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Peyre M, Sicre de Fontbrune F, Berceanu A, Benjemia L, Castelle M, D'Aveni M, Marçais A, Kaphan E, Bulabois CE, Sirvent A, Rohrlich PS, Coiteux V, Chantepie S, Nguyen-Quoc S, Peffault de Latour R, Coppo P. Efficacy of eculizumab in transplantation-associated thrombotic microangiopathy: results of the French nationwide study on behalf of the SFGM-TC and the CNR-MAT. Bone Marrow Transplant 2024:10.1038/s41409-024-02279-2. [PMID: 38605146 DOI: 10.1038/s41409-024-02279-2] [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] [Received: 08/25/2023] [Revised: 02/14/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Marion Peyre
- Hematology Department, Saint-Antoine Hospital, APHP, Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit - French Reference Center for Aplastic Anemia, Saint Louis Hospital, APHP, Paris, France.
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Lise Benjemia
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Martin Castelle
- Pediatric Hematology-Immunology and Rheumatology Unit, Necker Hospital, APHP, Paris, France
| | - Maud D'Aveni
- Hematology Department, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | | | - Eleonore Kaphan
- Hematology Department, Grenoble University Hospital, Grenoble, France
| | | | - Anne Sirvent
- Hematology Department, Montpellier University Hospital, Montpellier, France
| | | | - Valerie Coiteux
- Hematology Department, Lille University Hospital, Lille, France
| | | | | | - Régis Peffault de Latour
- Hematology Transplant Unit - French Reference Center for Aplastic Anemia, Saint Louis Hospital, APHP, Paris, France
| | - Paul Coppo
- Hematology Department, Saint-Antoine Hospital, APHP, Paris, France.
- French Reference Center for Thrombotic Microangiopathies, Paris, France.
- INSERM UMRS1138, Centre de Recherche des Cordeliers, Paris, France.
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2
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Bellanger AP, Gbaguidi-Haore H, Berceanu A, Gouzien L, El Machhour C, Bichard D, Lanternier F, Scherer E, Millon L. Use of the Mucorales qPCR on blood to screen high-risk hematology patients is associated with better survival. Med Mycol 2024; 62:myae030. [PMID: 38533663 DOI: 10.1093/mmy/myae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/01/2024] [Revised: 03/10/2024] [Accepted: 03/25/2024] [Indexed: 03/28/2024] Open
Abstract
Our objective was to determine whether the twice-weekly screening of high-risk hematology patients by Mucorales qPCR on serum affects the prognosis of mucormycosis. Results from all serum Mucorales qPCR tests performed on patients from the hematology unit from January 2017 to December 2022 were analyzed. Patients with positive results were classified as having proven, probable or 'PCR-only' mucormycosis. One-month mortality for the local cohort was compared with that of a national cohort of cases of mucormycosis collected by the French surveillance network for invasive fungal disease ('Réseau de surveillances des infections fongiques invasives en France' (RESSIF)) from 2012 to 2018. From 2017 to 2022, 7825 serum Mucorales qPCR tests were performed for patients from the hematology unit; 107 patients with at least one positive Mucorales qPCR (164 positive samples) were identified. Sixty patients (70 positive samples, median Cq = 40) had no radiological criteria for mucormycosis and were considered not to have invasive fungal disease (70/7825, 0.9% false positives). It was not possible to classify disease status for six patients (12 positive samples, median Cq = 38). Forty-one patients (82 positive samples, median Cq = 35) had a final diagnosis of mucormycosis. In comparison with the RESSIF cohort, the local cohort was independently associated with a 48% lower one-month all-cause mortality rate (age-, sex-, and primary disease-adjusted hazard ratio = 0.52; 95% confidence interval: 0.29-0.94; P 0.03). Proactive screening for invasive mold diseases in high-risk hematology patients, including twice-weekly Mucorales qPCR on serum, was associated with mucormycosis higher survival.
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Affiliation(s)
- Anne-Pauline Bellanger
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
| | - Houssein Gbaguidi-Haore
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
- Infection Control Department, University Hospital of Besançon, Besançon, France
| | - Ana Berceanu
- Hematological Intensive Care Unit, University Hospital of Besançon, Besançon, France
| | - Laura Gouzien
- Intensive Care Unit, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Chaima El Machhour
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
| | - Damien Bichard
- Pharmacy Department, University Hospital of Besançon, Besançon, France
| | - Fanny Lanternier
- Infectious Diseases Unit, Necker-Enfants Malades University Hospital, AP-HP, Paris, France
| | - Emeline Scherer
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
| | - Laurence Millon
- Parasitology-Mycology, University Hospital of Besançon, Besançon, France
- Chrono-Environment UMR CNRS- 6249, University of Franche-Comté, Besançon, France
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Longval T, Leprêtre AC, Ravinet A, Fayard A, Forcade E, Coman T, Redjoul R, Berceanu A, Buchbinder N, Berlie G, Mappoura M, Giannotti F, Chevillon F, Robin M, Peffault de Latour R, Sicre de Fontbrune F. Efficacy and safety of Daratumumab for the treatment of ABO-incompatible pure red cell aplasia after allogenic HSCT: report from SFGM-TC. Bone Marrow Transplant 2024:10.1038/s41409-024-02202-9. [PMID: 38461290 DOI: 10.1038/s41409-024-02202-9] [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] [Received: 08/28/2023] [Revised: 12/15/2023] [Accepted: 01/08/2024] [Indexed: 03/11/2024]
Affiliation(s)
- Thomas Longval
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland.
| | | | - Aurélie Ravinet
- Hematology Department, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France
| | - Amandine Fayard
- Hematology Department, Centre Hospitalier Universitaire Estaing, Clermont-Ferrand, France
| | - Edouard Forcade
- Hematology Department, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Tereza Coman
- Hematology Department, Gustave-Roussy, Villejuif, France
| | - Rabah Redjoul
- Hematology Department, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ana Berceanu
- Hematology Department, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Nimrod Buchbinder
- Hematopoietic Pediatric Transplant Center, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | | | - Maria Mappoura
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Federica Giannotti
- Division of Hematology, Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Florian Chevillon
- Hematology Adolescents and Young Adults, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Marie Robin
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Régis Peffault de Latour
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Flore Sicre de Fontbrune
- Hematology Transplant Unit, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
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4
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Caillet A, Simonet‐Boissard M, Forcade E, Robin M, Rubio M, Couturier M, Srour M, Maillard N, Devillier R, Huynh A, Bourhis J, Simand C, Chantepie S, Boisson C, Kroemer M, Deconinck E, Berceanu A. IDALLO study: A retrospective multicenter study of the SFGM-TC evaluating the efficacy and safety of ivosidenib in relapsed IDH1-mutated AML after allogeneic hematopoietic cell transplantation. Hemasphere 2024; 8:e44. [PMID: 38469458 PMCID: PMC10925725 DOI: 10.1002/hem3.44] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/13/2024] [Indexed: 03/13/2024] Open
Affiliation(s)
- Adrien Caillet
- Hematology Department, Hôpital Jean MinjozCHU BesançonBesançonFrance
| | | | - Edouard Forcade
- Hematology Department, Hôpital Haut‐LévêqueCHU BordeauxBordeauxFrance
| | - Marie Robin
- Hematology DepartmentHôpital Saint‐LouisParisFrance
| | | | | | - Micha Srour
- Hematology Department, CHU de LilleUniversity of LilleLilleFrance
| | | | | | - Anne Huynh
- Hematology DepartmentIUCT OncopoleToulouseFrance
| | | | | | | | - Cyril Boisson
- Methodological and Quality of Life in Oncology Unit, University Hospital of Besançon, Franche‐Comté University, INSERM, Etablissement Français du Sang Bourgogne Franche‐Comté, UMR 1098Interactions Hôte‐Greffon‐Tumeur/Ingénierie Cellulaire et GéniqueBesançonFrance
| | - Marie Kroemer
- Pharmacy Department, INSERM, Etablissement Français du Sang, Bourgogne Franche Comté, UMR 1098Interactions Hôte‐Greffon‐Tumeur/Inginérie Cellulaire et GéniqueBesançonFrance
| | - Eric Deconinck
- Hematology DepartmentCentre Hospitalier Universitaire de BesanconBesançonFrance
| | - Ana Berceanu
- Hematology Department, Hôpital Jean MinjozCHU BesançonBesançonFrance
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Rossi M, Szepetowski S, Yakouben K, Paillard C, Sirvent A, Castelle M, Pegon C, Piguet C, Grain A, Angoso M, Robin M, Dhedin N, Pondarré C, Dumesnil de Maricourt C, Berceanu A, Simon P, Marcais A, Poirée M, Gandemer V, Plantaz D, Nguyen S, Michel G, Loundou A, Dalle JH, Thuret I. Recent results of hematopoietic stem cell transplantation for thalassemia with busulfan-based conditioning regimen in France: improved thalassemia free survival despite frequent mixed chimerism. A retrospective study from the Francophone Society of Stem Cell Transplantation and Cellular Therapy (SFGM-TC). Bone Marrow Transplant 2023; 58:1254-1256. [PMID: 37542188 DOI: 10.1038/s41409-023-02079-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/06/2023]
Affiliation(s)
- Marica Rossi
- Department of Pediatric Hematology, Robert Debré Hospital, GHU APHP Nord, Université Paris Cité, Paris, France.
| | - Sarah Szepetowski
- Department of Pediatric Hematology and Oncology, Rare Disease Center for Thalassemia, La Timone Hospital, Marseille, France
| | - Karima Yakouben
- Department of Pediatric Hematology, Robert Debré Hospital, GHU APHP Nord, Université Paris Cité, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology and Oncology, Hautepierre Hospital, Strasbourg, France
| | - Anne Sirvent
- Department of Pediatric Hematology and Oncology, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Martin Castelle
- Department of Pediatric Immunology and Hematology, Necker-Enfants Malades Hospital, Paris, France
| | - Charline Pegon
- Department of Pediatric Hematology and Oncology, Estaing Hospital, Clermont-Ferrand, France
| | - Christophe Piguet
- Department of Pediatric Hematology and Oncology, Mother and Child University Hospital, Limoges, France
| | - Audrey Grain
- Department of Pediatric Hematology and Oncology, University Hospital of Nantes, Nantes, France
| | - Marie Angoso
- Department of Pediatric Hematology and Oncology, Pellegrin Hospital, Bordeaux, France
| | - Marie Robin
- Department of Stem Cell Transplantation, Saint-Louis Hospital, GHU APHP Nord, Université Paris Cité, Paris, France
| | - Nathalie Dhedin
- Unit of Hematology for Adolescents, Saint-Louis Hospital, Paris, France
| | - Corinne Pondarré
- Rare Disease Center for Sickle Cell Disease, Centre Hospitalier Intercommunal de Créteil, Créteil, INSERM U955, Paris Est Créteil University, Créteil, France
| | | | - Ana Berceanu
- Department of Adult Hematology, Jean Minjoz Hospital, Besançon, France
| | - Pauline Simon
- Department of Pediatric Hematology and Oncology, Jean Minjoz Hospital, Besançon, France
| | - Ambroise Marcais
- Department of Adult Hematology, Necker-Enfants Malades Hospital, Paris, France
| | - Maryline Poirée
- Department of Pediatric Hematology and Oncology, University Hospital of Nice, Nice, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Dominique Plantaz
- Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France
| | - Stéphanie Nguyen
- Department of Hematology, La Pitié-Salpêtrière Hospital, Paris, France
- Francophone Society of Stem Cell Transplantation and Cellular Therapy (SFGM-TC), Paris, France
| | - Gérard Michel
- Department of Pediatric Hematology and Oncology, Rare Disease Center for Thalassemia, La Timone Hospital, Marseille, France
| | - Anderson Loundou
- Unit for Clinical and Epidemiological Research, DRRC/AP-HM Faculté de Médecine de Marseille, Marseille, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, GHU APHP Nord, Université Paris Cité, Paris, France
| | - Isabelle Thuret
- Department of Pediatric Hematology and Oncology, Rare Disease Center for Thalassemia, La Timone Hospital, Marseille, France
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6
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Gavriilaki E, Sakellari I, Labopin M, Bornhäuser M, Hamladji RM, Casper J, Edinger M, Zák P, Yakoub-Agha I, Ciceri F, Schroeder T, Zuckerman T, Kobbe G, Yeshurun M, Narni F, Finke J, Diez-Martin JL, Berceanu A, Hilgendorf I, Verbeek M, Olivieri A, Savani B, Spyridonidis A, Nagler A, Mohty M. Survival advantage of treosulfan plus fludarabine (FT14) compared to busulfan plus fludarabine (FB4) in active acute myeloid leukemia post allogeneic transplantation: an analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant 2023; 58:1084-1088. [PMID: 37420011 DOI: 10.1038/s41409-023-02028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 06/02/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
We compared FT14 (fludarabine 150-160 mg/m2, treosulfan 42 g/m2) versus FB4 (fludarabine 150-160 mg/m2, busulfan 12.8 mg/kg) in acute myeloid leukemia (AML) transplanted at primary refractory/relapsed disease. We retrospectively studied: (a) adults diagnosed with AML, (b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated/sibling donor (2010-2020), (c) HSCT with primary refractory/relapsed disease, (d) conditioning regimen with FT14 or FB4. We studied 346 patients, 113 transplanted with FT14, and 233 with FΒ4. FT14 patients were significantly older, more frequently had an unrelated donor and had received a lower dose of fludarabine. Cumulative incidence (CI) of acute graft-versus-host disease (GVHD) grade III-IV and extensive chronic GVHD was similar. With a median follow-up of 28.7 months, 2-year CI of relapse was 43.4% in FT14 versus 53.2% in FB4, while non-relapse mortality (NRM) was respectively 20.8% versus 22.6%. This led to 2-year leukemia-free survival (LFS) of 35.8% for FT14 versus 24.2% in FB4, and overall survival (OS) of 44.4% versus 34%. Adverse cytogenetics and conditioning regimen independently predicted CI of relapse. Furthermore, conditioning regimen was the only independent predictor of LFS, OS, and GVHD-free/relapse-free survival. Therefore, our real-world multicenter study suggests that FT14 is associated with better outcomes in primary refractory/relapsed AML.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece.
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Myriam Labopin
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Martin Bornhäuser
- University Hospital Dresden, Medizinische Klinik und Poliklinik I, TU, Dresden, Germany
| | - Rose-Marie Hamladji
- Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria
| | - Jochen Casper
- Klinikum Oldenburg, Abt. Onkologie/Hämatologie, Oldenburg, Germany
| | - Matthias Edinger
- Department. of Hematology and Oncology, University Regensburg, Regensburg, Germany
| | - Pavel Zák
- Charles University Hospital, 4th Department of Internal Medicine - Hematology, Hradec_Kralove, Czech Republic
| | | | - Fabio Ciceri
- Ospedale San Raffaele s.r.l. Haematology and BMT, Milano, Italy
| | - Thomas Schroeder
- University Hospital Dept. of Bone Marrow Transplantation, Essen, Germany
| | - Tsila Zuckerman
- Dept. of Hematology & BMT, Rambam Medical Center, Haifa, Israel
| | - Guido Kobbe
- Heinrich Heine Universitaet, Klinik für Hämat,Onkol,Klin.Immun, Duesseldorf, Germany
| | - Moshe Yeshurun
- Hematology and BMT Department, Beilinson Hospital, Petach_Tikva, Israel
| | - Franco Narni
- Azienda Ospedaliero Universitaria di Modena Policlinico, Ematologia, Modena, Italy
| | - Jürgen Finke
- Department. of Medicine -Hematology, Oncology, University of Freiburg, Freiburg, Germany
| | | | - Ana Berceanu
- Hopital Jean Minjoz, Service d'Hématologie, Besancon, France
| | - Inken Hilgendorf
- Universitaetsklinikum Jena, Klinik für Innere Medizin II, (Abt. Hämatologie und Onkologie), Am Klinikum 1, Jena, Germany
| | - Mareike Verbeek
- Klinikum Rechts der Isar, III Med Klinik der TU, Munich, Germany
| | - Attilio Olivieri
- Azienda Ospedali Riuniti di Ancona, Department of Hematology, Ancona University, Ancona, Italy
| | - Bipin Savani
- Department of Hematology-Oncology, Vanderbilt University, Medical Center, Nashville, TN, USA
| | - Alexandros Spyridonidis
- Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece
| | - Arnon Nagler
- Department of Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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7
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Saraceni F, Labopin M, Raiola AM, Blaise D, Reményi P, Sorà F, Pavlu J, Bramanti S, Busca A, Berceanu A, Battipaglia G, Visani G, Sociè G, Bug G, Micò C, La Nasa G, Musso M, Olivieri A, Spyridonidis A, Savani B, Ciceri F, Nagler A, Mohty M. Thiotepa-busulfan-fludarabine Compared to Treosulfan-based Conditioning for Haploidentical Transplant With Posttransplant Cyclophosphamide in Patients With Acute Myeloid Leukemia in Remission: A Study From the Acute Leukemia Working Party of the EBMT. Hemasphere 2023; 7:e952. [PMID: 37746158 PMCID: PMC10513143 DOI: 10.1097/hs9.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/31/2023] [Indexed: 09/26/2023] Open
Abstract
We conducted a registry analysis including adult acute myeloid leukemia (AML) patients in remission who had received thiotepa, busulfan, and fludarabine (TBF) or treosulfan-based (Treo) conditioning for haplo-hematopoietic stem cell transplant (HSCT) with posttransplant cyclophosphamide (PTCy) between 2010 and 2020. A total of 1123 patients met the inclusion criteria (968 received TBF and 155 received Treo). A 1:1 matched-pair analysis was performed on 142 TBF and 142 Treo patients. In the Treo group, 68% of patients received treosulfan at a dose ≥36 g/m2 and 54% of patients received a second alkylator (thiotepa or melphalan). We observed a trend toward increased incidence of grade II-IV acute (a) graft-versus-host disease (GVHD) at 180 days in the TBF group compared with Treo (29% versus 20%; P = 0.08), while incidence of grade III-IV aGVHD was not statistically different. Similarly, the incidence of chronic (c) GVHD was not statistically different in the 2 groups. Incidence of nonrelapse mortality at 2 years was 19% in TBF and 14% in Treo (P = 0.4). Relapse incidence at 2 years was not statistically different in the 2 groups (16% and 18% in TBF and Treo, respectively; P = 0.9). Leukemia-free survival, overall survival, and GVHD-free, relapse-free survival was 65% versus 68% (P = 0.6), 73% versus 76% (P = 0.5), and 54% versus 53% (P = 0.8) in TBF versus Treo, respectively. In conclusion, we did not find a significant difference between the 2 conditioning in the present study; Treo and TBF represent 2 valid alternative regimens for haplo-HSCT with PTCy for AML in remission.
