CIHR funding announced to investigate preventative treatments for infections in patients with hematologic cancer patients withand low immune function

The CCTG SC30 (RATIONAL) trial has been successfully funded through the CIHR fall competition for nearly $1.2 million over four years. The study will investigate treatment options for patients with blood cancers and low antibody levels to determine the best supportive care interventions to prevent serious infections. 

“We currently recommend to patients to start on monthly (or weekly injections at home) blood transfusions of donor antibodies if the immune system is severely compromised or mildly compromised with frequent and serious infections. We don’t know if this is the best treatment for infection prevention, we don’t have studies to guide how much we should give patients, and we have no idea when it is safe to stop the treatment,” says Dr. Jeannie Callum, Hematologist at Kingston Health Sciences Centre and Queen's Professor in the Department of Pathology and Molecular Medicine and principal investigator for the Canadian portion of the RATIONAL trial. 

Antibodies are immune proteins that help prevent infections and low antibody levels are common in patients with blood cancers, either from the cancer itself or from the chemotherapy treatments. Infection for these patients and can lead to admissions to hospital, side effects from antibiotics, additional testing (x-rays, blood tests), and resulting delays in scheduled chemotherapy. The most common treatment for infection is immunoglobulin replacement (IgRT) even though there is little meaningful evidence it decreases serious infections and comes with substantial costs to the system. 

The objective of this trial is to compare the standard IgRT dose, with low-dose IgRT or oral antibiotics. Researchers will measure infection rates, antibiotic resistance, IgRT and antibiotic side effects, patient quality of life, and healthcare costs. Canada spends approximately $100 million on IgRT products for this patient population, and it is uncertain which patients should receive IgRT, what dose should be given, when it should be started, and when it can be safely stopped.

"This is the first collaboration between the Canadian Cancer Trials Group (CCTG) and the Canadian Transfusion Trials Group and the CCTG Hematology and Supportive Care Committees,” say Senior Investigator Dr Harriet Richardson. “It is wonderful to see the wider community coming together to enhance care for people living with blood cancers." 

This international study will also be conducted in collaboration with research partners in Australia and New Zealand.