Sickle Cell DiseaseEarly Phase 1NCT06313398
Determination of Red Cell Survival in Sickle Cell Disease and Other Hemoglobinopathies Using Biotin Labeling
A Early Phase 1 study testing Biotin-labeled red blood cells in people with Sickle Cell Disease and Thalassemia, run by National Heart, Lung, and Blood Institute (NHLBI) at 1 site in United States.
Trial summary
Background: Sickle cell disease (SCD) is an inherited disorder of the blood. SCD causes red blood cells (RBCs) to die early. This can lead to a shortage of healthy cells. SCD and other blood disorders can be managed with drugs or cured with a bone marrow transplant. Read more about this study
- Who is it for?
- Ages 18 to 100 years
- Conditions the study is for
- Sickle Cell Disease, Thalassemia, Hemoglobinopathy
- What is being tested?
- Biotin-labeled red blood cells
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- 1 siteUnited States
- Study dates
- 17 May 2024to 15 Jun 2029
- Phase
- Early Phase 1
- Are there results?
- Not yet: the study is under way
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 to 100 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- In order to be eligible to participate in this study, an individual must meet all of the following criteria:
- Provision of signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged 18 years or greater with confirmed diagnosis of SCD (all genotypes), thalassemia (beta and/or alpha), or other inherited hemoglobinopathy not otherwise specified.
- Be at steady state for their underlying disease (e.g. SCD or thalassemia) or post-bone marrow transplantation status, as evidenced by medical history.
- Ability to have blood samples drawn.
- For female participants of child-bearing potential, agree to use birth control during study participation. Female subjects of child-bearing potential must agree to use a medically acceptable method of birth control such as an oral contraceptive, intrauterine device, barrier and spermicide, or contraceptive implant/injection from start of screening through 4 months after infusion.
- Agreement to adhere to Lifestyle Considerations throughout study duration
Who cannot join
- An individual who meets any of the following criteria will be excluded from participation in this study:
- Consumption of biotin supplements or raw eggs within the last 30 days.
- Blood loss within the previous 8 weeks (>540 mL).
- Red cell transfusion for their underlying SCD and/or thalassemia within the last 3 months.
- Participants may be eligible after three months following their last transfusion.
- Patients on hemodialysis, due to possibility of early removal of biotinylated RBCs.
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- Pregnancy, lactation or absence of adequate contraception for fertile female subjects.
- Pediatric subjects will not participate in this study.
- Known allergic reactions to biotin, due to risk of possible life-threatening allergic reaction.
- Current diagnosis of malignancy (liquid and/or solid).
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site, 1 recruiting
- Recruiting
National Institutes of Health Clinical Center
Bethesda, Maryland, 20892
NIH Clinical Center Office of Patient Recruitment (OPR), 800-411-1222 ext. TTY dial 711, ccopr@nih.gov
About this study
Background:
Sickle cell disease (SCD) is an inherited disorder of the blood. SCD causes red blood cells (RBCs) to die early. This can lead to a shortage of healthy cells. SCD and other blood disorders can be managed with drugs or cured with a bone marrow transplant. Researchers want to know how long RBCs survive in people with SCD and other blood disorders before and after treatment compared to those who had a bone marrow transplant.
Read more
Objective:
To learn how long RBCs survive in the body in people with SCD and other blood disorders compared to those whose disease was cured with a bone marrow transplant.
Eligibility:
People aged 18 years or older with SCD or another inherited blood disorder. People whose SCD or blood disorder was cured with a bone marrow transplant are also needed.
Design:
Participants will be screened. They will have a physical exam with blood and urine tests.
Participants will have about 7 tablespoons of blood drawn. In the lab, this blood will be mixed with a vitamin called biotin. Biotin sticks to the outside of RBCs. This process is called "biotin labeling of RBCs." The next day, the participant s own biotin-labeled RBCs will be returned to their bloodstream.
Participants will return regularly to have smaller blood samples (about 2 teaspoons) drawn. These samples will be tested to detect the percentage of cells that have biotin labels. These visits may be every 2 weeks, 4 weeks, or some other interval. Participants will continue this schedule for up to 20 weeks or until biotin can no longer be detected....
