Detecting Autologous Transfusion by Measuring Alterations in the Dynamics of Red Blood Cell Maturation and Recycling

NCT ID: NCT02684747

Last Updated: 2018-05-14

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

Clinical Phase

EARLY_PHASE1

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-02-29

Study Completion Date

2018-05-05

Brief Summary

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A total of 40 subjects will be recruited for participation in this study. 20 subjects (10 males and 10 females) will be randomized to the active group (those receiving re-infusion of autologous blood) and 20 subjects (10 males and 10 females) will be randomized to the placebo group (receiving NS infusion).

Detailed Description

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Autologous blood transfusion is a major problem in a wide range of competitive sports. Methods with increased sensitivity, specificity, and feasibility are needed to identify athletes who cheat in this manner and compromise their health and the integrity of their sports in general. Complete blood counts (CBC) offer routine high-resolution assessment of the current hematologic status of individuals, providing estimates of a number of blood characteristics, such as the total hemoglobin concentration in the blood (HGB) and the volume fraction of cells in the blood (HCT). These CBC components are homeostatically controlled by the carefully regulated dynamic processes of red blood cell (RBC) production in and release from the bone marrow, RBC maturation in the peripheral circulation over the course of the \~100-day RBC lifespan, and clearance and recycling of senescent cells. Any significant perturbation to the circulating population of RBCs, like autologous transfusion, will immediately trigger compensatory modulation of one or more of these dynamic processes. The investigators believe quantification of these underlying dynamic processes will enable us to detect autologous transfusion. These dynamic RBC processes cannot currently be measured directly, but novel mathematical modeling enables their inference from routine complete blood and reticulocyte counts. The investigators propose to test the ability of modeled RBC dynamics to identify instances of autologous blood transfusion.

Conditions

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Blood Transfusion, Autologous Blood Doping

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Treatment - Autologous Transfusion

Participants will be randomized to the treatment group (autologous transfusion)

Group Type EXPERIMENTAL

Autologous Transfusion

Intervention Type OTHER

Participants will receive autologous transfusion on Day 21

Control - Normal Saline (Placebo)

Participants will either be randomized to the control group (saline transfusion)

Group Type PLACEBO_COMPARATOR

Control - Normal Saline (Placebo)

Intervention Type OTHER

Participants will receive saline on Day 21

Interventions

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Autologous Transfusion

Participants will receive autologous transfusion on Day 21

Intervention Type OTHER

Control - Normal Saline (Placebo)

Participants will receive saline on Day 21

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Male or female between 18-35 years old
2. Classified as low risk and will not have any major signs or symptoms suggestive of cardiovascular, pulmonary, or metabolic disease according to the American College of Sports Medicine's (ACSM) risk stratification categories
3. The subjects should be well-trained endurance athletes. This group could consist of cyclists (road and mountain), triathletes, runners, long-distance swimmers, etc.

Exclusion Criteria

1. Age less than 18 or greater than 35 on the day of enrollment
2. Any contraindication to blood donation as defined by the American Association of Blood Banks http://www.fda.gov/downloads/BiologicsBloodVaccines/BloodBloodProducts/QuestionsaboutBlood/UCM272981.pdf
3. Any chronic illness (e.g.diabetes, heart disease, hypotension, anemia, hemoglobinopathy, marrow diseases, leukemia/lymphoma, pregnancy, amenorrhea/female athlete triad)
4. Any abnormal CBC index or iron study; any blood dyscrasia
5. Abnormal blood and urine tests for doping agents (e.g. phthalates)
6. Positive uhCG or women who are attempting to get pregnant during the study period
7. Unwilling or unable to provide blood samples or receive a blood transfusion
8. Not a participant in endurance sports activities
9. Are currently on any medications that might affect hematologic parameters including, but not restricted to, hematopoietic medications
10. Subjects with a baseline hemoglobin above 16.7 g/dL, or baseline hematocrit below 35% or above 55%.
11. Any subject that plans to participate in an organized athletic event (or USA Cycling sanctioned event) within 30 days following the re-infusion phase of the study will not be allowed to participate in the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Sports Medicine Research and Testing Laboratory

INDUSTRY

Sponsor Role collaborator

Partnership for Clean Competition

OTHER

Sponsor Role collaborator

University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Daniel Cushman

M.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Daniel Cushman, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Utah

Locations

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University of Utah Center for Clinical & Translational Science

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Cowell HR, Swickard JW. Autotransfusion in children's orthopaedics. J Bone Joint Surg Am. 1974 Jul;56(5):908-12. No abstract available.

