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Randomised controlled study of iron supplementation to support the response to recombinant human erythropoietin for the treatment of chemotherapy-induced anaemia
ISRCTN ISRCTN11830961
ClinicalTrials.gov identifier NCT00482716
Public title Randomised controlled study of iron supplementation to support the response to recombinant human erythropoietin for the treatment of chemotherapy-induced anaemia
Scientific title
Acronym High Iron Study
Serial number at source Version 2 (Oct 2006)
Study hypothesis Parental iron will optimise the response to recombinant erythropoietin therapy in patients who are iron replete.
Ethics approval Approval received from the East London and the City Research Ethics Committee on the 17th October 2006 (ref: 06/Q0605/93).
Study design Randomised, controlled, open label, prospective trial
Countries of recruitment United Kingdom
Disease/condition/study domain Chemotherapy induced anaemia
Participants - inclusion criteria 1. Any patients with a haemoglobin of less than or equal to 10.5 g/dl who is going to receive at least six more weeks of chemotherapy for any non-myeloid malignancy
2. Any patients with a percent saturation of transferrin more than or equal to 20% and a serum ferritin between 225 and 2250 pmol/L. Confirmatory data will include a reticulocyte haemoglobin content (CHR) more than 31 and zinc protoporphyrin (ZPP) less than 80
3. Patients must be able to understand and signed written informed consent
4. An Eastern Cooperative Oncology Group (ECOG) performance status of zero to two
Participants - exclusion criteria 1. Patients with an anaemia of origin other than cancer or cancer chemotherapy
2. Prior intravenous (IV) iron therapy
3. Expectation of actual transfusion requirement during the course of the study. A transfusion given after randomisation wil be a study endpoint for that patient.
4. Allergy or intolerance to recombinant erythropoietin
5. Uncontrolled hypertension
6. Active infection
7. Primary bone marrow malignancies except for multiple myeloma, chronic lymphocytic leukaemia and indolent non Hogkin's lymphoma, where erythropoiesis-stimulating agents (ESA) therapy has been proven to be beneficial
Anticipated start date 01/11/2006
Anticipated end date 24/04/2009
Status of trial Stopped
Patient information material
Target number of participants Eighty patients
Interventions As of 07/08/2009 the status of this record was updated to read: 'STOPPED', as this trial terminated early due to poor patient recruitment. The initial anticipated end date was 01/11/2007 but this was extended after the lack of recruitment.

Eighty patients will be treated and randomised to receive either epoietin or epoietin plus 200 mg intravenous iron sucrose (Venefor) weekly for ten weeks or until a haemoglobin (Hb) of 13 g/dl is achieved (whichever is first). Any patient requiring blood transfusion while on the study will be considered to have completed the study at the time of the transfusion. Patients will be followed until the Hb reaches 13 g or until the end of the study period. Haemoglobin levels will be measured weekly.

Other blood tests include:
Baseline: zinc protoporphyrin (ZPP), reticulocyte haemoglobin content (CHR), transferrin saturation (TSAT), full blood count (FBC), ferritin, reticulocytes (Retic), vitamin B12, red cell folate, soluble transferrin receptor (sTFR), serum erythropoietin (EPO)
Week one: FBC, CHR, retic
Week four, eight and 12: as per baseline (without B12 and red cell folate)
Primary outcome measure(s) The primary outcome will be the maximum haemoglobin achieved during the conduct of the study.
Secondary outcome measure(s) The secondary outcome will be the time to zenith haemoglobin or the achievement of a haemoglobin level of more than 13 g. All side effects will be recorded and graded although none are anticipated. A further stratification will be responsive, stable or progressive disease.
Sources of funding St. Bartholomew's Hospital (UK) - internal funding
Trial website
Publications
Contact name Dr  Samir  Agrawal
  Address Barts and the London NHS Trust
St Bartholomew’s Hospital
West Smithfield
  City/town London
  Zip/Postcode EC1A 7BE
  Country United Kingdom
  Tel +44 (0)20 7601 2331
  Fax +44 (0)20 7601 8200
  Email s.g.agrawal@qmul.ac.uk
Sponsor Barts and the London NHS Trust (UK)
  Address Research and Development Department
3rd Floor Rutland House
42-46 New Road
Whitechapel
  City/town London
  Zip/Postcode E1 2AX
  Country United Kingdom
  Tel +44 (0)20 7882 7260
  Fax +44 (0)20 7882 7276
  Email Gerry.Leonard@bartsandthelondon.nhs.uk
  Sponsor website: http://www.bartsandthelondon.org.uk/
Date applied 17/11/2006
Last edited 07/08/2009
Date ISRCTN assigned 04/05/2007
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