1
|
Mesa R, Verstovsek S, Platzbecker U, Gupta V, Lavie D, Giraldo P, Recher C, Kiladjian JJ, Oh ST, Gerds AT, Devos T, Passamonti F, Vannucchi AM, Egyed M, Lech-Maranda E, Pluta A, Nilsson L, Shimoda K, McLornan D, Kawashima J, Klencke B, Huang M, Strouse B, Harrison C. Clinical outcomes of patients with myelofibrosis after immediate transition to momelotinib from ruxolitinib. Haematologica 2024; 109:676-681. [PMID: 37259556 PMCID: PMC10828756 DOI: 10.3324/haematol.2023.283106] [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: 03/09/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Ruben Mesa
- Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston Salem, NC.
| | | | | | - Vikas Gupta
- Princess Margaret Cancer Centre, Toronto, Ontario
| | - David Lavie
- Hadassah-Hebrew University Medical Center, Jerusalem
| | - Pilar Giraldo
- Miguel Servet University Hospital and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Zaragoza
| | - Christian Recher
- Institut Universitaire du Cancer de Toulouse, Université de Toulouse III, Toulouse
| | - Jean-Jacques Kiladjian
- Université Paris Cité, AP-HP, Ho_pital Saint-Louis, Centre d'Investigations Cliniques, INSERM, CIC1427, Paris
| | - Stephen T Oh
- Washington University School of Medicine, St. Louis, MO
| | - Aaron T Gerds
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH
| | - Timothy Devos
- Department of Hematology, University Hospitals Leuven and Department of Microbiology and Immunology, Laboratory of Molecular Immunology (Rega Institute), KU Leuven, Leuven, Belgium
| | | | | | - Miklos Egyed
- Somogy County Mór Kaposi General Hospital, Kaposvár, Hungary
| | - Ewa Lech-Maranda
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Andrzej Pluta
- Department of Hematological Oncology, Oncology Specialist Hospital, Brzozow, Poland
| | - Lars Nilsson
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | | | | | | | | | - Mei Huang
- Sierra Oncology, Inc., San Mateo, CA
| | | | | |
Collapse
|
2
|
Andrews C, Pullarkat V, Recher C. CPX-351 in FLT3-mutated acute myeloid leukemia. Front Oncol 2023; 13:1271722. [PMID: 38044999 PMCID: PMC10691756 DOI: 10.3389/fonc.2023.1271722] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/31/2023] [Indexed: 12/05/2023] Open
Abstract
CPX-351, a dual-drug liposomal encapsulation of daunorubicin and cytarabine in a 1:5 molar ratio, is approved for the treatment of newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes. In a pivotal phase III trial, CPX-351 significantly improved overall survival compared with standard-of-care 7 + 3 chemotherapy (7 days cytarabine; 3 days daunorubicin) in adults aged 60-75 years with newly diagnosed high-risk or secondary AML (median = 9.56 months vs. 5.95 months; hazard ratio = 0.69; 95% confidence interval = 0.52-0.90; p = 0.003). Approximately 30% of patients with newly diagnosed AML have mutations in the FLT3 gene, which may be associated with poor outcomes. Here, we review the current in vitro, clinical, and real-world evidence on the use of CPX-351 in patients with AML and mutations in FLT3. Additionally, we review preliminary data from clinical trials and patient case reports that suggest the combination of CPX-351 with FLT3 inhibitors may represent another treatment option for patients with FLT3 mutation-positive AML.
Collapse
Affiliation(s)
- Claire Andrews
- Department of Haematology, St Vincent’s University Hospital, Dublin, Ireland
| | - Vinod Pullarkat
- Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Christian Recher
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| |
Collapse
|
3
|
Perl AE, Larson RA, Podoltsev NA, Strickland S, Wang ES, Atallah E, Schiller GJ, Martinelli G, Neubauer A, Sierra J, Montesinos P, Recher C, Yoon SS, Maeda Y, Hosono N, Onozawa M, Kato T, Kim HJ, Hasabou N, Nuthethi R, Tiu R, Levis MJ. Outcomes in Patients with FLT3-Mutated Relapsed/ Refractory Acute Myelogenous Leukemia Who Underwent Transplantation in the Phase 3 ADMIRAL Trial of Gilteritinib versus Salvage Chemotherapy. Transplant Cell Ther 2023; 29:265.e1-265.e10. [PMID: 36526260 PMCID: PMC10189888 DOI: 10.1016/j.jtct.2022.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/04/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022]
Abstract
The fms-like tyrosine kinase 3 (FLT3) inhibitor gilteritinib improved the survival of patients with relapsed or refractory (R/R) FLT3-mutated acute myelogenous leukemia (AML) in the phase 3 ADMIRAL trial. In this study, we assessed survival and relapse rates of patients in the ADMIRAL trial who underwent hematopoietic stem cell transplantation (HSCT), as well as safety outcomes in patients who received post-transplantation gilteritinib maintenance therapy. ADMIRAL was a global phase 3 randomized controlled trial that enrolled adult patients with FLT3-mutated R/R AML. Patients with R/R AML who harbored FLT3 internal tandem duplication mutations in the juxtamembrane domain or D835/I836 point mutations in the tyrosine kinase domain were randomized (2:1) to gilteritinib (120 mg/day) or to preselected high- or low-intensity salvage chemotherapy (1 or 2 cycles). Patients in the gilteritinib arm who proceeded to HSCT could receive post-transplantation gilteritinib maintenance therapy if they were within 30 to 90 days post-transplantation and had achieved composite complete remission (CRc) with successful engraftment and no post-transplantation complications. Adverse events (AEs) during HSCT were recorded in the gilteritinib arm only. Survival outcomes and the cumulative incidence of relapse were assessed in patients who underwent HSCT during the trial. Treatment-emergent AEs were evaluated in patients who restarted gilteritinib as post-transplantation maintenance therapy. Patients in the gilteritinib arm underwent HSCT more frequently than those in the chemotherapy arm (26% [n = 64] versus 15% [n = 19]). For all transplantation recipients, 12- and 24-month overall survival (OS) rates were 68% and 47%, respectively. Despite a trend toward longer OS after pretransplantation CRc, post-transplantation survival was comparable in the 2 arms. Patients who resumed gilteritinib after HSCT had a low relapse rate after pretransplantation CRc (20%) or CR (0%). The most common AEs observed with post-transplantation gilteritinib therapy were increased alanine aminotransferase level (45%), pyrexia (43%), and diarrhea (40%); grade ≥3 AEs were related primarily to myelosuppression. The incidences of grade ≥III acute graft-versus-host disease and related mortality were low. Post-transplantation survival was similar across the 2 study arms in the ADMIRAL trial, but higher remission rates with gilteritinib facilitated receipt of HSCT. Gilteritinib as post-transplantation maintenance therapy had a stable safety and tolerability profile and was associated with low relapse rates. Taken together, these data support a preference for bridging therapy with gilteritinib over chemotherapy in transplantation-eligible patients.
Collapse
Affiliation(s)
- Alexander E Perl
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Richard A Larson
- Division of the Biological Sciences, University of Chicago, Chicago, Illinois
| | - Nikolai A Podoltsev
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Stephen Strickland
- Department of Internal Medicine, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
| | - Eunice S Wang
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Ehab Atallah
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Gary J Schiller
- Division of Hematology and Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Giovanni Martinelli
- IRCCS Istituto Scientifico Romagnolo per lo Studio dei Tumori "Dino Amadori" IRST S.r.l, Meldola, Italy
| | | | - Jorge Sierra
- Hospital de la Santa Creu i Sant Pau and Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Pau Montesinos
- Department of Hematology, University Hospital La Fe, Valencia, Spain
| | - Christian Recher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
| | - Sung-Soo Yoon
- Department of Hemato Oncology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoshinobu Maeda
- Department of Hematology and Oncology, Okayama University Hospital, Okoyama, Japan
| | - Naoko Hosono
- Department of Internal Medicine, University of Fukui, Fukui, Japan
| | | | - Takayasu Kato
- Department of Hematology, University of Tsukuba, Tsukuba, Japan
| | - Hee-Je Kim
- Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | | | - Ramon Tiu
- Astellas Pharma US, Inc., Northbrook, Illinois
| | - Mark J Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
4
|
Pabst T, Vey N, Adès L, Bacher U, Bargetzi M, Fung S, Gaidano G, Gandini D, Hultberg A, Johnson A, Ma X, Müller R, Nottage K, Papayannidis C, Recher C, Riether C, Shah P, Tryon J, Xiu L, Ochsenbein AF. Results from a phase I/II trial of cusatuzumab combined with azacitidine in patients with newly diagnosed acute myeloid leukemia who are ineligible for intensive chemotherapy. Haematologica 2023:0. [PMID: 36779592 DOI: 10.3324/haematol.2022.281563] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Indexed: 02/11/2023] Open
Abstract
Cusatuzumab is a high-affinity, anti-CD70 monoclonal antibody under investigation in AML. This two-part, open-label, multicenter, phase I/II trial evaluated cusatuzumab plus azacitidine in patients with newly diagnosed AML ineligible for intensive chemotherapy. Patients received a single dose of cusatuzumab at one of four dose levels (1, 3, 10, or 20 mg/kg), 14 days before starting combination therapy. In phase I dose-escalation, cusatuzumab was then administered on days 3 and 17, in combination with azacitidine (75 mg/m2) on days 1-7, every 28 days. Primary objective in phase I was to determine the recommended phase II dose (RP2D) of cusatuzumab plus azacitidine. Phase II primary objective was efficacy at the RP2D (selected as 10 mg/kg). Thirty-eight patients enrolled: 12 in phase I (three per dose level; four with ELN adverse risk) and 26 in phase II (21 with adverse risk). Objective response (≥ partial remission) was achieved by 19/38 patients (including 8/26 in phase II); 14/38 achieved complete remission. Eleven patients (37.9%) achieved objective response among the 29 patients in phase I and phase II treated at the RP2D. At median follow-up of 10.9 months, median duration of first response was 4.5 months and median overall survival was 11.5 months. Most common treatment-emergent adverse events were infections (84.2%) and hematologic toxicities (78.9%). Seven patients (18.4%) reported infusion-related reactions, including two with grade 3 events. Thus, cusatuzumab/azacitidine appears generally well tolerated and shows preliminary efficacy in this setting. Investigation of cusatuzumab combined with current standard-of-care therapy, comprising venetoclax and azacitidine, is ongoing.
Collapse
Affiliation(s)
- Thomas Pabst
- Department of Medical Oncology, University Hospital, Inselspital and University of Bern, Bern.
| | - Norbert Vey
- Hématologie Clinique, Institut Paoli-Calmettes, Marseille
| | - Lionel Adès
- Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, and Centre d'Investigation Clinique (INSERM CIC 1427), Paris
| | - Ulrike Bacher
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern
| | - Mario Bargetzi
- Division of Hematology and Transfusion Medicine, Kantonsspital Aarau, Aarau
| | - Samson Fung
- Fung Consulting Healthcare and Life Sciences, Eching
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Maggiore Hospital, Novara
| | | | | | - Amy Johnson
- Janssen Research and Development, Spring House, PA
| | - Xuewen Ma
- Janssen Research and Development, Spring House, PA
| | - Rouven Müller
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich
| | | | - Cristina Papayannidis
- IRCCS, Azienda Ospedaliero Universitaria di Bologna, Istituto di Ematologia "L e A Seràgnoli", Bologna
| | - Christian Recher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France and Université Toulouse III Paul Sabatier, Toulouse
| | - Carsten Riether
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of BioMedical Research (DBMR), University of Bern, Bern
| | - Priya Shah
- Janssen RD, High Wycombe, Buckinghamshire
| | | | | | - Adrian F Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of BioMedical Research (DBMR), University of Bern, Bern
| |
Collapse
|
5
|
Pollyea DA, Pratz KW, Wei AH, Pullarkat V, Jonas BA, Recher C, Babu S, Schuh AC, Dail M, Sun Y, Potluri J, Chyla B, DiNardo CD. Outcomes in Patients with Poor-Risk Cytogenetics with or without TP53 Mutations Treated with Venetoclax and Azacitidine. Clin Cancer Res 2022; 28:5272-5279. [PMID: 36007102 PMCID: PMC9751752 DOI: 10.1158/1078-0432.ccr-22-1183] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [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: 04/20/2022] [Revised: 07/06/2022] [Accepted: 08/22/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE To evaluate efficacy and safety of venetoclax + azacitidine in treatment-naïve patients with acute myeloid leukemia harboring poor-risk cytogenetics and TP53mut or TP53wt. PATIENTS AND METHODS We analyzed data from a phase III study (NCT02993523) comparing venetoclax (400 mg orally days 1-28) + azacitidine (75 mg/m2 days 1-7) or placebo + azacitidine, and from a phase Ib study (NCT02203773) of venetoclax + azacitidine. Patients were ineligible for intensive therapy. TP53 status was analyzed centrally; cytogenetic studies were performed locally. RESULTS Patients (n = 127) with poor-risk cytogenetics receiving venetoclax + azacitidine (TP53wt = 50; TP53mut = 54) were compared with patients with poor-risk cytogenetics (n = 56) receiving azacitidine alone (TP53wt = 22; TP53mut = 18).For poor-risk cytogenetics + TP53wt patients, venetoclax + azacitidine versus azacitidine alone resulted in composite remission rates (CRc) of 70% versus 23%, median duration of remission (DoR) of 18.4 versus 8.5 months, and median overall survival (OS) of 23.4 versus 11.3 months, respectively. Outcomes with venetoclax + azacitidine were comparable with similarly treated patients with intermediate-risk cytogenetics and TP53wt.For poor-risk cytogenetics + TP53mut patients, venetoclax + azacitidine versus azacitidine alone resulted in CRc of 41% versus 17%, median DoR of 6.5 versus 6.7 months, and median OS of 5.2 versus 4.9 months, respectively.For poor-risk cytogenetics + TP53mut patients, predominant grade ≥3 adverse events (AE) for venetoclax + azacitidine versus azacitidine were febrile neutropenia (55%/39%), thrombocytopenia (28%/28%), neutropenia (26%/17%), anemia (13%/6%), and pneumonia (28%/33%). AEs were comparable between TP53mut and TP53wt patients. CONCLUSIONS In poor-risk cytogenetics + TP53mut patients, venetoclax + azacitidine improved remission rates but not DoR or OS compared with azacitidine alone. However, in poor-risk cytogenetics + TP53wt patients, venetoclax + azacitidine resulted in higher remission rates and longer DoR and OS than azacitidine alone, with outcomes comparable with similarly treated patients with intermediate-risk cytogenetics. Toxicities were similar in TP53mut and TP53wt patients. See related commentary by Green and Zeidner, p. 5235.
Collapse
Affiliation(s)
- Daniel A. Pollyea
- Division of Hematology, School of Medicine, University of Colorado, Aurora, Colorado.,Corresponding Author: Daniel A. Pollyea, University of Colorado, 1665 Aurora Court, Mail Stop F754, Aurora, CO 80045. E-mail:
| | - Keith W. Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Andrew H. Wei
- Department of Clinical Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital and Division of Blood Cells and Blood Cancer, Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation and Gehr Family Center for Leukemia Research, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Brian A. Jonas
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, California
| | | | - Sunil Babu
- Fort Wayne Medical Oncology and Hematology, Fort Wayne, Indiana
| | - Andre C. Schuh
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Yan Sun
- AbbVie Inc., North Chicago, Illinois
| | | | | | - Courtney D. DiNardo
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
6
|
Duployez N, Largeaud L, Duchmann M, Kim R, Rieunier J, Lambert J, Bidet A, Larcher L, Lemoine J, Delhommeau F, Hirsch P, Fenwarth L, Kosmider O, Decroocq J, Bouvier A, Le Bris Y, Ochmann M, Santagostino A, Adès L, Fenaux P, Thomas X, Micol JB, Gardin C, Itzykson R, Soulier J, Clappier E, Recher C, Preudhomme C, Pigneux A, Dombret H, Delabesse E, Sébert M. Prognostic impact of DDX41 germline mutations in intensively treated acute myeloid leukemia patients: an ALFA-FILO study. Blood 2022; 140:756-768. [PMID: 35443031 PMCID: PMC9389637 DOI: 10.1182/blood.2021015328] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022] Open
Abstract
DDX41 germline mutations (DDX41MutGL) are the most common genetic predisposition to myelodysplastic syndrome and acute myeloid leukemia (AML). Recent reports suggest that DDX41MutGL myeloid malignancies could be considered as a distinct entity, even if their specific presentation and outcome remain to be defined. We describe here the clinical and biological features of 191 patients with DDX41MutGL AML. Baseline characteristics and outcome of 86 of these patients, treated with intensive chemotherapy in 5 prospective Acute Leukemia French Association/French Innovative Leukemia Organization trials, were compared with those of 1604 patients with DDX41 wild-type (DDX41WT) AML, representing a prevalence of 5%. Patients with DDX41MutGL AML were mostly male (75%), in their seventh decade, and with low leukocyte count (median, 2 × 109/L), low bone marrow blast infiltration (median, 33%), normal cytogenetics (75%), and few additional somatic mutations (median, 2). A second somatic DDX41 mutation (DDX41MutSom) was found in 82% of patients, and clonal architecture inference suggested that it could be the main driver for AML progression. DDX41MutGL patients displayed higher complete remission rates (94% vs 69%; P < .0001) and longer restricted mean overall survival censored at hematopoietic stem cell transplantation (HSCT) than 2017 European LeukemiaNet intermediate/adverse (Int/Adv) DDX41WT patients (5-year difference in restricted mean survival times, 13.6 months; P < .001). Relapse rates censored at HSCT were lower at 1 year in DDX41MutGL patients (15% vs 44%) but later increased to be similar to Int/Adv DDX41WT patients at 3 years (82% vs 75%). HSCT in first complete remission was associated with prolonged relapse-free survival (hazard ratio, 0.43; 95% confidence interval, 0.21-0.88; P = .02) but not with longer overall survival (hazard ratio, 0.77; 95% confidence interval, 0.35-1.68; P = .5).
Collapse
Affiliation(s)
- Nicolas Duployez
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | - Laëtitia Largeaud
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Matthieu Duchmann
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Rathana Kim
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Julie Rieunier
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | | | - Audrey Bidet
- Hematology Laboratory, CHU de Bordeaux, Bordeaux, France
| | - Lise Larcher
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean Lemoine
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - François Delhommeau
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Laboratoire d'hématologie biologique, Hôpital Saint-Antoine, Paris, France
| | - Pierre Hirsch
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Laboratoire d'hématologie biologique, Hôpital Saint-Antoine, Paris, France
| | - Laurène Fenwarth
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | | | | | - Anne Bouvier
- Hematology Laboratory, CHU Angers, Angers, France
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | | | | | - Lionel Adès
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Pierre Fenaux
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Xavier Thomas
- Hematology Department, Hospices Civils de Lyon, Lyon-Sud Hospital, Lyon, France
| | - Jean-Baptiste Micol
- Hematology Department, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Claude Gardin
- Hematology Department, Avicenne Hospital, AP-HP, Bobigny, France
- Unité 3518, Saint-Louis Institute for Research, Université de Paris, Paris, France
| | - Raphael Itzykson
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Jean Soulier
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Emmanuelle Clappier
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France; and
| | - Claude Preudhomme
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | - Arnaud Pigneux
- Hematology Department, CHU de Bordeaux, Bordeaux, France
| | - Hervé Dombret
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
- Unité 3518, Saint-Louis Institute for Research, Université de Paris, Paris, France
| | - Eric Delabesse
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Marie Sébert
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| |
Collapse
|
7
|
Konopleva M, Thirman MJ, Pratz KW, Garcia JS, Recher C, Pullarkat V, Kantarjian HM, DiNardo CD, Dail M, Duan Y, Chyla B, Potluri J, Miller CL, Wei AH. Impact of FLT3 Mutation on Outcomes after Venetoclax and Azacitidine for Patients with Treatment-Naïve Acute Myeloid Leukemia. Clin Cancer Res 2022; 28:2744-2752. [PMID: 35063965 PMCID: PMC9365380 DOI: 10.1158/1078-0432.ccr-21-3405] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [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: 09/29/2021] [Revised: 11/22/2021] [Accepted: 01/19/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate efficacy and safety of venetoclax + azacitidine among treatment-naïve patients with FLT3-mutant acute myeloid leukemia. PATIENTS AND METHODS Data were pooled from patients enrolled in a phase III study (NCT02993523) that compared patients treated with venetoclax + azacitidine or placebo + azacitidine and a prior phase Ib study (NCT02203773) where patients were treated with venetoclax + azacitidine. Enrolled patients were ineligible for intensive therapy due to age ≥75 years and/or comorbidities. Patients on venetoclax + azacitidine received venetoclax 400 mg orally (days 1-28) and azacitidine (75 mg/m2; days 1-7/28-day cycle). FLT3 mutation was analyzed centrally on pretreatment bone marrow aspirates. RESULTS In the biomarker evaluable population, FLT3 mutation was detected in 42 (15%) and 22 (19%) patients in the venetoclax + azacitidine and azacitidine groups. Composite complete remission [CRc; complete remission (CR) + CR with incomplete hematologic recovery (CRi)] rates (venetoclax + azacitidine/azacitidine) for FLT3-mutant patients were 67%/36%, median duration of remission (DoR) was 17.3/5.0 months, and median OS was 12.5/8.6 months. The CRc rates among FLT3 wild-type patients were 67%/25%, median DoR 18.4/13.4 months, and median OS 14.7/10.1 months. In patients treated with venetoclax + azacitidine, CRc in patients with FLT3-ITD and FLT3-TKD was 63% and 77% and median OS was 9.9 and 19.2 months, and in comutated FLT3-ITD + NPM1 patients, CRc was 70%, median DoR was not reached, and median OS was 9.1 months. There were no unexpected toxicities in the venetoclax + azacitidine group. CONCLUSIONS When treated with venetoclax + azacitidine, patients with FLT3 mutations and FLT3 wild-type had similar outcomes. Future analyses in larger patient populations may further define the impact of venetoclax + azacitidine in patients harboring FLT3-ITD. See related commentary by Perl and Vyas, p. 2719.