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Affiliation(s)
- Francesco Saraceni
- Ematologia, Trapianto e Terapia Cellulare, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Myriam Labopin
- SorbonneUniversité, INSERM UMR-S 938, CRSA, EBMT Statistical Unit, Paris, France
| | - Anna M. Raiola
- Ematoloia e Terapia Cellulare, IRCCS Ospedale Policlinico San Martino Genova, Italy
| | - Didier Blaise
- Programme de Transplantation and TherapieCellulaire, Centre de RechercheenCancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Péter Reményi
- Department of Hematology and Stem Cell Transplant, Budapest, Hungary
| | - Federica Sorà
- UniversitaCattolica S. Cuore, Istituto di Ematologia, Rome, Italy
| | - Jiri Pavlu
- Department of Hematology, Imperial College, Hammersmith Hospital, London, United Kingdom
| | - Stefania Bramanti
- Department of Oncology and Hematology, IstitutoClinicoHumanitas, Transplantation Unit, Milano, Italy
| | - Alessandro Busca
- S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Cittadella Salute e dellaScienza di Torino, Italy
| | - Ana Berceanu
- Hopital Jean Minjoz, Service d`Hématologie, Besançon, France
| | - Giorgia Battipaglia
- Division of Hematology, Federico II` Medical School, University of Napoli, Italy
| | - Giuseppe Visani
- Hematology and Transplant Center, AORMN Hospital, Pesaro, Italy
| | - Gerard Sociè
- Department of Hematology, Hopital St. Louis, BMT, Paris, France
| | - Gesine Bug
- Goethe-Universitaet, MedizinischeKlinik II, Hämatologie, MedizinischeOnkologie, Frankfurt_Main, Germany
| | - Caterina Micò
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Giorgio La Nasa
- Centro TrapiantiUnico Di CSE Adulti e Pediatrico A. O Brotzu, Cagliari, Italy
| | - Maurizio Musso
- Department of Oncologico, Ospedale La Maddalena, Palermo, Italy
| | - Attilio Olivieri
- Ematologia, Trapianto e Terapia Cellulare, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Alexandros Spyridonidis
- Bone Marrow Transplantation Unit and Institute of Cell Therapy, University of Patras, Greece
| | - Bipin Savani
- Long Term Transplant Clinic, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Fabio Ciceri
- Ospedale San Raffaele s.r.l., Hematology and BMT, Milano, Italy
| | - Arnon Nagler
- Hematology Division, ChaimShebaMedical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- SorbonneUniversité, INSERM UMR-S 938, CRSA, Service d’hématologie et thérapie cellulaire, AP-HP, Hôpital Saint-Antoine, Paris, France
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Peterlin P, Le Bris Y, Turlure P, Chevallier P, Ménard A, Gourin MP, Dumas PY, Thepot S, Berceanu A, Park S, Hospital MA, Cluzeau T, Bouzy S, Torregrosa-Diaz JM, Drevon L, Sapena R, Chermat F, Ades L, Dimicoli-Salazar S, Chevret S, Béné MC, Fenaux P. CPX-351 in higher risk myelodysplastic syndrome and chronic myelomonocytic leukaemia: a multicentre, single-arm, phase 2 study. Lancet Haematol 2023; 10:e521-e529. [PMID: 37245522 DOI: 10.1016/s2352-3026(23)00090-x] [Citation(s) in RCA: 1] [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] [Received: 01/31/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND CPX-351, an encapsulated form of cytarabine and daunorubicin, has shown greater efficacy than the classic 3 + 7 treatment administration in secondary acute myeloid leukaemia. Given that higher-risk myelodysplastic syndrome and chronic myelomonocytic leukaemia share similarities with secondary acute myeloid leukaemia, we aimed to investigate the safety and efficacy of CPX-351 in this context. METHODS This investigator-initiated two-cohort phase 2 trial was conducted by the Groupe Francophone des Myélodysplasies, with 12 participating centres in France. It comprised cohort A (reported here and completed), which included patients in first-line treatment, and cohort B, which was stopped for lack of inclusion (ie, not enough patients met the inclusion criteria), for patients with hypomethylating agent failure that is not reported here. Cohort A enrolled patients with newly diagnosed higher-risk myelodysplastic syndrome or chronic myelomonocytic leukaemia (aged 18-70 years old) with an Eastern Cooperative Oncology Group performance status of 0-1. Intravenous CPX-351 (100 mg/m2 cytarabine and 44 mg/m2 daunorubicin) was given on days 1, 3, and 5, with a second induction cycle given (same daily dose on days 1 and 3) if at least a partial response was not reached. Patients who responded could receive up to four monthly consolidation cycles (same daily dose on day 1) or allogeneic haematopoietic stem-cell transplantation (HSCT). Overall response rate after one or two induction courses according to European LeukemiaNet 2017 acute myeloid leukaemia was the primary endpoint after CPX-351 induction, whether patients received one or two induction cycles. Safety was assessed in all patients enrolled (in cohort A). This trial is registered with ClinicalTrials.gov, NCT04273802. FINDINGS Between April 29, 2020, and Feb 10, 2021, 21 (68%) male and ten (32%) female patients were enrolled. 27 (87%) of 31 patients responded (95% CI 70-96). 16 (52%) of the 31 patients received at least one consolidation cycle. 30 (97%) of the 31 patients included were initially considered eligible for allogeneic HSCT and 29 (94%) of the 31 patients had the procedure. Median follow-up was 16·1 months (IQR 8·3-18·1). The most common grade 3-4 adverse events were pulmonary (eight [26%] of 31 patients) and cardiovascular (six [19%] of 31 patients). There were 14 serious adverse events (mainly hospitalisation for infection [n=5] and only one was treatment-related) and no treatment-related death. INTERPRETATION CPX-351 appears to be active and safe in patients with higher-risk myelodysplastic syndrome and chronic myelomonocytic leukaemia, allowing bridging to allogenic HSCT in most patients. FUNDING Jazz Pharmaceuticals.
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Affiliation(s)
- Pierre Peterlin
- Clinical Hematology, Nantes University Hospital, Nantes, France.
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Pascal Turlure
- Clinical Hematology, Limoges University Hospital, Limoges, France
| | | | - Audrey Ménard
- Hematology Biology, Nantes University Hospital, Nantes, France
| | | | - Pierre-Yves Dumas
- Clinical Hematology, Bordeaux University Hospital Haut-Lévèque, Pessac, France
| | - Sylvain Thepot
- Clinical Hematology, Angers University Hospital, Angers, France
| | - Ana Berceanu
- Clinical Hematology, Besançon University Hospital, Besançon, France
| | - Sophie Park
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | | - Thomas Cluzeau
- Clinical Hematology, Nice University Hospital, Nice, France
| | - Simon Bouzy
- Hematology Biology, Nantes University Hospital, Nantes, France
| | | | - Louis Drevon
- Clinical Hematology, Hôpital Saint Louis, Paris, France
| | - Rosa Sapena
- Groupe Francophone des Myelodysplasies, Paris, France
| | | | - Lionel Ades
- Clinical Hematology, Hôpital Saint Louis, Paris, France
| | | | - Sylvie Chevret
- Biostatistics Department, Hôpital Saint Louis, Paris, France
| | | | - Pierre Fenaux
- Groupe Francophone des Myelodysplasies, Paris, France
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9
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Grain A, Rialland-Battisti F, Chevallier P, Blin N, Dalle JH, Michel G, Dhédin N, Peffault de Latour R, Pochon C, Yakoub-Agha I, Bertrand Y, Sirvent A, Jubert C, Forcade E, Berceanu A, Gandemer V, Schneider P, Bay JO, Rohrlich PS, Brissot E, Paillard C, Plantaz D, Nguyen Quoc S, Gonzales F, Maillard N, Planche L, Baruchel A. Hematopoietic stem cell transplantation for acute lymphoblastic leukemia: why do adolescents and young adults outcomes differ from those of children? A retrospective study on behalf of the Francophone Society of Stem Cell Transplantation and Cellular Therapy (SFGM-TC). J Cancer Res Clin Oncol 2023; 149:1473-1483. [PMID: 35507103 DOI: 10.1007/s00432-022-04021-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE In the acute lymphoblastic leukemia (ALL) landscape, adolescents and young adults (AYA) often present high-risk diseases and increased chemotherapy-related toxicity. Studies analyzing the outcomes of AYA after hematopoietic stem cell transplantation (HSCT) are scarce. Our study aimed to compare the outcomes of children and AYA with ALL after HSCT and to determine the factors influencing potential differences. METHOD 891 patients, from the SFGM-TC registry, aged between 1 and 25 years who received HSCT between 2005 and 2012 were included. The outcomes of AYA were compared to the ones of their younger counterparts. RESULTS Five-year OS and GRFS were lower in AYA: 53.1% versus 64% and 36% versus 47% (p = 0.0012 and p = 0.007, respectively). WhileCIR was similar in both groups, 5 year-treatment related mortality was higher in AYA: 19% versus 13% (p = 0.04). The lower GRFS in AYA was mainly explained by a higher chronic graft versus host disease (cGvHD) incidence: 32% versus 19% (p < 0.001). Use of peripheral blood stem cells and use of anti-thymoglobulin appeared to be the main factors impacting cGvHD occurrence in AYA. CONCLUSION AYA have worse outcomes than children after HSCT for ALL because of a greater risk of TRM due to cGvHD. HSCT practices should be questioned in this population.
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Affiliation(s)
- Audrey Grain
- Pediatric Hematology-Oncology Department, CHU Hopital Mère-Enfant, Nantes, France.
| | | | | | - Nicolas Blin
- Hematology Department, CHU Hotel Dieu, Nantes, France
| | - Jean-Hugues Dalle
- Robert Debré University Hospital (APHP), Université de Paris, Paris, France
| | - Gérard Michel
- Department of Paediatric Haematology and Oncology and EA3279, Timone Children Hospital and Aix-Marseille University, Marseille, France
| | - Nathalie Dhédin
- AYA Unit, Clinical Hematology Departments, Saint-Louis Hospital, Paris, France
| | | | - Cécile Pochon
- Allogeneic Hematopoietic Stem Cell Transplantation Unit, Department of Pediatric Oncohematology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | | | - Yves Bertrand
- Institut of Hematology and Pediatric Oncology, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Anne Sirvent
- Department of Clinical Haematology, CHU Montpellier, Montpellier, France
| | - Charlotte Jubert
- Department of Pediatric Hematology, Bordeaux Hospital, Bordeaux, France
| | - Edouard Forcade
- Department of Hematology and Cellular Therapy, CHU Bordeaux, Bordeaux, France
| | - Ana Berceanu
- Department of Hematology, CHU Besançon, Besançon, France
| | - Virginie Gandemer
- Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - Jacques-Olivier Bay
- Department of Hematology and Cellular Therapy CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Eolia Brissot
- Department of Haematology, Hôpital Saint-Antoine, Paris, France
| | - Catherine Paillard
- Pediatric Oncohematology and Bone Marrow Transplantation Unit, Hôpital de Hautepierre, CHRU, Strasbourg, France
| | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital Grenoble, Grenoble, France
| | | | - Fanny Gonzales
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer Heterogeneity Plasticity and Resistance to Therapies, 59000, Lille, France
| | | | - Lucie Planche
- Clinical Research Unit, CHD Vendée, La Roche sur Yon, France
| | - André Baruchel
- Robert Debré University Hospital (APHP), Université de Paris, Paris, France
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10
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Xhaard A, Xhaard C, Rubio MT, Berceanu A, Botella-Garcia C, Coman T, Tavernier E, Labussière-Wallet H, Chevallier P, Legrand F, Thiebaut A, Menard AL, Paillard C, Chantepie S, Robin M, Nguyen S. A 16-month-long experience of COVID-19 in allogeneic haematopoietic stem cell transplantation recipients: An SFGM-TC multicentre cohort study. Br J Haematol 2023. [PMID: 36921963 DOI: 10.1111/bjh.18754] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/24/2023] [Revised: 02/24/2023] [Accepted: 03/02/2023] [Indexed: 03/17/2023]
Abstract
This 16-month-long multicentre retrospective study of 225 allogeneic haematopoietic stem cell transplantation (alloHSCT) recipients with COVID-19 examines risk factors for severity and mortality, describing the successive waves of infections (from March to June 2020 and from August 2020 to June 2021). We confirm the negative role of low respiratory tract disease and immunosuppressive treatment. We highlight significantly lower percentages of severe forms and COVID-19-related mortality during the second wave. Monthly comparative evolution of cases in alloHSCT recipients and in the French population shows a higher number of cases in alloHSCT recipients during the first wave and a decrease from February 2021.
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Affiliation(s)
- Aliénor Xhaard
- Service d'hématologie-Greffe, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Constance Xhaard
- INSERM, Centre d'Investigations Cliniques Plurithématique 1433, INSERM 1116, CHRU de Nancy, FCRIN INI-CRCT, Université de Lorraine, Nancy, France
| | - Marie-Therese Rubio
- Service d'hématologie, Hôpital Brabois, CHRU Nancy et CNRS UMR 7563, Biopôle de l'Université de Lorraine, Vandoeuvre les Nancy, France
| | - Ana Berceanu
- Service d'hématologie, CHU Jean Minjoz, Besançon, France
| | | | - Tereza Coman
- Service d'hématologie, Institut Gustave Roussy, Villejuif, France
| | - Emmanuelle Tavernier
- Département d'hématologie Clinique et de Thérapie Cellulaire, CHU Saint-Etienne, Saint-Etienne, France
| | | | | | - Faezeh Legrand
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Anne Thiebaut
- Service d'hématologie, CHU Grenoble, Grenoble, France
| | | | | | | | - Marie Robin
- Service d'hématologie-Greffe, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Stephanie Nguyen
- Service d'hématologie Sorbonne Université, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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11
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Swoboda R, Labopin M, Giebel S, Schroeder T, Kröger N, Arat M, Savani B, Spyridonidis A, Hamladji RM, Potter V, Berceanu A, Yakoub-Agha I, Rambaldi A, Ozdogu H, Sanz J, Nagler A, Mohty M. Total body irradiation plus fludarabine versus busulfan plus fludarabine as a myeloablative conditioning for adults with acute myeloid leukemia treated with allogeneic hematopoietic cell transplantation. A study on behalf of the Acute Leukemia Working Party of the EBMT. Bone Marrow Transplant 2023; 58:282-287. [PMID: 36460819 DOI: 10.1038/s41409-022-01882-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 12/03/2022]
Abstract
Cyclophosphamide is frequently substituted with fludarabine (Flu) in conditioning regimens before allogeneic hematopoietic cell transplantation (allo-HCT). We aimed to compare retrospectively, total body irradiation (12 Gy) plus Flu (FluTBI12) versus busulfan (Bu) plus Flu (FB4) as a myeloablative conditioning before allo-HCT in patients with acute myeloid leukemia (AML). Out of 3203 patients who met the inclusion criteria, 109 patients treated with FluTBI12 and 213 treated with FB4 were included in a final matched-pair analysis. In both groups, median patient age was 41 years, first or second complete remission (CR1/CR2) proportion was 78%/22%, allo-HCT from an unrelated donor was performed in 78% of patients. The probabilities of leukemia-free survival and overall survival at 2 years in FluTBI12 and FB4 groups were 65% vs. 60% (p = 0.64) and 70% vs. 72% (p = 0.87), respectively. The cumulative incidence of relapse was 19% vs. 29% (p = 0.11), while non-relapse mortality was 16% vs. 11%, respectively (p = 0.13). There were no statistical differences in both acute and chronic graft-versus-host disease (GVHD) incidence. The probability of GVHD-free, relapse-free survival (GRFS) was 49% for both groups. FluTBI12 and FB4 are comparable myeloablative regimens before allo-HCT in AML patients transplanted in CR1 and CR2.
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Affiliation(s)
- Ryszard Swoboda
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
| | - Myriam Labopin
- Sorbonne Université, INSERM UMR-S 938, CRSA, Service d'Hématologie et Thérapie Cellulaire, AP-HP, Hôpital Saint-Antoine, 75 012, Paris, France
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Thomas Schroeder
- Deptartment of Hematology and Stem Cell Transplantation, University Hospital, Essen, Germany
| | - Nicolaus Kröger
- University Hospital Eppendorf, Bone Marrow Transplantation Centre, Hamburg, Germany
| | - Mutlu Arat
- Istanbul Florence Nightingale Hospital, Hematopoietic SCT Unit, Istanbul, Turkey
| | - Bipin Savani
- Division of Hematology and Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Rose-Marie Hamladji
- Centre Pierre et Marie Curie, Service Hématologie Greffe de Moëlle, Alger, Algeria
| | - Victoria Potter
- Department of Haematological Medicine, Kings College Hospital, King's Denmark Hill Campus, London, UK
| | - Ana Berceanu
- Hopital Jean Minjoz Service d'Hématologie, Besancon, France
| | | | - Alessandro Rambaldi
- Department of Oncology and Hematology, University of Milan and ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Hakan Ozdogu
- Haematology Division, BMT Unit, Haematology Research Laboratory, Training & Medical, Baskent University Hospital, Adana, Turkey
| | - Jaime Sanz
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Department of Hematology, Hospital Saint Antoine, Paris, France
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12
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Caillet A, Bellanger AP, Navellou JC, Daguindau E, Rocchi S, Scherer E, Berceanu A, Millon L. Refractory invasive pulmonary aspergillosis due to Aspergillus flavus detected with the combination of two in-house Aspergillus qPCR. J Mycol Med 2023; 33:101350. [PMID: 36375310 DOI: 10.1016/j.mycmed.2022.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/09/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
Abstract
We present a case of probable invasive pulmonary aspergillosis due to Aspergillus flavus, in a female patient treated for an acute myeloid leukemia. Two weeks after an allogenic stem cell transplantation a probable invasive pulmonary aspergillosis was diagnosed based on thoracic imaging combined with positive galactomannan antigen and positive in-house mitochondrial Aspergillus qPCR in serum. Although an antifungal treatment was initiated, Aspergillus qPCR and galactomannan antigen remained positive in serum and worsening of the thoracic lesions was observed. The discordance between the negativity of the in-house ribosomal Aspergillus qPCR (specific to A. fumigatus) and the positivity of the in-house mitochondrial Aspergillus qPCR (targeting A. fumigatus and some other Aspergillus) allowed the suspicion of a thermophilic Aspergillus species that was not A. fumigatus. No strain was obtained in culture but the involvement of A. flavus was confirmed using a specific A. flavus qPCR. This case illustrated the usefulness of our original strategy combining two different in-house Aspergillus qPCRs, in addition to galactomannan assay, to diagnose invasive aspergillosis in hematology patients.
