SARS-CoV-2 InfectionNCT04352556
COVID19-hematological Malignancies: the Italian Hematology Alliance
An observational study of SARS-CoV-2 Infection and Hematological Malignancies, run by Ospedale di Circolo - Fondazione Macchi at 81 sites in Italy.
Trial summary
This is a retrospective/prospective, cohort, non-interventional observational study. This means that all patients with documented COVID and HM diagnosed between February 2020 and study initiation will compose the retrospective part, while those diagnosed after study approval will enter prospective part. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- SARS-CoV-2 Infection, Hematological Malignancies
- How many people
- 250 participants
- Where
- 81 sitesItaly
- Study dates
- 7 Apr 2020to 1 Oct 2022
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study population will must be older than 18 years of age with Hematological malignancies and SARS-CoV-2 infection.
Who may be able to join
- Age equal to or greater than 18 years of age.
- History of hematological malignancies (acute leukemias, myelodysplastic syndromes, myeloproliferative neoplasms, lymphomas, myeloma).
- Active hematological malignancies (acute leukemias, myelodysplastic syndromes, myeloproliferative neoplasms, lymphomas, myeloma) at any stage/status.
- SARS-CoV-2 positive test (nasopharyngeal, BAL, fecal), documented by Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panels.
Who cannot join
- Hematological diseases, other than hematological malignancies.
- SARS-CoV-2 negative test.
Trial locations and contacts
81 sites in 1 country.
Marco Salvini, MD contact
81 sites in 1 country
Italy81 sites, 81 recruiting
- Recruiting
SC Ematologia Ospedale SS Antonio e Biagio e Cesare Arrigo
Alessandria
Marco Ladetto, MD
- Recruiting
UOC Ematologia, Ospedali Riuniti
Ancona
Attilio Olivieri, MD
- Recruiting
UOC Ematologia e Terapia Cellulare, Ospedale Mazzoni
Ascoli Piceno
Piero Galieni, MD
- Recruiting
SC Oncologia Medica, CRO
Aviano
Michele Spina, MD
- Recruiting
SC Ematologia, Policlinico Bari
Bari
Pellegrino Musto, MD
- Recruiting
UOC Ematologia, I.R.C.C.S Istituto Tumori Giovanni Paolo II
Bari
Attilio Guarini, MD
- Recruiting
SSD Ematologia, Ospedale degli Infermi
Biella
Anna Conconi, MD
- Recruiting
UOC Ematologia, Azienda Ospedaliero-Universitaria Policlinico S.Orsola-Malpighi,
Bologna
Michele Cavo, MD
- Recruiting
Ematologia e Centro Trapianto Midollo Osseo, Ospedale di Bolzano
Bolzano
Atto Billio, MD
- Recruiting
UO Ematologia e CTMO, ASST Spedali Civili
Brescia
Domenico Russo, MD
- Recruiting
UO Ematologia e CTMO, ASST Spedali Civili
Brescia
Chiara Cattaneo, MD
- Recruiting
UOC Onco-Ematologia ASST Valle Olona
Busto Arsizio
Fabrizio Ciambelli, MD
- Recruiting
SC Ematologia e CTMO AZIENDA OSPEDALIERA "G. BROTZU" - OSPEDALE ONCOLOGICO BUSINCO
Cagliari
Giorgio La Nasa, MD
- Recruiting
UOC Ematologia, AOU Policlinico Vittorio Emanuele
Catania
Francesco Di Raimondo, MD
- Recruiting
Ematologia, Ospedale Valduce
Como
Mauro Turrini, MD
- Recruiting
UOC Ematologia, Azienda Ospedaliera di Cosenza
Cosenza
Massimo Gentile, MD
- Recruiting
UO Ematologia e CTMO, ASST Cremona
Cremona
Alfredo Molteni, MD
- Recruiting
