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Gastinne T, Bouabdallah K, Moatti H, Tessoulin B, Shiano del colella JM, Lamy T, Casasnovas O, Borel C, Stamatoullas A, Gac AC, Chaoui D, Feugier P, Delmer A, Bonnet C, Fornecker L, Lazarovici J, Bras F, Ghesquieres H, Meignan M, Traverse Glehen A, Brice P. BRENTUXIMAB VEDOTIN AS CONSOLIDATION TREATMENT IN PATIENTS WITH STAGE I/II CLASSICAL HODGKIN'S LYMPHOMA AND A POSITIVE FDG‐PET AFTER 2 CYCLES OF ABVD: A LYSA PHASE 2 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.111_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- T. Gastinne
- University Hospital of Nantes Hematology Nantes France
| | - K. Bouabdallah
- Hopital Haut‐Levêque Centre Hospitalier Regional Universitaire de Bordeaux Department of Hematology Pessac France
| | - H. Moatti
- Hôpital saint Louis APHP Université Paris 7 Department of Oncohaematology Paris France
| | - B. Tessoulin
- University Hospital of Nantes Hematology Nantes France
| | | | - T. Lamy
- Rennes University Hospital Department of Clinical Hematology MICA Research Unit Rennes France
| | - O. Casasnovas
- University Hospital F Mitterrand and INSERM 1231 Department of Haematology Dijon France
| | - C. Borel
- IUCT‐Oncopole CHU Toulouse Department of Haematology Toulouse France
| | - A. Stamatoullas
- Centre Henri Becquerel Department of Haematology U918 Rouen France
| | - A. C. Gac
- Centre Hospitalier Universitaire de Caen Institut d'hématologie de Basse‐Normandie Caen France
| | - D. Chaoui
- Centre Hospitalier d'Argenteuil Department of Hematology Argenteuil France
| | - P. Feugier
- Nancy University Hospital Department of Clinical Hematology INSERM 1256 Nancy France
| | - A. Delmer
- University Hospital of Reims Department of Haematology Reims France
| | - C. Bonnet
- CHU Liège, Liège Université Campus Universitaire de Sart Tilman Clinical Hematology Unit Liège Belgium
| | - Luc‐M. Fornecker
- Strasbourg University Hospital Department of Clinical Hematology Strasbourg France
| | - J. Lazarovici
- Institut Gustave Roussy Département des Innovations Thérapeutiques et Essais Précoces Villejuif France
| | - F. Bras
- CHU Henri Mondor Department of Hematology Creteil France
| | - H. Ghesquieres
- Hospices Civils de Lyon Centre Hospitalier Lyon‐Sud and Université Claude Bernard Lyon‐1 Department of Haematology Lyon France
| | - M. Meignan
- Hôpital H Mondor LYSA Imaging Creteil France
| | - A. Traverse Glehen
- Centre Hospitalier Lyon‐Sud Hospices Civils de Lyon Pathology Department cedex, France, Lyon France
| | - P. Brice
- Hôpital saint Louis APHP Université Paris 7 Department of Oncohaematology Paris France
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Poirot C, Fortin A, Lacorte JM, Akakpo JP, Genestie C, Vernant JP, Brice P, Morice P, Leblanc T, Gabarre J, Delmer A, Badachi Y, Drouineaud V, Gouy S, Chalas C, Egels S, Dhédin N, Touraine P, Dommergues M, Lebègue G, Wolf JP, Capron F, Lefebvre G, Boissel N. Impact of cancer chemotherapy before ovarian cortex cryopreservation on ovarian tissue transplantation. Hum Reprod 2020; 34:1083-1094. [PMID: 31116405 DOI: 10.1093/humrep/dez047] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/27/2019] [Accepted: 03/07/2019] [Indexed: 12/18/2022] Open
Abstract
STUDY QUESTION How efficacious is transplantation of ovarian cortex previously exposed to chemotherapy? SUMMARY ANSWER Prior exposure to chemotherapy did not disrupt the function of cryopreserved ovarian tissue after transplantation. WHAT IS KNOWN ALREADY Ovarian tissue cryopreservation (OTC) followed by ovarian tissue transplantation (OTT) is an efficacious technique for restoration of female fertility. At least 130 children have been born following this procedure. To date, little is known about the efficacy of OTT in patients exposed to cancer chemotherapy prior to OTC. STUDY DESIGN, SIZE, DURATION This study evaluates the recovery of ovarian function and fertility in 31 consecutive patients who had received OTT, between 2005 and 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS Thirty one patients, wanting children, were transplanted with autologous ovarian cortex, among which 22 patients (71%) had been exposed to chemotherapy before OTC. Recovery of ovarian function was considered total once menstruation occurred. Ovarian function recovery (OFR), ovarian graft survival, and incidence of pregnancy were related to previous chemotherapy exposure, type of chemotherapy and graft characteristics (number of grafted fragments and follicular density). MAIN RESULTS AND ROLE OF CHANCE The amount of ovarian tissue collected was the only parameter to show any significant change between patients with versus without previous chemotherapy. At 1 year after OTT, the cumulative incidence of OFR was 83% (93% in patients exposed to chemotherapy and 67% in others (P = 0.14)). A low follicular density (<0.3 foll/mm2) in the transplant and a low number of grafted fragments (<16) were significantly associated with a delayed OFR. Graft survival at 2 years after OTT was 77%. It was significantly lower in patients exposed to bifunctional alkylating agents before ovarian cryopreservation and in patients with a low follicular density. The proportion of women who succeeded in having at least one live birth was 23% in the total population, 0% (0/9) in the group 'no previous chemotherapy', and 32% (7/22) in the group 'previous chemotherapy'. The cumulative incidence of pregnancy (Kaplan-Meier) at 3 years after OTT was 36% overall and 49% in case of previous chemotherapy, with no difference related to previous chemotherapy exposure. In total there were 13 pregnancies and 8 births in 7 patients. LIMITATIONS, REASONS FOR CAUTION The pathology in the two groups of patients was not comparable. In the group of patients who had chemotherapy before OTC, there were 95% of hematological malignancies. In the group of patients who did not have chemotherapy before OTC only 1 out of 9 patients had a malignant hematological disease while 44% had some pathology affecting the ovaries. Few women are available for study and only large changes are likely to have statistical significance. WIDER IMPLICATIONS OF THE FINDINGS These results suggest that prior cancer chemotherapy should no longer be considered a limitation to cryopreservation of ovarian tissue and current recommendations in this regard should be revised. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Agence de la Biomédecine (France's biomedical office). There are no competing interests to report. TRIAL REGISTRATION NUMBER NCT02184806.
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Affiliation(s)
- C Poirot
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, Assistance Publique-Hôpitaux de Paris (AP-HP) Saint Louis Hospital, Paris, France.,Médecine Sorbonne Université, Paris, France
| | - A Fortin
- Department of Obstetrics Gynecology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - J M Lacorte
- Médecine Sorbonne Université, Paris, France.,Department of Hormonal Biochemistry, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - J P Akakpo
- Department of Radiology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - C Genestie
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - J P Vernant
- Médecine Sorbonne Université, Paris, France.,Department of Hematology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - P Brice
- Department of Hematology/Oncology, AP-HP Saint Louis Hospital, Paris, France
| | - P Morice
- Department of Oncological Surgery, Gustave Roussy Institute, Villejuif, France.,Paris-Sud XI University, Le Kremlin-Bicêtre, France
| | - T Leblanc
- Department of Pediatric Hematology, AP-HP Robert Debré University Hospital, Paris, France
| | - J Gabarre
- Department of Hematology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - A Delmer
- Department of Clinical Hematology, Robert Debré Hospital, Reims, France.,Reims Champagne-Ardenne University, Reims, France
| | - Y Badachi
- Department of Radiology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - V Drouineaud
- Department of Reproductive Biology, AP-HP Cochin Hospital, Paris, France
| | - S Gouy
- Department of Oncological Surgery, Gustave Roussy Institute, Villejuif, France
| | - C Chalas
- Department of Reproductive Biology, AP-HP Cochin Hospital, Paris, France
| | - S Egels
- Department of Radiology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - N Dhédin
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, Assistance Publique-Hôpitaux de Paris (AP-HP) Saint Louis Hospital, Paris, France
| | - P Touraine
- Médecine Sorbonne Université, Paris, France.,Department of Endocrinology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - M Dommergues
- Médecine Sorbonne Université, Paris, France.,Department of Obstetrics Gynecology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - G Lebègue
- Department of Obstetrics Gynecology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - J P Wolf
- Department of Reproductive Biology, AP-HP Cochin Hospital, Paris, France.,Paris Descartes University, Paris, France
| | - F Capron
- Médecine Sorbonne Université, Paris, France.,Department of Pathology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - G Lefebvre
- Department of Obstetrics Gynecology, AP-HP Pitié-Salpêtrière-Charles Foix University Hospital, Paris, France
| | - N Boissel
- Department of Hematology, Adolescents and Young Adults Unit, Fertility Preservation, Assistance Publique-Hôpitaux de Paris (AP-HP) Saint Louis Hospital, Paris, France.,Paris Diderot University, Paris, France
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Durot C, Durot E, Morland D, Godard F, Jolly D, Delmer A, Mulé S, Hoeffel C. Paramètres d’analyse de texture du 18F-FDG TEP/CT pré-traitement comme biomarqueurs prédictifs de survie sans progression chez les patients présentant un lymphome folliculaire traité par immunochimiothérapie et maintenance par rituximab. Rev Epidemiol Sante Publique 2020. [DOI: 10.1016/j.respe.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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4
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Lemonnier F, Safar V, Ferchiou A, Cottereau A, Bachy E, Cartron G, Moles-Moreau M, Delmer A, Bouabdallah R, Voillat L, Parrens M, Casasnovas O, Cacheux V, Réguy C, Tilly H, Meignan M, Gaulard P, de Leval L, Delfau-Larrue M, Haioun C. BONE MARROW INVOLVEMENT, BUT NO BLOOD INVOLVEMENT, IMPAIRS SURVIVAL IN ANGIOIMMUNOBLASTIC T CELL LYMPHOMA: AN ANCILLARY STUDY OF THE REVAIL TRIAL. Hematol Oncol 2019. [DOI: 10.1002/hon.89_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- F. Lemonnier
- Unité Hémopathies Lymphoïdes, INSERMU955; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
| | - V. Safar
- Hématologie; Hôpital Lyon Sud; Pierre Bénite France
| | - A. Ferchiou
- Laboratoire d'immunologie; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
| | - A. Cottereau
- Département de Médecine Nucléaire; Hopital Cochin; Paris France
| | - E. Bachy
- Hématologie; Hôpital Lyon Sud; Pierre Bénite France
| | - G. Cartron
- Département d'Hématologie Clinique; CHU Montpellier; Montpellier France
| | | | - A. Delmer
- Service d'Hématologie Clinique; CHU Reims; Reims France
| | - R. Bouabdallah
- Service d'Hématologie; Institut Paoli Calmette; Marseille France
| | - L. Voillat
- Service d'Hématologie; CH Chalon sur Saône; Chalon-sur-Saône France
| | - M. Parrens