Collapse
Affiliation(s)
- Marina Konopleva
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.,Corresponding Author: Marina Konopleva, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 428, Houston, TX 77030. Phone: 713-794-1628; E-mail:
| | - Michael J. Thirman
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago Medicine, Chicago, Illinois
| | - Keith W. Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacqueline S. Garcia
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation and Gehr Family Center for Leukemia Research, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Hagop M. Kantarjian
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Courtney D. DiNardo
- Department of Leukemia, Division of Cancer Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | - Andrew H. Wei
- Department of Hematology, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
8
|
Dohner H, Montesinos P, Vives Polo S, Zarzycka E, Wang J, Bertani G, Heuser M, Calado RT, Schuh AC, Yeh SP, de la Fuente Burguera A, Cerchione C, Daigle S, Hui J, Pandya SS, Gianolio DA, Recher C, De Botton S. Hematologic improvements with ivosidenib + azacitidine compared to placebo + azacitidine in patients with newly diagnosed acute myeloid leukemia. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7042] [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] [Indexed: 11/20/2022] Open
Abstract
7042 Background: Ivosidenib (IVO) is a potent oral targeted inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1). IVO plus azacitidine (AZA) significantly improved event-free survival (EFS), overall survival and complete remission + partial hematologic recovery rates compared with placebo (PBO) + AZA, in patients (pts) with newly diagnosed IDH1-mutant acute myeloid leukemia (AML) in the Phase 3 AGILE trial (NCT03173248). Here we report blood count recovery results from the AGILE trial. Methods: Pts were randomized 1:1 to IVO 500 mg QD + AZA 75 mg/m2 SC or IV for 7 days in 28-day cycles (n = 72), or PBO+AZA (n = 74). Red blood cell (RBC)/platelet transfusion history were assessed at screening and follow-up. Bone marrow (BM) and peripheral blood samples were obtained at screening, and during weeks 9, 17, 25, 33, 41, 53, and every 24 weeks thereafter, and at end of treatment and during EFS follow up. Samples were analyzed at each local site according to ICSH guidelines. Results: In the IVO+AZA and PBO+AZA arms, 4.2% and 5.5% of pts, respectively, received concomitant granulocyte colony-stimulating factor. Hemoglobin levels steadily increased from baseline at a similar rate in both treatment arms. Mean platelet count recovered from baseline values in the IVO+AZA and PBO+AZA arms (71.0 and 92.6 x 109/L, respectively) as early as week 9 of treatment (171.1 and 155.1 x 109/L, respectively) and continued to steadily increase thereafter in the treated population. In pts receiving IVO+AZA, mean neutrophil counts rapidly increased from baseline (0.99 x 109/L) to week 2 (2.05 x 109/L) and week 5 (4.07 x 109/L), and then generally stabilized to within the normal range to study end (last available cycle value; ̃2.0 x 109/L). Mean neutrophil counts initially declined with PBO+AZA before slowly recovering to near-normal levels after 36-40 weeks. The increased blood counts were accompanied by a rapid decrease in the mean BM blast percentage from 54.8% at baseline to 12.0% and 7.2% at week 9 and 17, respectively, in IVO+AZA treated patients and were maintained for 149 weeks. The decline in BM blasts was slower in the PBO+AZA arm (53.7%, 34.6% and 19.6% at baseline, week 9 and week 17, respectively). Among patients who were RBC/platelet transfusion-dependent at baseline (̃54.0% in both groups), 46.2% in the IVO+AZA group achieved RBC/platelet transfusion independence compared with 17.5% in the PBO+AZA arm (1-sided p = 0.0032). Additionally, fewer adverse events of febrile neutropenia (28.2% vs 34.2%) and infections (28.2% vs 49.3%) were reported in the IVO+AZA arm compared to the PBO+AZA arm. Conclusions: IVO+AZA demonstrated a significant clinical benefit compared with PBO+AZA and this sub-analysis demonstrated a rapidly improved recovery of blood counts and a reduced dependence on RBC and/or platelet transfusion. Moreover, rates of febrile neutropenia and infections were reduced with IVO+AZA. Clinical trial information: NCT03173248.
Collapse
Affiliation(s)
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Ewa Zarzycka
- Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland
| | | | - Giambattista Bertani
- ASST Grande Ospedale Metropolitano Niguarda–Presidio Ospedaliero Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Rodrigo T. Calado
- Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Su-Peng Yeh
- China Medical University Hospital, Taichung, Taiwan
| | | | - Claudio Cerchione
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | | | | | - Christian Recher
- Institut Universitaire du Cancer Toulouse–Oncopole, Toulouse, France
| | | |
Collapse
|
9
|
Schuh AC, De Botton S, Recher C, Vives Polo S, Zarzycka E, Wang J, Bertani G, Heuser M, Calado RT, Yeh SP, Hui J, Pandya SS, Gianolio DA, Chamberlain CX, Dohner H, Montesinos P. Changes in health-related quality of life in patients with newly diagnosed acute myeloid leukemia receiving ivosidenib + azacitidine or placebo + azacitidine. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e19024] [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] [Indexed: 11/20/2022] Open
Abstract
e19024 Background: Ivosidenib (IVO) is a potent, targeted inhibitor of mutant isocitrate dehydrogenase 1 (mIDH1) that is approved for acute myeloid leukemia (AML). IVO plus azacitidine (AZA) demonstrated clinical benefit compared with placebo (PBO) and AZA in the AGILE study (NCT03173248), and here we report the impact of IVO+AZA versus PBO+AZA on health-related quality of life (HRQoL). Methods: In the double-blind, PBO-controlled phase 3 AGILE study, patients (pts) were randomized 1:1 to IVO 500 mg QD + AZA 75 mg/m2 SC or IV for 7 days in 28-day cycles, or PBO+AZA. HRQoL was a secondary endpoint assessed using two validated questionnaires: the European Organisation of Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and the EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L). Questionnaires were administered pre-dose on cycle (C) 1 Day (D) 1, on C1D15, C2D1, C2D15, and on D1 of every odd cycle thereafter until the end of treatment. Score change from baseline across visits for all subscales of EORTC QLQ-C30 was analyzed with mixed models. A 10-point threshold in EORTC QLQ-C30 subscale score was used to evaluate clinically meaningful changes from baseline or differences between arms. Two-sided nominal p-values are reported. Results: At baseline, 69 and 68 pts out of 72 receiving IVO+AZA completed the EORTC QLQ-C30 and EQ-5D-5L, respectively, and 66 pts out of 74 receiving PBO+AZA completed both. Mean baseline HRQoL scores were similar between treatment arms. There was an initial decline in HRQoL (EORTC QLQ-C30 global health status [GHS/QoL]) in both arms for ̃4 months, consistent with time to response, and which was generally not clinically meaningful. IVO+AZA was associated with preserved or improved HRQoL compared to baseline for most subscales of the EORTC QLQ-C30 from C5 to C19 (after which no PBO+AZA HRQoL data were available), and at most timepoints for EQ-5D-5L VAS scores and index values. EORTC QLQ-C30 subscales with clinically meaningful improvements from baseline at most timepoints from C5 to C19 in the IVO+AZA arm included GHS/QoL, fatigue, pain and appetite loss. In contrast, there were few clinically meaningful improvements from baseline in PBO+AZA pts. GHS/QoL scores were significantly improved (p≤0.05) for IVO+AZA versus PBO+AZA at C2D1, C2D15, C7 and C9, and differences were clinically meaningful at C2D1 (10.2 point difference), C2D15 (10.1), C7 (12.6), C9 (22.6), C13 (14.9), C15 (15.4) and C19 (19.2). Likewise, improvements in EORTC QLQ-C30 fatigue, appetite loss, nausea and vomiting, diarrhea, cognitive functioning and social functioning favored IVO+AZA over PBO+AZA at multiple timepoints. Conclusions: Data from the AGILE study show that patients with mIDH1 AML receiving treatment with IVO+AZA tended to report maintenance or improved HRQoL from cycle 5 through to cycle 19 compared with PBO+AZA. Clinical trial information: NCT03173248.
Collapse
Affiliation(s)
- Andre C. Schuh
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | | | | | | | - Ewa Zarzycka
- Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland
| | | | - Giambattista Bertani
- ASST Grande Ospedale Metropolitano Niguarda–Presidio Ospedaliero Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Rodrigo T. Calado
- Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Su-Peng Yeh
- China Medical University Hospital, Taichung, Taiwan
| | | | | | | | | | | | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| |
Collapse
|
10
|
De Botton S, Choe S, Marchione DM, Montesinos P, Recher C, Vives Polo S, Zarzycka E, Wang J, Bertani G, Heuser M, Calado RT, Schuh AC, Yeh SP, Hui J, Pandya SS, Gianolio DA, Daigle S, Dinardo CD, Dohner H. Molecular characterization of clinical response in patients with newly diagnosed acute myeloid leukemia treated with ivosidenib + azacitidine compared to placebo + azacitidine. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7019] [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] [Indexed: 11/20/2022] Open
Abstract
7019 Background: Acute myeloid leukemia (AML) is a disease with a dynamic mutational landscape; 6–10% of patients (pts) have somatic mutations in isocitrate dehydrogenase 1 ( IDH1), which can drive oncogenesis. Ivosidenib (IVO) is a potent oral targeted inhibitor of mutant IDH1 (mIDH1). IVO 500 mg QD + azacitidine (AZA) 75 mg/m2 SC or IV for 7 days in 28-day cycles was shown to significantly improve event-free survival (HR = 0.33 [95% CI 0.16, 0.69], p = 0.0011), median overall survival (24.0 vs 7.9 months), and complete remission + partial hematologic recovery rates (CR/CRh; 52.8% vs 17.6%) vs placebo (PBO) + AZA in the double-blind phase 3 AGILE study (NCT03173248) in pts with newly diagnosed IDH1-mutated AML (ND-AML). IDH1-mutation clearance ( IDH1-MC) and baseline co-mutation analysis from AGILE is reported. Methods: Genomic DNA from bone marrow mononuclear cells (BMMCs) or peripheral blood mononuclear cells (PBMCs), and/or bone marrow aspirate (BMA) were used for molecular studies. IDH1-MC analysis on BMMCs was performed by BEAMing digital PCR (limit of detection 0.02%-0.04%). BMA, BMMCs and PBMCs were utilized for co-mutational analysis by next-generation sequencing, ACE Extended Cancer Panel (detection limit 2%). Results: 146 pts were randomized: 72 to IVO+AZA; 74 to PBO+AZA. Median (range) baseline m IDH1 variant allele frequency in BMMCs was 36.7% (3.1–50.5) in the IVO+AZA arm and 35.5% (3.0–48.6) in the PBO+AZA arm. Updated IDH1-MC data (October 2021) from 47 IVO+AZA and 32 PBO+AZA treated pts with at least 1 on-treatment sample demonstrated IDH1-MC in 21/35 (60%) IVO+AZA pts achieving CR/CRh vs 4/11 (36%) PBO+AZA pts. In CR/CRh pts with time points available after IDH1-MC, suppression of the m IDH1 was durable and IDH1-MC maintained in all subsequent samples in 17/17 (100%) IVO+AZA treated pts and 1/3 (33%) PBO+AZA pts. Further analysis of baseline co-mutations on 120 pts (IVO+AZA: n = 58; PBO+AZA: n = 62) showed that DNMT3A, SRSF2, and RUNX1 were the most frequent in both treatment arms. Importantly, comparison of CR/CRh and non CR/CRh responses by cohort did not identify any single gene or pathway associated with an inferior outcome in IVO+AZA pts compared to PBO+AZA pts (p < 0.05, Fisher’s Exact test). Several genes ( DNMT3A, RUNX1, SRSF2, STAG2) and pathways (Differentiation, Epigenetics, Splicing) were associated with improved outcomes with IVO+AZA, including the RTK pathway, which was previously reported to be associated with primary resistance to IVO monotherapy. Further analysis of patient subgroups, including R132 variants (i.e., R132C vs R132S), will be presented. Conclusions: These data suggest that improved clinical outcomes with IVO+AZA are associated with sustained clearance of the m IDH1 clone including pts with disease that harbor mutations implicated in resistance to IVO monotherapy (e.g., with RTK pathway mutations). Clinical trial information: NCT03173248.
Collapse
Affiliation(s)
| | - Sung Choe
- Servier Pharmaceuticals LLC, Boston, MA
| | | | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Christian Recher
- Institut Universitaire du Cancer Toulouse–Oncopole, Toulouse, France
| | | | - Ewa Zarzycka
- Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland
| | | | - Giambattista Bertani
- ASST Grande Ospedale Metropolitano Niguarda–Presidio Ospedaliero Ospedale Niguarda Ca' Granda, Milan, Italy
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Rodrigo T. Calado
- Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Su-Peng Yeh
- China Medical University Hospital, Taichung, Taiwan
| | | | | | | | | | | | | |
Collapse
|
11
|
Perl AE, Hosono N, Montesinos P, Podoltsev N, Martinelli G, Panoskaltsis N, Recher C, Smith CC, Levis MJ, Strickland S, Röllig C, Groß-Langenhoff M, Chou WC, Lee JH, Yokoyama H, Hasabou N, Lu Q, Tiu RV, Altman JK. Clinical outcomes in patients with relapsed/refractory FLT3-mutated acute myeloid leukemia treated with gilteritinib who received prior midostaurin or sorafenib. Blood Cancer J 2022; 12:84. [PMID: 35637252 PMCID: PMC9151663 DOI: 10.1038/s41408-022-00677-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 12/10/2021] [Revised: 04/15/2022] [Accepted: 05/09/2022] [Indexed: 12/17/2022] Open
Abstract
The fms-like tyrosine kinase 3 (FLT3) inhibitor gilteritinib is indicated for relapsed or refractory (R/R) FLT3-mutated acute myeloid leukemia (AML), based on its observed superior response and survival outcomes compared with salvage chemotherapy (SC). Frontline use of FLT3 tyrosine kinase inhibitors (TKIs) midostaurin and sorafenib may contribute to cross-resistance to single-agent gilteritinib in the R/R AML setting but has not been well characterized. To clarify the potential clinical impact of prior TKI use, we retrospectively compared clinical outcomes in patients with R/R FLT3-mutated AML in the CHRYSALIS and ADMIRAL trials who received prior midostaurin or sorafenib against those without prior FLT3 TKI exposure. Similarly high rates of composite complete remission (CRc) were observed in patients who received a FLT3 TKI before gilteritinib (CHRYSALIS, 42%; ADMIRAL, 52%) and those without prior FLT3 TKI therapy (CHRYSALIS, 43%; ADMIRAL, 55%). Among patients who received a prior FLT3 TKI in ADMIRAL, a higher CRc rate (52%) and trend toward longer median overall survival was observed in the gilteritinib arm versus the SC arm (CRc = 20%; overall survival, 5.1 months; HR = 0.602; 95% CI: 0.299, 1.210). Remission duration was shorter with prior FLT3 TKI exposure. These findings support gilteritinib for FLT3-mutated R/R AML after prior sorafenib or midostaurin.
Collapse
Affiliation(s)
- Alexander E Perl
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
| | | | - Pau Montesinos
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Giovanni Martinelli
- Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" IRST S. r. l, Meldola, Italy
| | - Nicki Panoskaltsis
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Mark J Levis
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | | | - Je-Hwan Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hisayuki Yokoyama
- Sendai Medical Center, National Hospital Organization, Sendai, Japan.,Tohoku University, National Hospital Organization, Sendai, Japan
| | | | | | | | - Jessica K Altman
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
12
|
Jonas BA, Wei AH, Recher C, DiNardo CD, Jang J, Pratz K, Panayiotidis P, Montesinos P, Yeh S, Ivanov V, Fiedler W, Yamauchi T, Duan Y, Mendes W, Potluri J, Tews B, Ofran Y. Timing of response with venetoclax combination treatment in patients with newly diagnosed acute myeloid leukemia. Am J Hematol 2022; 97:E299-E303. [PMID: 35567776 PMCID: PMC9542845 DOI: 10.1002/ajh.26600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/08/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Brian A. Jonas
- Department of Internal Medicine, Division of Hematology and Oncology University of California Davis School of Medicine Sacramento CA USA
| | - Andrew H. Wei
- Department of Hematology The Alfred Hospital and Monash University Melbourne Australia
| | - Christian Recher
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse Toulouse France
- Université Toulouse III Paul Sabatier Toulouse France
| | - Courtney D. DiNardo
- Department of Leukemia The University of Texas MD Anderson Cancer Center Houston TX USA
| | - Jun‐Ho Jang
- Department of Hematology‐Oncology, Samsung Medical Center Sungkyunkwan University School of Medicine Seoul South Korea
| | - Keith Pratz
- Department of Medicine University of Pennsylvania Philadelphia PA USA
| | - Panayiotis Panayiotidis
- National and Kapodistrian University of Athens, Haematology Department and Bone Marrow Transplantation Unit, Laikon General Hospital Athens Greece
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Su‐Peng Yeh
- Division of Hematology and Oncology, Department of Internal Medicine China Medical University Hospital Taichung Taiwan
| | - Vladimir Ivanov
- Almazov National Medical Research Center Saint Petersburg Russia
| | - Walter Fiedler
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section Pneumology University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Takahiro Yamauchi
- Department of Hematology and Oncology University of Fukui Hospital Fukui Japan
| | | | | | | | | | - Yishai Ofran
- Department of Hematology, Shaare Zedek Medical Center, Faculty of Medicine Hebrew University of Jerusalem Jerusalem Israel
| |
Collapse
|
13
|
Montesinos P, Recher C, Vives S, Zarzycka E, Wang J, Bertani G, Heuser M, Calado RT, Schuh AC, Yeh SP, Daigle SR, Hui J, Pandya SS, Gianolio DA, de Botton S, Döhner H. Ivosidenib and Azacitidine in IDH1-Mutated Acute Myeloid Leukemia. N Engl J Med 2022; 386:1519-1531. [PMID: 35443108 DOI: 10.1056/nejmoa2117344] [Citation(s) in RCA: 164] [Impact Index Per Article: 82.0] [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: 12/12/2022]
Abstract
BACKGROUND The combination of ivosidenib - an inhibitor of mutant isocitrate dehydrogenase 1 (IDH1) - and azacitidine showed encouraging clinical activity in a phase 1b trial involving patients with newly diagnosed IDH1-mutated acute myeloid leukemia. METHODS In this phase 3 trial, we randomly assigned patients with newly diagnosed IDH1-mutated acute myeloid leukemia who were ineligible for intensive induction chemotherapy to receive oral ivosidenib (500 mg once daily) and subcutaneous or intravenous azacitidine (75 mg per square meter of body-surface area for 7 days in 28-day cycles) or to receive matched placebo and azacitidine. The primary end point was event-free survival, defined as the time from randomization until treatment failure (i.e., the patient did not have complete remission by week 24), relapse from remission, or death from any cause, whichever occurred first. RESULTS The intention-to-treat population included 146 patients: 72 in the ivosidenib-and-azacitidine group and 74 in the placebo-and-azacitidine group. At a median follow-up of 12.4 months, event-free survival was significantly longer in the ivosidenib-and-azacitidine group than in the placebo-and-azacitidine group (hazard ratio for treatment failure, relapse from remission, or death, 0.33; 95% confidence interval [CI], 0.16 to 0.69; P = 0.002). The estimated probability that a patient would remain event-free at 12 months was 37% in the ivosidenib-and-azacitidine group and 12% in the placebo-and-azacitidine group. The median overall survival was 24.0 months with ivosidenib and azacitidine and 7.9 months with placebo and azacitidine (hazard ratio for death, 0.44; 95% CI, 0.27 to 0.73; P = 0.001). Common adverse events of grade 3 or higher included febrile neutropenia (28% with ivosidenib and azacitidine and 34% with placebo and azacitidine) and neutropenia (27% and 16%, respectively); the incidence of bleeding events of any grade was 41% and 29%, respectively. The incidence of infection of any grade was 28% with ivosidenib and azacitidine and 49% with placebo and azacitidine. Differentiation syndrome of any grade occurred in 14% of the patients receiving ivosidenib and azacitidine and 8% of those receiving placebo and azacitidine. CONCLUSIONS Ivosidenib and azacitidine showed significant clinical benefit as compared with placebo and azacitidine in this difficult-to-treat population. Febrile neutropenia and infections were less frequent in the ivosidenib-and-azacitidine group than in the placebo-and-azacitidine group, whereas neutropenia and bleeding were more frequent in the ivosidenib-and-azacitidine group. (Funded by Agios Pharmaceuticals and Servier Pharmaceuticals; AGILE ClinicalTrials.gov number, NCT03173248.).