SC Ematologia Ospedale S. Croce
Cuneo
Massimo Massaia, MD
- Recruiting
UOC, Ematologia Azienda Ospedaliero Universitaria Arcispedale S. Anna
Ferrara
Antonio Cuneo, MD
- Recruiting
S.O.D. Ematologia, Azienda Ospedaliero Universitaria Careggi
Florence
Alberto Bosi, MD
- Recruiting
UOC Ematologia, Policlinico Ospedali Riuniti
Foggia
Celestino Ferrandina, MD
- Recruiting
IRST-IRCC di Meldola
Forlì
Giovanni Martinelli, MD
- Recruiting
UO Ematologia, Ospedale Policlinico S.Martino IRCCS
Genova
Roberto Lemoli, MD
- Recruiting
UO Ematologia, Ospedale Policlinico San Martino
Genova
Emanuele Angelucci, MD
- Recruiting
UOC di Ematologia e Trapianto di Cellule Staminali, P.O. Vito Fazzi
Lecce
Nicola Di Renzo, MD
- Recruiting
UOC di Ematologia, Ospedale di Legnano
Legnano
Alessandro Corso, MD
- Recruiting
UO Dipartimento di Ematologia, USL 6
Livorno
Annarosa Cuccaro, MD
- Recruiting
UOC Oncologia ASST Lodi
Lodi
Alessandro Inzoli, MD
- Recruiting
UOC Ematologia Azienda Ospedaliera Universitaria "G.Martino"
Messina
Caterina Musolino, MD
- Recruiting
UO Ematologia, Ospedale dell'Angelo di Mestre
Mestre
Renato Bassan, MD
- Recruiting
Ematologia, IEO
Milan
Corrado Tarella, MD
- Recruiting
SC Ematologia, Istituto Nazionale dei Tumori
Milan
Paolo Corradini, MD
- Recruiting
SC Ematologia, Ospedale Niguarda
Milan
Roberto Cairoli, MD
- Recruiting
UO Ematologia, IRCCS Ospedale San Raffaele
Milan
Fabio Ciceri, MD
- Recruiting
UO Servizio di Ematologia e Medicina Trasfusionale, Ospedale Luigi Sacco
Milan
Augusto Federici, MD
- Recruiting
UOC Ematologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
Milan
Nicola Fracchiolla, MD
- Recruiting
UO Ematologia Policlinico di Modena
Modena
Mario Luppi, MD
- Recruiting
UOC Ematologia, Ospedale S. Gerardo
Monza
Carlo Gambacorti Passerini, MD
- Recruiting
SC Ematologia Istituto Nazionale Tumori - IRCCS "Fondazione G. Pascale",
Naples
Antonio Pinto, MD
- Recruiting
UOC Ematologia e Trapianti di Midollo, AOU Federico II
Naples
Fabrizio Pane, MD
- Recruiting
UOC Ematologia, Ospedale Antonio Cardarelli
Naples
Felicetto Ferrara, MD
- Recruiting
UOC Ematologia, Azienda Ospedaliero-Universitaria Maggiore della Carità
Novara
Gianluca Gaidano, MD
- Recruiting
Ospedale san Luigi Gonzaga
Orbassano
Daniela Cilloni, MD
- Recruiting
Ematologia Azienda Ospedaliera di Padova
Padova
Giampietro Semenzato, MD
- Recruiting
UO Ematologia, Policlinico Paolo Giaccone
Palermo
Sergio Siragusa, MD
- Recruiting
UOC Ematologia e CTMO, Azienda Ospedaliero-Universitaria di Parma
Parma
Nicola Giuliani, MD
- Recruiting
SC Ematologia, Fondazione IRCCS Policlinico San Matteo
Pavia
Luca Arcaini, MD
- Recruiting
SC Ematologia e Trapianto di Midollo Osseo, Azienda Ospedaliera di Perugia
Perugia
Brunangelo Falini, MD
- Recruiting
UO Ematologia e CTMO, Azienda Ospedaliera Ospedali Riuniti
Pesaro
Giuseppe Visani, MD
- Recruiting
UOC di Ematologia, Ospedale Civile Spirito Santo
Pescara
Antonio Spadano, MD
- Recruiting
UO Ematologia e CTMO, Presidio Ospedaliero di Piacenza
Piacenza
Daniele Vallisa, MD
- Recruiting
UO Ematologia, AOU Pisana- Santa Chiara
Pisa
Sara Galimberti, MD
- Recruiting
UO Ematologia dell'Ospedale Santa Maria delle Croci
Ravenna
Francesco Lanza, MD
- Recruiting