- Service de Pathologie; CHU Bordeaux Haut Levèque; Pessac France
| | | | - V. Cacheux
- Service d'Hématologie; CHU de Clermont-Ferrand; Clermont Ferrand France
| | - C. Réguy
- Service d'Hématologie; CHU Grenoble; La Tronche France
| | - H. Tilly
- Service d'Hématologie; Centre Henri Becquerel; Rouen France
| | | | - P. Gaulard
- Département de Pathologie; Hôpital Henri Mondor; Créteil France
| | - L. de Leval
- Département de Pathologie; Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | - M. Delfau-Larrue
- Laboratoire d'immunologie; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
| | - C. Haioun
- Unité Hémopathies Lymphoïdes, INSERMU955; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
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5
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Tournilhac O, Truemper L, Ziepert M, Bouabdallah K, Nickelsen M, Maury S, Reimer P, Jaccard A, Herr W, Wilhelm M, Cartron G, Wulf G, Sanhes L, Dreger P, Lamy T, Kroschinsky F, Lindemann H, Roussel M, Viardot A, Sibon D, Delmer A, De Leval L, Damaj G, Gisselbrecht C, Gaulard P, Rosenwald A, Friedrichs B, Altmann B, Schmitz N. FIRST-LINE THERAPY OF T-CELL LYMPHOMA: ALLOGENEIC OR AUTOLOGOUS TRANSPLANTATION FOR CONSOLIDATION - FINAL RESULTS OF THE AATT STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.64_2629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- O. Tournilhac
- Service d'Hematologie, EA7453 Chelter, CIC-1405; CHU de Clermont-Ferrand, Université Clermont Auvergne; Clermont-Ferrand France
| | - L. Truemper
- Hematology and Oncology; Georg August University Göttingen; Goettingen Germany
| | - M. Ziepert
- Statistics and Epidemology; Institute for Medical Informatics, Leipzig University; Leipzig Germany
| | - K. Bouabdallah
- Department of Haematology; University Hospital of Bordeaux; Bordeaux Pessac France
| | - M. Nickelsen
- Onkologie Lerchenfeld; Onkologie Lerchenfeld; Hamburg Germany
| | - S. Maury
- Université Paris-Est Créteil Val De Marne; AP-HP Hôpital Henri Mondor; Créteil France
| | - P. Reimer
- Hämatologie; Kliniken Essen-Sued; Essen Germany
| | - A. Jaccard
- Hématologie Clinique et Thérapie Cellulaire; CHU de Limoges - Hôpital Dupuytren; Limoges France
| | - W. Herr
- Department of Internal Medicine III; University Medical Center of the Johannes Gutenberg-University; Mainz Germany
| | - M. Wilhelm
- Med. Klinik 5; Klinikum Nuernberg; Nuernberg Germany
| | - G. Cartron
- Service d'Hématologie Clinique; CHU de Montpellier, UMR CNRS 5235; Montpellier France
| | - G. Wulf
- Hematology and Oncology; Georg August University Göttingen; Goettingen Germany
| | - L. Sanhes
- Hematology; Centre Hospitalier Saint Jean; Perpignan France
| | - P. Dreger
- Internal Medicine V; University of Heidelberg; Heidelberg Germany
| | - T. Lamy
- Rennes University Hospital; INSERM Research Unit 1236, Rennes University; Rennes France
| | - F. Kroschinsky
- Medical Department I; Dresden University Hospital; Dresden Germany
| | - H. Lindemann
- Hematology Oncology Clinic; Saint Josefs Hospital; Hagen Germany
| | - M. Roussel
- Service d'Hématologie; IUC Oncopole; Toulouse France
| | - A. Viardot
- Internal Medicine III; University Hospital Ulm; Ulm Germany
| | - D. Sibon
- Hematology; CHU Necker; Paris France
| | - A. Delmer
- Hematology; CHU Robert Debré; Reims France
| | - L. De Leval
- Pathologie Clinique; Institut Universitaire de Pathologie; Lausanne Switzerland
| | - G.L. Damaj
- Institut d'Hématologie; CHU de Caen; Caen France
| | | | - P. Gaulard
- Département de Pathologie; Groupe Hospitalier Henri Mondor; Créteil France
| | - A. Rosenwald
- Institute of Pathology; University of Wuerzburg; Wuerzburg Germany
| | - B. Friedrichs
- Hämatologie; Medizinische Klinik A Hämatologie UniversitätsklinikMünster; Münster Germany
| | - B. Altmann
- Statistics and Epidemology; Institute for Medical Informatics (IMISE); Leipzig Germany
| | - N. Schmitz
- Hämatologie; Medizinische Klinik A Hämatologie UniversitätsklinikMünster; Münster Germany
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6
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Durot E, Kanagaratnam L, D'sa S, Tomowiak C, Hivert B, Toussaint E, Guerrero-Garcia T, Itchaki G, Vos J, Michallet A, Godet S, Bomsztyk J, Morel P, Leblond V, Treon S, Delmer A, Castillo J. A PROGNOSTIC SCORE FOR TRANSFORMED WALDENSTRÖM MACROGLOBULINEMIA. Hematol Oncol 2019. [DOI: 10.1002/hon.71_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E. Durot
- Department of Hematology; University Hospital of Reims; Reims France
| | - L. Kanagaratnam
- Department of Research and Innovation; University Hospital of Reims; Reims France
| | - S. D'sa
- Department of Hematology; University College London Hospitals (UCLH) NHS Foundation Trust; London United Kingdom
| | - C. Tomowiak
- Department of Hematology; University Hospital of Poitiers; Poitiers France
| | - B. Hivert
- Department of Hematology; Hospital of Lens; Lens France
| | - E. Toussaint
- Department of Hematology; University Hospital of Strasbourg; Strasbourg France
| | - T. Guerrero-Garcia
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - G. Itchaki
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - J. Vos
- Department of Hematology; Academical Medical Center; Amsterdam Netherlands
| | - A. Michallet
- Department of Hematology; Centre Léon Bérard; Lyon France
| | - S. Godet
- Department of Hematology; University Hospital of Reims; Reims France
| | - J. Bomsztyk
- Department of Hematology; University College London Hospitals (UCLH) NHS Foundation Trust; London United Kingdom
| | - P. Morel
- Department of Hematology; University Hospital of Amiens; Amiens France
| | - V. Leblond
- Department of Hematology; Pitié-Salpêtrière Hospital; Paris France
| | - S.P. Treon
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
| | - A. Delmer
- Department of Hematology; University Hospital of Reims; Reims France
| | - J.J. Castillo
- Department of Hematology; Dana-Farber Cancer Institute, Harvard Medical School; Boston United States
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7
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Durot E, Mulé S, Morland D, Jolly D, Delmer A, Hoeffel C, Durot C. FOLLICULAR LYMPHOMA: PRE-TREATMENT TEP/CT SCAN TEXTURE PARAMETERS AS PREDICTIVE BIOMARKERS OF PROGRESSION FREE SURVIVAL AND TIME TO NEXT TREATMENT. Hematol Oncol 2019. [DOI: 10.1002/hon.64_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- E. Durot
- Department of Hematology; University Hospital of Reims; Reims France
| | - S. Mulé
- Radiology; Henri Mondor University Hospital; Créteil France
| | - D. Morland
- Nuclear Medicine; Jean Godinot Institute; Reims France
| | - D. Jolly
- Department of Research and Innovation; Reims University Hospital; Reims France
| | - A. Delmer
- Department of Hematology; University Hospital of Reims; Reims France
| | - C. Hoeffel
- Radiology; University Hospital of Reims; Reims France
| | - C. Durot
- Radiology; University Hospital of Reims; Reims France
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8
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Romaru J, Lebrun D, Brunet A, Kheirallah S, Cousson J, Delmer A, Bani-Sadr F. [Isolated digestive localization of Hodgkin lymphoma in an HIV-infected patient, detected after hemophagocytic lymphohistiocytosis]. Med Mal Infect 2019; 49:221-224. [PMID: 30691919 DOI: 10.1016/j.medmal.2019.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/05/2018] [Accepted: 01/10/2019] [Indexed: 11/18/2022]
Affiliation(s)
- J Romaru
- Service de médecine interne, maladies infectieuses et immunologie clinique, hôpital Robert-Debré, CHU Reims, avenue Général-Koenig, 51100 Reims, France.
| | - D Lebrun
- Service de médecine interne, maladies infectieuses et immunologie clinique, hôpital Robert-Debré, CHU Reims, avenue Général-Koenig, 51100 Reims, France; Service de médecine interne et maladies infectieuses, centre hospitalier de Charleville-Mézières, 08000 Charleville-Mézières, France
| | - A Brunet
- Service de médecine interne, maladies infectieuses et immunologie clinique, hôpital Robert-Debré, CHU Reims, avenue Général-Koenig, 51100 Reims, France
| | - S Kheirallah
- Laboratoire d'anatomie pathologique, hôpital Robert-Debré, CHU Reims, France
| | - J Cousson
- Unité de réanimation polyvalente, hôpital Robert-Debré, CHU Reims, France
| | - A Delmer
- Service d'hématologie clinique, hôpital Robert-Debré, CHU Reims, France
| | - F Bani-Sadr
- Service de médecine interne, maladies infectieuses et immunologie clinique, hôpital Robert-Debré, CHU Reims, avenue Général-Koenig, 51100 Reims, France
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9
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Lemonnier F, Safar V, Cottereau A, Fataccioli V, Chaillol I, Pelletier R, Letourneau A, Dupuy A, Bossard C, Martin A, Robe C, Pelletier L, Pujals A, Bachy E, Delmer A, Moles Moreau M, Tilly H, Parrens M, Delfau-Larue M, Missiaglia E, Meignan M, de Leval L, Haioun C, Gaulard P. INTEGRATIVE ANALYSIS OF FEATURES ASSOCIATED WITH TET2, IDH2, DNMT3A, AND RHOA MUTATIONS IN ANGIOIMMUNOBLASTIC T CELL LYMPHOMA: A LYSA STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- F. Lemonnier
- INSERMU955, Unité Hémopathies Lymphoïdes; Université Paris Est, Hôpitaux universitaire Henri Mondor; Créteil France
| | - V. Safar
- Hématologie clinique; Centre Hopsitalier Lyon Sud; Pierre Bénite France
| | - A. Cottereau
- Médecine nucléaire; Hôpital Tenon, APHP; Paris France
| | - V. Fataccioli
- INSERMU955; Institut Mondor de Recherche Biomédicale; Créteil France
| | - I. Chaillol
- Lysarc; Centre Hospitalier Lyon Sud; Pierre Bénite France
| | - R. Pelletier
- INSERMU955; Institut Mondor de Recherche Biomédicale; Créteil France
| | - A. Letourneau
- Pathologie; Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | - A. Dupuy
- INSERMU955; Institut Mondor de Recherche Biomédicale; Créteil France
| | - C. Bossard
- Anatomie et cytologie pathologique; Hotel Dieu, CHU Nantes; Nantes France
| | - A. Martin
- anatomie pathologique, Hôpital Avicenne; Bobigny France
| | - C. Robe
- INSERMU955; Institut Mondor de Recherche Biomédicale; Créteil France
| | - L. Pelletier
- INSERMU955; Institut Mondor de Recherche Biomédicale; Créteil France
| | - A. Pujals
- INSERMU955, Département de Pathologie; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
| | - E. Bachy
- Lysarc; Centre Hospitalier Lyon Sud; Pierre Bénite France
| | - A. Delmer
- hématologie clinique; centre hospitalier universitaire; Reims France
| | - M. Moles Moreau
- hématologie clinique; centre hospitalier universitaire; Angers France
| | - H. Tilly
- Hématologie clinique; CLCC Henri Becquerel; Rouen France
| | - M. Parrens
- Pathologie; Hôpital Haut-Lévêque; Pessac France
| | - M. Delfau-Larue
- Immunologie biologique; Hôpitaux universitaires Henri Mondor; Créteil France
| | - E. Missiaglia
- Pathologie; Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | - M. Meignan
- LYSA image; Hôpitaux Universitaires Henri Mondor; Créteil France
| | - L. de Leval
- Pathologie; Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | - C. Haioun
- INSERMU955, Unité Hémopathies Lymphoïdes; Université Paris Est, Hôpitaux universitaire Henri Mondor; Créteil France
| | - P. Gaulard
- INSERMU955, Département de Pathologie; Université Paris Est, Hôpitaux Universitaires Henri Mondor; Créteil France
