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Impact of Optical Genome Mapping in Acute Myeloblastic Leukemia

Active, not recruiting
Conditions
Acute Myeloblastic Leukemia
Registration Number
NCT05499611
Lead Sponsor
University Hospital, Bordeaux
Brief Summary

A retrospective study using a new technology will be performed: the Optical Genome Mapping (OGM) on acute myelogenous leukemia (AML) samples stored at the CRB-Cancer of the Bordeaux University Hospital and annotated in the DATAML clinical database. The main objective is to estimate the proportion of AML patients for whom OGM detects at least one additional abnormality compared to conventional techniques. This study will constitute an important step in the validation of COA as a reference technique for cytogenetic analysis in AML, replacing the classical techniques, and could also constitute a first argument for redesigning the prognostic classification of AML.

Detailed Description

In AML prognostic classifications, such as the ELN 2017 classification, which are used to guide treatment choices in the majority of protocols, rely heavily on genetic abnormalities. The Optical Genome Mapping (OGM) is a new technology that combines in one and the same technique the results of karyotype, FISH and SNP-Array, the latter being very little used in current practice in AML. OGM with greater sensitivity and a better resolution than the usual techniques should therefore allow us to identify more abnormalities than conventional cytogenetics; we would then like to determine whether these additional abnormalities have a prognostic impact, i.e., whether they lead to reclassification of patients initially classified as "favorable" or "intermediate" into the "unfavorable" prognostic category, with therapeutic consequences.

A retrospective study using the OGM is will be performed on samples stored at the CRB-Cancer of the Bordeaux University Hospital and annotated in the DATAML clinical database. In an original way, the focus will be on AML patients in whom 1 to 3 chromosomal abnormalities (non-recurrent WHO, not related to an unfavourable prognosis) have already been demonstrated by classical techniques, making the hypothesis that it is in this population that we would more easily have patients who could fall into the definition of the complex karyotype and thus into the unfavourable risk category.

OGM should therefore reveal a greater number of abnormalities which would allow a better definition of karyotypes with abnormalities, the number of complex and/or monosomal karyotypes and a better stratification of the prognosis of these patients with AML. This is an applied translational research study based on innovative technology that will define the place of OGM over current techniques used in the initial management of AML patients, and it may well become the new standard for cytogenetic analysis of AML in the coming years.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Patients ≥ 18 years and ≤ 65 years of age who have been treated with intensive chemotherapy
  • Diagnosis of AML (with a minimum follow-up of 24 months)
  • Presence of samples included in CRB-K in the AML collection
  • Cytogenetic data available: karyotype with 1-3 abnormalities present in one or more clones, excluding recurrent WHO abnormalities (t(8;21), inv(16) or t(16;16), t(9;11), t(v;11)(v;q23. 3), t(6;9), inv(3) or t(3;3) and t(9;22)) or assigned by itself to an unfavorable prognosis: -5 or del(5q); -7; -17/abn(17p).
  • Molecular data available for the following genes: ASXL1, CEBPA, FLT3-ITD, NPM1, RUNX1 and TP53 (the list of genes of interest may be adapted according to the upcoming ELN 2022 classification)
Exclusion Criteria
  • Samples not included in the CRB-K (lack of consent, insufficient material...)
  • Karyotype with one of the following abnormalities: (t(8;21), inv(16) or t(16;16), t(9;11), t(v;11)(v;q23.3), t(6;9), inv(3) or t(3;3), and t(9;22)) or associated with an unfavorable prognosis on its own: -5 or del(5q); -7; -17/abn(17p)
  • Karyotype without clonal abnormality

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Proportion of patients with more abnormalities detected by OGM than by conventional cytogeneticsAt baseline
Secondary Outcome Measures
NameTimeMethod
Interobserver reproducibility for interpretation of OGM results (Fleiss Kappa coefficient)At baseline
Average number of additional abnormalities detected by OGM compared to conventional techniquesAt baseline
Comparison of overall survival and event-free survival curves of patients reclassified to the unfavorable group to those of the intermediate and unfavorable groups in a historical cohortFrom baseline to Month 36
Proportion of patients reclassified as complex and/or monosomal karyotype according to current ELN definitionsAt baseline
Proportion of patients for whom a change in therapeutic management could have been proposedFrom baseline to Month 36

Trial Locations

Locations (1)

CHU de Bordeaux, service Hématologie Biologique

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Bordeaux, France

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