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Balsat M, Alcazer V, Etienne G, Huguet F, Berger M, Cayssials E, Charbonnier A, Escoffre-Barbe M, Johnson-Ansah H, Legros L, Roy L, Delmer A, Ianotto JC, Orvain C, Larosa F, Meunier M, Amé S, Andreoli A, Cony-Makhoul P, Morisset S, Tigaud I, Rea D, Nicolini FE. First-line second generation tyrosine kinase inhibitors in patients with newly diagnosed accelerated phase chronic myeloid leukemia. Leuk Res 2023; 130:107308. [PMID: 37230027 DOI: 10.1016/j.leukres.2023.107308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023]
Abstract
Accelerated phase (AP) CML at onset and have poorer prognosis than CP-CML. We hypothesize that off-license use of second generation TKI (TKI2) as front-line therapy might counterbalance this poor prognosis, with limited toxicity. In "real-life" conditions, newly diagnosed patients meeting the ELN cytological criteria for AP-CML or harboring ACA and treated with first-line TKI2 were included in this retrospective multicenter observational study. We enrolled 69 patients [69.5 % male, median age 49.5 years, median follow-up 43.5 months], segregated into hematologic AP [HEM-AP (n = 32)] and cytogenetically defined AP [ACA-AP (n = 37)]. Hematologic parameters were worse in HEM-AP [spleen size (p = 0.014), PB basophils (p < .001), PB blasts (p < .001), PB blasts+promyelocytes (p < .001), low hemoglobin levels (p < .001)]. Dasatinib was initiated in 56 % patients in HEM-AP and in 27 % in ACA-AP, nilotinib in 44 % and 73 % respectively. Response and survival do not differ, regardless of the TKI2: 81 % vs 84.3 % patients achieved CHR, 88 % vs 84 % CCyR, 73 % vs 75 % MMR respectively. The estimated 5-year PFS 91.5 % (95%CI: 84.51-99.06 %) and 5-year OS 96.84 % (95%CI: 92.61-100 %). Only BM blasts (p < 0.001) and BM blasts+promyelocytes (p < 0.001) at diagnosis negatively influenced OS. TKI2 as front-line therapy in newly diagnosed AP-CML induce excellent responses and survival, and counterbalance the negative impact of advanced disease phase.
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Affiliation(s)
- Marie Balsat
- Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France; French Group of CML (Fi-LMC), Lyon, France
| | - Vincent Alcazer
- Hematology Department, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Gabriel Etienne
- Hematology Department, Institut Bergonié, Bordeaux, France; French Group of CML (Fi-LMC), Lyon, France
| | - Françoise Huguet
- Hematology Department, Institut Universitaire du Cancer, Toulouse, France; French Group of CML (Fi-LMC), Lyon, France
| | - Marc Berger
- Hematology Department, CHU Estaing, Clermont-Ferrand, France; French Group of CML (Fi-LMC), Lyon, France
| | - Emilie Cayssials
- Hematology Department, Hôpital Jean Bernard, Poitiers, France; French Group of CML (Fi-LMC), Lyon, France
| | - Aude Charbonnier
- Hematology Department, Institut Paoli Calmettes, Marseilles, France; French Group of CML (Fi-LMC), Lyon, France
| | - Martine Escoffre-Barbe
- Hematology Department, Hôpital de Pontchaillou, Rennes, France; French Group of CML (Fi-LMC), Lyon, France
| | - Hyacinthe Johnson-Ansah
- Hematology Department, Hôpital Clémenceau, Caën, France; French Group of CML (Fi-LMC), Lyon, France
| | - Laurence Legros
- Hematology Department, Hôpital Paul Brousse, Villejuif, France; French Group of CML (Fi-LMC), Lyon, France
| | - Lydia Roy
- Hematology department, Hôpital Universitaire Henri Mondor - AP-HP & Faculté de Santé - UPEC, Créteil, France; French Group of CML (Fi-LMC), Lyon, France
| | | | - Jean-Christophe Ianotto
- Hematology Department, Hôpital Morvan, Brest, France; French Group of CML (Fi-LMC), Lyon, France
| | - Corentin Orvain
- Hematology Department, Hôpital universitaire, Angers, France; French Group of CML (Fi-LMC), Lyon, France
| | - Fabrice Larosa
- Gerontology Department, Hôpital du Bocage, Dijon, France; French Group of CML (Fi-LMC), Lyon, France
| | - Mathieu Meunier
- Hematology Department, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France; French Group of CML (Fi-LMC), Lyon, France
| | - Shanti Amé
- Hematology Department, Institut de Cancérologie Strasbourg Europe, Strasbourg, France; French Group of CML (Fi-LMC), Lyon, France
| | - Annalisa Andreoli
- Hematology Department, CH d'Argenteuil, Argenteuil, France; French Group of CML (Fi-LMC), Lyon, France
| | - Pascale Cony-Makhoul
- Hematology Department, Centre Hospitalier Annecy Genevois, Pringy, France; French Group of CML (Fi-LMC), Lyon, France
| | | | - Isabelle Tigaud
- Laboratory for Cytogenetics, Centre Hospitalier Lyon Sud, Pierre Bénite, France; French Group of CML (Fi-LMC), Lyon, France
| | - Delphine Rea
- Hematology Department, Hôpital Saint Louis, Paris, France; French Group of CML (Fi-LMC), Lyon, France
| | - Franck Emmanuel Nicolini
- Hematology Department, Centre Léon Bérard, Lyon, France; INSERM U1052, CRCL, Lyon, France; French Group of CML (Fi-LMC), Lyon, France.
