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Recruiting

NCT Number: NCT03827694

Non-Invasive Diagnosis of Pediatric Pulmonary Invasive Mold Infections

This study will establish a non-invasive diagnostic approach and evaluate clinical outcomes for children at high-risk for pulmonary invasive fungal infection (PIFI).

Recruiting

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Key information

Age range

120 day–21 year

Sex eligibility

All sexes

Study type

Observational

Primary location

The Hospital for Sick Children, Toronto, Ontario, Canada

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Males or females age > 120 days and < 22 years at any participating site
  • Have at least one of the following conditions associated with a known high incidence of IFI: hematopoietic stem cell transplantation (HSCT), aplastic anemia, bone marrow failure, primary or acquired immune deficiency, or malignancy
  • New (last 96 hours) radiographic evidence of at least one of the following: at least one nodular lesion greater than or equal to 5 mm in size, a wedge-shaped and segmental or lobar consolidation, a cavitary lesion, a lesion with a halo sign, a lesion with a reverse halo sign, or a lesion with an air crescent sign
  • Prolonged neutropenia (absolute neutrophil count < 500 cells/µl for a period of ≥ 5 consecutive days) in 30 days prior to and including the day of qualifying chest MRI or CT scan date OR currently receiving systemic therapy for acute or chronic graft-versus-host disease (GVHD) OR presence of neutrophil dysfunction because of underlying acquired or primary immune deficiency (e.g. chronic granulomatous disease) on the date of the qualifying chest MRI or CT scan
  • Subject consent or parental/guardian permission (informed consent) and if appropriate, child assent

Exclusion criteria

  • Weight <3 kg, so as to not exceed 3 ml/kg in a single blood draw
  • Previous inclusion in this study

Treatment and study plan

Non-Invasive Testing for PIFI

Diagnostic Test

galactomannan assay, fungal PCRs, cell-free next-generation DNA/RNA sequencing, RNAseq

Primary outcomes

  1. Likelihood ratio of the galactomannan assay to return a positive result among subjects determined to have PIFI

    Time frame: Baseline

  2. Likelihood ratio of galactomannan assay to return a negative result among subjects determined not to have PIFI

    Time frame: Baseline

  3. Likelihood ratio of fungal PCRs (Aspergillus PCR, Mucorales PCR) to return a positive result among subjects determined to have PIFI

    Time frame: Baseline

  4. Likelihood ratio of fungal PCRs (Aspergillus PCR, Mucorales PCR) to return a negative result among subjects determined not to have PIFI

    Time frame: Baseline

  5. Likelihood ratio of cell-free next generation DNA/RNA sequencing identifying a fungal pathogen to return a positive result among subjects determined to have PIFI

    Time frame: Baseline

  6. Likelihood ratio of cell-free next generation DNA/RNA sequencing identifying a fungal pathogen to return a negative result among subjects determined not to have PIFI

    Time frame: Baseline

  7. Likelihood ratio of molecular RNAseq platform assessing host immune response to return a positive result among subjects determined to have PIFI

    Time frame: Baseline

  8. Likelihood ratio of molecular RNAseq platform assessing host immune response to return a negative result among subjects determined not to have PIFI

    Time frame: Baseline

Secondary outcomes

  1. Composite outcome score between patients with possible pulmonary invasive fungal infection managed with empirical antifungal therapy versus an invasive diagnostic procedure

    Time frame: 49 days

    Outcome score inclusive of outcomes and adverse events. Comprehensive clinical outcome score from most to least desirable are score of 1 (survival, improvement in pulmonary nodules, no adverse events related to anti-fungal therapy or invasive diagnostic intervention) to score of 7 (death)

Study contacts

Contact information is provided by the study sponsor or research team.

PFN Central Coordinator

CONTACT

[email protected]

501-364-3057

Sponsors and collaborators

Lead sponsor

Arkansas Children's Hospital Research Institute

Other

Collaborators

  • Children's Hospital of Philadelphia
  • National Institute of Allergy and Infectious Diseases (NIAID)

Registry information

Acronym: DOMINIC

Important dates

Study start
2018
Primary completion
2025
Study completion
2026
First posted
Feb 1, 2019
Registry last updated
Sep 25, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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