Read the detailed description
Study Description:
This study will use biotin-labeling of red blood cells (RBCs) to determine the mean potential lifespan (MPL) of RBCs in patients with sickle cell disease (SCD) and other hemoglobinopathies (e.g. thalassemia), including in those receiving disease modifying therapies or who have undergone curative hematopoietic stem cell transplantation (HSCT: allogeneic or autologous). Previous studies have corroborated the MPL of healthy donor RBCs to be approximately 115 days, while RBCs from patients with SCD have a more variable but consistently shorter MPL of approximately 32 days. We recently validated these findings and demonstrated the feasibility, safety, and efficacy of determining MPL of biotin-labeled RBCs in patients with SCD before and after transplant, persons with sickle cell trait, and healthy donors. Allogeneic HSCT is a curative treatment for severe SCD with stable, mixed donor-recipient chimerism after HSCT sufficient to reverse the sickle cell phenotype by virtue of improved donor red cell survival compared to the ineffective erythropoiesis of SCD. HSCT, both allogeneic and autologous, are also curative for certain hemoglobinopathies, such as transfusion dependent beta thalassemia (TDT), with donor cells able to overcome the ineffective erythropoiesis in TDT as well. We predict that the hematologic variables associated with red cell survival among patients with SCD and other hemoglobinopathies vary between individuals and are affected by disease modifying therapy, including curative therapies. The data generated will refine our understanding of the degree of correction necessary to reverse the clinical phenotype of SCD and other hemoglobinopathies, including that needed for autologous gene therapy to be curative.
Objectives:
Primary Objective:
To determine and compare red blood cell survival, by virtue of the mean number of days of detectable biotin-labeled RBCs, in participants with SCD and/or other hemoglobinopathies before and after initiation of disease modifying therapy, including those who have undergone HSCT.
Secondary Objective:
To validate the association of red cell survival with known markers of increased survival, specifically absolute reticulocyte count, hemoglobin F or hemoglobin A percentage, and alpha globin mutation status (SCD participants only).
Exploratory Objective:
To create and pilot a mathematical model incorporating RBC survival and reticulocyte count to determine the necessary amount of normal hemoglobin or hemoglobin F needed to reverse sickle cell complications. Information from participants with inherited high HbF will be used.
Endpoints:
Primary Endpoint:
Red blood cell survival via measurement of detectable biotin-labeled RBC with time
Secondary Endpoint:
Relationship of RBC survival to hematologic parameters.
Exploratory Endpoint:
Amount of normal hemoglobin or hemoglobin F needed to reverse the sickle cell complications.
- Conditions
- Sickle Cell Disease, Thalassemia, Hemoglobinopathy
- Being tested
- Biotin-labeled red blood cells
- Keywords
- Red Cell, Hemoglobinopathy, Thalassemia, Sickle Cell Disease, Biotin
- Medical subject headings
- Anemia, Sickle Cell, Thalassemia, Hemoglobinopathies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Biotin-labeled red blood cellsBiological
Cellular Product (patient's own red blood cells washed in Biotin and infused back to patient)
| Study group | Role | What they receive |
|---|---|---|
| RBC survival in patients with SCD | Experimental | RBC lifespan, determined by the mean number of days from biotin-labeled RBC infusion until biotin-labeled RBCs are below limit of detection, in patients with inherited hemoglobinopathies prior to and post initiation of disease modifying therapy or HSCT Receives: Biological: Biotin-labeled red blood cells |
What is being measured
The primary outcome is the main question the study is designed to answer.
To determine and compare red blood cell survival, by virtue of the mean number of days of detectable biotin-labeled RBCs, in participants with SCD and/or other hemoglobinopathies.
Enumeration of biotin-labeled RBCS (BioRBCs) will be performed by flow cytometry. F-cell and/or S-cell measurement will be done by flow cytometry. BioRBCs will be isolated from post-infusion blood samples using flow cytometry separation. The collected BioRBCs and the whole blood fraction will be analyzed by high performance liquid chromatography (HPLC) for hemoglobin content.
Measured: Patients w/o transplant: lab draw every 2 weeks until biotin-labeled cells are no longer detected. Patients Post-transplant: lab draw every four weeks, until week 12. Lab draw every 2 weeks until biotin-labeled cells are no longer detected.
Secondary outcomes (1)
Validate the association of RBC survival with known markers of increased survival.
We will measure the relationship of RBC survival to hematologic parameters known to be associated with survival, specifically hemolysis markers (e.g. absolute reticulocyte count, lactate dehydrogenase, total bilirubin, and aspartate aminotransferase), hemoglobin F or hemoglobin A percentage, and alpha globin gene mutation status obtained at baseline and during scheduled lab draws (except for alpha globin gene mutation analysis which is only done at baseline).