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Affiliation(s)
- Adrien Caillet
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Anne-Pauline Bellanger
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France.
| | | | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Steffi Rocchi
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
| | - Emeline Scherer
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon 25000, France
| | - Laurence Millon
- Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon 25000, France; Parasitology-Mycology Department, Besançon University Hospital, Besançon 25000, France
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13
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Kaphan E, Bettega F, Forcade E, Labussière-Wallet H, Fegueux N, Robin M, De Latour RP, Huynh A, Lapierre L, Berceanu A, Marcais A, Debureaux PE, Vanlangendonck N, Bulabois CE, Magro L, Daniel A, Galtier J, Lioure B, Chevallier P, Antier C, Loschi M, Guillerm G, Mear JB, Chantepie S, Cornillon J, Rey G, Poire X, Bazarbachi A, Rubio MT, Contentin N, Orvain C, Dulery R, Bay JO, Croizier C, Beguin Y, Charbonnier A, Skrzypczak C, Desmier D, Villate A, Carré M, Thiebaut-Bertrand A. Late relapse after hematopoietic stem cell transplantation for acute leukemia: a retrospective study by SFGM-TC. Transplant Cell Ther 2023:S2666-6367(23)01129-6. [PMID: 36849078 DOI: 10.1016/j.jtct.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/14/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
Late relapse (LR) after allogeneic hematopoietic stem cell transplantation (AHSCT) for acute leukemia is a rare event (nearly 4.5%) and raises the questions of prognosis and outcome after salvage therapy. We performed a retrospective multicentric study between January 1, 2010, and December 31, 2016, using data from the French national retrospective register ProMISe provided by the SFGM-TC (French Society for Bone Marrow Transplantation and Cellular Therapy). We included patients presenting with LR, defined as a relapse occurring at least 2 years after AHSCT. We used the Cox model to identify prognosis factors associated with LR. During the study period, a total of 7582 AHSCTs were performed in 29 centers, and 33.8% of patients relapsed. Among them, 319 (12.4%) were considered to have LR, representing an incidence of 4.2% for the entire cohort. The full dataset was available for 290 patients, including 250 (86.2%) with acute myeloid leukemia and 40 (13.8%) with acute lymphoid leukemia. The median interval from AHSCT to LR was 38.2 months (interquartile range [IQR], 29.2 to 49.7 months), and 27.2% of the patients had extramedullary involvement at LR (17.2% exclusively and 10% associated with medullary involvement). One-third of the patients had persistent full donor chimerism at LR. Median overall survival (OS) after LR was 19.9 months (IQR, 5.6 to 46.4 months). The most common salvage therapy was induction regimen (55.5%), with complete remission (CR) obtained in 50.7% of cases. Ninety-four patients (38.5%) underwent a second AHSCT, with a median OS of 20.4 months (IQR, 7.1 to 49.1 months). Nonrelapse mortality after second AHSCT was 18.2%. The Cox model identified the following factors as associated with delay of LR: disease status not in first CR at first HSCT (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.04 to 1.64; P = .02) and the use of post-transplantation cyclophosphamide (OR, 2.23; 95% CI, 1.21 to 4.14; P = .01). Chronic GVHD appeared to be a protective factor (OR, .64; 95% CI, .42 to .96; P = .04). The prognosis of LR is better than in early relapse, with a median OS after LR of 19.9 months. Salvage therapy associated with a second AHSCT improves outcome and is feasible, without creating excess toxicity.
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Affiliation(s)
- E Kaphan
- Department of Hematology-Transplantation, CHU Grenoble, Grenoble, France.
| | - F Bettega
- University Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble, France
| | - E Forcade
- Department of Hematology-Transplantation, Hôpital de Bordeaux, Bordeaux, France
| | - H Labussière-Wallet
- Department of Hematology-Transplantation, CHU Lyon Sud, Pierre-Bénite, France
| | - N Fegueux
- Department of Hematology, CHU Montpellier, Montpellier, France
| | - M Robin
- Department of Hematology-Transplantation, Hôpital Saint-Louis, APHP, Université de Paris, Paris, France
| | - R Peffault De Latour
- Department of Hematology-Transplantation, Hôpital Saint-Louis, APHP, Université de Paris, Paris, France
| | - A Huynh
- Department of Hematology, Transplantation, and Cellular Therapy, IUCT Oncopole, Toulouse, France
| | - L Lapierre
- Department of Hematology, Transplantation, and Cellular Therapy, IUCT Oncopole, Toulouse, France
| | - A Berceanu
- Department of Intensive Care and Transplantation, CHU Jean Minjoz, Besançon, France
| | - A Marcais
- Department of Hematology, Hôpital Necker, Paris, France
| | - P E Debureaux
- Department of Hematology-Transplantation, Hôpital Saint-Louis, APHP, Université de Paris, Paris, France
| | - N Vanlangendonck
- Department of Hematology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - C-E Bulabois
- Department of Hematology-Transplantation, CHU Grenoble, Grenoble, France
| | - L Magro
- Department of Hematology-Transplantation, CHRU Lille, Lille, France
| | - A Daniel
- Department of Hematology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - J Galtier
- Department of Hematology-Transplantation, Hôpital de Bordeaux, Bordeaux, France
| | - B Lioure
- Department of Hematology, CHRU Strasbourg, Strasbourg, France
| | - P Chevallier
- Department of Hematology, CHU Nantes, Nantes, France
| | - C Antier
- Department of Hematology, CHU Nantes, Nantes, France
| | - M Loschi
- Department of Hematology-Transplantation, CHU Nice, Nice, France
| | - G Guillerm
- Department of Hematology, CHRU Brest, Brest, France
| | - J B Mear
- Department of Hematology-Transplantation, Hôpital de Rennes, Rennes, France
| | - S Chantepie
- Basse-Normandie Hematology Institute, CHU Caen, Caen, France
| | - J Cornillon
- Department of Clincial Hematology and Cellular Therapy, CHU Saint-Étienne, Saint-Priest-en-Jarez, France
| | - G Rey
- Department of Clincial Hematology and Cellular Therapy, CHU Saint-Étienne, Saint-Priest-en-Jarez, France
| | - X Poire
- Department of Hematology, CHU Saint-Luc, Brussels, Belgium
| | - A Bazarbachi
- Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - M T Rubio
- Department of Hematology, CHU Nancy, Nancy, France
| | - N Contentin
- Department of Hematology, Centre Henri Becquerel, Rouen, France
| | - C Orvain
- Department of Hematology-Transplantation, CHU Angers, Angers, France
| | - R Dulery
- Department of Clinical Hematology, CHU St Antoine, APHP, Paris, France
| | - J O Bay
- Department of Clinical Hematology and Cellular Therapy, CHU Estaing, Clermont-Ferrand, France
| | - C Croizier
- Department of Clinical Hematology and Cellular Therapy, CHU Estaing, Clermont-Ferrand, France
| | - Y Beguin
- CU of Liège and University of Liège, Liège, Belgium
| | - A Charbonnier
- Department of Hematology-Transplantation, CHU Amiens, Amiens, France
| | - C Skrzypczak
- Department of Hematology-Transplantation, CHU Amiens, Amiens, France
| | - D Desmier
- Department of Hematology, CHU Poitiers, Poitiers, France
| | - A Villate
- Department of Hematology, CHRU Tours, Tours, France
| | - M Carré
- Department of Hematology-Transplantation, CHU Grenoble, Grenoble, France
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14
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Michel C, Robin M, Morisset S, Blaise D, Maertens J, Chevalier P, Castilla-Llorente C, Forcade E, Ceballos P, Yakoug-Agha I, Poire X, Carre M, Bay JO, Beguin Y, Loschi M, Huynh A, Guillerm G, François S, Mear JB, Duléry R, Suarez F, Bilger K, Cornillon J, Chalandon Y, Maillard N, Labussière-Wallet H, Charbonnier A, Turlure P, Berceanu A, Chantepie S, Maury S, Bazarbachi A, Menard AL, Nguyen-Quoc S, Rubio MT, D'Aveni M. Outcome after allogeneic stem cell transplantation with haploidentical versus HLA-matched donors in patients with higher-risk MDS. Bone Marrow Transplant 2023; 58:534-543. [PMID: 36774430 PMCID: PMC10162937 DOI: 10.1038/s41409-023-01931-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/21/2023] [Accepted: 01/30/2023] [Indexed: 02/13/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation remains the best curative option for higher-risk myelodysplastic syndrome. The presence of monosomal karyotype and/or complex karyotype abnormalities predicts inferior survival after allo-SCT in MDS patients. Haploidentical allo-SCT has been increasingly used in acute leukemia (AL) and has similar results as using HLA-matched donors, but data on higher-risk MDS is sparse. We compared outcomes in 266 patients with higher-risk MDS after HLA-matched sibling donor (MSD, n = 79), HLA-matched unrelated donor (MUD, n = 139) and HLA haploidentical donor (HID, n = 48) from 2010 to 2019. Median donor age differed between the three groups (p < 0.001). The overall survival was significantly different between the three groups with a better OS observed in the MUD group (p = 0.014). This observation could be explained by a higher progression-free survival with MUD (p = 0.014). The cumulative incidence of grade 2-4 acute GvHD was significantly higher in the HID group (p = 0.051). However, in multivariable analysis, patients transplanted using an HID had comparable mortality to patients transplanted using a MUD (subdistribution hazard ratio [sHR]: 0.58 [0.32-1.07]; p = 0.080) and a MSD ([sHR]: 0.56 [0.28-1.11]; p = 0.094). MUD do not remain a significant positive predictor of survival, suggesting that beyond the donor-recipient HLA matching, the donor age might impact recipient outcome.
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Affiliation(s)
- Claire Michel
- Hematology department, University hospital of Nancy, Nancy, France
| | - Marie Robin
- Hematology department, Hôpital Saint-Louis, Paris, France
| | | | - Didier Blaise
- Hematology department, Institut Paoli Calmette, Marseille, France
| | - Johan Maertens
- Hematology department, Hôpital UZ Leuven, Louvain, Belgium
| | - Patrice Chevalier
- Hematology department, University hospital of Nantes, Nantes, France
| | | | - Edouard Forcade
- Hematology department, Hôpital Haut-Levêque, Bordeaux, France
| | | | - Ibrahim Yakoug-Agha
- Hematology department, CHU de Lille, Univ Lille, INSERM U1286, Infinite, Lille, France
| | - Xavier Poire
- Section of Hematology, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Martin Carre
- Hematology department, Hôpital Michallon, Grenoble, France
| | - Jacques-Olivier Bay
- Service de Thérapie Cellulaire et d'Hématologie Clinique Adulte, CHU Clermont-Ferrand Hôpital Estaing, Estaing, France
| | - Yves Beguin
- Hematology department, University hospital of Liège, Liège, Belgium
| | | | - Anne Huynh
- Hematology department, University hospital of Toulouse, Toulouse, France
| | - Gaëlle Guillerm
- Hematology department, University hospital of Brest, Brest, France
| | - Sylvie François
- Hematology department, University hospital of Angers, Angers, France
| | | | - Rémy Duléry
- Hematology department, Hôpital Saint-Antoine, Paris, France
| | - Felipe Suarez
- Hematology department, Hôpital Necker, Paris, France
| | - Karin Bilger
- Hematology department University hospital of Strasbourg, Strasbourg, France
| | - Jérôme Cornillon
- Hematology department University hospital of Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Yves Chalandon
- Hematology division, University hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Natacha Maillard
- Hematology department University hospital of Poitiers, Poitiers, France
| | | | | | - Pascal Turlure
- Hematology department, Hôpital Dupuytren, Limoges, France
| | - Ana Berceanu
- Hematology department, University hospital of Besançon, Besançon, France
| | | | - Sébastien Maury
- Hematology department, Hôpital Henri Mondor, Créteil, France
| | - Ali Bazarbachi
- Hematology department, American university of Beyrouth, Beyrouth, Lebanon
| | | | | | | | - Maud D'Aveni
- Hematology department, University hospital of Nancy, Nancy, France.
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15
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Puget L, Berceanu A, Node J, Coaquette A, Overs A, Herbein G, Prétet JL, Daguindau E, Lepiller Q. Human cytomegalovirus-viruria in hematopoietic stem cell transplant recipients: Context and impact. Infect Dis Now 2023; 53:104651. [PMID: 36702306 DOI: 10.1016/j.idnow.2023.104651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/16/2022] [Revised: 01/05/2023] [Accepted: 01/15/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND Episodes of CMV-viruria have been reported in hematopoietic stem cell transplant (HSCT) recipients, but their context of occurrence, pathophysiology, and clinical significance remain misunderstood. METHODS Uurine samples from 517 recipients were collected. Clinical features of recipients with or without episodes of CMV-viruria were retrospectively compared. RESULTS CMV-viruria was detected in 15.5 % of cases. Age, sex, type of transplantation, HLA-matching, conditioning regimen, and immunosuppressive therapies did not differ between patients with and without CMV-viruria. CMV-seropositive status (R + ) was more frequent among CMV-viruric recipients. Cumulated mortality did not differ between the two groups but graft-versus-host diseases occurred more frequently among CMV-viruric patients (p = 0.04). No reduction of the estimated glomerular filtration rates was observed in CMV-viruric recipients. CONCLUSIONS CMV-viruria primarily occurs in CMV-seropositive recipients and is not related to the degree of immunosuppression. We suggest that CMV-viruria is primarily related to the inability of the graft immune system to contain CMV-replication in R + patients. CMV-viruria is not associated with increased mortality or renal dysfunction.
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Affiliation(s)
- L Puget
- Laboratoire de Virologie, CHU Besançon, France
| | - A Berceanu
- Service d'Hématologie, CHU Besançon, France
| | - J Node
- Laboratoire de Virologie, CHU Besançon, France
| | - A Coaquette
- Laboratoire de Virologie, CHU Besançon, France
| | - A Overs
- Laboratoire de Virologie, CHU Besançon, France
| | - G Herbein
- Laboratoire de Virologie, CHU Besançon, France; EA4266, Université Bourgogne Franche-Comté, France
| | - J-L Prétet
- Laboratoire de Biologie Cellulaire et Moléculaire, CHU Besançon, France; EA3181, Université Bourgogne Franche-Comté, France
| | - E Daguindau
- Service d'Hématologie, CHU Besançon, France; Université Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Q Lepiller
- Laboratoire de Virologie, CHU Besançon, France; EA3181, Université Bourgogne Franche-Comté, France.
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16
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Jondreville L, D’Aveni M, Labussière-Wallet H, Le Bourgeois A, Villate A, Berceanu A, Bezsera SM, Thiebaut A, Boissard-Simonet M, Legrand M, Cornillon J, Rubio MT, Chevallier P, Nguyen S. Pre-exposure prophylaxis with tixagevimab/cilgavimab (AZD7442) prevents severe SARS-CoV-2 infection in recipients of allogeneic hematopoietic stem cell transplantation during the Omicron wave: a multicentric retrospective study of SFGM-TC. J Hematol Oncol 2022; 15:169. [PMID: 36443846 PMCID: PMC9702670 DOI: 10.1186/s13045-022-01387-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022] Open
Abstract
Since the emergence of the Omicron variant of SARS-CoV-2, though considered less virulent, hospitalization and death rates among immunocompromised patients remain high, especially for poor responders to vaccination. We conducted a retrospective multicentric study to evaluate pre-exposure prophylaxis with AZD7442 (tixagevimab/cilgavimab) for preventing COVID-19 in adult allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. Among the 161 patients of our cohort, 22 (14%) contracted COVID-19 after a median follow-up of 105 days, but no severe form was observed. Only one major adverse event was reported: an acute coronary syndrome, resolved without sequelae. Pending randomized controlled trial results, our data support the use of AZD7442 as pre-exposure prophylaxis for COVID-19 during Omicron wave in allo-HSCT patients who failed to develop humoral immunity to vaccination, to prevent severe and potentially lethal forms of SARS-CoV-2 infection.
