Clinical Trial Details
— Status: Recruiting
Administrative data
NCT number |
NCT04114084 |
Other study ID # |
201807760-A |
Secondary ID |
|
Status |
Recruiting |
Phase |
|
First received |
|
Last updated |
|
Start date |
May 23, 2019 |
Est. completion date |
May 23, 2024 |
Study information
Verified date |
January 2024 |
Source |
University of Iowa |
Contact |
Melissa Bates, PhD |
Phone |
319-335-7972 |
Email |
melissa-bates[@]uiowa.edu |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
This study involves patients with plasma cell dyscrasia including monoclonal gammopathy of
undetermined significance (MGUS) or multiple myeloma (MM), with and without sleep apnea, who
are providing bone marrow specimens. Specimens will be obtained at the time that patients
undergo a standard-of-care procedure in order to minimize discomfort and reduce any risk.
Description:
Obesity is a risk factor for the development of MM, although the mechanisms that link obesity
and MM are unclear. Obesity, in turn, is closely associated with obstructive sleep apnea.
Interestingly, the key risk factors for both sleep apnea and MM are overlapping (age, sex,
race and body mass index). During the apnea, or cessation of normal breathing, arterial
oxygen saturation falls. This can occur as often as 60 times per hour, resulting in chronic
intermittent hypoxia (CIH). In preliminary studies, investigators exposed C57BL/6 mice, that
are typically resistant to engraftment of malignant plasma cells to CIH, followed by
injection of malignant 5TGM1 cells. With CIH, 5TGM1 cells homed to bone marrow, and engrafted
and expanded, resulting in lethal disease. These mice had key features of the myeloma
phenotype, including bone damage and gammopathy. Investigators explored potential mechanisms
by which CIH promote MM progression by performing whole bone marrow RNASeq analysis. They
found pathways relevant to angiogenesis, cell adhesion, and stromal cell development
(including dendritic cells and eosinophils) to be upregulated. This is an exciting and
potentially translational finding because these elements are also upregulated in the bone
marrow of human myeloma patients. Investigators also found upregulation of B cell and plasma
cell development and differentiation pathway, and downregulation of B-cell apoptosis
pathways. Taking these preliminary findings together, the overarching hypothesis is that CIH
increases oxidative stress, thereby supporting B cell maturation and changing the bone marrow
stromal microenvironment to drive the progression to MM.