PET/CT and Bacterial/Fungal PCR in High Risk Febrile Neutropenia

NCT ID: NCT03429387

Last Updated: 2022-05-17

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

NA

Total Enrollment

147 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-08

Study Completion Date

2021-01-23

Brief Summary

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Patients with acute leukaemia requiring induction or consolidation chemotherapy and those requiring a haematopoietic stem cell transplant are at high risk of fever and infection when they have low white cell counts (neutropenic fever). The causes of neutropenic fever are frequently unknown and patients are treated with broad antibiotics, without a clear target to what is being treated.

This study will prospectively enroll patients who are receiving chemotherapy for acute leukaemia or for a stem cell transplant and compare the diagnostic utility of bacterial and fungal PCR performed directly off blood drawn, to the standard blood culture. Patients who have persistent fever after 72 hours of antibiotics will then be randomized to have either the interventional scan (PET/CT) or the conventional scan (standard CT) to look for a source of infection. Diagnostic yield, change in management and outcomes will be compared between arms.

Detailed Description

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Conditions

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Acute Myeloid Leukemia Acute Lymphoblastic Leukemia Haematopoietic Stem Cell Transplant, Autologous Haematopoietic Stem Cell Transplant, Allogeneic Febrile Neutropenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to either the PET/CT arm or the conventional CT arm
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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FDG-PET/CT arm

Participants with persistent febrile neutropenia after 72 hours of onset who are randomized to this arm will have an FDG-PET/CT performed to look for source of fever.

Group Type EXPERIMENTAL

FDG-PET/CT

Intervention Type DIAGNOSTIC_TEST

FDG-PET performed with low dose CT

Conventional CT arm

Participants with persistent febrile neutropenia after 72 hours of onset who are randomized to this arm will have a conventional CT (HRCT chest and sinuses +/- other regions as per clinician's discretion) performed to look for source of fever.

Group Type ACTIVE_COMPARATOR

Conventional CT

Intervention Type DIAGNOSTIC_TEST

HRCT and CT of sinuses +/- other regions as per clinician's discretion

Interventions

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FDG-PET/CT

FDG-PET performed with low dose CT

Intervention Type DIAGNOSTIC_TEST

Conventional CT

HRCT and CT of sinuses +/- other regions as per clinician's discretion

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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PET/CT

Eligibility Criteria

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Inclusion Criteria

* About to have an allogeneic haematopoietic stem cell transplant, OR
* About to have an autologous haematopoietic stem cell transplant, OR
* Commencing induction or consolidation chemotherapy with curative intent for acute myeloid or acute lymphoid leukaemia

Exclusion Criteria

* Current actively diagnosed infection prior to transplant or chemotherapy
* Allergy to intravenous contrast for CT imaging
* eGFR \<30
* Pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Melbourne Health

OTHER

Sponsor Role collaborator

Westmead Hospital

UNKNOWN

Sponsor Role collaborator

Victorian Infectious Diseases Reference Laboratory

UNKNOWN

Sponsor Role collaborator

Peter MacCallum Cancer Centre, Australia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Monica Slavin, MBBS, MD

Role: PRINCIPAL_INVESTIGATOR

Peter MacCallum Cancer Centre, Australia

Locations

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Peter MacCallum Cancer Centre

Melbourne, Victoria, Australia

Site Status

Melbourne Health

Parkville, Victoria, Australia

Site Status

Countries

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Australia

References

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Tew M, Douglas AP, Szer J, Bajel A, Harrison SJ, Tio SY, Worth LJ, Hicks RJ, Ritchie D, Slavin MA, Thursky KA, Dalziel K. Evaluating the cost-effectiveness of [18F]FDG-PET/CT for investigation of persistent or recurrent neutropenic fever in high-risk haematology patients. Cancer Imaging. 2023 Dec 15;23(1):119. doi: 10.1186/s40644-023-00647-7.

Reference Type DERIVED
PMID: 38102639 (View on PubMed)

Douglas A, Thursky K, Spelman T, Szer J, Bajel A, Harrison S, Tio SY, Bupha-Intr O, Tew M, Worth L, Teh B, Chee L, Ng A, Carney D, Khot A, Haeusler G, Yong M, Trubiano J, Chen S, Hicks R, Ritchie D, Slavin M. [18F]FDG-PET-CT compared with CT for persistent or recurrent neutropenic fever in high-risk patients (PIPPIN): a multicentre, open-label, phase 3, randomised, controlled trial. Lancet Haematol. 2022 Aug;9(8):e573-e584. doi: 10.1016/S2352-3026(22)00166-1. Epub 2022 Jun 28.

Reference Type DERIVED
PMID: 35777413 (View on PubMed)

Other Identifiers

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17/98

Identifier Type: -

Identifier Source: org_study_id

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