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Affiliation(s)
- Ludovic Jondreville
- grid.50550.350000 0001 2175 4109Department of Clinical Hematology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP Sorbonne Université, 47-83 Boulevard de L’Hôpital, 75013 Paris, France
| | - Maud D’Aveni
- grid.410527.50000 0004 1765 1301Department of Clinical Hematology, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Hélène Labussière-Wallet
- grid.413852.90000 0001 2163 3825Department of Clinical Hematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Amandine Le Bourgeois
- grid.277151.70000 0004 0472 0371Department of Clinical Hematology, Nantes University Hospital, Nantes, France
| | - Alban Villate
- grid.411167.40000 0004 1765 1600Department of Clinical Hematology, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Ana Berceanu
- grid.411158.80000 0004 0638 9213Department of Clinical Hematology, Besançon University Hospital, Besançon, France
| | - Silvia-Maria Bezsera
- grid.488279.80000 0004 1798 7163Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Anne Thiebaut
- grid.410529.b0000 0001 0792 4829Department of Clinical Hematology, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Marion Boissard-Simonet
- grid.411158.80000 0004 0638 9213Department of Clinical Hematology, Besançon University Hospital, Besançon, France
| | - Marlène Legrand
- grid.413852.90000 0001 2163 3825Department of Clinical Hematology, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Jérôme Cornillon
- grid.488279.80000 0004 1798 7163Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Marie-Thérèse Rubio
- grid.410527.50000 0004 1765 1301Department of Clinical Hematology, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
| | - Patrice Chevallier
- grid.277151.70000 0004 0472 0371Department of Clinical Hematology, Nantes University Hospital, Nantes, France
| | - Stéphanie Nguyen
- grid.50550.350000 0001 2175 4109Department of Clinical Hematology, Groupe Hospitalier Pitié-Salpêtrière, AP-HP Sorbonne Université, 47-83 Boulevard de L’Hôpital, 75013 Paris, France
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17
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Cavalieri D, Rubio MT, Corriger A, Pereira B, Cabrespine A, Robin M, Labussière-Wallet H, Calleja A, Forcade E, Chevallier P, Guillerm G, Berceanu A, Bulabois CE, Maillard N, Nguyen S, Raus N, Schoemans H, Bay JO, Ravinet A. Salvage haploidentical or cord-blood allogeneic stem cell transplantation after a prior alternative allograft in hematologic malignancies: a retrospective study from the SFGM-TC. Eur J Haematol 2022; 110:40-49. [PMID: 36151965 DOI: 10.1111/ejh.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/13/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Haploidentical (haplo-) donors and cord-blood (CB) stem cells provide alternative transplant options in patients lacking an HLA-matched donor. In case of relapse or graft failure after a first alternative allogeneic hematopoietic stem cell transplant (HSCT), a second alternative HSCT (HSCT2) is rarely considered due to a high risk of toxicity. METHODS A retrospective French multicenter study was performed, including patients with hematologic malignancies who underwent two consecutive HSCT from alternative donors. All data were exported from the national ProMISE database between 2000 and 2016. RESULTS Forty-three patients (61.4%) received a CB-HSCT2 and 27 (38.6%) a haplo-HSCT2. Indications for HSCT were graft failure (51.4%) or disease progression (48.6%). Two-years probabilities of overall survival, progression-free survival and toxicity-related mortality were 18.5%, 17.8% and 55.8%, respectively. In multivariate analysis, complete remission status at HSCT2 and year of HSCT2 ≥2012 were significantly associated with a better outcome (with respectively hazard ratio (HR)=0.42, p=0.002 and HR=0.5, p=0.051). CONCLUSIONS Neither the indication of HSCT2 nor the source of stem cell was more advantageous towards overall patient survival. A salvage haploidentical or cord-blood stem cell transplantation is a high-risk procedure, that may be considered for patients achieving a complete remission before receiving the second HSCT.
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Affiliation(s)
- Doriane Cavalieri
- Université Clermont Auvergne, CHU Clermont-Ferrand, EA7283, INSERM CIC501, BP 10448, Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
| | - Marie-Thérèse Rubio
- Service d'hématologie, Centre Hospitalier Régional et Universitaire de Nancy / CNRS UMR 7563, Biopole de l'Université de Lorraine, Vandoeuvre-les Nancy, France
| | - Alexandrine Corriger
- Université Clermont Auvergne, CHU Clermont-Ferrand, EA7283, INSERM CIC501, BP 10448, Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Direction de la Recherche Clinique et de l'Innovation, Secteur Biométrie et Médico-économie, Clermont-Ferrand, France
| | - Aurélie Cabrespine
- CHU Clermont-Ferrand, Direction de la Recherche Clinique et de l'Innovation, Secteur Biométrie et Médico-économie, Clermont-Ferrand, France
| | - Marie Robin
- Service d'hématologie-allogreffe, Hôpital Saint-Louis - Assistance Publique-Hôpitaux de Paris (AP-HP) / Université Paris 7, Paris, France
| | - Hélène Labussière-Wallet
- Service d'hématologie clinique, Centre Hospitalier Lyon Sud - Hospices Civils de Lyon, Pierre Bénite, France
| | - Anne Calleja
- Service d'hématologie clinique, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Edouard Forcade
- Service d'hématologie clinique, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Patrice Chevallier
- Service d'hématologie clinique adulte, Centre Hospitalier Universitaire de Nantes - Hôtel-Dieu, Nantes, France
| | - Gaelle Guillerm
- Service d'hématologie clinique, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | - Ana Berceanu
- Service d'hématologie, Centre Hospitalier Régional et Universitaire de Besançon, Besançon
| | - Claude-Eric Bulabois
- Service d'hématologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Natacha Maillard
- Service d'oncologie hématologique et de thérapie cellulaire, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Stéphanie Nguyen
- Service d'hématologie clinique, Hôpital de la Pitié-Salpêtrière - Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Nicole Raus
- Service d'hématologie clinique, Centre Hospitalier Lyon Sud - Hospices Civils de Lyon, Lyon, France
| | - Hélène Schoemans
- Department of Hematology, University Hospitals Leuven and KU, Leuven, Belgium
| | - Jacques-Olivier Bay
- Université Clermont Auvergne, CHU Clermont-Ferrand, EA7283, INSERM CIC501, BP 10448, Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
| | - Aurélie Ravinet
- Université Clermont Auvergne, CHU Clermont-Ferrand, EA7283, INSERM CIC501, BP 10448, Service de Thérapie Cellulaire et Hématologie Clinique Adulte, Clermont-Ferrand, France
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18
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Gavriilaki E, Labopin M, Sakellari I, Salmenniemi U, Yakoub-Agha I, Potter V, Berceanu A, Rambaldi A, Hilgendorf I, Kröger N, Mielke S, Zuckerman T, Sanz J, Busca A, Ozdogu H, Anagnostopoulos A, Savani B, Giebel S, Bazarbachi A, Spyridonidis A, Nagler A, Mohty M. Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: An analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant 2022; 57:1803-1809. [PMID: 36138068 DOI: 10.1038/s41409-022-01830-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022]
Abstract
Different doses of treosulfan plus fludarabine have shown advantage over reduced intensity regimens. However, data comparing higher doses of treosulfan to myeloablative busulfan are limited. Thus, we compared outcomes between FT14 (fludarabine 150/160 mg/m2 and treosulfan 42 g/m2, or FT14) over FB4 (fludarabine 150/160 mg/m2 and busulfan 12.8 mg/kg). We retrospectively studied patients from European Society for Blood and Marrow Transplantation registry: a) adults diagnosed with acute myeloid leukemia (AML), b) recipients of first allogeneic hematopoietic stem cell transplantation (HSCT) from unrelated or sibling donor (2010-2020), c) HSCT at first or second complete remission, d) conditioning with FT14 or FB4. FT14 recipients (n = 678) were older, with higher rates of secondary AML, unrelated donors, peripheral blood grafts, and adverse cytogenetics, but lower percentage of female donor to male recipient compared to FB4 (n = 2025). Analysis was stratified on age. In patients aged < 55 years, FT14 was associated with higher relapse incidence (RI) and lower Leukemia-Free Survival (LFS). In patients aged≥55 years, acute GVHD CI was higher in FB4, without significant differences in other outcomes. Although FT14 has been used for higher-risk HSCT patients, our large real-world multicenter study suggests that FB4 is associated with better outcomes compared to FT14 in younger patients.
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Affiliation(s)
- Eleni Gavriilaki
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece.
| | - Myriam Labopin
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Ioanna Sakellari
- Hematology Department-BMT Unit, G Papanikolaou Hospital, Thessaloniki, Greece
| | - Urpu Salmenniemi
- HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit - Helsinki, Helsinki, Finland
| | | | - Victoria Potter
- Kings College Hospital, Dept. of Haematological Medicine, King's Denmark Hill Campus - London, London, UK
| | - Ana Berceanu
- Hopital Jean Minjoz, Service d'Hématologie - Besançon, Besançon, France
| | - Alessandro Rambaldi
- Department of Oncology and Hematology, University of Milan and Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Inken Hilgendorf
- Universitaetsklinikum Jena, Klinik für Innere Medizin II - Jena, Jena, Germany
| | - Nicolaus Kröger
- University Hospital Eppendorf, Bone Marrow Transplantation Centre - Hamburg, Hamburg, Germany
| | - Stephan Mielke
- Karolinska University Hospital, Dept. of Hematology - Stockholm, Stockholm, Sweden
| | - Tsila Zuckerman
- Rambam Medical Center, Dept. of Hematology & BMT - Haifa, Haifa, Israel
| | - Jaime Sanz
- University Hospital La Fe, Hematology Department - Valencia, Valencia, Spain
| | - Alessandro Busca
- S.S.C.V.D Trapianto di Cellule Staminali, A.O.U Citta della Salute e della Scienza di Torino, Torino, Italy
| | - Hakan Ozdogu
- Baskent University Hospital, Haematology Division, BMT Unit, Haematology Reserach Laboratory, Training & Medical - Adana, Adana, Turkey
| | | | - Bipin Savani
- Vanderbilt University Medical Center, Division of Hematology/ Oncology, Nashville, TN, USA
| | - Sebastian Giebel
- Maria Sklodowska-Curie Institute, Department of Bone Marrow Transplantation and Oncohematology, Oncology Center - Gliwice, Gliwice, Poland
| | - Ali Bazarbachi
- American University of Beirut, Medical Center, Department of Internal Medicine - Beirut, Beirut, Lebanon
| | - Alexandros Spyridonidis
- Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece
| | - Arnon Nagler
- Chaim Sheba Medical Center, Dept. of Bone Marrow Transplantation - Tel-Hashomer, Tel-Hashomer, Israel
| | - Mohamad Mohty
- Service d' Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
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19
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Trad R, Warda W, Alcazer V, Neto da Rocha M, Berceanu A, Nicod C, Haderbache R, Roussel X, Desbrosses Y, Daguindau E, Renosi F, Roumier C, Bouquet L, Biichle S, Guiot M, Seffar E, Caillot D, Depil S, Robinet E, Salma Y, Deconinck E, Deschamps M, Ferrand C. Chimeric antigen receptor T-cells targeting IL-1RAP: a promising new cellular immunotherapy to treat acute myeloid leukemia. J Immunother Cancer 2022; 10:jitc-2021-004222. [PMID: 35803613 PMCID: PMC9272123 DOI: 10.1136/jitc-2021-004222] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
Background Acute myeloid leukemia (AML) remains a very difficult disease to cure due to the persistence of leukemic stem cells (LSCs), which are resistant to different lines of chemotherapy and are the basis of refractory/relapsed (R/R) disease in 80% of patients with AML not receiving allogeneic transplantation. Methods In this study, we showed that the interleukin-1 receptor accessory protein (IL-1RAP) protein is overexpressed on the cell surface of LSCs in all subtypes of AML and confirmed it as an interesting and promising target in AML compared with the most common potential AML targets, since it is not expressed by the normal hematopoietic stem cell. After establishing the proof of concept for the efficacy of chimeric antigen receptor (CAR) T-cells targeting IL-1RAP in chronic myeloid leukemia, we hypothesized that third-generation IL-1RAP CAR T-cells could eliminate AML LSCs, where the medical need is not covered. Results We first demonstrated that IL-1RAP CAR T-cells can be produced from AML T-cells at the time of diagnosis and at relapse. In vitro and in vivo, we showed the effectiveness of IL-1RAP CAR T-cells against AML cell lines expressing different levels of IL-1RAP and the cytotoxicity of autologous IL-1RAP CAR T-cells against primary cells from patients with AML at diagnosis or at relapse. In patient-derived relapsed AML xenograft models, we confirmed that IL-1RAP CAR T-cells are able to circulate in peripheral blood and to migrate in the bone marrow and spleen, are cytotoxic against primary AML cells and increased overall survival. Conclusion In conclusion, our preclinical results suggest that IL-1RAP CAR T-based adoptive therapy could be a promising strategy in AML treatment and it warrants the clinical investigation of this CAR T-cell therapy.
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Affiliation(s)
- Rim Trad
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Walid Warda
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | | | - Mathieu Neto da Rocha
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | - Ana Berceanu
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | | | | | - Xavier Roussel
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | | | | | - Florain Renosi
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | | | - Lucie Bouquet
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Sabeha Biichle
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Melanie Guiot
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Evan Seffar
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France
| | - Denis Caillot
- Clinical Hematology, CHU François Mitterrand, Dijon, France
| | | | | | - Yahya Salma
- Laboratory of Applied Biotechnology (LBA3B), Lebanese University, Tripoli, Lebanon
| | - Eric Deconinck
- Clinical Hematology, C.H. Univ Jean Minjoz, Besancon, France
| | - Marina Deschamps
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France.,CanCell Therapeutics, Besancon, France
| | - Christophe Ferrand
- TIMC, EFSBFC, INSERM UMR1098 RIGHT,UFC, Besancon, France .,CanCell Therapeutics, Besancon, France
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20
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Millon L, Caillot D, Berceanu A, Bretagne S, Lanternier F, Morio F, Letscher-Bru V, Dalle F, Denis B, Alanio A, Boutoille D, Bougnoux ME, Botterel F, Chouaki T, Charbonnier A, Ader F, Dupont D, Bellanger AP, Rocchi S, Scherer E, Gbaguidi-Haore H, Herbrecht R. Evaluation of serum Mucorales PCR for the diagnosis of Mucormycoses: The MODIMUCOR prospective trial. Clin Infect Dis 2022; 75:777-785. [PMID: 34986227 DOI: 10.1093/cid/ciab1066] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [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: 08/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early diagnosis and prompt initiation of specific antifungal treatment is essential for improving the prognosis of mucormycosis. We aimed to assess the performance of serum Mucorales quantitative PCR (qPCR) for the early diagnosis and follow-up of mucormycosis. METHODS We prospectively enrolled 232 patients with suspicion of invasive mold disease, evaluated using standard imaging and mycological procedures. Thirteen additional patients with proven or probable mucormycosis were included to analyze DNA load kinetics. Serum samples were collected twice-a-week for Mucorales qPCR tests targeting the Mucorales species Lichtheimia, Rhizomucor and Mucor/Rhizopus. RESULTS The sensitivity was 85·2%, specificity 89·8%, and positive and negative likelihood ratios 8·3 and 0·17, respectively in this prospective study. The first Mucorales qPCR-positive serum was observed a median of four days (IQR, 0-9) before sampling of the first mycological or histological positive specimen and a median of one day (IQR, (-2)-6) before the first imaging was performed. Negativity of Mucorales qPCR within seven days after liposomal-amphotericin B initiation was associated with an 85% lower 30-day mortality rate (adjusted hazard Ratio = 0·15, 95%CI [0·03-0·73], p = 0·02). CONCLUSION Our study argues for the inclusion of qPCR for the detection of circulating Mucorales DNA for mucormycosis diagnosis and follow-up after treatment initiation. Positive results should be added to the criteria for the consensual definitions from the European Organization for the Research and Treatment of Cancer/ Mycoses Study Group Education and Research Consortium (EORTC/MSGERC), as already done for Aspergillus PCR.
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Affiliation(s)
- Laurence Millon
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Denis Caillot
- Department of Clinical Hematology, CHU Dijon, Dijon, France
| | - Ana Berceanu
- Service d'Hematologie, CHU Besançon, Besançon, France
| | - Stéphane Bretagne
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - Fanny Lanternier
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Université de Paris, Paris, France.,Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, IHU Imagine, Paris, France
| | - Florent Morio
- Laboratoire de Parasitologie-Mycologie, CHU Nantes, Nantes, France.,Département de Parasitologie et Mycologie Médicale, EA1155 - IICiMed, Nantes Université, Nantes, France
| | - Valérie Letscher-Bru
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg Strasbourg, France
| | - Frédéric Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon France.,UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - Blandine Denis
- Infectious Diseases Department, APHP, Saint-Louis Hospital, Paris, France
| | - Alexandre Alanio
- Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses & Antifungals, UMR2000, Paris, France.,Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - David Boutoille
- Unité Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France
| | - Marie-Elisabeth Bougnoux
- Parasitology-Mycology Unit, Necker Enfants Malades Hospital, APHP, Paris, France.,Fungal Biology and Pathogenicity Unit - INRA USC 2019. Institut Pasteur, Paris, France
| | - Françoise Botterel
- EA Dynamyc 7380 UPEC, ENVA, Faculté de Médecine, Créteil, France.,Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, DHU VIC, CHU Henri Mondor, Créteil, France
| | - Taieb Chouaki
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens Picardie, Amiens, France.,Equipe AGIR : Agents Infectieux, Résistance et Chimiothérapie UR4294, Université de Picardie Jules Verne, Amiens, France
| | - Amandine Charbonnier
- Department of Clinical Hematology and Cellular Therapy, Amiens University Medical Center, Amiens, France
| | - Florence Ader
- Hospices Civils de Lyon, Département des Maladies Infectieuses et Tropicales, F-69004, Lyon, France
| | - Damien Dupont
- Institut des Agents Infectieux, Parasitologie Mycologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Steffi Rocchi
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Emeline Scherer
- Laboratoire de Parasitologie-Mycologie, CHU Besançon, Besançon, France.,UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France
| | - Houssein Gbaguidi-Haore
- UMR 6249 CNRS Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France.,Infection Control Department, CHU Besançon, Besançon, France
| | - Raoul Herbrecht
- Université de Strasbourg, INSERM, IRFAC UMR-S1113, Strasbourg, France.,Service d'Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
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21
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Sicre De Fontbrune F, Barraco F, Dalle J, Forcade E, Terriou L, Berceanu A, Lebon D, Thépot S, Abraham J, Fahd M, Lioure B, Contejean A, Moluçon Chabrot C, Leblanc T, Leclerc-Teffahi S, Affinito S, Kamar D, Havet A, Bénard S, Regis P. Suivi de l’utilisation de l’Eltrombopag en vie réelle en France à partir des données de l’Observatoire National de l’Insuffisance Médullaire (RIME) : étude REVEPI. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.272] [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: 11/25/2022]
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22
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Pierron A, Bozon F, Berceanu A, Fontan J, Brion A, Deconinck E, Chirouze C, Brunel AS. Vaccination coverage in hematological patients undergoing chemotherapy: Should we move towards personalized vaccination? Vaccine 2021; 39:7036-7043. [PMID: 34740475 DOI: 10.1016/j.vaccine.2021.10.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/01/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Immunocompromised patients are at high-risk for severe influenza and invasive pneumococcal diseases (IPD). Despite the French Public Health Council (FPHC) and the 7th European Conference on Infections in Leukaemia (ECIL7) recommendations, vaccination coverage remains insufficient. This study aimed to estimate the coverage and determinants of influenza, pneumococcal and diphtheria-tetanus-poliomyelitis (dTP) vaccinations in hematological patients underlying chemotherapy. METHODS A survey was distributed to all patients of the hematology day hospital assessing vaccine uptakes and general opinion about vaccination. Vaccine uptakes were collected from medical and vaccination records; knowledge of and attitudes towards vaccinations in immunocompromised patients were evaluated for each general practitioner (GP) by phone call. Adequacy between vaccine uptakes and indication or not to vaccinate according to ECIL7 guidelines was assessed. Factors associated with vaccine uptakes were assessed by multivariate logistic regression. RESULTS Among 145 patients, 66 % were aged 65 years or older, 40 % were followed for lymphoma and 38 % for multiple myeloma, 39 % were treated with anti-CD20 antibodies. Vaccination coverage was suboptimal for influenza (45-56 %), dTP (44 %) and IPD (16-19 %) regardless of the guidelines followed, with a wide variation in rates by information source (19-76 %). Adequacy rate with ECIL7 recommendations were 63 % and 87 % for influenza and IPD respectively. Information of patients on specific vaccinations was positively associated with flu and IPD vaccinations, as well as favorable attitude toward vaccination and age ≥ 65 years for flu vaccination, and recommendation by hematologist for pneumococcal vaccination. CONCLUSION Despite vaccination opportunities, the complexity of these specific recommendations and the lack of communication between the health actors could explain the suboptimal vaccination coverage in this high-risk population. A proactive attitude of all actors in the city and hospital, including better patient information and a personalized and evolving vaccination schedule to help GPs to coordinate vaccination would allow to improve vaccine coverage.
