CClinicalTrials.gg
CompletedNCT03008642Poly-COUpdated Sep 19, 2025

CO-Rebreathing in Comparison to Isotopic Red Cell Volume Determination in the Diagnosis of Primitive and Secondary Polycythemia

An interventional study of CO-Rebreathing technique at diagnosis of polycythemia in Polycythemia, sponsored by Centre Hospitalier Universitaire, Amiens. Completed at 1 site in France. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2025-09-19.

Sponsored by Centre Hospitalier Universitaire, Amiens · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Not applicable
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The optimized CO-Rebreathing is an efficient method to evaluate the red cell mass and has been used in the vast majority of studies in sport medicine. However, this method has never been evaluated on a large scale in the diagnosis of primitive or secondary polycythemia. The standard procedure to evaluate the red cell mass is based on isotopic measurement using Cr51-labelled red cells, but its lack of availability in many centers highlights the need for a non-invasive and rapid alternative method. The purpose of this study is to evaluate and validate the CO-Rebreathing method in this set of indications.

Read the detailed description

The definition of a true polycythemia is stricto sensu an increased red cell mass (RCM) above 125% of the expected value depending on the size and the weight of the patient. However, this measurement requires an isotopic labeling of red cells and is not available in most of the hospitals. Therefore, the diagnosis of polycythemia, and particularly Polycythemia Vera (PV) is based on routine red blood cells parameters, i.e. hemoglobin level and hematocrit. If these parameters are efficient in marked polycythemia, discrepancies have been observed in milder cases. Two situations where a RCM evaluation is particularly required can be described:

  • In patients with a hematocrit level between 52 and 60% (men) or between 48 and 56% (women) in order to limit invasive investigations to patients with a confirmed polycythemia diagnosis
  • In JAK2V617F positive myeloproliferative neoplasms (MPN) with hematocrit and hemoglobin levels under the PV cut-off in order to discriminate between masked PV and essential thrombocythemia CO-Rebreathing is a fast, non invasive alternative method for RCM evaluation. It is based on the high affinity of carbon monoxide (CO) for hemoglobin. The decrease in the HbCO percentage after CO inhalation is dependent on the total hemoglobin mass from which RCM can be obtained. The investigators propose a tri-centric study evaluating CO-Rebreathing as an alternative tool to measure RCM in the diagnosis of polycythemia in the two categories of patients described above.
02

Conditions studied

  • Polycythemia

Keywords

  • Polycythemia
  • CO-Rebreathing
  • red cell mass determination
  • myeloproliferative neoplasms
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Adult patient
  2. Informed consent obtained
  3. Requirement of an isotopic red cell mass determination:

    a - Hematocrit between 52 and 60% (men) or 48 and 56% (women) with no argument for a PV (JAK2V617F negative, EPO level normal/high).

    b - Patients with a JAK2V617F positive MPN and a hematocrit level between 46 and 50% (women) or 48 and 52% for men.

  4. No recent vascular event (\<6 mois)
  5. No unstable coronaropathy
  6. Non smoking since 24 hours.
  7. ECOG \<2
  8. Negativity of pregnancy test/effective contraception for childbearing age women,
  9. Health insurance

Exclusion criteria

Exclusion Criteria:

  1. Recent venous event \<1 months, cerebral stroke \< 6 mois)
  2. Evolutive cardiopathy (\< 6 months)
  3. Chronic Respiratory failure
  4. Smokers with no withdrawal in the last 24 hours before CO-Rebreathing
  5. Basal HbCO>7% the day of CO-Rebreathing
  6. Pregnant or breast feeding women
  7. Patient enable to give an informed consent
  8. Inclusion in an interventional clinical trial in the last three months.
  9. Any contraindication to lung function testing
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
60 participants (actual)

Study arms

  • Experimental
    CO-Rebreathing

    The intervention consists in one red cell mass determination using the CO-Rebreathing technique at diagnosis of polycythemia, in addition to the regular tests performed in this indication, including RCM isotopic measurement.

    Other: CO-Rebreathing technique at diagnosis of polycythemia

Interventions

  • OtherCO-Rebreathing technique at diagnosis of polycythemia

    The intervention consists in one red cell mass determination using the CO-Rebreathing technique at diagnosis of polycythemia, in addition to the regular tests performed in this indication, including RCM isotopic measurement.

05

What researchers measure

Primary outcomes

  1. equivalence of RCM determination by CO-Rebreathing in comparison to the traditional isotopic measurement in the diagnosis of polycythemia

    The primary outcome is to prove the equivalence of RCM determination by CO-Rebreathing in comparison to the traditional isotopic measurement in the diagnosis of polycythemia.

    Time frame: 1 month

Secondary outcomes

  1. AE / SAE / EI

    Incidence, grade type according to NCI-CTCAE v4.0

    Time frame: 1 month

  2. Cumulative incidence of thrombotic and hemorrhagic complications

    Cumulative incidence of thrombotic and hemorrhagic complications List according to PT1 protocol.

    Time frame: 1 month

  3. Deaths and causes

    Deaths and causes

    Time frame: 1 month

  4. Analysis of the results of VGTCO and VGTi

    Analysis of the results of VGTCO and VGTi as a function of hemoglobin and hematocrit

    Time frame: 1 month

06

Study locations

1 site
  • CHU Amiens Picardie
    Amiens, Picardie 80054, France
07

References and documents

Publications

  • Maaziz N, Georges M, Basille D, Gallet M, Gardie B, Diouf M, Garcon L, Girodon F. Carbon monoxide rebreathing method is a reliable test to evaluate the red cell mass in polycythaemia. Br J Haematol. 2024 Feb;204(2):706-709. doi: 10.1111/bjh.19169. Epub 2023 Dec 3. No abstract available. PubMed 38044575 ↗
08

Registry details

Key details

Study ID
NCT03008642
Lead sponsor
Centre Hospitalier Universitaire, Amiens
Responsible party
Sponsor
First posted
Jan 2, 2017
Start date
Apr 1, 2019
Primary completion
May 1, 2020
Completion
May 1, 2020
Last update
Sep 19, 2025

Study contacts

Loïc GARCON, professor
study director · CHU Amiens-Picardie
Lydia ROY, Doctor
principal investigator · CHU Henri Mondor, France
Marjolaine GEORGES, Doctor
principal investigator · Centre Hospitalier Universitaire Dijon

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion