Role of Adrenomedullin in Leukemic Endosteal/Vascular Niches

Study Overview
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Brief Summary
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The present study will be divided into 5 phases: Collection of bone marrow and peripheral blood (PB) samples from AML patients at diagnosis; Measurement of Midregional Proadrenomedullin (MR-proADM) plasma concentrations with an Immunoluminometric Assay of newly diagnosed AML patients not affected by concomitant cardiovascular disease or sepsis. Analysis of exosomes and microvesicles derived from PB and bone marrow samples of AML patients and culture media collected from AML samples stimulated with ADM and/or ADM (22-52) Study of adrenomedullin system in leukemic stem cells (CD44+/CD38-/CD31+/Lin-) in order to define a correlated expression of ADM and ADM receptors (RAMPs, PAM) with adhesion molecules (CD31, CD38, CD44s, CD44v6), cell cycle regulatory proteins (p21, p27) and genes or molecules involved in the hematopoietic differentiation process (Cul5, CD11b, CD11c, CD66, CD14, CD15, PML-RARα) In vitro evaluation of ADM activity in the growth, maturation and trans-endothelial migration of blasts and/or fusion of leukemic cells with endothelial cells. To do this, leukemic cells will be alternatively cultured by using in vitro models of endosteal and vascular niches.

Official Title
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Role of Adrenomedullin in Leukemic Endosteal/Vascular Niches

Conditions
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Acute Myeloid Leukemia

Intervention / Treatment
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* Other: Adrenomedullin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with new diagnosis of primary or secondary AML. Participant is willing and able to give signed written informed consent according to ICH/EU/GCP and national local laws. Male or Female, aged >18 years. Exclusion Criteria: Patients affected by concomitant cardiovascular disease , such as essential hypertension (any grade), chronic renal failure (creatinine>1.5 mg/dL), heart failure (any NYHA class), and peripheral arterial occlusive diseases, or sepsis. Patients affected by HIV, B or C hepatitis.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Biological evaluation<br>Adrenomedullin evaluation at diagnosis at first CR and 1 year of follow-up | Other: Adrenomedullin<br>* Adrenomedullin sample evaluation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of therapeutic potential of ADM inhibition on leukaemia stem cells | Rate estimation of the in vitro arrest of leukemic blasts proliferation by ADM inhibition. | at 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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adrenomedullin