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Marouf A, Molinari N, Sibon D, Cottereau AS, Kanoun S, Antoine C, Debureaux PE, Cavalieri D, Fornecker LM, Casasnovas RO, Herbaux C, Amorim S, Rossi C, Bouscary D, Brice P, Ghesquieres H, Tamburini J, Deau B. Tandem haematopoietic stem cell transplantation versus single cell transplant and BV maintenance in relapsed/refractory Hodgkin lymphoma: A matched cohort analysis from the LYSA. Br J Haematol 2023. [PMID: 37192755 DOI: 10.1111/bjh.18859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
Autologous hematopoietic stem cell transplant (ASCT) is the standard curative treatment for patients with high-risk relapsed/refractory Hodgkin lymphoma (R/R HL). The AETHERA study showed survival gain with Brentuximab Vedotin (BV) maintenance after ASCT in BV-naive patients, which was recently confirmed in the retrospective AMAHRELIS cohort, including a majority of BV-exposed patients. However, this approach has not been compared to intensive tandem auto/auto or auto/allo transplant strategies, which were used before BV approval. Here, we matched BV maintenance (AMAHRELIS) and tandem SCT (HR2009) cohorts, and observed that BV maintenance was associated with better survival outcome in patients with HR R/R HL.
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Grignano E, Cantero-Aguilar L, Tuerdi Z, Chabane T, Vazquez R, Johnson N, Zerbit J, Decroocq J, Birsen R, Fontenay M, Kosmider O, Chapuis N, Bouscary D. Dihydroartemisinin-induced ferroptosis in acute myeloid leukemia: links to iron metabolism and metallothionein. Cell Death Discov 2023; 9:97. [PMID: 36928207 PMCID: PMC10020442 DOI: 10.1038/s41420-023-01371-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Artemisinin is an anti-malarial drug that has shown anticancer properties. Recently, ferroptosis was reported to be induced by dihydroartemisinin (DHA) and linked to iron increase. In the current study, we determined the effect of DHA in leukemic cell lines on ferroptosis induction and iron metabolism and the cytoprotective effect triggered in leukemic cells. We found that treatment of DHA induces early ferroptosis by promoting ferritinophagy and subsequent iron increase. Furthermore, our study demonstrated that DHA activated zinc metabolism signaling, especially the upregulation of metallothionein (MT). Supportingly, we showed that inhibition MT2A and MT1M isoforms enhanced DHA-induced ferroptosis. Finally, we demonstrated that DHA-induced ferroptosis alters glutathione pool, which is highly dependent on MTs-driven antioxidant response. Taken together, our study indicated that DHA activates ferritinophagy and subsequent ferroptosis in AML and that MTs are involved in glutathione regenerating and antioxidant response.
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Comont T, Heiblig M, Riviere E, Terriou L, Rossignol J, Bouscary D, Rieu V, Le Guenno G, Mathian A, Aouba A, Vinit J, Dion J, Kosmider O, Terrier B, Georgin-Lavialle S, Fenaux P, Mekinian A. Utilisation de l’azacitidine dans le VEXAS chez des patients porteurs d’un syndrome myélodysplasique : données du registre Français VEXAS. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Fouquet G, Wartski M, Dechmi A, Willems L, Deau‐Fischer B, Franchi P, Descroocq J, Deschamps P, Clerc J, Bouscary D, Barreau S, Chapuis N, Vignon M, Cottereau A. PREDICTIVE VALUE OF FDG PET/CT IN PATIENTS WITH RELAPSE/REFRACTORY MULTIPLE MYELOMA BEFORE TREATMENT WITH ANTI‐CD38 IMMUNOTHERAPY. Hematol Oncol 2021. [DOI: 10.1002/hon.99_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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5
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Marouf A, Cottereau AS, Kanoun S, Deschamps P, Franchi P, Meignan M, Sibon D, Gastinne T, Borel C, Hammoud M, Sicard G, Gille R, Cavalieri D, Stamatoullas A, Clement L, Lazarovici J, Chauchet A, Fornecker LM, Amorin S, Rocquet M, Raus N, Burroni B, Rubio MT, Casasnovas O, Cartron G, Bouscary D, Brice P, Ghesquieres H, Tamburini J, Deau B. AMAHRELIS : ADCETRIS MAINTENANCE AFTER AUTOLOGOUS STEM CELL TRANSPLANTATION IN HODGKIN LYMPHOMA : A REAL LIFE STUDY FROM SFGMTC AND LYSA GROUPS. Hematol Oncol 2021. [DOI: 10.1002/hon.101_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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6
