Condition category
Haematological Disorders
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr Michael R. DeBaun


Contact details

WUSM CB 8519
4444 Forest Park Blvd.
Saint Louis
United States of America
+1 314 286 1186

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title


SIT Trial

Study hypothesis

On 12/03/2008 this trial record was updated. The start date and anticipated end date of this trial were also updated from 01/04/2000 and 30/04/2005 to 01/12/2005 and 30/11/2012, respectively.

Added as of 12/03/2008:
Primary hypothesis:
1. Prophylactic blood transfusion therapy in children with silent cerebral infarcts will result in at least 86% reduction in the proportion of patients with clinically evident strokes or new or progressive silent cerebral infarcts.

Secondary hypotheses:
1. Prophylactic blood transfusion therapy will limit the further decline in general intellectual abilities when compared to the observation arm.
2. The overall benefit of blood transfusion therapy for silent cerebral infarctions outweighs the risks associated with this therapy.

Ethics approval

Not provided at time of registration

Study design

Randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet


Sickle Cell Anemia and Stroke


Participants will be randomly assigned to one of two groups - the blood transfusion group or the observation group. The blood transfusion group will receive regular blood transfusion therapy. All participants will receive history and physical exams every three months, cognitive testing and neurological exam annually, a TCD 12-18 months following randomization, and a final MRI of the brain at study exit. Active participation on the study is 3 years.

Intervention type



Not Specified

Drug names

Primary outcome measure

Not provided at time of registration

Secondary outcome measures

Not provided at time of registration

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Inclusion criteria amended as of 12/03/2008:
Inclusion Criteria for Screening:
1. Patient must have sickle cell anemia (hemoglobin SS or sickle B) as confirmed by the local institution by hemoglobin analysis after six months of age
2. Patient must be 5 through 14 years of age (i.e., must have attained their 5th, but not their 15th birthday when the screening consent is signed)
3. Informed consent with assent in accordance with the institutional policies

Inclusion criteria provided at time of registration:
1. Patients ages 6-12 with sickle cell anemia (Hemoglobin SS or SB)
2. Patient must have a silent cerebral infarct documented by magnetic resonance imaging (MRI) of the brain as read by the neuroradiology panel

Participant type


Age group




Target number of participants

Added as of 12/03/2008: Screen 1880; Randomize at least 204 and up to 250

Participant exclusion criteria

Exclusion criteria amended as of 12/03/2008:
Exclusion Criteria for Screening at initial screening evaluation and after informed consent has been signed as well as during the interval up to randomization:
1. Patient with a history of a focal neurologic event lasting more than 24 hours with medical documentation or a history of prior overt stroke
2. Patient with other neurological problems, such as neurofibromatosis, lead poisoning, non-febrile seizure disorder, or tuberous sclerosis
3. Patient with HIV infection
4. Pregnancy or lactating females
5. Patient who received treatment with anti-sickling drugs or hydroxyurea within 3 months or anticipate receiving anti-sickling drugs or hydroxyurea during the course of the study
6. Patients on chronic blood transfusion therapy for other reasons
7. Patient judged not likely to be compliant by his/her hematologist and study coordinator based on previous compliance in clinic appointments and following advice. Specifically, families that have missed at least two appointments without notification within 12 months prior to the trial or parents/guardians of potential patients that have been reported for medical or education neglect are not eligible for this trial
8. Patient unable to receive blood transfusion because of alloimmunization
9. Patients who have or anticipate receiving permanent (or semi-permanent) metallic structures attached to their body. (e.g., braces on teeth, body piercings), which their physicians believe will interfere with the MRI of the head to assess the presence of silent cerebral infarct
10. Patients with any person living in the same household who have been randomly assigned in the SIT Trial

Exclusion criteria provided at time of registration:
1. Patients with a history of overt stroke or focal neurological event lasting more than 24 hours
2. Patients with other neurological problems, such as neurofibromatosis, lead poisoning, or tuberous sclerosis
3. Patients with a transcranial doppler (TCD) study with a time-averaged mean velocity greater than 200 cm/sec verified by the study radiologist

Recruitment start date


Recruitment end date



Countries of recruitment

United States of America

Trial participating centre

WUSM CB 8519
Saint Louis, MO
United States of America

Sponsor information


National Institute of Neurological Disorders and Stroke (NINDS) (USA)

Sponsor details

Neuroscience Center
Room 2212
6001 Executive Blvd
United States of America

Sponsor type




Funder type


Funder name

National Institute of Neurological Disorders and Stroke (NINDS) (USA) (ref: U01NS42804)

Alternative name(s)

The National Institute of Neurological Disorders and Stroke, NINDS

Funding Body Type

government organisation

Funding Body Subtype

Research institutes and centers


United States of America

Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2014 results in:

Publication citations

  1. Results

    DeBaun MR, Gordon M, McKinstry RC, Noetzel MJ, White DA, Sarnaik SA, Meier ER, Howard TH, Majumdar S, Inusa BP, Telfer PT, Kirby-Allen M, McCavit TL, Kamdem A, Airewele G, Woods GM, Berman B, Panepinto JA, Fuh BR, Kwiatkowski JL, King AA, Fixler JM, Rhodes MM, Thompson AA, Heiny ME, Redding-Lallinger RC, Kirkham FJ, Dixon N, Gonzalez CE, Kalinyak KA, Quinn CT, Strouse JJ, Miller JP, Lehmann H, Kraut MA, Ball WS, Hirtz D, Casella JF, Controlled trial of transfusions for silent cerebral infarcts in sickle cell anemia., N. Engl. J. Med., 2014, 371, 8, 699-710, doi: 10.1056/NEJMoa1401731.

Additional files

Editorial Notes