Collapse
Affiliation(s)
- Pau Montesinos
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Christian Recher
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Susana Vives
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Ewa Zarzycka
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Jianxiang Wang
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Giambattista Bertani
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Michael Heuser
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Rodrigo T Calado
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Andre C Schuh
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Su-Peng Yeh
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Scott R Daigle
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Jianan Hui
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Shuchi S Pandya
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Diego A Gianolio
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Stephane de Botton
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Hartmut Döhner
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| |
Collapse
|
14
|
Pratz KW, Panayiotidis P, Recher C, Wei X, Jonas BA, Montesinos P, Ivanov V, Schuh AC, DiNardo CD, Novak J, Pejsa V, Stevens D, Yeh SP, Kim I, Turgut M, Fracchiolla N, Yamamoto K, Ofran Y, Wei AH, Bui CN, Benjamin K, Kamalakar R, Potluri J, Mendes W, Devine J, Fiedler W. Venetoclax combinations delay the time to deterioration of HRQoL in unfit patients with acute myeloid leukemia. Blood Cancer J 2022; 12:71. [PMID: 35443742 PMCID: PMC9021259 DOI: 10.1038/s41408-022-00668-8] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/24/2022] [Accepted: 04/01/2022] [Indexed: 12/17/2022] Open
Abstract
Phase 3 trials Viale-A and Viale-C evaluated health-related quality of life (HRQoL) in patients with AML unfit for intensive chemotherapy who received venetoclax (VEN) + (AZA) (Viale-A) or low-dose cytarabine (LDAC) (Viale-C) or placebo (PBO) + AZA or LDAC. Patient-reported outcomes included: EORTC QLQ-C30 global health status (GHS/QoL) and physical functioning (PF), PROMIS Cancer Fatigue Short Form 7a (Fatigue), and EQ-5D-5L health status visual analog scale (HS-VAS). Time to deterioration (TTD), defined as worsening from baseline in meaningful change thresholds (MCT) of ≥10, 5, or 7 points for GHS/QoL or PF, fatigue, and HS-VAS, respectively, was assessed; differences between groups were analyzed using Kaplan-Meier and unadjusted log-rank analyses. VEN + AZA vs PBO + AZA patients had longer TTD in GHS/QoL (P = 0.066) and fatigue (P = 0.189), and significantly longer TTD in PF (P = 0.028) and HS-VAS (P < 0.001). VEN + LDAC vs PBO + LDAC patients had significantly longer TTD in GHS/QoL (P = 0.011), PF (P = 0.020), and fatigue (P = 0.004), and a trend in HS-VAS (P = 0.057). Approximately 43%, 35%, 32%, and 18% of patients treated with VEN + AZA, AZA + PBO, VEN + LDAC, or LDAC + PBO, respectively, saw improvements >MCT in GHS/QoL. Overall, VEN may positively impact HRQoL in patients with AML ineligible for intensive chemotherapy, leading to longer preservation of functioning and overall health status.
Collapse
Affiliation(s)
- Keith W Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
| | - Panayiotis Panayiotidis
- National and Kapodistrian University of Athens Medical School, Laiko General Hospital, Athens, Greece
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
| | - Xudong Wei
- The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China
| | - Brian A Jonas
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Pau Montesinos
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vladimir Ivanov
- Almazov National Medical Research Center, Saint Petersburg, Russian Federation
| | - Andre C Schuh
- Princess Margaret Cancer Centre and University of Toronto, Toronto, ON, Canada
| | - Courtney D DiNardo
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jan Novak
- Department of Internal Medicine and Hematology, University Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vlatko Pejsa
- Department of Hematology, University Hospital Dubrava, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Don Stevens
- Norton Cancer Institute, Louisville, KY, USA
| | - Su-Peng Yeh
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Inho Kim
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Mehmet Turgut
- Department of Internal Medicine, Division of Hematology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Nicola Fracchiolla
- Hematology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| | - Yishai Ofran
- Department of Hematology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Andrew H Wei
- Australian Center for Blood Diseases, The Alfred Hospital and Monash University, Melbourne, Australia
| | | | | | | | | | | | | | - Walter Fiedler
- Department of Oncology, Hematology and Bone Marrow Transplantation With Section Pneumology, Hubertus Wald University Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
15
|
Adès L, Duployez N, Guerci-Bresler A, Laribi K, Peterlin P, Vey N, Thepot S, Wickenhauser S, Zerazhi H, Stamatoullas A, Wattel E, Recher C, Toma A, Dimicoli-Salazar S, Braun T, Beyne-Rauzy O, Marolleau JP, Cheze S, Park S, Cluzeau T, Nimubona S, Bordessoule D, Benramdane R, Quesnel B, Amé S, de Botton S, Chermat F, Preudhomme C, Chevret S, Fenaux P. A randomised phase II study of azacitidine (AZA) alone or with Lenalidomide (LEN), Valproic acid (VPA) or Idarubicin (IDA) in higher-Risk MDS or low blast AML: GFM's "pick a winner" trial, with the impact of somatic mutations. Br J Haematol 2022; 198:535-544. [PMID: 35438802 DOI: 10.1111/bjh.18193] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 02/03/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022]
Abstract
In order to improve the outcome observed with azacitidine (AZA) in higher-risk Myelodysplastic syndrome (MDS), its combination with other drugs in MDS must be evaluated. So far, no combination has not been shown to be more effective than AZA alone. AZA-PLUS was a phase II trial that, in a "pick a winner" approach, randomly assigned patients with higher-risk MDS, CMML and low blast count AML to: AZA; AZA plus lenalidomide; AZA plus Valproic Acid or AZA plus Idarubicin. 322 patients were included. After six cycles, 69 (21.4%) CR + PR were observed with no benefit from any combination. Median EFS and OS were 17.2 and 19.7 months in the whole cohort, respectively, with no difference across randomised arms. Infection and rates of hospitalisation during the first six cycles were higher in the AZA-LEN And AZA-IDA arm, related to increased myelosuppression. Factors associated with better response were IPSS, favourable or intermediate karyotype, haemoglobin, lower circulating blast count, fibrinogen level and lower LDH, while poorer survival was seen in therapy-related MDS and, in the case of TP53, PTPN11 or CSF3R mutation. The combinations used did not improve the outcome obtained with AZA alone. However, our "pick a winner" randomised strategy may remain useful with potentially more active drugs to be tested in combination with AZA.
Collapse
Affiliation(s)
- Lionel Adès
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| | - Nicolas Duployez
- Lille University Hospital, Lille and INSERM UMR-S 1277, Lille, France
| | | | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Sylvain Thepot
- Hematology Department, Angers University Hospital, Angers, France
| | | | - Hacene Zerazhi
- Hematology Department, Centre Hospitalier d'Avignon, Avignon, Fran, France
| | | | - Eric Wattel
- Hematology Department, Lyon University Hospital, Lyon, France
| | - Christian Recher
- Hematology Department, Toulouse University Hospital, Toulouse, France
| | - Andrea Toma
- Hematology Department, Creteil, University Hospital, Creteil, France
| | | | - Thorsten Braun
- Hematology Department, Hôpital Avicenne Assistance publique hôpitaux de paris, and Université Paris 13, Bobigny, France
| | - Odile Beyne-Rauzy
- Hematology Department, Toulouse University Hospital, Toulouse, France
| | | | - Stéphane Cheze
- Hematology Department, Caen, University Hospital, Caen, France
| | - Sophie Park
- Hematology Department, Grenoble, University Hospital, Grenoble, France
| | - Thomas Cluzeau
- Hematology Department, Nice, University Hospital, Nice, France
| | | | | | - Riad Benramdane
- Department of Hematology, Centre Hospitalier, Pontoise, France
| | - Bruno Quesnel
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020, UMR-S 1277, Lille, France
| | - Shanti Amé
- Hematology Department, Strasbourg, University Hospital, Strasbourg, France
| | | | | | - Claude Preudhomme
- Lille University Hospital, Lille and INSERM UMR-S 1277, Lille, France
| | - Sylvie Chevret
- Biostatistics and Clinical Epidemiology Research Team (ECSTRRA), INSERM UMR-1153 (CRESS), Université de Paris, Paris, France
| | - Pierre Fenaux
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| |
Collapse
|
16
|
Drevin G, Briet M, Bazzoli C, Gyan E, Schmidt A, Dombret H, Orvain C, Giltat A, Recher C, Ifrah N, Guardiola P, Hunault-Berger M, Abbara C. Daunorubicin and Its Active Metabolite Pharmacokinetic Profiles in Acute Myeloid Leukaemia Patients: A Pharmacokinetic Ancillary Study of the BIG-1 Trial. Pharmaceutics 2022; 14:pharmaceutics14040792. [PMID: 35456626 PMCID: PMC9029035 DOI: 10.3390/pharmaceutics14040792] [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: 03/08/2022] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 02/01/2023] Open
Abstract
Daunorubicin pharmacokinetics (PK) are characterised by an important inter-individual variability, which raises questions about the optimal dose regimen in patients with acute myeloid leukaemia. The aim of the study is to assess the joint daunorubicin/daunorubicinol PK profile and to define an optimal population PK study design. Fourteen patients were enrolled in the PK ancillary study of the BIG-1 trial and 6–8 samples were taken up to 24 h after administration of the first dose of daunorubicin (90 mg/m2/day). Daunorubicin and daunorubicinol quantifications were assessed using a validated liquid chromatography technique coupled with a fluorescence detector method. Data were analysed using a non-compartmental approach and non-linear mixed effects modelling. Optimal sampling strategy was proposed using the R function PFIM. The median daunorubicin and daunorubicinol AUC0-tlast were 577 ng/mL·hr (Range: 375–1167) and 2200 ng/mL·hr (range: 933–4683), respectively. The median metabolic ratio was 0.32 (range: 0.1–0.44). Daunorubicin PK was best described by a three-compartment parent, two-compartment metabolite model, with a double first-order transformation of daunorubicin to metabolite. Body surface area and plasma creatinine had a significant impact on the daunorubicin and daunorubicinol PK. A practical optimal population design has been derived from this model with five sampling times per subject (0.5, 0.75, 2, 9, 24 h) and this can be used for a future population PK study.
Collapse
Affiliation(s)
- Guillaume Drevin
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France; (G.D.); (M.B.)
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
| | - Marie Briet
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France; (G.D.); (M.B.)
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
- MITOVASC, Equipe CarMe, SFR ICAT, INSERM, CNRS, F-49000 Angers, France
| | - Caroline Bazzoli
- Grenoble INP, TIMC-IMAG, Université Grenoble Alpes, CNRS, F-38000 Grenoble, France;
| | - Emmanuel Gyan
- Service d’Hématologie et Thérapie Cellulaire, Equipe LNOx, ERL CNRS 7001, Centre Hospitalier Universitaire, Université de Tours, F-37000 Tours, France;
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
| | - Aline Schmidt
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
- Service des Maladies du Sang, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France
- Inserm, CRCINA, SFR ICAT, Université Angers, Université de Nantes, F-49000 Angers, France
| | - Hervé Dombret
- Blood Disease Department, University Hospital Saint Louis AP-HP, F-75010 Paris, France;
| | - Corentin Orvain
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
- Service des Maladies du Sang, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France
| | - Aurelien Giltat
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
- Service des Maladies du Sang, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France
| | - Christian Recher
- Insitut Universitaire du Cancer de Toulouse Oncolpole, Unversité Toulouse III Paul Sabatier, F-31000 Toulouse, France;
| | - Norbert Ifrah
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
- Service des Maladies du Sang, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France
| | - Philippe Guardiola
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
| | - Mathilde Hunault-Berger
- UFR Santé, Université Angers, F-49100 Angers, France; (A.S.); (N.I.); (P.G.); (M.H.-B.)
- Fédération Hospitalo-Universitaire GOAL, F-49033 Angers, France; (C.O.); (A.G.)
- Service des Maladies du Sang, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France
- Inserm, CRCINA, SFR ICAT, Université Angers, Université de Nantes, F-49000 Angers, France
| | - Chadi Abbara
- Service de Pharmacologie-Toxicologie et Pharmacovigilance, Centre Hospitalo-Universitaire d’Angers, F-49100 Angers, France; (G.D.); (M.B.)
- Correspondence:
| |
Collapse
|
17
|
Pratz KW, Jonas BA, Pullarkat V, Recher C, Schuh AC, Thirman MJ, Garcia JS, DiNardo CD, Vorobyev V, Fracchiolla NS, Yeh SP, Jang JH, Ozcan M, Yamamoto K, Illes A, Zhou Y, Dail M, Chyla B, Potluri J, Döhner H. Measurable Residual Disease Response and Prognosis in Treatment-Naïve Acute Myeloid Leukemia With Venetoclax and Azacitidine. J Clin Oncol 2022; 40:855-865. [PMID: 34910556 PMCID: PMC8906463 DOI: 10.1200/jco.21.01546] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE There is limited evidence on the clinical utility of monitoring measurable residual disease (MRD) in patients with acute myeloid leukemia treated with lower-intensity therapy. Herein, we explored the outcomes of patients treated with venetoclax and azacitidine who achieved composite complete remission (CRc; complete remission + complete remission with incomplete hematologic recovery) and MRD < 10-3 in the VIALE-A trial. METHODS The patients included in this report were treated with venetoclax and azacitidine. Bone marrow aspirate samples for multiparametric flow cytometry assessments were collected for central analysis at baseline, end of cycle 1, and every three cycles thereafter. MRD-negative response was defined as < 1 residual blast per 1,000 leukocytes (< 10-3 or 0.1%) with an estimated analytic sensitivity of 0.0037%-0.0027%. CRc, duration of remission (DoR), event-free survival (EFS), and overall survival (OS) were assessed. A multivariate Cox regression analysis identified prognostic factors associated with OS. RESULTS One hundred sixty-four of one hundred ninety (86%) patients with CRc were evaluable for MRD. MRD < 10-3 was achieved by 67 of 164 (41%), and 97 of 164 (59%) had MRD ≥ 10-3. The median DoR, EFS, and OS were not reached in patients with CRc and MRD < 10-3, and the 12-month estimates for DoR, EFS, and OS in this group were 81.2%, 83.2%, and 94.0%. Among patients with CRc and MRD ≥ 10-3, the median DoR, EFS, and OS were 9.7, 10.6, and 18.7 months. Multivariate analysis showed that CRc with MRD < 10-3 was a strong predictor of OS (adjusted hazard ratio = 0.285; 95% CI, 0.159 to 0.510; P < .001). CONCLUSION Patients who achieved CRc and MRD < 10-3 with venetoclax and azacitidine had longer DoR, EFS, and OS, than responding patients with MRD ≥ 10-3.
Collapse
Affiliation(s)
- Keith W Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Brian A Jonas
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, Sacramento, CA
| | - Vinod Pullarkat
- Department of Hematology and Hematopoietic Cell Transplantation and Gehr Family Center for Leukemia Research, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Christian Recher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
| | - Andre C Schuh
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Michael J Thirman
- Section of Hematology/Oncology, Department of Medicine, The University of Chicago Medicine, Chicago, IL
| | - Jacqueline S Garcia
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Courtney D DiNardo
- Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Vladimir Vorobyev
- Department of Hematology, S. P. Botkin City Clinical Hospital, Moscow, Russia
| | - Nicola S Fracchiolla
- UOC Ematologia, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Su-Peng Yeh
- Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jun Ho Jang
- Department of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Muhit Ozcan
- Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Arpad Illes
- University of Debrecen, Faculty of Medicine, Department of Hematology, Debrecen, Hungary
| | | | | | | | | | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| |
Collapse
|
18
|
Paolillo R, Boulanger M, Gâtel P, Gabellier L, De Toledo M, Tempé D, Hallal R, Akl D, Moreaux J, Baik H, Gueret E, Recher C, Sarry JE, Cartron G, Piechaczyk M, Bossis G. The NADPH oxidase NOX2 is a marker of adverse prognosis involved in chemoresistance of acute myeloid leukemias. Haematologica 2022; 107:2562-2575. [PMID: 35172562 PMCID: PMC9614539 DOI: 10.3324/haematol.2021.279889] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Indexed: 12/01/2022] Open
Abstract
Resistance to chemotherapeutic drugs is a major cause of treatment failure in acute myeloid leukemias (AML). To better characterize the mechanisms of chemoresistance, we first identified genes whose expression is dysregulated in AML cells resistant to daunorubicin or cytarabine, the main drugs used for induction therapy. The genes found to be activated are mostly linked to immune signaling and inflammation. Among them, we identified a strong upregulation of the NOX2 NAPDH oxidase subunit genes (CYBB, CYBA, NCF1, NCF2, NCF4 and RAC2). The ensuing increase in NADPH oxidase expression and production of reactive oxygen species, which is particularly strong in daunorubicin-resistant cells, participates in the acquisition and/or maintenance of resistance to daunorubicin. Gp91phox (CYBB-encoded Nox2 catalytic subunit), was found to be more expressed and active in leukemic cells from patients with the French-American-British (FAB) M4/M5 subtypes of AML than in those from patients with the FAB M0-M2 ones. Moreover, its expression was increased at the surface of patients’ chemotherapy-resistant AML cells. Finally, using a gene expression based score we demonstrated that high expression of NOX2 subunit genes is a marker of adverse prognosis in AML patients. The prognostic NOX score we defined is independent of the cytogenetic-based risk classification, FAB subtype, FLT3/NPM1 mutational status and age.
