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Prospective registry study for children and young adults with severe immune cytopenias (persisting/chronic immune thrombocytopenia, autoimmune hemolytic anemia, and Evans syndrome) to improve the management, facilitate the differential diagnostic work-up, and document the clinical course under various treatments.
Time points: at inclusion, after 6 months, after 12 months, then yearly up to 4 years after inclusion.
No intervention, mere observation and documentation. Guided pre-inclusion (differential) diagnostic work-up.
The study aims to improve the management and care of patients with severe immune cytopenias, to identify underlying causes of severe immune cytopenias and to develop a strategy for early treatment stratification based on a standardized diagnostic algorithm, potentially supported by biomarker analyses and (off study) genetic analyses, where clinically indicated.
Primary Goal:
Rapid detection of underlying causes of severe immune cytopenias with the aid of a structured diagnostic approach and access to a clinical care network of the participating centers, allowing early treatment stratification
Secondary Goals:
There will be no additional venous punctures or investigational time points. At clinical visits around planned study time points, additional blood parameters and stool specimen will be obtained. The current clinical management follows international guidelines, which are summarized in the study documents but do not represent part of the study (no diagnostic or therapeutic investigational arm).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients | all who fulfil inclusion criteria and consent to participation; potential biomarkers will be documented |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| potential biomarkers | Diagnostic Test | facs analysis, microbiome analysis |
|
| Measure | Description | Time Frame |
|---|---|---|
| underlying disease that causes or is associated with severe immune cytopenia | identify the underlying condition or other disease, e.g., primary immunodeficiency or bone marrow failure syndrome by diagnostic procedures according to a standardized algorithm | 0-4 years |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical course | Documentation of physician-reported clinical symptoms including outcome measures/performance scores | 0-4 years |
| Biomarkers - Blood | Identification of novel biomarkers by flow cytometry of leukocytes |
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Inclusion Criteria:
Exclusion Criteria:
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consecutive registration of pediatric, adolescent, and young adult patients with severe immune cytopenia who consent
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| Name | Affiliation | Role |
|---|---|---|
| Seidel | Medical University of Graz | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pediatric Hematology-Oncology Outpatient Clinic | Graz | Styria | 8036 | Austria |
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| ID | Term |
|---|---|
| D016553 | Purpura, Thrombocytopenic, Idiopathic |
| D000744 | Anemia, Hemolytic, Autoimmune |
| C536380 | Evans Syndrome |
| D000081207 | Primary Immunodeficiency Diseases |
| D010198 | Pancytopenia |
| D000741 | Anemia, Aplastic |
| D009190 | Myelodysplastic Syndromes |
| ID | Term |
|---|---|
| D011696 | Purpura, Thrombocytopenic |
| D011693 | Purpura |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
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stool, peripheral blood mononuclear cells
| 0-4 years |
| Biomarkers - Stool | Identification of potential modifiers of immune tolerance by studying the intestinal microbiome | 0-4 years |
| Routine laboratory parameters | documentation of laboratory parameters that are routinely assessed for immune cytopenia | 0-4 years |
| Number of participants with the diagnosis of severe immune cytopenia per participating centre and per year | epidemiological data acquisition, participants included according to the inclusion criteria | 0-4 years |
| D006425 |
| Hemic and Lymphatic Diseases |
| D057049 | Thrombotic Microangiopathies |
| D013921 | Thrombocytopenia |
| D001791 | Blood Platelet Disorders |
| D000095542 | Cytopenia |
| D006474 | Hemorrhagic Disorders |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012877 | Skin Manifestations |
| D012816 | Signs and Symptoms |
| D000743 | Anemia, Hemolytic |
| D000740 | Anemia |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007153 | Immunologic Deficiency Syndromes |
| D000080983 | Bone Marrow Failure Disorders |
| D001855 | Bone Marrow Diseases |