family Children's Hospital, University of Wisconsin
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Milwaukee, Wisconsin, United States, 53226
- Children's Hospital of Wisconsin-Milwaukee
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
WAS participants will be defined as males who have:
- thrombocytopenia (< 100K) AND EITHER molecular diagnosis of WAS OR reduced WASP expression; OR
- thrombocytopenia (< 100K) AND positive family history consistent with WAS diagnosis; OR
- chronic thrombocytopenia (< 100K for minimum of 3 months) AND low mean platelet volume (MPV below normal range for age) AND EITHER recurrent and/or severe infections requiring treatment and/or eczema OR lack of antibody response to polysaccharide antigens or low IgM.
Longitudinal Analysis (Retrospective and Prospective)
Stratum A. Participants with WAS who have or will Receive HCT
- Participants with WAS who have received an HCT since January 1, 1990
Stratum B. Participants with WAS who have or will Receive Gene Transfer
- Participants in which the intention is to treat with gene transfer with autologous modified cells
- Cross-Sectional Analysis (Strata A and B) 1. Participants with WAS who are surviving and at least 2 years after the most recent HCT or gene therapy.
Exclusion Criteria:
- As this is a natural history study, for both the Longitudinal Analysis and the Cross-Sectional Analysis we will not exclude any patients due to race or age who fit the inclusion criteria.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
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Retrospective Cohort (Longitudinal Analysis)
Participants with WAS treated at consortium centers since 1990 who have received transplant (Stratum A) or gene therapy (Stratum B)
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Prospective Cohort (Longitudinal Analysis)
Participants treated at consortium centers since 1990 who will receive transplant (Stratum A) or gene therapy (Stratum B)
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Cross-Sectional Cohort (Cross-sectional Analysis)
Living participants with WAS who have received transplant (Stratum A) or gene therapy (Stratum B) at Consortium Centers 1990-Present And >= 2 Years Post-Transplant
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Longitudinal Analysis: Overall Survival From Time of HCT/Gene Therapy
Time Frame: an expected average of 5 years
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The event analyzed is death from any cause.
The time to this event is the time from HCT/gene therapy to death or last follow-up.
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an expected average of 5 years
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Cross-Sectional Analysis: Proportion of Participants Achieving Full T Cell Reconstitution
Time Frame: an expected average of 5 years
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Full T cell reconstitution is defined by all of the following:
When possible the proliferation to PHA should be calculated as a percentage of the lower limit of normal controls for that laboratory; alternatively, the lower limit of normal controls for the day may be used |
an expected average of 5 years
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Cross-Sectional Analysis: Proportion of Participants Achieving Full B Cell Reconstitution
Time Frame: an expected average of 5 years
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Full B cell reconstitution is defined by all of the following:
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an expected average of 5 years
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Cross-Sectional Analysis: Proportion of Participants Achieving Resolution of thrombocytopenia
Time Frame: an expected average of 5 years
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Resolution of thrombocytopenia defined by Platelets ≥ 150,000/microliter (transfusion independent for at least 7 consecutive days)
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an expected average of 5 years
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Cross-Sectional Analysis: Day of Recovery of Absolute Neutrophil Count (ANC) to 500 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Absolute Neutrophil Count (ANC) to 500 / uL is defined as the first day of at least 3 different days the ANC is measured as 500 / uL or greater
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an expected average of 5 years
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Cross-sectional Analysis: Day of Recovery of Platelet Count to 20,000 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Platelet Count to 20,000 / uL is defined as the first day of at least 3 laboratory values obtained on different days where the platelet count was measured as 20,000 / uL or greater, AND without platelet transfusions for at least 7 consecutive days immediately preceding this day.
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an expected average of 5 years
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Cross-sectional Analysis: Day of Recovery of Platelet Count to 50,000 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Platelet Count to 50,000 / uL is defined as the first day of at least 3 laboratory values obtained on different days where the platelet count was measured as 50,000 / uL or greater, AND without platelet transfusions for at least 7 consecutive days immediately preceding this day.
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an expected average of 5 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Longitudinal Analysis: Proportion of Participants Achieving Hematologic Reconstitution
Time Frame: an expected average of 5 years
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Hematologic Reconstitution is defined as attainment of each of the following lab test values:
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an expected average of 5 years
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Longitudinal Analysis: Day of Recovery of Absolute Neutrophil Count (ANC) to 500 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Absolute Neutrophil Count (ANC) to 500 / uL is defined as the first day of at least 3 different days the ANC is measured as 500 / uL or greater.
