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Denys-Drash Syndrome and Risk of Post-transplant Lymphoproliferative Disorder

Observational Denys-Drash Syndrome

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Collection of data from the patient's medical file.
Who it may be relevant to
Registry conditions: Denys-Drash Syndrome. Basic parameters: No limits · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
France
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Post-transplant Lymphoproliferative Disorder Following Kidney Transplantation in Denys-Drash Syndrome: a Case-control Study

Overview

Denys-Drash syndrome is a rare genetic disorder of childhood characterized by nephrotic syndrome, nephroblastomas, and genital developmental abnormalities. These children present with rapidly progressive renal failure, leading to kidney transplantation at a median age of 3.6 years. In a study of the French cohort of patients with Denys-Drash syndrome, a high risk of lymphoproliferative syndrome was observed (20%). This frequency is significantly higher than in the general transplant population (4%). The aim of the study is to evaluate the risk of post-transplant lymphoproliferative disorder following kidney transplantation in patients with Denys-Drash syndrome compared to patients with kidney transplant patients without Denys-Drash syndrome.

Detailed description

Denys-Drash syndrome is a rare genetic disorder of childhood characterized by nephrotic syndrome, nephroblastomas, and genital developmental abnormalities. These children present with rapidly progressive renal failure, leading to kidney transplantation at a median age of 3.6 years. In a study of the French cohort of patients with Denys-Drash syndrome, a high risk of lymphoproliferative syndrome was observed (20%). This frequency is significantly higher than in the general transplant population (4%).

The aim of the study is to evaluate the risk of post-transplant lymphoproliferative disorder following kidney transplantation in patients with Denys-Drash syndrome compared to patients with kidney transplant patients without Denys-Drash syndrome.

The study hypothesizes that there is an increased risk of lymphoproliferative disorder in children with Denys-Drash syndrome. If this hypothesis is confirmed, it would allow for the development of active treatment methods to combat post-transplant lymphoproliferative disorder in this population.

Interventions

  • Other Collection of data from the patient's medical file
    Collection of data from the patient's medical file. The data will be collected until 2024.

Primary outcome measures

  • Occurrence of lymphoproliferative disorder [Time frame: Up to 24 years]
Secondary outcome measures (2)
  • Description of risk factors of post-transplant lymphoproliferative disorder following kidney transplantation [Time frame: Up to 24 years]
  • Comparison of the time to onset of post-transplant lymphoproliferative disorder following kidney transplantation [Time frame: Up to 24 years]

Eligibility criteria

Inclusion criteria

  • Patient must be a minor at the time of kidney transplantation
  • Diagnosis of Denys-Drash syndrome (WT1 pathogenic variants in exons 8 or 9) for cases
  • Controls: minor patient, kidney transplanted at the same center as the case, immediately before and immediately after the case
  • Kidney transplant recipient on immunosuppressants
  • Hospital follow-up in a participating center in France
  • Regardless of their Epstein-Barr virus status before transplantation
  • Between 2000 and 2022
  • Holders of parental authority or adult patients informed of the study and not objecting to the processing of medical data for the study

Exclusion criteria

  • History of lymphoproliferative disorder prior to transplantation
  • Other hematopoietic cancer
  • Other genetic disease with a proven increased risk of lymphoproliferative disorder

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model
Case-control

Study locations

France · 7 centers
  • Hôpital Femme Mère Enfant, Hospices Civils de Lyon — Bron
  • CHU de Lille — Lille
  • CHU Montpellier — Montpellier
  • CHU de Nancy - Hôpitaux de Brabois — Nancy
  • Hôpital enfants et adolescents, CHU Nantes — Nantes
  • Hôpital Necker-Enfants Malades — Paris
  • Hôpital Robert Debré — Paris

Publications

  • Glenisson M, Grapin M, Blanc T, Preka E, Hogan J, Aurelle M, Roussey G, Mouche A, Rousset-Rouviere C, Novo R, Faudeux C, Fila M, Vrillon I, Cloarec S, Simon T, Harambat J, Casado EM, Rod J, Lecoindre MC, Heidet L, Boyer O, Garcelon N, Kachmar J, Dorval G, Sarnacki S. Genotype-Phenotype Correlations in Denys-Drash Syndrome in Children. Kidney Int Rep. 2025 Jan 16;10(4):1205-1212. doi: 10.1016/j.eki PMID 40303223
  • Lopez-Gonzalez M, Ariceta G. WT1-related disorders: more than Denys-Drash syndrome. Pediatr Nephrol. 2024 Sep;39(9):2601-2609. doi: 10.1007/s00467-024-06302-y. Epub 2024 Feb 7. PMID 38326647
  • Fulchiero R, Amaral S. Post-transplant lymphoproliferative disease after pediatric kidney transplant. Front Pediatr. 2022 Dec 7;10:1087864. doi: 10.3389/fped.2022.1087864. eCollection 2022. PMID 36568415
  • Mynarek M, Hussein K, Kreipe HH, Maecker-Kolhoff B. Malignancies after pediatric kidney transplantation: more than PTLD? Pediatr Nephrol. 2014 Sep;29(9):1517-28. doi: 10.1007/s00467-013-2622-5. Epub 2013 Sep 24. PMID 24061645

Identifiers

NCT: NCT07605884 · APHP251805

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