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Vovelle J, Row C, Larosa F, Guy J, Mihai AM, Maynadié M, Barben J, Manckoundia P. Prescription of Blood Lymphocyte Immunophenotyping in the Diagnosis of Lymphoid Neoplasms in Older Adults. J Clin Med 2022; 11:jcm11061748. [PMID: 35330073 PMCID: PMC8949070 DOI: 10.3390/jcm11061748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Lymphoid neoplasms are a heterogeneous group of lymphoid neoplastic diseases with multiple presentations, and varying prognoses. They are especially frequent in older patients (OPs) and the atypism of this frail elderly population can make the diagnostic process even more difficult. Blood lymphocyte immunophenotyping (BLI) is essential in rapid noninvasive diagnosis orientation and guides complementary investigations. To our knowledge, BLI prescription has never been evaluated in OPs. We hypothesized that, when there is a suspicion of lymphoid neoplasm in the geriatric population, a BLI is performed in view of various clinical or biological abnormalities. This study aimed to: (1) describe the characteristics of hospitalized OPs having undergone BLI for suspected lymphoid neoplasm, (2) identify the causes leading to BLI prescription, and (3) identify the most profitable criteria for BLI prescription. This was a descriptive retrospective study on 151 OPs aged ≥75 years who underwent BLI over a 2-year period. Regarding BLI prescriptions, eight had lymphocytosis, constituting the “lymphocytosis group” (LG+), while the 143 others had BLI prescribed for reasons other than lymphocytosis (LG−), mainly general weakness and anemia. In the LG−, we compared OPs with positive and negative BLI results. The criteria found to be profitable for BLI prescription were lymphadenopathy, splenomegaly, lymphocytosis, and thrombocytopenia. BLI identified circulating lymphoid neoplasms (positive BLI) in 21/151 OPs, mainly marginal zone lymphoma and chronic lymphocytic leukemia. In polymorbid OPs, as per our study population, the diagnostic and therapeutic complexity explained in part the sole use of indirect and minimally invasive diagnostic techniques such as BLI.
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Affiliation(s)
- Jérémie Vovelle
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (J.V.); (F.L.); (A.-M.M.); (J.B.)
| | - Céline Row
- Department of Biological Hematology, University Hospital, 21079 Dijon, France; (C.R.); (J.G.); (M.M.)
| | - Fabrice Larosa
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (J.V.); (F.L.); (A.-M.M.); (J.B.)
| | - Julien Guy
- Department of Biological Hematology, University Hospital, 21079 Dijon, France; (C.R.); (J.G.); (M.M.)
| | - Anca-Maria Mihai
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (J.V.); (F.L.); (A.-M.M.); (J.B.)
| | - Marc Maynadié
- Department of Biological Hematology, University Hospital, 21079 Dijon, France; (C.R.); (J.G.); (M.M.)
| | - Jérémy Barben
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (J.V.); (F.L.); (A.-M.M.); (J.B.)
| | - Patrick Manckoundia
- “Pôle Personnes Âgées”, Hospital of Champmaillot, University Hospital, 21079 Dijon, France; (J.V.); (F.L.); (A.-M.M.); (J.B.)
- INSERM U-1093, Cognition, Action and Sensorimotor Plasticity, University of Burgundy Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380-29-39-70; Fax: +33-380-29-36-21
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Girard N, Odille G, Sanchez S, Lelarge S, Mignot A, Putot S, Larosa F, Vovelle J, Nuss V, Da Silva S, Barben J, Manckoundia P, Putot A. Comment on: "Beyond Chronological Age: Frailty and Multimorbidity Predict In-hospital Mortality in Patients With Coronavirus Disease 2019". J Gerontol A Biol Sci Med Sci 2021; 76:e155-e156. [PMID: 33417667 PMCID: PMC7929354 DOI: 10.1093/gerona/glab005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Noémie Girard
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Geoffrey Odille
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Stéphane Sanchez
- Service de médecine interne et de gériatrie aigue, Centre Hospitalier de Troyes, France
| | - Sarah Lelarge
- Service de médecine gériatrique aigue, Centre Hospitalier de Auxerre, France
| | - Alexandre Mignot
- Service de médecine gériatrique aigue, CH Hospitalier William Morey, Chalon sur Saône, France
| | - Sophie Putot
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Fabrice Larosa
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Jérémie Vovelle
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Valentine Nuss
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Sofia Da Silva
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Jérémy Barben
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Patrick Manckoundia
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
| | - Alain Putot
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, France
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Fodil S, Raffoux E, Dumas PY, Desbrosses Y, Larosa F, Chantepie S, Larcher MV, Mear JB, Peterlin P, Hunault-Berger M, Hospital MA, Morel V, Lucas N, Vidal V, Salanoubat C, Michel J, Mediavilla C, Ojeda-Uribe M, Alexis M, Frayfer J, Carré M, Maillard N, Redjoul R, Banos A, Detrait M, Cluzeau T, Wickenhauser S, Chaoui D, Elassy M, Pigneux A, Dombret H, Récher C, Bertoli S. Data from French named patient program of quizartinib in relapsed/refractory acute myeloid leukemia. Leuk Lymphoma 2021; 62:1756-1760. [PMID: 33596765 DOI: 10.1080/10428194.2021.1881505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- S Fodil
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - E Raffoux
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Y Dumas
- Service d'Hématologie, CHU Bordeaux, F-33000, Bordeaux, France
| | - Y Desbrosses
- Service d'Hématologie, CHRU Jean Minjoz, Besançon, France
| | - F Larosa
- Service d'Hématologie, CHU de Dijon, Dijon, France
| | - S Chantepie
- Service d'Hématologie, Institut d'Hématologie de Basse-Normandie CHU de Caen, Caen, France
| | - M V Larcher
- Service d'Hématologie, Hospices civils de Lyon, CHU de Lyon, Lyon, France
| | - J B Mear
- Service d'Hématologie, CHU de Rennes - Hôpital Pontchaillou, Rennes, France
| | - P Peterlin
- Service d'Hématologie, CHU de Nantes, Nantes, France
| | - M Hunault-Berger
- Service des Maladies du Sang, Centre Hospitalier Universitaire, FHU GOAL, CRCINA, INSERM, Angers, France
| | - M A Hospital
- Service d'Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - V Morel
- Service d'Hématologie, Hôpital Pitié-Salpêtrière AP-HP, Paris, France
| | - N Lucas
- Service d'Hématologie, Institut Gustave Roussy, Villejuif, France
| | - V Vidal
- Service d'Hématologie, Hôpital Avicenne AP-HP, Bobigny, France
| | - C Salanoubat
- Service d'Hématologie, C.H. Sud Francilien, Corbeil-Essonnes, France
| | - J Michel
- Service d'Hématologie, C.H.R. - Hôpital Félix Maréchal, Metz-Thionville, France
| | - C Mediavilla
- Service d'Hématologie, Hôpital Saint-Antoine AP-HP, Paris, France
| | - M Ojeda-Uribe
- Service d'Hématologie, Groupe Hospitalier Régional Mulhouse Sud-Alsace, Mulhouse, France
