Evaluation of the Redox Profiles of Healthy and Pathological B Cells in Patients With Chronic Lymphocytic Leukemia

NCT ID: NCT03971565

Last Updated: 2019-06-03

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 47 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2019-03-19
• Study Completion Date: 2021-03-18

Brief Summary

In recent years, considerable progress has been made in understanding the biology of chronic lymphocytic leukemia (CLL), resulting in the emergence of new therapeutic agents that have significantly improved the long-term survival of patients. However, LLC is still considered an incurable disease.

Cytogenetic abnormalities are frequently found in this pathology. Some abnormalities are associated with a more aggressive disease and a poor prognosis. The deletion of chromosome 17p (del (17p)), in particular, makes leukemic cells more resistant to standard therapy. Chromosome 17p contains the Tumor Protein 53 gene (TP53) which encodes the tumor suppressor protein 53 (P53) protein. P53 plays a central role in the regulation of important cellular functions such as DNA damage response, cell cycle regulation, apoptosis, and drug sensitivity of chemotherapies. In patients with CLL, the loss of p53 function is a major factor of chemoresistance and is associated with an adverse prognosis. The deletion (17p) is observed in approximately 5 to 10% of patients with CLL. In contrast, mutations in the TP53 gene are observed in approximately 30% of patients with CLL. This means that about one-third of patients with CLL have p53 dysfunction. TP53 and / or del (17p) mutated LLC cells show marked mitochondrial dysfunction. This dysfunction is responsible for a deregulation of intracellular redox phenomena, leading to an increase in oxidative stress and an overproduction of reactive oxygen derivatives (ROS).

Dimethyl Ampal Thiolester (DIMATE) is an active, competitive and irreversible inhibitor of aldehyde dehydrogenases (ALDH) 1 and 3. In vitro, DIMATE eradicates human cells from acute myeloblastic leukemia (AML). In patients with CLL, current treatments, particularly effective, do not specifically target pathological B cells. This results in chronic B lymphopenia and hypogammaglobulinemias that provide severe long-term infections, which is the leading cause of death in patients with CLL.

Through this study, we will study, in vitro, the expression of ALDH 1, 3, 9 but also of glutathione (GSH) and ROS on tumor B lymphocytes and healthy patients carrying an LLC. Depending on the differences in expression observed, DIMATE could specifically eradicate leukemic lymphocyte cells by sparing healthy lymphocytes, a hypothesis that will be tested in vitro. A special evaluation will be made in patients with del (17) and / or TP53 mutation whose prognosis is still considered unfavorable despite new therapeutic advances.

Conditions

Chronic Lymphocytic Leukemia

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

Patients with chronic lymphocytic leukemia

Patient with a minimum period of 90 days without treatment

Blood sample 5 milliliter

Intervention Type: BIOLOGICAL

The blood of the patients will be collected during their hospitalization of the hematology department participating in the research

Interventions

Blood sample 5 milliliter

The blood of the patients will be collected during their hospitalization of the hematology department participating in the research

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

• Major patient (greater than or equal to 18 years)
• Patients with 4 to 5 (or equivalent) grade 4 or 5 Matheol Score-confirmed chronic lymphocytic leukemia (CLL), whether prior to treatment or relapse
• For relapsed patients of their CLL, a minimum period of 90 days without treatment (including corticosteroids) compared to previous chemotherapy
• Patient having received the information and having given his non-opposition

Exclusion Criteria

• Previous chemotherapy treatment outside of previous CLL therapy
• Active secondary cancer currently being treated with the exception of non-melanoma skin cancer or cervical cancer in situ
• Transformation into high grade lymphoma, Richter syndrome or pro-lymphocytic leukemia,
• Viral or fungal bacterial infection active at the time of screening Infection with human immunodeficiency virus,
• Medical or psychological condition that could interact with the ability to understand the study

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Assistance Publique Hopitaux De Marseille

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Jean-Olivier ARNAUD, Director

Role: STUDY_DIRECTOR

Assitance Publique Hôpitaux de Marseille

Locations

Assitance Publique Hôpitaux de Marseille

Marseille, , France

Site Status: RECRUITING

Countries

France

Central Contacts

Régis COSTELLO, PU-PH

Role: CONTACT

regis.costello@ap-hm.fr

491384150 ext. +33

Facility Contacts

Régis COSTELLO, PU-PH

Role: primary

regis.costello@ap-hm.fr

491384150 ext. +33

Other Identifiers

2018-A02574-51

Identifier Type: OTHER

Identifier Source: secondary_id

2018-52

Identifier Type: -

Identifier Source: org_study_id