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an expected average of 5 years
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Longitudinal Analysis: Day of Recovery of Platelet Count to 20,000 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Platelet Count to 20,000 / uL is defined as the first day of at least 3 laboratory values obtained on different days where the platelet count was measured as 20,000 / uL or greater, AND without platelet transfusions for at least 7 consecutive days immediately preceding this day.
|
an expected average of 5 years
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Longitudinal Analysis: Day of Recovery of Platelet Count to 50,000 / uL
Time Frame: an expected average of 5 years
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Day of Recovery of Platelet Count to 50,000 / uL is defined as the first day of at least 3 laboratory values obtained on different days where the platelet count was measured as 50,000 / uL or greater, AND without platelet transfusions for at least 7 consecutive days immediately preceding this day.
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an expected average of 5 years
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Longitudinal Analysis: Proportion of Participants Achieving Full T Cell Immune Reconstitution
Time Frame: an expected average of 5 years
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an expected average of 5 years
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Longitudinal Analysis: Proportion of Participants Achieving Full B Cell Immune Reconstitution
Time Frame: an expected average of 5 years
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an expected average of 5 years
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Longitudinal Analysis: State of Lineage Specific Chimerism (HCT Stratum)
Time Frame: an expected average of 5 years
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Peripheral blood chimerism will be assessed by FISH XX/XY, STRs, or WASP expression.
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an expected average of 5 years
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Longitudinal Analysis: Definition of Graft Failure / Rejection
Time Frame: an expected average of 5 years
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Failure to achieve ≥5% donor cells in all lineages or in whole blood by 100 days post-HCT will be defined as graft failure/rejection. Patients who receive a second transplant by day 100 will be considered graft failure. |
an expected average of 5 years
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Longitudinal Analysis: Severe bleeding episodes
Time Frame: an expected average of 5 years
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Any severe bleeding episode requiring platelet and/or RBC transfusion(s)
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an expected average of 5 years
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Longitudinal Analysis: Malignancy
Time Frame: an expected average of 5 years
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New onset or relapse of lymphoid malignancy confirmed by relevant pathologic and genetic features.
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an expected average of 5 years
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Longitudinal Analysis: Growth
Time Frame: an expected average of 5 years
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Z score of weight and height pre-HCT/gene therapy and post-HCT/gene therapy.
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an expected average of 5 years
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Longitudinal Analysis: Incidence of Acute GVHD
Time Frame: an expected average of 5 years
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The occurrence of skin, gastrointestinal or liver abnormalities fulfilling the Consensus criteria of Grades IIIV or grades III-IV acute GVHD1 are considered events.
Death is a competing risk, and patients alive without acute GVHD will be censored at the time of last follow-up.
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an expected average of 5 years
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Longitudinal Analysis: Incidence of Chronic GVHD
Time Frame: an expected average of 5 years
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Chronic GVHD will be graded as limited or extensive.2
Occurrence of symptoms in any organ system that meet the criteria of chronic GVHD will be recorded.
Death is a competing risk, and patients alive without chronic GVHD will be censored at time of last follow-up.
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an expected average of 5 years
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Longitudinal Analysis: Autoimmunity disorders
Time Frame: an expected average of 5 years
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Incidence of documented autoimmunity disorders
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an expected average of 5 years
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Longitudinal Analysis: Infections / blood borne infections
Time Frame: an expected average of 5 years
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an expected average of 5 years
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Cross-sectional Analysis: Current State of Lineage Specific Chimerism (HCT Stratum)
Time Frame: an expected average of 5 years
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Peripheral blood donor chimerism will be assessed by FISH XX/XY, STR, and/or WASP expression
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an expected average of 5 years
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Cross-sectional Analysis: Current frequency and severity of infections
Time Frame: an expected average of 5 years
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an expected average of 5 years
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Cross-sectional Analysis: Current Status of Growth
Time Frame: an expected average of 5 years
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Current Z score of weight and height pre-HCT/gene therapy and post-HCT/gene therapy.