| | - M Alexis
- Service d'Hématologie, CHR Orléans, Orléans, France
| | - J Frayfer
- Service d'Hématologie, Grand Hôpital de l'Est Francilien - Site de Meaux, Meaux, France
| | - M Carré
- Service d'Hématologie, CHU Grenoble Alpes, La Tronche, France
| | - N Maillard
- Service d'Hématologie, CHU de Poitiers, Poitiers, France
| | - R Redjoul
- Service d'Hématologie, CHU Henri Mondor, AP-HP et UPEC, Créteil, France
| | - A Banos
- Service d'Hématologie, Centre hospitalier de la côte basque, Bayonne, France
| | - M Detrait
- Service d'Hématologie, CHRU de Nancy, Nancy, France
| | - T Cluzeau
- Département d'Hématologie, Université Cote d'Azur, CHU de Nice, Nice, France
| | | | - D Chaoui
- Service d'Hématologie, CH d'Argenteuil, Argenteuil, France
| | - M Elassy
- Service d'Hématologie, CH d'Auxerre, Auxerre, France
| | - A Pigneux
- Service d'Hématologie, CHU Bordeaux, F-33000, Bordeaux, France
| | - H Dombret
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - C Récher
- Service d'Hématologie, CHU de Toulouse, Centre de Recherches en Cancérologie de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
| | - S Bertoli
- Service d'Hématologie, CHU de Toulouse, Centre de Recherches en Cancérologie de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
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Odille G, Girard N, Sanchez S, Lelarge S, Mignot A, Putot S, Larosa F, Vovelle J, Nuss V, Da Silva S, Barben J, Manckoundia P, Putot A. Should We Prescribe Antibiotics in Older Patients Presenting COVID-19 Pneumonia? J Am Med Dir Assoc 2021; 22:258-259. [PMID: 33385334 PMCID: PMC7832463 DOI: 10.1016/j.jamda.2020.11.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 11/29/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Geoffrey Odille
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Noémie Girard
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Stéphane Sanchez
- Service de médecine interne et de geriatrie aigue, Centre Hospitalier de Troyes, Troyes, France
| | - Sarah Lelarge
- Service de médecine geriatrique aigue, Centre Hospitalier de Auxerre, Auxerre, France
| | - Alexandre Mignot
- Service de médecine geriatrique aigue, CH Hospitalier William Morey, Chalon sur Saone, France
| | - Sophie Putot
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Fabrice Larosa
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Jérémie Vovelle
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Valentine Nuss
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Sofia Da Silva
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Jérémy Barben
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Patrick Manckoundia
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Alain Putot
- Service de médecine geriatrique aigue, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
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Odille G, Girard N, Sanchez S, Lelarge S, Mignot A, Putot S, Larosa F, Vovelle J, Nuss V, Da Silva S, Barben J, Manckoundia P, Putot A. Comment on: Predicting In-Hospital Mortality in COVID-19 Older Patients with Specifically Developed Scores. J Am Geriatr Soc 2021; 69:884-886. [PMID: 33426643 PMCID: PMC8013681 DOI: 10.1111/jgs.17030] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/24/2022]
Abstract
See the Reply by De Matteis et al.
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Affiliation(s)
- Geoffrey Odille
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Noémie Girard
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Stephane Sanchez
- Service de médecine interne et de gériatrie aigue, Centre Hospitalier de Troyes, Troyes, France
| | - Sarah Lelarge
- Service de médecine gériatrique aigue, Centre Hospitalier de Auxerre, Auxerre, France
| | - Alexandre Mignot
- Service de médecine gériatrique aigue, CH Hospitalier William Morey, Chalon sur Saône, France
| | - Sophie Putot
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Fabrice Larosa
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Jeremie Vovelle
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Valentine Nuss
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Sofia Da Silva
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Jeremy Barben
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Patrick Manckoundia
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
| | - Alain Putot
- Service de Médecine Interne Gériatrie, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon, France
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Roussel X, Daguindau E, Berceanu A, Desbrosses Y, Saas P, Ferrand C, Seilles E, Pouthier F, Deconinck E, Larosa F. Altered thymic CD4 + T-cell recovery after allogeneic hematopoietic stem cell transplantation is critical for nocardiosis. Curr Res Transl Med 2019; 67:135-143. [PMID: 31164285 DOI: 10.1016/j.retram.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE OF THE STUDY Nocardia affects immunocompromised human host exhibiting an altered cell-mediated immunity. Infectious risk after allogeneic hematopoietic cell transplantation (AHCT) is significantly correlated to the recovery status of donor-derived immune system, especially CD4+ T-cells reconstitution and thymopoiesis. The purpose of this paper is to highlight a lack of cell-mediated immunity recovery for patients presenting a nocardiosis compared to a control cohort. PATIENTS AND METHODS This is a case control retrospective monocentric study. We retrospectively analyzed a monocentric cohort of 15 cases of nocardiosis after AHCT and we explored the degree of patients' immunosuppression by phenotyping circulating lymphoid subpopulations, including NK cells, CD8+ T-cells, CD4+ T-cells and CD19+ B-cells. We focused on CD4+ T-cell subsets to appreciate thymic output, especially on naive CD4+ T-cells (NTE, CD45RA+/RO- CD4+ T-cells) and recent thymic emigrants (RTE, CD4+CD45RA+/RO-/CD31+). Infected patients were paired with a control cohort of patients with identical transplantation characteristics screened on hematological disease, AHCT conditioning, primary graft-versus-host disease (GHVD) prophylaxis, graft type, sex, age, and season at the AHCT and data concerning immunological reconstitution were compared. RESULTS At onset of nocardiosis, circulating lymphocytes and CD4+ T-cells means count were respectively 730/μL and 162/μL. CD8+ T-cells, CD56+ NK cells and CD19+ B-cells means count were respectively 362/μL, 160/μL, 112/μL. CD4+ T-cells subpopulations, naïve CD4+ T-cells production was impaired with NTE and RTE means count at 26/μL and 11/μL respectively. Comparison between nocardiosis cohort and control cohort over time highlight significant lower cellular count for lymphocytes, CD4+ T-cells, NTE and RTE with p = 0.001, p < 0.001, p < 0.001, p < 0.001 respectively. CONCLUSION Immune recovery monitoring follow-up after AHCT is of particular importance to identify patients susceptible to develop Nocardiosis. Efficient microbiological investigations toward Nocardia such PCR should be used in case of compatible clinical presentation.