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Affiliation(s)
- Alix Pierron
- Infectious Diseases Unit, Besancon University Hospital, Besancon, France
| | - Fabienne Bozon
- Infectious Diseases Unit, Besancon University Hospital, Besancon, France
| | - Ana Berceanu
- Hematology Unit, Besancon University Hospital, Besancon, France
| | - Jean Fontan
- Hematology Unit, Besancon University Hospital, Besancon, France
| | - Annie Brion
- Hematology Unit, Besancon University Hospital, Besancon, France
| | - Erick Deconinck
- Hematology Unit, Besancon University Hospital, Besancon, France
| | - Catherine Chirouze
- Infectious Diseases Unit, Besancon University Hospital, Besancon, France
| | - Anne-Sophie Brunel
- Infectious Diseases Unit, Besancon University Hospital, Besancon, France.
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23
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Bailly B, Péré H, Veyer D, Berceanu A, Daguindau E, Roux P, Hermine O, de Lamballerie X, Bastard P, Lacombe K, Autran B, Angelot Delettre F, Casanova JL, Imbeaud S, Clairet AL, Kroemer M, Spehner L, Robillard N, Puech J, Marty-Quinternet S, Lepiller Q, Chirouze C, Bouiller K. Persistent COVID-19 in an immunocompromised host treated by SARS-CoV-2-specific monoclonal antibodies. Clin Infect Dis 2021; 74:1706-1707. [PMID: 34598278 PMCID: PMC8522390 DOI: 10.1093/cid/ciab868] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Benoit Bailly
- Service de maladies infectieuses, Centre hospitalier universitaire de Besançon, Besançon, France.,Service de maladies infectieuse, Centre hospitalier Jura Sud, Lons le Saunier, France
| | - Helene Péré
- Centre de Recherche des Cordeliers, INSERM, Université Sorbonne Paris Cité, Université de Paris, UMRS, Equipe FunGest, Paris, France
| | - David Veyer
- Centre de Recherche des Cordeliers, INSERM, Université Sorbonne Paris Cité, Université de Paris, UMRS, Equipe FunGest, Paris, France.,Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ana Berceanu
- Service d'hématologie, Centre hospitalier universitaire de Besançon, Besançon, France
| | - Etienne Daguindau
- Service d'hématologie, Centre hospitalier universitaire de Besançon, Besançon, France
| | - Pauline Roux
- Service de pneumologie, Centre hospitalier universitaire de Besançon, Besançon, France
| | - Olivier Hermine
- Service d'hématologie adulte, Hôpital Necker, Institut Imagine, INSERM U 1163, Université de Paris, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier de Lamballerie
- Unité des Virus Emergents, UVE: Aix Marseille Univ, IRD 190, INSERM 1207, IHU Méditerranée Infection, Marseille, France
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U 1163, Necker Hospital for Sick Children, Paris, France.,University of Paris, Imagine Institute, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Karine Lacombe
- Service de maladies infectieuses, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Brigitte Autran
- INSERM Pierre Louis Institute of Epidemiology and Public Health, IPLESP, Sorbonne University, Paris, France.,Sorbonne-Université, Paris, France; UMR-S Inserm/UPMC 1135, CIMI-Paris (Centre de Recherches Immunité Maladies Infectieuses), Paris, France
| | - Fanny Angelot Delettre
- Etablissement Français du Sang Bourgogne Franche-Comté, Service Délivrance/Distributions des PSL, F-2500 Besançon, France.,Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Jean Laurent Casanova
- University of Paris, Imagine Institute, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Howard Hughes Medical Institute, New York, NY, USA.,Laboratoire de génétique humaine et de maladies infectieuses, Inserm U 1163, Hôpital Necker enfant malade, Paris, France.,Centre de Recherche des Cordeliers, Sorbonne Université, INSERM, Université de Paris, Paris, France
| | - Sandrine Imbeaud
- Centre de Recherche des Cordeliers, INSERM, Université Sorbonne Paris Cité, Université de Paris, UMRS, Equipe FunGest, Paris, France
| | - Anne Laure Clairet
- Département de pharmacie, Centre hospitalier universitaire de Besancon, Besancon, France
| | - Marie Kroemer
- Département de pharmacie, Centre hospitalier universitaire de Besancon, Besancon, France.,INSERM, EFS BFC, UMR1098 RIGHT, université de Bourgogne Franche comté, France
| | - Laurie Spehner
- INSERM, EFS BFC, UMR1098 RIGHT, université de Bourgogne Franche comté, France.,Service d'oncologie médicale, Centre hospitalier universitaire de Besancon, Besancon, France
| | - Nicolas Robillard
- Laboratoire de Virologie, Service de Microbiologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Julien Puech
- Laboratoire de Virologie, Service de Microbiologie, hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Quentin Lepiller
- Laboratoire de virologie, Centre hospitalier universitaire de Besancon, Besancon, France
| | - Catherine Chirouze
- Service de maladies infectieuses, Centre hospitalier universitaire de Besançon, Besançon, France.,UMR-CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
| | - Kevin Bouiller
- Service de maladies infectieuses, Centre hospitalier universitaire de Besançon, Besançon, France.,UMR-CNRS 6249 Chrono-environnement, Université Bourgogne Franche-Comté, Besançon, France
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24
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Jullien M, Orvain C, Berceanu A, Couturier MA, Guillaume T, Peterlin P, Garnier A, Le Bourgeois A, Klemencie M, Schmidt A, Hunault M, Daguindau E, Roussel X, Delepine P, Guillerm G, Giltat A, François S, Thepot S, Le Gouill S, Béné MC, Chevallier P. Impact of allogeneic stem cell transplantation comorbidity indexes after haplotransplant using post-transplant cyclophosphamide. Cancer Med 2021; 10:7194-7202. [PMID: 34547182 PMCID: PMC8525117 DOI: 10.1002/cam4.4262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 08/26/2021] [Indexed: 01/11/2023] Open
Abstract
Background Three different scoring systems have been developed to assess pre‐transplant comorbidity in allogeneic hematopoietic stem cell transplantation (Allo‐HSCT): the Hematopoietic Cell Transplantation‐Specific Comorbidity Index, the Comorbidity/Age index, and the Augmented Comorbidity/Age index. All were devised to predict overall survival (OS) and disease‐free survival (DFS) survivals and non‐relapse mortality (NRM) in patients receiving HLA‐matched Allo‐HSCT, but their performance has scarcely been studied in the haploidentical Allo‐HSCT setting with post‐transplant cyclophosphamide, a procedure in constant expansion worldwide. Methods To address this issue, their impact on survivals and NRM was examined in a cohort of 223 patients treated with haploidentical Allo‐HSCT in four different centers. Results With a median follow‐up of 35.6 months, 3‐year OS, DFS, and NRM were 48.1% ± 4%, 46.3% ± 4%, and 30.0% ± 3%, respectively. No impact was found for any of the three comorbidity scores in univariate analysis. In multivariate analyses, the only three factors associated with lower OS were DRI (p < 0.001), an older age of recipients (≥55 years old, p = 0.02) and of donors (≥40 years old, p = 0.005). Older donor age was also associated with lower DFS and higher NRM. Conclusion The comorbidity scores do not predict survivals nor NRM in haploidentical Allo‐HSCT with PTCY, suggesting that pre‐transplant comorbidities should not be a contra‐indication to this procedure.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Corentin Orvain
- Hematology Department, Angers University Hospital, Angers, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Marion Klemencie
- Hematology Department, Angers University Hospital, Angers, France
| | - Aline Schmidt
- Hematology Department, Angers University Hospital, Angers, France
| | - Mathilde Hunault
- Hematology Department, Angers University Hospital, Angers, France
| | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Xavier Roussel
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Pascal Delepine
- Cell therapy Unit, Etablissement Français du Sang - Bretagne, Site of Brest, Brest, France
| | - Gaelle Guillerm
- Hematology Department, Brest University Hospital, Brest, France
| | - Aurelien Giltat
- Hematology Department, Angers University Hospital, Angers, France
| | - Sylvie François
- Hematology Department, Angers University Hospital, Angers, France
| | - Sylvain Thepot
- Hematology Department, Angers University Hospital, Angers, France
| | - Steven Le Gouill
- Hematology Department, Nantes University Hospital, Nantes, France.,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
| | - Marie-C Béné
- INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France.,Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France.,INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
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25
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Jullien M, Orvain C, Berceanu A, Couturier MA, Guillaume T, Peterlin P, Garnier A, Bourgeois AL, Klemencie M, Schmidt A, Hunault M, Daguindau E, Roussel X, Delepine P, Guillerm G, Giltat A, François S, Thepot S, Gouill SL, Béné MC, Chevallier P. Early Post-Transplantation Serum Ferritin Level Predicts Survival in Recipients of Haploidentical Stem Cell Transplantation Using Post-Transplantation Cyclophosphamide as Graft-versus-Host Disease Prophylaxis. Transplant Cell Ther 2021; 27:861.e1-861.e7. [PMID: 34245928 DOI: 10.1016/j.jtct.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/20/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
The negative impact of high serum ferritin level (SFL) before and after allogeneic hematopoietic cell transplantation (allo-HSCT) on outcomes is well recognized. However, it is poorly documented in adults undergoing haploidentical HSCT (haplo-HSCT) with post-transplantation cyclophosphamide (PTCY) for hematologic malignancies. The main objective was to assess the impact of pretransplantation and post-transplantation SFL on overall survival (OS), disease-free survival (DFS), and nonrelapse mortality (NRM) in patients undergoing haplo-HSCT with PTCY. The secondary objective was to identify factors associated with outcomes after transplantation by comparing SFL with other parameters related to the status of patients or donors. This multicentric retrospective study included 223 consecutive patients who underwent haplo-HSCT with PTCY in 4 French centers (Nantes, Angers, Besançon, and Brest) between October 2013 and January 2020. The impact of SFL on OS, DFS, and NRM at different time points was assessed based on receiver operating characteristic curves. With a median follow-up of 37.6 months (interquartile range, 23.5 to 51.0 months), 3-year OS, DFS, and NRM were 48.1 ± 4%, 46.3 ± 4%, and 30.0 ± 3%, respectively. Pretransplantation SFL had no impact on outcomes irrespective of the cutoff tested. Considering patients alive at 3 months post-transplantation, an SFL ≥3500 µg/L at 3 months was statistically significantly associated with worse 3-year OS (32.7 ± 8.7% versus 53.4 ± 7.2%; P = .01) and DFS (30.1 ± 8.2% versus 53.1 ± 7.1%; P = .008), with a trend toward higher NRM (33.2 ± 8.6% versus 17.6 ± 5.4%; P = .10). Similarly, high SFL (≥2700 µg/L) at 6 months post-transplantation was associated with worse 3-year OS (56.1 ± 9.1% versus 79.2 ± 6.0%; P = .02) and DFS (53.6 ± 8.7% versus 74.9 ± 6.2%; P = .01), with a trend toward higher NRM (21.4 ± 7.4% versus 8.2 ± 4.0%; P = .10). In multivariate analysis, high 3-month and 6-month FL remained associated with lower OS and DFS, with a trend toward higher NRM. Pretransplantation SFL appears to have no impact on outcomes in haplo-HSCT with PTCY, in contrast to what is documented in the matched allo-HSCT setting. In contrast, in the haplo-HSCT setting, high SFL early post-transplantation is associated with lower survival and a trend toward higher NRM.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Corentin Orvain
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Ana Berceanu
- Hematology Department, Besançon University Hospital, Besançon, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Marion Klemencie
- Hematology Department, Angers University Hospital, Angers, France
| | - Aline Schmidt
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Mathilde Hunault
- Hematology Department, Angers University Hospital, Angers, France; INSERM, CRCINA, University of Angers, Angers, France
| | - Etienne Daguindau
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Xavier Roussel
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Pascal Delepine
- Cell Therapy Unit, Etablissement Français du Sang-Bretagne, Brest, France
| | - Gaelle Guillerm
- Hematology Department, Brest University Hospital, Brest, France
| | - Aurelien Giltat
- Hematology Department, Besançon University Hospital, Besançon, France
| | - Sylvie François
- Hematology Department, Angers University Hospital, Angers, France
| | | | - Steven Le Gouill
- Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France
| | - Marie-C Béné
- INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France; Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France; INSERM UMR1232, CRCINA IRS-UN, University of Nantes, Nantes, France.
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26
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Alain S, Feghoul L, Girault S, Lepiller Q, Frobert E, Michonneau D, Berceanu A, Ducastelle-Lepretre S, Tilloy V, Guerin E, Le Goff J, Peytavin G, Hantz S. Letermovir breakthroughs during the French Named Patient Programme: interest of monitoring blood concentration in clinical practice. J Antimicrob Chemother 2021; 75:2253-2257. [PMID: 32413116 DOI: 10.1093/jac/dkaa135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/24/2020] [Accepted: 03/03/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To analyse mechanisms of letermovir breakthrough during compassionate primary and secondary prophylaxis. METHODS Mechanisms of letermovir breakthrough during compassionate primary and secondary prophylaxis were analysed in four patients from the French Named Patient Programme by the French National Reference Centre for Herpesviruses. RESULTS Of three absolute resistance cases, two were associated with treatment interruption or low letermovir concentrations in blood. A fourth case of breakthrough was not associated with resistance. Next-generation sequencing (NGS) genotyping confirmed rapid emergence of resistant mutants, within 3 months of treatment initiation. CONCLUSIONS Measurement of letermovir concentration and genotyping should be recommended for patient follow-up during letermovir therapy.
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Affiliation(s)
- S Alain
- UMR Inserm 1092, RESINFIT, Université de Limoges, Limoges, France.,National Reference Centre for Herpesviruses, Bacteriology Virology Hygiene Department, CHU Limoges, Limoges, France.,Medical Genomic and Bioinformatics Units, GenoLim, CHU Limoges, Limoges, France
| | - L Feghoul
- Virology Department, Hôpital Saint Louis, Université de Paris, Paris, France
| | - S Girault
- Haematology Department, CHU Limoges, Limoges, France
| | - Q Lepiller
- Virology Department, CHU Besançon, Besançon, France
| | - E Frobert
- Virology Department, CBPE, Hospices Civils de Lyon, Lyon, France
| | - D Michonneau
- Haematology and Transplantation Unit, Hôpital Saint Louis, Université de Paris, Paris, France
| | - A Berceanu
- Haematology and Transplantation Unit, CHU Besançon, Besançon, France
| | | | - V Tilloy
- National Reference Centre for Herpesviruses, Bacteriology Virology Hygiene Department, CHU Limoges, Limoges, France.,Medical Genomic and Bioinformatics Units, GenoLim, CHU Limoges, Limoges, France
| | - E Guerin
- Medical Genomic and Bioinformatics Units, GenoLim, CHU Limoges, Limoges, France
| | - J Le Goff
- Virology Department, Hôpital Saint Louis, Université de Paris, Paris, France
| | - G Peytavin
- APHP, Pharmacology & Toxicology Laboratory and IAME, Inserm UMR 1137, Université Paris 7, Paris, France
| | - S Hantz
- UMR Inserm 1092, RESINFIT, Université de Limoges, Limoges, France.,National Reference Centre for Herpesviruses, Bacteriology Virology Hygiene Department, CHU Limoges, Limoges, France
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27
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Comont T, Meunier M, Cherait A, Santana C, Cluzeau T, Slama B, Laribi K, Giraud JT, Dimicoli S, Berceanu A, Le Clech L, Cony-Makhoul P, Gruson B, Torregrosa J, Sanhes L, Jachiet V, Azerad MA, Al Jijakli A, Gyan E, Gaudin C, Broner J, Guerveno C, Guillaume T, Ades PL, Beyne-Rauzy O, Fenaux P. Eltrombopag for myelodysplastic syndromes or chronic myelomonocytic leukaemia with no excess blasts and thrombocytopenia: a French multicentre retrospective real-life study. Br J Haematol 2021; 194:336-343. [PMID: 34151423 DOI: 10.1111/bjh.17539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/02/2021] [Accepted: 03/30/2021] [Indexed: 12/15/2022]
Abstract
Despite a moderate prevalence in low-risk myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML), thrombocytopenia remains a risk of severe bleeding and therapeutic options are still limited. There are only a few studies with eltrombopag (ELT), a thrombopoietin receptor agonist, in those patients. In this retrospective multicentre study, ELT was used in 50 patients with MDS and 11 with CMML, with no excess of marrow blasts and platelet counts of <50 × 109 /l in a 'real-life' situation. Platelet response occurred in 47 (77%) patients. The median (range) duration of response was 8 (0-69) months. None of the eight still responders who discontinued ELT had relapsed, at a median (range) of 16 (6-23) months after ELT discontinuation. Although 36% of the patients were anti-coagulated or anti-aggregated only 10% of patients had Grade ≥3 bleeding events. Thrombotic events were observed in six (10%) patients, who all but one had a medical history of arterial or venous thrombosis. Progression to acute myeloid leukaemia occurred in four (7%) patients. In this first 'real-life' study, ELT was effective and generally well tolerated in patients with MDS/CMML without excess blasts.