Measured: Patients w/o transplant: lab draw every 2 weeks until biotin-labeled cells are no longer detected. Patients Post-transplant: lab draw every four weeks, until week 12. Lab draw every 2 weeks until biotin-labeled cells are no longer detected.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Mar 2024
- Study start17 May 2024
- Primary completion1 May 2029 (estimated)
- Study completion15 Jun 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Sickle Cell DiseaseStudies of the same condition, open and under way.
- More trials run by National Heart, Lung, and Blood Institute (NHLBI)The sponsor's other registered studies.
- 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
- Interventional
- Phase
- Early Phase 1
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Collaborators
- Children's National Research Institute
- Responsible party
- Sponsor
- Investigators
- John F Tisdale, M.D., Principal investigator, National Heart, Lung, and Blood Institute (NHLBI)
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06313398
- Sponsor's protocol ID
- 10001883
- Other IDs
- 001883-H
- Status last verified
- 24 Sep 2026
- First submitted
- 14 Mar 2024
- Last updated
- 28 Sep 2026
- Results posted
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Determination of Red Cell Survival in Sickle Cell Disease and Other Hemoglobinopathies Using Biotin Labeling
- ClinicalTrials.gov ID
- NCT06313398
- Acronym / sponsor ID
- 10001883
- Conditions
- Sickle Cell Disease, Thalassemia, Hemoglobinopathy
- Keywords
- Red Cell, Hemoglobinopathy, Thalassemia, Sickle Cell Disease, Biotin
- Phase
- Early Phase 1
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- National Heart, Lung, and Blood Institute (NHLBI)US National Institutes of Health
- Collaborators
- Children's National Research Institute
- Study start
- 17 May 2024 (actual)
- Primary completion
- 1 May 2029 (estimated)
- Study completion
- 15 Jun 2029 (estimated)
- First posted
- 15 Mar 2024 (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.
Background:
Sickle cell disease (SCD) is an inherited disorder of the blood. SCD causes red blood cells (RBCs) to die early. This can lead to a shortage of healthy cells. SCD and other blood disorders can be managed with drugs or cured with a bone marrow transplant. Researchers want to know how long RBCs survive in people with SCD and other blood disorders before and after treatment compared to those who had a bone marrow transplant.
Objective:
To learn how long RBCs survive in the body in people with SCD and other blood disorders compared to those whose disease was cured with a bone marrow transplant.
Eligibility:
People aged 18 years or older with SCD or another inherited blood disorder. People whose SCD or blood disorder was cured with a bone marrow transplant are also needed.
Design:
Participants will be screened. They will have a physical exam with blood and urine tests.
Participants will have about 7 tablespoons of blood drawn. In the lab, this blood will be mixed with a vitamin called biotin. Biotin sticks to the outside of RBCs. This process is called "biotin labeling of RBCs." The next day, the participant s own biotin-labeled RBCs will be returned to their bloodstream.
Participants will return regularly to have smaller blood samples (about 2 teaspoons) drawn. These samples will be tested to detect the percentage of cells that have biotin labels. These visits may be every 2 weeks, 4 weeks, or some other interval. Participants will continue this schedule for up to 20 weeks or until biotin can no longer be detected....
Detailed description
Study Description:
This study will use biotin-labeling of red blood cells (RBCs) to determine the mean potential lifespan (MPL) of RBCs in patients with sickle cell disease (SCD) and other hemoglobinopathies (e.g. thalassemia), including in those receiving disease modifying therapies or who have undergone curative hematopoietic stem cell transplantation (HSCT: allogeneic or autologous). Previous studies have corroborated the MPL of healthy donor RBCs to be approximately 115 days, while RBCs from patients with SCD have a more variable but consistently shorter MPL of approximately 32 days. We recently validated these findings and demonstrated the feasibility, safety, and efficacy of determining MPL of biotin-labeled RBCs in patients with SCD before and after transplant, persons with sickle cell trait, and healthy donors. Allogeneic HSCT is a curative treatment for severe SCD with stable, mixed donor-recipient chimerism after HSCT sufficient to reverse the sickle cell phenotype by virtue of improved donor red cell survival compared to the ineffective erythropoiesis of SCD. HSCT, both allogeneic and autologous, are also curative for certain hemoglobinopathies, such as transfusion dependent beta thalassemia (TDT), with donor cells able to overcome the ineffective erythropoiesis in TDT as well. We predict that the hematologic variables associated with red cell survival among patients with SCD and other hemoglobinopathies vary between individuals and are affected by disease modifying therapy, including curative therapies. The data generated will refine our understanding of the degree of correction necessary to reverse the clinical phenotype of SCD and other hemoglobinopathies, including that needed for autologous gene therapy to be curative.