Collapse
Affiliation(s)
- Rosa Paolillo
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Mathias Boulanger
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Pierre Gâtel
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Ludovic Gabellier
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris, France; Département d'Hématologie Clinique, CHU de Montpellier, Montpellier
| | - Marion De Toledo
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Denis Tempé
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Rawan Hallal
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Dana Akl
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | | | - Hayeon Baik
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Elise Gueret
- MGX, Univ Montpellier, CNRS, INSERM, Montpellier
| | - Christian Recher
- Service d'Hématologie, CHU de Toulouse, Toulouse, France; CRCT, University of Toulouse, INSERM, CNRS, Toulouse
| | | | | | - Marc Piechaczyk
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris
| | - Guillaume Bossis
- IGMM, Univ Montpellier, CNRS, Montpellier, France; Equipe labellisée Ligue Contre le Cancer, Paris.
| |
Collapse
|
19
|
Peffault de Latour R, Kulasekararaj A, Iacobelli S, Terwel SR, Cook R, Griffin M, Halkes CJM, Recher C, Barraco F, Forcade E, Vallejo JC, Drexler B, Mear JB, Smith AE, Angelucci E, Raymakers RAP, de Groot MR, Daguindau E, Nur E, Barcellini W, Russell NH, Terriou L, Iori AP, La Rocca U, Sureda A, Sánchez-Ortega I, Xicoy B, Jarque I, Cavenagh J, Sicre de Fontbrune F, Marotta S, Munir T, Tjon JML, Tavitian S, Praire A, Clement L, Rabian F, Marano L, Hill A, Palmisani E, Muus P, Cacace F, Frieri C, van Lint MT, Passweg JR, Marsh JCW, Socié G, Mufti GJ, Dufour C, Risitano AM. Eltrombopag Added to Immunosuppression in Severe Aplastic Anemia. N Engl J Med 2022; 386:11-23. [PMID: 34986284 DOI: 10.1056/nejmoa2109965] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND A single-group, phase 1-2 study indicated that eltrombopag improved the efficacy of standard immunosuppressive therapy that entailed horse antithymocyte globulin (ATG) plus cyclosporine in patients with severe aplastic anemia. METHODS In this prospective, investigator-led, open-label, multicenter, randomized, phase 3 trial, we compared the efficacy and safety of horse ATG plus cyclosporine with or without eltrombopag as front-line therapy in previously untreated patients with severe aplastic anemia. The primary end point was a hematologic complete response at 3 months. RESULTS Patients were assigned to receive immunosuppressive therapy (Group A, 101 patients) or immunosuppressive therapy plus eltrombopag (Group B, 96 patients). The percentage of patients who had a complete response at 3 months was 10% in Group A and 22% in Group B (odds ratio, 3.2; 95% confidence interval [CI], 1.3 to 7.8; P = 0.01). At 6 months, the overall response rate (the percentage of patients who had a complete or partial response) was 41% in Group A and 68% in Group B. The median times to the first response were 8.8 months (Group A) and 3.0 months (Group B). The incidence of severe adverse events was similar in the two groups. With a median follow-up of 24 months, a karyotypic abnormality that was classified as myelodysplastic syndrome developed in 1 patient (Group A) and 2 patients (Group B); event-free survival was 34% and 46%, respectively. Somatic mutations were detected in 29% (Group A) and 31% (Group Β) of the patients at baseline; these percentages increased to 66% and 55%, respectively, at 6 months, without affecting the hematologic response and 2-year outcome. CONCLUSIONS The addition of eltrombopag to standard immunosuppressive therapy improved the rate, rapidity, and strength of hematologic response among previously untreated patients with severe aplastic anemia, without additional toxic effects. (Funded by Novartis and others; RACE ClinicalTrials.gov number, NCT02099747; EudraCT number, 2014-000363-40.).
Collapse
Affiliation(s)
- Régis Peffault de Latour
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Austin Kulasekararaj
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Simona Iacobelli
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Sofie R Terwel
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Riley Cook
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Morag Griffin
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Constantijn J M Halkes
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Christian Recher
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Fiorenza Barraco
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Edouard Forcade
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Juan-Carlos Vallejo
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Beatrice Drexler
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Jean-Baptiste Mear
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Alexander E Smith
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Emanuele Angelucci
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Reinier A P Raymakers
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Marco R de Groot
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Etienne Daguindau
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Erfan Nur
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Wilma Barcellini
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Nigel H Russell
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Louis Terriou
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Anna-Paola Iori
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Ursula La Rocca
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Anna Sureda
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Isabel Sánchez-Ortega
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Blanca Xicoy
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Isidro Jarque
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - James Cavenagh
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Flore Sicre de Fontbrune
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Serena Marotta
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Talha Munir
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Jennifer M L Tjon
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Suzanne Tavitian
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Aline Praire
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Laurence Clement
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Florence Rabian
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Luana Marano
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Anita Hill
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Elena Palmisani
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Petra Muus
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Fabiana Cacace
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Camilla Frieri
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Maria-Teresa van Lint
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Jakob R Passweg
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Judith C W Marsh
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Gérard Socié
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Ghulam J Mufti
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Carlo Dufour
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| | - Antonio M Risitano
- From the French Reference Center for Aplastic Anemia and Paroxysmal Nocturnal Hemoglobinuria, Saint-Louis Hospital and Université de Paris (R.P.L., F.S.F., C.F., G.S.), and the Adolescent and Young Adult Hematology Unit, Saint-Louis Hospital (F.R.), Paris, the Hematology Department, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse (C.R., S.T.), Centre Hospitalier Universitaire Lyon Sud, Lyon (F.B., A.P.), Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévêque, Pessac (E.F., L.C.), the Department of Clinical Hematology, Rennes University Hospital, Rennes (J.-B.M.), Service d'Hématologie, Hôpital Jean Minjoz, Besançon (E.D.), and Hôpital Claude Huriez, Lille (L.T.) - all in France; the Clinical Study Unit, European Society for Blood and Marrow Transplantation (R.P.L., A.K., S.I., S.R.T., I.S.-O., C.F., C.D., A.M.R.), and the Department of Hematology, Leiden University Medical Center (C.J.M.H., J.M.L.T.), Leiden, the Department of Hematology, University Medical Center Utrecht, Utrecht (R.A.P.R.), the Department of Hematology, University Medical Center Groningen, Groningen (M.R.G.), and the Department of Clinical Hematology, Amsterdam University Medical Centers, Academic Medical Center, Amsterdam (E.N.) - all in the Netherlands; the Department of Haematological Medicine, King's College Hospital NHS Foundation Trust (A.K., R.C., A.E.S., P.M., J.C.W.M., G.J.M.), and Barts Health NHS Trust, St. Bartholomew's Hospital (J.C.), London, the Department of Haematology, St. James's University Hospital, Leeds (M.G., T.M., A.H., P.M.), and the Centre for Clinical Haematology, Nottingham University Hospital, Nottingham (N.H.R.) - all in the United Kingdom; the Department of Biology, Università Tor Vergata (S.I.), and the Department of Translational and Precision Medicine, Division of Hematology, Sapienza University (A.P.I., U.L.R.), Rome, Ematologia e Centro Trapianti, IRCCS Ospedale Policlinico San Martino (E.A., M.T.L.), and the Hematology Unit, IRCCS Istituto Giannina Gaslini (E.P., C.D.), Genoa, Unità Operativa Complessa di Ematologia, Unità Operativa Complessa di Fisiopatologia delle Anemie, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan (W.B.), the Department of Clinical Medicine and Surgery, Federico II University, Naples (S.M., L.M., F.C., C.F., A.M.R.), and Ematologia e Trapianto Emopoietico, Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati, Avellino (L.M., C.F., A.M.R.) - all in Italy; University Hospital Donostia, San Sebastián (J.C.V.), the Department of Hematology, Catalan Institute of Oncology Bellvitge Hospital-Hospital Duran i Reynals, L'Hospitalet de Llobregat (A.S.), Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Barcelona (B.X.), and Servicio de Hematología y Hemoterapia, Hospital Universitario y Politécnico La Fe, Valencia (I.J.) - all in Spain; and the Department of Hematology, University Hospital Basel, Basel, Switzerland (B.D., J.R.P.)
| |
Collapse
|
20
|
Ounoughene Y, Fourgous E, Boublik Y, Saland E, Guiraud N, Recher C, Urbach S, Fort P, Sarry JE, Fesquet D, Roche S. SHED-Dependent Oncogenic Signaling of the PEAK3 Pseudo-Kinase. Cancers (Basel) 2021; 13:cancers13246344. [PMID: 34944965 PMCID: PMC8699254 DOI: 10.3390/cancers13246344] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 01/09/2023] Open
Abstract
Simple Summary The human kinome is composed of about 50 pseudo-kinases with unclear function, because they are predicted to be catalytically inactive; however, they are shown to play an important role in cancer, similar to active kinases. Understanding how these pseudo-kinases promote tumor formation despite their catalytic inactivity is a great challenge, which may lead to innovative anti-cancer therapies. The PEAK1 and 2 pseudo-kinases have emerged as important components of the protein tyrosine kinase pathway implicated in cancer progression. They can signal using a scaffolding mechanism via a conserved split helical dimerization (SHED) module. In this study, we uncovered a similar SHED-dependent oncogenic activity for PEAK3, a recently discovered new member of this family. We also show that this new signaling mechanism may be implicated in acute myeloid leukemia. Abstract The PEAK1 and Pragmin/PEAK2 pseudo-kinases have emerged as important components of the protein tyrosine kinase pathway implicated in cancer progression. They can signal using a scaffolding mechanism that involves a conserved split helical dimerization (SHED) module. We recently identified PEAK3 as a novel member of this family based on structural homology; however, its signaling mechanism remains unclear. In this study, we found that, although it can self-associate, PEAK3 shows higher evolutionary divergence than PEAK1/2. Moreover, the PEAK3 protein is strongly expressed in human hematopoietic cells and is upregulated in acute myeloid leukemia. Functionally, PEAK3 overexpression in U2OS sarcoma cells enhanced their growth and migratory properties, while its silencing in THP1 leukemic cells reduced these effects. Importantly, an intact SHED module was required for these PEAK3 oncogenic activities. Mechanistically, through a phosphokinase survey, we identified PEAK3 as a novel inducer of AKT signaling, independent of growth-factor stimulation. Then, proteomic analyses revealed that PEAK3 interacts with the signaling proteins GRB2 and ASAP1/2 and the protein kinase PYK2, and that these interactions require the SHED domain. Moreover, PEAK3 activated PYK2, which promoted PEAK3 tyrosine phosphorylation, its association with GRB2 and ASAP1, and AKT signaling. Thus, the PEAK1-3 pseudo-kinases may use a conserved SHED-dependent mechanism to activate specific signaling proteins to promote oncogenesis.
Collapse
Affiliation(s)
- Youcef Ounoughene
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
| | - Elise Fourgous
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
| | - Yvan Boublik
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
| | - Estelle Saland
- CRCT, INSERM, CNRS, University of Toulouse, Equipe Labellisée Ligue Contre le Cancer, F-31037 Toulouse, France; (E.S.); (N.G.); (C.R.); (J.-E.S.)
| | - Nathan Guiraud
- CRCT, INSERM, CNRS, University of Toulouse, Equipe Labellisée Ligue Contre le Cancer, F-31037 Toulouse, France; (E.S.); (N.G.); (C.R.); (J.-E.S.)
| | - Christian Recher
- CRCT, INSERM, CNRS, University of Toulouse, Equipe Labellisée Ligue Contre le Cancer, F-31037 Toulouse, France; (E.S.); (N.G.); (C.R.); (J.-E.S.)
| | - Serge Urbach
- IGF, CNRS, INSERM, University Montpellier, F-34000 Montpellier, France;
| | - Philippe Fort
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
| | - Jean-Emmanuel Sarry
- CRCT, INSERM, CNRS, University of Toulouse, Equipe Labellisée Ligue Contre le Cancer, F-31037 Toulouse, France; (E.S.); (N.G.); (C.R.); (J.-E.S.)
| | - Didier Fesquet
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
- Correspondence: (D.F.); (S.R.)
| | - Serge Roche
- CRBM, University Montpellier, CNRS, Equipe Labellisée Ligue Contre le Cancer, F-34000 Montpellier, France; (Y.O.); (E.F.); (Y.B.); (P.F.)
- Correspondence: (D.F.); (S.R.)
| |
Collapse
|
21
|
Comont T, Nicolau-Travers ML, Bertoli S, Recher C, Vergez F, Treiner E. MAIT cells numbers and frequencies in patients with acute myeloid leukemia at diagnosis: association with cytogenetic profile and gene mutations. Cancer Immunol Immunother 2021; 71:875-887. [PMID: 34477901 DOI: 10.1007/s00262-021-03037-9] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022]
Abstract
Harnessing or monitoring immune cells is actually a major topic in pre-clinical and clinical studies in acute myeloid leukemia (AML). Mucosal-Associated Invariant T cells (MAIT) constitute one of the largest subset of innate-like, cytotoxic T cell subsets in humans. Despite some papers suggesting a role for MAIT cells in cancer, their specific involvement remains unclear, especially in myeloid malignancies. This prospective monocentric study included 216 patients with a newly diagnosed AML. Circulating MAIT cells were quantified by flow cytometry at diagnosis and during intensive chemotherapy. We observed that circulating MAIT cells show a specific decline in AML patients at diagnosis compared to healthy donors. Post-induction monitored patients presented with a drastic drop in MAIT cell numbers, with recovery after one month. We also found correlation between decrease in MAIT cells number and adverse cytogenetic profile. FLT3-ITD and IDH ½ mutations were associated with higher MAIT cell numbers. Patients with high level of activated MAIT cells are under-represented within patients with a favorable cytogenetic profile, and over-represented among patients with IDH1 mutations or bi-allelic CEBPA mutations. We show for the first time that circulating MAIT cells are affected in newly diagnosed AML patients, suggesting a link between MAIT cells and AML progression. Our work fosters new studies to deepen our knowledge about the role of MAIT cells in cancer.
Collapse
Affiliation(s)
- Thibault Comont
- Department of Internal Medicine, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Laboratory of Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
| | | | - Sarah Bertoli
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- Department of Clinical Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Christian Recher
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- Department of Clinical Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Francois Vergez
- Laboratory of Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Emmanuel Treiner
- Laboratory of Immunology, CHU Toulouse, Toulouse, France.
- University Paul Sabatier III, Toulouse, France.
- Infinity, Inserm UMR1291, 330 Avenue de Grande Bretagne, 31000, Toulouse, France.
| |
Collapse
|
22
|
de Botton S, Brandwein JM, Wei AH, Pigneux A, Quesnel B, Thomas X, Legrand O, Recher C, Chantepie S, Hunault-Berger M, Boissel N, Nehme SA, Frattini MG, Tosolini A, Marion-Gallois R, Wang JJ, Cameron C, Siddiqui M, Hutton B, Milkovich G, Stein EM. Improved survival with enasidenib versus standard of care in relapsed/refractory acute myeloid leukemia associated with IDH2 mutations using historical data and propensity score matching analysis. Cancer Med 2021; 10:6336-6343. [PMID: 34427990 PMCID: PMC8446562 DOI: 10.1002/cam4.4182] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 05/28/2021] [Accepted: 07/01/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The present study evaluated the relative survival benefits associated with enasidenib and current standard of care (SoC) therapies for patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) and an isocitrate dehydrogenase 2 (IDH2) mutation who are ineligible for hematopoietic stem cell transplantation (HSCT). METHODS Propensity score matching (PSM) analysis compared survival outcomes observed with enasidenib 100 mg daily in the phase I/II AG221-C-001 trial and SoC outcomes obtained from a real-world chart review of patients in France. RESULTS Before matching, enasidenib (n = 195) was associated with numerically improved overall survival (OS) relative to SoC (n = 80; hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.61-1.11). After matching and adjusting for covariates (n = 78 per group), mortality risk was significantly lower with enasidenib than with SoC (HR, 0.67; 95% CI, 0.47-0.97). The median OS was 9.26 months for enasidenib (95% CI, 7.72-13.24) and 4.76 months for SoC (95% CI, 3.81-8.21). Results remained robust across all sensitivity analyses conducted. CONCLUSIONS PSM analyses indicate that enasidenib significantly prolongs survival relative to SoC among patients with R/R AML and an IDH2 mutation who are ineligible for HSCT. Future prospective studies are needed to validate these findings using other data sources and to assess the comparative efficacy of enasidenib for other treatment outcomes.
Collapse
Affiliation(s)
| | | | - Andrew H Wei
- Alfred Hospital and Monash University, Melbourne, Australia
| | | | | | | | | | - Christian Recher
- CHU de Toulouse, Université de Toulouse III Paul Sabatier, Toulouse, France
| | | | | | | | - Salem A Nehme
- Celgene International, a Bristol Myers Squibb Company, Boudry, Switzerland
| | | | | | | | | | - Chris Cameron
- Cornerstone Research Group, Burlington, Ontario, Canada
| | | | - Brian Hutton
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Eytan M Stein
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
23
|
Lesieur A, Thomas X, Nibourel O, Boissel N, Fenwarth L, De Botton S, Fournier E, Celli-Lebras K, Raffoux E, Recher C, Lambert J, Berthon C, Pigneux A, Itzykson R, Turlure P, Pautas C, Vargaftig J, Preudhomme C, Dombret H, Duployez N. Minimal residual disease monitoring in acute myeloid leukemia with non-A/B/D-NPM1 mutations by digital polymerase chain reaction: feasibility and clinical use. Haematologica 2021; 106:1767-1769. [PMID: 33299234 PMCID: PMC8168487 DOI: 10.3324/haematol.2020.260133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
Not available.
Collapse
Affiliation(s)
| | - Xavier Thomas
- Hospices Civils de Lyon, Lyon-Sud University Hospital, Department of Hematology, Lyon
| | - Olivier Nibourel
- CHU Lille, Laboratory of Hematology, F-59000 Lille, FRANCE; Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille
| | - Nicolas Boissel
- AP-HP, Saint-Louis Hospital, Department of Hematology, Saint-Louis Research Institute, Université de Paris, Paris
| | - Laurène Fenwarth
- CHU Lille, Laboratory of Hematology, F-59000 Lille, FRANCE; Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille
| | | | - Elise Fournier
- CHU Lille, Laboratory of Hematology, F-59000 Lille, FRANCE; Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille
| | - Karine Celli-Lebras
- AP-HP, Saint-Louis Hospital, Department of Hematology, Saint-Louis Research Institute, Université de Paris, Paris
| | - Emmanuel Raffoux
- AP-HP, Saint-Louis Hospital, Department of Hematology, Saint-Louis Research Institute, Université de Paris, Paris
| | - Christian Recher
- Toulouse Cancer University Institute, Department of Hematology, Toulouse
| | | | - Céline Berthon
- Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille, FRANCE; CHU Lille, Department of Clinic Hematology, F-59000 Lille
| | - Arnaud Pigneux
- Bordeaux Haut-Lévêque University Hospital, Department of Hematology, Pessac
| | - Raphael Itzykson
- AP-HP, Saint-Louis Hospital, Department of Hematology, Saint-Louis Research Institute, Université de Paris, Paris
| | - Pascal Turlure
- CHU Limoges, Univ. Limoges, Department of Hematology, Limoges
| | - Cécile Pautas
- AP-HP, Department of Hematology, Henri Mondor Hospital, Créteil
| | | | - Claude Preudhomme
- CHU Lille, Laboratory of Hematology, F-59000 Lille, FRANCE; Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille
| | - Hervé Dombret
- AP-HP, Saint-Louis Hospital, Department of Hematology, Saint-Louis Research Institute, Université de Paris, Paris
| | - Nicolas Duployez
- CHU Lille, Laboratory of Hematology, F-59000 Lille, FRANCE; Univ. Lille, CNRS, Inserm, CHU Lille, Institut de Recherche contre le Cancer de Lille, UMR9020 - UMR-S 1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, F-59000 Lille.
| |
Collapse
|
24
|
Malard F, Vekhoff A, Lapusan S, Isnard F, D'incan-Corda E, Rey J, Saillard C, Thomas X, Ducastelle-Lepretre S, Paubelle E, Larcher MV, Rocher C, Recher C, Tavitian S, Bertoli S, Michallet AS, Gilis L, Peterlin P, Chevallier P, Nguyen S, Plantamura E, Boucinha L, Gasc C, Michallet M, Dore J, Legrand O, Mohty M. Gut microbiota diversity after autologous fecal microbiota transfer in acute myeloid leukemia patients. Nat Commun 2021; 12:3084. [PMID: 34035290 PMCID: PMC8149453 DOI: 10.1038/s41467-021-23376-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 09/25/2020] [Accepted: 04/22/2021] [Indexed: 12/20/2022] Open
Abstract
Acute myeloid leukemia (AML) intensive chemotherapy combined with broad-spectrum antibiotics, leads to gut microbiota dysbiosis promoting pathological conditions and an increased incidence of complications. Here we report findings from a phase II single-arm, multicenter study evaluating autologous fecal microbiota transfer (AFMT) in 25 AML patients treated with intensive chemotherapy and antibiotics (ClinicalTrials.gov number: NCT02928523). The co-primary outcomes of the study are to evaluate the efficacy of AFMT in dysbiosis correction and multidrug-resistant bacteria eradication. The main secondary outcomes are to define a dysbiosis biosignature, to evaluate the effect of dysbiosis correction on patient clinical status, to assess the short and mid-term safety of AFMT in this immunocompromised population, and to evaluate the feasibility of the AFMT procedure and acceptability by the patient. Intensive induction chemotherapy induces a dramatic decrease of α-diversity indices, and a microbial dysbiosis with a significant shift of the microbial communities and domination of pro-inflammatory families. After AFMT treatment, α-diversity indices return to their initial mean levels and the similarity index shows the restoration of microbial communities. The trial meets pre-specified endpoints. AFMT appears to be safe and may be effective for gut microbiota restoration in AML patients receiving intensive chemotherapy and antibiotics, with an excellent gut microbiota reconstruction based on both richness and diversity indices at the species level. The combination of chemotherapy and broad-spectrum antibiotics induces gut microbiota (GM) dysbiosis in acute myeloid leukaemia (AML) leading to additional complications. Here, the authors report the efficacy in GM restoration and safety of autologous faecal microbiota transfer in treated AML patients in a phase II clinical trial.
