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Trial registered on ANZCTR
Registration number
ACTRN12611001084976
Ethics application status
Approved
Date submitted
18/10/2011
Date registered
19/10/2011
Date last updated
19/10/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
What is the best form of nutrition support during an Allogeneic Transplant
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Scientific title
A randomized comparison of tolerance of parenteral nutrition and enteral feeding as nutritional support during allogeneic haematopoietic progenitor cell transplantation
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Secondary ID [1]
273224
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Allogeneic transplants
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Nutrition support
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Condition category
Condition code
Cancer
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0
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Leukaemia - Acute leukaemia
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Cancer
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0
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Leukaemia - Chronic leukaemia
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Cancer
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0
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients who require supplementary feeding when undergoing an Allogeneic transplant will be randomised to supplemental nutritional support by parenteral nutrition (PN) versus enteral nutrition (EN) on a 1:1 basis. PN will be administered through a central venous catheter using a standard central parenteral nutrition solution including intravenous vitamin supplementation. EN will be a standard 1.25kcal/ml ready to hang formula administered through a nasogastric tube inserted at the onset of supplemental feeding. The feeding rate and goal to meet requirements will be as per the ward Dietitian. Feeding will continue until patients are able to meet 60% of requirements through oral intake for atleast one day. If a patient does not tolerate their mode of feeding they can be changed to the alternate mode of feeding at any time.
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Intervention code [1]
269558
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Treatment: Other
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Comparator / control treatment
The comparator is Parenteral feeding. Parenteral feeding is standard practice at this hospital currently and this study will evaluate the tolerance of enteral versus parenteral feeding. Parenteral feeding will be administered through a central venous catheter using a standard central parenteral nutrition solution including intravenous vitamin supplementation. Feeding will continue until patients are able to meet 60% of requirements through oral intake for atleast one day or a patient does not tolerate their mode of feeding.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary endpoint is tolerance of route of supplemental feeding. Tolerance of route of supplemental nutritional support is defined as <30% of patients needing to change to the alternative route of support for any reason.
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Assessment method [1]
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Timepoint [1]
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The primary outcome is measured throughout the period of supplementary feeding.
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Secondary outcome [1]
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Percentage of goal nutrition delivered.
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Assessment method [1]
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Timepoint [1]
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Data collected daily while supplementary feeding is being given
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Secondary outcome [2]
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Duration of requirement for nutritional support (days)
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Assessment method [2]
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Timepoint [2]
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At cessation of supplementary feeding
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Secondary outcome [3]
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Biochemical derangements during nutritional support ie: liver function, triglyceride, blood sugar abnormalities. Impaired liver function is defined as >2 liver enzymes at or more than twice the upper limit of normal.
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Assessment method [3]
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Timepoint [3]
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Data collected daily while supplementary feeding is being given
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Secondary outcome [4]
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Duration of neutropenia. Neutrophil count is monitored daily in a blood test which is part of standard care during a transplant.
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Assessment method [4]
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Timepoint [4]
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Before discharge from hospital
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Secondary outcome [5]
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Incidence of graft versus host disease (GVHD). This will be assessed through a medical chart audit and if GVHD is diagnosed and documented by the patients Haematologist in the chart it will be recorded as an outcome.
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Assessment method [5]
294486
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Timepoint [5]
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At day 100 post transplant
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Secondary outcome [6]
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Length of hospital stay
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Assessment method [6]
294487
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Timepoint [6]
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Upon patients discharge from hospital
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Secondary outcome [7]
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Nutritional status using Patient generated subjective global assessment (PG-SGA)
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Assessment method [7]
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Timepoint [7]
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On admission to hospital for transplant
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Eligibility
Key inclusion criteria
Inclusion criteria include: Patients undertaking allogeneic transplants, aged >18 and <65 years and have an ability to understand and willingness to sign a written informed consent document.
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria include: Known anatomic deformity preventing nasogastric tube insertion, non-functional and / or inaccessible gastrointestinal tract to enteral feeding when feeding is required, as defined by presence of Grade 3-4 mucositis or intestinal ileus or intractable vomiting.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients are informed about the study by a transplant coordinator pre admission and are consented to the study by their haematologist in clinic pre admission. Patients are randomised to enteral or parenteral feeding by a computer generated randomisation list if they require supplementary feeding. The primary investigator contacts another member of the research team to randomise the patient to a type of feeding when it is required.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
16/09/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
66
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Royal Brisbane and Womens Hospital Foundation
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Address [1]
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Royal Brisbane and Womens Hospital, Butterfield Street, Herston, QLD 4029
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Glen Kennedy
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Address
Department of Clinical Haematology, Royal Brisbane and Womens Hospital, Level 5, Joyce Tweddell Building, Butterfield Street, Herston, QLD 4029
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Merrilyn Banks
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Address [1]
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Nutrition and Dietetics, Level 2, Dr James Mayne Building, Royal Brisbane and Womens Hospital, Butterfield Street, Herston, QLD 4029
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Sarah Cohen
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Address [1]
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Nutrition and Dietetics, Level 2, Dr James Mayne Building, Royal Brisbane and Womens Hospital, Butterfield Street, Herston, QLD 4029
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Royal Brisbane and Womens Hospital Human Research Ethics committee.
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Ethics committee address [1]
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Butterfield Street Herston, QLD 4029
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Ethics committee country [1]
272011
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Australia
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Date submitted for ethics approval [1]
272011
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Approval date [1]
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14/03/2011
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Ethics approval number [1]
272011
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Summary
Brief summary
Patients undergoing a Stem Cell Transplant (SCT) often have difficulty eating adequately due to the side effects of treatment and malnutrition can occur which is associated with poor outcomes post transplant. The best type of nutrition support to be given during a SCT is controversial and Parenteral Nutrition/ Intravenous feeding (PN) is usually given over Enteral Nutrition/ Nasogastric feeding (EN) despite the increased cost, infection risks and other complications associated with PN. This project aims to determine whether PN or EN is better tolerated by SCT patients who are unable to eat adequately. If EN is successfully tolerated this will eliminate the risks, complications and cost associated with routine use of PN. This research will directly improve future patient care and will result in changes to current nutrition support practices and lead to improved outcomes for cancer transplant patients.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Sarah Cohen
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Address
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Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Level 2, Dr James Mayne Building, Butterfield Street, Herston, QLD, 4029
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Country
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Australia
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Phone
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+61736367997
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Sarah Cohen
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Address
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Nutrition and Dietetics, Royal Brisbane and Women’s Hospital, Level 2, Dr James Mayne Building, Butterfield Street, Herston, QLD, 4029
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Country
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Australia
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Phone
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+61736367997
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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