UOC Ematologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli
Reggio Calabria
Bruno Martino, MD
- Recruiting
SC Ematologia, Arcispedale Santa Maria Nuova
Reggio Emilia
Francesco Merli, MD
- Recruiting
UO Ematologia, Ospedale Infermi
Rimini
Patrizia Tosi, MD
- Recruiting
AOU Azienda Ospedaliera Universitaria Sant'Andrea
Roma
Agostino Tafuri, MD
- Recruiting
IFO - Ematologia e Trapianto Cellule -Istituto Nazionale del Cancro di Regina Elena
Roma
Francesco Marchesi, MD
- Recruiting
SC Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Roma
Livio Pagano, MD
- Recruiting
UO Ematologia e Trapianti di Cellule Staminali, A.O. S. Camillo-Forlanini
Roma
Luigi Rigacci, MD
- Recruiting
UO Ematologia, Policlinico Tor Vergata
Roma
Adriano Venditti, MD
- Recruiting
UOC Ematologia e trapianto di cellule staminali, Policlinico Universitario Campus Bio-Medico
Roma
Giuseppe Avvisati, MD
- Recruiting
UOC Ematologia Policlinico Umberto I
Roma
Maurizio Martelli, MD
- Recruiting
UOC Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Roma
Valerio De Stefano, MD
- Recruiting
UOC Ematologia- Azienda Ospedaliera San Giovanni Addolorata
Roma
Laura Cudillo, MD
- Recruiting
UO Ematologia, Istituto Clinico Humanitas
Rozzano
Matteo Della Porta, MD
- Recruiting
UOC Ematologia e centro trapianti cellule staminali emopoietiche, AOU San Giovanni Di Dio e Ruggi D'aragona
Salerno
Carmine Selleri, MD
- Recruiting
Ematologia ASL Imperiese
Sanremo
Tullio Calzamiglia, MD
- Recruiting
Medicina Interna ed Ematologia, Asl 1
Savona
Marina Cavaliere, MD
- Recruiting
UOC Ematologia, Policlinico Santa Maria alle Scotte
Siena
Monica Bocchia, MD
- Recruiting
UOC Ematologia e Trapianto Midollo Osseo, Ospedale S. G. Moscati
Taranto
Patrizio Mazza, MD
- Recruiting
SCDU Ematologia e terapie cellulari, Ospedale Mauriziano Umberto I
Torino
Carmen Fava, MD
- Recruiting
UO Ematologia, Ospedale Universitario Molinette San Giovanni Battista
Torino
Benedetto Bruno, MD
- Recruiting
UO Ematologia, Ospedale Universitario Molinette San Giovanni Battista
Torino
Alessandro Busca, MD
- Recruiting
UO Ematologia, Ospedale Civili Ca' Foncello
Treviso
Filippo Gherlinzoni, MD
- Recruiting
SC Ematologia, Azienda sanitaria universitaria Giuliano Isontina
Trieste
Francesco Zaja, MD
- Recruiting
Clinica Ematologia, Azienda Ospedaliera-Universitaria Santa Maria della Misericordia
Udine
Renato Fanin, MD
- Recruiting
UOC Ematologia, ASST Sette Laghi, Osp. Di Circolo e Fondazione Macchi
Varese, 21100
Francesco Passamonti, MD
- Recruiting
UOC Ematologia, Azienda Ospedaliera Integrata di Verona
Verona
Mauro Krampera, MD
- Recruiting
UOC Ematologia, Azienda Ospedaliera Integrata di Verona
Verona
Carlo Visco, MD
- Recruiting
UOC Ematologia, Ospedale San Bortolo
Vicenza
Marco Ruggeri, MD
About this study
Official title: SARS-CoV-2 Infection in Patients With Hematological Malignancies: the Italian Hematology Alliance
This is a retrospective/prospective, cohort, non-interventional observational study. This means that all patients with documented COVID and HM diagnosed between February 2020 and study initiation will compose the retrospective part, while those diagnosed after study approval will enter prospective part.