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Affiliation(s)
- Xavier Roussel
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France.
| | - Etienne Daguindau
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France; Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Ana Berceanu
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
| | - Yohan Desbrosses
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
| | - Philippe Saas
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Christophe Ferrand
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Estelle Seilles
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Fabienne Pouthier
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Eric Deconinck
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France; Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, F-25000 Besançon, France
| | - Fabrice Larosa
- University Hospital of Besancon, Department of Hematology, F-25000 Besançon, France
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Warda W, Larosa F, Neto Da Rocha M, Trad R, Deconinck E, Fajloun Z, Faure C, Caillot D, Moldovan M, Valmary-Degano S, Biichle S, Daguindau E, Garnache-Ottou F, Tabruyn S, Adotevi O, Deschamps M, Ferrand C. CML Hematopoietic Stem Cells Expressing IL1RAP Can Be Targeted by Chimeric Antigen Receptor-Engineered T Cells. Cancer Res 2018; 79:663-675. [PMID: 30514753 DOI: 10.1158/0008-5472.can-18-1078] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/09/2018] [Accepted: 11/29/2018] [Indexed: 12/16/2022]
Abstract
Chronic myeloid leukemia (CML) is a chronic disease resulting in myeloid cell expansion through expression of the BCR-ABL1 fusion transcript. Tyrosine kinase inhibitors (TKI) have significantly increased survival of patients with CML, and deep responders may consider stopping the treatment. However, more than 50% of patients relapse and restart TKI, subsequently suffering unknown toxicity. Because CML is a model immune system-sensitive disease, we hypothesize that chimeric antigen receptor (CAR) T cells targeting IL1 receptor-associated protein (IL1RAP) in quiescent CML stem cells may offer an opportunity for a permanent cure. In this study, we produced and molecularly characterized a specific monoclonal anti-IL1RAP antibody from which fragment antigen-binding nucleotide coding sequences were cloned as a single chain into a lentiviral backbone and secured with the suicide gene iCASP9/rimiducid system. Our CAR T-cell therapy exhibited cytotoxicity against both leukemic stem cells and, to a lesser extent, monocytes expressing IL1RAP, with no apparent effect on the hematopoietic system, including CD34+ stem cells. This suggests IL1RAP as a tumor-associated antigen for immunotherapy cell targeting. IL1RAP CAR T cells were activated in the presence of IL1RAP+ cell lines or primary CML cells, resulting in secretion of proinflammatory cytokines and specifically killing in vitro and in a xenograft murine model. Overall, we demonstrate the proof of concept of a CAR T-cell immunotherapy approach in the context of CML that is applicable for young patients and primary TKI-resistant, intolerant, or allograft candidate patients. SIGNIFICANCE: These findings present the first characterization and proof of concept of a chimeric antigen receptor directed against IL1RAP expressed by leukemic stem cells in the context of CML.
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Affiliation(s)
- Walid Warda
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Laboratory of Applied Biotechnology, Azm Centre for Research in Biotechnology and its Applications, EDST and Faculty of Sciences 3, Lebanese University, Tripoli, Liban
| | - Fabrice Larosa
- Department of Hematology, University Hospital of Besancon, Besancon, France
| | | | - Rim Trad
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Eric Deconinck
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Department of Hematology, University Hospital of Besancon, Besancon, France
| | - Ziad Fajloun
- Laboratory of Applied Biotechnology, Azm Centre for Research in Biotechnology and its Applications, EDST and Faculty of Sciences 3, Lebanese University, Tripoli, Liban
| | - Cyril Faure
- Department of Internal Medicine, Hospital of Haute Saone, Vesoul, France
| | - Denis Caillot
- Department of Hematology, University Hospital of Dijon, Dijon, France
| | - Marius Moldovan
- Department of Internal Medicine, Hospital Nord Franche-Comté, Belfort, France
| | | | - Sabeha Biichle
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Etienne Daguindau
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.,Department of Hematology, University Hospital of Besancon, Besancon, France
| | | | | | - Olivier Adotevi
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Marina Deschamps
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098, EFS BFC, University of Bourgogne Franche-Comté, Besançon, France.
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9
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Alsuliman T, Kitel C, Dulery R, Guillaume T, Larosa F, Cornillon J, Labussière-Wallet H, Médiavilla C, Belaiche S, Delage J, Alain S, Yakoub-Agha I. Cytotect®CP as salvage therapy in patients with CMV infection following allogeneic hematopoietic cell transplantation: a multicenter retrospective study. Bone Marrow Transplant 2018; 53:1328-1335. [PMID: 29654288 DOI: 10.1038/s41409-018-0166-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/21/2018] [Accepted: 03/04/2018] [Indexed: 11/09/2022]
Abstract
Cytomegalovirus is one of the main contributing factors to high mortality rates in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). The main factors of treatment failure are both drug resistance and intolerance. In some cases, Cytotect®CP CMV-hyperimmune globulin is used as salvage therapy. This study aims to investigate the safety and efficacy of Cytotect®CP as a salvage therapy in patients with CMV infection after allo-HCT. Twenty-three consecutive patients received Cytotect®CP for CMV infection after prior CMV therapy. At the time of Cytotect®CP introduction, 17 patients (74%) had developed acute GVHD and 15 patients (64%) were receiving steroid treatment; Cytotect®CP was used as monotherapy (n = 7) and in combination (n = 16). Overall, response was observed in 18 patients (78%) with a median time of 15 days (range: 3-51). Of the 18 responders, 4 experienced CMV reactivation, while 5 responders died within 100 days of beginning treatment. Of these 5 deaths, 4 were due to causes unrelated to CMV. Estimated 100-day OS from the introduction of Cytotect®CP was 69.6%. No statistically significant difference was observed in 100-day OS between responders and non-responders (73.7% vs 50.0%, p = 0.258). Cytotect®CP as salvage therapy is effective and well-tolerated. Given its safety profile, early treatment use should be considered.
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Affiliation(s)
- Tamim Alsuliman
- Maladies du sang, CHRU de Lille, 59037, Lille, France.,Service d'Hématologie, CH de Boulogne, 62321, Boulogne sur mer, France
| | | | - Rémy Dulery
- Service d'Hématologie, Hôpital Saint-Antoine, AP-HP, Université Pierre et Marie Curie (UPMC), 75012, Paris, France
| | - Thierry Guillaume
- Service d'Hématologie, CHU de Nantes, 44093, Nantes, Cedex 1, France
| | - Fabrice Larosa
- Service d'Hématologie, CHU de Besançon, 25030, Besançon, France
| | - Jérôme Cornillon
- Service d'Hématologie, IC Loire, 42270, Saint-Priest-en-Jarez, France
| | | | | | | | - Jeremy Delage
- Service d'Hématologie, CHU de Montpellier, 34295, Montpellier, cedex 5, France
| | - Sophie Alain
- National Reference Center for Herpes viruses, Inserm U1092, Université de Limoges, Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Limoges, Limoges, France
| | - Ibrahim Yakoub-Agha
- Maladies du sang, CHRU de Lille, 59037, Lille, France. .,CHU de Lille, LIRIC, INSERM U995, université de Lille2, 59000, Lille, France.
