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Clonal Architecture of ASXL1-mutated Myelofibrosis

Not Applicable
Recruiting
Conditions
Myelofibrosis
Interventions
Biological: Clonal architecture determination
Registration Number
NCT05710211
Lead Sponsor
University Hospital, Angers
Brief Summary

Prospective study to decipher the clonal architecture of ASXL1-mutated primary and secondary myelofibrosis and its impact on prognosis

Detailed Description

The clonal architecture of myelofibrosis patients is still little described. Inconsistent results in terms of the prognostic value of some mutations are observed in the literature, in particular concerning ASXL1 mutations. We assume that a better understanding of the clonal architecture of ASXL1-mutated myelofibrosis could help refining the prognostic impact of ASXL1 mutations.

This study aims to evaluate a multicenter cohort of 50 patients. Blood of patients will be collected within 18 months of diagnosis. After 4 years of follow-up of the patient as part of his usual care, data on survival and leukemic transformation will be collected.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Adults (age ≥18 years),
  • Affiliated to the national social security system,
  • ASXL1 mutated primary or secondary myelofibrosis,
  • Signed the consent to participate in the study,
  • Included, or consenting to be included, in the national clinical-biological database of France Intergroupe Syndrome Myéloprolifératifs (FIM).
Exclusion Criteria
  • Patient with another active hematological disease or cancer at the time of diagnosis,
  • Person subject to legal protection scheme or incapable of giving consent.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
CLONEMF cohortClonal architecture determination-
Primary Outcome Measures
NameTimeMethod
Identify subgroups of ASXL1-mutated myelofibrosis based on clonal architecture data24 months

The clonal architecture is defined by the number of mutations (numerical), the order of acquisition of the mutations (categorial, pre/post/separated), the mutational branching (categorial, yes/no), the presence of distinct clones (categorial, yes/no) and the transition towards homozygosity of each clone (categorial, yes/no). All parameters of clonal architecture will be analyzed together using a multivariate classification (Factor Analysis for Mixed Data) followed by a clustering which allow us to identify homogeneous cluster of patients.

Secondary Outcome Measures
NameTimeMethod
Description of previously constituted prognostic genomic groups (according to Luque Paz et al. 2021) within identified clusters of clonal architecture24 months

The repartition of patients onto genomic groups will be reported for each clusters of clonal architecture (number and percentage).

Studying the functional characteristics of each subtype of clonal architecture by transcriptomics24 months

Gene Set Enrichment Analysis (GSEA) will be performed for each cluster of clonal architecture

Comparison of male proportion within the subtypes of clonal architecture24 months

Repartition of gender will be compared

Comparison of splenomegaly proportion within the subtypes of clonal architecture24 months

Proportion of patients with splenomegaly will be compared

Evaluation of overall survival of the patients at 4 years according to their clonal architecture profile72 months

Overall survival will be evaluated by Cox models

Comparison of age at the time of diagnosis within the subtypes of clonal architecture24 months

Age at the time (years) of diagnosis will be compared

Comparison of blood counts within the subtypes of clonal architecture24 months

Blood counts (g/dL or G/L) at the time of diagnosis will be compared

Comparison of LDH levels within the subtypes of clonal architecture24 months

LDH levels (UI/L) at the time of diagnosis will be compared

Comparison of constitutional symptoms proportion within the subtypes of clonal architecture24 months

Proportion of patients with constitutional symptoms will be compared

Evaluation of the leukemia-free survival of the patients at 4 years according to their clonal architecture profile72 months

Leukemia-free survival will be evaluated by Cox models

Trial Locations

Locations (13)

CHU Henri MONDOR

🇫🇷

Creteil, France

CH Cholet

🇫🇷

Cholet, France

CH de Cornouaille

🇫🇷

Quimper, France

CHRU Tours - Hôpital Bretonneau

🇫🇷

Tours, France

CHU Nantes

🇫🇷

Nantes, France

CHU de Bordeaux

🇫🇷

Pessac, France

CHU Lyon

🇫🇷

Pierre Bénite, France

CHRU Brest

🇫🇷

Brest, France

CH de Vannes

🇫🇷

Vannes, France

Institut Paoli Calmettes

🇫🇷

Marseille, France

AP-HP Hôpital Saint Louis

🇫🇷

Paris, France

Hôpital Bicêtre

🇫🇷

Paris, France

CHU Angers

🇫🇷

Angers, France

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