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Fabien M, Schernberg A, Arsene Henry A, Vignon M, Bouscary D, Kirova Y. OC-0462: Solitary plasmacytoma treated by Lenalidomide-Dexamethasone in combination with radiation therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Contejean A, Jaffrelot L, Benaboud S, Treluyer J, Grignano E, Willems L, Gauzit R, Bouscary D, Hirt D, Kerneis S. Un modèle pharmacocinétique du méropénème chez le patient traité pour une hémopathie maligne. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Contejean A, Jaffrelot L, Benaboud S, Tréluyer JM, Grignano E, Willems L, Gauzit R, Bouscary D, Gana I, Boujaafar S, Kernéis S, Hirt D. A meropenem pharmacokinetics model in patients with haematological malignancies. J Antimicrob Chemother 2020; 75:2960-2968. [DOI: 10.1093/jac/dkaa275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023] Open
Abstract
Abstract
Background
Optimal dosing of antibiotics is critical in immunocompromised patients suspected to have an infection. Data on pharmacokinetics (PK) of meropenem in patients with haematological malignancies are scarce.
Objectives
To optimize dosing regimens, we aimed to develop a PK population model for meropenem in this population.
Methods
Patients aged ≥18 years, hospitalized in the haematology department of our 1500 bed university hospital for a malignant haematological disease and who had received at least one dose of meropenem were eligible. Meropenem was quantified by HPLC. PK were described using a non-linear mixed-effect model and external validation performed on a distinct database. Monte Carlo simulations estimated the PTA, depending on renal function, duration of infusion and MIC. Target for free trough concentration was set at >4× MIC.
Results
Overall, 88 patients (181 samples) were included, 66 patients (75%) were in aplasia and median Modification of Diet in Renal Disease (MDRD) CLCR was 117 mL/min/1.73 m2 (range: 35–359). Initial meropenem dosing regimen ranged from 1 g q8h to 2 g q8h over 30 to 60 min. A one-compartment model with first-order elimination adequately described the data. Only MDRD CLCR was found to be significantly associated with CL. Only continuous infusion achieved a PTA of 100% whatever the MIC and MDRD CLCR. Short duration of infusion (<60 min) failed to reach an acceptable PTA, except for bacteria with MIC < 0.25 mg/L in patients with MDRD CLCR below 90 mL/min/1.73 m2.
Conclusions
In patients with malignant haematological diseases, meropenem should be administered at high dose (6 g/day) and on continuous infusion to reach acceptable trough concentrations.
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Debureaux PE, Arrondeau J, Bouscary D, Goldwasser F. Nivolumab combined with ruxolitinib: antagonism or synergy? Ann Oncol 2019; 29:1334-1335. [PMID: 29788168 DOI: 10.1093/annonc/mdy077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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10
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de Forceville L, Deau-Fischer B, Franchi P, Arsène-Henry A, Cassou Mounat T, Bouscary D, Kirova YM. Radiotherapy in combination with nivolumab for relapsed/refractory classical Hodgkin lymphoma: About two cases. Cancer Radiother 2019; 23:232-239. [PMID: 31147173 DOI: 10.1016/j.canrad.2018.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/09/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022]
Abstract
Hodgkin lymphoma is a highly curable malignancy involving lymph nodes and the lymphatic system. Even at late stage disease, about 70% of patients will be cured with standard first line therapy. For patients who experience relapse or refractory classical Hodgkin lymphoma, the standard treatment option is high-dose chemotherapy followed by autologous stem cell rescue or transplant. However about 50% of patients will have recurrence after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and have worse prognosis with median overall survival of 32% at 5 years. The anti-PD1 checkpoints inhibitors pembrolizumab and nivolumab have remarkably improved outcomes of patients with relapse of refractory classical Hodgkin lymphoma after high-dose chemotherapy followed by autologous stem cell rescue or transplantation. On the other hand, radiotherapy is an entire component of salvage therapy and its efficacy is now well established in term of local disease control in sites of relapsed or refractory Hodkin lymphoma. Defining the optimal modality and timing of radiotherapy as these new agents arrive is a challenge. An interesting approach is the combination of radiotherapy with checkpoint inhibitor and the possibility of stopping the treatment when complete response is achieved. We add to the literature two new cases of combination of radiotherapy with immunotherapy in patients who relapsed after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and consolidation with brentuximab vedotin, resulting in excellent outcomes.