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10
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Kroemer M, Spehner L, Mercier-Letondal P, Boullerot L, Kim S, Jary M, Galaine J, Picard E, Ferrand C, Nguyen T, Larosa F, Adotévi O, Godet Y, Borg C. SALL4 oncogene is an immunogenic antigen presented in various HLA-DR contexts. Oncoimmunology 2018; 7:e1412030. [PMID: 29632725 PMCID: PMC5889287 DOI: 10.1080/2162402x.2017.1412030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/11/2017] [Accepted: 11/26/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose: To investigate the immunoprevalence of SALL4-derived peptides in healthy volunteers and cancer patients. Experimental Design: A multistep approach including prediction algorithms was used to design in silico SALL4-derived peptides theoretically able to bind on common HLA-DR and HLA-A/B molecules. The presence of T-cell responses after a long term T-cell assay (28 days) against SALL4 was monitored in 14 healthy donors and the presence of T-cell responses after a short term T-cell assay (10 days) was monitored in 67 cancer patients using IFN-γ ELISPOT assay. A T-cell clone specific for the immunoprevalent A18 K-derived peptide was isolated, characterized and used as a tool to characterize the natural processing of A18 K. Results: A SALL4 specific T-cell repertoire was present in healthy donors (8/14) and cancer patients (29/67) after short term T-cell assay. We further identified two immunoprevalant SALL4-derived peptides, R18 A and A18 K, which bind MHC-class II. In parallel, an A18 K specific Th1 clone recognized monocyte derived Dendritic Cell (moDC) loaded with SALL4 containing cell lysate. The level of IFN-γ secreted by specific T-cell clone was greater in presence of moDC loaded with SALL4 containing cell lysate (49.23 ± 14.02%) than with moDC alone (18.03 ± 3.072%) (p = 0.0477) Conclusion: These results show for the first time immunogenicity of SALL4 oncogenic protein-derived peptides, especially A18 K and R18 A peptides and make them potential targets for personalized medicine. Thus, SALL4 possess major characteristics of a tumor antigen.
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Affiliation(s)
- Marie Kroemer
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
- Department of pharmacy, University hospital of Besançon, Besançon, France
| | - Laurie Spehner
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Patricia Mercier-Letondal
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Laura Boullerot
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Stefano Kim
- Department of medical oncology, University Hospital of Besançon, Besançon, France
| | - Marine Jary
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
- Department of medical oncology, University Hospital of Besançon, Besançon, France
| | - Jeanne Galaine
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Emilie Picard
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Christophe Ferrand
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Thierry Nguyen
- Department of medical oncology, University Hospital of Besançon, Besançon, France
| | - Fabrice Larosa
- Department of hematology, University Hospital of Besançon, Besançon, France
| | - Olivier Adotévi
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
- Department of medical oncology, University Hospital of Besançon, Besançon, France
| | - Yann Godet
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
| | - Christophe Borg
- University of Bourgogne Franche-Comté (UBFC), INSERM, EFS BFC, UMR1098, Interactions hôte-greffon-tumeur – Ingénierie Cellulaire et Génique, Besançon, France
- Department of medical oncology, University Hospital of Besançon, Besançon, France
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11
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Marcandetti M, hocquet D, Bourcier V, Larosa F, Boulanger E. Infection bactérienne à Citrobacter koseri transmise par transfusion plaquettaire. Transfus Clin Biol 2017. [DOI: 10.1016/j.tracli.2017.06.253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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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
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13
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Gamonet C, Bole-Richard E, Delherme A, Aubin F, Toussirot E, Garnache-Ottou F, Godet Y, Ysebaert L, Tournilhac O, Caroline D, Larosa F, Deconinck E, Saas P, Borg C, Deschamps M, Ferrand C. New CD20 alternative splice variants: molecular identification and differential expression within hematological B cell malignancies. Exp Hematol Oncol 2016; 5:7. [PMID: 26937306 PMCID: PMC4774009 DOI: 10.1186/s40164-016-0036-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/20/2015] [Accepted: 02/13/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND CD20 is a B cell lineage-specific marker expressed by normal and leukemic B cells and targeted by several antibody immunotherapies. We have previously shown that the protein from a CD20 mRNA splice variant (D393-CD20) is expressed at various levels in leukemic B cells or lymphoma B cells but not in resting, sorted B cells from the peripheral blood of healthy donors. RESULTS Western blot (WB) analysis of B malignancy primary samples showed additional CD20 signals. Deep molecular PCR analysis revealed four new sequences corresponding to in-frame CD20 splice variants (D657-CD20, D618-CD20, D480-CD20, and D177-CD20) matching the length of WB signals. We demonstrated that the cell spliceosome machinery can process ex vivo D480-, D657-, and D618-CD20 transcript variants by involving canonical sites associated with cryptic splice sites. Results of specific and quantitative RT-PCR assays showed that these CD20 splice variants are differentially expressed in B malignancies. Moreover, Epstein-Barr virus (EBV) transformation modified the CD20 splicing profile and mainly increased the D393-CD20 variant transcripts. Finally, investigation of three cohorts of chronic lymphocytic leukemia (CLL) patients showed that the total CD20 splice variant expression was higher in a stage B and C sample collection compared to routinely collected CLL samples or relapsed refractory stage A, B, or C CLL. CONCLUSION The involvement of these newly discovered alternative CD20 transcript variants in EBV transformation makes them interesting molecular indicators, as does their association with oncogenesis rather than non-oncogenic B cell diseases, differential expression in B cell malignancies, and correlation with CLL stage and some predictive CLL markers. This potential should be investigated in further studies.