The total duration of the study will be 12 months.
The study population will must be older than 18 years of age with HM and SARS-CoV-2 infection. All patients with documented SARS-CoV-2 infection (COVID) and history or active hematological malignancies, who refer to any Hematological Unit will be included.
Read the detailed description
This is a retrospective/prospective, cohort, non-interventional observational study. An informed consensus for the participation is available. In this section we provide informations on sample size and statistical analysis.
In Italy, the projected estimate of complete HM prevalence at Jan 1, 2020 has been established as 48,254 cases for Hodgkin lymphoma, 110.715 cases for non Hodgkin Lymphomas, 67,301 for leukemias, and 25,066 for multiple myeloma (Guzzinati et al, BMC Cancer 2018). The Italian Dipartimento della Protezione Civile website reported (March 23, 2020) that 63,927 cases are currently infected with SARS-CoV-2. No formal sample size calculation was made for this project but, on the basis of data available to date, considering the prevalence of hematological patients in Italy (0.4%) and assuming that these patients have the same risk of contracting COVID-19 as the general population, we supposed to enroll at least 250 patients (at March 24, 2020).
Statistical analyses All data collected will be summarized using appropriate descriptive statistics: absolute and relative frequencies for discrete variables; mean, standard deviation, median and interquartile range for continuous ones. To identify factors significantly associated with composite endpoint, log-binomial regression will be used for modelling risk ratio together with 95% confidence interval estimated.
The least absolute shrinkage and selection operator (LASSO) method will be applied for selecting the factors able to independently predict primary end-point. LASSO selects variables correlates to the measured outcome by shrinking coefficients weights, down to zero for the ones not correlated to outcome. In addition, machine learning techniques will be used for validating results from LASSO. A weight will be assigned to each coefficient of the selected predictors and weights will be summed to produce a total aggregate score. Predictive performance will be assessed through discrimination and calibration. Discrimination indicates how well the model can distinguish individuals with the outcome from those without the outcome. Two, the net reclassification improvement (NRI) will be calculated for assessing the 'net' number of individuals correctly reclassified using "the new model" over a comparator index [i.e., CCI (Charlson Comorbidity Score) or MCS (Multisource Comorbidity Score), or HM-disease specific]. Calibration ascertains the concordance between the model's predictions and observed outcomes, which we evaluated using a calibration plot. Cartographic and geostatistical methods will be used to exploring the spatial patterns of disease. An Exploratory Spatial Data Analysis (ESDA) and the Kriging method will be also applied to describe and model spatial (geographical) pattern.
- Conditions
- SARS-CoV-2 Infection, Hematological Malignancies
- Keywords
- Hematological Malignancies, Covid-19, SARS-CoV-2, Italian Hematology Alliance, Leukemia, Lymphoma, Multiple Myeloma
- Medical subject headings
- COVID-19, Hematologic Neoplasms, Leukemia, Lymphoma, Multiple Myeloma
What is being measured
The primary outcome is the main question the study is designed to answer.
To evaluate mortality.
The percentage of HM patients with COVID-19 who died.
Measured: At 2 months from study initiation
To evaluate potential predictive biochemical parameters of mortality.