Collapse
Affiliation(s)
- Florent Malard
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France.
| | - Anne Vekhoff
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Simona Lapusan
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Francoise Isnard
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | | | - Jérôme Rey
- Service d'hématologie, Institut Paoli Calmettes, Marseille, France
| | - Colombe Saillard
- Service d'hématologie, Institut Paoli Calmettes, Marseille, France
| | - Xavier Thomas
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | | | - Etienne Paubelle
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Marie-Virginie Larcher
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Clément Rocher
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Christian Recher
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | - Suzanne Tavitian
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | - Sarah Bertoli
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | | | - Lila Gilis
- Service d'hématologie, Centre Léon Bérard, Lyon, France
| | | | | | - Stéphanie Nguyen
- Service d'hématologie clinique, Hôpital de la Pitié Salpétrière, APHP, Sorbonne Université, Paris, France
| | | | | | | | | | - Joel Dore
- Université Paris-Saclay, INRAE, MetaGenoPolis, AgroParisTech, MICALIS, Jouy-en-Josas, France
| | - Ollivier Legrand
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Mohamad Mohty
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| |
Collapse
|
25
|
Perl AE, Larson RA, Podoltsev NA, Strickland S, Wang ES, Schiller GJ, Martinelli G, Neubauer A, Sierra J, Montesinos P, Recher C, Yoon SS, Hosono N, Onozawa M, Chiba S, Kim HJ, Hasabou N, Lu Q, Tiu RV, Levis MJ. Follow-up of patients with FLT3-mutated R/R AML in the phase 3 ADMIRAL trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7013 Background: The phase 3 ADMIRAL trial demonstrated the superiority of gilteritinib to salvage chemotherapy (SC) in patients (pts) with FLT3-mutated ( FLT3mut+) R/R AML. Aim/Objective: A follow-up of ADMIRAL assessed long-term survivors, transplant (HSCT) outcomes. and gilteritinib safety beyond 1 year. Methods: A data cut was performed on September 20, 2020—2 years after the primary analysis. Patients who were alive without relapse, pts who underwent HSCT, and adverse events of interest (AEIs) in Years 1 (≤12 months) and 2 ( > 12 months) of gilteritinib therapy were evaluated. Results: As of September 20, 2020, 17% (n = 63/371) of pts in the intention-to-treat (ITT) population were alive (gilteritinib, n = 49; SC, n = 14); 16 pts assigned to gilteritinib remained on treatment. After a median follow-up of 37.1 months, 26 of the 49 pts in the gilteritinib arm who were alive were also without relapse; 18 of these 26 pts underwent HSCT, with 16 receiving post-HSCT gilteritinib maintenance therapy. Nineteen of the 26 pts in the gilteritinib arm without relapse continued gilteritinib beyond 1 year and remained in CR. Of the 371 ITT pts, 83 (22%) underwent HSCT during the study (gilteritinib, n = 64; SC, n = 19). Pre-HSCT CRc rates were similar across arms (gilteritinib: n = 40/64; 63%; SC: n = 11/19; 58%); 10 of 11 pts preselected for low-intensity SC achieved pre-HSCT CRc (gilteritinib, n = 9; SC, n = 1). Forty of 64 (63%) transplanted pts in the gilteritinib arm received post-HSCT gilteritinib maintenance after achieving pre-HSCT CRc; the 24-month relapse rate in pts who resumed gilteritinib after pre-HSCT CRc was 19%. Post-HSCT treatment with chemotherapy or other tyrosine kinase inhibitors was administered in 26 pts who received gilteritinib before transplantation. Cumulative 24-month relapse rates in gilteritinib-treated pts who achieved pre-HSCT CR and CRc were 20% and 45%, respectively. Median post-HSCT overall survival (landmarked to HSCT date), was similar across arms (gilteritinib, 16.1 months; SC, 15.3 months; HR = 1.076; 95% CI: 0.536, 2.160). Overall, 10.2% (n = 25/246) had ≥24 months of gilteritinib exposure. Most common AEIs during Years 1 and 2 of gilteritinib therapy were elevated ALT/AST levels. Incidences of all AEIs declined in Year 2. Cardiac AEIs in Year 2 were nonfatal cardiorespiratory arrest (n = 1) and ventricular tachycardia (n = 1). One case of differentiation syndrome and cutaneous squamous cell carcinoma occurred in Years 1 and 2, respectively. Conclusions: A high proportion of gilteritinib-treated R/R FLT3mut+ AML pts who were alive without relapse had received HSCT followed by gilteritinib maintenance. Among all transplanted pts in ADMIRAL, pre-HSCT remission rates and post-HSCT survival were similar across arms. Post-HSCT gilteritinib maintenance may relate to the low post-HSCT relapse rate in the gilteritinib arm. The safety profile of gilteritinib is stable at 2 years with no new or significant safety signals. Clinical trial information: NCT02421939.
Collapse
Affiliation(s)
- Alexander E. Perl
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Eunice S. Wang
- Roswell Park Comprehensive Cancer Institute, Buffalo, NY
| | | | - Giovanni Martinelli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | - Jorge Sierra
- Hospital de la Santa Creu I Sant Pau and Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | | | | | - Sung-Soo Yoon
- Seoul National University Hospital, Seoul, South Korea
| | | | | | - Shigeru Chiba
- Department of Neuropsychiatry, Asahikawa University School of Medicine, Asahikawa, Japan
| | - Hee-Je Kim
- Catholic Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | | | | | - Mark J. Levis
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| |
Collapse
|
26
|
De Botton S, Yee KWL, Recher C, Wei A, Montesinos P, Taussig D, Pigneux A, Braun T, Curti A, Esteve J, Grove C, Jonas BA, Khwaja A, Legrand O, Peterlin P, Polyanskaya O, Sweeney J, Mohamed H, Cortes JE, Fenaux P. Effect of olutasidenib (FT-2102) on complete remissions in patients with relapsed/refractory (R/R) m IDH1 acute myeloid leukemia (AML): Results from a planned interim analysis of a phase 2 clinical trial. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7006] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7006 Background: Olutasidenib, a potent, selective, oral, small molecule inhibitor of mutant IDH1 (m IDH1), has exhibited favorable tolerability and clinical activity in high-risk AML patients (pts) in a phase 1 trial (Watts, Blood 2019). Here, we present interim analysis results of a phase 2 trial (NCT02719574) in R/R m IDH1 AML pts receiving olutasidenib monotherapy 150 mg twice daily. Methods: The efficacy evaluable (EE) set comprised m IDH1R132X pts whose first dose was ≥180 days before the data cut-off (18-JUN-20). The primary endpoint was CR+CRh (complete remission [CR] or CR with partial hematologic recovery [CRh] according to modified IWG 2003 criteria) rate. CRh was defined as bone marrow blasts <5%, absolute neutrophil count >0.5×109/L, and platelet count >50×109/L. Overall response rate (ORR) comprised CR+CRh+CR with incomplete recovery (CRi) + morphologic leukemia-free state (MLFS) + partial response (PR). Duration of treatment (DOT), duration of response (DOR), and overall survival (OS) were estimated using Kaplan-Meier methodology. Results: This clinical trial met its pre-specified early enrollment-stopping criteria for efficacy. A total of 153 pts with R/R AML received olutasidenib; median DOT, 5.5 mo (95% CI: 4.4, 8.7). 43 pts (28%) remain on treatment and 110 (72%) discontinued, most commonly due to: disease progression, 31%; AEs, 14%; death, 10%; and transplant, 8%. For the EE set (123 pts), the median age was 71 y (range: 32‒87) with a median number of prior therapies of 2 (1‒7). The CR+CRh rate was 33% including 30% of pts in CR (Table). Median duration of CR+CRh was not reached (NR) and 13.8 mo in a sensitivity analysis when HSCT or relapse was deemed end of response. ORR was 46% and median duration of ORR was 11.7 mo. Of responders who were transfusion-dependent at baseline, 56-day platelet transfusion independence (TI) and RBC TI were gained by 100% and 83%, respectively, of pts who achieved CR+CRh, and by 56% and 50% who did not. Median OS was 10.5 mo (EE set). In CR+CRh responders, median OS was NR and the estimated 18-mo OS was 87%. TEAEs in ≥25% of pts were nausea, 38%; constipation, 25%; leukocytosis, 25%. Grade 3/4 all-causality TEAEs in >10% of pts were febrile neutropenia, 20%; anemia, 19%; thrombocytopenia, 16%; neutropenia, 13%. Investigator-assessed IDH1 differentiation syndrome (any grade) was observed in 21 pts (14%); most cases resolved with treatment management; one case was fatal; 19 pts had concomitant leukocytosis. Conclusions: Olutasidenib was well tolerated and induced durable CR in a subset of high-risk R/R m IDH1 AML pts. TI was achieved in all response groups. Clinical benefit, per DOR and OS, extended beyond CR+CRh responders. Clinical trial information: NCT02719574. [Table: see text]
Collapse
Affiliation(s)
| | | | | | - Andrew Wei
- The Alfred Hospital and Monash University, Melbourne, Australia
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | - Thorsten Braun
- Avicenne Hospital Paris XIII University, Bobigny, France
| | - Antonio Curti
- Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Carolyn Grove
- PathWest & Sir Charles Gairdner Hospital, Nedlands, Australia
| | | | - Asim Khwaja
- University College London, London, United Kingdom
| | - Ollivier Legrand
- Hôpital Saint-Antoine, Université Pierre et Marie Curie, Paris, France
| | | | | | | | | | | | - Pierre Fenaux
- Service d’Hématologie Séniors, Hôpital Saint-Louis, Université Paris 7, Paris, France
| |
Collapse
|
27
|
Pullarkat V, Pratz K, Dohner H, Recher C, Thirman MJ, Dinardo CD, Fenaux P, Schuh AC, Wei AH, Pigneux A, Jang JH, Juliusson G, Miyazaki K, Selleslag D, Arellano ML, Naqvi K, Yu J, Ridgeway J, Potluri J, Konopleva M. Venetoclax and azacitidine combination in chemotherapy ineligible untreated patients with therapy-related myeloid neoplasms, antecedent myelodysplastic syndromes, or myelodysplastic/myeloproliferative neoplasms. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7011 Background: Patients (pts) with therapy-related myeloid neoplasms (tMN), antecedent myelodysplastic syndrome, or antecedent myelodysplastic/myeloproliferative neoplasms (A-MDS/MPN) may have poor outcomes due to age and adverse genetic/karyotypic features. In the VIALE-A study, pts with tMN and A-MDS/MPN unfit for intensive chemotherapy treated with venetoclax (Ven) and azacitidine (Aza) demonstrated superior response rates and overall survival (OS) than Aza alone. Herein, the efficacy and safety of Ven+Aza among pts with tMN and A-MDS/MPN are described. Methods: Data were pooled from pts enrolled in VIALE-A (NCT02993523) comparing pts who received Ven+Aza or placebo (Pbo)+Aza and a prior phase 1b study (NCT02203773) where pts received Ven+Aza. Enrolled pts were ≥18 years, treatment-naïve with no prior exposure to hypomethylating agents, and ineligible for intensive chemotherapy. Pts on Ven+Aza received Ven 400 mg orally (days 1–28) and Aza (75 mg/m2; days 1-7/28-day cycle). Composite complete remission rate (CRc; complete remission [CR] + CR with incomplete hematologic recovery [CRi]), duration of response (DoR), and OS were assessed. Disease assessments were per modified International Working Group response criteria for AML. Results: In this pooled analysis, tMN was observed in (Ven+Aza/Pbo+Aza) 31/9 and A-MDS/MPN in 59/26 pts. Poor-risk cytogenetics were observed in 18 (58%)/6 (67%) with tMN (5 or 5q deletion [del]: 4/1 ; 7 or 7q del: 6/1 ; complex [≥ 3 clonal abnormalities]: 10/4), and 19 (32%)/13 (50%) with A-MDS/MPN (5 or 5q del: 10/5; 7 or 7q del: 6/1; complex: 14/9). TP53 mutation was observed in 5/3 pts with tMN and 8/0 pts with A-MDS/MPN. Pts with tMN received a median (Ven+Aza/Pbo+Aza) of 5/4 cycles of treatment. CRc was achieved by 19 (61%)/1 (11%). The mDoR was not reached (NR) (95% CI: 17.8, NR)/8.5 (NR, NR) months. The mOS was 16.4 (95% CI: 4.1, NR)/11.3 (0.6, 17.5) months. Pts with A-MDS/MPN received a median (Ven+Aza/Pbo+Aza) of 9/5 cycles of treatment. CRc was achieved by 39 (66%)/7 (27%) pts with mDoR of 17.3 (95% CI: 9.6, NR)/5.8 (1.1, NR) mos. The mOS was 15.9 (95% CI: 11.5, NR)/10.1 (4.7, 14.5) mos. Common grade≥3 adverse events (Ven+Aza/Pbo+Aza) were febrile neutropenia (tMN: 39%/11% and A-MDS/MPN: 36%/12%) neutropenia (tMN: 29%/33%; A-MDS/MPN: 39%31%), and thrombocytopenia (tMN: 32%/33%; A-MDS/MPN: 39%/62%). Conclusions: Ven+Aza compared to Aza monotherapy resulted in higher CRc rates with longer DoR and median OS among treatment-naïve pts with tMN and A-MDS/MPN ineligible for intensive chemotherapy. The safety profile was similar to overall pts with the Ven+Aza combination. Outcomes by cytogenetic and molecular risk-groups will be presented. Clinical trial information: NCT02993523, NCT02203773.
Collapse
Affiliation(s)
| | - Keith Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | - Pierre Fenaux
- Hôpital Saint-Louis, Assistance Publique – Hôpitaux de Paris, Paris, France
| | | | | | | | - Jun Ho Jang
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | - Kazuhito Miyazaki
- Department of Respiratory Medicine, Yokohama Municipal Citizen’s Hospital, Kanagawa, Japan
| | | | | | | | - Jun Yu
- AbbVie Inc., North Chicago, IL
| | | | | | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
28
|
Pratz K, Jonas BA, Pullarkat V, Recher C, Schuh AC, Thirman MJ, Garcia JS, Dinardo CD, Vorobyev V, Fracchiolla N, Yeh SP, Jang JH, Ozcan M, Yamamoto K, Illes A, Zhou Y, Dail M, Chyla B, Potluri J, Dohner H. Measurable residual disease response in acute myeloid leukemia treated with venetoclax and azacitidine. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7018 Background: In the phase 3 VIALE-A trial, rates of composite complete remission (CRc; complete remission [CR] + CR with incomplete hematologic recovery [CRi]) and measurable residual disease response (MRD<10-3) were higher in patients (pts) treated with venetoclax (Ven) + azacitidine (Aza) compared to Aza alone (23.4%/7.6%, p<0.001). There is limited evidence of the clinical significance of MRD monitoring in pts receiving low-intensity chemotherapy. Herein, we explored the outcomes of pts treated with Ven+Aza who achieved both CRc and MRD<10-3 in the VIALE-A trial (NCT02993523). Methods: Enrolled pts were ≥18 years and unfit for intensive chemotherapy. Pts received Ven 400 mg orally; days 1–28 and Aza 75 mg/m2; days 1-7/28-day cycle. Bone marrow aspirate samples for multiparametric flow cytometry assessments by integrated leukemia-associated immunophenotypes and different than normal procedures were collected for central analysis (Covance Central Laboratory Services) at baseline, end of cycle 1, and every 3 cycles thereafter. Assessments were performed independent of disease responses. MRD response was defined as <1 residual blast /1000 leukocytes (<10-3). CRc, DoR, OS, and EFS were assessed. Disease assessments were per modified International Working Group response criteria for AML. Results: 211/286 (74%) pts treated with Ven+Aza with at least one valid post-baseline MRD assessment were considered MRD evaluable; 78/211 (37%) achieved MRD<10-3 and 133/211 (63%) had MRD≥10-3. Median age (MRD<10-3/ MRD≥10-3) was 76 (range: 49-89)/77 (58-91) yrs. Pts (MRD<10-3/ MRD≥10-3) received median of 14.5 (range: 1-28) /7.0 (1-30) cycles of Ven+Aza. At median follow-up of 22.0 (range: 20.1-23.0)/20.8 (19.8-22.3) months (mos), CRc + MRD<10-3/ MRD≥10-3 was achieved by 67 (86%)/ 97 (73%); 20/67 (30%) achieved CRc + MRD<10-3 by end of cycle 1. Median DoR, OS, and EFS were not reached in pts with CRc + MRD<10-3 response (Table). The 12-mo estimates for DoR, OS, and EFS for pts with CRc + MRD<10-3response were 81.2%, 94.0%, and 83.2%, respectively. Adverse events ≥grade 3 (MRD<10-3/ MRD≥10-3) were febrile neutropenia (50%/43%), neutropenia (50%/35%), and thrombocytopenia (44%/44%), similar to the overall population. Conclusions: Pts with best response of CRc who achieved MRD<10-3 response with Ven+Aza treatment had longer DoR, OS, and EFS than pts who were CRc and MRD positive. Clinical trial information: NCT02993523. [Table: see text]
Collapse
Affiliation(s)
- Keith Pratz
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | | | | | | | | | | | | | | | | | | | - Su-Peng Yeh
- China Medical University Hospital, Taichung, Taiwan
| | - Jun Ho Jang
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Muhit Ozcan
- Ankara University School of Medicine Department of Hematology, Ankara, Turkey
| | | | - Arpad Illes
- University of Debrecen, Medical and Health Science Center, Debrecen, Hungary
| | | | | | | | | | | |
Collapse
|
29
|
Jouzier C, Hamel JF, Dumas PY, Delaunay J, Bonmati C, Guièze R, Hunault M, Banos A, Lioure B, Béné MC, Ianotto JC, Ojeda-Uribe M, Paul F, Bernard M, Jourdan E, Zerazhi H, Vey N, Ifrah N, Recher C, Pigneux A, Cahn JY. Conventional chemotherapy for acute myeloid leukemia in older adults: Impact on nutritional, cognitive, and functional status. Eur J Haematol 2021; 106:859-867. [PMID: 33733520 DOI: 10.1111/ejh.13624] [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] [Received: 12/07/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The impact of conventional treatment for acute myeloid leukemia (AML) on the nutritional, cognitive, and functional status of elderly patients is seldom studied. This assessment was performed in the context of the LAMSA 2007 trial. METHODS The trial enrolled 424 patients with de novo AML. Among them, 316 benefited from geriatric assessment (GA) including nutritional, cognitive, and functional status and were scored according to Eastern Cooperative Oncology Group (ECOG) and sorror for the prediction of treatment toxicity, morbidity, and mortality. Patients were investigated at diagnosis for three times during follow-up. RESULTS This study showed that AML and its treatment have no impact on cognitive (P = .554) nor functional status (P = .842 for Activity of Daily Living and P = .087 for Instrumental Activities of Daily Living). The nutritional status improved over time (P = .041). None of these three parameters at baseline, associated or not with ECOG and sorror scores, impacted survivals or toxicities. CONCLUSIONS The cognitive, functional, and nutritional status had no impact in this cohort of fit elderly AML patients without unfavorable cytogenetics. The GA tools used provided no additional information compared with ECOG and sorror scores, to predict toxicity, morbidity, or mortality due to intensive chemotherapy.