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Migault C, Lebrun D, Toubas O, Nguyen Y, Giltat A, Julien G, Toubas D, Lebargy F, Delmer A, Bani-Sadr F. Pneumopathies sévères sous idelalisib : ne pas méconnaître la toxicité pulmonaire médicamenteuse. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hentzien M, Strady C, Vernet-Garnier V, Servettaz A, De Champs C, Delmer A, Bani-Sadr F, N’Guyen Y. Facteurs pronostiques associés à la mortalité intra-hospitalière sur 30 jours lors des bactériémies à staphylocoques à coagulase négative : absence d’impact de la concentration minimale inhibitrice à la vancomycine. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Tchernonog E, Faurie P, Coppo P, Monjanel H, Bonnet A, Algarte Génin M, Mercier M, Dupuis J, Bijou F, Herbaux C, Delmer A, Fabiani B, Besson C, Le Gouill S, Gyan E, Laurent C, Ghesquieres H, Cartron G. Clinical characteristics and prognostic factors of plasmablastic lymphoma patients: analysis of 135 patients from the LYSA group. Ann Oncol 2017; 28:843-848. [PMID: 28031174 DOI: 10.1093/annonc/mdw684] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Indexed: 11/14/2022] Open
Abstract
Background Plasmablastic lymphoma (PBL), initially described in 1997 in the oral cavity of HIV positive patients, is now recognized as a distinct aggressive and rare entity of diffuse large B-cells lymphoma by the World Health Organization (WHO) classification. Since the original description, others cases have been reported. However, these are largely derived from case reports or small series limiting any definitive conclusions on clinical characteristics and outcome. Patients and methods The clinical, biological, pathological features and outcome of a cohort including 135 patients with PBL, from LYSA centers in France and Belgium, were reported and analyzed. Results The median age was 58 years, with a male predominance. The cohort was divided into 56 HIV-positive patients, 17 post-transplant patients and 62 HIV-negative/non-transplanted patients. Within HIV-negative/non-transplanted, a relative immunosuppression was found in most cases (systemic inflammatory disease, history of cancer, increased age associated with weakened immune system). We have also described a new subtype, PBL arising in a chronic localized inflammatory site, without any sign of immunosuppression. At presentation, 19% of patients showed oral involvement. Immunophenotype showed CD138 positivity in 88% of cases and CD20 negativity in 90% of cases. Chemotherapy was administered to 80% of patients, with a complete response (CR) rate of 55%. The median overall survival (OS) was 32 months. In univariate analysis, HIV positive status showed better OS when compared with HIV negative status. In multivariate analysis, International Prognostic Index score, chemotherapy and CR were associated with survival benefit. Conclusion(s) This cohort, the largest reported to date, increases the spectrum of knowledge on PBL, rarely described. However, specific guidelines to clarify treatment are lacking, and may improve the poor prognosis of this rare disease.
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Affiliation(s)
- E Tchernonog
- Department of Hematology, University Hospital of Montpellier, Montpellier, France
| | - P Faurie
- Department of Hematology, Léon Bérard Center, Lyon, France
| | - P Coppo
- Department of Hematology, Saint Antoine University Hospital, Paris, France
| | - H Monjanel
- Department of Hematology, University Hospital of Tours, Tours, France
| | - A Bonnet
- Department of Hematology, University Hospital of Nantes, Nantes, France
| | - M Algarte Génin
- Institute Pierre Louis of Epidemiology and Public Health, Paris, France
| | - M Mercier
- Department of Hematology, University Hospital of Angers, Angers, France
| | - J Dupuis
- Lymphoid Malignancies Unit University Hospital Henri Mondor, Créteil, France
| | - F Bijou
- Institute Bergonie, Bordeaux, France
| | - C Herbaux
- Department of Hematology, University Hospital of Lille, Lille, France
| | - A Delmer
- Department of Hematology, University Hospital of Reims, Reims, France
| | - B Fabiani
- Department of Biopathology, University Hospital Saint Antoine, Paris, France
| | - C Besson
- Department of Hematology, University Hospital Kremlin Bicêtre, Paris, France
| | - S Le Gouill
- Department of Hematology, University Hospital of Nantes, Nantes, France
| | - E Gyan
- Department of Hematology, University Hospital of Tours, Tours, France
| | - C Laurent
- Department of Biopathology, University Hospital of Toulouse, Toulouse, France
| | - H Ghesquieres
- Department of Hematology, University Hospital of Lyon Sud, Lyon, France, France
| | - G Cartron
- Department of Hematology, University Hospital of Montpellier, Montpellier, France
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Sellner L, Boumendil A, Finel H, Choquet S, de Rosa G, Falzetti F, Scime R, Kobbe G, Ferrara F, Delmer A, Sayer H, Amorim S, Bouabdallah R, Finke J, Salles G, Yakoub-Agha I, Faber E, Nicolas-Virelizier E, Facchini L, Vallisa D, Zuffa E, Sureda A, Dreger P. Thiotepa-based high-dose therapy for autologous stem cell transplantation in lymphoma: a retrospective study from the EBMT. Bone Marrow Transplant 2016; 51:212-218. [PMID: 26569093 DOI: 10.1038/bmt.2015.273] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 11/08/2022]
Abstract
Clinical information about thiotepa-based autologous stem cell transplantation (auto-SCT) outside the primary central nervous system lymphoma (PCNSL) field is sparse. In this registry-based retrospective study, we evaluated potential risks and benefits of thiotepa-based preparative regimens compared with BEAM (carmustine, etoposide, cytarabine, melphalan) in auto-SCT for diffuse large B-cell lymphoma (DLBCL, excluding PCNSL), follicular lymphoma (FL) or Hodgkin lymphoma (HL). A total of 14 544 patients (589 thiotepa and 13 955 BEAM) met the eligibility criteria, and 535 thiotepa- and 1031 BEAM-treated patients were matched in a 1:2 ratio for final comparison. No significant differences between thiotepa and BEAM groups for any survival end point were identified in the whole sample or disease entity subsets. For a more detailed analysis, 47 TEAM (thiotepa, etoposide, cytarabine, melphalan)-treated patients were compared with 75 matched BEAM patients with additional collection of toxicity data. Again, there were no significant differences between the two groups for any survival end point. In addition, the frequency of common infectious and non-infectious complications including secondary malignancies was comparable between TEAM and BEAM. These results indicate that thiotepa-based high-dose therapy might be a valuable alternative to BEAM in DLBCL, HL and FL. Further evaluation by prospective clinical trials is warranted.
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Affiliation(s)
- L Sellner
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - A Boumendil
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - H Finel
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
| | - S Choquet
- Department of Hematology, Pitié-Salpêtrière Hospital, Paris, France
| | | | | | - R Scime
- Department of Hematology, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - G Kobbe
- University Hospital Düsseldorf, Department of Hematology, Oncology and Clinical Immunology, Heinrich Heine University, Düsseldorf, Germany
| | | | - A Delmer
- Service d'Hématologie Clinique, Hôpital Robert Debré, Centre Hospitalier Universitaire (CHU) de Reims, Reims, France
| | - H Sayer
- Department of Hematology and Oncology, Helios Hospital Erfurt, Erfurt, Germany
| | - S Amorim
- APHP, Hopital Saint-louis, Hemato-Oncology Paris Diderot University, Sorbonne Paris Cité, Paris, France
| | - R Bouabdallah
- Hematology Department, Paoli Calmettes Institute, Marseille Aix-Marseille University, Marseille, France
| | - J Finke
- Department of Hematology, Freiburg University Medical Center, Freiburg, Germany
| | - G Salles
- Hematologie, Hospices Civils de Lyon and Université Claude Bernard Lyon-1, Pierre Bénite, France
| | - I Yakoub-Agha
- LIRIC-U995, Hematology Department and Hematopoietic Stem Cell Transplantation Unit, University-Hospital of Lille, Lille, France
| | - E Faber
- Department of Hemato-Oncology, Faculty Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | | | - L Facchini
- Hematology Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - D Vallisa
- Hematology Unit, Ospedale Civile, Piacenza, Italy
| | - E Zuffa
- Hematology Unit, S Maria delle Croci Hospital, Ravenna, Italy
| | - A Sureda
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
- Institut Català d'Oncologia, Hospital Duran i Reynals, Barcelona, Spain
| | - P Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Lymphoma Working Party, European Society for Blood and Marrow Transplantation, Paris, France
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Djelbani-Ahmed S, Chandesris MO, Mekinian A, Canioni D, Brouzes C, Hanssens K, Pop G, Durieu I, Durupt S, Grosbois B, Besnard S, Tournilhac O, Beyne-Rauzy O, Agapé P, Delmer A, Ranta D, Jeandel PY, Georgin-Lavialle S, Frenzel L, Damaj G, Eder V, Lortholary O, Hermine O, Fain O, Soussan M. FDG-PET/CT findings in systemic mastocytosis: a French multicentre study. Eur J Nucl Med Mol Imaging 2015; 42:2013-20. [PMID: 26140850 DOI: 10.1007/s00259-015-3117-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 06/10/2015] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Mastocytosis is a clonal haematological disease characterized by uncontrolled proliferation and the activation of mast cells. The value of FDG-PET/CT (FDG-PET) in mastocytosis has yet to be determined. METHODS We retrospectively identified patients with an established diagnosis of systemic mastocytosis (SM), according to the WHO criteria, who underwent PET using the French Reference Centre for Mastocytosis database. Semi-quantitative and visual analysis of FDG-PET was performed and compared to the clinico-biological data. RESULTS Our cohort included 19 adult patients, median age 65 years [range 58-74], including three with smouldering SM (SSM), three with aggressive SM (ASM), 10 with an associated clonal haematological non-mast-cell lineage disease (SM-AHNMD), and three with mast cell sarcoma (MCS). FDG-PET was performed at the time of the SM diagnosis (15/19), to evaluate lymph node (LN) activity (3/19) or the efficacy of therapy (1/19). FDG uptake was observed in the bone marrow (BM) (9/19, 47%), LN (6/19, 32%), spleen (12/19, 63%), or liver (1/19, 5%). No significant FDG uptake was observed in the SSM and ASM patients. A pathological FDG uptake was observed in the BM of 6/10 patients with SM-AHNMD, appearing as diffuse and homogeneous, and in the LN of 5/10 patients. All 3 MCS patients showed intense and multifocal BM pathological uptake, mimicking metastasis. No correlation was found between the FDG-PET findings and serum tryptase levels, BM mast cell infiltration percentage, and CD30 and CD2 expression by mast cells. CONCLUSIONS FDG uptake does not appear to be a sensitive marker of mast cell activation or proliferation because no significant FDG uptake was observed in most common forms of mastocytosis (notably purely aggressive SM). However, pathological FDG uptake was observed in the SM-AHNMD and in MCS cases, suggesting a role of FDG-PET in their early identification and as a tool of therapeutic assessment in this subgroup of patients.