We will assess the correlation between some biochemical parameters at diagnosis of COVID (i.e. hemoglobin, platelets, lymphocytes, clotting tests, CRP), each on the basis of its specific unit of measure, and mortality.
Measured: At 2 months from study initiation
To evaluate potential predictive HM-related parameters of mortality.
We will assess the correlation between HM-related parameters at diagnosis of COVID [i.e. disease type (leukemia, lymphomas, myeloma), disease status (remission / stable / progression), therapy status (on / off therapy)] and mortality.
Measured: At 2 months from study initiation
To evaluate COVID severity as predictive parameter of mortality.
We will assess the correlation between COVID severity [mild (non-pneumonia and mild pneumonia), severe (dyspnea, respiratory frequency ≥ 30/min, SpO2 ≤ 93%, PaO2/FiO2 < 300 and/or lung infiltrates > 50%) and critical (respiratory failure, septic shock, and/or multiple organ disfunction or failure)] and mortality
Measured: At 2 months from study initiation
Secondary outcomes (5)
Epidemiology of patients with HM infected by SARS-CoV-2with any spectrum of illness severity
Description of the different types of hematological malignancies (WHO criteria) in patients with SARS-CoV-2 infection. All aggregated data will be stratified on the basis of COVID severity: mild (non-pneumonia and mild pneumonia), severe (dyspnea, respiratory frequency ≥ 30/min, SpO2 ≤ 93%, PaO2/FiO2 < 300 and/or lung infiltrates > 50%) and critical disease (respiratory failure, septic shock, and/or multiple organ disfunction or failure)
Measured: At 6 months from study initiation
Definition of complete clinical picture of COVID-19 in HM
Characterization of clinical and biochemical profile of patients with SARS-CoV-2 positivity.
Measured: At 2 months from study initiation
Evolution of HM
Assessment of HM status post SARS-CoV-2 infection stratified as no implication, loss of response, progression of the hematological disease.
Measured: At 2 months from study initiation
To evaluate admission to ICU requiring mechanical ventilation or death per characteristics
Percentage of HM patients being admitted to ICU requiring mechanical ventilation, or death stratified per disease type, status, per off-therapy/on-therapy, per type of therapy (chemo, immunotherapy, cell therapy, stem cell transplant).
Measured: At 2 months from study initiation
Viral dynamics in infected HM patients
Measured: At 12 months from study initiation
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Apr 2020
- Study start7 Apr 2020
- Primary completion1 Oct 2022 (estimated)
- Study completion1 Oct 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for SARS-CoV-2 InfectionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Other
- Enrolment
- 250 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ospedale di Circolo - Fondazione Macchi
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Francesco Passamonti, Ospedale di Circolo - Fondazione Macchi
- Investigators
- Francesco Passamonti, MD, Principal investigator, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04352556
- Sponsor's protocol ID
- HM-COVID19-Italy
- Status last verified
- Sep 2022
- First submitted
- 9 Apr 2020
- Last updated
- 23 Sep 2022
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
PubMed 32109013Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, Bi Y, Ma X, Zhan F, Wang L, Hu T, Zhou H, Hu Z, Zhou W, Zhao L, Chen J, Meng Y, Wang J, Lin Y, Yuan J, Xie Z, Ma J, Liu WJ, Wang D, Xu W, Holmes EC, Gao GF, Wu G, Chen W, Shi W, Tan W. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020 Feb 22;395(10224):565-574. doi: 10.1016/S0140-6736(20)30251-8. Epub 2020 Jan 30.
PubMed 32007145Xia Y, Jin R, Zhao J, Li W, Shen H. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020 Apr;21(4):e180. doi: 10.1016/S1470-2045(20)30150-9. Epub 2020 Mar 3. No abstract available.
PubMed 32142622Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020 Apr;21(4):e181. doi: 10.1016/S1470-2045(20)30149-2. Epub 2020 Mar 3. No abstract available.