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Legendre P, Chahwan D, Mohty M, Hermine O, Kahn J, Lortholary O, Bouscary D, Dougados M, Durand-Zaleski I, Godeau B, Mouthon L. Utilisation des immunoglobulines intraveineuses et sous-cutanées chez des patients atteints de déficits Immunitaires secondaires : analyse rétrospective (ULTIMATE). Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Grignano E, Laurent J, Deau-Fisher B, Burroni B, Bouscary D, Kirova Y. The Role of Radiation Therapy in Refractory or Relapsing Diffuse Large B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Grignano É, Deau-Fischer B, Loganadane G, Breton M, Burroni B, Bouscary D, Kirova YM. Radiotherapy of relapse-refractory follicular lymphoma. Cancer Radiother 2018; 22:126-130. [PMID: 29477304 DOI: 10.1016/j.canrad.2017.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/24/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the efficacy of treatment and outcomes of patients with relapsed or refractory follicular lymphoma treated with external beam irradiation. PATIENTS AND METHODS Fifteen patients who received external beam radiotherapy for relapsed or refractory follicular lymphoma were studied. The median age was 68.3 years (range: 37.9-87.08 years) with four men and 11 women. Seven patients had early stage (I or II); eight advanced stage (III or IV). Median FLIPI score was 2. Two patients had high tumour bulk disease. Six patients had extranodal invasion, with five patients having bone marrow invasion. RESULTS The median time of follow-up after relapse or first-line treatment in case of refractory disease was 61.9 months (range: 9.1-119.7 months). Complete response after external beam radiotherapy was seen in 11 cases (73%) and partial response in two (13%), with a median dose of 30Gy (range: 2-40Gy) and median number of fractions of 15 (range: 2-20). Eight patients (53%) relapsed after external beam radiation therapy in a median of 20.2 months, mostly out of irradiated volumes. Most patients (66%) had a disease control after one or two courses of external beam radiation therapy. At last follow-up, 86% of patients were in remission including those with salvage chemotherapy. The toxicity profile was favourable with toxicity higher than grade 1. In univariate analysis, a Follicular Lymphoma International Prognostic Index (FLIPI) score above 2 was the only predicting factor for non-control disease. CONCLUSION For relapsed and refractory follicular lymphoma, external beam radiotherapy should be considered as an effective modality when integrated in a multimodality approach. Randomised studies are warranted to validate this strategy.
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Hunault-Berger M, Maillard N, Himberlin C, Recher C, Schmidt-Tanguy A, Choufi B, Bonmati C, Carré M, Couturier MA, Daguindau E, Marolleau JP, Orsini-Piocelle F, Delaunay J, Tavernier E, Lissandre S, Ojeda-Uribe M, Sanhes L, Sutton L, Banos A, Fornecker LM, Bernard M, Bouscary D, Saad A, Puyade M, Rouillé V, Luquet I, Béné MC, Hamel JF, Dreyfus F, Ifrah N, Pigneux A. Maintenance therapy with alternating azacitidine and lenalidomide in elderly fit patients with poor prognosis acute myeloid leukemia: a phase II multicentre FILO trial. Blood Cancer J 2017; 7:e568. [PMID: 28574488 PMCID: PMC5520397 DOI: 10.1038/bcj.2017.50] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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15
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Poulain L, Sujobert P, Zylbersztejn F, Barreau S, Stuani L, Lambert M, Palama TL, Chesnais V, Birsen R, Vergez F, Farge T, Chenevier-Gobeaux C, Fraisse M, Bouillaud F, Debeissat C, Herault O, Récher C, Lacombe C, Fontenay M, Mayeux P, Maciel TT, Portais JC, Sarry JE, Tamburini J, Bouscary D, Chapuis N. High mTORC1 activity drives glycolysis addiction and sensitivity to G6PD inhibition in acute myeloid leukemia cells. Leukemia 2017; 31:2326-2335. [PMID: 28280275 DOI: 10.1038/leu.2017.81] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/13/2017] [Accepted: 02/27/2017] [Indexed: 01/03/2023]