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Affiliation(s)
- S Djelbani-Ahmed
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
- Sorbonne Paris Cité, Paris 13 University, Bobigny, France
| | - M O Chandesris
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - A Mekinian
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Saint Antoine Hospital, Paris, France
| | - D Canioni
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Department of Pathology, Necker Children's Hospital, APHP, Paris, France
| | - C Brouzes
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Laboratory of Haematology, Necker Children's Hospital, APHP, Paris, France
| | - K Hanssens
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- INSERM U1068, Centre de Recherche en Cancérologie de Marseille (Signaling, Hematopoiesis and Mechanism of Oncogenesis), Paoli Calmettes Institute, Aix-Marseille University, Marseille, France
| | - G Pop
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
| | - I Durieu
- Department of Internal and Vascular Medicine, Hospices Civils de Lyon, Groupe Hopitalier Sud, Université de Lyon, Pierre-Bénite, France
| | - S Durupt
- Department of Internal and Vascular Medicine, Hospices Civils de Lyon, Groupe Hopitalier Sud, Université de Lyon, Pierre-Bénite, France
| | - B Grosbois
- Department of Internal Medicine, Rennes University Hospital, Rennes, France
| | - S Besnard
- Department of Internal Medicine, Rennes University Hospital, Rennes, France
| | - O Tournilhac
- Department of Internal Medicine, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - O Beyne-Rauzy
- Department of Internal Medicine, Purpan University Hospital, Toulouse, France
| | - P Agapé
- Department of Oncology and Haematology, Saint-Denis University Hospital, Saint-Denis de la Réunion, France
| | - A Delmer
- Department of Haematology, Reims University Hospital, Reims, France
| | - D Ranta
- Department of Haematology, Brabois University Hospital, Vandoeuvre les Nancy, France
| | - P Y Jeandel
- Department of Internal Medicine, Nice University Hospital, Nice, France
| | | | - L Frenzel
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - G Damaj
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Caen University Hospital, Caen, France
| | - V Eder
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France
| | - O Lortholary
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
- Department of Infectious Diseases and Tropical Medicine, Necker Children's Hospital, APHP, Pasteur Institute, Paris, France
| | - O Hermine
- French Reference center for Mastocytosis (Centre de Référence des Mastocytoses, CEREMAST), Necker Children's Hospital, APHP, Paris, France
- Department of Haematology, Necker Children's Hospital, APHP, Paris, France
- Sorbonne Paris Cité, Imagine Institute, Paris Descartes University, Paris, France
| | - O Fain
- Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), AP-HP, Saint Antoine Hospital, Paris, France
| | - M Soussan
- Department of Nuclear Medicine, Avicenne Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Bobigny, France.
- Sorbonne Paris Cité, Paris 13 University, Bobigny, France.
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Robin M, Porcher R, Ades L, Raffoux E, Michallet M, François S, Cahn J, Delmer A, Wattel E, Vigouroux S, Bay J, Cornillon J, Huynh A, Nguyen S, Rubio M, Vincent L, Maillard N, Charbonnier A, de Latour RP, Oumedaly R, Dombret H, Fenaux P, Socié G. 15 HLA-MATCHED ALLOGENEIC STEM CELL TRANSPLANTATION IMPROVES OVERALL SURVIVAL OF HIGHER RISK MYELODYSPLASTIC SYNDROME. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30016-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Robin M, Porcher R, Adès L, Raffoux E, Michallet M, François S, Cahn JY, Delmer A, Wattel E, Vigouroux S, Bay JO, Cornillon J, Huynh A, Nguyen S, Rubio MT, Vincent L, Maillard N, Charbonnier A, de Latour RP, Reman O, Dombret H, Fenaux P, Socié G. HLA-matched allogeneic stem cell transplantation improves outcome of higher risk myelodysplastic syndrome A prospective study on behalf of SFGM-TC and GFM. Leukemia 2015; 29:1496-501. [DOI: 10.1038/leu.2015.37] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/26/2014] [Accepted: 12/01/2014] [Indexed: 11/09/2022]
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Anuset D, Quinquenel A, Lesage C, Durlach A, Delmer A, Bernard P, Grange F. Lymphoprolifération cutanée plasmocytoïde d’évolution fulgurante satellite d’un carcinome spinocellulaire chez un patient greffé rénal. Ann Dermatol Venereol 2014. [DOI: 10.1016/j.annder.2014.09.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mounier N, Brice P, Bologna S, Briere J, Gaillard I, Heczko M, Gabarre J, Casasnovas O, Jaubert J, Colin P, Delmer A, Devidas A, Bachy E, Nicolas-Virelizier E, Aoudjhane A, Humbrecht C, Andre M, Carde P. ABVD (8 cycles) versus BEACOPP (4 escalated cycles ≥4 baseline): final results in stage III–IV low-risk Hodgkin lymphoma (IPS 0–2) of the LYSA H34 randomized trial. Ann Oncol 2014; 25:1622-8. [DOI: 10.1093/annonc/mdu189] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Joly B, Plonquet A, Grare M, Delfau-Larue M, Delarue R, Delmer A, Casasnovas O, Gisselbrecht C, Gaulard P, Haioun C. Rituximab in combination with CHOP regimen in angioimmunoblastic T-cell lymphoma: Results of the phase II RAIL trial—A prospective study of the Groupe d'Etude des Lymphomes de l'Adulte (GELA). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Delmer A, Fitoussi O, Gaulard P, Laurent G, Bordessoule D, Morschhauser F, Ferme C, Tilly H, Gisselbrecht C, Coiffier B. A phase II study of bortezomib in combination with intensified CHOP-like regimen (ACVBP) in patients with previously untreated T-cell lymphoma: Results of the GELA LNH05–1T trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8554] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8554 Background: Patients with peripheral T/NK cell lymphomas (PTCL) still have a dismal prognosis with 5-yr survival less than 30% in most cases. No alternative regimen has been proven superior to CHOP so far. This multicenter phase II study was carried out to assess efficacy and safety of bortezomib in combination with an intensified CHOP-like regimen. Methods: Pts aged 18 to 65 yrs with previously untreated PTCL were planned to receive 4 bi-monthly cycles of ACVBP (doxorubicine 75 mg/m2 D1, cyclophosphamide 1200 mg/m2 D1, vindesine 2 mg/m2 D1 and D5, bleomycine 10 mg D1 and D5 and prednisone D1 to D5) followed by a sequential consolidation consisting of HD methotrexate (2 courses), etoposide + ifosfamide (4 courses) and cytarabine (2 courses) at 2 weeks intervals. Bortezomib 1.5 mg/m2 was administered at D1 and D5 of each ACVBP cycle, and then at D1, D8 and D15 every 4 weeks during consolidation phase for a total of 20 injections during the whole treatment. Results: 57 eligible pts (M 38, F 19, median age 52.5 yrs) with mostly AITL and PTCL NOS subtypes were enrolled between January 2006 and November 2007; 78% had stage III-IV disease and 53% had aaIPI ≥ 2. Forty six pts (81%) have completed induction treatment with ACVBP and only 28 (49%) the consolidation phase, mainly for disease progression. The CR + CRu rate was 45% after induction and 46% after consolidation. As of November 14th, 2008, 22 pts (39%) have died, mostly from lymphoma. The median percentage of planned dose of bortezomib received was 98% during ACVBP induction where the vinca alkaloid used was vindesine, and ranged from 90 to 95% during the consolidation courses. The dose intensity of bortezomib was 84.3% during induction, similar to that of doxorubicine and cyclophosphamide. Thrombocytopenia was more pronounced than previously observed with ACVBP alone but no life-threatening hemorrhagic event occurred. Conclusions: The combination of bortezomib with ACVBP is feasible without neurological or platelet unexpected toxicities. The response rate of such a regimen in PTCL does not appear higher than previously observed with ACVBP alone in our historical cohort. No significant financial relationships to disclose.
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Affiliation(s)
- A. Delmer
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - O. Fitoussi
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - P. Gaulard
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - G. Laurent
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - D. Bordessoule
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - F. Morschhauser
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - C. Ferme
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - H. Tilly
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - C. Gisselbrecht
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
| | - B. Coiffier
- Hôpital Robert Debré, Reims, France; Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France; Hôpital Henri Mondor, Créteil, France; Hôpital Purpan, Toulouse, France; Hôpital Dupuytren, Limoges, France; Hôpital Claude Huriez, Lille, France; Institut Gustave Roussy, Villejuif, France; Centre Henri Becquerel, Rouen, France; Hôpital Saint-Louis, Paris, France; Hôpital Lyon Sud, Pierre-Bénite, France
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Jaussaud R, Servettaz A, Tabary T, Cousson J, Vernet-Garnier V, Delmer A. Déficit immunitaire commun variable et polymorphisme génétique d’IRAK-1 chez un splénectomisé associés à un échec clinique de la vaccination antipneumococcique et de l’antibioprophylaxie. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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22
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Salanoubat C, Delmer A, Marie JP. [Chronic lymphoid B-cell leukemia]. Rev Med Suisse 2006; 2:2498-502. [PMID: 17120720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- C Salanoubat
- Département d'hématologie et d'oncologie médicale, Hôpital Hôtel-Dieu, Assistance publique Hôpitaux de Paris, 75181 Paris cedex 04
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Audard V, Larousserie F, Grimbert P, Abtahi M, Sotto JJ, Delmer A, Boue F, Nochy D, Brousse N, Delarue R, Remy P, Ronco P, Sahali D, Lang P, Hermine O. Minimal change nephrotic syndrome and classical Hodgkin's lymphoma: Report of 21 cases and review of the literature. Kidney Int 2006; 69:2251-60. [PMID: 16672913 DOI: 10.1038/sj.ki.5000341] [Citation(s) in RCA: 135] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Minimal change nephrotic syndrome (MCNS) is described as a paraneoplastic manifestation of classical Hodgkin's lymphoma (cHL). We reassessed the pathophysiological and clinical significance of this association. A retrospective study was performed to evaluate a cohort of adult patients who developed MCNS and cHL. Twenty-one patients recruited in 15 French centers were analyzed. cHL was associated with inflammatory and general symptoms in most cases. The morphological subtype was predominantly nodular sclerosis (71.4%). MCNS appeared before the diagnosis of lymphoma in eight patients (38.1%) and in this case, it was characterized by a nephrotic syndrome (NS) frequently resistant (50%) or dependent (12.5%) to steroid treatment. Interestingly, diagnosis (3-120 months after MCNS) and effective treatment of the hemopathy were associated with the disappearance of the MCNS. cHL was diagnosed before MCNS in nine patients (42.9%), and in this case, glomerulopathy was associated with cHL relapse in 55.5% of cases. In four patients (19%), the two diseases occurred simultaneously. Extensive immunohistochemical study of lymph nodes was performed in eight patients and did not reveal particular features. In conclusion, MCNS associated with cHL is frequently dependent or resistant to steroid regimen, but remission of NS is obtained with the cure of lymphoma.
