Purpose

In parallel with the growth of American Thrombosis and Hemostasis Network's (ATHN) clinical studies, the number of new therapies for all congenital and acquired hematologic conditions, not just those for bleeding and clotting disorders, is increasing significantly. Some of the recently FDA-approved therapies for congenital and acquired hematologic conditions have yet to demonstrate long-term safety and effectiveness. In addition, results from well-controlled, pivotal studies often cannot be replicated once a therapy has been approved for general use.(1,2,3,4) In 2019 alone, the United States Food and Drug Administration (FDA) has issued approvals for twenty-four new therapies for congenital and acquired hematologic conditions.(5) In addition, almost 10,000 new studies for hematologic diseases are currently registered on www.clinicaltrials.gov.(6) With this explosion of potential new therapies on the horizon, it is imperative that clinicians and clinical researchers in the field of non-neoplastic hematology have a uniform, secure, unbiased, and enduring method to collect long-term safety and efficacy data. As emphasized in a recently published review, accurate, uniform and quality national data collection is critical in clinical research, particularly for longitudinal cohort studies covering a lifetime of biologic risk.(7) The overarching objective of this longitudinal, observational study is to characterize the safety, effectiveness and practice of treatments for all people with congenital and acquired hematologic disorders in the US.

Conditions

Eligibility

Eligible Ages
All ages
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

and none of the

Exclusion Criteria

are eligible for enrollment in the cohort study. Inclusion Criteria 1. Any age 2. Having any congenital or acquired non-neoplastic hematologic disorder; or 3. Having a bleeding phenotype as indicated by an age adjusted abnormal ISTH Bleeding Assessment Tool score with an unknown diagnosis; or 4. Connective tissue disorder with bleeding tendency as indicated by an age adjusted abnormal ISTH Bleeding Assessment Tool score. Exclusion Criteria 1. Does not qualify for inclusion in a cohort 2. Unable to give informed consent or assent 3. Unwilling to perform study procedures Cohort Participant Selection Each participant is to be enrolled in the cohort for which they qualify as defined below. Hemophilia Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Factor VIII or factor IX activity < 50%, without another explanation for low clotting factor other than congenital hemophilia or being a known carrier for congenital hemophilia; OR 2. Being a known carrier for congenital hemophilia with a factor VIII or factor IX activity >50% with or without a bleeding phenotype as indicated by an age-adjusted abnormal ISTH Bleeding Assessment Tool score OR 3. Known congenital hemophilia that have a factor level >50% after receiving vector. 4. Acquired hemophilia Exclusion Criteria None Von Willebrand Disease Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Meeting the definition of VWD or low VWF per most recent international guidelines Exclusion Criteria None Congenital Platelet Disorder Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Abnormalities of platelet function a. Glanzmann thrombasthenia (GPIIb or GPIIIa) b. Bernard-Soulier syndrome (GPIbalpha, GPIbbeta, or GPIX) 2. Abnormalities of platelet granules 3. Abnormalities of platelet signal transduction 4. Abnormalities of platelet secretion 5. Collagen Receptor Defect 6. ADP Receptor Defect 7. Thromboxane Receptor Defect 8. Giant Platelet Disorder 9. Abnormalities in platelet aggregation testing due to another or unknown cause (not drug related) Exclusion Criteria Congenital platelet disorders secondary to medications or other substances Rare Bleeding Disorders Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Have an established Rare Coagulation Disorder (RCD) diagnosis of one of the following: 1. PAI-1 deficiency 2. Factor I, II, V, VII, X, XI, XIII deficiencies 3. Combined FV and FVIII deficiency Exclusion Criteria None Bleeding NOS Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Have a bleeding phenotype as indicated by an age-adjusted abnormal ISTH Bleeding Assessment Tool score with an unknown diagnosis; OR 2. Connective tissue disorder with bleeding tendency as indicated by an age-adjusted abnormal ISTH Bleeding Assessment Tool score Exclusion Criteria None Thrombosis/Thrombophilia Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Have arterial or venous thrombosis 2. Patients with a known congenital or acquired thrombophilia with or without a thrombosis a. Established genetic factors: i. Protein C deficiency ii. Protein S deficiency iii. Antithrombin deficiency iv. Factor V Leiden v. Prothrombin gene mutation b. Rare genetic factors i. Dysfibrinogenemias ii. Hyperhomocysteinemia c. Indeterminate genetic factors i. Elevated factor VIII ii. Elevated factor IX iii. Elevated factor XI iv. Plasminogen deficiency v. Decreased tissue plasminogen activator vi. Elevated lipoprotein (a) d. Acquired thrombophilias i. Lupus anticoagulant ii. Anti-cardiolipin antibodies iii. Antiphospholipid syndrome Exclusion Criteria 1. Acquired thrombophilia secondary to medications (birth control pills or hormone replacement therapy, overweight or obesity, smoking, cancer, pregnancy, surgery, injury, prolonged inactivity/bedrest, heart failure, inflammatory bowel disease, or kidney disease Non-Neoplastic Hematologic Conditions Cohort Inclusion Criteria Participants who meet the following inclusion criteria are eligible for enrollment into this cohort: 1. Having any congenital or acquired non-neoplastic hematologic disorder not included in any other cohort Exclusion Criteria None