Abstract
Alterations in metabolic activities are cancer hallmarks that offer a wide range of new therapeutic opportunities. Here we decipher the interplay between mTORC1 activity and glucose metabolism in acute myeloid leukemia (AML). We show that mTORC1 signaling that is constantly overactivated in AML cells promotes glycolysis and leads to glucose addiction. The level of mTORC1 activity determines the sensitivity of AML cells to glycolysis inhibition as switch-off mTORC1 activity leads to glucose-independent cell survival that is sustained by an increase in mitochondrial oxidative phosphorylation. Metabolic analysis identified the pentose phosphate pathway (PPP) as an important pro-survival pathway for glucose metabolism in AML cells with high mTORC1 activity and provided a clear rational for targeting glucose-6-phosphate dehydrogenase (G6PD) in AML. Indeed, our analysis of the cancer genome atlas AML database pinpointed G6PD as a new biomarker in AML, as its overexpression correlated with an adverse prognosis in this cohort. Targeting the PPP using the G6PD inhibitor 6-aminonicotinamide induces in vitro and in vivo cytotoxicity against AML cells and synergistically sensitizes leukemic cells to chemotherapy. Our results demonstrate that high mTORC1 activity creates a specific vulnerability to G6PD inhibition that may work as a new AML therapy.
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Le Ray E, Belin L, Plancher C, Bouscary D, Kirova Y. Intensity Modulated Radiation Therapy by Tomotherapy (IMRT) Concurrent With a Short Systemic Treatment for Solitary Plasmacytoma of the Bone (SPB) With Improvement of Progression-Free Survival. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Gagliardi L, Szwebel TA, Hugol D, Rousset P, Bouscary D, Le Jeunne C, Aslangul E. Myosite neutrophilique chez un patient neutropénique. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Vignon M, Michonneau D, Baixench MT, Al-Nawakil C, Bouscary D, Buzyn A, Salmon D, Paugam A. Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient. Bone Marrow Transplant 2010; 46:1276-7. [PMID: 21113187 DOI: 10.1038/bmt.2010.292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Scotland S, Boutzen H, Wang Z, Green A, Micklow E, Danet-Desnoyers G, Bouscary D, Tamburini J, Récher C, Selak M, Carroll M, Sarry J. R45: Metformine comme traitement adjuvant de la leucémie aiguë myéloïde. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)30962-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chapuis N, Tamburini J, Green AS, Willems L, Bardet V, Park S, Lacombe C, Mayeux P, Bouscary D. Perspectives on inhibiting mTOR as a future treatment strategy for hematological malignancies. Leukemia 2010; 24:1686-99. [PMID: 20703258 DOI: 10.1038/leu.2010.170] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Mammalian target of rapamycin (mTOR) is a protein kinase implicated in the regulation of various cellular processes, including those required for tumor development, such as the initiation of mRNA translation, cell-cycle progression and cellular proliferation. In a wide range of hematological malignancies, the mTORC1 signaling pathway has been found to be deregulated and has been designed as a major target for tumor therapy. Given that pre-clinical studies have clearly established the therapeutic value of mTORC1 inhibition, numerous clinical trials of rapamycin and its derivates (rapalogs) are ongoing for treatment of these diseases. At this time, although disease stabilization and tumor regression have been observed, objective responses in some tumor types have been modest. Nevertheless, some of the mechanisms underlying cancer-cell resistance to rapamycin have now been described, thereby leading to the development of new strategy to efficiently target mTOR signaling in these diseases. In this review, we discuss the rationale for using mTOR inhibitors as novel therapies for a variety of hematological, malignancies with a focus on promising new perspectives for these approaches.