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Affiliation(s)
- V Audard
- Department of Nephrology, Henri Mondor Hospital, Paris 12 University, Creteil, Paris, France
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Cauvain A, Delmer A, Godeau MJ, Molina T, Durdux C, Marinho E, Crickx B, Descamps V. [MALT (Mucosal Associated Lymphoid Tissue) lymphoma of the palpebral conjunctiva]. Ann Dermatol Venereol 2006; 133:168-70. [PMID: 16508604 DOI: 10.1016/s0151-9638(06)70871-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND MALT (Mucosal Associated Lymphoid Tissue) lymphomas of the conjunctiva belong to the extranodal marginal zone B-cell lymphomas. This site, while standard, is uncommon. CASE-REPORT A pink papular tumor developed on the lower eyelid of a 59-year-old woman. Sarcoidosis was diagnosed 9 years earlier associated with mediastinal lymphadenopathy and erythema nodosum not requiring treatment. Histological examination yielded a diagnosis of conjunctival MALT lymphoma. No visceral involvement was demonstrated. Radiotherapy (30 Gy) induced a complete response. A remote lesion developed on the patient's arm 18 months later. No other sites were found. Further radiotherapy (26 Gy) again induced complete remission. No new lesions were seen after 24 months of follow-up. DISCUSSION This case is interesting because of the association of a MALT lymphoma and previous sarcoidosis, described in the literature as "sarcoidosis-lymphoma syndrome". Association of sarcoidosis with MALT lymphoma is infrequent. Treatment of conjunctival MALT lymphoma is standardized. Radiotherapy offers excellent efficacy and is well tolerated at this site. Regular and long-term follow-up is required. Local and distant relapse can occur.
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Affiliation(s)
- A Cauvain
- Service de Dermatologie, Université Denis-Diderot, Paris VII, Centre Hospitalier Bichat Claude Bernard, Assistance Publique-Hôpitaux de Paris
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David C, Bureau-Chalot F, Kolb B, Jarraud S, Delmer A, de Champs C. Légionellose à Legionella gormanii de découverte fortuite et leucémie lymphoïde chronique : à propos d'un cas et revue de la littérature. Med Mal Infect 2006; 36:172-3. [PMID: 16459042 DOI: 10.1016/j.medmal.2005.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2005] [Accepted: 11/16/2005] [Indexed: 10/25/2022]
Abstract
Legionellosis due to other species than Legionella pneumophila is rarely described in human cases. It has been reported in immunocompromised patients with respiratory symptoms of pneumonia. We report a case of legionellosis in an immunocompromised 54-year-old man hospitalized for a blood transfusion. A routine pulmonary X- Ray was made and then a bronchoalveolar lavage was collected in which Legionella gormanii was identified. The diagnostic of legionellosis must be considered in all immunocompromised patients presenting with any pulmonary symptoms.
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Affiliation(s)
- C David
- Laboratoire de bactériologie-virologie-hygiène, CHU Robert-Debré, avenue du général-Koenig, 51092 Reims cedex, France.
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Tamburini J, Lévy V, Chaleteix C, Fermand JP, Delmer A, Stalniewicz L, Morel P, Dreyfus F, Grange MJ, Christian B, Choquet S, Leblond V. Fludarabine plus cyclophosphamide in Waldenström's macroglobulinemia: results in 49 patients. Leukemia 2005; 19:1831-4. [PMID: 16121217 DOI: 10.1038/sj.leu.2403885] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Fludarabine (FDR) therapy gives a response rate of about 30% in previously treated patients with Waldenström's macroglobulinemia (WM). The combination of FDR and cyclophosphamide (Cy) has been shown to be effective in chronic lymphoproliferative disorders. We administered the combination of FDR (30 mg/m2 i.v. D1-D3) and Cy (300 mg/m2 i.v. D1-D3) to 49 patients. Median age was 64 years. The median hemoglobin, albumin, beta 2 microglobulin and immunoglobulin M (IgM) levels were 9.9 g/100 ml, 39.6 g/l, 3 mg/l and 24.7 g/l, respectively. In all, 14 patients (29%) had not previously been treated. FDR/Cy was administered every 4 weeks for a median of four cycles. In all, 38 patients (77.6%) had partial responses, nine had stable disease and two had progressive disease. After a median of follow-up of 25 months, six patients relapsed and two patients developed large-cell lymphoma. The median time to treatment failure was 27 months. The main toxicity was hematological. In all, 12 patients died, four from progression, one from large-cell lymphoma, three from infection and four from a second malignancy. Two factors negatively influenced overall and event-free survival, age >65 years and IgM <40 g/l. The FDR/Cy combination, therefore, gives a high response rate in WM, even in previously treated patients with factors of poor prognosis.
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Affiliation(s)
- J Tamburini
- Service d'hématologie Hôpital Pitié Salpêtrière, Paris, France
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Viguié F, Aboura A, Bouscary D, Ramond S, Delmer A, Tachdjian G, Marie JP, Casadevall N. Common 4q24 deletion in four cases of hematopoietic malignancy: early stem cell involvement? Leukemia 2005; 19:1411-5. [PMID: 15920487 DOI: 10.1038/sj.leu.2403818] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We determined bone marrow karyotype at diagnosis in four female acute myeloid leukemia (AML) or myelodysplasia patients, aged between 52 and 56 years. In each case, we observed chromosome rearrangement involving the same 4q24 band. Three patients had a balanced reciprocal translocation as the sole abnormality - t(3;4)(q26;q24), t(4;5)(q24;p16) and t(4;7)(q24;q21) - and the fourth had del(4)(q23q24), +4. We used a set of 4q BAC probes for fluorescent in situ hybridization (FISH) in these four cases. We found a 4q24 submicroscopic deletion in all three translocations, with a common deletion of approximately 0.5 Mb. In three cases, we concluded that rearrangement occurred in an early hematopoietic stem cell, as it was detected, in mosaic with a normal karyotype, in a fraction of remission bone marrow cells, peripheral T and B lymphocytes, malignant lymph node T-lymphoma cells in one case and B-lymphoblastoid cell lines established in two cases. Moreover, one of 10 additional AML patients tested by FISH had a normal karyotype and deletion of one of the commonly deleted probe sequences. A tumor suppressor gene may therefore be involved, especially as two patients developed malignant lymphoma at the same time as myeloid proliferation.
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Affiliation(s)
- F Viguié
- Laboratoire de Cytogénétique Onco-Hématologique, Hôpital Hôtel-Dieu, Paris, France.
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Camilleri-Broët S, Mounier N, Delmer A, Brière J, Casasnovas O, Cassard L, Gaulard P, Christian B, Coiffier B, Sautès-Fridman C. FcγRIIB expression in diffuse large B-cell lymphomas does not alter the response to CHOP+rituximab (R-CHOP). Leukemia 2004; 18:2038-40. [PMID: 15470484 DOI: 10.1038/sj.leu.2403536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Delarue R, Haioun C, Brice P, Delmer A, Ribrag V, Van Hoof A, Casasnovas O, Tilly H, Salles G, Hermine O. CHOP and DHAP plus rituximab followed by autologous stem cell transplantation (ASCT) in mantle cell lymphoma (MCL): A pilot study from the GELA. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.6529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- R. Delarue
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - C. Haioun
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - P. Brice
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - A. Delmer
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - V. Ribrag
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - A. Van Hoof
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - O. Casasnovas
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - H. Tilly
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - G. Salles
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
| | - O. Hermine
- Hopital Necker, Paris, France; Hopital Henri Mondor, Creteil, France; Hopital Saint Louis, Paris, France; Hopital Hotel Dieu, Paris, France; Institut Gustave Roussy, Villejuif, France; AZ Saint Jan, Brugge, Belgium; CHU Dijon, Dijon, France; Centre Henri Becquerel, Rouen, France; CH Lyon Sud, Pierre Benite, France
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Binn M, Ruskoné-Fourmestraux A, Lepage E, Haioun C, Delmer A, Aegerter P, Lavergne A, Guettier C, Delchier JC. Surgical resection plus chemotherapy versus chemotherapy alone: comparison of two strategies to treat diffuse large B-cell gastric lymphoma. Ann Oncol 2004; 14:1751-7. [PMID: 14630680 DOI: 10.1093/annonc/mdg495] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The usefulness of chemotherapy to treat gastric diffuse large B-cell lymphomas (DLBCL) is well known. Whether or not chemotherapy should be performed as the only treatment or after surgical resection is debated. The aim of this study was to compare two strategies: surgical resection plus chemotherapy versus chemotherapy alone. PATIENTS AND METHODS Between January 1988 and December 1996, 58 patients included in the trials promoted by the Groupe d'Etude des Lymphomes de l'Adulte (GELA) (LNH-87 and LNH-93) received chemotherapy and 48 included in the protocol of the Groupe d'Etude des Lymphomes Digestifs (GELD) underwent surgical resection followed by chemotherapy. They all presented with localized DLBCL (stage IE and IIE according to the Ann Arbor classification). From the GELA group, seven patients received additional radiotherapy. Gastrectomy was total in 27 of the 48 patients in the GELD group. In both groups chemotherapy included anthracyclin and alkylating agents. Chemotherapy was more intensive in the GELA group than in the GELD group. RESULTS In the GELA and the GELD groups, distribution according to sex ratio, age (>60 or < or = 60 years), ECOG performance status (> or = 2 or <2) and staging (IE or IIE) was similar. Univariate analysis comparing prognostic factors in both groups showed significant differences: serum lactate dehydrogenase level above normal (28.6% versus 2.4%, P = 0.001), tumor size >10 cm (28.6% versus 12.5%, P = 0.04), patients with International Prognostic Index (IPI) >1 (21.4% versus 11.1%, P = 0.168) and 5-year survival (79% versus 90%, P = 0.03). Multivariate analysis of prognostic factors with a Cox model showed that IPI was the only independent prognostic factor (odds ratio 3, P = 0.03). Consequently, patients with IPI 0-1 were selected for comparison between the GELA group (44 patients) and the GELD group (40 patients). There was no significant difference between the two groups. Median follow-up was 59 months (range 3-128). Estimates of 5-year survival rates and event-free survival rates were 90.5% versus 91.1% (P = 0.303) and 85.9% versus 91.6% (P = 0.187), respectively. In the GELA group, seven of 44 patients died: five from a lymphoma-unrelated cause and two from tumor progression. In the GELD group, four of 40 patients died: two of unrelated causes and two from tumor progression. CONCLUSIONS This study shows that in localized gastric DLBCL with IPI 0-1, a similar 5-year survival rate (>90%) is to be expected with either surgery plus chemotherapy or chemotherapy alone.
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Affiliation(s)
- M Binn
- Hôpital Henri Mondor, Gastroentérologie, Créteil, Val de Marne, France
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Bachmeyer C, Turc Y, Fraitag S, Delmer A, Aractingi S. [Aleukemic monoblastic leukemia cutis]. Ann Dermatol Venereol 2003; 130:773-5. [PMID: 14576608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND The diagnostic and prognostic value of specific cutaneous lesions in acute leukemia is well-known. Paradoxically, these lesions may initially develop without peripheral blood or bone marrow involvement. We report the case of a patient with cutaneous lesions of acute monoblastic leukemia whereas peripheral blood was normal and massive infiltration of dermis was demonstrated. OBSERVATION A 49 year-old man had papules and nodules of the back and upper arms evolving for several months. Histological examination with appropriate immunostaining led to the diagnosis of specific cutaneous lesions of acute monoblastic leukemia. Several hemograms with peripheral blood smears were normal, bone marrow smear demonstrated an important blastic infiltration on one site and a discrete infiltration on another. Cutaneous lesions disappeared with chemotherapy. DISCUSSION Specific cutaneous lesions may be isolated during acute leukemia, and called aleukemic leukemia cutis. These are a rare form, the underlying mechanism of which relies on the accumulation of small quantities of myeloblasts in bone narrow and with high tropism for the dermis.