Study Design

Phase
Study Type
Observational
Observational Model
Case-Only
Time Perspective
Prospective

Arm Groups

ArmDescriptionAssigned Intervention
Hemophilia This cohort includes three Arms: PUPs Arm: This Arm is for previously untreated patients (PUPs) with congenital hemophilia A or B. This is a longitudinal, observational, prospective and retrospective Arm of PUPs with moderate or severe congenital hemophilia. Participants will be followed to assess inhibitor development within 50 exposure days (ED). Hemophilia Natural History Arm: This Arm is investigating a natural history of the safety, effectiveness, and practice of treatment for people with hemophilia. It is a longitudinal, observational, prospective Arm for participants with acquired or congenital hemophilia A or B. Hemophilia Gene Therapy Outcomes Arm: This Arm is investigating the safety and effectiveness of gene therapy in people with hemophilia. It is a longitudinal, observational cohort Arm following participants prospectively and retrospective for 15 years after vector infusion.
Von Willebrand Disease The Severe VWD Natural History Arm is investigating the natural history of the safety, effectiveness, and practice of treatment for people with severe von Willebrand disease (VWD). It is a longitudinal, observational cohort Arm following participants every 6 months for at least 2 years.
Congenital Platelet Disorders No Arms or Modules at this time.
Rare Bleeding Disorders No Arms or Modules at this time
Bleeding NOS No Arms or Modules at this time
Thrombosis/Thrombophilia No Arms or Modules at this time
Non-Neoplastic Hematologic Conditions No Arms or Modules at this time

Recruiting Locations

Louisiana Center for Bleeding and Clotting Disorders, Tulane University
New Orleans, Louisiana 70112
Contact:
Melody Benton
mbenton@tulane.edu

More Details

Status
Recruiting
Sponsor
American Thrombosis and Hemostasis Network

Study Contact

Carol Fedor, ND, RN, CCRC
800-360-2846
cfedor@athn.org

Detailed Description

This is a longitudinal, natural history observational cohort study being conducted at approximately 150 ATHN-affiliated sites. Participants will be followed for a minimum of 15 years. Harmonized data elements will be collected at time of enrollment, quarterly, ad hoc, and annually. Base data to be collected for all participants. Specific data will be collected for participants enrolled in cohort-specific Arms and Modules. Each participant will be assigned in a single cohort: Hemophilia, Von Willebrand Disease, Congenital Platelet Disorder, Rare Bleeding Disorders, Bleeding not otherwise specified (NOS), Thrombosis/Thrombophilia, or Non-Neoplastic Hematologic Conditions. The cohort for which a participant qualifies will be determined by the site Investigator. Study Arms and study Modules may be developed to provision disease and/or disease specific insights related to stakeholders, including but not limited to pharmaceutical companies, ATHN, and Hemophilia Treatment Centers (HTCs). Arms may branch off into product-specific data collection via Modules to be collected during the study, in conjunction with planned study assessments. ATHN Transcends Principal Investigator: Michael Recht, MD, PhD, MBA American Thrombosis and Hemostasis Network ATHN Transcends Co-Investigator: Lynn Malec, MD, MSc Versiti Blood Research Institute Arm Principal Investigators: PUPs Arm: Shannon Carpenter, MD, MS University of Missouri Kansas City School of Medicine Children's Mercy Hospital Courtney Thornburg, MD, MS University of California San Diego Rady Children's Hospital San Diego Hemophilia Natural History Arm Tyler Buckner, MD, MSc Hemophilia and Thrombosis Center University of Colorado Anschutz Medical Campus Michael Recht, MD, PhD, MBA American Thrombosis and Hemostasis Network Hemophilia Gene Therapy Outcomes Arm: Janice M. Staber, MD Iowa Hemophilia and Thrombosis Center University of Iowa Stead Family Children's Hospital Ulrike M. Reiss, MD Hemophilia Treatment Center St. Jude's Children's Research Hospital Severe VWD Natural History Arm: Robert F. Sidonio, Jr., MD, MSc Aflac Cancer and Blood Disorders Center, Hemophilia of Georgia Center for Bleeding and Clotting Disorders Angela C. Weyand, MD C.S. Mott Children's Hospital, University of Michigan Medical School, Ann Arbor

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.