C-X-C Chemokine Receptor 4 in Chronic Lymphocytic Leukemia

Chronic Lymphocytic Leukemia Clinical Trial

Official title:

C-X-C Chemokine Receptor 4 as Prognostic Marker in Chronic Lymphocytic Leukemia

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT03150849
• Other study ID #: cxcll
• Status: Not yet recruiting
• Phase: N/A
• First received: May 7, 2017
• Last updated: May 11, 2017
• Start date: July 1, 2017
• Est. completion date: December 1, 2019

Study information

• Verified date: May 2017
• Source: Assiut University
• Contact: Eman mohamed salah, MD
• Phone: 01028030966
• Email: Emansalah.eldin[@]yahoo.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Chronic lymphocytic leukemia is the most common type of chronic leukemia, accounting for approximately 40% of all leukemias and mainly affecting older individuals. As it has a highly variable clinical course, identification of molecular and biological prognostic markers has provided new insights into the risk stratification of patients with chronic lymphocytic leukemia.

Description:

Prognosis depends primarily on the stage of the disease at diagnosis. There is a correlation between disease stage and median survival. However, about 50% of patients in early stage will develop more advanced disease. Also there is marked variation in disease progression amongst patients with similar Stages .

Extreme clinical heterogeneity is one of the hallmark features of chronic lymphocytic leukemia despite the identification of genetic and phenotypic markers that correlate with prognosis, the biological basis of this clinical variability remains unclear .. In addition, the interactions of chronic lymphocytic leukemia cells with the microenvironment in secondary lymphoid tissues and the bone marrow are known to promote chronic lymphocytic leukemia cell survival and proliferation.

The median age at diagnosis is 72 years, in the last decades chronic lymphocytic leukemia is more often diagnosed also in younger individuals, with almost 15% Of patients Of 55 years old or younger. There is a gender predisposition, As men are more frequently affected by chronic lymphocytic leukemia than women (male: female ratio of 1.5-2:1).

C-X-C chemokine receptor type 4 (CXCR4) is a chemokine and chemokine receptor pair playing critical roles in tumorigenesis. Overexpression of C-X-C chemokine receptor type 4 is a hallmark of many hematological malignancies including acute myeloid leukemia, chronic lymphocytic leukemia and non-Hodgkin's lymphoma, and generally correlates with a poor prognosis. A highly potent competitive antagonist of C-X-C chemokine receptor type 4 recently has been identified with suppression of cancer cells aggressiveness in a variety of cancers.

The protein-coupled receptor C-X-C chemokine receptor type 4 is activated by stromal cell-derived factor 1 and is involved in the control of migration and homing of cells notably for engraftment of normal and neoplastic hematopoietic cells in the bone marrow (BM).

Bruton's tyrosine kinase (BTK) is a key player in B-cell antigen receptor (BCR) signaling that regulates B-cell growth. In addition to B-cell antigen receptor signaling, Bruton's tyrosine kinase participates in signal transduction through growth-factor receptors, Toll-like receptors, integrins and G-protein-coupled receptors such as C-X-C chemokine receptor type 4 and C-X-C chemokine receptor type 5. Bruton's tyrosine kinase inhibition results in impaired C-X-C chemokine receptor type 4 chemokine receptor surface expression, signaling and function in chronic lymphocytic leukemia. inhibition of Bruton's tyrosine kinase function would lead to a loss of tumor volume by preventing replenishment after spontaneous or drug-induced death, and by subverting leukemia cell retention in and homing back to sustaining tissue niches. Decrease C-X-C chemokine receptor type 4 delays disease progression and prolongs survival

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 50
• Est. completion date: December 1, 2019
• Est. primary completion date: July 1, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 20 Years to 80 Years

Eligibility

Inclusion Criteria:

• All patients are newly diagnosed as chronic lymphocytic leukemia

Exclusion Criteria:

• Patients with associated malignancies.

• Chronic lymphocytic leukemia patients on chemotherapy

Related Conditions & MeSH terms

• Chronic Lymphocytic Leukemia
• Leukemia
• Leukemia, Lymphocytic, Chronic, B-Cell
• Leukemia, Lymphoid

Intervention

Diagnostic Test:
• C-X-C Chemokine Receptor 4
marker assessed by flowcytometry in a blood sample

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

References & Publications (7)

Barretina J, Juncà J, Llano A, Gutiérrez A, Flores A, Blanco J, Clotet B, Esté JA. CXCR4 and SDF-1 expression in B-cell chronic lymphocytic leukemia and stage of the disease. Ann Hematol. 2003 Aug;82(8):500-5. Epub 2003 May 29. — View Citation

Burger JA, Peled A. CXCR4 antagonists: targeting the microenvironment in leukemia and other cancers. Leukemia. 2009 Jan;23(1):43-52. doi: 10.1038/leu.2008.299. Epub 2008 Nov 6. Review. — View Citation

Domanska UM, Kruizinga RC, Nagengast WB, Timmer-Bosscha H, Huls G, de Vries EG, Walenkamp AM. A review on CXCR4/CXCL12 axis in oncology: no place to hide. Eur J Cancer. 2013 Jan;49(1):219-30. doi: 10.1016/j.ejca.2012.05.005. Epub 2012 Jun 9. Review. — View Citation

Li SH, Dong WC, Fan L, Wang GS. Suppression of chronic lymphocytic leukemia progression by CXCR4 inhibitor WZ811. Am J Transl Res. 2016 Sep 15;8(9):3812-3821. eCollection 2016. — View Citation

Marchese A. Endocytic trafficking of chemokine receptors. Curr Opin Cell Biol. 2014 Apr;27:72-7. doi: 10.1016/j.ceb.2013.11.011. Epub 2013 Dec 14. Review. — View Citation

Palmesino E, Moepps B, Gierschik P, Thelen M. Differences in CXCR4-mediated signaling in B cells. Immunobiology. 2006;211(5):377-89. Epub 2006 Apr 18. — View Citation

Vlad A, Deglesne PA, Letestu R, Saint-Georges S, Chevallier N, Baran-Marszak F, Varin-Blank N, Ajchenbaum-Cymbalista F, Ledoux D. Down-regulation of CXCR4 and CD62L in chronic lymphocytic leukemia cells is triggered by B-cell receptor ligation and associated with progressive disease. Cancer Res. 2009 Aug 15;69(16):6387-95. doi: 10.1158/0008-5472.CAN-08-4750. Epub 2009 Aug 4. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The level of C-X-C Chemokine Receptor 4 in chronic lymphocytic leukemia patient and healthy individual	the level of C-X-C Chemokine Receptor 4 marker assessed by flowcytometry in a blood sample	2 years