Collapse
Affiliation(s)
- Claire Jouzier
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | | - Pierre-Yves Dumas
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | | | | | - Romain Guièze
- Clinical Hematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Mathilde Hunault
- Clinical Hematology, Angers University Hospital & INSERM U 892/CNRS 6299, Angers, France
| | - Anne Banos
- Clinical Hematology, Cote Basque General Hospital, Bayonne, France
| | - Bruno Lioure
- Clinical Hematology, Strasbourg University Hospital, Strasbourg, France
| | | | | | | | - Franciane Paul
- Clinical Hematology, Montpellier University Hospital, Montpellier, France
| | - Marc Bernard
- Clinical Hematology, Rennes University Hospital, Rennes, France
| | - Eric Jourdan
- Clinical Hematology, Nîmes University Hospital, Nîmes, France
| | - Hacène Zerazhi
- Clinical Hematology, Avignon General Hospital, Avignon, France
| | - Norbert Vey
- Clinical Hematology, Paoli-Calmettes Institute, Marseille, France
| | - Norbert Ifrah
- Clinical Hematology, Angers University Hospital & INSERM U 892/CNRS 6299, Angers, France
| | - Christian Recher
- Clinical Hematology, Toulouse University Hospital, Cancer University Institute Toulouse Oncopole, Paul Sabatier University, Toulouse, France
| | - Arnaud Pigneux
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | - Jean-Yves Cahn
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | |
Collapse
|
30
|
Cluzeau T, Sebert M, Rahmé R, Cuzzubbo S, Lehmann-Che J, Madelaine I, Peterlin P, Bève B, Attalah H, Chermat F, Miekoutima E, Rauzy OB, Recher C, Stamatoullas A, Willems L, Raffoux E, Berthon C, Quesnel B, Loschi M, Carpentier AF, Sallman DA, Komrokji R, Walter-Petrich A, Chevret S, Ades L, Fenaux P. Eprenetapopt Plus Azacitidine in TP53-Mutated Myelodysplastic Syndromes and Acute Myeloid Leukemia: A Phase II Study by the Groupe Francophone des Myélodysplasies (GFM). J Clin Oncol 2021; 39:1575-1583. [PMID: 33600210 PMCID: PMC8099409 DOI: 10.1200/jco.20.02342] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [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] [Indexed: 01/25/2023] Open
Abstract
TP53-mutated (TP53m) myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) have very poor outcome irrespective of the treatment received, including 40% responses (20% complete remission [CR]) with azacitidine (AZA) alone, short response duration, and a median overall survival (OS) of approximately 6 months. Eprenetapopt (APR-246), a novel first-in-class drug, leads to p53 protein reconformation and reactivates its proapoptotic and cell-cycle arrest functions.
Collapse
Affiliation(s)
- Thomas Cluzeau
- Cote d'Azur University, Hematology Department, Centre Hospitalier Universitaire of Nice, Nice, France.,Cote d'Azur University, Mediterranean Center of Molecular Medicine, INSERM U1065, Nice, France.,GFM
| | - Marie Sebert
- GFM.,Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| | - Ramy Rahmé
- GFM.,Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| | | | | | | | | | | | | | | | - Elsa Miekoutima
- Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| | | | | | | | - Lise Willems
- GFM.,Hematology Department, Hospital Cochin, APHP, Paris, France
| | - Emmanuel Raffoux
- GFM.,Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| | | | - Bruno Quesnel
- GFM.,Hematology Department, CHU of Lille, Lille, France
| | - Michael Loschi
- Cote d'Azur University, Hematology Department, Centre Hospitalier Universitaire of Nice, Nice, France.,Cote d'Azur University, Mediterranean Center of Molecular Medicine, INSERM U1065, Nice, France
| | | | - David A Sallman
- Hematology Unit, Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Rami Komrokji
- Hematology Unit, Moffitt Cancer Center and Research Institute, Tampa, FL
| | | | - Sylvie Chevret
- SBIM, Hospital Saint Louis, APHP, and Paris University, Paris, France
| | - Lionel Ades
- GFM.,Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| | - Pierre Fenaux
- GFM.,Hematology Department, Hospital Saint Louis, Assistance Publique des Hopitaux de Paris (APHP), and Paris University, Paris, France
| |
Collapse
|
31
|
Sauvage M, Tavitian S, Sibaud V, Boulinguez S, Pages-Laurent C, Lamant L, Tournier E, Recher C, Meyer N. Aggressive locoregional behavior of cutaneous squamous cell carcinoma during ruxolitinib use. Ann Dermatol Venereol 2021; 148:140-141. [PMID: 33478822 DOI: 10.1016/j.annder.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/26/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023]
Affiliation(s)
- M Sauvage
- Department of Dermatology, Institut Universitaire du Cancer de Toulouse, Centre Hospitalier Universitaire de Toulouse, Université Paul-Sabatier Toulouse-III, 31100 Toulouse, France
| | - S Tavitian
- Department of Hematology, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, 31100 Toulouse, France
| | - V Sibaud
- Department of Oncodermatology, Institut Universitaire du Cancer de Toulouse - Oncopole, 31100 Toulouse, France
| | - S Boulinguez
- Department of Dermatology, Institut Universitaire du Cancer de Toulouse, Centre Hospitalier Universitaire de Toulouse, Université Paul-Sabatier Toulouse-III, 31100 Toulouse, France
| | - C Pages-Laurent
- Department of Oncodermatology, Institut Universitaire du Cancer de Toulouse - Oncopole, 31100 Toulouse, France
| | - L Lamant
- Department of Histopathology, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, 31100 Toulouse, France
| | - E Tournier
- Department of Histopathology, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, 31100 Toulouse, France
| | - C Recher
- Department of Hematology, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, 31100 Toulouse, France
| | - N Meyer
- Department of Dermatology, Institut Universitaire du Cancer de Toulouse, Centre Hospitalier Universitaire de Toulouse, Université Paul-Sabatier Toulouse-III, 31100 Toulouse, France.
| |
Collapse
|
32
|
Belliere J, Colombat M, Kounde C, Recher C, Ribes D, Huart A, Chauveau D, Demas V, Luquet I, Beyne-Rauzy O, Tavitian S, Faguer S. Kidney Involvement in Patients With Chronic Myelomonocytic Leukemia or BCR-ABL-Negative Myeloproliferative Neoplasms. Kidney Int Rep 2020; 6:737-745. [PMID: 33732988 PMCID: PMC7938079 DOI: 10.1016/j.ekir.2020.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/06/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 01/11/2023] Open
Abstract
Introduction The identification of specific molecular signatures and the development of new targeted drugs have changed the paradigm of onco-nephrology, now allowing a multiscale approach of kidney involvement related to hematologic malignancies relying on combined hematologic and molecular assessments. In this study, we aimed to refine the spectrum of kidney disorders associated with chronic myelomonocytic leukemia (CMML) or BCR-ABL–negative myeloproliferative neoplasms (MPNs), 2 very rare conditions scarcely described. Methods Case series. Patients with myeloid neoplasms who were referred to Toulouse University Hospital Nephrology Unit and were diagnosed with acute kidney injury (AKI), chronic kidney disease (CKD), or urine abnormalities were retrospectively included. Results Eighteen patients (males n=13, CMML n=8, essential thrombocytosis [ET] n=7, polycythemia vera [PV] n=1, and myelofibrosis n=2) developed kidney disease 7.7±2 years after the diagnosis of the malignancy. Twelve patients had AKI at presentation. Eight patients had glomerular presentation (high-range proteinuria 33%, microscopic hematuria 56%). Kidney biopsy (n=14) showed various patterns, including pauci-immune glomerulosclerosis (n=5), extramedullary hematopoiesis (n=6), or tubular atrophy and interstitial fibrosis with polymorphic inflammation (n=8). Immunostaining of CD61 confirmed the infiltration of megakaryocytes within glomeruli or interstitium in 5 of 8 patients. Other pictures of glomerulopathy were identified in 3 patients (IgA nephropathy n=2, AA amyloidosis n=1). Massive kidney infiltration by CMML was identified in 1 patient. After a mean follow-up of 24±6 months, malignancy was considered as stable in 11 patients (61%), but 22% of patients had progressed to end-stage renal failure. The remaining had persistently reduced kidney function. No correlation between the malignancy and the renal presentation and outcomes could be identified. Conclusions Kidney complications of CMML/MPN are heterogenous, and kidney biopsy may help to identify new molecular targets to prevent the development of kidney fibrosis.
Collapse
Affiliation(s)
- Julie Belliere
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France.,INSERM U1048, Institut des maladies métaboliques et cardio-vasculaires, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Magali Colombat
- Université Paul Sabatier, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Département d'Anatomopathologie, Toulouse, France
| | - Clément Kounde
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France
| | - Christian Recher
- Université Paul Sabatier, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'Hématologie, Toulouse, France
| | - David Ribes
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France
| | - Antoine Huart
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France
| | - Dominique Chauveau
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France.,INSERM U1048, Institut des maladies métaboliques et cardio-vasculaires, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| | - Véronique Demas
- Université Paul Sabatier, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Isabelle Luquet
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Odile Beyne-Rauzy
- Université Paul Sabatier, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service de Médecine interne, Toulouse, France
| | - Suzanne Tavitian
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'Hématologie, Toulouse, France
| | - Stanislas Faguer
- Centre Hospitalier Universitaire de Toulouse, Département de Néphrologie et Transplantation d'Organes, Centre de reference des Maladies rénales rares, Toulouse, France.,INSERM U1048, Institut des maladies métaboliques et cardio-vasculaires, Toulouse, France.,Université Paul Sabatier, Toulouse, France
| |
Collapse
|
33
|
Abstract
The development of Bruton's tyrosine kinase (BTK) inhibitors represents a major breakthrough in the treatment of chronic lymphocytic leukemia and other B cell malignancies. The first-generation inhibitor ibrutinib works by covalent irreversible binding to BTK, a non-receptor tyrosine kinase of the TEC (transient erythroblastopenia of childhood) family that plays a critical role in the B-cell receptor signaling pathway. It also induces an 'off-target' inhibition of a range of other kinases including (but not limited to) epidermal growth factor receptor (EGFR), SRC, and other kinases of the TEC family (interleukin-2-inducible T-cell kinase [ITK], Tec, BMX). Dermatological toxicities are among the most common toxicities of ibrutinib, but remain of mild to moderate intensity in most cases and are readily manageable. Their incidence is highest during the first year of treatment and declines over time. In addition, it has been postulated that ibrutinib-related dermatologic adverse events are mediated by the direct binding to both BTK and other 'off-target' kinases. Bruising, ecchymoses, and petechiae represent the most characteristic dermatologic adverse events. Nail and hair changes are also common, as skin infections (opportunistic infections including herpes simplex and herpes zoster virus reactivations, and Staphylococcus aureus superinfection), folliculitis, and other types of rashes. Panniculitis, aphthous-like ulcerations with stomatitis, neutrophilic dermatosis, peripheral edema, and skin cracking can also occur. Next-generation BTK inhibitors, acalabrutinib and zanubrutinib, have been designed to optimize BTK inhibition and minimize off-target inhibition of alternative kinases (Tec, ITK, EGFR, SRC-family kinases). These drugs have been recently FDA-approved for relapsed or refractory mantle cell lymphoma. Although the overall incidence of their toxicities is expected to be more limited, acalubrutinib and zanubrutinib are associated with a range of dermatologic toxic effects that appear to be similar to those previously described with ibrutinib, including bruising and ecchymoses, panniculitis, human herpesvirus infections, cellulitis, and skin rash. In particular, both drugs induce skin bleeding events in more than 30% of patients treated. However, the available dermatological data are still rather limited and will have to be consolidated prospectively. This review article analyses the wide spectrum of dermatological toxicities that can be encountered with first- and second-generation BTK inhibitors. Finally, recommendations for appropriate treatment as well as a synthesis algorithm for management are also proposed.
Collapse
Affiliation(s)
- Vincent Sibaud
- Oncodermatology Department, Institut Claudius Regaud and Institut Universitaire du Cancer Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France.
| | - Marie Beylot-Barry
- Dermatology Department, Hôpital Saint-André, INSERM U1053, Oncogenesis of Cutaneous Lymphoma, Bordeaux, France
| | - Caroline Protin
- Haematology Department, Institut Universitaire du Cancer Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France
| | - Emmanuelle Vigarios
- Oral Medicine Department, Institut Universitaire du Cancer Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France
| | - Christian Recher
- Haematology Department, Institut Universitaire du Cancer Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France
| | - Loic Ysebaert
- Haematology Department, Institut Universitaire du Cancer Toulouse Oncopole, 1 avenue Irène Joliot-Curie, 31059, Toulouse Cedex 9, France
| |
Collapse
|
34
|
Medrano C, Oberic L, Puisset F, Recher C, Larrieu-Ciron D, Ysebaert L, Protin C, Picard M, Perriat S, Chatelut E, Bertoli S, Huguet F, Tavitian S, Faguer S. Life-threatening complications after high-dose methotrexate and the benefits of glucarpidase as salvage therapy: a cohort study of 468 patients. Leuk Lymphoma 2020; 62:846-853. [PMID: 33179543 DOI: 10.1080/10428194.2020.1846733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aims of this study were to characterize the incidence and outcomes of severe toxicities following the administration of high-dose methotrexate (HD-MTX; ≥1 g/m2). Among the 468 patients included in the study, 69 (14.9%) developed at least one episode of acute kidney injury (AKI; 138/1264 HD-MTX administrations), including 34 (7.2%) who developed KDIGO stage 2-3 AKI. The three baseline factors independently associated with the risk of developing AKI were age, body mass index and a diagnosis of acute lymphoblastic leukemia. Higher plasma MTX concentration was associated with AKI and extra-renal toxicities. Notwithstanding potentially confounding factors, most patients with AKI who received glucarpidase (n = 41) developed extra-renal toxicity (leading to the death of two patients) despite early administration. Thus, severe toxicity and death can occur whether or not glucarpidase is administered, which confirms the need for further interventional studies to provide greater precision on its role in the management of HD-MTX toxicity.
Collapse
Affiliation(s)
- Chloé Medrano
- Département de Néphrologie et Transplantation d'organes - Unité de Réanimation, Centre Hospitalier Universitaire de Toulouse, French Intensive Care Renal Network, Toulouse, France
| | - Lucie Oberic
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Florent Puisset
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Loïc Ysebaert
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Caroline Protin
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Muriel Picard
- Département d'anesthésie et de réanimation, Réanimation Médicale, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sophie Perriat
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Etienne Chatelut
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d'organes - Unité de Réanimation, Centre Hospitalier Universitaire de Toulouse, French Intensive Care Renal Network, Toulouse, France.,INSERM U1048 (Institut des Maladies Métaboliques et Cardiovasculaires, équipe 12), Hôpital Rangueil, Toulouse, France.,Université Paul Sabatier - Toulouse III, Toulouse, France
| |
Collapse
|
35
|
Gomes N, Huynh A, Borel C, Guenounou S, Recher C, Barres B, Vigarios E, Sibaud V. Oral acute graft versus host disease after donor lymphocyte infusions: Clinicopathological characterization in a monocenter cohort. Oral Oncol 2020; 114:105082. [PMID: 33187825 DOI: 10.1016/j.oraloncology.2020.105082] [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: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
Donor lymphocyte infusions (DLI) are used after hematopoietic stem cell transplant (HSCT) in order to boost the graft-versus-tumor effect. The most significant toxicity is acute or chronic graft-versus-host disease (GVHD), whose clinical symptoms mirror those occurring after HSCT. By contrast, oral acute GVHD lesions have been exceptionally described post-DLI. We report on a monocenter cohort of 12 adult patients that developed oral acute GVHD after DLI. The majority was treated for acute myeloid leukemia. A total of 29 DLI treatments were applied and the median time between the last DLI and the oral mucosal lesions was 42 days. Most patients presented these oral lesions concomitant with skin lesions and none of them had exclusive oral involvement. Oral lichenoid changes were observed in 11 patients, including plaque-like lesions and/or reticulated white streaks consistent with Wickham's striae, affecting mainly the buccal mucosa and dorsal or lateral aspects of the tongue. Mucosal histopathological findings showed a patchy-to-florid lichenoid interface dermatitis for 3 biopsied patients. Eight patients also experienced salivary gland changes. The treatment of oral lesions included high- to very high-potency topical corticosteroids in the majority of patients. Oral GVHD lesions have seldom been described after DLI, and only exceptionally in an acute setting. Our results are not consistent with those reported in the literature evaluating GVHD after DLI. In fact, oral acute GVHD lesions post-DLI appeared very common and similar to the oral lichenoid reactions of chronic GVHD following HSCT. The main limitations of this work are its retrospective design and the relatively small sample size.
Collapse
Affiliation(s)
- Nuno Gomes
- Dermatovenereology Department, Centro Hospitalar Universitário de São João EPE - Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Anne Huynh
- Hematology Department, Institut Universitaire du Cancer Toulouse Oncopole, Centre Hospitalier Universitaire (CHU) de Toulouse, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Cécile Borel
- Hematology Department, Institut Universitaire du Cancer Toulouse Oncopole, Centre Hospitalier Universitaire (CHU) de Toulouse, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Sarah Guenounou
- Hematology Department, Institut Universitaire du Cancer Toulouse Oncopole, Centre Hospitalier Universitaire (CHU) de Toulouse, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Christian Recher
- Hematology Department, Institut Universitaire du Cancer Toulouse Oncopole, Centre Hospitalier Universitaire (CHU) de Toulouse, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Beatrice Barres
- Pathology Department, Institut Claudius REGAUD and Institut Universitaire du Cancer Toulouse Oncopole, Centre Hospitalier Universitaire (CHU) de Toulouse, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Emmanuelle Vigarios
- Oral Medicine Department, Institut Claudius REGAUD and Institut Universitaire du Cancer Toulouse Oncopole, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France
| | - Vincent Sibaud
- Oncodermatology Department, Institut Claudius REGAUD and Institut Universitaire du Cancer Toulouse Oncopole, France - 1 avenue Irène Joliot-Curie 31059, Toulouse Cedex 9, France.
| |
Collapse
|
36
|
Rieu J, Coster L, Corre J, Tavitian S, Recher C, Huynh A, Picard M, Derreumaux C, Bertoli S, Vergez F, Largeaud L. A case of cup-like blasts associated with B-lymphoblastic leukemia without NPM1 and FLT3 internal tandem duplication mutations. EJHaem 2020; 1:589-592. [PMID: 35845019 PMCID: PMC9175993 DOI: 10.1002/jha2.91] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Jean‐Baptiste Rieu
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Lucie Coster
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Jill Corre
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Suzanne Tavitian
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Christian Recher
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Anne Huynh
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Muriel Picard
- Intensive Care UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Celine Derreumaux
- Intensive Care UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Sarah Bertoli
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Francois Vergez
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Laetitia Largeaud
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| |
Collapse
|
37
|
Bories P, Prade N, Lagarde S, Cabarrou B, Largeaud L, Plenecassagnes J, Luquet I, De Mas V, Filleron T, Cassou M, Sarry A, Fornecker LM, Simand C, Bertoli S, Recher C, Delabesse E. Impact of TP53 mutations in acute myeloid leukemia patients treated with azacitidine. PLoS One 2020; 15:e0238795. [PMID: 33001991 PMCID: PMC7529302 DOI: 10.1371/journal.pone.0238795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/24/2020] [Indexed: 12/31/2022] Open
Abstract
Hypomethylating agents are a classical frontline low-intensity therapy for older patients with acute myeloid leukemia. Recently, TP53 gene mutations have been described as a potential predictive biomarker of better outcome in patients treated with a ten-day decitabine regimen., However, functional characteristics of TP53 mutant are heterogeneous, as reflected in multiple functional TP53 classifications and their impact in patients treated with azacitidine is less clear. We analyzed the therapeutic course and outcome of 279 patients treated with azacitidine between 2007 and 2016, prospectively enrolled in our regional healthcare network. By screening 224 of them, we detected TP53 mutations in 55 patients (24.6%), including 53 patients (96.4%) harboring high-risk cytogenetics. The identification of any TP53 mutation was associated with worse overall survival but not with response to azacitidine in the whole cohort and in the subgroup of patients with adverse karyotype. Stratification of patients according to three recent validated functional classifications did not allow the identification of TP53 mutated patients who could benefit from azacitidine. Systematic TP53 mutant classification will deserve further exploration in the setting of patients treated with conventional therapy and in the emerging field of therapies targeting TP53 pathway.
