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Trial registered on ANZCTR
Registration number
ACTRN12620000840987
Ethics application status
Approved
Date submitted
10/07/2020
Date registered
26/08/2020
Date last updated
26/08/2020
Date data sharing statement initially provided
26/08/2020
Type of registration
Retrospectively registered
Titles & IDs
Public title
Mesenchymal stromal cell (MSC) therapy for COVID-19 pneumonia
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Scientific title
Phase I trial on safety and tolerability of bone-marrow derived mesenchymal stromal cells (MSC) for deteriorating COVID-19 pneumonia
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Secondary ID [1]
301718
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Royal Perth Hospital (15261)
Protocol Number: RGS0000003982
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Secondary ID [2]
301719
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CTN Application ID: CT-2020-CTN-01580-1 v1
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Universal Trial Number (UTN)
U1111-1254-9427
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Trial acronym
MSCCOVIDP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
COVID-19 pneumonia
318178
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Condition category
Condition code
Respiratory
316191
316191
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0
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Other respiratory disorders / diseases
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Infection
316192
316192
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Allogeneic, bone marrow derived, culture expanded mesenchymal stromal cells
Dose: 2 x 10^6 cells/kg patient weight
Duration: day 0 and day 3
Mode: intravenous administration
Administered by: respiratory physcian
Intervention recorded in patient charts, on product infusion records and in product tracking records.
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Intervention code [1]
318022
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Safety and tolerability of MSC infusions by adverse events recorded including:
Infusion toxicity related to MSC determined by clinical assessment. Clinical assessment includes monitoring of vital signs and physical examination
Hypersensitivity reactions determined by clinical assessment
Desaturation of oxygen level as measured by pulse oximeter, during or in the 4 hours after MSC infusion (defined by a drop in O2 saturation of 2% or a change to supplemental oxygen therapy)
Hypoxia requiring intubation within 2 hours of MSC infusion by clinical assessment
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Assessment method [1]
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Timepoint [1]
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Day 0 and day 3 post infusion of MSC.
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Primary outcome [2]
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Rate of secondary infection following study intervention as assessed by microbial and infectious disease testing of blood and other samples and other assessments as indicated, and obtained from the clinical case record review.
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Assessment method [2]
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Timepoint [2]
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Within 30 days post infusion
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Primary outcome [3]
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Safety by routine assessments and standard of care including:
Concomitant medications, therapies and procedures obtained from patient source notes and clinical care records
Physical examination
Full blood count including white cell differential and platelets, reticulocyte count
Biochemistry- urea, electrolytes, creatinine, liver function, lactate dehydrogenase, CRP, d-dimer
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Assessment method [3]
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Timepoint [3]
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Day 3, 7, 14, 30 and 90 following study intervention
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Secondary outcome [1]
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Requirement for oxygen therapy to maintain SaO2>92% over time from patient clinical care records.
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Assessment method [1]
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Timepoint [1]
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Day 3, 7, 14 and 30 post intervention administration
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Secondary outcome [2]
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Requirement for ICU admission, requirement for mechanical ventilation and duration of ICU admission among ICU eligible patients from patient clinical care records.
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Assessment method [2]
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Timepoint [2]
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Day 30 post intervention administration
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Secondary outcome [3]
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Mechanical ventilation free days from patient clinical care records
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Assessment method [3]
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Timepoint [3]
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Day 30 post intervention administration
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Secondary outcome [4]
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Hospital length of stay from patient medical records.
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Assessment method [4]
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Timepoint [4]
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Day 30 post intervention
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Secondary outcome [5]
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Clinical status from patient clinical care records including COVID status and lung clearance
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Assessment method [5]
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Timepoint [5]
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Day 3, 7, 30 and day 90 post intervention administration
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Secondary outcome [6]
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Incidence of ARDS by standard PaO2/FiO2 and assessed by peripheral oximetry or arterial blood gases if clinically indicated.
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Assessment method [6]
385136
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Timepoint [6]
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Day 30 post intervention administration
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Secondary outcome [7]
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Incidence of secondary cardiac damage as a composite and measured by AMI rate, arrhythmia rate and peak troponin obtained by ECG and by serum assay, respectively.
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Assessment method [7]
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Timepoint [7]
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Day 90 post intervention administration
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Secondary outcome [8]
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Treatment effect on inflammatory markers from blood samples, including serum analysis for C-reactive protein (CRP), interleukin (IL)-6, IL-10, tumour necrosis factor (TNF)a and extracellular vesicles.
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Assessment method [8]
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Timepoint [8]
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Day 0 prior to intervention administration and day 3, 7 and 14 post intervention administration.