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Affiliation(s)
- Clémentine Gamonet
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Elodie Bole-Richard
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Aurélia Delherme
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - François Aubin
- EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Eric Toussirot
- EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France ; CHRU, Department of Rheumatology, Université de Franche-Comté EA 4266, INSERM CIC-1431, 25000 Besançon, France ; EA 4266, Université de Franche-Comté, Besançon, France
| | - Francine Garnache-Ottou
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Yann Godet
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Loïc Ysebaert
- Inserm U1037, Université Toulouse 3-ERL CNRS, CHU Purpan, Toulouse, France
| | - Olivier Tournilhac
- Hématologie Clinique, CHU Estaing, 1 Place Lucie Aubrac, 63003 Clermont-Ferrand Cedex 1, France
| | | | - Fabrice Larosa
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; Hematology Department, CHU Jean Minjoz, 25020 Besançon, France
| | - Eric Deconinck
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France ; Hematology Department, CHU Jean Minjoz, 25020 Besançon, France
| | - Philippe Saas
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Christophe Borg
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Marina Deschamps
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; Laboratoire de Thérapeutique Immuno-Moléculaire et cellulaire des cancers, INSERM UMR1098, Etablissement Français du Sang-Bourgogne/Franche-Comté, 8, rue du Docteur Jean-François-Xavier Girod, 25020 Besançon Cedex, France
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14
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Bellanger AP, Millon L, Berceanu A, Grenouillet F, Grenouillet FE, Larosa F, Deconinck E. CombiningAspergillusmitochondrial and ribosomal QPCR, in addition to galactomannan assay, for early diagnosis of invasive aspergillosis in hematology patients. Med Mycol 2015; 53:760-4. [DOI: 10.1093/mmy/myv051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 05/29/2015] [Indexed: 11/14/2022] Open
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15
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Gamonet C, Bole-Richard E, Delherme A, Aubin F, Toussirot E, Garnache-Ottou F, Godet Y, Ysebaert L, Tournilhac O, Dartigeas C, Larosa F, Deconinck E, Saas P, Borg C, Deschamps M, Ferrand C. Erratum to: New CD20 alternative splice variants: molecular identification and differential expression within hematological B cell malignancies. Exp Hematol Oncol 2015; 5:10. [PMID: 27081577 PMCID: PMC4831155 DOI: 10.1186/s40164-016-0038-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Clémentine Gamonet
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Elodie Bole-Richard
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Aurélia Delherme
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - François Aubin
- EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Eric Toussirot
- EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France ; CHRU, Department of Rheumatology, Université de Franche-Comté EA 4266, INSERM CIC-1431, 25000 Besançon, France ; EA 4266, Université de Franche-Comté, Besançon, France
| | - Francine Garnache-Ottou
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Yann Godet
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Loïc Ysebaert
- Inserm U1037, Université Toulouse 3-ERL CNRS, CHU Purpan, Toulouse, France
| | - Olivier Tournilhac
- Hématologie Clinique, CHU Estaing, 1 Place Lucie Aubrac, 63003 Clermont-Ferrand Cedex 1, France
| | | | - Fabrice Larosa
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; Hematology Department, CHU Jean Minjoz, 25020 Besançon, France
| | - Eric Deconinck
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France ; Hematology Department, CHU Jean Minjoz, 25020 Besançon, France
| | - Philippe Saas
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Christophe Borg
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; EA3181 et Service de Dermatologie, Université de Franche Comté, CHU de Besançon, Besançon, France
| | - Marina Deschamps
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France
| | - Christophe Ferrand
- INSERM UMR1098, Établissement Français du Sang Bourgogne Franche Comté, Université de Franche-Comté, SFR FED4234, 25020 Besançon, France ; Laboratoire de Thérapeutique Immuno-Moléculaire et cellulaire des cancers, INSERM UMR1098, Etablissement Français du Sang-Bourgogne/Franche-Comté, 8, rue du Docteur Jean-François-Xavier Girod, 25020 Besançon Cedex, France
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Bourdelin M, Daguindau E, Larosa F, Legrand F, Nerich V, Deconinck E, Limat S. [Mucositis after allogeneic stem cell transplantation: Risk factors, clinical consequences and prophylaxis]. ACTA ACUST UNITED AC 2014; 63:106-10. [PMID: 25555496 DOI: 10.1016/j.patbio.2014.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/17/2014] [Indexed: 11/28/2022]
Abstract
AIM Oral mucositis is a very common complication of allograft. However, preventive treatments are still limited. The objective of this study is to identify risk factors for onset of oral mucositis in patients undergoing allogeneic hematopoietic stem cells transplantation (HSCT), to measure clinical consequences and to study their evolution according to type of prevention. PATIENTS AND METHODS All patients undergoing HSCT in hematology unit of CHU Besançon between January 2009 and August 2010 were included, and received according to their choice, either the standard protocol: solution of sodium bicarbonate 1.4% associated with chlorhexidine-chlorobutanol (Eludril(®)) (n=49), or the experimental treatment by the ionic solution, Caphosol(®) (n=42). RESULTS The overall incidence of severe mucositis and mucositis is respectively 69% and 36%. In multivariate analysis, a myeloablative conditioning (OR=11.1) and prevention of GVHD (graft-versus-host disease) including methotrexate (OR=7.5) appear such as the two significant mucositis risk factors. The presence of mucositis resulting in a significant increase in the incidence of febrile aplasia (P=0.008) and the use of opioid analgesics and parenteral nutrition (P<10(-3)). The risk of acute gastrointestinal GVHD is also increased in severe mucositis (P=0.01). The duration of post-transplant hospitalization is not changed. The type of prevention does not influence the incidence of mucositis (P=0.11). CONCLUSION The consequences of mucositis are significant and the risk factors identified. The interest of the ionic solution Caphosol(®) seems limited, the incidence of mucositis is not decreased by this prevention.