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Affiliation(s)
- Thibault Comont
- Service de Médecine Interne, IUCT Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Mathieu Meunier
- CHU Grenoble Alpes, Université Grenoble Alpes, Institute for Advanced Biosciences, INSERM U1209, CNRS, UMR 5309, Grenoble, France
| | - Amina Cherait
- Service d'Hématologie Sénior, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | | | - Thomas Cluzeau
- Service d'Hématologie Clinique, CHU de Nice, Nice, France
| | - Bohrane Slama
- Service d'onco-hématologie, Centre Hospitalier Général d'Avignon, Avignon, France
| | - Kamel Laribi
- Service d'Hématologie, Centre Hospitalier Le Mans, Le Mans, France
| | - Jean-Thomas Giraud
- Service de Médecine Interne, Centre Hospitalier de Tarbes, Tarbes, France
| | - Sophie Dimicoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Ana Berceanu
- Service d'Hématologie, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Lenaïg Le Clech
- Service d'Hématologie, Centre Hospitalier de Quimper, Quimper, France
| | | | - Berangere Gruson
- Service d'Hématologie, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Jose Torregrosa
- Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Laurence Sanhes
- Service d'Hématologie, Centre Hospitalier de Perpignan, Perpignan, France
| | - Vincent Jachiet
- Service de Médecine Interne, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - Marie-Agnes Azerad
- Service d'Hématologie, Centre Hospitalier Universitaire de Liège, Liège, Belgique
| | - Ahmad Al Jijakli
- Service d'Hématologie, Centre Hospitalier d'Argenteuil, Argenteuil, France
| | - Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Clement Gaudin
- Service de Médecine Interne-Oncogériatrie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jonathan Broner
- Service de Médecine Interne, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Claire Guerveno
- Service de Médecine Interne, Centre Hospitalier d'Albi, Albi, France
| | - Thierry Guillaume
- Service d'Hématologie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Pr Lionel Ades
- Service d'Hématologie Sénior, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), Université de Paris, Paris, France
| | - Odile Beyne-Rauzy
- Service de Médecine Interne, IUCT Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre Fenaux
- Service d'Hématologie Sénior, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris (APHP), Université de Paris, Paris, France
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Kayser S, Schlenk RF, Lebon D, Carre M, Götze KS, Stölzel F, Berceanu A, Schäfer-Eckart K, Peterlin P, Hicheri Y, Rahme R, Raffoux E, Chermat F, Krause SW, Aulitzky WE, Rigaudeau S, Noppeney R, Berthon C, Görner M, Jost E, Carassou P, Keller U, Orvain C, Braun T, Saillard C, Arar A, Kunzmann V, Wemeau M, De Wit M, Niemann D, Bonmati C, Schwänen C, Abraham J, Aljijakli A, Haiat S, Krämer A, Reichle A, Gnadler M, Willekens C, Spiekermann K, Hiddemann W, Müller-Tidow C, Thiede C, Röllig C, Serve H, Bornhäuser M, Baldus CD, Lengfelder E, Fenaux P, Platzbecker U, Adès L. Characteristics and outcome of patients with low-/intermediate-risk acute promyelocytic leukemia treated with arsenic trioxide - an international collaborative study. Haematologica 2021; 106:3100-3106. [PMID: 34047178 PMCID: PMC8634174 DOI: 10.3324/haematol.2021.278722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Indexed: 12/02/2022] Open
Abstract
The aim of this study was to characterize a large series of 154 patients with acute promyelocytic leukemia (median age, 53 years; range, 18-90 years) and evaluate real-life outcome after up-front treatment with arsenic trioxide and all-trans retinoic acid. All patients were included in the prospective NAPOLEON registry (NCT02192619) between 2013 and 2019. The acute promyelocytic leukemia was de novo in 91% (n=140) and therapy-related in 9% (n=14); 13% (n=20) of the patients were older than 70 years. At diagnosis bleeding/hemorrhage was present in 38% and thrombosis in 3%. Complete remission was achieved in 152 patients (99%), whereas two patients (1%) experienced induction death within 18 days after starting therapy. With a median follow-up of 1.99 years (95% confidence interval: 1.61-2.30 years) 1-year and 2-year overall survival rates were 97% (95% confidence interval: 94-100%) and 95% (95% confidence interval: 91-99%), respectively. Age above 70 years was associated with a significantly shorter overall survival (P<0.001) compared to that of younger patients. So far no relapses have been observed. Six patients (4%) died in complete remission at a median of 0.95 years after diagnosis (range, 0.18-2.38 years). Our data confirm the efficiency and durability of arsenic trioxide and all-trans retinoic acid therapy in the primary management of adults with low-/intermediate-risk acute promyelocytic leukemia in the real-life setting, irrespective of age.
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Affiliation(s)
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany; NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg.
| | - Richard F Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg; Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg
| | | | - Martin Carre
- 5HCE Grenoble, Service d'Oncologie et Hématologie Pédiatrique, Grenoble
| | | | - Friedrich Stölzel
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
| | - Ana Berceanu
- Service d'Hématologie du Pr. Cahn Hopital Jean Minjoz, Besancon
| | | | | | - Yosr Hicheri
- Département d'Hématologie Clinique du Chu Saint Eloi Montpellier
| | - Ramy Rahme
- Hôpital Saint Louis, Université Paris Diderot, Paris
| | | | | | - Stefan W Krause
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen
| | | | - Sophie Rigaudeau
- Service d'Hémato-Oncologie du Pr. Castaigne Hopital Andre Mignot le Chesnay
| | | | - Celine Berthon
- Service des Maladies du Sang Chru, Hopital Claude Huriez, Lille
| | - Martin Görner
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Bielefeld Mitte
| | | | - Philippe Carassou
- Service de Médecine interne, Hématologie du Pr. Christian Chr Metz Thionville, Hopital de Marcy, Metz
| | - Ulrich Keller
- Department of Hematology, Oncology and Tumor Immunology, Charité-University Medical Center, Campus Benjamin Franklin, Berlin
| | - Corentin Orvain
- Angers University Hospital, Maladies du Sang, Angers; Fédération Hospitalo-Universitaire Grand-Ouest Acute Leukemia, FHU-GOAL, France; Université d'Angers, Inserm, CRCINA, Angers
| | - Thorsten Braun
- Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris
| | | | - Ali Arar
- Service d' Oncologie Médicale Hopital de la Source, Orleans
| | | | | | | | - Dirk Niemann
- Gemeinschaftsklinikum Mittelrhein gGmbH, Koblenz
| | - Caroline Bonmati
- Division of Hematology, Hôpital de Brabois, Centre Hospitalier Universitaire de Nancy, Nancy
| | | | - Julie Abraham
- Service d' Hématologie, Thérapie Cellulaire du Pr. Bordessoule, Hopital Universitaire Dupuytren, Limoges
| | - Ahmad Aljijakli
- Service d'Hématologie du Dr. Sutton Centre Hospitalier v. Dupouy, Argenteuil
| | - Stephanie Haiat
- Service d'Hematologie Clinique, CH Sud Francilien, Corbeil Essonnes
| | - Alwin Krämer
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg; German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg
| | - Albrecht Reichle
- Department of Medicine III - Hematology and Internal Oncology, University Hospital Regensburg, Regensburg
| | - Martina Gnadler
- St. Vincentius Kliniken, Abteilung für Hämatologie, Onkologie, Immunologie und Palliativmedizin, Karlsruhe
| | - Christophe Willekens
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif; INSERM Unit 1170, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif
| | - Karsten Spiekermann
- Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich
| | - Wolfgang Hiddemann
- Department of Medicine III, University Hospital, Ludwig-Maximilians University (LMU) Munich, Munich
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
| | - Hubert Serve
- Department of Internal Medicine II, University Hospital of Frankfurt Main
| | - Martin Bornhäuser
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, TU Dresden
| | | | - Eva Lengfelder
- Department of Hematology and Oncology, University Hospital Mannheim, Mannheim
| | - Pierre Fenaux
- Hôpital Saint Louis, Université Paris Diderot, Paris
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig
| | - Lionel Adès
- Hôpital Saint Louis, Université Paris Diderot, Paris
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Chevallier P, Berceanu A, Peterlin P, Garnier A, Le Bourgeois A, Imbert BM, Daguindau E, Mahé B, Dubruille V, Blin N, Touzeau C, Gastinne T, Lok A, Tessoulin B, Vantyghem S, Desbrosses Y, Bressollette C, Duquesne A, Eveillard M, Le Bris Y, Dormoy A, Malugani C, Deconinck E, Moreau P, Le Gouill S, Béné MC, Guillaume T. Grade 2 acute GVHD is a factor of good prognosis in patients receiving peripheral blood stem cells haplo-transplant with post-transplant cyclophosphamide. Acta Oncol 2021; 60:466-474. [PMID: 33112687 DOI: 10.1080/0284186x.2020.1837947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The impact of acute graft versus host disease (GVHD) on survivals for patients receiving a haploidentical allogeneic stem-cell transplant (Allo-SCT) with peripheral blood stem-cells (PBSC) complemented by post-transplant cyclophosphamide (PTCY) is ill-known. MATERIAL AND METHODS This retrospective study included 131 patients who received a PBSC haplograft in order to precise the impact of acute GVHD on outcomes. There were 78 males and 53 females and the median age for the whole cohort was 59 years (range: 20-71). Thirty-five patients were allografted for a lymphoid disease and 96 for a myeloid malignancy, including 67 patients with acute myeloid leukemia (AML). RESULTS The cumulative incidence (CI) of day 100 grade 2-4 and 3-4 acute GVHD was 43.4 + 4.6% and 16.7 + 3.4%, respectively. The 2-year CI of moderate/severe chronic GVHD was 10.1 + 2.8%. The only factor affecting the occurrence of GVHD was GVHD prophylaxis. Indeed, CI of day 100 grade 2-4 (but not grade 3-4) acute GVHD was significantly reduced when adding anti-thymoglobulin (ATG) to PTCY. However, in multivariate analysis, grade 2 acute GVHD was significantly associated with better disease-free (HR: 0.36; 95%CI: 0.19-0.69, p = .002) and overall (HR: 0.35; 95%CI: 0.1-0.70, p = .003) survivals. The same results were observed when considering only AML patients. CONCLUSION Acute grade 2 GVHD is a factor of good prognosis after PBSC haplotransplant with PTCY. Further and larger studies are needed to clarify the complex question of GVHD prophylaxis in the setting of haplo-transplant, especially that of combining ATG and PTCY.
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Affiliation(s)
| | | | | | - Alice Garnier
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | | | - Béatrice Mahé
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | - Nicolas Blin
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | - Anne Lok
- Hematology Department, CHU Hotel-Dieu, Nantes, France
| | | | | | | | | | - Alix Duquesne
- Cellular Engineering Unit, EFS Pays de la Loire, Nantes, France
| | | | - Yannick Le Bris
- Hematology/Biology Department, CHU Hotel-Dieu, Nantes, France
| | - Anne Dormoy
- EFS Bourgogne Franche-Comté, Besançon, France
| | | | - Eric Deconinck
- Hematology Department, CHU, Besançon, France
- Université de Franche-Comté, Inserm UMR1098 RIGHT, Besançon, France
| | | | | | - Marie C. Béné
- Hematology/Biology Department, CHU Hotel-Dieu, Nantes, France
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30
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Xhaard A, Xhaard C, D'Aveni M, Salvator H, Chabi ML, Berceanu A, Coman T, Beguin Y, Chalandon Y, Poiré X, Loschi M, Paillard C, Bruno B, Ceballos P, Dalle JH, Bilger K, Bay JO, Robin M, N'Guyen-Quoc S, Rubio MT. Risk factors for a severe form of COVID-19 after allogeneic haematopoietic stem cell transplantation: a Société Francophone de Greffe de Moelle et de Thérapie cellulaire (SFGM-TC) multicentre cohort study. Br J Haematol 2021; 192:e121-e124. [PMID: 33522598 PMCID: PMC8013848 DOI: 10.1111/bjh.17260] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Alienor Xhaard
- Service d'Hématologie-Greffe, Hôpital Saint-Louis, Université Paris Diderot, Paris, France
| | - Constance Xhaard
- Centre d'Investigations Cliniques Plurithématique 1433, Université de Lorraine, INSERM, INSERM 1116, CHRU de Nancy, FCRIN INI-CRCT, Nancy, France
| | - Maud D'Aveni
- Service d'Hématologie, Hôpital Brabois, CHRU Nancy et CNRS UMR 7563, Biopôle de l'Université de Lorraine, Vandoeuvre les Nancy, France
| | | | | | - Ana Berceanu
- Service d'Hematologie, CHU Jean Minjoz, Besançon, France
| | - Tereza Coman
- Service d'Hématologie, Institut Gustave Roussy, Villejuif, France
| | - Yves Beguin
- Department of Haematology, CHU of Liège, University of Liège, Liège, Belgium
| | - Yves Chalandon
- Service d'Hématologie, Faculty of Medicine, Hôpitaux Universitaires de Genève, University of Geneva, Genève, Suisse
| | | | | | | | | | | | | | - Karin Bilger
- Service d'Hématologie, CHRU Strasbourg, Strasbourg, France
| | | | - Marie Robin
- Service d'Hématologie-Greffe, Hôpital Saint-Louis, Université Paris Diderot, Paris, France
| | | | - Marie-Therese Rubio
- Service d'Hématologie, Hôpital Brabois, CHRU Nancy et CNRS UMR 7563, Biopôle de l'Université de Lorraine, Vandoeuvre les Nancy, France
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Bellanger AP, Tatoyan N, Monnot T, Deconinck E, Scherer E, Montange D, Bichard D, Millon L, Gbaguidi-Haore H, Berceanu A. Investigating the impact of posaconazole prophylaxis on systematic fungal screening using galactomannan antigen, Aspergillus fumigatus qPCR, and Mucorales qPCR. J Mycol Med 2021; 31:101117. [PMID: 33610794 DOI: 10.1016/j.mycmed.2021.101117] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/14/2021] [Accepted: 01/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
| | - Natacha Tatoyan
- Parasitology Mycology Department, University Hospital, Besançon, France
| | - Tess Monnot
- Pharmacy Department, University Hospital, Besançon, France
| | - Eric Deconinck
- Hematology Department, University Hospital, Besançon, France
| | - Emeline Scherer
- Parasitology Mycology Department, University Hospital, Besançon, France
| | - Damien Montange
- Pharmacology Department, University Hospital, Besançon, France
| | - Damien Bichard
- Pharmacy Department, University Hospital, Besançon, France
| | - Laurence Millon
- Parasitology Mycology Department, University Hospital, Besançon, France
| | | | - Ana Berceanu
- Hematology Department, University Hospital, Besançon, France
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32
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Bellanger AP, Navellou JC, Lepiller Q, Brion A, Brunel AS, Millon L, Berceanu A. Mixed mold infection with Aspergillus fumigatus and Rhizopus microsporus in a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) patient. Infect Dis Now 2021; 51:633-635. [PMID: 33527098 PMCID: PMC7839422 DOI: 10.1016/j.idnow.2021.01.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022]
Affiliation(s)
- A-P Bellanger
- Department of parasitology-mycology, University hospital of Besançon, 25000 Besançon, France; CNRS-University of Franche-Comte/UMR 6249 Chrono-environment, 25000 Besançon, France.
| | - J-C Navellou
- Intensive medical care unit, Regional hospital of Besançon, 25000 Besançon, France
| | - Q Lepiller
- Department of virology, University hospital of Besançon, 25000 Besançon, France
| | - A Brion
- Intensive care haematology department, University hospital of Besançon, 25000 Besançon, France
| | - A-S Brunel
- Infectious and tropical disease department, University hospital of Besançon, 25000 Besançon, France
| | - L Millon
- Department of parasitology-mycology, University hospital of Besançon, 25000 Besançon, France; CNRS-University of Franche-Comte/UMR 6249 Chrono-environment, 25000 Besançon, France
| | - A Berceanu
- Intensive care haematology department, University hospital of Besançon, 25000 Besançon, France
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Roussel X, Daguindau E, Berceanu A, Desbrosses Y, Warda W, Neto da Rocha M, Trad R, Deconinck E, Deschamps M, Ferrand C. Acute Myeloid Leukemia: From Biology to Clinical Practices Through Development and Pre-Clinical Therapeutics. Front Oncol 2020; 10:599933. [PMID: 33363031 PMCID: PMC7757414 DOI: 10.3389/fonc.2020.599933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022] Open
Abstract
Recent studies have provided several insights into acute myeloid leukemia. Studies based on molecular biology have identified eight functional mutations involved in leukemogenesis, including driver and passenger mutations. Insight into Leukemia stem cells (LSCs) and assessment of cell surface markers have enabled characterization of LSCs from hematopoietic stem and progenitor cells. Clonal evolution has been described as having an effect similar to that of microenvironment alterations. Such biological findings have enabled the development of new targeted drugs, including drug inhibitors and monoclonal antibodies with blockage functions. Some recently approved targeted drugs have resulted in new therapeutic strategies that enhance standard intensive chemotherapy regimens as well as supportive care regimens. Besides the progress made in adoptive immunotherapy, since allogenic hematopoietic stem cell transplantation enabled the development of new T-cell transfer therapies, such as chimeric antigen receptor T-cell and transgenic TCR T-cell engineering, new promising strategies that are investigated.