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Secondary outcome [9]
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Radiological status as determined by CT scan/chest x ray
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Assessment method [9]
385318
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Timepoint [9]
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Day 3, 7 and 30 post intervention administration
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Eligibility
Key inclusion criteria
Confirmed bi-lateral pneumonia on chest X-ray
Confirmed COVID-19 infection
Worsening hypoxia with an increasing oxygen requirement by 2L/min (Hudson mask or nasal prongs) to maintain SaO2>92%, measured on 2 occasions over >2 hours or requiring more than 4L/min to maintain SaO2>92% with no history suggestive of chronic hypoxia.
Planned for active treatment with goals of care category A, B or C, including those not eligible for ICU transfer.
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Minimum age
18
Years
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Maximum age
No limit
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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
Life expectancy < 48 hours or GOPC D (palliation only).
Any condition that in the opinion of the investigator may interfere with the safety of the patient or evaluation of study objectives.
Unable to provide consent.
Recent therapy within the last 3 months with immunomodulatory agents including monoclonal antibodies and anti-neoplastics.
Age <18 years
Enrolled in another interventional trial.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Descriptive statistical analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
5/05/2020
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Date of last participant enrolment
Anticipated
30/12/2020
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Actual
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Date of last data collection
Anticipated
31/03/2021
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Actual
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Sample size
Target
10
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
17039
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Royal Perth Hospital - Perth
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Recruitment hospital [2]
17040
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
30708
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6000 - Perth
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Recruitment postcode(s) [2]
30709
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6150 - Murdoch
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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 Perth Hospital
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Address [1]
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Wellington Street
Perth
WA 6000
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Country [1]
306156
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Australia
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Primary sponsor type
Hospital
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Name
Royal Perth Hospital Cell & Tissue Therapies WA
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Address
Cell & Tissue Therapies WA
Royal Perth Hospital
Wellington Street
Perth WA 6000
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Country
Australia
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Secondary sponsor category [1]
306627
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None
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Name [1]
306627
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Address [1]
306627
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Country [1]
306627
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
306372
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Royal Perth Hospital (RPH) Human Ethics Committee
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Ethics committee address [1]
306372
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Royal Perth Hospital Wellington Street Perth WA 6000
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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03/04/2020
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Approval date [1]
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29/04/2020
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Ethics approval number [1]
306372
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RGS0000003982
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Summary
Brief summary
The cytokine storm, resulting from the extreme immune response to COVID-19 virus, has been identified as the key event that leads to the acute respiratory distress and multiple organ damage, eventually leading to death in COVID-19 infection. The cell therapy, mesenchymal stromal cells (MSC), secrete anti-inflammatory factors that can prevent the cytokine storm. The first published report of 7 patients with severe COVID-19 pneumonia showed that MSC therapy was able to change the inflammatory status of severely ill patients and significantly improve pulmonary function. The small study demonstrated that MSC therapy was safe and effective in severe COVID-19 pneumonia. Our centre manufactures an allogeneic MSC product, under licence from Isopogen Pty Ltd, that is cryopreserved for off-the-shelf use. No donor matching is required and the MSC have natural immunity to COVID-19. The objective of this study is to identify and treat deteriorating COVID-19 patients with MSC therapy to attenuate the cytokine storm response to the COVID-19 virus and thus prevent acute respiratory distress and multi organ damage, improving chance of survival. This is an open label trial, planned to recruit and consent 10 high risk patients on admission. Patients will receive MSC infusions if they are COVID-19 positive and have increasing oxygen requirements to maintain O2 sat of >92%. The primary study endpoint is safety, with secondary endpoints of clinical parameter assessment, including oxygen requirements, ventilatory support, ICU admission, length of stay, survival and the effect of treatment on inflammatory markers.
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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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Dr Ben Carnley
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Address
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Cell & Tissue Therapies WA
Royal Perth Hospital
Wellington Street
Perth WA 6000
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Country
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Australia
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Phone
103650
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+61 8 92242405
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Fax
103650
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+61 8 92241420
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Email
103650
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[email protected]
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Contact person for public queries
Name
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Marian Sturm
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Address
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Cell & Tissue Therapies WA
Royal Perth Hospital
Wellington Street
Perth WA 6000
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Country
103651
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Australia
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Phone
103651
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+61 8 92241987
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Fax
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+61 8 92241420
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Email
103651
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[email protected]
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Contact person for scientific queries
Name
103652
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Marian Sturm
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Address
103652
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Cell & Tissue Therapies WA
Royal Perth Hospital
Wellington Street
Perth WA 6000
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Country
103652
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Australia
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Phone
103652
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+61 8 92241987
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Fax
103652
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+61 8 92241420
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Email
103652
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Data will be provided in publication of trial outcome. This will exclude raw and individual participant data.
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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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