Collapse
MESH Headings
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic/therapeutic use
- Azacitidine/therapeutic use
- Biomarkers, Tumor/genetics
- Female
- France/epidemiology
- Genes, p53
- Humans
- Kaplan-Meier Estimate
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Male
- Middle Aged
- Mutation
- Prognosis
- Prospective Studies
- Registries
- Tumor Suppressor Protein p53/genetics
Collapse
Affiliation(s)
- Pierre Bories
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Réseau Onco-occitanie, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- * E-mail:
| | - Naïs Prade
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Stéphanie Lagarde
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Bastien Cabarrou
- Unité de biostatistique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Julien Plenecassagnes
- Unité de bioinformatique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Thomas Filleron
- Unité de biostatistique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Manon Cassou
- Unité de bioinformatique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Luc-Matthieu Fornecker
- Service d'Onco-Hématologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Célestine Simand
- Service d'Onco-Hématologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| |
Collapse
|
38
|
Belliere J, Colombat M, Koundé C, Recher C, Ribes D, Chauveau D, Demas V, Beyne Rauzy O, Tavitian S, Faguer S. Complications rénales des leucémies myélomonocytaires chroniques et des syndromes myéloprolifératifs BCR-ABL négatifs. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
39
|
Tremblay G, Cariou C, Recher C, Dolph M, Brandt P, Blanc AS, Forsythe A. Cost-effectiveness of midostaurin in the treatment of newly diagnosed FLT3-mutated acute myeloid leukemia in France. Eur J Health Econ 2020; 21:543-555. [PMID: 31970530 DOI: 10.1007/s10198-019-01149-9] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 10/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Midostaurin (MIDO) combined with standard chemotherapy was approved by the European Medicines Agency in 2017 for the treatment of adults with newly diagnosed FLT3-mutated acute myeloid leukemia (AML) based on results from the RATIFY trial. METHODS A cost-effectiveness model was developed to compare MIDO and standard-of-care (SOC) to SOC alone in France. Per Haute Autorité de Santé (HAS) guidelines, a partitioned survival model with eight health states was used: diagnosis/induction, complete remission, relapse, hematopoietic stem cell transplantation (HSCT), HSCT recovery, post-HSCT recovery (stabilized after HSCT recovery), post-HSCT relapse, and mortality. A lifetime horizon was used beginning at diagnosis with a "cure model,", which assumed natural mortality after trial cut-off. Utility values were obtained from a systematic literature review and included disutilities. Resource utilization was based on HAS clinical guidelines and a survey of French physicians and included drugs and administration, adverse events, routine medical care, HSCT, and end-of-life care costs. RESULTS In RATIFY and after extrapolation, MIDO improved survival compared to SOC, translating into MIDO-treated patients gaining 1.12 life years (LYs) and 1.23 quality-adjusted life years (QALYs) versus SOC. The incremental cost-effectiveness ratio (ICER) for MIDO versus SOC was €68,781 per LY and €62,305 per QALY. Sensitivity analyses showed consistency with base case findings. CONCLUSIONS MIDO represents a clinically significant advancement in the management of newly diagnosed FLT3-mutated AML. In this analysis, MIDO add-on therapy showed gains in LYs and QALYs versus SOC alone and was found to be a cost-effective option at a €100,000 per QALY threshold for end-of-life treatment.
Collapse
Affiliation(s)
| | | | - Christian Recher
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole-Centre Hospitalier Université de Toulouse, Toulouse, France
| | - Mike Dolph
- Purple Squirrel Economics, New York, USA
| | | | | | | |
Collapse
|
40
|
Perl AE, Martinelli G, Cortes JE, Neubauer A, Berman E, Paolini S, Montesinos P, Baer MR, Larson RA, Ustun C, Fabbiano F, Erba HP, Di Stasi A, Stuart R, Olin R, Kasner M, Ciceri F, Chou WC, Podoltsev N, Recher C, Yokoyama H, Hosono N, Yoon SS, Lee JH, Pardee T, Fathi AT, Liu C, Hasabou N, Liu X, Bahceci E, Levis MJ. Gilteritinib or Chemotherapy for Relapsed or Refractory FLT3-Mutated AML. N Engl J Med 2019; 381:1728-1740. [PMID: 31665578 DOI: 10.1056/nejmoa1902688] [Citation(s) in RCA: 688] [Impact Index Per Article: 137.6] [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: 11/19/2022]
Abstract
BACKGROUND Patients with relapsed or refractory acute myeloid leukemia (AML) with mutations in the FMS-like tyrosine kinase 3 gene (FLT3) infrequently have a response to salvage chemotherapy. Gilteritinib is an oral, potent, selective FLT3 inhibitor with single-agent activity in relapsed or refractory FLT3-mutated AML. METHODS In a phase 3 trial, we randomly assigned adults with relapsed or refractory FLT3-mutated AML in a 2:1 ratio to receive either gilteritinib (at a dose of 120 mg per day) or salvage chemotherapy. The two primary end points were overall survival and the percentage of patients who had complete remission with full or partial hematologic recovery. Secondary end points included event-free survival (freedom from treatment failure [i.e., relapse or lack of remission] or death) and the percentage of patients who had complete remission. RESULTS Of 371 eligible patients, 247 were randomly assigned to the gilteritinib group and 124 to the salvage chemotherapy group. The median overall survival in the gilteritinib group was significantly longer than that in the chemotherapy group (9.3 months vs. 5.6 months; hazard ratio for death, 0.64; 95% confidence interval [CI], 0.49 to 0.83; P<0.001). The median event-free survival was 2.8 months in the gilteritinib group and 0.7 months in the chemotherapy group (hazard ratio for treatment failure or death, 0.79; 95% CI, 0.58 to 1.09). The percentage of patients who had complete remission with full or partial hematologic recovery was 34.0% in the gilteritinib group and 15.3% in the chemotherapy group (risk difference, 18.6 percentage points; 95% CI, 9.8 to 27.4); the percentages with complete remission were 21.1% and 10.5%, respectively (risk difference, 10.6 percentage points; 95% CI, 2.8 to 18.4). In an analysis that was adjusted for therapy duration, adverse events of grade 3 or higher and serious adverse events occurred less frequently in the gilteritinib group than in the chemotherapy group; the most common adverse events of grade 3 or higher in the gilteritinib group were febrile neutropenia (45.9%), anemia (40.7%), and thrombocytopenia (22.8%). CONCLUSIONS Gilteritinib resulted in significantly longer survival and higher percentages of patients with remission than salvage chemotherapy among patients with relapsed or refractory FLT3-mutated AML. (Funded by Astellas Pharma; ADMIRAL ClinicalTrials.gov number, NCT02421939.).
Collapse
Affiliation(s)
- Alexander E Perl
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Giovanni Martinelli
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Jorge E Cortes
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Andreas Neubauer
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Ellin Berman
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Stefania Paolini
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Pau Montesinos
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Maria R Baer
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Richard A Larson
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Celalettin Ustun
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Francesco Fabbiano
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Harry P Erba
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Antonio Di Stasi
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Robert Stuart
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Rebecca Olin
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Margaret Kasner
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Fabio Ciceri
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Wen-Chien Chou
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Nikolai Podoltsev
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Christian Recher
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Hisayuki Yokoyama
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Naoko Hosono
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Sung-Soo Yoon
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Je-Hwan Lee
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Timothy Pardee
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Amir T Fathi
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Chaofeng Liu
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Nahla Hasabou
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Xuan Liu
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Erkut Bahceci
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| | - Mark J Levis
- From the Abramson Cancer Center, University of Pennsylvania (A.E.P.), and Thomas Jefferson University (M.K.) - both in Philadelphia; Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola (G.M.), L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna (S.P.), Ospedali Riuniti Villa Sofia-Cervello, Palermo (F.F.), and IRCCS San Raffaele Scientific Institute, Milan (F.C.) - all in Italy; University of Texas M.D. Anderson Cancer Center, Houston (J.E.C.); Universitätsklinikum Giessen und Marburg, Marburg, Germany (A.N.); Memorial Sloan Kettering Cancer Center, New York (E. Berman); Hospital Universitari i Politècnic La Fe, Valencia, and Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Instituto Carlos III, Madrid - both in Spain (P.M.); University of Maryland Greenebaum Comprehensive Cancer Center (M.R.B.) and Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (M.J.L.) - both in Baltimore; University of Chicago, Chicago (R.A.L.), and Astellas Pharma, Northbrook (C.L., N. Hasabou, X.L., E. Bahceci) - both in Illinois; University of Minnesota, Minneapolis (C.U.); University of Alabama at Birmingham, Birmingham (H.P.E., A.D.S.); Hollings Cancer Center, Medical University of South Carolina, Charleston (R.S.); University of California, San Francisco, San Francisco (R.O.); National Taiwan University, Taipei City, Taiwan (W.-C.C.); Yale University School of Medicine, New Haven, CT (N.P.); Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France (C.R.); Sendai Medical Center, National Hospital Organization, Sendai (H.Y.), and University of Fukui, Fukui (N. Hosono) - both in Japan; Seoul National University (S.-S.Y.) and Asan Medical Center, University of Ulsan College of Medicine (J.-H.L.) - both in Seoul, South Korea; Wake Forest Baptist Medical Center, Winston-Salem, NC (T.P.); and Massachusetts General Hospital, Harvard Medical School, Boston (A.T.F.)
| |
Collapse
|
41
|
Angenendt L, Röllig C, Montesinos P, Martínez-Cuadrón D, Barragan E, García R, Botella C, Martínez P, Ravandi F, Kadia T, Kantarjian HM, Cortes J, Juliusson G, Lazarevic V, Höglund M, Lehmann S, Recher C, Pigneux A, Bertoli S, Dumas PY, Dombret H, Preudhomme C, Micol JB, Terré C, Ráčil Z, Novák J, Žák P, Wei AH, Tiong IS, Wall M, Estey E, Shaw C, Exeler R, Wagenführ L, Stölzel F, Thiede C, Stelljes M, Lenz G, Mikesch JH, Serve H, Ehninger G, Berdel WE, Kramer M, Krug U, Schliemann C. Chromosomal Abnormalities and Prognosis in NPM1-Mutated Acute Myeloid Leukemia: A Pooled Analysis of Individual Patient Data From Nine International Cohorts. J Clin Oncol 2019; 37:2632-2642. [PMID: 31430225 PMCID: PMC8462529 DOI: 10.1200/jco.19.00416] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Nucleophosmin 1 (NPM1) mutations are associated with a favorable prognosis in acute myeloid leukemia (AML) when an internal tandem duplication (ITD) in the fms-related tyrosine kinase 3 gene (FLT3) is absent (FLT3-ITDneg) or present with a low allelic ratio (FLT3-ITDlow). The 2017 European LeukemiaNet guidelines assume this is true regardless of accompanying cytogenetic abnormalities. We investigated the validity of this assumption. METHODS We analyzed associations between karyotype and outcome in intensively treated patients with NPM1mut/FLT3-ITDneg/low AML who were prospectively enrolled in registry databases from nine international study groups or treatment centers. RESULTS Among 2,426 patients with NPM1mut/FLT3-ITDneg/low AML, 2,000 (82.4%) had a normal and 426 (17.6%) had an abnormal karyotype, including 329 patients (13.6%) with intermediate and 83 patients (3.4%) with adverse-risk chromosomal abnormalities. In patients with NPM1mut/FLT3-ITDneg/low AML, adverse cytogenetics were associated with lower complete remission rates (87.7%, 86.0%, and 66.3% for normal, aberrant intermediate, and adverse karyotype, respectively; P < .001), inferior 5-year overall (52.4%, 44.8%, 19.5%, respectively; P < .001) and event-free survival (40.6%, 36.0%, 18.1%, respectively; P < .001), and a higher 5-year cumulative incidence of relapse (43.6%, 44.2%, 51.9%, respectively; P = .0012). These associations remained in multivariable mixed-effects regression analyses adjusted for known clinicopathologic risk factors (P < .001 for all end points). In patients with adverse-risk chromosomal aberrations, we found no significant influence of the NPM1 mutational status on outcome. CONCLUSION Karyotype abnormalities are significantly associated with outcome in NPM1mut/FLT3-ITDneg/low AML. When adverse-risk cytogenetics are present, patients with NPM1mut share the same unfavorable prognosis as patients with NPM1 wild type and should be classified and treated accordingly. Thus, cytogenetic risk predominates over molecular risk in NPM1mut/FLT3-ITDneg/low AML.
Collapse
Affiliation(s)
- Linus Angenendt
- University Hospital Münster, Münster, Germany,Linus Angenendt, MD, Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany; e-mail:
| | - Christoph Röllig
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - Eva Barragan
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | | | | | | | - Farhad Ravandi
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tapan Kadia
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jorge Cortes
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Martin Höglund
- Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Sören Lehmann
- Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | | | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Bordeaux, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre-Yves Dumas
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Bordeaux, France
| | | | - Claude Preudhomme
- Institut National de la Santé et de la Recherche Médicale Lille, Lille, France
| | | | | | - Zdeněk Ráčil
- Masaryk University, University Hospital Brno, Brno, Czech Republic
| | - Jan Novák
- University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Žák
- University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Andrew H. Wei
- The Alfred Hospital, Monash University, Melbourne, Australia
| | - Ing S. Tiong
- The Alfred Hospital, Monash University, Melbourne, Australia
| | | | - Elihu Estey
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Carole Shaw
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Lisa Wagenführ
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Friedrich Stölzel
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Christian Thiede
- University Hospital of the Technical University Dresden, Dresden, Germany
| | | | - Georg Lenz
- University Hospital Münster, Münster, Germany
| | | | - Hubert Serve
- University Hospital Frankfurt, Frankfurt, Germany
| | - Gerhard Ehninger
- University Hospital of the Technical University Dresden, Dresden, Germany
| | | | - Michael Kramer
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Utz Krug
- Klinikum Leverkusen, Leverkusen, Germany
| | | |
Collapse
|
42
|
Perl AE, Martinelli G, Cortes JE, Neubauer A, Berman E, Paolini S, Montesinos P, Baer MR, Larson RA, Ustun C, Fabbiano F, Stasi AD, Stuart R, Olin R, Kasner M, Ciceri F, Chou WC, Podoltsev N, Recher C, Yokoyama H, Hosono N, Yoon SS, Lee JH, Pardee T, Fathi AT, Liu C, Liu X, Bahceci E, Levis MJ. Abstract CT184: Gilteritinib significantly prolongs overall survival in patients with FLT3-mutated ( FLT3mut+) relapsed/refractory (R/R) acute myeloid leukemia (AML): Results from the Phase III ADMIRAL trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-ct184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Gilteritinib is a potent/selective oral inhibitor of FMS-like tyrosine kinase 3 (FLT3). Based upon interim analysis response rates from the ADMIRAL Phase III study of gilteritinib vs salvage chemotherapy (SC) in patients (pts) with R/R FLT3mut+ AML (NCT02421939), gilteritinib became the first FLT3 inhibitor approved as single agent therapy in this population. Here we present the final results of this pivotal trial.
Methods: Adults with confirmed FLT3mut+ AML (FLT3-ITD and/or FLT3-TKD D835 or I836 mutations) refractory to induction chemotherapy or in untreated first relapse were randomized (2:1) to receive continuous 28-day cycles of 120 mg/day gilteritinib or pre-randomization selected SC: low-dose cytarabine (LoDAC), azacitidine (AZA), mitoxantrone/etoposide/cytarabine (MEC), or fludarabine/cytarabine/granulocyte colony-stimulating factor/idarubicin (FLAG-IDA). Prior FLT3 inhibitor use, other than midostaurin or sorafenib, was excluded. Overall survival (OS) and the combined rate of complete remission/complete remission with partial hematologic recovery (CR/CRh) were co-primary endpoints. Secondary endpoints were event-free survival (EFS) and CR rate; safety/tolerability was also examined.
Results: A total of 371 pts were randomized: 247 to gilteritinib and 124 to SC (MEC, 25.7%; FLAG-IDA, 36.7%; LoDAC, 14.7%; AZA, 22.9%). Median age was 62 years (range, 19-85). Baseline FLT3 mutations were: FLT3-ITD, 88.4%; FLT3-TKD, 8.4%; both FLT3-ITD and FLT3-TKD, 1.9%; unconfirmed, 1.3%. Overall, 39.4% of pts had refractory AML and 60.6% had relapsed AML. Patients randomized to gilteritinib had significantly longer OS (9.3 months) than SC (5.6 months; hazard ratio [HR] for death = 0.637; P=0.0007); 1-year survival rates were 37.1% and 16.7%, respectively. The CR/CRh rates for gilteritinib and SC were 34.0% and 15.3%, respectively (P=0.0001); CR rates were 21.1% and 10.5% (2-sided P=0.0106). Median EFS was 2.8 months and 0.7 months in the gilteritinib and SC arms, respectively (HR 0.793, P=0.0830). Common adverse events (AEs) in all randomized pts were febrile neutropenia (43.7%), anemia (43.4%), and pyrexia (38.6%). Common grade ≥3 AEs related to gilteritinib were anemia (19.5%), febrile neutropenia (15.4%), thrombocytopenia (12.2%), and decreased platelet count (12.2%). Adjusted for exposure duration, serious treatment-emergent AEs per patient year were less common with gilteritinib (7.1%) than SC (9.2%).
Conclusions: In patients with R/R FLT3mut+ AML, the potent, selective FLT3 inhibitor gilteritinib resulted in significantly longer OS and higher response rates compared with chemotherapy and had a favorable safety profile. These results change the treatment paradigm for salvage therapy of R/R FLT3mut+ AML and establish gilteritinib as the new standard of care.
Citation Format: Alexander E. Perl, Giovanni Martinelli, Jorge E. Cortes, Andreas Neubauer, Ellin Berman, Stefania Paolini, Pau Montesinos, Maria R. Baer, Richard A. Larson, Celalettin Ustun, Francesco Fabbiano, Antonio Di Stasi, Robert Stuart, Rebecca Olin, Margaret Kasner, Fabio Ciceri, Wen-Chien Chou, Nikolai Podoltsev, Christian Recher, Hisayuki Yokoyama, Naoko Hosono, Sung-Soo Yoon, Je-Hwan Lee, Timothy Pardee, Amir T. Fathi, Chaofeng Liu, Xuan Liu, Erkut Bahceci, Mark J. Levis. Gilteritinib significantly prolongs overall survival in patients with FLT3-mutated (FLT3mut+) relapsed/refractory (R/R) acute myeloid leukemia (AML): Results from the Phase III ADMIRAL trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr CT184.