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Affiliation(s)
- M Bourdelin
- Pôle pharmaceutique, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France.
| | - E Daguindau
- Service d'hématologie, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France; Inserm UMR 1098, établissement français du sang, 25000 Besançon, France
| | - F Larosa
- Service d'hématologie, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France
| | - F Legrand
- Service d'hématologie, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France
| | - V Nerich
- Pôle pharmaceutique, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France; Inserm UMR 1098, établissement français du sang, 25000 Besançon, France
| | - E Deconinck
- Service d'hématologie, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France; Inserm UMR 1098, établissement français du sang, 25000 Besançon, France
| | - S Limat
- Pôle pharmaceutique, CHRU de Besançon, 1, boulevard Fleming, 25000 Besançon, France; Inserm UMR 1098, établissement français du sang, 25000 Besançon, France
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Rocchi S, Reboux G, Larosa F, Scherer E, Daguindeau E, Berceanu A, Deconinck E, Millon L, Bellanger AP. Evaluation of invasive aspergillosis risk of immunocompromised patients alternatively hospitalized in hematology intensive care unit and at home. Indoor Air 2014; 24:652-661. [PMID: 24621176 DOI: 10.1111/ina.12108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 03/06/2014] [Indexed: 06/03/2023]
Abstract
UNLABELLED Contrary to hospital exposure, little is known about the indoor fungal exposure of hematology patients at home. The aim of our study was to investigate the mold exposure of hematology patients both at home and at hospital to assess their invasive aspergillosis (IA) risk. Fungal exposure was assessed by quantifying opportunistic molds at hospital during hospitalization and in homes of 53 hematology patients. IA was diagnosed in 13 of 53 patients and invasive fungal infection (IFI) in one patient. In hospital, no opportunistic species, or low levels of opportunistic species, were found in 98% of weekly controls. Only 2% of hematology intensive care unit (ICU) controls showed a high level of Aspergillus fumigatus spores in corridor air. Five patients IA were hospitalized during these periods. Seven dwellings of 53 (5/14 dwellings of patients with IA/IFI and 2/39 dwellings of non-IA patients) had a percentage of A. fumigatus and Aspergillus flavus to total mold (significant predictor variable of IA/IFI in our study, general linear model, P-value = 0.02) as high as 15%. Maintaining a 'zero Aspergillus' goal at hospital is essential, and establishing specific and individually opportunistic mold monitoring at home could help to further reduce the IA risk through continuous surveillance. PRACTICAL IMPLICATIONS This study emphasizes the fact that preventive measures should not be aimed only at the hospital setting: among patients diagnosed with invasive aspergillosis/invasive fungal infection (IA/IFI), 5 of 14 (36%) were exposed to opportunistic fungal species at home exclusively. Moreover, four of these five patients were living in homes having the highest percentage of Aspergillus fumigatus and Aspergillus flavus (>15%), one of which had 48% of A. fumigatus. Therefore, our work supports the need for a counselor to carry out an environmental survey in patients’ homes.
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Affiliation(s)
- S Rocchi
- Chrono-Environnement UMR 6249 Research Team, Franche-Comté University, Besançon, France
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Bourdelin M, Grenouillet F, Daguindau E, Muret P, Desbrosses Y, Dubut J, Deconinck E, Limat S, Larosa F. Posaconazole prophylaxis in neutropenic patients with hematological malignancies: limits in clinical practice. Med Mycol 2014; 52:728-35. [DOI: 10.1093/mmy/myu042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Mansi L, Daguindau E, Saas P, Pouthier F, Ferrand C, Dormoy A, Patry I, Garnache F, Rohrlich PS, Deconinck E, Larosa F. Diagnosis and management of nocardiosis after bone marrow stem cell transplantation in adults: Lack of lymphocyte recovery as a major contributing factor. ACTA ACUST UNITED AC 2014; 62:156-61. [DOI: 10.1016/j.patbio.2014.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
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20
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Martino S, Daguindau E, Ferrand C, Bamoulid J, Hayette S, Nicolini FE, Capellier G, Deconinck E, Larosa F. A successful renal transplantation for renal failure after dasatinib-induced thrombotic thrombocytopenic purpura in a patient with imatinib-resistant chronic myelogenous leukaemia on nilotinib. Leuk Res Rep 2013; 2:29-31. [PMID: 24371772 DOI: 10.1016/j.lrr.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 12/26/2012] [Revised: 02/05/2013] [Accepted: 02/06/2013] [Indexed: 11/29/2022] Open
Abstract
Second-generation tyrosine kinase inhibitors (TKI2) often induce molecular remission, and prolonged survival with a better tolerance in imatinib-resistant chronic myelogenous leukaemia (CML) patients. We report the case of a CML in first chronic phase who was diagnosed in August 2003 in a young 24 year-old Caucasian woman. Our patient received first imatinib and then dasatinib and nilotinib. Imatinib was well tolerated and she developed TTP/HUS on dasatinib without documented evolution of CML and finally obtained MR5.0 with nilotinib and without any side effect. This case also illustrates the absence of cross-resistance and side-effects between the different TKIs and the feasibility of kidney transplantation associated with a nilotinib treatment of CML allowing a continuing MR5.0 and no further side effects.
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Affiliation(s)
| | - Etienne Daguindau
- CHU Besançon, Service d'Hématologie, Besançon, France ; Université de Franche-Comté, IFR 133, Besançon, France
| | - Christophe Ferrand
- Etablissement Français du sang Bourgogne Franche-Comté (EFS B/FC), Laboratoire d'onco-hématologie moléculaire, 25020 Besançon cedex, France ; Inserm UMR1098, Besançon, France, 4 CHU Besançon, service de Néphrologie, Besançon, France ; Fi-LMC, Poitiers, France
| | - Jamal Bamoulid
- Inserm UMR1098, Besançon, France, 4 CHU Besançon, service de Néphrologie, Besançon, France ; Université de Franche-Comté, IFR 133, Besançon, France
| | - Sandrine Hayette
- Laboratoire Biologie moléculaire (Hématologie), CHU Lyon Sud 69495 Pierre Bénite, France ; Fi-LMC, Poitiers, France
| | - F-E Nicolini
- Service d'Hématologie clinique 1G, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite, France ; Fi-LMC, Poitiers, France
| | - G Capellier
- CHU Besançon, service de Réanimation, Besançon, France
| | - Eric Deconinck
- CHU Besançon, Service d'Hématologie, Besançon, France ; Inserm UMR1098, Besançon, France, 4 CHU Besançon, service de Néphrologie, Besançon, France ; Université de Franche-Comté, IFR 133, Besançon, France
| | - Fabrice Larosa
- CHU Besançon, Service d'Hématologie, Besançon, France ; Fi-LMC, Poitiers, France
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Bourdelin M, Larosa F, Muret P, Legrand F, Henon T, Limat S, Deconinck E, Grenouillet F. Prophylaxie antifongique par posaconazole dans un service d’hématologie soins intensifs : suivi pharmacologique thérapeutique et limites en pratique clinique. J Mycol Med 2013. [DOI: 10.1016/j.mycmed.2012.12.015] [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: 10/27/2022]
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22
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Millon L, Larosa F, Lepiller Q, Legrand F, Rocchi S, Daguindau E, Scherer E, Bellanger AP, Leroy J, Grenouillet F. Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients. Clin Infect Dis 2013; 56:e95-101. [PMID: 23420816 DOI: 10.1093/cid/cit094] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of our study was to assess the detection of circulating DNA from the most common species of Mucorales for early diagnosis of mucormycosis in at-risk patients. METHODS We retrospectively evaluated a combination of 3 quantitative polymerase chain reaction (qPCR) assays using hydrolysis probes targeting Mucor/Rhizopus, Lichtheimia (formerly Absidia), and Rhizomucor for circulating Mucorales detection. Serial serum samples from 10 patients diagnosed with proven mucormycosis (2-9 samples per patient) were analyzed. RESULTS No cross-reactivity was detected in the 3 qPCR assays using 19 reference strains of opportunistic fungi, and the limit of detection ranged from 3.7 to 15 femtograms/10 µL, depending on the species. DNA from Mucorales was detected in the serum of 9 of 10 patients between 68 and 3 days before mucormycosis diagnosis was confirmed by histopathological examination and/or positive culture. All the qPCR results were concordant with culture and/or PCR-based identification of the causing agents in tissue (Lichtheimia species, Rhizomucor species, and Mucor/Rhizopus species in 4, 3, and 2 patients, respectively). Quantitative PCR was negative in only 1 patient with proven disseminated mucormycosis caused by Lichtheimia species. CONCLUSION Our study suggests that using specific qPCR targeting several species of Mucorales according to local ecology to screen at-risk patients could be useful in a clinical setting. The cost and efficacy of this strategy should be evaluated. However, given the human and economic cost of mucormycosis and the need for rapid diagnosis to initiate prompt directed antifungal therapy, this strategy could be highly attractive.
