A Clinical Study to Investigate Interferon Gamma (IFNɣ) Signature in Patients Post HSCT and in Patients With Impaired HSC Proliferation Pre-transplant

This clinical study is designed to investigate IFNγ activity in two cohorts of patients.

• First group will include patients post HSCT at risk of graft failure (GF) based on their underlying diseases and on the transplant procedure.
• Second group will contain patients with conditions where HSC proliferation is impaired (e.g. aplastic anemia) and with matched controls (healthy volunteers (HV) samples collected outside this clinical protocol).

IFNɣ activity will be assessed by measuring IFNγ and CXCL9 in serum.

For HSCT cohort, the following sampling time points are required: on day -7, pre HSCT on day 0, 1, 3, 5, 9, 13, 17, 21, 28, 31, 38 and one additional sample at the time when primary or secondary GF is suspected if not on the planned schedule. In addition, the following time points are recommended: day 7, 11, 15, 19, 24, 35, 42. It is also suggested to collect a sample when Graft vs Host Disease (GVHD) is diagnosed during any visit that the patients will attend as part of his/her standard treatment during the first 100 days post-transplant. The patient will be followed up until around day 100 post-transplant. This follow up will consist of capturing HSCT outcome information from patient hospital records around day 100.

For IHSCP cohort pre-transplant, it is recommended that, one sample per patient at the time of diagnosis (if possible not more than 1 week from the date of diagnosis) is collected. Age/sex matched control samples should be collected from healthy volunteers or patients with malignant disease outside of this protocol after appropriate consent.

Different sets of data will be collected for the HSCT and IHSCP cohorts respectively as described below:

Data collected for both cohorts

• Age and sex
• Inflammatory markers
• IFNɣ
• CXCL9
• Other potential relevant exploratory biomarkers
• Diagnosis
• Date of disease diagnosis
• Relevant medical history
• Date and time of sample collection

Data collected for HSCT cohort only

• Laboratory parameters assessed at the site laboratory on the date of sample collection and between collection dates when available:
• Absolute neutrophile count (ANC) and Platelets will be measured as per the schedule of assessment, if possible when routine monitoring of patient health is conducted
• Ferritin and Chimerism data will be collected when available (if measured as per site routine practice)
• Concomitant medications at the time of sample collection and between collection dates
• Presence of infection at the time of sample collection with the date of onset
• Presence of donor specific antibodies (DSA)
• Transplant information
• Date of start of conditioning
• Type of conditioning (Reduced Intensity Conditioning (RIC) / Myeloablative Conditioning (MAC) / Non-myeloablative Conditioning (NMAC) and medications
• Transplant details (donor type, degree of match, transplant manipulation, stem cell source)
• Date of transplant
• Date of primary / secondary GF or of confirmed engraftment
• GVHD with the date of onset
• Post-transplant treatment and date (Donor Lymphocyte Infusion (DLI), Stem Cell (SC) boost, growth factor, GVHD prophylaxis, second HSCT procedure)

Data collected for IHSCP cohort only

• Disease severity
• In addition, the following data will be recorded for pediatric patients up to 18 years old, if available:
• PNH clones
• History of hepatitis
• Karyotype

Study duration:

The study will be conducted, until the required number of patients is recruited.

• HSCT cohort: At patient level, the study will last about 100 days from pre-transplant blood collection to last follow up data collection around day 100 post HSCT, matching the standard HSCT patient care
• IHSCP cohort: At patient level the study will last 1 day.