The Role of Genetic Polymorphisms in Innate Immune Response Genes in Susceptibility to Infections

January 19, 2011 updated by: Memorial Sloan Kettering Cancer Center

The purpose of this study is to better understand genetic susceptibility to infections and the interactions of specific genetic polymorphisms of innate immune receptors with microbial and fungal organisms.

The goals of this study are:

  1. Find out if some people are more likely to get severe infections, than others. To do this we will compare patients with leukemia who develop severe infections to patients who do not develop infections.
  2. Find out if some people are more likely to develop lymphoma than others. To do this we will compare patients with lymphoma to people without lymphoma who are of the same sex and similar age and ethnic background to the patients with lymphoma.

Study Overview

Status

Completed

Conditions

Detailed Description

A small number of patients will develop severe infection after chemotherapy or after allogeneic bone marrow transplantation. The ability of patients with leukemia or bone marrow transplantation to fight infections is decreased. One reason is that chemotherapy transiently destroys the type of white blood cells called neutrophils. Neutrophils are the first line of defense of our body against infections. Bone marrow transplant patients may be receiving edications to prevent graft versus host disease. Such medications may decrease the ability of the body to fight infections.

People respond to infections in different ways. Some may be born with genes that make them more likely to get certain types of infections. Specific genes may affect the response to different microbes (pathogens). We want to find out which genes have normal changes in them and lead to different responses to infections. We also want to find out how the ability to fight infections is related to the way these genes work.

Responses to infection are controlled by our immune system. Changes in genes of the immune system that may alter control of infection may make people more susceptible to some types of lymphoma The goals of this study are:

  1. Find out if some people are more likely to get severe infections, than others. To do this we will compare patients with leukemia who develop severe infections to patients who do not develop infections.
  2. Find out if some people are more likely to develop lymphoma than others. To do this we will compare patients with lymphoma to people without lymphoma who are of the same sex and similar age and ethnic background to the patients with lymphoma.

The purpose of this study is to better understand genetic susceptibility to infections and the interactions of specific genetic polymorphisms of innate immune receptors with microbial and fungal organisms.

To accomplish this, blood specimens from patients with acute myeloid leukemia, RAEB, RAEBT or acute lymphocytic leukemia, follicular or mantle cell lymphoma or recipients of allogeneic hematopoietic stem cell transplants (HSCT) will be collected. We will genotype the genes of innate immune receptors to identify genetic polymorphisms associated with higher frequency of invasive infections or susceptibility to lymphoma. All specimens will be processed in the Infectious Diseases Laboratory at MSKCC. RNA will be extracted from peripheral blood mononuclear cells (PBMCs). Genotyping will be done from genomic DNA or from cDNA generated from RNA by RT-PCR. Cell lines will be created from PBMCs and will be analyzed in functional assays for responses to bacterial and fungal products (cytokine secretion, upregulation of cell surface molecules). All patient samples including genomic DNA, RNA, cDNA and cell lines will be banked in the Infectious Disease laboratory at MSKCC.

In order to perform this study, patients diagnosed with acute leukemia will be asked to provide blood, and permission to review the medical charts. We will collect (removed prospectively) data regarding risk factors for infections, diagnosis of infections, response to treatment and outcome.

Study Type

Observational

Enrollment (Actual)

319

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New York
      • New York, New York, United States, 10065
        • Memorial Sloan Kettering Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

The population for this study is composed of patients with leukemia. It is projected that the marginal probability of an allelic variant in the TLR and an infection is 0.12 and 0.30 respectively in this patient population.

Description

Inclusion Criteria:

  • Subject must either:

    1. Have histologically confirmed acute myeloid leukemia (AML), acute lymphocytic leukemia (ALL), follicular or mantle cell lymphoma RA-EB, RAEB-T newly diagnosed at first or second remission AND are going to receive or have received myelosuppressive chemotherapy; OR
    2. Will receive or have received allogeneic HSCT for hematologic malignancy.
  • Subject has signed informed consent before entering the study.

Participation of children: For subjects under the age of 18, we will obtain the subject's and their parents' approval to enroll them.

Exclusion Criteria:

  • Subject has been diagnosed with leukemia other than acute myeloid leukemia RA-EB or RAEB-T or acute lymphocytic.
  • Subject is not going to receive chemotherapy or has not received chemotherapy.
  • Subject will undergo/had undergone HSCT for disease other than hematologic malignancy.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
1

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Risk for developing infection or lymphoma due to allelic variation in genes of immune system that specialize in pathogen recognition compared to absence of allelic variation.
Time Frame: 6 years
6 years

Secondary Outcome Measures

Outcome Measure
Time Frame
Risk for developing infectns due to somatic mutatns/polymorphisms in genes involved in signaling pathways downstream of receptors of immune recognitn.Characterize in vitro diff in functional responses to pathogens among genetic variants.
Time Frame: 6 years
6 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

February 1, 2003

Primary Completion (Actual)

January 1, 2011

Study Completion (Actual)

January 1, 2011

Study Registration Dates

First Submitted

January 8, 2008

First Submitted That Met QC Criteria

January 16, 2008

First Posted (Estimate)

January 17, 2008

Study Record Updates

Last Update Posted (Estimate)

January 20, 2011

Last Update Submitted That Met QC Criteria

January 19, 2011

Last Verified

January 1, 2011

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 03-017

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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