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Affiliation(s)
- C Bachmeyer
- Département de Médecine Interne, Centre Hospitalier Laënnec, boulevard Laënnec, BP 72, 60109 Creil.
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Sanhes L, Tang R, Delmer A, DeCaprio JA, Ajchenbaum-Cymbalista F. Fludarabine-induced apoptosis of B chronic lymphocytic leukemia cells includes early cleavage of p27kip1 by caspases. Leukemia 2003; 17:1104-11. [PMID: 12764376 DOI: 10.1038/sj.leu.2402895] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
B-cell chronic lymphocytic leukemia (B-CLL) is characterized by the accumulation of growth arrested clonal B lymphocytes that undergo apoptosis when treated with fludarabine. To further explore the mechanism for the cell cycle arrest, we examined the expression and activity of cyclin-dependent kinases and inhibitors in primary B-CLL cells. We observed high levels of p27kip1, cyclin D2, cyclin E, cdk2, and cdk4 expression in freshly isolated B-CLL cells. Despite high levels of cyclins and cdks, little cdk2 or cdk4 activity was observed with p27kip1 in complex with cyclinD2/cdk4 and cyclin E/cdk2. Remarkably, when B-CLL cells were treated in vitro with fludarabine, p27kip1 underwent caspase-specific degradation accompanied by an increase in cdk4 activity. We conclude that the G0/G1 arrest of B-CLL cells may protect against apoptosis and that the decrease in p27kip1 expression by caspase cleavage may be a key step in chemotherapy-induced apoptosis in B-CLL.
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Affiliation(s)
- L Sanhes
- Hematology Department, INSERM 9912-EA1517, APHP, Hotel-Dieu, 1 place du parvis Notre-Dame, 75004 Paris, France
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Bouabdallah R, Mounier N, Guettier C, Molina T, Ribrag V, Thieblemont C, Sonet A, Delmer A, Belhadj K, Gaulard P, Gisselbrecht C, Xerri L. T-cell/histiocyte-rich large B-cell lymphomas and classical diffuse large B-cell lymphomas have similar outcome after chemotherapy: a matched-control analysis. J Clin Oncol 2003; 21:1271-7. [PMID: 12663714 DOI: 10.1200/jco.2003.06.046] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Because it is unclear whether T-cell/histiocyte-rich large B-cell lymphomas (H/TCRBCL) should be considered as a true clinicopathologic entity, we conducted a matched-control analysis comparing patients with H/TCRBCL and patients with diffuse large-B cell lymphoma (B-DLCL). PATIENTS AND METHODS More than 4,500 patients were enrolled onto non-Hodgkin's lymphoma trials conducted by the Groupe d'Etude des Lymphomes de l'Adulte. After histologic review, 50 patients were subclassified as H/TCRBCL. They were matched to 150 patients with B-DLCL for each of the factors of the International Prognostic Index (IPI). RESULTS Clinical characteristics of H/TCRBCL patients showed a male predominance and a median age of 47 years. Performance status was normal in 89% of patients, whereas lactate dehydrogenase level was increased in 60% of patients. The disease was disseminated in 81% of patients, and 48% had two or more involved extranodal sites. The IPI score was >or= 2 in 53% of patients. The complete response rate to chemotherapy was 63%, and 5-year overall survival (OS) and event-free survival (EFS) rates (mean +/- SD) were 58% +/- 18% and 53% +/- 16%, respectively. The matched-control analysis showed a trend toward a better response to chemotherapy for patients with B-DLCL (P =.06), whereas no difference was observed in OS (P =.9) and EFS (P =.8). CONCLUSION H/TCRBCL is an aggressive disease that often presents with adverse prognostic factors. However, when treatment is adapted to the disease risk, outcome is equivalent to that observed in patients with B-DLCL. Thus H/TCRBCL should be considered a pathologic variant that belongs to the B-DLCL category.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Histiocytes/pathology
- Humans
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/mortality
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Matched-Pair Analysis
- Middle Aged
- Prognosis
- Survival Rate
- T-Lymphocytes/pathology
- Treatment Outcome
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Affiliation(s)
- R Bouabdallah
- Cancer Center Institut Paoli-Calmettes-Université de la Méditerranée, Marseille.
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Damaj G, Verkarre V, Delmer A, Solal-Celigny P, Yakoub-Agha I, Cellier C, Maurschhauser F, Bouabdallah R, Leblond V, Lefrère F, Bouscary D, Audouin J, Coiffier B, Varet B, Molina T, Brousse N, Hermine O. Primary follicular lymphoma of the gastrointestinal tract: a study of 25 cases and a literature review. Ann Oncol 2003; 14:623-9. [PMID: 12649111 DOI: 10.1093/annonc/mdg168] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To describe better the clinical, biological, endoscopic and pathological presentations, as well as the outcome, of primary follicular lymphoma (FL) of the gastrointestinal (GI) tract. PATIENTS AND METHODS From November 1983 to February 2001, 25 eligible patients with primary FL of the GI tract were retrieved from several French Departments of Pathology departments based on histological diagnosis and immunophenotype. Median age was 56 years (range 44-71) with a sex ratio female/male of 2 (17/8). RESULTS Abdominal pain was the main presenting symptom followed by intestinal obstruction. The small intestine was the most common site of involvement. Lesions were unifocal in the majority of patients (15/25). A pattern similar to lymphomatous polyposis was observed in 50% (7/14) of patients. Twelve patients had stage I, 10 patients stage II and three patients stage IV disease, and there was minimal extra intestinal involvement. Lymphoma tissues were composed of neoplastic follicles, most of which were grade 1 according to the World Health Organization (WHO) classification. The immunophenotype of the lymphoma cells was CD20+, CD10+, bcl2+ and CD5-. In tissue samples, IgH/bcl2 rearrangement at the MBR locus was present in 11 of 14 patients tested. Seven patients did not receive any treatment; four of them progressed after a median follow-up of 37.5 months. Treatment was otherwise heterogeneous, and complete remission was obtained in 15 patients which lasted for a median of 31 months. Relapses were either in the GI tract (n = 3) or outside the GI tract (n = 3). After a median follow-up of 34 months (range 5-203), 22 patients were still alive (complete remission, 11; partial remission, three; stable disease, six; progressive disease, two). CONCLUSIONS Primary FL of the GI tract is a predominantly female lymphoma that most frequently involves the small intestine. Since the endoscopic and clinical presentation may not be different from lymphomatous polyposis, which is often associated with mantle cell origin of tumor cells, it is mandatory to perform an immunohistological and, if possible, a molecular analysis of GI lymphoma. The course of the disease is indolent and does not differ from nodal FL. Thus, therapy may not be required unless significant clinical symptoms are present or until disease progression.
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Affiliation(s)
- G Damaj
- Hôpital Necker Enfants-Malades, Paris, France.
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Parrado A, Noguera ME, Delmer A, McKenna S, Davies J, Le Gall I, Bentley P, Whittaker JA, Sigaux F, Chomienne C, Padua RA. Deregulated expression of promyelocytic leukemia zinc finger protein in B-cell chronic lymphocytic leukemias does not affect cyclin A expression. Hematol J 2002; 1:15-27. [PMID: 11920165 DOI: 10.1038/sj.thj.6200012] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/1999] [Accepted: 09/25/1999] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The promyelocytic leukemia zinc finger (PLZF) gene encodes a transcription factor expressed in myeloid, lymphoid and CD34(+) progenitor cells. Structurally related to BCL-6, which is involved in human lymphoma, PLZF may have a role in proliferation, differentiation and survival of hematopoietic cells, that could be mediated by transcriptional repression of the cyclin A gene. MATERIALS AND METHODS Quantitative competitive reverse transcription-polymerase chain reaction was used to measure the levels of expression of PLZF and cyclin A in normal leukocyte subsets (including CD19(+) lymphocytes, n=21) and malignant B lymphocytes (including B-chronic lymphocytic leukemias [B-CLL], n=63). Results obtained with this method were confirmed by Western and Northern blot analysis. Transactivation assays were performed using an expression construct for PLZF and two cyclin A promoter luciferase reporters in an Epstein-Barr virus (EBV)-transformed B-cell line. Cyclin A expression, cell growth kinetics, and cell cycle were analysed in stable clones of the Burkitt lymphoma (BL) B-cell line DG75 with inducible expression of PLZF, generated using the tetracycline-regulated expression system. RESULTS Expression of PLZF was 100-fold downregulated in 90% B-CLL (56/63) compared to normal B lymphocytes (P<0.001). B-CLL patients with the highest levels of PLZF had a poorer survival (P<0.013). In transactivation assays, PLZF inhibited the activity of the cyclin A reporters by 50%, demonstrating that PLZF can repress cyclin A expression in non-malignant B lymphocytes. However, in B-CLL patients, the level of cyclin A expression was found to be within the normal range. Altered PLZF function in B lymphoid malignancies was further corroborated in the PLZF-regulatable DG75 clones, where induction of PLZF expression did not significantly alter the levels of cyclin A expression, the cell growth kinetics, or the cell cycle phase distribution. CONCLUSION The lower survival of patients with the highest levels of PLZF suggests that this protein may be a marker of progression in B-CLL. The absence of co-ordinated regulation of PLZF and cyclin A genes in B-CLL and in a malignant B-cell line may indicate a loss of cyclin A control by PLZF in B-CLL and other B-cell disorders. Deregulation of PLZF could thus play a role in B-cell malignancy.
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MESH Headings
- Antigens, CD/blood
- Base Sequence
- Cyclin A/genetics
- DNA Primers
- DNA-Binding Proteins/genetics
- Exons
- Gene Expression Regulation, Neoplastic
- HL-60 Cells
- Hematopoietic Stem Cells/physiology
- Humans
- Kruppel-Like Transcription Factors
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Lymphocyte Subsets/immunology
- Promyelocytic Leukemia Zinc Finger Protein
- RNA, Messenger/genetics
- RNA, Messenger/isolation & purification
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription Factors/genetics
- Transcriptional Activation
- Tumor Cells, Cultured
- Zinc Fingers
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Affiliation(s)
- A Parrado
- Laboratoire de Biologie Cellulaire Hématopoïétique, Université Paris 7, France.