Collapse
Affiliation(s)
- Alexander E. Perl
- 1Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Giovanni Martinelli
- 2Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRST IRCCS, Meldola, Italy
| | - Jorge E. Cortes
- 3University of Texas, MD Anderson Cancer Center, Houston, TX
| | - Andreas Neubauer
- 4Universitätsklinikum Giessen und Marburg GmbH, Marburg, Germany
| | - Ellin Berman
- 5Memorial Sloan-Kettering Cancer Center, New York City, NY
| | - Stefania Paolini
- 6L. and A. Seràgnoli Institute of Hematology, Bologna University Medical School, Bologna, Italy
| | - Pau Montesinos
- 7Hospital Universitari i Politècnic La Fe, Valencia & CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Maria R. Baer
- 8University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD
| | | | | | | | | | - Robert Stuart
- 13Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Rebecca Olin
- 14University of California San Francisco, San Francisco, CA
| | | | - Fabio Ciceri
- 16IRCCS San Raffaele Scientific Institute, Milano, Italy
| | | | | | - Christian Recher
- 19Institut Universitaire du Cancer Toulouse – Oncopole, Cedez, France
| | - Hisayuki Yokoyama
- 20Sendai Medical Center, National Hospital Organization, Sendai, Japan
| | | | - Sung-Soo Yoon
- 22Seoul National University, Seoul, Republic of Korea
| | - Je-Hwan Lee
- 23Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Amir T. Fathi
- 25Massachussetts General Hospital, Harvard Medical School, Boston, MA
| | - Chaofeng Liu
- 26Astellas Pharma Global Development, Northbrook, IL
| | - Xuan Liu
- 26Astellas Pharma Global Development, Northbrook, IL
| | - Erkut Bahceci
- 26Astellas Pharma Global Development, Northbrook, IL
| | - Mark J. Levis
- 27Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| |
Collapse
|
43
|
Levis MJ, Perl AE, Martinelli G, Cortes JE, Neubauer A, Berman E, Montesinos P, Baer MR, Larson RA, Chou WC, Yokoyama H, Recher C, Yoon SS, Hill JE, Rosales M, Liu C, Bahceci E. Effect of gilteritinib on survival in patients with FLT3-mutated (FLT3mut+) relapsed/refractory (R/R) AML who have common AML co-mutations or a high FLT3-ITD allelic ratio. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.7000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7000 Background: The FLT3 inhibitor, gilteritinib, showed superior response and overall survival (OS) compared with salvage chemotherapy (SC) in patients (pts) with FLT3mut+ R/R AML in the phase 3 ADMIRAL study. We analyzed the impact of baseline co-mutations and FLT3-ITD allelic ratio (AR) on response and OS. Methods: A total of 37 recurrently mutated genes in AML (Archer Core Myeloid Panel) were analyzed by next-generation sequencing; the cutoff for co-mutation positivity (co-mut+) was ≥0.027. Baseline FLT3-ITD AR ( FLT3-ITD to FLT3 wild-type DNA) was measured by the LeukoStrat CDx FLT3 Mutation Assay. The median FLT3-ITD AR value of 0.77 was used to define high (≥0.77) vs low (<0.77) FLT3-ITD AR. Results: Analysis of 361 FLT3mut+ pts identified four major co-mutation cohorts, each with ≥10% of pts: NPM1 (n=173; 47.9%), DNMT3A (n=115; 31.9%), DNMT3A/NPM1 (n=86; 23.8%) , and WT1 (n=65; 18.0%). In addition, seven pts (1.9%) had all three co-mutations (ie, NPM1, DNMT3A, and WT1). The gilteritinib arm had superior response rates and OS across all four major co-mutation cohorts, with the greatest survival benefit in pts with DNMT3A/NPM1 co-mut+ (Table). In FLT3-ITD AR analyses (n=335), gilteritinib conferred longer OS than SC in pts with a high or low FLT3-ITD AR (gilteritinib: high FLT3-ITD AR, 7.1 mos vs low FLT3-ITD AR, 10.6 mos; SC: high FLT3-ITD AR, 4.3 mos vs low FLT3-ITD AR, 6.9 mos). In both arms, OS was longer in the low FLT3-ITD AR cohort than the high FLT3-ITD AR cohort but the difference in the gilteritinib arm was not statistically significant (gilteritinib: HR=1.341, P=0.0712; SC: HR=2.01, P=0.0021). Conclusions: The ADMIRAL trial shows that the clinical benefit of gilteritinib in FLT3mut+ R/R AML is maintained regardless of NPM1, DNMT3A, DNMT3A/ NPM1, or WT1 co-mut+ or high FLT3-ITD AR. Clinical trial information: NCT02421939. [Table: see text]
Collapse
Affiliation(s)
- Mark J. Levis
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD
| | - Alexander E. Perl
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA
| | - Giovanni Martinelli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Jorge E. Cortes
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Ellin Berman
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia & CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Maria R. Baer
- University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), Baltimore, MD
| | | | | | - Hisayuki Yokoyama
- Sendai Medical Center, National Hospital Organization, Sendai, Japan
| | - Christian Recher
- Institut Universitaire du Cancer Toulouse–Oncopole, Cedex, France
| | | | | | | | | | | |
Collapse
|
44
|
Berger E, Delpierre C, Despas F, Berard E, Recher C, Lamy S. Do patients’ SEP influence therapeutic strategy in acute myeloid leukaemia: Results from a French longitudinal observational study. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.05.336] [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: 10/28/2022] Open
|
45
|
Prata PH, Bally C, Prebet T, Recher C, Venton G, Thomas X, Raffoux E, Pigneux A, Cluzeau T, Desoutter J, Gay J, Preudhomme C, Fenaux P, Adès L. NPM1 mutation is not associated with prolonged complete remission in acute myeloid leukemia patients treated with hypomethylating agents. Haematologica 2018; 103:e455-e457. [PMID: 29748442 DOI: 10.3324/haematol.2018.189886] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Cécile Bally
- Hématologie Clinique, Hôpital Saint Louis, Paris, France
| | | | - Christian Recher
- Clinical Hematology, IUCT Oncopole, Toulouse University Hospital, France
| | | | | | | | - Arnaud Pigneux
- Hematology Department, Centre Hospitalier Universitaire (CHU) de Bordeaux, Universités de Bordeaux, France
| | | | - Judith Desoutter
- Laboratoire d'Hématologie, CHRU Lille, Université de Lille, France
| | - Julie Gay
- Service d'Hématologie, Centre Hospitalier de la Côte Basque, Bayonne, France
| | - Claude Preudhomme
- Centre de Biologie-Pathologie, Centre Hospitalier Universitaire de Lille, France
| | | | - Lionel Adès
- Hématologie Clinique, Hôpital Saint Louis, Paris, France
| |
Collapse
|
46
|
Berger E, Delpierre C, Despas F, Berard E, Bories P, Sarry A, Recher C, Lamy S. La position sociale influence-t-elle le choix du traitement dans la leucémie aiguë myéloïde du sujet âgé ? Une étude longitudinale en Midi-Pyrénées (France). Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.03.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
47
|
De Clara E, Gourvest M, Ma H, Vergez F, Tosolini M, Dejean S, Demur C, Delabesse E, Recher C, Touriol C, Martelli MP, Falini B, Brousset P, Bousquet M. Long non-coding RNA expression profile in cytogenetically normal acute myeloid leukemia identifies a distinct signature and a new biomarker in NPM1-mutated patients. Haematologica 2017; 102:1718-1726. [PMID: 28679652 PMCID: PMC5622856 DOI: 10.3324/haematol.2017.171645] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 06/22/2017] [Indexed: 12/13/2022] Open
Abstract
Long non-coding RNAs are defined as transcripts larger than 200 nucleotides but without protein-coding potential. There is growing evidence of the important role of long non-coding RNAs in cancer initiation, development and progression. In this study, we sought to evaluate the long non-coding RNA expression profile of patients with cytogenetically normal acute myeloid leukemia (AML). RNA-sequencing of 40 cytogenetically normal AML patients allowed us to quantify 11,036 long non-coding RNAs. Among these, more than 8000 were previously undescribed long non-coding RNAs. Using unsupervised analysis, we observed a specific long non-coding RNA expression profile dependent on the mutational status of the NPM1 gene. Statistical analysis allowed us to identify a minimal set of 12 long non-coding RNAs capable of discriminating NPM1-mutated from NPM1-wild-type patients. These results were validated by qRT-PCR on an independent cohort composed of 134 cytogenetically normal AML patients. Furthermore, we have identified one putative biomarker, the long non-coding RNA XLOC_109948 whose expression pattern predicts clinical outcome. Interestingly, low XLOC_109948 expression indicates a good prognosis especially for NPM1-mutated patients. Transient transfection of GapmeR against XLOC_109948 in NPM1-mutated OCI-AML3 cell line treated with Ara-C or ATRA enhances apoptosis suggesting XLOC_109948 plays a role in drug sensitivity. This study improves our knowledge of the long non-coding RNA transcriptome in cytogenetically normal AML patients. We observed a distinct long non-coding RNA expression profile in patients with the NPM1 mutation. The newly identified XLOC_109948 long non-coding RNA emerged as a strong prognostic factor able to better stratify NPM1-mutated patients.
Collapse
Affiliation(s)
- Etienne De Clara
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France
| | - Morgane Gourvest
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France
| | | | - François Vergez
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France.,Laboratoire et Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer, France
| | - Marie Tosolini
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France
| | - Sébastien Dejean
- Institut de Mathématiques de Toulouse, UMR 5219 Université de Toulouse/CNRS Université Paul Sabatier, France
| | - Cécile Demur
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France.,Laboratoire et Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer, France
| | - Eric Delabesse
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France.,Laboratoire et Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer, France
| | - Christian Recher
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France.,Laboratoire et Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer, France
| | - Christian Touriol
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France
| | - Maria Paola Martelli
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Italy
| | - Brunangelo Falini
- Institute of Hematology, University of Perugia, Ospedale S. Maria della Misericordia, Italy
| | - Pierre Brousset
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France.,Department of Pathology, Institut Universitaire du Cancer de Toulouse-Oncopole and Centre Hospitalier Universitaire de Toulouse, France
| | - Marina Bousquet
- Cancer Research Center of Toulouse (CRCT), UMR1037 Inserm/Université Toulouse III Paul Sabatier, ERL5294 CNRS, Laboratoire d'Excellence Toulouse Cancer (TOUCAN), France
| |
Collapse
|
48
|
Hunault-Berger M, Maillard N, Himberlin C, Recher C, Schmidt-Tanguy A, Choufi B, Bonmati C, Carré M, Couturier MA, Daguindau E, Marolleau JP, Orsini-Piocelle F, Delaunay J, Tavernier E, Lissandre S, Ojeda-Uribe M, Sanhes L, Sutton L, Banos A, Fornecker LM, Bernard M, Bouscary D, Saad A, Puyade M, Rouillé V, Luquet I, Béné MC, Hamel JF, Dreyfus F, Ifrah N, Pigneux A. Maintenance therapy with alternating azacitidine and lenalidomide in elderly fit patients with poor prognosis acute myeloid leukemia: a phase II multicentre FILO trial. Blood Cancer J 2017; 7:e568. [PMID: 28574488 PMCID: PMC5520397 DOI: 10.1038/bcj.2017.50] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- M Hunault-Berger
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - N Maillard
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - C Himberlin
- Service d'Hématologie, CHU Reims, Reims, France
| | - C Recher
- Hématologie Clinique, CHU, Institut Universitaire du Cancer Toulouse-Oncopole, CRCT UMR1037, Université de Toulouse III, Toulouse, France
| | - A Schmidt-Tanguy
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - B Choufi
- Service d'Hématologie, CH Boulogne, Boulogne, France
| | - C Bonmati
- Service d'Hématologie, CHU Nancy, Nancy, France
| | - M Carré
- Service d'Hématologie, UMR 5525, CHU Grenoble Alpes, La Tronche, France
| | - M-A Couturier
- Institut d'Hématologie et de Cancérologie, Hôpital Augustin Morvan, Brest, France
| | - E Daguindau
- Service d'Hématologie, CHU Besançon, Besançon, France
| | | | | | - J Delaunay
- Service d'Hématologie, CHU Nantes, Nantes, France
| | - E Tavernier
- Service d'Hématologie, Institut de Cancérologie de la Loire, Saint Etienne, France
| | - S Lissandre
- Service d'Hématologie et thérapie cellulaire, CHU, Tours, France
| | - M Ojeda-Uribe
- Service d'Hématologie, CH Mulhouse, Mulhouse, France
| | - L Sanhes
- Service d'Hématologie, CH Perpignan, Perpignan, France
| | - L Sutton
- Service d'Hématologie, CH Argenteuil, Argenteuil, France
| | - A Banos
- Service d'Hématologie, CH Côte Basque, Bayonne, France
| | - L M Fornecker
- Département d'Hématologie et d'Oncologie, CHU Hautepierre, Strasbourg, France
| | - M Bernard
- Hématologie Clinique, Hôpital Pontchaillou, Rennes, France
| | - D Bouscary
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - A Saad
- Hématologie, CH Béziers, Béziers, France
| | - M Puyade
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - V Rouillé
- Service Hématologie, Hôpital Lapeyronie, Montpellier, France
| | - I Luquet
- Hématologie Biologique, CHU, IUC Toulouse-Oncopole, Toulouse, France
| | - M C Béné
- Hématologie Biologique, CHU de Nantes, Nantes, France
| | - J-F Hamel
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - F Dreyfus
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - N Ifrah
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - A Pigneux
- Hématologie Clinique, CHU Bordeaux, Inserm 1035, Bordeaux, France
| |
Collapse
|
49
|
Cahu X, Carré M, Recher C, Pigneux A, Hunault-Berger M, Vey N, Chevallier P, Delaunay J, Gyan E, Lioure B, Bonmati C, Himberlin C, Hicheri Y, Guillerm G, Didier B, Larosa F, Ojeda-Uribe M, Bernard M, Bene MC, Ifrah N, Cahn JY. Impact of body-surface area on patients’ outcome in younger adults with acute myeloid leukemia. Eur J Haematol 2017; 98:443-449. [DOI: 10.1111/ejh.12850] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Xavier Cahu
- Department of Hematology; Hôpital Pontchaillou; CHU; Rennes France
| | - Martin Carré
- Department of Hematology; CHU Grenoble Alpes; La Tronche France
| | - Christian Recher
- Department of Hematology; CHU de Toulouse; Centre de Recherches en Cancerologie de Toulouse; Universite Paul Sabatier; Toulouse France
| | - Arnaud Pigneux
- Department of Hematology; CHU Bordeaux; Université Bordeaux; Bordeaux France
| | | | - Norbert Vey
- Department of Hematology; Institut Paoli-Calmettes; Marseille France
| | | | - Jacques Delaunay
- Department of Hematology; Centre Catherine de Sienne; Nantes France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy; UMR CNRS 7292; Centre Hospitalier Universitaire; Tours France
| | - Bruno Lioure
- Department of Hematology; Hopitaux Universitaires de Strasbourg; Strasbourg France
| | - Caroline Bonmati
- Department of Hematology; CHU Vandoeuvre-les-Nancy; Nancy France
| | | | - Yosr Hicheri
- Department of Hematology; CHU Montpellier; Montpellier France
| | | | - Bouscary Didier
- Department of Hematology; Hôpital Cochin; AP-HP; Paris France
| | | | - Mario Ojeda-Uribe
- Department of Hematology; Centre Hospitalier Mulhouse; Mulhouse France
| | - Marc Bernard
- Department of Hematology; Hôpital Pontchaillou; CHU; Rennes France
| | | | | | - Jean-Yves Cahn
- Department of Hematology; CHU Grenoble Alpes; La Tronche France
| |
Collapse
|
50
|
Thomas X, de Botton S, Chevret S, Caillot D, Raffoux E, Lemasle E, Marolleau JP, Berthon C, Pigneux A, Vey N, Reman O, Simon M, Recher C, Cahn JY, Hermine O, Castaigne S, Celli-Lebras K, Ifrah N, Preudhomme C, Terré C, Dombret H. Randomized Phase II Study of Clofarabine-Based Consolidation for Younger Adults With Acute Myeloid Leukemia in First Remission. J Clin Oncol 2017; 35:1223-1230. [PMID: 28221862 DOI: 10.1200/jco.2016.70.4551] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To evaluate the efficacy and safety of a clofarabine-based combination (CLARA) versus conventional high-dose cytarabine (HDAC) as postremission chemotherapy in younger patients with acute myeloid leukemia (AML). Patients and Methods Patients age 18 to 59 years old with intermediate- or unfavorable-risk AML in first remission and no identified donor for allogeneic stem-cell transplantation (SCT) were eligible. Two hundred twenty-one patients were randomly assigned to receive three CLARA or three HDAC consolidation cycles. The primary end point was relapse-free survival (RFS). To handle the confounding effect of SCT that could occur in patients with late donor identification, hazard ratios (HRs) of events were adjusted on the time-dependent treatment × SCT interaction term. Results At 2 years, RFS was 58.5% (95% CI, 49% to 67%) in the CLARA arm and 46.5% (95% CI, 37% to 55%) in the HDAC arm. Overall, 110 patients (55 in each arm) received SCT in first remission. On the basis of a multivariable Cox-adjusted treatment × SCT interaction, the HR of CLARA over HDAC before or in absence of SCT was 0.65 (95% CI, 0.43 to 0.98; P = .041). In a sensitivity analysis, when patients who received SCT in first remission were censored at SCT time, 2-year RFS was 53.3% (95% CI, 39% to 66%) in the CLARA arm and 31.0% (95% CI, 19% to 43%) in the HDAC arm (HR, 0.63; 95% CI, 0.41 to 0.98; P = .043). Gain in RFS could be related to the lower cumulative incidence of relapse observed in the CLARA arm versus the HDAC arm (33.9% v 46.4% at 2 years, respectively; cause-specific HR, 0.61; 95% CI, 0.40 to 0.94; P = .025). CLARA cycles were associated with higher hematologic and nonhematologic toxicity than HDAC cycles. Conclusion These results suggest that CLARA might be considered as a new chemotherapy option in younger patients with AML in first remission.
Collapse
Affiliation(s)
- Xavier Thomas
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Stéphane de Botton
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Sylvie Chevret
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Denis Caillot
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Emmanuel Raffoux
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Emilie Lemasle
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Jean-Pierre Marolleau
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Céline Berthon
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Arnaud Pigneux
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Norbert Vey
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Oumedaly Reman
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Marc Simon
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Christian Recher
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Jean-Yves Cahn
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Olivier Hermine
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Sylvie Castaigne
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Karine Celli-Lebras
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Norbert Ifrah
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Claude Preudhomme
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Christine Terré
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| | - Hervé Dombret
- Xavier Thomas, Lyon-Sud University Hospital, Pierre Bénite; Stéphane de Botton, Gustave-Roussy Cancer Institute, Villejuif; Sylvie Chevret, Emmanuel Raffoux, and Hervé Dombret, Paris Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Paris Diderot; Olivier Hermine, Paris Necker University Hospital, AP-HP, University Paris Descartes; Karine Celli-Lebras, Acute Leukemia French Association Coordination Office, Paris Saint-Louis University Hospital, Paris; Denis Caillot, Dijon University Hospital, Dijon; Emilie Lemasle, Henri-Becquerel Cancer Center, Rouen; Jean-Pierre Marolleau, Amiens University Hospital, Amiens; Céline Berthon, Claude Huriez University Hospital; Claude Preudhomme, University of Lille, Claude Huriez University Hospital, Institut National de la Santé et de la Recherche Médicale UMR-S 1172, Jean-Pierre Aubert Research Institute, Lille; Arnaud Pigneux, Bordeaux Haut-Leveque University Hospital, Pessac; Norbert Vey, Paoli-Calmette Cancer Institute, Marseille; Oumedaly Reman, George-Clémenceau University Hospital, Caen; Marc Simon, Valenciennes Hospital, Valenciennes; Christian Recher, Toulouse Cancer University Institute, Toulouse; Jean-Yves Cahn, Grenoble University Hospital, Grenoble; Sylvie Castaigne and Christine Terré, Versailles University Hospital, Versailles-Saint Quentin University, Le Chesnay; and Norbert Ifrah, Angers University Hospital, Angers, France
| |
Collapse
|