Myeloproliferative Neoplasm
Conditions
Brief summary
First-line treatment for patients with polycythemia vera, essential thrombocythemia, and pre-myelofibrosis is based on hydroxyurea or pegylated interferon. The objective of treatment is to prevent thrombotic complications and leukemic transformation. Despite overall good response rates, some patients do not respond to treatment and others lose their response over time. Both situations are associated with worse survival and there are to date no clear predictive factors for response although the existence of additional mutations seems unfavorable. In this exploratory study, we hypothesize that biological factors at diagnosis are associated with hematological response at 12 months. We will more specifically study the association between mutational profile, assessed by next-generation sequencing, and cytokine profile with hematological response. This study will help in identifying patients who will not respond to hydroxyurea or pegylated interferon and give the opportunity to try other treatments upfront, in the perspective of precision medicine. On the basic science side, this study will help in understanding the molecular and immunological factors involved in resistance to treatment.
Interventions
DIAGNOSTIC_TESTNext-generation sequencing
Next-generation sequencing and cytokine profile will be established in all patients before the start of treatment.
Sponsors
University Hospital, Angers
University Hospital, Brest
Nantes University Hospital
Poitiers University Hospital
Rennes University Hospital
University Hospital, Tours
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults with polycythemia vera, essential thrombocythemia, or pre-myelofibrosis. * Indication for first-line treatment with hydroxyurea or pegylated interferon. * Consent to participate. * Affiliated to social security.
Exclusion criteria
* Previous treatment. * Other on-going malignancy, including overt myelofibrosis. * Other treatment such as phlebotomy solely, ruxolitinib, anagrelide, or pipobroman.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Complete hematological response | 12 months | ELN-2013 criteria by meeting all of the following: * Durable resolution of disease-related signs including palpable hepatosplenomegaly, large symptoms improvement, AND * Durable peripheral blood count remission, defined as: platelet count ≤400 ×109/L, WBC count \<10 × 109/L, Ht lower than 45% without phlebotomies (for PV patients), absence of leukoerythroblastosis, AND * Without signs of progressive disease, and absence of any hemorrhagic or thrombotic events. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complete hematological response | 24, 36, 48, and 60 months | ELN-2013 criteria by meeting all of the following: * Durable resolution of disease-related signs including palpable hepatosplenomegaly, large symptoms improvement, AND * Durable peripheral blood count remission, defined as: platelet count ≤400 ×109/L, WBC count \<10 × 109/L, Ht lower than 45% without phlebotomies (for PV patients), absence of leukoerythroblastosis, AND * Without signs of progressive disease, and absence of any hemorrhagic or thrombotic events. |
| Molecular response | 12 and 24 months | ELN-2013 criteria: Complete response is defined as eradication of a preexisting abnormality (CALR, JAK2, or MPL mutations) by quantitative PCR. Partial response applies only to patients with at least 20% mutant allele burden at baseline. Partial response is defined as ≥50% decrease in allele burden by quantitative PCR. |
Countries
France
Contacts
CONTACTCORENTIN ORVAIN, DOCTOR
Outcome results
None listed