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Affiliation(s)
- Xavier Roussel
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Etienne Daguindau
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Ana Berceanu
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Yohan Desbrosses
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Walid Warda
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | | | - Rim Trad
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Eric Deconinck
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
- Department of Hematology, University Hospital of Besançon, Besançon, France
| | - Marina Deschamps
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
| | - Christophe Ferrand
- Inserm EFS BFC, UMR1098 RIGHT, University Bourgogne Franche-Comté, Besançon, France
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Floch A, Morel A, Zanchetta-Balint F, Cordonnier-Jourdin C, Allali S, Grall M, Ithier G, Carpentier B, Pakdaman S, Merle JC, Goulabchand R, Khalifeh T, Berceanu A, Helmer C, Chantalat-Auger C, Frémeaux-Bacchi V, Michel M, de Montalembert M, Mekontso-Dessap A, Pirenne F, Habibi A, Bartolucci P. Anti-C5 antibody treatment for delayed hemolytic transfusion reactions in sickle cell disease. Haematologica 2020; 105:2694-2697. [PMID: 33131265 PMCID: PMC7604638 DOI: 10.3324/haematol.2020.253856] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Aline Floch
- Etablissement francais du sang Ile de France, INSERM Unit 955, Laboratory of Excellence GR-Ex, Mondor Institute of Biomedical Research, Paris-Est Creteil University, Creteil
| | - Alexandre Morel
- French Sickle Cell Referral Center, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GR-Ex, INSERM Unit 955, Mondor Institute of Biomedical Research, Paris- Est Creteil University, Creteil
| | - Fabian Zanchetta-Balint
- French Sickle Cell Referral Center, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GR-Ex, INSERM Unit 955, Mondor Institute of Biomedical Research, Paris- Est Creteil University, Creteil
| | | | - Slimane Allali
- Department of Pediatrics, Necker Hospital for Sick Children, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GREx, Paris Descartes University, Paris
| | | | - Ghislaine Ithier
- Hematology Unit, Reference Center of Sickle Cell Disease, Robert Debré Hospital, Assistance Publique-Hopitaux de Paris, Paris
| | - Benjamin Carpentier
- Department of Hematology, Saint Vincent de Paul Hospital, Lille Catholic University, Lille
| | - Sadaf Pakdaman
- Etablissement francais du sang Ile de France, INSERM Unit 955, Laboratory of Excellence GR-Ex, Mondor Institute of Biomedical Research, Paris-Est Creteil University, Creteil
| | - Jean-Claude Merle
- Department of Anesthesia and Surgical Intensive Care, Liver Intensive Care Unit, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Creteil
| | - Radjiv Goulabchand
- Department of Internal Medicine-Multiorganic Diseases, Local Referral Center for Autoimmune Diseases, Saint-Eloi Hospital, Montpellier University, Montpellier
| | - Tackwa Khalifeh
- Pediatric Medical-Surgical Department, Poitiers Teaching Hospital, Poitiers, France
| | - Ana Berceanu
- Intensive Care Hematology Unit, Besancon Teaching Hospital, Besancon
| | - Cécile Helmer
- Etablissement francais du sang Auvergne-Rhône Alpes, Grenoble
| | - Christelle Chantalat-Auger
- Department of Internal Medicine, Bicetre Teaching Hospital, Assistance Publique-Hopitaux de Paris, Universite Paris 11, Le Kremlin-Bicetre, Paris
| | - Véronique Frémeaux-Bacchi
- Laboratory of Immunology, European Georges Pompidou Hospital, Assistance Publique-Hopitaux de Paris, Mixed Health Research Unit INSERM 872, Cordeliers Research Center, Paris
| | - Marc Michel
- Department of Internal Medicine, National Referral Center for Immune Cytopenias, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Creteil
| | - Mariane de Montalembert
- Department of Pediatrics, Necker Hospital for Sick Children, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GREx, Paris Descartes University, Paris
| | - Armand Mekontso-Dessap
- Medical Intensive Care Unit, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Creteil, France
| | - France Pirenne
- Etablissement francais du sang Ile de France, INSERM Unit 955, Laboratory of Excellence GR-Ex, Mondor Institute of Biomedical Research, Paris-Est Creteil University, Creteil
| | - Anoosha Habibi
- French Sickle Cell Referral Center, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GR-Ex, INSERM Unit 955, Mondor Institute of Biomedical Research, Paris- Est Creteil University, Creteil
| | - Pablo Bartolucci
- French Sickle Cell Referral Center, Henri Mondor Teaching Hospital, Assistance Publique-Hopitaux de Paris, Laboratory of Excellence GR-Ex, INSERM Unit 955, Mondor Institute of Biomedical Research, Paris- Est Creteil University, Creteil
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Bazarbachi A, Labopin M, Blaise D, Forcade E, Socié G, Berceanu A, Angelucci E, Bulabois CE, Kröger N, Rambaldi A, Ceballos P, Mielke S, El Cheikh J, Yakoub-Agha I, Savani B, Spyridonidis A, Nagler A, Mohty M. Comparable outcomes of haploidentical transplant with TBF conditioning versus matched unrelated donor with fludarabine/busulfan conditioning for acute myeloid leukemia. Bone Marrow Transplant 2020; 56:622-634. [PMID: 33020591 DOI: 10.1038/s41409-020-01074-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/15/2020] [Accepted: 09/22/2020] [Indexed: 11/09/2022]
Abstract
We compared transplant outcomes of 708 acute myeloid leukemia (AML) patients receiving haploidentical allogeneic hematopoietic-cell transplantation using thiotepa/busulfan/fludarabine (TBF) conditioning with posttransplant cyclophosphamide (ptCy), to 2083 patients receiving matched unrelated donor (MUD) transplantation using fludarabine/busulfan (FB) conditioning and in vivo T-cell depletion. For intermediate cytogenetic risk AML transplanted in first complete remission (CR1), multivariate analysis revealed that haplo-TBF significantly increased nonrelapse mortality (NRM) (HR 2.1; p = 0.0006) but did not affect relapse incidence (RI), leukemia-free survival (LFS), overall survival (OS), or graft-versus-host disease-free, relapse-free survival (GRFS). For high cytogenetic risk AML transplanted in CR1, haplo-TBF significantly increased NRM (HR = 2.7; p = 0.02), decreased RI (HR = 0.45; p = 0.03) but had no influence on LFS, OS, or GRFS. For AML transplanted in CR2, haplo-TBF significantly increased NRM (HR = 2.36; p = 0.008), decreased RI (HR = 0.38; p = 0.005), but had no influence on LFS, OS, or GRFS. Finally, for AML patients transplanted with active disease, haplo-TBF had no influence on transplant outcomes. In conclusion, compared to MUD-FB, haplo-TBF increased NRM, reduced RI in high-risk AML in CR, resulting in similar LFS, OS, and GRFS. These results comparing two different approaches support the use of a haploidentical family donor for high-risk AML patients lacking a matched sibling donor.
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Affiliation(s)
- Ali Bazarbachi
- Bone Marrow Transplant Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| | - Myriam Labopin
- Department of Haematology and EBMT Paris Study Office/CEREST-TC, Saint Antoine Hospital, INSERM UMR 938, Université Pierre et Marie Curie, Paris, France
| | - Didier Blaise
- Programme de Transplantation & Therapie Cellulaire, Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
| | - Edouard Forcade
- CHU Bordeaux, service d'hematologie et therapie Cellulaire, F-33000, Bordeaux, France
| | - Gerard Socié
- Department of Hematology-BMT, Hopital St. Louis, Paris, France
| | - Ana Berceanu
- Service d'Hématologie, Hopital Jean Minjoz, Besancon, France
| | - Emanuele Angelucci
- Hematology and Transplant Center, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Claude Eric Bulabois
- Service d'Hématologie, CHU Grenoble Alpes-Université Grenoble Alpes, Grenoble, France
| | - Nicolaus Kröger
- Bone Marrow Transplantation Centre, University Hospital Eppendorf, Hamburg, Germany
| | - Alessandro Rambaldi
- Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Patrice Ceballos
- Département d'Hématologie Clinique, 11 CHU Saint Eloi, Unité de Greffes Hématologiques, Montpellier, France
| | - Stephan Mielke
- Department of Laboratory Medicine, CAST, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Jean El Cheikh
- Bone Marrow Transplant Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Bipin Savani
- Department of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Aviv University, Tel HaShomer, Israel
| | - Mohamad Mohty
- Department of Haematology and EBMT Paris Study Office/CEREST-TC, Saint Antoine Hospital, INSERM UMR 938, Université Pierre et Marie Curie, Paris, France.
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Tavitian S, Uzunov M, Bérard E, Bouscary D, Thomas X, Raffoux E, Leguay T, Gallego Hernanz MP, Berceanu A, Leprêtre S, Hicheri Y, Chevallier P, Bertoli S, Lhéritier V, Dombret H, Huguet F. Ponatinib-based therapy in adults with relapsed or refractory Philadelphia chromosome-positive acute lymphoblastic leukemia: results of the real-life OPAL study. Leuk Lymphoma 2020; 61:2161-2167. [DOI: 10.1080/10428194.2020.1762876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Suzanne Tavitian
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - Madalina Uzunov
- Department of Hematology, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Emilie Bérard
- CHU de Toulouse, UMR 1027, INSERM-Université Toulouse III, Toulouse, France
| | | | - Xavier Thomas
- Department of Hematology, CHU de Lyon Sud, Pierre-Bénite, France
| | - Emmanuel Raffoux
- AP-HP, Hopital Saint-Louis, Service Hematologie Adulte, Paris, France
| | - Thibaut Leguay
- Service d'hématologie clinique et thérapie cellulaire, Hôpital du Haut-Lévèque, CHU de Bordeaux, Bordeaux, France
| | | | - Ana Berceanu
- Department of Hematology, CHU Besancon, Besancon, France
| | | | | | | | - Sarah Bertoli
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - Véronique Lhéritier
- Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL), Lyon, France
| | - Hervé Dombret
- Hospital Saint-Louis, Hématologie Adulte, Paris, France
| | - Françoise Huguet
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
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Robin C, Thiebaut A, Alain S, Sicre de Fontbrune F, Berceanu A, D'Aveni M, Ceballos P, Redjoul R, Nguyen-Quoc S, Bénard N, Pahlavan-Grumel G, Cordonnier C. Letermovir for Secondary Prophylaxis of Cytomegalovirus Infection and Disease after Allogeneic Hematopoietic Cell Transplantation: Results from the French Compassionate Program. Biol Blood Marrow Transplant 2020; 26:978-984. [DOI: 10.1016/j.bbmt.2020.01.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/22/2022]
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Bellanger AP, Berceanu A, Scherer E, Desbrosses Y, Daguindau E, Rocchi S, Millon L. Invasive Fungal Disease, Isavuconazole Treatment Failure, and Death in Acute Myeloid Leukemia Patients. Emerg Infect Dis 2020; 25:1778-1779. [PMID: 31441760 PMCID: PMC6711214 DOI: 10.3201/eid2509.190598] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We present 2 fatal cases of invasive fungal disease with isavuconazole treatment failure in immunocompromised patients: one with a TR34-L98H azole–resistant Aspergillus fumigatus isolate and the other a Rhizomucor–A. fumigatus co-infection. Such patients probably require surveillance by galactomannan antigen detection and quantitative PCRs for A. fumigatus and Mucorales fungi.
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Delarue M, Berceanu A, Laude MC, Louvrier A. Giant Blisters. J Stomatol Oral Maxillofac Surg 2019; 120:497-498. [PMID: 30664956 DOI: 10.1016/j.jormas.2019.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/30/2018] [Accepted: 01/08/2019] [Indexed: 06/09/2023]
Affiliation(s)
- M Delarue
- Centre Hospitalier Universitaire de Besançon, Service de chirurgie maxillo-faciale, 25030, Besançon, France.
| | - A Berceanu
- Centre Hospitalier Universitaire de Besançon, Service de Soins Intensifs Hématologie, 25030, Besançon, France
| | - M-C Laude
- Centre Hospitalier Universitaire de Besançon, Service de Soins Intensifs Hématologie, 25030, Besançon, France
| | - A Louvrier
- Centre Hospitalier Universitaire de Besançon, Service de chirurgie maxillo-faciale, 25030, Besançon, France; INSERM, EFS BFC, UMR 1098, Interactions hôte-greffon-tumeur - Ingénierie cellulaire et génique, Université de Bourgogne Franche-Comté, Besançon, France
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40
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Roussel X, Daguindau E, Berceanu A, Desbrosses Y, Saas P, Ferrand C, Seilles E, Pouthier F, Deconinck E, Larosa F. Altered thymic CD4 + T-cell recovery after allogeneic hematopoietic stem cell transplantation is critical for nocardiosis. Curr Res Transl Med 2019; 67:135-143. [PMID: 31164285 DOI: 10.1016/j.retram.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/10/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE OF THE STUDY Nocardia affects immunocompromised human host exhibiting an altered cell-mediated immunity. Infectious risk after allogeneic hematopoietic cell transplantation (AHCT) is significantly correlated to the recovery status of donor-derived immune system, especially CD4+ T-cells reconstitution and thymopoiesis. The purpose of this paper is to highlight a lack of cell-mediated immunity recovery for patients presenting a nocardiosis compared to a control cohort. PATIENTS AND METHODS This is a case control retrospective monocentric study. We retrospectively analyzed a monocentric cohort of 15 cases of nocardiosis after AHCT and we explored the degree of patients' immunosuppression by phenotyping circulating lymphoid subpopulations, including NK cells, CD8+ T-cells, CD4+ T-cells and CD19+ B-cells. We focused on CD4+ T-cell subsets to appreciate thymic output, especially on naive CD4+ T-cells (NTE, CD45RA+/RO- CD4+ T-cells) and recent thymic emigrants (RTE, CD4+CD45RA+/RO-/CD31+). Infected patients were paired with a control cohort of patients with identical transplantation characteristics screened on hematological disease, AHCT conditioning, primary graft-versus-host disease (GHVD) prophylaxis, graft type, sex, age, and season at the AHCT and data concerning immunological reconstitution were compared. RESULTS At onset of nocardiosis, circulating lymphocytes and CD4+ T-cells means count were respectively 730/μL and 162/μL. CD8+ T-cells, CD56+ NK cells and CD19+ B-cells means count were respectively 362/μL, 160/μL, 112/μL. CD4+ T-cells subpopulations, naïve CD4+ T-cells production was impaired with NTE and RTE means count at 26/μL and 11/μL respectively. Comparison between nocardiosis cohort and control cohort over time highlight significant lower cellular count for lymphocytes, CD4+ T-cells, NTE and RTE with p = 0.001, p < 0.001, p < 0.001, p < 0.001 respectively. CONCLUSION Immune recovery monitoring follow-up after AHCT is of particular importance to identify patients susceptible to develop Nocardiosis. Efficient microbiological investigations toward Nocardia such PCR should be used in case of compatible clinical presentation.
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Affiliation(s)
- Xavier Roussel
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France.
| | - Etienne Daguindau
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France; Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Ana Berceanu
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
| | - Yohan Desbrosses
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
| | - Philippe Saas
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Christophe Ferrand
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Estelle Seilles
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Fabienne Pouthier
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Eric Deconinck
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France; Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Fabrice Larosa
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
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Prata PH, Resche-Rigon M, Blaise D, Socié G, Rohrlich PS, Milpied N, Turlure P, Nguyen S, Sirvent A, Bulabois CE, Berceanu A, Charbonnier A, Chevallier P, Bay JO, Neven B, Jubert C, Mohty M, Rubio MT, Peffault de Latour R. Outcomes of Salvage Haploidentical Transplant with Post-Transplant Cyclophosphamide for Rescuing Graft Failure Patients: a Report on Behalf of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy. Biol Blood Marrow Transplant 2019; 25:1798-1802. [PMID: 31129355 DOI: 10.1016/j.bbmt.2019.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 01/17/2019] [Revised: 04/26/2019] [Accepted: 05/12/2019] [Indexed: 01/27/2023]
Abstract
Prognosis of patients with graft failure is dismal, and retransplantation is the sole option for long-term survival. To address the interest of haploidentical transplantation as a salvage option in this context, we analyzed data from 24 patients with graft failure or loss retransplanted with a haploidentical donor who received post-transplant cyclophosphamide (PTCy) as graft-versus-host disease prophylaxis (GVHD). Fludarabine-based reduced-intensity conditioning was used in 23 patients and the Baltimore regimen in 14 patients. The median delay between previous and salvage transplantation for graft failure was 63 days (range, 39 to 98). In addition to PTCy, all patients received cyclosporine, and 22 patients also received mycophenolate mofetil for GVHD prophylaxis. With a median follow-up of 353 days (range, 16 to 2010), 1-year overall survival (OS) was 56% (95% confidence interval, 38% to 81%). Transplant complications accounted for 80% of deaths. The cumulative incidence of neutrophil engraftment at day +30 was 79%. Cumulative incidence of grades II to IV acute GVHD at day 100 was 14%, and 1-year cumulative incidence of chronic GVHD was 31%. One-year cumulative incidence of relapse was 13%. Stem cell source did not impact on engraftment, GVHD, relapse, or OS. Salvage haploidentical transplant with PTCy for rescuing graft failure patients leads to an acceptable 1-year OS and might be a valid option in this poor situation.
