Assessment of Body, Liver and Labile Plasma Iron and Their Association With Outcome and Immunological Recovery in Myelodysplastic Syndrome (MDS) or Acute Myeloid Leukemia (AML) Patients Undergoing Allogeneic Stem Cell Transplantation - ALLIVE (ALLogeneic Iron inVEstigators) Observational Trial

GWT-TUD GmbH134 enrolled

Overview

The ALLIVE (ALLogeneic Iron inVEstigators) trial aims at quantifying the extent and dynamic change of LPI occurrence during conditioning and at identifying LPI-predictive peri-transplant parameters. Further points of interest are the improvement of systemic iron overload (SIO) diagnostics and the correlation of different SIO parameters with outcome after transplantation. The results of this trial will help to design prospective interventional studies addressing therapeutic options in patients at risk for SIO-associated toxicity during allogeneic stem-cell transplantation (allo-SCT).

Study Type

OBSERVATIONAL

Enrollment

134

Conditions

MDS and AML Prior to Allogeneic SCT

Interventions

No intervention and study treatmentOTHER

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \>= 18 years at the time of signing the informed consent form * Signed informed consent * Diagnosis of AML or MDS according to WHO classification * Planned allogeneic stem cell transplantation after reduced intensity or myeloablative conditioning from related or unrelated donors * At risk for iron toxicity as defined by ferritin \>500 ng/ml and/or history of more than 10 RBC transfusions prior to allo-SCT Exclusion Criteria: * Claustrophobia or other mental disorders making MRI imaging unbearable for the patient * Cardiac pacemakers, metal implants splinters or other contraindications for MRI * More than 1 Human leukocyte antigen (HLA) allele or antigen mismatch between donor and recipient * Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study * Patients with a history of chronic drug abuse or another illness which does not allow the patient to assess the nature and/or possible consequences of the study * Patients who are not likely to follow the trial protocol (lack of willingness to cooperate)

Locations (5)

III. Medizinischen Klinik Hämatologie und Internistische Onkologie Universitätsmedizin Mannheim

Mannheim, Baden-Wurttemberg, Germany

III. Medizinischen Klinik des Klinikums rechts der Isar

München, Bavaria, Germany

Universitätsklinikum MKII, Hämatologie/Onkologie, Universitäres Zentrum für Tumorerkrankungen

Frankfurt am Main, Hesse, Germany

Medizinische Klinik und Poliklinik III Abteilung für Hämatologie und Onkologie Universitätsklinikum Bonn

Bonn, North Rhine-Westphalia, Germany

Universitätsklinikum Carl Gustav Carus der TU Dresden Medizinische Klinik und Poliklinik I

Dresden, Saxony, Germany

Outcomes

Primary Outcomes

Description of dynamic changes of LPI prior, during and after conditioning for allo-SCT using standard descriptive parameters (Mean or Median and appropriate confidence intervals)

Time frame: one year

Secondary Outcomes

• Correlation coefficient of Liver iron concentration (LIC) and duration of detectable LPI during and after conditioning

Time frame: one year

• Area under the Receiver-Operator-Characteristic (ROC) as well as sensitivity and specificity of specific thresholds of serum ferritin and transfusion history for prediction of LIC

Time frame: one year

• Association of serum ferritin and LIC with hematopoietic cell transplantation comorbidity index (HCT-CI)

Time frame: one year

• Time course of LPI, enhanced labile plasma iron (eLPI), directly chelatable iron (DCI) and hepcidin during allo-SCT

Time frame: one year

• Association of detectable LPI or eLPI during conditioning and occurrence of elevated liver enzymes during in hospital treatment course for allo-SCT

Time frame: one year

• Cumulative incidence of graft versus host disease (aGvHD) grade 2-4 with respect to serum ferritin >1000 µg/l, transfusion burden >20 units of Red blood cells (RBC), LIC >125 µmol/g, peak value and duration of detectable labile plasma iron above median

Time frame: one year

• Cumulative incidence of day 100 non-relapse mortality (NRM) with respect to serum ferritin >1000 µg/l, transfusion burden >20 units of RBC, LIC >125 µmol/g and peak value and duration of detectable labile plasma iron above median

Time frame: one year

• Cumulative incidence of infections with respect to serum ferritin >1000 µg/l, transfusion burden >20 parasitized red blood cell (PRBC), LIC >125 µmol/g and peak value and duration of detectable labile plasma iron above median

Time frame: one year

• Median change of serum ferritin and LIC 100 days and 1 year after allo-SCT

Time frame: one year

• Association between immune profile and iron parameters (serum ferritin >1000 µg/l, transfusion burden >20 units RBC, LIC >90 µmol/g and peak value and duration of detectable labile plasma iron above median

Time frame: one year