Aplastic Anaemia and other bone marrow failure syndromes Registry
Haemoglobinopathies including thalassaemia and sickle cell disease
Lymphoma and Related Diseases Registry
Australian and New Zealand Massive Transfusion Registry
Myelodysplastic Syndromes Registry (MDS) pilot project
Myeloma and Related Diseases Registry
Asia-Pacific Myeloma and Related Diseases Registry
Neonatal Alloimmune Thrombocytopenia
Thrombotic Microangiopathies (TMA) Registry
Venous Thromboembolism Cohort study
Two ongoing analyses led by TRU are sub-studies of the ASPREE international trial of low-dose aspirin or placebo in the healthy elderly. ASPREE-Anaemia is characterising contributors to, and consequences of, anaemia in the elderly, funded by the Alfred Research Trust. The NHMRC-funded ASPREE-CHIP (clonal haematopoiesis of indeterminate potential) study is studying development of CHIP and its consequences, using genomics analysis of samples from the ASPREE biobank.
An NHMRC-funded trial to evaluate anti-fibrinolytic therapy in thrombocytopenia, a collaborative RCT with NHS Blood and Transplant UK) that explores the efficacy and safety of tranexamic acid to limit bleeding in people with haematologic malignancies and low platelet counts.
Role of antibiotic therapy or IVIg on infections in haematology, a National Blood Authority-funded trial ascertaining the safety and efficacy of oral antibiotics or intravenous immunoglobulin to reduce infection risk in adults with haematologic malignancies and low immunoglobulin levels. Data will inform a future large scale RCT.
Red blood cell transfusion thresholds and quality of life in myelodysplastic syndromes (MDS). The REDDS-1 feasibility trial of haemoglobin thresholds for red cell transfusion in transfusion-dependent MDS was presented at the American Society of Hematology in 2018 and published in 2020. The REDDS-2 trial will assess a novel weekly transfusion schedule, using matched red cells, in patients with transfusion-dependent MDS on clinical functional outcomes and quality of life, as well as red cell use. Patient and healthcare worker experiences will be explored via a qualitative study. REDDS is a collaboration between Monash University, the UK National Health Service Blood and Transplant (NHSBT) and hospitals in Australia, UK and the Netherlands. The results will inform the design and conduct of an international phase III trial. REDDS-2 in Australia is funded by the Australian & New Zealand Society of Blood Transfusion, Monash Haematology and the National Blood Authority.
Diagnosis of Aplastic Anaemia, Management, and Outcomes utilising a National Dataset. A national registry-based clinical trial using a novel adaptive (Bayesian) study design, to investigate the benefit and costs of avatrombopag, a second-generation thrombopoietin receptor agonist, in addition to conventional immunosuppressive therapies, in adult patients with Aplastic Anaemia. This work is funded by the Medical Research Future Fund.
IV iron for treatment of anaemia before cardiac surgery, in collaboration with The Alfred. This is an international RCT comparing efficacy, safety and cost effectiveness of preoperative intravenous iron in cardiac surgery patients with anaemia, funded by the NHMRC and ANZCA.
The Australasian Myeloma Research Consortium (AMaRC), led by Alfred Health, aims to promote, facilitate and sponsor multi-centre investigator-initiated trials and collaborative laboratory research projects in myeloma, acting as a trial centre supporting the participating sites in Australasia. Several AMARC studies are in association with the MRDR.
The Role of Antibiotic Therapy or Ig On iNfections in hAematoLogy: Immunoglobulin Stopping or Extension. RATIONALISE is an NHMRC funded Phase II/III trial evaluating the cessation of immunoglobulin (Ig) therapy in adult patients with blood cancer. The trial aims to determine if Ig therapy can be stopped if patients are free of major infection after six months of Ig therapy, and after stopping Ig, if oral antibiotics can be used to prevent future infection. The trial includes a health economics analysis to explore the cost-effectiveness of the trial interventions, a biological sub-study and a qualitative sub-study to explore patient perspectives on infection prevention and related treatments.
Other research activities
Data linkage and modelling studies
In collaboration with established large clinical registries (for trauma, intensive care and cardiac surgery) and using data from these sources as well as administrative datasets (such as hospital admissions and laboratory information), we can study clinical outcomes for patients and develop models for transfusion to predict and monitor blood use. An example of this work includes development of the ACSePT model for predicting blood use in cardiac surgery. Other projects using donor travel information and large public health datasets to develop models of risk for transfusion-transmitted infections such as West Nile Virus.
Meta-analyses and systematic reviews
We undertake meta-analyses and systematic reviews to better understand the current evidence base for transfusion practice and identify evidence gaps for future research. Our national and international activities include collaborations with the Australian Leukaemia and Lymphoma Group, National Blood Authority, Oxford's Systematic Reviews Initiative, the US National Institutes of Health, and the Canadian Institute of Health Research.