Autoimmune Diseases, Autoinflammatory Diseases, Clonal Hematopoiesis of Indeterminate Potential, Hematologic Diseases, Hematopoiesis Clonal, Immune System Diseases, Inflammation, Leukemia, Leukemia Myelomonocytic Chronic, Lymphoma, Lymphoproliferative Disorders, Monoclonal Gammopathy of Undetermined Significance, Myelodysplastic-Myeloproliferative Diseases, Myelodysplastic Syndromes, Myeloproliferative Disorders, Vexas Syndrome
Conditions
Keywords
Inflammation, Autoinflammatory Diseases, Vexas syndrome, Autoimmune Diseases, Clonal Hematopoiesis of Indeterminate Potential, Myelodysplastic-Myeloproliferative Diseases, Lymphoproliferative Disorders, Monoclonal Gammopathy of Undetermined Significance
Brief summary
Ambispective, national, multicenter observational cohort study aimed at characterizing the satellite dysimmune manifestations of clonal hematopoiesis, including Vexas (Vacuoles, E1 enzyme, X-linked, Autoinflammatory and Somatic) syndrome.
Detailed description
The clinical spectrum of dysimmune manifestations associated with blood diseases is wide. The pathophysiology of these manifestations is not well understood and their management is poorly codified. This observational cohort aims to list the different clinical pictures, the therapeutic management and the prognosis of patients according to the type of dysimmune manifestations and the type of hemopathy. We wish to have an inventory of the demographic, genetic, clinical and evolutionary data of patients with an inflammatory manifestation associated or not with a myeloid or lymphoid hemopathy. This will make it possible to establish quantitative data on the morbidity and mortality of these rare diseases and to propose therapeutic trials for the most serious patients. This is an International, multicentre, observational cohort study with retrospective and prospective components (ambispective). The primary objective is to describe the incidence of immuno-inflammatory manifestations in patients with clonal hematopoiesis or a haematological disease. The secondary objectives are as follows: * To describe the clinical and biological presentation of immuno-inflammatory manifestations according to the type of underlying haematological disease or clonal hematopoiesis; * To describe the clinical and biological presentation of VEXAS syndrome and its association with other haematological diseases; * To study the relationship between giant cell arteritis and clonal hematopoiesis; * To specify clinical symptoms according to the genetic mutations identified; * To define the main genetic mutations associated with these manifestations; * To identify patients eligible for different therapeutic trials; * To assess the characteristics of associated haematological diseases; * To compare the effectiveness of immunomodulatory and antitumour treatments according to the type of immuno-inflammatory manifestation and type of underlying haematological disease or clonal hematopoiesis; * To study the profile of patients eligible for stem cell transplantation; * To study mortality in patients followed for an inflammatory disease with or without haematological disease/clonal hematopoiesis; * To explore the natural history of patients over a 10-year follow-up in order to better characterise long-term complications; * To build a multicentre reference database enabling cross-sectional and longitudinal analyses to guide future therapeutic strategies; * To establish correlations between clinical, biological and molecular characteristics in order to better stratify risk and adapt patient management.
Interventions
observational cohort study
Sponsors
Study design
Eligibility
Inclusion criteria
* Age \>=18 years old; * Confirmed dysimmune manifestations: clinical or biological abnormality or systemic disease; * Presence or absence of myeloid or lymphoid blood disease according to World Health Organization (WHO) classification
Exclusion criteria
* Persons benefiting from special protection: adults under guardianship and curatorship; * People hospitalized without their consent and not protected by law; persons deprived of liberty; * Persons not affiliated to the social security system
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of dysimmune manifestations associated with hematological disorders | Baseline | Number of new cases |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| VEXAS syndrome | 10 years | Number of patients with VEXAS syndrome |
| Dysimmune manifestations other than VEXAS syndrome | 10 years | Number of patients with dysimmune manifestations other than VEXAS syndrome |
| Myeloid hemopathy | 10 years | Number of patients with myeloid hemopathy |
| Lymphoid hemopathy | 10 years | Number of patients with lymphoid hemopathy |
| Clonal hematopoiesis of undeterminate potential | 10 years | Number of patients with clonal hematopoiesis of undeterminate potential |
| Skin involvement | 10 years | Number of patients with skin involvement |
| Musculoskeletal involvement | 10 years | Number of patients with musculoskeletal involvement |
| Ocular involvement | 10 years | Number of patients with ocular involvement |
| Vascular involvement | 10 years | Number of patients with vascular involvement |
| Neurological involvement | 10 years | Number of patients with neurological involvement |
| Digestive system involvement | 10 years | Number of patients with digestive system involvement |
| Cardiac involvement | 10 years | Number of patients with cardiac involvement |
| Pulmonary involvement | 10 years | Number of patients with pulmonary involvement |
| Renal involvement | 10 years | Number of patients with renal involvement |
| Therapeutic interventions received | 10 years | Type and duration of therapeutic interventions received |
| Progression to acute myeloid leukemia | 10 years | Number of patients who progressed to acute myeloid leukemia |
| Overall mortality | 10 years | Overall mortality rate from all causes |
Countries
France
Contacts
Service de médecine interne, Hôpital Saint Antoine, APHP, Paris