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an expected average of 5 years
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Cross-Sectional Analysis: Graft-versus-host Disease (GvHD)
Time Frame: an expected average of 5 years
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Presence of chronic GVHD, current assessment; graded as limited or extensive
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an expected average of 5 years
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Cross-Sectional Analysis: Autoimmunity Disorders
Time Frame: an expected average of 5 years
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Presence of autoimmunity disorders
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an expected average of 5 years
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Cross-sectional Analysis: Severe Bleeding Episodes
Time Frame: an expected average of 5 years
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Any severe bleeding episode requiring platelet and/or RBC transfusion(s) during the previous year.
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an expected average of 5 years
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Cross-sectional Analysis: fertility
Time Frame: an expected average of 5 years
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Whether the subject has biological offspring will be recorded.
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an expected average of 5 years
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Cross-sectional Analysis: malignancy
Time Frame: an expected average of 5 years
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New onset or relapse of lymphoid malignancy confirmed by relevant pathologic and genetic features.
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an expected average of 5 years
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Cross-sectional Analysis: Quality of Life Questionnaire
Time Frame: an expected average of 5 years
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Age appropriate testing will be performed at the cross-sectional visit inpatients surviving at least two years post-transplant
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an expected average of 5 years
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Collaborators and Investigators
Collaborators
Investigators
- Study Chair: Lauri M. Burroughs, MD, Fred Hutchinson Cancer Center
- Study Chair: David J. Rawlings, MD, Department of Pediatrics, University of Washington-Seattle Children's Hospital
- Study Chair: Luigi D. Notarangelo, MD, National Institute of Allergy and Infectious Diseases, NIH
- Study Chair: Alexandra H. Filipovich, MD, Children's Hospital Medical Center, Cincinnati
Publications and helpful links
General Publications
- Griffith LM, Cowan MJ, Kohn DB, Notarangelo LD, Puck JM, Schultz KR, Buckley RH, Eapen M, Kamani NR, O'Reilly RJ, Parkman R, Roifman CM, Sullivan KE, Filipovich AH, Fleisher TA, Shearer WT. Allogeneic hematopoietic cell transplantation for primary immune deficiency diseases: current status and critical needs. J Allergy Clin Immunol. 2008 Dec;122(6):1087-96. doi: 10.1016/j.jaci.2008.09.045. Epub 2008 Nov 6.
- Griffith LM, Cowan MJ, Notarangelo LD, Kohn DB, Puck JM, Pai SY, Ballard B, Bauer SC, Bleesing JJ, Boyle M, Brower A, Buckley RH, van der Burg M, Burroughs LM, Candotti F, Cant AJ, Chatila T, Cunningham-Rundles C, Dinauer MC, Dvorak CC, Filipovich AH, Fleisher TA, Bobby Gaspar H, Gungor T, Haddad E, Hovermale E, Huang F, Hurley A, Hurley M, Iyengar S, Kang EM, Logan BR, Long-Boyle JR, Malech HL, McGhee SA, Modell F, Modell V, Ochs HD, O'Reilly RJ, Parkman R, Rawlings DJ, Routes JM, Shearer WT, Small TN, Smith H, Sullivan KE, Szabolcs P, Thrasher A, Torgerson TR, Veys P, Weinberg K, Zuniga-Pflucker JC; workshop participants. Primary Immune Deficiency Treatment Consortium (PIDTC) report. J Allergy Clin Immunol. 2014 Feb;133(2):335-47. doi: 10.1016/j.jaci.2013.07.052. Epub 2013 Oct 15.
- Griffith LM, Cowan MJ, Notarangelo LD, Kohn DB, Puck JM, Shearer WT, Burroughs LM, Torgerson TR, Decaluwe H, Haddad E; workshop participants. Primary Immune Deficiency Treatment Consortium (PIDTC) update. J Allergy Clin Immunol. 2016 Aug;138(2):375-85. doi: 10.1016/j.jaci.2016.01.051. Epub 2016 Apr 22.
- Pai SY, Logan BR, Griffith LM, Buckley RH, Parrott RE, Dvorak CC, Kapoor N, Hanson IC, Filipovich AH, Jyonouchi S, Sullivan KE, Small TN, Burroughs L, Skoda-Smith S, Haight AE, Grizzle A, Pulsipher MA, Chan KW, Fuleihan RL, Haddad E, Loechelt B, Aquino VM, Gillio A, Davis J, Knutsen A, Smith AR, Moore TB, Schroeder ML, Goldman FD, Connelly JA, Porteus MH, Xiang Q, Shearer WT, Fleisher TA, Kohn DB, Puck JM, Notarangelo LD, Cowan MJ, O'Reilly RJ. Transplantation outcomes for severe combined immunodeficiency, 2000-2009. N Engl J Med. 2014 Jul 31;371(5):434-46. doi: 10.1056/NEJMoa1401177.