PubMed 32142621Corrao G, Rea F, Di Martino M, De Palma R, Scondotto S, Fusco D, Lallo A, Belotti LMB, Ferrante M, Pollina Addario S, Merlino L, Mancia G, Carle F. Developing and validating a novel multisource comorbidity score from administrative data: a large population-based cohort study from Italy. BMJ Open. 2017 Dec 26;7(12):e019503. doi: 10.1136/bmjopen-2017-019503.
PubMed 29282274Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertu L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F; ITA-HEMA-COV investigators. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv. 2022 Jan 11;6(1):327-338. doi: 10.1182/bloodadvances.2021005691.
PubMed 34644385Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertu L, Corrao G, Pagano L, Corradini P; ITA-HEMA-COV Investigators. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020 Oct;7(10):e737-e745. doi: 10.1016/S2352-3026(20)30251-9. Epub 2020 Aug 13.
PubMed 32798473
Study at a glance
From the registry record, last updated by the sponsor on 23 Sep 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- SARS-CoV-2 Infection in Patients With Hematological Malignancies: the Italian Hematology Alliance
- ClinicalTrials.gov ID
- NCT04352556
- Acronym / sponsor ID
- HM-COVID19-Italy
- Conditions
- SARS-CoV-2 Infection, Hematological Malignancies
- Keywords
- Hematological Malignancies, Covid-19, SARS-CoV-2, Italian Hematology Alliance, Leukemia, Lymphoma, Multiple Myeloma
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 250 participants (estimated)
- Lead sponsor
- Ospedale di Circolo - Fondazione MacchiUniversity, hospital or other
- Study start
- 7 Apr 2020 (actual)
- Primary completion
- 1 Oct 2022 (estimated)
- Study completion
- 1 Oct 2022 (estimated)
- First posted
- 20 Apr 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a retrospective/prospective, cohort, non-interventional observational study. This means that all patients with documented COVID and HM diagnosed between February 2020 and study initiation will compose the retrospective part, while those diagnosed after study approval will enter prospective part.
The total duration of the study will be 12 months.
The study population will must be older than 18 years of age with HM and SARS-CoV-2 infection. All patients with documented SARS-CoV-2 infection (COVID) and history or active hematological malignancies, who refer to any Hematological Unit will be included.
Detailed description
This is a retrospective/prospective, cohort, non-interventional observational study. An informed consensus for the participation is available. In this section we provide informations on sample size and statistical analysis.
In Italy, the projected estimate of complete HM prevalence at Jan 1, 2020 has been established as 48,254 cases for Hodgkin lymphoma, 110.715 cases for non Hodgkin Lymphomas, 67,301 for leukemias, and 25,066 for multiple myeloma (Guzzinati et al, BMC Cancer 2018). The Italian Dipartimento della Protezione Civile website reported (March 23, 2020) that 63,927 cases are currently infected with SARS-CoV-2. No formal sample size calculation was made for this project but, on the basis of data available to date, considering the prevalence of hematological patients in Italy (0.4%) and assuming that these patients have the same risk of contracting COVID-19 as the general population, we supposed to enroll at least 250 patients (at March 24, 2020).
Statistical analyses All data collected will be summarized using appropriate descriptive statistics: absolute and relative frequencies for discrete variables; mean, standard deviation, median and interquartile range for continuous ones. To identify factors significantly associated with composite endpoint, log-binomial regression will be used for modelling risk ratio together with 95% confidence interval estimated.