Reference Type BACKGROUND
PMID: 4847238 (View on PubMed)

Cregan P, Donegan E, Gotelli G. Hemolytic transfusion reaction following transfusion of frozen and washed autologous red cells. Transfusion. 1991 Feb;31(2):172-5. doi: 10.1046/j.1537-2995.1991.31291142950.x.

Reference Type BACKGROUND
PMID: 1996486 (View on PubMed)

Domen RE. Adverse reactions associated with autologous blood transfusion: evaluation and incidence at a large academic hospital. Transfusion. 1998 Mar;38(3):296-300. doi: 10.1046/j.1537-2995.1998.38398222875.x.

Reference Type BACKGROUND
PMID: 9563411 (View on PubMed)

Higgins JM, Mahadevan L. Physiological and pathological population dynamics of circulating human red blood cells. Proc Natl Acad Sci U S A. 2010 Nov 23;107(47):20587-92. doi: 10.1073/pnas.1012747107. Epub 2010 Nov 8.

Reference Type BACKGROUND
PMID: 21059904 (View on PubMed)

Kumar S, Goyal K, Dube SK, Dubey S, Bindra A, Kedia S. Anaphylactic reaction after autologous blood transfusion: A case report and review of the literature. Asian J Neurosurg. 2015 Apr-Jun;10(2):145-7. doi: 10.4103/1793-5482.154983.

Reference Type BACKGROUND
PMID: 25972952 (View on PubMed)

Morkeberg J, Belhage B, Ashenden M, Borno A, Sharpe K, Dziegiel MH, Damsgaard R. Screening for autologous blood transfusions. Int J Sports Med. 2009 Apr;30(4):285-92. doi: 10.1055/s-0028-1105938. Epub 2009 Feb 6.

Reference Type BACKGROUND
PMID: 19199200 (View on PubMed)

Popovsky MA, Whitaker B, Arnold NL. Severe outcomes of allogeneic and autologous blood donation: frequency and characterization. Transfusion. 1995 Sep;35(9):734-7. doi: 10.1046/j.1537-2995.1995.35996029156.x.

Reference Type BACKGROUND
PMID: 7570932 (View on PubMed)

Pottgiesser T, Sottas PE, Echteler T, Robinson N, Umhau M, Schumacher YO. Detection of autologous blood doping with adaptively evaluated biomarkers of doping: a longitudinal blinded study. Transfusion. 2011 Aug;51(8):1707-15. doi: 10.1111/j.1537-2995.2011.03076.x. Epub 2011 Mar 7.

Reference Type BACKGROUND
PMID: 21382045 (View on PubMed)

Solymos E, Guddat S, Geyer H, Flenker U, Thomas A, Segura J, Ventura R, Platen P, Schulte-Mattler M, Thevis M, Schanzer W. Rapid determination of urinary di(2-ethylhexyl) phthalate metabolites based on liquid chromatography/tandem mass spectrometry as a marker for blood transfusion in sports drug testing. Anal Bioanal Chem. 2011 Aug;401(2):517-28. doi: 10.1007/s00216-010-4589-4. Epub 2010 Dec 25.

Reference Type BACKGROUND
PMID: 21188579 (View on PubMed)

Weatherall DJ. Systems biology and red cells. N Engl J Med. 2011 Jan 27;364(4):376-7. doi: 10.1056/NEJMcibr1012683. No abstract available.

Reference Type BACKGROUND
PMID: 21268732 (View on PubMed)

Basson, M. Red blood cells by the numbers. Nature Medicine 16, 1 (2010).

Reference Type BACKGROUND

Other Identifiers

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83533

Identifier Type: -

Identifier Source: org_study_id

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