Objectives:
Primary Objective:
To determine and compare red blood cell survival, by virtue of the mean number of days of detectable biotin-labeled RBCs, in participants with SCD and/or other hemoglobinopathies before and after initiation of disease modifying therapy, including those who have undergone HSCT.
Secondary Objective:
To validate the association of red cell survival with known markers of increased survival, specifically absolute reticulocyte count, hemoglobin F or hemoglobin A percentage, and alpha globin mutation status (SCD participants only).
Exploratory Objective:
To create and pilot a mathematical model incorporating RBC survival and reticulocyte count to determine the necessary amount of normal hemoglobin or hemoglobin F needed to reverse sickle cell complications. Information from participants with inherited high HbF will be used.
Endpoints:
Primary Endpoint:
Red blood cell survival via measurement of detectable biotin-labeled RBC with time
Secondary Endpoint:
Relationship of RBC survival to hematologic parameters.
Exploratory Endpoint:
Amount of normal hemoglobin or hemoglobin F needed to reverse the sickle cell complications.
Study design
- Primary purpose
- Other
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| RBC survival in patients with SCD | Experimental | Biological: Biotin-labeled red blood cellsRBC lifespan, determined by the mean number of days from biotin-labeled RBC infusion until biotin-labeled RBCs are below limit of detection, in patients with inherited hemoglobinopathies prior to and post initiation of disease modifying therapy or HSCT |
Who may qualify
- Ages
- 18 to 100 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- In order to be eligible to participate in this study, an individual must meet all of the following criteria:
- Provision of signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged 18 years or greater with confirmed diagnosis of SCD (all genotypes), thalassemia (beta and/or alpha), or other inherited hemoglobinopathy not otherwise specified.
- Be at steady state for their underlying disease (e.g. SCD or thalassemia) or post-bone marrow transplantation status, as evidenced by medical history.
Key exclusion criteria (10 listed)
- An individual who meets any of the following criteria will be excluded from participation in this study:
- Consumption of biotin supplements or raw eggs within the last 30 days.
- Blood loss within the previous 8 weeks (>540 mL).
- Red cell transfusion for their underlying SCD and/or thalassemia within the last 3 months.
- Patients on hemodialysis, due to possibility of early removal of biotinylated RBCs.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Biotin-labeled red blood cellsCellular Product (patient's own red blood cells washed in Biotin and infused back to patient) | Biological | RBC survival in patients with SCD |
Primary outcome
To determine and compare red blood cell survival, by virtue of the mean number of days of detectable biotin-labeled RBCs, in participants with SCD and/or other hemoglobinopathies.
Time frame: Patients w/o transplant: lab draw every 2 weeks until biotin-labeled cells are no longer detected. Patients Post-transplant: lab draw every four weeks, until week 12. Lab draw every 2 weeks until biotin-labeled cells are no longer detected.
Enumeration of biotin-labeled RBCS (BioRBCs) will be performed by flow cytometry. F-cell and/or S-cell measurement will be done by flow cytometry. BioRBCs will be isolated from post-infusion blood samples using flow cytometry separation. The collected BioRBCs and the whole blood fraction will be analyzed by high performance liquid chromatography (HPLC) for hemoglobin content.
1 secondary outcome
Validate the association of RBC survival with known markers of increased survival.
Time frame: Patients w/o transplant: lab draw every 2 weeks until biotin-labeled cells are no longer detected. Patients Post-transplant: lab draw every four weeks, until week 12. Lab draw every 2 weeks until biotin-labeled cells are no longer detected.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Sep 2026.
- NIH Clinical Center Detailed Web PageLink provided by the sponsor.
- 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.
John F Tisdale, M.D. principal investigator
National Heart, Lung, and Blood Institute (NHLBI)
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Early Phase 1 study testing Biotin-labeled red blood cells in people with Sickle Cell Disease and Thalassemia, run by National Heart, Lung, and Blood Institute (NHLBI) at 1 site in United States.
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 8 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 28 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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.
What does this phase mean?
Early Phase 1 (sometimes called Phase 0) studies give a very small amount of a treatment to a few people, mainly to see how the body handles it.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Christina C Luckett ((301) 529-7863, christina.luckett@nih.gov), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
To determine and compare red blood cell survival, by virtue of the mean number of days of detectable biotin-labeled RBCs, in participants with SCD and/or other hemoglobinopathies. (time frame: Patients w/o transplant: lab draw every 2 weeks until biotin-labeled cells are no longer detected. Patients Post-transplant: lab draw every four weeks, until week 12. Lab draw every 2 weeks until biotin-labeled cells are no longer detected.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 28 Sep 2026.