The least absolute shrinkage and selection operator (LASSO) method will be applied for selecting the factors able to independently predict primary end-point. LASSO selects variables correlates to the measured outcome by shrinking coefficients weights, down to zero for the ones not correlated to outcome. In addition, machine learning techniques will be used for validating results from LASSO. A weight will be assigned to each coefficient of the selected predictors and weights will be summed to produce a total aggregate score. Predictive performance will be assessed through discrimination and calibration. Discrimination indicates how well the model can distinguish individuals with the outcome from those without the outcome. Two, the net reclassification improvement (NRI) will be calculated for assessing the 'net' number of individuals correctly reclassified using "the new model" over a comparator index [i.e., CCI (Charlson Comorbidity Score) or MCS (Multisource Comorbidity Score), or HM-disease specific]. Calibration ascertains the concordance between the model's predictions and observed outcomes, which we evaluated using a calibration plot. Cartographic and geostatistical methods will be used to exploring the spatial patterns of disease. An Exploratory Spatial Data Analysis (ESDA) and the Kriging method will be also applied to describe and model spatial (geographical) pattern.
Study design
- Observational model
- Cohort
- Time perspective
- Other
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study population will must be older than 18 years of age with Hematological malignancies and SARS-CoV-2 infection.
Key inclusion criteria (4 listed)
- Age equal to or greater than 18 years of age.
- History of hematological malignancies (acute leukemias, myelodysplastic syndromes, myeloproliferative neoplasms, lymphomas, myeloma).
- Active hematological malignancies (acute leukemias, myelodysplastic syndromes, myeloproliferative neoplasms, lymphomas, myeloma) at any stage/status.
- SARS-CoV-2 positive test (nasopharyngeal, BAL, fecal), documented by Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panels.
Key exclusion criteria (2 listed)
- Hematological diseases, other than hematological malignancies.
- SARS-CoV-2 negative test.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
To evaluate mortality.
Time frame: At 2 months from study initiation
The percentage of HM patients with COVID-19 who died.
To evaluate potential predictive biochemical parameters of mortality.
Time frame: At 2 months from study initiation
We will assess the correlation between some biochemical parameters at diagnosis of COVID (i.e. hemoglobin, platelets, lymphocytes, clotting tests, CRP), each on the basis of its specific unit of measure, and mortality.
To evaluate potential predictive HM-related parameters of mortality.
Time frame: At 2 months from study initiation
We will assess the correlation between HM-related parameters at diagnosis of COVID [i.e. disease type (leukemia, lymphomas, myeloma), disease status (remission / stable / progression), therapy status (on / off therapy)] and mortality.
To evaluate COVID severity as predictive parameter of mortality.
Time frame: At 2 months from study initiation
We will assess the correlation between COVID severity [mild (non-pneumonia and mild pneumonia), severe (dyspnea, respiratory frequency ≥ 30/min, SpO2 ≤ 93%, PaO2/FiO2 < 300 and/or lung infiltrates > 50%) and critical (respiratory failure, septic shock, and/or multiple organ disfunction or failure)] and mortality
5 secondary outcomes
Epidemiology of patients with HM infected by SARS-CoV-2with any spectrum of illness severity
Time frame: At 6 months from study initiation
Definition of complete clinical picture of COVID-19 in HM
Time frame: At 2 months from study initiation
Evolution of HM
Time frame: At 2 months from study initiation
To evaluate admission to ICU requiring mechanical ventilation or death per characteristics
Time frame: At 2 months from study initiation
Viral dynamics in infected HM patients
Time frame: At 12 months from study initiation
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Sep 2022.
- Background: PubMed 32109013Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
- Background: PubMed 32007145Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, Wang W, Song H, Huang B, Zhu N, Bi Y, Ma X, Zhan F, Wang L, Hu T, Zhou H, Hu Z, Zhou W, Zhao L, Chen J, Meng Y, Wang J, Lin Y, Yuan J, Xie Z, Ma J, Liu WJ, Wang D, Xu W, Holmes EC, Gao GF, Wu G, Chen W, Shi W, Tan W. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020 Feb 22;395(10224):565-574. doi: 10.1016/S0140-6736(20)30251-8. Epub 2020 Jan 30.
- Background: PubMed 32142622Xia Y, Jin R, Zhao J, Li W, Shen H. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020 Apr;21(4):e180. doi: 10.1016/S1470-2045(20)30150-9. Epub 2020 Mar 3. No abstract available.