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Affiliation(s)
- Pedro H Prata
- Bone Marrow Transplant Unit, Saint Louis Hospital, Paris, France.
| | | | - Didier Blaise
- Department of Hematology, Institut Paoli-Calmettes, Marseille, France
| | - Gérard Socié
- Bone Marrow Transplant Unit, Saint Louis Hospital, Paris, France
| | | | - Noel Milpied
- Department of Hematology, Haut-Leveque Hospital, Bordeaux, France
| | - Pascal Turlure
- Department of Hematology, CHU de Limoges, Limoges, France
| | - Stephanie Nguyen
- Department of Hematology, Pitié Salpêtrière Hospital, Paris, France
| | - Anne Sirvent
- Department of Pediatric Onco-Hematology, CHU de Montpellier, Montpellier, France
| | | | - Ana Berceanu
- Department of Hematology, CHU Jean Minjoz, Besançon, France
| | | | | | - Jacques-Olivier Bay
- Department of Hematology and Cell Therapy, CHU Estaing, Clermont Ferrand, France
| | - Benedicte Neven
- Department of Pediatric Immunology and Hematology, Necker Hospital, Paris, France
| | - Charlotte Jubert
- Department of Pediatric Onco-Hematology, Pellegrin Hospital, Bordeaux, France
| | - Mohamad Mohty
- Department of Hematology, Saint Antoine Hospital, Paris, France
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Lengline E, Drenou B, Peterlin P, Tournilhac O, Abraham J, Berceanu A, Dupriez B, Guillerm G, Raffoux E, de Fontbrune FS, Ades L, Balsat M, Chaoui D, Coppo P, Corm S, Leblanc T, Maillard N, Terriou L, Socié G, de Latour RP. Nationwide survey on the use of eltrombopag in patients with severe aplastic anemia: a report on behalf of the French Reference Center for Aplastic Anemia. Haematologica 2017; 103:212-220. [PMID: 29170252 PMCID: PMC5792265 DOI: 10.3324/haematol.2017.176339] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/15/2017] [Indexed: 11/24/2022] Open
Abstract
Few therapeutic options are available for patients with aplastic anemia who are ineligible for transplantation or refractory to immunosuppressive therapy. Eltrombopag was recently shown to produce trilineage responses in refractory patients. However, the effects of real-life use of this drug remain unknown. This retrospective study (2012–2016) was conducted by the French Reference Center for Aplastic Anemia on patients with relapsed/refractory aplastic anemia, and patients ineligible for antithymocyte globulin or transplantation, who received eltrombopag for at least 2 months. Forty-six patients with aplastic anemia were given eltrombopag without prior antithymocyte globulin treatment (n=11) or after antithymocyte globulin administration (n=35) in a relapsed/refractory setting. Eltrombopag (median daily dose 150 mg) was introduced 17 months (range, 8–50) after the diagnosis of aplastic anemia. At last followup, 49% were still receiving treatment, 9% had stopped due to a robust response, 2% due to toxicity and 40% due to eltrombopag failure. Before eltrombopag treatment, all patients received regular transfusions. The overall rates of red blood cell and platelet transfusion independence were 7%, 33%, 46% and 46% at 1, 3, 6 months and last follow-up. Responses were slower to develop in antithymocyte treatment-naïve patients. In patients achieving transfusion independence, hemoglobin concentration and platelet counts improved by 3 g/dL (interquartile range, 1.4–4.5) and 42×109/L (interquartile range, 11–100), respectively. Response in at least one lineage (according to National Institutes of Health criteria) was observed in 64% of antithymocyte treatment-naïve and 74% of relapsed/refractory patients, while trilineage improvement was observed in 27% and 34%, respectively. We found high rates of hematologic improvement and transfusion independence in refractory aplastic anemia patients but also in patients ineligible for antithymocyte globulin receiving first-line treatment. In conclusion, elderly patients unfit for antithymocyte globulin therapy may benefit from eltrombopag.
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Affiliation(s)
- Etienne Lengline
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France
| | - Bernard Drenou
- Department of Hematology, Hôpital Emile Muller - CH de Mulhouse, France
| | - Pierre Peterlin
- Department of Hematology, Nantes University Hospital, France
| | - Olivier Tournilhac
- Service d'Hematologie Clinique et de Therapie Cellulaire, CHU, Universite d'Auvergne, Clermont-Ferrand, France
| | - Julie Abraham
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, France
| | - Ana Berceanu
- Department of Hematology, Besançon University Hospital, France
| | | | - Gaelle Guillerm
- Department of Hematology and Oncology, CH Augustin Morvan, Brest, France
| | - Emmanuel Raffoux
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France
| | - Flore Sicre de Fontbrune
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France
| | - Lionel Ades
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France
| | - Marie Balsat
- Department of Hematology 1G, Centre Hospitalier Lyon Sud, Pierre Benite, France
| | - Driss Chaoui
- Department of Hematology, CH Victor Dupouy, Argenteuil, France
| | - Paul Coppo
- Department of Hematology, French Reference Center for Thrombotic Microangiopathies, Saint Antoine University Hospital, Paris, France
| | - Selim Corm
- Department of Hematology, Hôpital Privé Médipole de Savoie, Challes les Eaux, France
| | - Thierry Leblanc
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France.,Department of Pediatric Hematology, Robert-Debré University Hospital, Paris, France
| | - Natacha Maillard
- Bone Marrow Transplant Unit Clinical Hematology, Hopital La Miletrie, Poitiers University Hospital, France
| | - Louis Terriou
- Department of Internal Medicine, Clinical Immunology, Hôpital Huriez Lille University Hospital, France
| | - Gerard Socié
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France.,University Paris Denis Diderot & INSERM UMR 1160, France
| | - Regis Peffault de Latour
- Department of Hematology, CRNMR Aplasie Médullaire, Saint-Louis University Hospital - AP-HP, Paris, France
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Bellanger AP, Gbaguidi Haore H, Berceanu A, Scherer E, Millon L. Analyse rétrospective des seuils de positivé du galactomannane dans les lavages broncho-alvéolaires. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.044] [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: 11/25/2022]
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Jeanvoine A, Berceanu A, Emery A, Damassie M, Scherer E, Millon L, Bellanger AP. Comparaison des CMI vis-à-vis du posaconazole et de l’isavuconazole pour des souches de Mucorales isolées au CHRU de Besançon. J Mycol Med 2017. [DOI: 10.1016/j.mycmed.2017.04.037] [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: 10/18/2022]
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Bergeron A, Chevret S, Granata A, Chevallier P, Vincent L, Huynh A, Tabrizi R, Labussiere-Wallet H, Bernard M, Chantepie S, Bay JO, Thiebaut-Bertrand A, Thepot S, Contentin N, Fornecker LM, Maillard N, Risso K, Berceanu A, Blaise D, Peffault de La Tour R, Chien JW, Coiteux V, Socié G. Effect of Azithromycin on Airflow Decline-Free Survival After Allogeneic Hematopoietic Stem Cell Transplant: The ALLOZITHRO Randomized Clinical Trial. JAMA 2017; 318:557-566. [PMID: 28787506 PMCID: PMC5817485 DOI: 10.1001/jama.2017.9938] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IMPORTANCE Bronchiolitis obliterans syndrome has been associated with increased morbidity and mortality after allogeneic hematopoietic stem cell transplant (HSCT). Previous studies have suggested that azithromycin may reduce the incidence of post-lung transplant bronchiolitis obliterans syndrome. OBJECTIVE To evaluate if the early administration of azithromycin can improve airflow decline-free survival after allogeneic HSCT. DESIGN, SETTING, AND PARTICIPANTS The ALLOZITHRO parallel-group trial conducted in 19 French academic transplant centers and involving participants who were at least 16 years old, had undergone allogeneic HSCT for a hematological malignancy, and had available pretransplant pulmonary function test results. Enrollment was from February 2014 to August 2015 with follow-up through April 26, 2017. INTERVENTIONS Patients were randomly assigned to receive 3 times a week either 250 mg of azithromycin (n = 243) or placebo (n = 237) for 2 years, starting at the time of the conditioning regimen. MAIN OUTCOMES AND MEASURES The primary efficacy end point was airflow decline-free survival at 2 years after randomization. Main secondary end points were overall survival and bronchiolitis obliterans syndrome at 2 years. RESULTS Thirteen months after enrollment, the independent data and safety monitoring board detected an unanticipated imbalance across blinded groups in the number of hematological relapses, and the treatment was stopped December 26, 2016. Among 480 randomized participants, 465 (97%) were included in the modified intention-to-treat analysis (mean age, 52 [SD, 14] years; 75 women [35%]). At the time of data cutoff, 104 patients (22%; 54 azithromycin vs 50 placebo) had experienced an airflow decline; 138 patients (30%) died (78 azithromycin vs 60 placebo). Two-year airflow decline-free survival was 32.8% (95% CI, 25.9%-41.7%) with azithromycin and 41.3% (95% CI, 34.1%-50.1%) with placebo (unadjusted hazard ratio [HR], 1.3; 95% CI, 1.02-1.70; P = .03). Of the 22 patients (5%) who experienced bronchiolitis obliterans syndrome, 15 (6%) were in the azithromycin group and 7 (3%) in the placebo group (P = .08). The azithromycin group had increased mortality, with a 2-year survival of 56.6% (95% CI, 50.2%-63.7%) vs 70.1% (95% CI, 64.2%-76.5%) in the placebo group (unadjusted HR, 1.5; 95% CI, 1.1-2.0; P = .02). In a post hoc analysis, the 2-year cumulative incidence of hematological relapse was 33.5% (95% CI, 27.3%-39.7%) with azithromycin vs 22.3% (95% CI, 16.4%-28.2%) with placebo (unadjusted cause-specific HR, 1.7; 95% CI, 1.2-2.4; P = .002). CONCLUSIONS AND RELEVANCE Among patients undergoing allogeneic HSCT for hematological malignancy, early administration of azithromycin resulted in worse airflow decline-free survival than did placebo; these findings are limited by early trial termination. The potential for harm related to relapse requires further investigation. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01959100.
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Affiliation(s)
- Anne Bergeron
- AP-HP, Hôpital Saint-Louis, Service de Pneumologie, Paris, France
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France
| | - Sylvie Chevret
- Université Paris Diderot, Sorbonne Paris Cité, UMR 1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France
- AP-HP, Hôpital Saint-Louis, Service de Biostatistique et Information médicale, Paris, France
| | | | | | - Laure Vincent
- Département d’hématologie clinique, CHU de Montpellier, Montpellier, France
| | - Anne Huynh
- Secteur de Greffe, CHU-Oncopole, Toulouse, France
| | - Reza Tabrizi
- CHU Bordeaux, Service d'Hématologie et Thérapie Cellulaire, Bordeaux, France
| | - Hélène Labussiere-Wallet
- Département d’Hématologie, Lyon-Sud Hospital, Hospices Civils de Lyon, Pierre Bénite, Lyon, France
| | - Marc Bernard
- Hématologie Clinique, CHU Pontchaillou, Rennes, France
| | - Sylvain Chantepie
- Institut d’Hématologie de Basse-Normandie, CHU Caen, Avenue Côte de Nacre Caen, France
| | - Jacques-Olivier Bay
- Service de Thérapie Cellulaire et d'Hématologie Clinique Adulte, Université d'Auvergne, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - Anne Thiebaut-Bertrand
- Clinique Universitaire d’Hématologie, CHU Grenoble Alpes, Université Grenoble Alpes, CS 10217, Grenoble, France
| | - Sylvain Thepot
- Service d’Hématologie–Maladies du Sang, CHU d’Angers, Angers, France
- Université d'Angers, Inserm, Unité 1232, LabEx IGO, Angers, France
| | | | | | | | - Karine Risso
- Centre Hospitalier Universitaire de Nice, Service d’Hématologie, Nice, France
| | | | - Didier Blaise
- Institut Paoli-Calmettes, Aix Marseille Université, CNRS, INSERM, CRCM, Marseille, France
| | | | | | - Valérie Coiteux
- CHRU Lille, Service des Maladies du Sang, Secteur Allogreffe de Cellules Souches Hématopoïétiques, Lille, France
| | - Gérard Socié
- APHP, Hématologie-Transplantation Hôpital St Louis, Université Denis Diderot and INSERM UMR 1160, Paris, France
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Bellanger AP, Millon L, Berceanu A, Grenouillet F, Grenouillet FE, Larosa F, Deconinck E. CombiningAspergillusmitochondrial and ribosomal QPCR, in addition to galactomannan assay, for early diagnosis of invasive aspergillosis in hematology patients. Med Mycol 2015; 53:760-4. [DOI: 10.1093/mmy/myv051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 05/29/2015] [Indexed: 11/14/2022] Open
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Alanio A, Olivi M, Cabaret O, Foulet F, Bellanger AP, Millon L, Berceanu A, Cordonnier C, Costa JM, Bretagne S. Correlation Between Pneumocystis jirovecii Mitochondrial Genotypes and High and Low Fungal Loads Assessed by Single Nucleotide Primer Extension Assay and Quantitative Real-Time PCR. J Eukaryot Microbiol 2015; 62:650-6. [PMID: 25940946 DOI: 10.1111/jeu.12222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 02/06/2015] [Accepted: 02/06/2015] [Indexed: 12/12/2022]
Abstract
We designed a single nucleotide primer extension (SNaPshot) assay for Pneumocystis jirovecii genotyping, targeting mt85 SNP of the mitochondrial large subunit ribosomal RNA locus, to improve minority allele detection. We then analyzed 133 consecutive bronchoalveolar lavage (BAL) fluids tested positive for P. jirovecii DNA by quantitative real-time PCR, obtained from two hospitals in different locations (Hospital 1 [n = 95] and Hospital 2 [n = 38]). We detected three different alleles, either singly (mt85C: 39.1%; mt85T: 24.1%; mt85A: 9.8%) or together (27%), and an association between P. jirovecii mt85 genotype and the patient's place of hospitalization (p = 0.011). The lowest fungal loads (median = 0.82 × 10(3) copies/μl; range: 15-11 × 10(3) ) were associated with mt85A and the highest (median = 1.4 × 10(6) copies/μl; range: 17 × 10(3) -1.3 × 10(7) ) with mt85CTA (p = 0.010). The ratios of the various alleles differed between the 36 mixed-genotype samples. In tests of serial BALs (median: 20 d; range 4-525) from six patients with mixed genotypes, allele ratio changes were observed five times and genotype replacement once. Therefore, allele ratio changes seem more frequent than genotype replacement when using a SNaPshot assay more sensitive for detecting minority alleles than Sanger sequencing. Moreover, because microscopy detects only high fungal loads, the selection of microscopy-positive samples may miss genotypes associated with low loads.
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Affiliation(s)
- Alexandre Alanio
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Université Paris-Diderot, Sorbonne Cité, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France.,CNRS URA3012, Paris, France
| | - Martine Olivi
- Laboratoire Cerba, Cergy-Pontoise, Saint-Ouen-l'Aumône, France
| | - Odile Cabaret
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France.,Université Paris-Est-Créteil, Créteil, France
| | - Françoise Foulet
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France.,Université Paris-Est-Créteil, Créteil, France
| | - Anne-Pauline Bellanger
- Laboratoire de Parasitologie-Mycologie, Centre hospitalier universitaire, Besançon, France.,Laboratoire Chrono-Environnement, Université Franche-Comté, UMR CNRS 6249, Besançon, France
| | - Laurence Millon
- Laboratoire de Parasitologie-Mycologie, Centre hospitalier universitaire, Besançon, France.,Laboratoire Chrono-Environnement, Université Franche-Comté, UMR CNRS 6249, Besançon, France
| | - Ana Berceanu
- Service d'Hématologie, Centre Hospitalier Universitaire, Besançon, France
| | - Catherine Cordonnier
- Université Paris-Est-Créteil, Créteil, France.,Département d'Hématologie, APHP, Groupe Hospitalier Albert Chenevier-Henri Mondor, Creteil, France
| | - Jean-Marc Costa
- Laboratoire Cerba, Cergy-Pontoise, Saint-Ouen-l'Aumône, France.,Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe hospitalier Chenevier-Mondor, Créteil, France
| | - Stéphane Bretagne
- Laboratoire de Parasitologie-Mycologie, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, Paris, France.,Université Paris-Diderot, Sorbonne Cité, Paris, France.,Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycologie et Antifongiques, Paris, France.,CNRS URA3012, Paris, France
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Rocchi S, Reboux G, Larosa F, Scherer E, Daguindeau E, Berceanu A, Deconinck E, Millon L, Bellanger AP. Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home. Indoor Air 2014; 24:652-661. [PMID: 24621176 DOI: 10.1111/ina.12108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 03/06/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED Contrary to hospital exposure, little is known about the indoor fungal exposure of hematology patients at home. The aim of our study was to investigate the mold exposure of hematology patients both at home and at hospital to assess their invasive aspergillosis (IA) risk. Fungal exposure was assessed by quantifying opportunistic molds at hospital during hospitalization and in homes of 53 hematology patients. IA was diagnosed in 13 of 53 patients and invasive fungal infection (IFI) in one patient. In hospital, no opportunistic species, or low levels of opportunistic species, were found in 98% of weekly controls. Only 2% of hematology intensive care unit (ICU) controls showed a high level of Aspergillus fumigatus spores in corridor air. Five patients IA were hospitalized during these periods. Seven dwellings of 53 (5/14 dwellings of patients with IA/IFI and 2/39 dwellings of non-IA patients) had a percentage of A. fumigatus and Aspergillus flavus to total mold (significant predictor variable of IA/IFI in our study, general linear model, P-value = 0.02) as high as 15%. Maintaining a 'zero Aspergillus' goal at hospital is essential, and establishing specific and individually opportunistic mold monitoring at home could help to further reduce the IA risk through continuous surveillance. PRACTICAL IMPLICATIONS This study emphasizes the fact that preventive measures should not be aimed only at the hospital setting: among patients diagnosed with invasive aspergillosis/invasive fungal infection (IA/IFI), 5 of 14 (36%) were exposed to opportunistic fungal species at home exclusively. Moreover, four of these five patients were living in homes having the highest percentage of Aspergillus fumigatus and Aspergillus flavus (>15%), one of which had 48% of A. fumigatus. Therefore, our work supports the need for a counselor to carry out an environmental survey in patients’ homes.
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Affiliation(s)
- S Rocchi
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France
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Ojeda-Uribe M, Schneider A, Luquet I, Berceanu A, Cornillet-Lefebvre P, Jeandidier E, Lioure B, Ades L, Mauvieux L, Himberlin C. Therapy-related acute myeloid leukemia (t-AML) with poor-risk cytogenetics in two patients with persistent molecular complete remission of acute promyelocytic leukemia. Eur J Haematol 2012; 89:267-72. [DOI: 10.1111/j.1600-0609.2012.01805.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Mario Ojeda-Uribe
- Département d'Hématologie; Service d'Hématologie Clinique et Unité de Thérapie Cellulaire; Hôpital E. Muller; Mulhouse; France
| | | | | | - Ana Berceanu
- Département d'Oncologie-Hématologie; Hôpital Hautepierre; Strasbourg; France
| | | | | | - Bruno Lioure
- Département d'Oncologie-Hématologie; Hôpital Hautepierre; Strasbourg; France
| | - Lionel Ades
- Service d'Hématologie Clinique; CHU Avicenne; Assistance Publique-Hopitaux de Paris (AP-HP) Bobigny-Paris; France
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50
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Bay J, Cabrespine A, Faucher C, Tabrizi R, Bordigoni P, Berceanu A, Coiteux V, Renaud M, Mialou V, Robin M, Kuentz M, Chevallier P, Dhédin N, Huynh A, Garban F, Witz F, Buzyn A, De Revel T, Galambrun C, Deconinck E, Contentin N, François S, Gratecos N, Blaise D, Michallet M. Double Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Study from the SFGM-TC. Biol Blood Marrow Transplant 2012; 18:250-6. [DOI: 10.1016/j.bbmt.2011.06.015] [Citation(s) in RCA: 5] [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] [Received: 03/23/2011] [Accepted: 06/30/2011] [Indexed: 12/28/2022]
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