Optimized Diagnostics for Improved Therapy Stratification in Invasive Fungal Infections

NCT ID: NCT02492594

Last Updated: 2021-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

244 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-03-31

Study Completion Date

2019-03-31

Brief Summary

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Invasive fungal infections (IFI) in immunocompromised patients pose a major challenge for diagnostics designed to permit timely onset of appropriate treatment. The aim of the current clinical-diagnostic studies, one in in pediatric and one in adult patients at high risk of IFI, is to test newly developed diagnostic approaches to invasive fungal infections in relation to established procedures. The studies will be performed in a prospective, blinded fashion, and represent a work package within the FUNGITECT grant supported by the European Commission. The studies will focus on analyses of blood-samples from patients with febrile neutropenia during treatment of acute leukaemia and other tumour entities, and patients undergoing allogeneic stem cell transplantation treated with intensive chemotherapy.

Detailed Description

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Samples from immunosuppressed patients with febrile neutropenia (NP - defined as fever ≥ 38.5ºC and \<500 ANC) will be taken:

* at the start of neutropenic fever
* after 24 hours
* after 48 hours
* before the start of antimycotic therapy, if pertinent
* at the end of antimycotic therapy, if pertinent

The results ot analyses by a panfungal PCR screening assay developed at our institution (European patent No 1960536) and methods newly developed during the FUNGITECT project will be compared with conventional methods for fungal diagnostics such as HR (High Resolution)-CT, serological testing, histology and fungal culture. Additionally, genomic approaches will be employed to investigate host- and pathogen-related factors of susceptibility, pathogenicity and antimycotic resistance.

Conditions

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Systemic Mycosis

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Study Groups

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Pediatric patients with febrile neutropenia

Peripheral blood sampling - samples from 200 pediatric patients with severe immunosuppression and neutropenic fever will be analyzed

Peripheral blood sampling

Intervention Type OTHER

Peripheral blood samples will be taken at 3-5 defined timepoints during febrile neutropenia:

* at the start of neutropenic fever
* after 24 hours
* after 48 hours
* before the start of antimycotic therapy, if pertinent
* at the end of antimycotic therapy, if pertinent

Adult patients with febrile neutropenia

Peripheral blood sampling - samples from 200 adult patients with severe immunosuppression and neutropenic fever will be analyzed

Peripheral blood sampling

Intervention Type OTHER

Peripheral blood samples will be taken at 3-5 defined timepoints during febrile neutropenia:

* at the start of neutropenic fever
* after 24 hours
* after 48 hours
* before the start of antimycotic therapy, if pertinent
* at the end of antimycotic therapy, if pertinent

Interventions

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Peripheral blood sampling

Peripheral blood samples will be taken at 3-5 defined timepoints during febrile neutropenia:

* at the start of neutropenic fever
* after 24 hours
* after 48 hours
* before the start of antimycotic therapy, if pertinent
* at the end of antimycotic therapy, if pertinent

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Adult study:

* Patients between 18-90 years of age with high risk of invasive fungal infections
* signed informed consent

Pediatric study:

* patients between 0-18 years of age with high risk of invasive fungal infections
* signed informed consent

Exclusion Criteria

Adult study:

* pregnancy
* no consent

Pediatric study:

\- no consent
Minimum Eligible Age

6 Months

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Anna Kinderkrebsforschung

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas Lion, Prof MD PhD MSc

Role: STUDY_CHAIR

St. Anna Kinderkrebsforschung

Locations

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Medical University of Vienna, Department of Internal Medicine I

Vienna, , Austria

Site Status

Hospital Hietzing

Vienna, , Austria

Site Status

Hanusch Krankenhaus

Vienna, , Austria

Site Status

Wilhelminenspital

Vienna, , Austria

Site Status

St. Anna Children's Hospital

Vienna, , Austria

Site Status

Princess Máxima Center for pediatric oncology

Utrecht, , Netherlands

Site Status

First Saint-Petersburg Pavlov State Medical University

Saint Petersburg, , Russia

Site Status

Countries

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Austria Netherlands Russia

References

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Landlinger C, Preuner S, Baskova L, van Grotel M, Hartwig NG, Dworzak M, Mann G, Attarbaschi A, Kager L, Peters C, Matthes-Martin S, Lawitschka A, van den Heuvel-Eibrink MM, Lion T. Diagnosis of invasive fungal infections by a real-time panfungal PCR assay in immunocompromised pediatric patients. Leukemia. 2010 Dec;24(12):2032-8. doi: 10.1038/leu.2010.209. Epub 2010 Sep 30.

Reference Type RESULT
PMID: 20882044 (View on PubMed)

Lucini C, Obrova K, Krickl I, Nogueira F, Kocmanova I, Herndlhofer S, Gleixner KV, Sperr WR, Frank T, Andrade N, Peters C, Engstler G, Dworzak M, Attarbaschi A, van Grotel M, van den Heuvel-Eibrink MM, Moiseev IS, Rogacheva Y, Zubarovskaya L, Zubarovskaya N, Pichler H, Lawitschka A, Koller E, Keil F, Mayer J, Weinbergerova B, Valent P, Lion T. Prevalence of fungal DNAemia mediated by putatively non-pathogenic fungi in immunocompromised patients with febrile neutropenia: a prospective cohort study. J Hematol Oncol. 2024 Aug 7;17(1):63. doi: 10.1186/s13045-024-01583-0.

Reference Type DERIVED
PMID: 39113112 (View on PubMed)

Related Links

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http://www.kinderkrebsforschung.at/

Link to the web page of the Children's Cancer Research Institute (St. Anna Kinderkrebsforschung), the sponsor of the study.

Other Identifiers

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VB MD-AN-007-3D

Identifier Type: -

Identifier Source: org_study_id

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