- Background: PubMed 32142621Wang H, Zhang L. Risk of COVID-19 for patients with cancer. Lancet Oncol. 2020 Apr;21(4):e181. doi: 10.1016/S1470-2045(20)30149-2. Epub 2020 Mar 3. No abstract available.
- Background: PubMed 29282274Corrao G, Rea F, Di Martino M, De Palma R, Scondotto S, Fusco D, Lallo A, Belotti LMB, Ferrante M, Pollina Addario S, Merlino L, Mancia G, Carle F. Developing and validating a novel multisource comorbidity score from administrative data: a large population-based cohort study from Italy. BMJ Open. 2017 Dec 26;7(12):e019503. doi: 10.1136/bmjopen-2017-019503.
- Derived from this study: PubMed 34644385Visco C, Marcheselli L, Mina R, Sassone M, Guidetti A, Penna D, Cattaneo C, Bonuomo V, Busca A, Ferreri AJM, Bruna R, Petrucci L, Cairoli R, Salvini M, Bertu L, Ladetto M, Pilerci S, Pinto A, Ramadan S, Marchesi F, Cavo M, Arcaini L, Coviello E, Romano A, Musto P, Massaia M, Fracchiolla N, Marchetti M, Scattolin A, Tisi MC, Cuneo A, Della Porta M, Trentin L, Turrini M, Gherlinzoni F, Tafuri A, Galimberti S, Bocchia M, Cardinali V, Cilloni D, Corso A, Armiento D, Rigacci L, La Barbera EO, Gambacorti-Passerini C, Visani G, Vallisa D, Venditti A, Selleri C, Conconi A, Tosi P, Lanza F, Candoni A, Krampera M, Corradini P, Passamonti F, Merli F; ITA-HEMA-COV investigators. A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study. Blood Adv. 2022 Jan 11;6(1):327-338. doi: 10.1182/bloodadvances.2021005691.
- Derived from this study: PubMed 32798473Passamonti F, Cattaneo C, Arcaini L, Bruna R, Cavo M, Merli F, Angelucci E, Krampera M, Cairoli R, Della Porta MG, Fracchiolla N, Ladetto M, Gambacorti Passerini C, Salvini M, Marchetti M, Lemoli R, Molteni A, Busca A, Cuneo A, Romano A, Giuliani N, Galimberti S, Corso A, Morotti A, Falini B, Billio A, Gherlinzoni F, Visani G, Tisi MC, Tafuri A, Tosi P, Lanza F, Massaia M, Turrini M, Ferrara F, Gurrieri C, Vallisa D, Martelli M, Derenzini E, Guarini A, Conconi A, Cuccaro A, Cudillo L, Russo D, Ciambelli F, Scattolin AM, Luppi M, Selleri C, Ortu La Barbera E, Ferrandina C, Di Renzo N, Olivieri A, Bocchia M, Gentile M, Marchesi F, Musto P, Federici AB, Candoni A, Venditti A, Fava C, Pinto A, Galieni P, Rigacci L, Armiento D, Pane F, Oberti M, Zappasodi P, Visco C, Franchi M, Grossi PA, Bertu L, Corrao G, Pagano L, Corradini P; ITA-HEMA-COV Investigators. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020 Oct;7(10):e737-e745. doi: 10.1016/S2352-3026(20)30251-9. Epub 2020 Aug 13.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Marco Salvini, MD contact
Francesco Passamonti, MD principal investigator
Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
81 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of SARS-CoV-2 Infection and Hematological Malignancies, run by Ospedale di Circolo - Fondazione Macchi at 81 sites in Italy.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 23 Sep 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 81 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Francesco Passamonti, MD (+39-0332-393648, francesco.passamonti@asst-settelaghi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To evaluate mortality. (time frame: At 2 months from study initiation). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04352556, which also lists 7 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2022.