Evaluation of the AMICUS RBCx System in Sickle Cell Patients

Evaluation of the AMICUS Red Blood Cell Exchange (RBCx) System in Sickle Cell Patients

The purpose of this study is to evaluate the performance of the AMICUS Red Blood Cell Exchange (RBCx) System (Exchange and Depletion/Exchange procedures) in patients with sickle cell disease.

Study Overview

• Status: Completed
• Conditions: Sickle Cell Anemia
• Intervention / Treatment: Device: Amicus Red Cell Exchange in SCD patients

Detailed Description

The goal of Red Blood Cell Exchange is to remove a patient's red blood cells (RBCs) and replace the blood volume removed with either healthy donor RBCs and/or colloid/crystalloid solutions. Depending on the RF used, the procedure can be considered an RBC Exchange or RBC Depletion/Exchange procedure. The RBC Depletion/Exchange procedure is a modification of the RBC Exchange procedure. The AMICUS RBCx protocol provides the ability to use various RFs including healthy donor RBCs or a combination of fluids, such as saline followed by RBCs. In RBC Exchange and the exchange portion of the RBC Depletion/Exchange procedures, RBC units are used as the RF, while colloid and/or crystalloid solutions are used as the RF in the depletion portion of the RBC Depletion/Exchange procedures. A new operating protocol on the AMICUS Separator that enables the device to perform Red Blood Cell Exchange (RBCx) procedures in accordance with the replacement fluid(s) (RF) prescribed by a physician for patients with sickle cell disease

• Study Type: Interventional
• Enrollment (Actual): 83
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85016
      • Phoenix Children's Hospital
  • Michigan
    • Detroit, Michigan, United States, 48201
      • Barbara Ann Karmanos Cancer Institute
  • Missouri
    • Saint Louis, Missouri, United States, 63110
      • Washington University
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • The Children's Hospital of Philadelphia
  • Texas
    • Dallas, Texas, United States, 75390
      • University of Texas Southwestern Medical Center
  • Wisconsin
    • Milwaukee, Wisconsin, United States, 53226
      • BloodCenter of Wisconsin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects with documented diagnosis of a type of sickle cell disorder who require RBC Exchange or RBC Depletion/Exchange treatment.
• Medically stable subjects who have been previously treated for sickle cell disease with RBC Exchange or RBC Depletion/Exchange.
• Subjects, or subject's legal representative, who have provided signed informed consent, and assent when applicable, prior to participation.
• Adequate availability of sickle trait negative, leukoreduced, Blood type (ABO) blood group, Rhesus factor D (Rh (D)) compatible, unexpired replacement RBC products.
• Subjects with sufficient vascular access to accommodate the RBCx procedure as determined by the medical staff responsible for obtaining intravenous access.
• Subjects who are able and agree to report adverse events (AEs) during the required reporting period.

Exclusion Criteria:

• Procedures that occur during acute hospitalization.
• Procedures prescribed within one week of discharge of a hospitalization.
• Subjects with altered mental status that would prohibit the giving and understanding of informed consent, and assent when applicable, who do not have a legally authorized representative.
• Drug abuse, alcohol abuse, or other factors that in the opinion of the investigator could affect the ability of the subject to comply with the requirements of the protocol.
• Subjects who have experienced a serious adverse event associated with an RBCx procedure in the past.
• In the opinion of the investigator, subjects who have a life expectancy fewer than 30 days.
• Subjects who refuse blood products.
• Subjects who are pregnant.
• Subjects who fail to comply with site requirements for cessation of medication that interfere or increase procedure risk.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Amicus Red Cell Exchange in SCD patients; Open arm. Patients with sickle cell disease (SCD) treated using one Amicus Red Cell Exchange procedure.	Device: Amicus Red Cell Exchange in SCD patients; Each patient will be treated with one RBCx procedure using the AMICUS RBCx System; Other Names: AMICUS RBCx System

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Actual Fraction of Original Red Blood Cells Remaining to the Target Fraction of Cells Remaining (FCR).	The primary endpoint will evaluate the mean ratio of the Actual FCR (FCRa) to Target FCR (FCRt) as measured by the patient's Hb S pre-procedure and post-procedure. The predefined mean ratio of the FCRa to FCRt is 0.75 to 1.25.	Actual FCR will be assessed by taking a pre-procedure sample from the patient on the day of the procedure and a post-procedure sample approximately 10-15 min after procedure completion.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Accuracy of Patient's End Hematocrit as Measured by the Patient's Post-procedure Hematocrit.	Evaluate the accuracy of subject hematocrit post-procedure (End Hematocrit) (as measured by the patient's hematocrit at the end of the procedure) compared to the target End Hematocrit.	Actual End Hematocrit will be measured by taking a sample from the patient approximately 10-15 min after procedure completion.
Subject Cell Loss Post-Procedure (WBC)	WBC loss post-procedure as measured with a complete blood count	Patient's blood cells will be measured by taking a sample from the patient approximately 10-15 min after procedure completion.
Serious Adverse Events	Evaluate the number of device related serious adverse events during the procedure and approximately 18-24 hours post-procedure.	During the procedure up to 24 hours post-procedure.
Subject Cell Loss Post-Procedure (Platelets)	Platelet loss post-procedure as measured with a complete blood count	Patient's blood cells will be measured by taking a sample from the patient approximately 10-15 min after procedure completion.

Collaborators and Investigators

• Sponsor: Fenwal, Inc.
• Collaborators: Children's Hospital of Philadelphia; Washington University School of Medicine; University of Texas; Barbara Ann Karmanos Cancer Institute; Phoenix Children's Hospital; Versiti
• Investigators: Study Chair: Paul Swerdlow, MD, Barbara Ann Karmanos Cancer Institute

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2015
• Primary Completion (Actual): December 7, 2017
• Study Completion (Actual): January 19, 2018

Study Registration Dates

• First Submitted: February 6, 2015
• First Submitted That Met QC Criteria: February 20, 2015
• First Posted (Estimate): February 26, 2015

Study Record Updates

• Last Update Posted (Actual): July 29, 2022
• Last Update Submitted That Met QC Criteria: July 7, 2022
• Last Verified: July 1, 2022

More Information

Terms related to this study

• Keywords: Sickle Cell Disease; Hemoglobin (Hb) S Disease; Hb S Disease; Congenital Hemolytic Anemia
• Additional Relevant MeSH Terms: Hematologic Diseases; Genetic Diseases, Inborn; Anemia; Anemia, Hemolytic, Congenital; Anemia, Hemolytic; Hemoglobinopathies; Anemia, Sickle Cell
• Other Study ID Numbers: AMIC-003-CMD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No