Active clinical trials for "Anemia"

To observe the changes in the inflammatory anemiaassociated parameters of patients with sepsis in the early stage of intensive care unit (ICU) admission. To evaluate their association with 28-days mortality To evaluate the effect of blood transfusion on these parameters and the survival of the studied patients

Blood transfusion is an expensive and finite resource and optimum transfusion threshold in surgical patients is yet to be defined. Patients commonly receive blood transfusions to reduce the risk of myocardial ischaemia or improve perfusion of other organs (e.g. the kidneys), but this treatment may have important adverse effects including postoperative infection. Patients undergoing surgery for fractured neck of femur are often elderly, with co-morbidities and a high risk of postoperative complications, including MI and AKI. We propose to conduct a study with the following aims: To describe the incidence of anaemia and transfusion in patients undergoing surgery for fractured neck of femur. To use clinical and biochemical data to measure the incidence of perioperative cardiac and kidney injury in this group. To evaluate highly sensitive serum troponin and urinary MALDI-MS as possible endpoints in a future prospective randomised trial of perioperative transfusion.

Preoperative anemia is a known risk factor for morbidity, mortality and increased healthcare resource utilisation. The Investigator's previous study demonstrated the rate of preoperative anemia in Singapore General Hospital (SGH) to be at 26.6%. The rate is highest in the elderly group which stands at 49.9%. The main objective of this study is to investigate the perioperative morbidity and mortality, blood transfusion rate, healthcare outcomes and patient-centric outcomes among anemic elderly patients undergoing major surgery. The investigators hypothesize that elderly patients who undergoes major abdominal surgery with preoperative anemia will have higher composite morbidity and mortality rates (primary outcome), longer length of hospital stay, higher blood transfusion requirements and lower health-related quality of life (HRQoL) at 1, 3 and 6 months (secondary outcomes) when compared to elderly patients without preoperative anemia. The investigators will conduct a prospective observational study of 450 consecutive patients above 65 years, who are undergoing elective major open abdominal surgery in SGH over 12 months. Baseline clinical assessment, including iron studies for anemic patients, will be done within 14 days prior to surgery. To determine the primary outcome, patients will be followed up prospectively for 30 days from the day of surgery. This will be done via a mixture of medical records review and phone interview. For secondary outcomes, the length of hospital stay and readmissions for any reason within 3 and 6 months will be recorded. HRQoL questionnaires will be done through phone calls by a study team member. Findings from this study will hopefully fill the knowledge gaps such as how anemia impacts elderly people in terms of perioperative morbidity, mortality, postsurgical quality of life and their eventual return to the community as well as providing local data on the healthcare resource utilisation in this group.

This observational study follows a cohort of patients scheduled for elective hip- or knee surgery but has preoperative anemia and are treated with Intravenous (IV) iron prior to surgery according to a recently introduced standardized treatment protocol at 6 high-volume surgical centres.

Allogeneic haematopoietic stem cell transplantation (HSCT) is a potentially curative therapy for patients with both haematological and some non-haematological disorders. However, one of the major limiting factors for transplantation is the inability to identify a suitable HLA-matched donor. Development of an cost-effective and clinically efficacious alternative to HLA-identical sibling or unrelated donor transplantation would significantly expand the availability of allogeneic HSCT to patients in Singapore. Preliminary results indicate that the use of high dose post-transplant cyclophosphamide (Cy) for graft versus host disease (GVHD) prophylaxis in haplo-identical allogeneic HSCT is associated a low incidence of GVHD and low treatment related toxicity. We propose a phase II clinical trial to assess the efficacy of a haplo-identical allogeneic transplantation protocol using high dose post-transplant Cy for the treatment of patients with haematological disorders. A non-myeloablative protocol (Fludarabine-low dose cyclophosphamide-TBI) will be used for patients with bone marrow failure syndromes and indolent lymphoid disease. In view of the higher relapse risk of patients with myeloid malignancies, these patients will be treated with a reduced intensity conditioning regimen (Fludarabine-Busulphan). The primary end-point of the study will be overall survival at one year. Economic cost of the haplo-identical transplantation, as well as treatment timelines will be recorded and compared will other forms of unrelated donor allogeneic transplantation (umbilical cord blood transplantation and unrelated HLA-matched adult donor). Immunological reconstitution of patients following haplo-transplantation will be analysed and data will be utilized to guide future immunotherapy strategies post-transplantation. One year survival after non-myeloablative haploidentical stem cell transplantation is not inferior to that observed after non-myeloablative volunteer unrelated donor or unrelated cord blood haematopoietic stem cell transplantation.

Iron deficiency anemia is a worldwide medical disorder. So far, it is the most common medical complication in pregnancy specially in developing countries. It is the cause of many adverse effects on mother and fetus and contributes significantly to high maternal mortality. Maternal iron deficiency anemia is frequently associated with premature delivery, low birth weight babies

Iron deficiency anemia is the leading cause of anemia during pregnancy, which can still reach 10 to 20% of pregnant women in developed countries, with potentially serious consequences for the child. Systematic iron supplementation remains controversial. This study aims to identify in the first trimester of pregnancy clinical and biological predictive factors for the occurrence of iron deficiency anemia in the third trimester of pregnancy.

The investigators aim to give an overview of Iron overload(IOL) of patients with AA and low and int-1 risk MDS and their sequelae under different chelation treatment. And the investigators also aim to evaluate the relationship of LIC and T2*/R2*.

Iron deficiency anemia during pregnancy, which may lead to adverse pregnancy outcomes, was a serious health problem in China. Various iron supplements used in different regions of China, however, the effects have not been well investigated. The objective of this study is to investigate the diagnosis, treatment and prognosis of iron deficiency and iron deficiency anemia in Chinese pregnant women.

Congenital dyserythropoietic anemia is a heterogeneous inherited disease. Hyperplasic erythropoiesis is ineffective and associated with morphological abnormalities of some of the erythroblasts that form the basis of cytological classification. The cumulative incidence is not very clear, but varies between countries from 0.08 million in Scandinavia to 2.6 cases/million inhabitants in Italy where it appears to be the most reported. The common manifestation is moderate chronic congenital anemia. This anaemia is either normocytic or discreetly macrocytic, non-regenerative or inappropriate regarding anaemia, contrasting with signs of hemolysis with moderate unconjugated hyperbilirubinemia. Diagnosis is usually made in the pediatric period, but because of the great heterogeneity, the diagnosis sometimes may be delayed. Splenomegaly and jaundice are mostly present. Secondary hemochromatosis is common in the absence of transfusion due to hyper-intestinal absorption of iron induced by the dyserythropoiesis. The transmission mode for Type I and II is autosomal recessive, while it is autosomal dominant or sporadic for Type III. Several clinical questions remain concerning this disease : the median survival of patients is not well known, neither the causes of death benefit/risk of splenectomy iron overload quantification and consequences The idea is to stablish a French registry of congenital dyserythropoietic anemia in order to help to understand the correlation between phenotype and genotype of this disease.