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Chevallier P, Fornecker L, Lioure B, Béné MC, Pigneux A, Recher C, Witz B, Fegueux N, Bulabois CE, Daliphard S, Bouscary D, Vey N, Delain M, Bay JO, Turlure P, Bernard M, Himberlin C, Luquet I, Ifrah N, Harousseau JL. Tandem versus single autologous peripheral blood stem cell transplantation as post-remission therapy in adult acute myeloid leukemia patients under 60 in first complete remission: results of the multicenter prospective phase III GOELAMS LAM-2001 trial. Leukemia 2010; 24:1380-5. [PMID: 20508614 DOI: 10.1038/leu.2010.111] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Krauter J, Ottmann OG, Schlenk RF, Schaich M, Bouscary D, Dombret H, Lüdicke F, Weber HJ, Winiger IJ. A phase Ib study of oral panobinostat (LBH589) in combination with cytarabine (ARA-C) and mitoxantrone (MT) as salvage therapy for refractory or relapsed acute myeloid leukemia (AML). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Lopez I, Guerci A, Bouscary D, Lacombe C, Botella A, Melle J, Dreyfus F, Fontenay-Roupie M. Elevated thrombopoietin serum concentrations in myelodysplasias. Platelets 2009; 9:287-90. [PMID: 16793751 DOI: 10.1080/09537109876519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Thrombopoietin (TPO) serum levels were quantified in patients with myelodysplastic syndromes using an ELISA test for TPO. We found that TPO levels were significantly elevated in the whole group of patients as compared with normal healthy donors (521.9 75.3 pg/ml vs 160.1 19.6 pg/ml; P = 0.011). TPO serum levels were inversely correlated with the megakaryocyte mass in both the RA/RARS and RAEB/RAEBt subgroups ( P = 0.012 and P = 0.031, respectively). Two subsets of patients with a possible dysregulation of TPO production were identified.
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Tamburini J, Elie C, Park S, Beyne-Rauzy O, Gardembas M, Berthou C, Mahe B, Sanhes L, Stamatoullas A, Vey N, Aouba A, Slama B, Quesnel B, Vekhoff A, Sotto J, Vassilief D, Al-Nawakil C, Fenaux P, Dreyfus F, Bouscary D. Effectiveness and tolerance of low to very low dose thalidomide in low-risk myelodysplastic syndromes. Leuk Res 2009; 33:547-50. [DOI: 10.1016/j.leukres.2008.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 06/02/2008] [Accepted: 06/03/2008] [Indexed: 12/01/2022]
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Kelaidi C, Park S, Brechignac S, Mannone L, Vey N, Dombret H, Aljassem L, Stamatoullas A, Adès L, Giraudier S, de Botton S, Raynaud S, Lepelley P, Picard F, Leroux G, Daniel MT, Bouscary D, Dreyfus F, Fenaux P. Treatment of myelodysplastic syndromes with 5q deletion before the lenalidomide era; the GFM experience with EPO and thalidomide. Leuk Res 2008; 32:1049-53. [PMID: 18191202 DOI: 10.1016/j.leukres.2007.11.037] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2007] [Revised: 11/27/2007] [Accepted: 11/30/2007] [Indexed: 10/22/2022]
Abstract
Anemia in MDS with 5q deletion was generally considered, until the advent of lenalidomide, unresponsive to available treatments. We analyzed erythroid response to erythropoetin (EPO) or darbepoetin (DAR) and thalidomide in MDS with 5q deletion treated by French centers (GFM) and in whom karyotype was successfully performed. Of 345 patients treated with EPO or DAR+/-G-CSF, 48 had 5q deletion. The response rate was 46% (31% major, 15% minor) according to International Working Group (IWG) 2000 criteria versus 64% in patients without 5q deletion (p=0.03). According to IWG 2006 criteria, the response rate in patients with 5q deletion was 39% versus 52% in patients without 5q deletion (p=0.10). Mean duration of response was 14 months versus 25 months (IWG 2000) and 13 months versus 27 months (IWG 2006) in 5q deletion and non-5q deletion patients (p=0.019 and 0.003, respectively). Of 120 MDS treated with thalidomide, all of whom had successful cytogenetic analysis, 37% of the 24 patients with 5q deletion responded (IWG 2000 criteria, 20% major, 17% minor) with a mean duration of 9.5 months, versus 32% (18% major, 14% minor) in MDS without 5q deletion and a mean response duration of 9 months (p=NS). Our results confirm that response rates to EPO or DAR and thalidomide are clearly inferior to those obtained with lenalidomide.
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