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Lefrère F, Delmer A, Suzan F, Levy V, Belanger C, Djabarri M, Arnulf B, Damaj G, Maillard N, Ribrag V, Janvier M, Sebban C, Casasnovas RO, Bouabdallah R, Dreyfus F, Verkarre V, Delabesse E, Valensi F, McIntyre E, Brousse N, Varet B, Hermine O. Sequential chemotherapy by CHOP and DHAP regimens followed by high-dose therapy with stem cell transplantation induces a high rate of complete response and improves event-free survival in mantle cell lymphoma: a prospective study. Leukemia 2002; 16:587-93. [PMID: 11960337 DOI: 10.1038/sj.leu.2402406] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2001] [Accepted: 11/16/2001] [Indexed: 11/09/2022]
Abstract
Mantle cell lymphoma (MCL) is a distinct clinico-pathological entity with a poor prognosis. We have conducted a prospective study in patients with MCL to evaluate a therapeutic strategy in which CHOP polychemotherapy was followed by DHAP if CHOP failed to induce complete remission. Responding patients then proceeded to an intensification therapy with autologous peripheral blood stem cell transplantation (APBSCT). Twenty-eight consecutive patients with newly diagnosed aggressive MCL were included. After four cycles of CHOP regimen, two complete responses (CR) were obtained (7%) and 14 (50%), five (18%) and seven (25%) patients achieved partial (PR), minor (MR) and no response, respectively (one patient died from septic complications during CHOP induction). The two patients in CR after CHOP underwent intensification with TBI, high-dose cyclophosphamide-etoposide and APBSCT. The other twenty-five patients received DHAP and in this group a response rate of 92% (21 CR (84%), two PR (8%)) was observed. Two patients had progressive disease. The twenty-three responding patients received high-dose therapy (TAM8 regimen: TBI-cytarabine-melphalan) followed by APBSCT. One of the two partial responding patients achieved CR after TAM8. After a median follow-up of 47.6 months (range, 14-70), seven patients have relapsed. Our data confirm that: (1) CHOP regimen induces a low CR rate in MCL; (2) CHOP plus DHAP appears to be much more efficient and allows a large proportion of patients to proceed to high-dose therapy in CR; (3) consolidation therapy including TBI and high-dose Arac-C followed by APBSCT may improve event-free survival.
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Affiliation(s)
- F Lefrère
- Service d'Hématologie Adultes, Hôpital Necker, Paris, France
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Radosevic N, Delmer A, Tang R, Marie JP, Ajchenbaum-Cymbalista F. Cell cycle regulatory protein expression in fresh acute myeloid leukemia cells and after drug exposure. Leukemia 2001; 15:559-66. [PMID: 11368357 DOI: 10.1038/sj.leu.2402092] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Characteristics of treatment-induced cell cycle arrest are important for in vitro and in vivo sensitivity of acute myeloid leukemia (AML) cells to cytotoxic drugs. We analyzed the expression of the major G1 cell cycle regulators (p21Cip1, p27Kip1, cyclins D, cyclin E and pRb) in 41 fresh AML cell samples. The level of p27 expression was the only factor correlated with the response to chemotherapy, a high level of p27 expression being predictive of complete remission. There was a close relation between expression of pRb, cyclin D2 and FAB subtype, illustrated by the absence of both proteins in most samples having a monocytic component (M4, M5). We also assessed the expressions of pRb, cyclin E, p21 and p27 and the activity of cdk2, the major regulator of S-phase entry, after exposure to cytosine-arabinoside (AraC) and daunorubicin (DNR), and found these proteins could characterize time- and dose-dependent cellular response to each drug. We observed hyperphosphorylated pRb, increased levels of cyclin E and a high cdk2 activity, but no p21 induction, in AML cells exposed to 10(-6) M AraC. After exposure to 10(-5) M AraC, corresponding to the serum concentration reached in high-dose AraC regimens (HDAraC), a strong p21 induction was observed, associated with similarly overexpressed cyclin E and even higher cdk2 activity than after 10(-6) M AraC, while apoptosis was significantly increased. These data suggest that cdk2 activity is likely to play a role in AraC-induced apoptosis in AML cells. This mechanism may account for high efficacy of HDAraC in cells showing little sensitivity to conventional AraC doses.
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Affiliation(s)
- N Radosevic
- Hematology Department, INSERM E9912/EA1529, Hotel-Dieu, Paris, France
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38
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Costello R, Sainty D, Bouabdallah R, Fermand JP, Delmer A, Diviné M, Marolleau JP, Gastaut JA, Olive D, Rousselot P, Chaïbi P. Primary plasma cell leukaemia: a report of 18 cases. Leuk Res 2001; 25:103-7. [PMID: 11166824 DOI: 10.1016/s0145-2126(00)00102-8] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Primary plasma cell leukaemia (P-PCL) is a variant of multiple myeloma (MM) first diagnosed in the leukemic phase, with >2000/mm(3) circulating plasma cells (PCs) and plasmacytosis >20% of the white cell count. We investigated the clinical characteristics, therapy, immunophenotype and prognosis factors of 18 patients. Common features at diagnosis were asthenia (seven patients), renal insufficiency (ten patients), bone pain (seven patients), splenomegaly or hepatomegaly (five patients). Hypercalcemia was present at diagnosis in seven patients and was the most potent poor prognosis factor (P<0.05). Most patients (16 out of 18) were treated with an anthracyclin containing regiment; complete remission was attained in one patient and partial remission in 11 patients while six patients had no response. The median survival time from diagnosis was 7 months (2--12, 95% confidence interval), but response to treatment had favorable predictive value (P<0.05). The PCs were usually positive for mature B-cell markers (PCA-1, CD38). They expressed integrins which may increase their binding to endothelial cells and thus participate in PCL physiopathology by favoring plasmocyte extramedullary spread.
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Affiliation(s)
- R Costello
- Département d'Hématologie, Institut Paoli-Calmettes, 232 bd de Sainte Marguerite, 13009 Marseille, France.
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39
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Lacoste V, Judde JG, Brière J, Tulliez M, Garin B, Kassa-Kelembho E, Morvan J, Couppié P, Clyti E, Forteza Vila J, Rio B, Delmer A, Mauclère P, Gessain A. Molecular epidemiology of human herpesvirus 8 in africa: both B and A5 K1 genotypes, as well as the M and P genotypes of K14.1/K15 loci, are frequent and widespread. Virology 2000; 278:60-74. [PMID: 11112482 DOI: 10.1006/viro.2000.0629] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We have studied 52 new HHV8 strains by sequencing the complete hypervariable K1 gene and genotyping the K14.1/K15 loci located at both sides, respectively, of the viral genome. The samples originated from 49 patients with Kaposi's sarcoma (KS; 32 patients), multicentric Castleman's disease (MCD; 12 patients), or primary effusion lymphoma (PEL; 5 patients). Among these patients, 32 were of African origin (West and Central African countries and Creoles from French Guiana) and the 17 others were mostly French homosexuals. Comprehensive phylogenetic studies allowed the identification of distinct groups within the three already known main subtypes. Interestingly, two new sequences that did not cluster within a known subtype or group could be considered as prototypes of early/ancient variants of the C subtype and A/C set, respectively. Among the 32 African strains, the majority were either of the B subtype (13 cases) or of the A5 group (11 cases), indicating that this latter genotype is frequent and widespread in Africa. In contrast, a subtype C strain infected most of the 17 other patients. PCR-based genotyping of the K14.1/K15 loci revealed an overall predominance of P subtype, except in the A5 and B K1 groups, in which the P and M alleles were equally represented. The implications of these data on the evolution and spread of HHV8 among human African populations are discussed.
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Affiliation(s)
- V Lacoste
- Unité d'Oncologie Virale, Département du SIDA et des Rétrovirus, Institut Pasteur, 25-28 rue du Dr. Roux, Paris Cedex 15, 75724, France
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Dufau JP, Le Tourneau A, Molina T, Le Houcq M, Claessens YE, Rio B, Delmer A, Diebold J. Intravascular large B-cell lymphoma with bone marrow involvement at presentation and haemophagocytic syndrome: two Western cases in favour of a specific variant. Histopathology 2000; 37:509-12. [PMID: 11122432 DOI: 10.1046/j.1365-2559.2000.00980.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To report two cases of an unusual form of intravascular lymphoma, characterized by bone marrow involvement at presentation with haemophagocytic syndrome. METHODS AND RESULTS We describe the clinicopathological features of two patients with intravascular lymphoma primarily involving bone marrow. Both patients complained only of fever with pancytopenia and reactive haemophagocytic syndrome. Diagnosis was made on bone marrow examination, which showed large tumour cells of B-cell lineage confined within the lumen of sinuses. CONCLUSION These two cases and five previous reports could represent a variant of intravascular lymphoma, characterized by early involvement of bone marrow without dissemination to other organs. This form of intravascular lymphoma, called IVL-HS, seems to be an 'Asian' variant with a high prevalence in Asian people and a very low prevalence in Western countries. At a practical level, bone marrow biopsy may be useful in the diagnosis of intravascular lymphoma when the clinical presentation is restricted to fever of unknown origin with a reactive haemophagocytic syndrome.
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Affiliation(s)
- J P Dufau
- Department of Pathology, Hôpital d'Instruction des Armées Percy, Clamart, France.
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41
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Duong Van Huyen JP, Molina T, Delmer A, Audouin J, Le Tourneau A, Zittoun R, Bernadou A, Diebold J. Splenic marginal zone lymphoma with or without plasmacytic differentiation. Am J Surg Pathol 2000; 24:1581-92. [PMID: 11117778 DOI: 10.1097/00000478-200012000-00001] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report a series of 31 cases of splenic marginal zone lymphomas with an enlarged spleen and a multimicronodular macroscopic pattern. Two groups, A and B, were distinguished based on the presence (A) or absence (B) of a lymphoplasmacytic component with monoclonal immunoglobulin expression in the cytoplasm. There were no differences between the groups as far as age, sex, spleen weight, and progression. The only difference was the presence in group A of a monoclonal serum component and autoimmune disorders, particularly autoimmune hemolytic anemia. In most cases in which a liver and/or bone marrow biopsy was performed, lymphomatous infiltration was detected. Seven cases had a seric monoclonal IgM of 5 g/L or more and liver or bone marrow infiltration, corresponding to the definition of Waldenstrom's macroglobulinemia. Lymphoma cells had a monocytoid, centrocytoid and, in group A, lymphoplasmacytic morphology. The lymphomatous cells were positive for CD20, CD45 RA, and bcl-2. They expressed IgD in 9 cases, partially in 6, and were negative for IgD in 9 of the 24 cases studied. Progression seems to be slow, with a long survival. Three patients presented with transformation into a large B-cell lymphoma, which was responsible for death in two patients.
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42
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Molina TJ, Delmer A, Cymbalista F, Le Tourneau A, Perrot JY, Ramond S, Marie JP, Audouin J, Zittoun R, Diebold J. Mantle cell lymphoma, in leukaemic phase with prominent splenomegaly. A report of eight cases with similar clinical presentation and aggressive outcome. Virchows Arch 2000; 437:591-8. [PMID: 11193469 DOI: 10.1007/s004280000284] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mantle cell lymphoma (MCL) is a well-defined peripheral B-cell lymphoma usually diagnosed upon peripheral lymph node biopsy. We report eight cases of peripheral B-cell leukaemia that demonstrate presumptive evidence of mantle cell characteristics. The patients had a median age of 68.5 years, and five were male. All presented with an enlarged spleen without any peripheral lymphadenopathies, and they were leukaemic at presentation (median lymphocytosis, 38x10(9)/l). Morphological diagnosis of MCL was very difficult in five cases but easier in three because we were able to analyse either pre- or post-mortem lymph nodes and spleen. The immunophenotype of blood lymphocytosis using flow cytometry, the presence of a t(11;14)(q13;q32) and a cyclin D1 expression by leukaemic cells all fit with the diagnosis of MCL. All patients progressed and died with a median overall survival of 8 months. Multifocal areas of transformation in blastoid or large cell variants were observed in the three autopsied patients. In summary, one should consider the diagnosis of MCL at presentation in leukaemic phase even in the absence of peripheral adenopathies.
