RecruitingPhase 2Phase 3NCT07202078

Role of Antibiotic Therapy or Immunoglobulin On iNfections in hAematoLogy: Starting Immunoglobulin (Start Ig)

Role of Antibiotic Therapy or Immunoglobulin On iNfections in hAematoLogy (Start Ig)


Sponsor

Monash University

Enrollment

900 participants

Start Date

May 7, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This study is being conducted to find out how safe and effective different strategies of infection prevention are in comparison to each other, for preventing infection in patients with blood cancers. The best way to find out this information is to directly compare the effect of different treatment strategies in patients with blood cancers. We want to know how these different treatments impact on your health and your use of healthcare services. This research project uses an Adaptive Platform Design. This design allows the researchers to compare multiple infection prevention strategies within the same trial at the same time (rather than running separate trials), to analyse results as the trial occurs and to add new research questions during the course of the trial. The treatments that you may receive as part of the study will be determined by which domain(s) of the platform you participate in. By combining data collected within each domain as part of the platform, the researchers can investigate and compare treatment strategies and infection outcomes across a broader range of participants.


Eligibility

Min Age: 18 Years

Inclusion Criteria1

  • None.

Exclusion Criteria13

  • Prior or planned allogeneic haematopoietic stem cell transplantation.
  • Already receiving systemic antibiotic prophylaxis for the purpose of preventing bacterial infection (NB: patients may receive antiviral, antifungal and PJP prophylaxis).
  • Received immunoglobulin replacement in the preceding three months.
  • Objection to receiving immunoglobulin products.
  • Known history of IgA deficiency with anti-IgA.
  • History of severe allergy to immunoglobulin products.
  • Current active infection requiring systemic antibiotics.
  • Allergy or intolerance of all domain antibiotic options.
  • Pregnant or breastfeeding.
  • Severe renal impairment (estimated or measured creatinine clearance of \< 30 mL/min).
  • Previous splenectomy.
  • Previous participation in this domain.
  • Treating team deems enrolment in the domain is not in the best interest of the patient.

Interventions

DRUGTrimethoprim / Sulfamethoxazole

Once daily trimethoprim-sulfamethoxazole (co-trimoxazole) 160mg/800mg. NB: Doxycycline 100mg daily as an alternative for patients with hypersensitivity to co-trimoxazole.

BIOLOGICALImmune Globulin Intravenous

IVIg every 4 weeks ± 1 week at a dose of 0.4g/kg, modified to achieve an IgG trough level of at least lower limit of age-specific serum IgG reference range; or SCIg, weekly, may be used in patients who meet local criteria for home-based self-administration in centres with established SCIg programs. Dosing is usually given at 100mg/kg/week, modified to achieve an IgG steady state level of at least the lower limit of the serum reference range. A loading IVIg dose may be given in the first month if required.


Locations(3)

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Austin Hospital

Melbourne, Victoria, Australia

Northern Health

Melbourne, Victoria, Australia

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NCT07202078


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