Acute Leukemia Biphenotypic in Remission, Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia in Remission, Lymphoma in Remission, Myelodysplasia With Stable Blasts is Cell Number and < 10% of Blastocysts, Non-progressive Myeloproliferative Syndrome
Conditions
Brief summary
The aim is to validate an in vitro diagnosis medical device to predict grade II to IV aGVHD after a cell graft
Detailed description
Acute Graft Versus Host Disease (aGVHD) is the most frequent complication in allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT). It affects up to 50% patients, among whom 15% to 25% develop severe forms, often lethal, yet impossible to predict even for donors with a Human Leukocyte Antigene (HLA) 10/10 compatibility. Global Overall Survival (OS) after transplantation is 40% to 60% only due to post transplant severe complications. There is a major medical need for a technology that would predict the risk of aGVHD and would allow the selection of a favourable donor among multiple Human Leukocyte Antigene (HLA)10/10 compatible donors. MT. Rubio and M. Bouillié at Pr Olivier Hermine's lab previously reported that enhanced early post-transplant invariant Natural Killer T (iNKT) cells reconstitution from donor cells was correlated to reduced risk of aGVHD, without impairment of the Graft Versus Leukemia (GVL) effect. They subsequently demonstrated that the expansion of donors CD4neg invariant Natural Killer T (iNKT) cells subpopulation was predictive of a reduced risk of aGVHD, and developed a method for predicting this risk based on the expansion factor of CD4neg invariant Natural Killer T (iNKT) cells in the peripheral blood stem cell (PBSC) graft. This invariant Natural Killer T (iNKT) cells functional test reaches its optimal predictive capacity with 94% sensitivity and 100% specificity in allo-HSCT performed with Human Leukocyte Antigene (HLA) 10/10 matched peripheral blood stem cell (PBSC) grafts for non-progressive hematological malignant diseases, in complete response, which represent the majority of the indications of allogeneic HSCT. Similar predictive value was also observed when the test was performed from donor's peripheral blood before G-CSF mobilization. It was not associated with an increased risk of relapse. This test could therefore allow to easily selecting the best donor if different siblings or unrelated donors are available before PBSC allo-HSCT.
Interventions
DIAGNOSTIC_TESTEx vivo capacities of CD4neg INkT expansion of the peripheral blood donor with the Predictor test
Calculation of ex vivo capacities of CD4neg INkT expansion of the peripheral blood from an identified donor for an allograft. Sample is collected before mobilization and the blood culture and analysis using the Predictor test are performed by the central lab.
Sponsors
SATT
SNC Graft Versus Host Disease
Imagine Institute
Axonal-Biostatem
CERBA laboratory
Assistance Publique - Hôpitaux de Paris
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* PATIENT : * Age between 18 and 65 years ( included ) * Being candidate to a graft of peripheral hematopoietic stem cells , according the following criteria : * HLA compatibility 10 / 10 with the selected donor * Malignant haematological disorder as described below : * Acute Myeloid Leukemia (AML) or Acute Lymphoblastic Leukemia ( ALL) in 1st or 2d complete remission * Aggressive lymphoma in complete remission * Non - progressive myeloproliferative syndrome , * Myelodysplasia with stable blasts is cell number and \< 10 % of blastocysts, * Acute leukemia biphenotypic in 1st or 2d complete remission * Sequential graft conditioning, myeloablative or with a reduced intensity, both may include ATG * Classical scheme for immunosuppression decrease ( from day 90 to day 180 ) • Not being opposed to medical data collection DONOR * Adult ( ≥ 18 year old) up to the maximum authorized by each National Transplantation Authority * Being a patient's sibling or registered in the Bone Marrow Donors Worldwide registry or a national registry * Being candidate to a Peripheral Blood Stem Cells donation with a Human Leucocyt Antigen (HLA) 10 / 10 compatibility with the recipient , * Signed and dated informed consent ( in accordance with local regulation of the country in which the observation is performed )
Exclusion criteria
* Participating in a clinical trial, if interventional on the prophylaxis treatment ( not on the prophylaxis ) of GVHD, in the 30 days prior to the inclusion and during the Predictor 2 study , * Being placed under legal supervision , * Presenting any impossibility to fulfil the study requirements, due to geographical, social or physical reasons
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of aGVHD of grade II to IV observed for the recipients | 3 month after allograft performance | To predict the risk of acute GVHD. Number of aGVHD of grade II to IV observed for the recipients in the 3 months after the graft and results of the Predictor test, before graft, on their own donor's blood. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Evaluation of medico-economic aspect of the Predictor test Total estimated cost of the aGVHD treatment | 3 month after allograft performance. | Number of hospitalization or medical consultation, exams, concomitant treatments. |
| Evaluation of the medico-economic aspect of the Predictor test Total estimated cost of the aGVHD treatment | 3 month after allograft performance. | Number of medical consultations |
Countries
Belgium, France, Germany
Contacts
Primary ContactYannick VACHER
Backup ContactMarie-Lou CAMUT
Outcome results
None listed