NCT04882605

Brief Summary

The use of haploidentical donors for aHSCT has greatly increased this past decade leading to a major paradigm shift: while finding 10/10 HLA-matched donors represented the prior difficulty for decades, the current problem is about finding the best haploidentical donor among several potential ones. The prediction of NK cells alloreactivity toward leukemic cells provides promising perspectives, although the underlying biological processes remain unclear. To date, many prediction models based on KIR and MHC genotyping have been designed and used across studies, which contribute to blur clinical conclusions. The investigators hypothesized that the diversity of models used to predict NK alloreactivity in aHSCT could partly be responsible for the current literature discrepancies. The main objective of this work consisted of applying the major KIR-based prediction models in D/R couples undergoing aHSCT in different fashions - with MSD and haploidentical donors - to describe their heterogeneity and potential correlations. As clinical data were available for these two cohorts, the investigators described correlations that could be assessed between the scoring strategies and the clinical outcomes. As suspected, it was highlighted that the different scoring strategies greatly impact the assessment of alloreactivity within D/R couples. As an example, two broadly used scoring strategies - educational models and missing-ligand models - show clear opposite predictions. Moreover, some scoring strategies seem to be better adapted to genoidentical or haploidentical cohorts, whereas others are robust across the different cohorts. Concerning the clinical-biological correlations, it was highlighted that (i) each scoring strategy is differentially associated to the different outcomes (ii) the different scoring strategies predict one particular outcome with different efficacy (iii) the D/R compatibility greatly impacts the pertinence of the scoring strategy. This work therefore contributes to unravel the KIR-based alloreactivity prediction of NK cells in aHSCT. This would help to overcome the current literature discrepancies in this field as in making new hypotheses to better understand and predict NK alloreactivity to further develop its use in medical practice.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
156

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Mar 2015

Longer than P75 for all trials

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 23, 2015

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 25, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

July 25, 2019

Completed
1.8 years until next milestone

First Submitted

Initial submission to the registry

May 4, 2021

Completed
8 days until next milestone

First Posted

Study publicly available on registry

May 12, 2021

Completed
Last Updated

May 12, 2021

Status Verified

May 1, 2021

Enrollment Period

4.3 years

First QC Date

May 4, 2021

Last Update Submit

May 9, 2021

Conditions

Keywords

Hematopoietic Stem Cell Transplantationacute Graft versus Host Diseasechronic Graft versus Host DiseaseKiller Immunoglobulin-like ReceptorsNK-mediated alloreactivity

Outcome Measures

Primary Outcomes (2)

  • Describe the heterogeneity of the major KIR-based prediction models in assessing alloreactivity

    At inclusion

  • Describe the potential correlations between a KIR-based prediction models and post-allograft outcomes

    at least 4 months

Study Arms (2)

Donor/recipient couple with Matched Sibling Donor

Donor/recipient couple = Patient undergoing a hematopoietic stem cell transplantation \+ its 10/10 HLA-matched donor recruited among his siblings

Genetic: MHC typingGenetic: KIR typingGenetic: Assessment of KIR-based prediction scores

Donor/recipient couple with Haploidentical Donor

Donor/recipient couple = Patient undergoing a hematopoietic stem cell transplantation \+ its 5/10 HLA-matched donor recruited among his relatives

Genetic: MHC typingGenetic: KIR typingGenetic: Assessment of KIR-based prediction scores

Interventions

MHC typingGENETIC

Allelic genotyping resolution of MHC genes (HLA-A, -B, -C, -DRB1, -DQA1, -DQB1, -DPA1, -DPB1 and -DRB3/4/5) using Illumina technology.

Donor/recipient couple with Haploidentical DonorDonor/recipient couple with Matched Sibling Donor
KIR typingGENETIC

Allelic genotyping resolution of all 13 KIR genes (KIR2DL1, KIR2DL2/2DL3, KIR2DL4, KIR2DL5A, KIR2DL5B, KIR2DS1, KIR2DS2, KIR2DS3, KIR2DS3/2DS5, KIR2DS4, KIR3DL1/3DS1, KIR3DL2, KIR3DL3), 2 KIR pseudogenes (KIR2DP1 and -3DP1) using Illumina technology.

Donor/recipient couple with Haploidentical DonorDonor/recipient couple with Matched Sibling Donor

Compiling donor/recipient MHC and KIR typings into 28 major KIR-based prediction scores

Donor/recipient couple with Haploidentical DonorDonor/recipient couple with Matched Sibling Donor

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Two independents cohorts of D/R couples (i) Matched siblig donors (MSD) couples : 50 couples selected from the French national database CRYOSTEM (ii) Haploidentical donors couples: exhaustive local cohort of haploidentical HSCT performed in the Hematology Department of Nancy's University Hospital, Lorraine, France. French Minister registration number : DC-2020-4068

You may qualify if:

  • recipient of HSCT selected from the French national database CRYOSTEM
  • adult patients (18-50 years old)
  • transplanted in first remission
  • receiving myeloablative conditioning without anti-thymoglobulin
  • couples without any sign of GVH (8 males and 8 females)
  • couples with aGVH without cGVH
  • couples with cGVH without aGVH

You may not qualify if:

  • insufficient DNA material after Miltenyi extraction
  • insufficient DNA material after Miltenyi extraction (7 MSD couples)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Bronchiolitis Obliterans Syndrome

Condition Hierarchy (Ancestors)

Organizing PneumoniaBronchiolitis ObliteransBronchiolitisBronchitisBronchial DiseasesRespiratory Tract DiseasesLung Diseases, ObstructiveLung DiseasesGraft vs Host DiseaseImmune System Diseases

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
OTHER
Target Duration
4 Months
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 4, 2021

First Posted

May 12, 2021

Study Start

March 23, 2015

Primary Completion

July 25, 2019

Study Completion

July 25, 2019

Last Updated

May 12, 2021

Record last verified: 2021-05