- Haddad E, Allakhverdi Z, Griffith LM, Cowan MJ, Notarangelo LD. Survey on retransplantation criteria for patients with severe combined immunodeficiency. J Allergy Clin Immunol. 2014 Feb;133(2):597-9. doi: 10.1016/j.jaci.2013.10.022. Epub 2013 Dec 10. No abstract available.
- Shearer WT, Dunn E, Notarangelo LD, Dvorak CC, Puck JM, Logan BR, Griffith LM, Kohn DB, O'Reilly RJ, Fleisher TA, Pai SY, Martinez CA, Buckley RH, Cowan MJ. Establishing diagnostic criteria for severe combined immunodeficiency disease (SCID), leaky SCID, and Omenn syndrome: the Primary Immune Deficiency Treatment Consortium experience. J Allergy Clin Immunol. 2014 Apr;133(4):1092-8. doi: 10.1016/j.jaci.2013.09.044. Epub 2013 Nov 28.
- Dvorak CC, Cowan MJ, Logan BR, Notarangelo LD, Griffith LM, Puck JM, Kohn DB, Shearer WT, O'Reilly RJ, Fleisher TA, Pai SY, Hanson IC, Pulsipher MA, Fuleihan R, Filipovich A, Goldman F, Kapoor N, Small T, Smith A, Chan KW, Cuvelier G, Heimall J, Knutsen A, Loechelt B, Moore T, Buckley RH. The natural history of children with severe combined immunodeficiency: baseline features of the first fifty patients of the primary immune deficiency treatment consortium prospective study 6901. J Clin Immunol. 2013 Oct;33(7):1156-64. doi: 10.1007/s10875-013-9917-y. Epub 2013 Jul 2.
- Griffith LM, Cowan MJ, Notarangelo LD, Puck JM, Buckley RH, Candotti F, Conley ME, Fleisher TA, Gaspar HB, Kohn DB, Ochs HD, O'Reilly RJ, Rizzo JD, Roifman CM, Small TN, Shearer WT; Workshop Participants. Improving cellular therapy for primary immune deficiency diseases: recognition, diagnosis, and management. J Allergy Clin Immunol. 2009 Dec;124(6):1152-60.e12. doi: 10.1016/j.jaci.2009.10.022.
- Burroughs LM, Petrovic A, Brazauskas R, Liu X, Griffith LM, Ochs HD, Bleesing JJ, Edwards S, Dvorak CC, Chaudhury S, Prockop SE, Quinones R, Goldman FD, Quigg TC, Chandrakasan S, Smith AR, Parikh S, Davila Saldana BJ, Thakar MS, Phelan R, Shenoy S, Forbes LR, Martinez C, Chellapandian D, Shereck E, Miller HK, Kapoor N, Barnum JL, Chong H, Shyr DC, Chen K, Abu-Arja R, Shah AJ, Weinacht KG, Moore TB, Joshi A, DeSantes KB, Gillio AP, Cuvelier GDE, Keller MD, Rozmus J, Torgerson T, Pulsipher MA, Haddad E, Sullivan KE, Logan BR, Kohn DB, Puck JM, Notarangelo LD, Pai SY, Rawlings DJ, Cowan MJ. Excellent outcomes following hematopoietic cell transplantation for Wiskott-Aldrich syndrome: a PIDTC report. Blood. 2020 Jun 4;135(23):2094-2105. doi: 10.1182/blood.2019002939.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Immunologic Deficiency Syndromes
- Immune System Diseases
- Disease
- Hematologic Diseases
- Blood Coagulation Disorders, Inherited
- Hemorrhagic Disorders
- Genetic Diseases, Inborn
- Genetic Diseases, X-Linked
- Blood Coagulation Disorders
- Leukopenia
- Leukocyte Disorders
- Primary Immunodeficiency Diseases
- Lymphopenia
- Syndrome
- Wiskott-Aldrich Syndrome
Other Study ID Numbers
- DAIT RDCRN PIDTC-6904
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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