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MESH Headings
- Aged
- Aged, 80 and over
- Biopsy
- Bone Marrow/pathology
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 14
- Cyclin D1/analysis
- Cytogenetic Analysis
- Fatal Outcome
- Female
- Flow Cytometry
- Gene Deletion
- Humans
- Immunophenotyping
- Leukemia, B-Cell/pathology
- Lymph Nodes/pathology
- Lymphocyte Count
- Lymphoma, Mantle-Cell/genetics
- Lymphoma, Mantle-Cell/pathology
- Male
- Middle Aged
- Splenomegaly
- Translocation, Genetic
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Affiliation(s)
- T J Molina
- Department of Pathology, H tel-Dieu de Paris, AP-HP, France.
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Lévy V, Marjanovic Z, Vekhoff A, Belhocine R, Marie JP, Delmer A, Ajchenbaum-Cymbalista F, Zittoun R, Rio B. Relapse after autologous hematopoietic stem cell transplantation in acute myeloid leukemia, a single center experience over 13 years. Am J Hematol 2000; 64:232-3. [PMID: 10861826 DOI: 10.1002/1096-8652(200007)64:3<232::aid-ajh20>3.0.co;2-#] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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44
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Bachmeyer C, Audouin J, Bouillot JL, Coutarel P, Mougeot-Martin M, Delmer A. Immune thrombocytopenic purpura as the presenting feature of gastric MALT lymphoma. Am J Gastroenterol 2000; 95:1599-600. [PMID: 10894617 DOI: 10.1111/j.1572-0241.2000.02113.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
AIMS Diffuse haemangiomatosis of the spleen is a rare benign vascular condition occurring as a manifestation of systemic angiomatosis or, less commonly, confined to the spleen. It is sometimes accompanied by severe disturbance of blood coagulation. The goal of this study was to characterize an additional case of isolated diffuse haemangiomatosis of the spleen and to determine the histogenesis of this lesion which remains obscure. METHODS AND RESULTS We describe a case of isolated diffuse haemangiomatosis of the spleen in which histological and immunohistological findings suggested the possibility of a malformative tumour-like lesion. The pathological cavernous vessels were distributed randomly through the red pulp, without continuity with sinuses. The endothelial cells expressed vimentin, factor VIII related antigen and CD34, but not CD8. Some cells lining the sinus lumen expressed CD68, lysozyme and myeloperoxidase. In addition, trabecular veins presented with intimal thickening. These results allow making a diagnosis between diffuse haemangiomatosis and other tumours/tumour-like lesions of the spleen, especially littoral cell angioma, splenoma and peliosis. CONCLUSION If diffuse haemangiomatosis is usually classified as a benign proliferation of endothelial cells, we suggest that diffuse haemangiomatosis, when confined to the spleen, could be a tumour-like vascular lesion. In this hypothesis, the aetiology may be hamartomatous or malformative as is suspected in arterio-venous haemangioma of the lower extremities. The histogenesis is still questionable and no definitive proof in favour of one or the other hypothesis has been reported.
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Affiliation(s)
- J P Dufau
- Service d'Anatomie Pathologique, Hôpital d'Instruction des Armées Percy, Clamart, France.
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Baudard M, Beauchamp-Nicoud A, Delmer A, Rio B, Blanc C, Zittoun R, Marie JP. Has the prognosis of adult patients with acute myeloid leukemia improved over years? A single institution experience of 784 consecutive patients over a 16-year period. Leukemia 1999; 13:1481-90. [PMID: 10516746 DOI: 10.1038/sj.leu.2401544] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We reviewed the reports of 784 consecutive patients admitted to our department for newly diagnosed acute myeloid leukemia (AML) over a 16-year period. Median, 5-year and 10-year overall survivals were 9. 5 months, 17.3% and 11.7% respectively. Induction treatment (698 patients) resulted in 50% complete remissions (CR) (from 26.5% in secondary AML to 81.2% in patients <60 years with de novo AML). Period of diagnosis (1980-84/85-89/90-95) demonstrated a major significance for CR achievement and OS in multivariate analysis. In patients >/=60 years (372), CR rate increased (25% to 36.8%, P = 0. 03), and 5-year OS (3.7% to 10.6%, P = 0.022) improved, probably due to an increase in the proportion of patients administered conventional combined chemotherapy (54.5% to 83.8%, P < 0.0001). In younger patients CR rate continuously increased (61.5% to 74.8%, P = 0.028) with an associated improvement of 5-year OS (19.2% to 35.4%). No significant change in DFS and CR durations was observed. This large single center study on a large cohort of unselected AML patients reflects the improvement achieved in the management of AML patients, likely due to improvement of supportive care practices, administration of conventional induction to more elderly patients, and intensification of induction and post-remission treatments in patients <60 years.
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Affiliation(s)
- M Baudard
- Service d'Hématologie Clinique, Hôtel-Dieu, Paris, France
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Levy V, Ugo V, Delmer A, Tang R, Ramond S, Perrot JY, Vrhovac R, Marie JP, Zittoun R, Ajchenbaum-Cymbalista F. Cyclin D1 overexpression allows identification of an aggressive subset of leukemic lymphoproliferative disorder. Leukemia 1999; 13:1343-51. [PMID: 10482984 DOI: 10.1038/sj.leu.2401470] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The conjunction of clinical features, cell morphology and immunological characteristics allows an accurate diagnosis in most cases of B cell chronic lymphoproliferative disorders (CLD). However, the diagnosis remains uncertain in a small percentage of cases, often referred as to unclassified B cell proliferation or atypical chronic lymphocytic leukemia (CLL). We have studied retrospectively the 192 cases of leukemic CLD seen in our institution over a 3-year period, for which both clinical and routine biological data at presentation were available. Forty cases (20%) did not fit into any of the well-identified categories according to the FAB criteria and remained unclassified. We assessed cyclin D1 expression in all of these cases and found that 10 of them expressed a high level of cyclin D1 protein. We compared the characteristics of these 10 cases with those of the 30 cyclin D1 negative CLD. Despite non-distinctive cytological and phenotypic features, the 10 cyclin D1 positive patients exhibited a strikingly uniform clinical presentation with elevated leukocytosis, massive spleen enlargement and no superficial lymphadenopathy. Their outcome was very poor with a median survival of 10 months, contrasting with the prolonged survival of the cyclin D1 negative patients. The cytological features of tumor cells from these 10 patients with cyclin D1 positive unclassified leukemic CLD were similar to those of the circulating lymphoid cells from 15 patients with histologically proven mantle cell lymphoma (MCL) and primary or secondary blood involvement. Therefore, cyclin D1 expression allowed identification among the unclassified CLD, a subset of aggressive disorders which represent a leukemic counterpart of MCL (mantle cell leukemia). We suggest that determination of cyclin D1 expression by any technique available should be systematically included when investigating atypical CLL.
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Affiliation(s)
- V Levy
- Service d'Hématologie Clinique, Paris, France
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Than-Trong T, Morel X, D'Hermies F, Dighiero P, Le Tourneau A, Audouin J, Diebold J, Delmer A, Zittoun R, Renard G. [Orbital lymphoma and AIDS. Apropos of a case]. J Fr Ophtalmol 1999; 22:594-8. [PMID: 10417924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
We report the case of a 33-year-old HIV-seropositive male who had a large cell Epstein-Barr virus-associated non-Hodgkin's orbital lymphoma. A thorough medical examination enabled us to find on thoracic CT-scan a mediastinal lymph node involvement as large as 18 cm in diameter. The regression of the tumor was dramatic under chemotherapy with complete disappearance of the tumor and no recurrence was found after more than 21 months follow-up. We discuss the differential diagnosis with orbital infection.
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Affiliation(s)
- T Than-Trong
- Service d'ophtalmologie du Pr. Renard, Hôtel Dieu, Paris
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49
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Marie JP, Marjanovic Z, Vekhoff A, Bouvet A, Chast F, Levy V, Baudard M, Legrand O, Rio B, Delmer A, Zittoun R. Piperacillin/tazobactam plus tobramycin versus ceftazidime plus tobramycin as empiric therapy for fever in severely neutropenic patients. Support Care Cancer 1999; 7:89-94. [PMID: 10089089 DOI: 10.1007/s005200050233] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objective of this trial was to evaluate the potential advantages of the combination of piperacillin and tazobactam in the control of fever in neutropenic patients. In this single-center study, patients who experienced a total of 247 febrile episodes were prospectively randomized to receive either our standard regimen, ceftazidime 3 g/day (1 g t.i.d.) plus tobramycin 3 mg/kg per day (1.5 mg/kg b.i.d.), or piperacillin 12 g/day plus tazobactam 1.5 g/day (4 g+0.5 g t.i.d.) plus tobramycin 3 mg/kg per day (1.5 mg/kg b.i.d.). Vancomycin was added in all cases of persistent fever in the ceftazidime arm, but only when there was microbiologically documented resistance in the piperacillin/tazobactam arm. All 247 episodes were evaluable by "intent-to-treat" analysis. The two populations were well matched in terms of age, gender, underlying disease, chemotherapy received, oral decontamination, clinical and bacterial documentation, and severity and duration of neutropenia. Initial antibacterial therapy was successful (apyrexia at 72 h, without antibiotic change) more frequently (P = 0.008) with the regimen containing piperacillin/tazobactam (54.4%) than with the one including ceftazidime (37.6%). Fewer (P = 0.02) major infectious events (infectious death or delay in treatment of underlying disease due to infection) were observed during piperacillin/ tazobactam treatment (2.6%) than with the ceftazidime regimen (11.3%), despite a lower frequency of glycopeptide addition when piperacillin/tazobactam was used (54.4% versus 77.4%) according to the rules adopted. This trial confirmed the efficacy of the piperacillin/tazobactam combination for empirical treatment of febrile neutropenic patients. This antibiotic combination permitted a dramatic decrease in empiric glycopeptide antibiotic administration in such patients.
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Affiliation(s)
- J P Marie
- Department of Hematology, Hôtel-Dieu of Paris, France.
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Pautier P, Devidas A, Delmer A, Dombret H, Sutton L, Zini JM, Nedelec G, Molina T, Marolleau JP, Brice P. Angioimmunoblastic-like T-cell non Hodgkin's lymphoma: outcome after chemotherapy in 33 patients and review of the literature. Leuk Lymphoma 1999; 32:545-52. [PMID: 10048427 DOI: 10.3109/10428199909058412] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We analyzed 33 patients with AILD T-NHL in a retrospective multicentric study. The median age was 62 yr (35-84 yr) (19 patients over 60 yr). Advanced disease (n = 31) and B-symptoms were consistently found (n = 29) and 20 patients had bone marrow involvement. The main laboratory abnormalities were: anemia (n = 13), hypereosinophilia (n = 13), lymphopenia (n = 14), hypergammaglobulinemia (n = 17), elevated lactate dehydrogenase (LDH) level (n = 24). First-line therapy was chemotherapy (ChT) alone (n = 25) or ChT after steroids (n = 8). Most patients received a CHOP-like regimen for a median number of 6 cycles and 3 patients received interferon alpha (IFN alpha) as consolidation after chemotherapy. With a median follow-up of 46 mo, 60% achieved a complete response but the outcome was poor with a relapse rate at 56%, a median survival referring to the total population was of 36 mo (2-108+ mo) and an overall survival at 5 yr of 36%. Two patients received high-dose chemotherapy (with total body irradiation) and autologous progenitor-cell transplantation for chemosensitive relapse and were free of disease at, respectively, 76 and 24 mo+. In conclusion AILD T-NHL still has a poor prognosis compared to other NHL. The role of intensive therapy and IFN alpha still remains to be evaluated.
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