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Affiliation(s)
- Laurence Millon
- CNRS-Université de Franche-Comté, UMR 6249 Chrono-environnement, Besançon, France.
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Ferrand C, Garnache-Ottou F, Collonge-Rame MA, Larosa F, Blanc M, Behar C, Giannoli C, Garnier F, Tiberghien P, Deconinck E, Rohrlich PS. Systematic donor blood qualification by flow cytometry would have been able to avoid CLL-type MBL transmission after unrelated hematopoietic stem cell transplantation. Eur J Haematol 2012; 88:269-72. [PMID: 22168404 DOI: 10.1111/j.1600-0609.2011.01741.x] [Citation(s) in RCA: 8] [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: 11/26/2022]
Abstract
The current screening for eligibility of unrelated volunteer marrow donors comprises a complete clinical check-up, a blood CBC and serum protein immunoelectrophoresis. This allows to eliminate acute leukemias, myeloproliferative and myelodysplastic disorders, myelomas and MGUS. To date, the risk of transmission of chronic lymphocytic leukemia (CLL) disease is only evaluated by the clinical evaluation and CBC. We report here the case of a CLL-type MBL disease occurring in a 12-year-old boy after unrelated BMT. Deep biological investigations, as Immunophenotyping, cytogenetic and molecular biology allow us to determine the donor origin of the CLL clone. In 2010, 14.2% donor (105/737) for unrelated hematopoietic stem cell transplantation were over 45y. It is currently estimated (USA) that 1 in 210 men and women will be diagnosed with CLL during their lifetime. Given the long asymptomatic phase of CLL, this raises the case for a detection strategy analog to that used for MGUS and myeloma through serum protein electrophoresis. This case-report, to our knowledge, of a CLL-type MBL unrelated donor-to-recipient transmission through BMT raises ethical and practical questions, such as the proper information about disease transmission risk. The cost-effectiveness of a systematic peripheral blood Immunophenotyping in donors elder than 40y at time of stem cell donation should be evaluated.
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Affiliation(s)
- Christophe Ferrand
- INSERM UMR645, IFR133, Etablissement Français du sang Bourgogne Franche-Comté, Besançon, France.
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Solly F, Angelot F, Garand R, Ferrand C, Seillès E, Schillinger F, Decobecq A, Billot M, Larosa F, Plouvier E, Deconinck E, Legrand F, Saas P, Rohrlich PS, Garnache-Ottou F. CD304 is preferentially expressed on a subset of B-lineage acute lymphoblastic leukemia and represents a novel marker for minimal residual disease detection by flow cytometry. Cytometry A 2011; 81:17-24. [DOI: 10.1002/cyto.a.21162] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 09/20/2011] [Accepted: 10/05/2011] [Indexed: 01/22/2023]
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Marmier-Savet C, Larosa F, Legrand F, Witz B, Michallet M, Ranta D, Louvat P, Puyraveau M, Raus N, Tavernier M, Mathieu-Nafissi S, Hequet O, Pouthier F, Deconinck E, Tiberghien P, Robinet E. Persistence of lymphocyte function perturbations after granulocyte-colony-stimulating factor mobilization and cytapheresis in normal peripheral blood stem cell donors. Transfusion 2011; 50:2676-85. [PMID: 20663114 DOI: 10.1111/j.1537-2995.2010.02781.x] [Citation(s) in RCA: 10] [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: 11/30/2022]
Abstract
BACKGROUND The short-term effects of granulocyte-colony-stimulating factor (G-CSF) have been extensively studied, but recent reports of G-CSF-induced genetic perturbations raised concerns regarding its long-term safety. In this respect, duration of G-CSF-induced perturbations has been less studied than short-term effects and needs to be evaluated. STUDY DESIGN AND METHODS G-CSF mobilization-induced immunologic alterations were prospectively analyzed in a cohort of 24 healthy donors. Blood samples were taken before G-CSF administration; at the time of administration; and at 1, 3, 6, and 12 months and analyzed for blood cell counts and in vitro cytokines (interleukin [IL]-2, -8, and -10) and immunoglobulin production, quantified in the culture supernatant of peripheral blood mononuclear cells (PBMNCs) after, respectively, phytohemagglutinin and pokeweed mitogen stimulation. RESULTS Platelet, granulocyte, monocyte, B, and dendritic blood cell counts as well as the IL-2, -8, and -10 secretion by PBMNCs, perturbed at the time of G-CSF mobilization, returned to baseline values at 1 month, with T-cell and natural killer cell counts recovering at 3 months. In vitro immunoglobulin production was increased up to 6 months after mobilization. CONCLUSION Although assessment of the potential long-term risk of G-CSF administration will require prolonged observation of larger cohorts, our data show that the duration of immunologic perturbations may be more persistent than previously anticipated, especially for B-cell functional alterations. Most perturbations remain, however, transient with a return to baseline values within 1 year.
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Affiliation(s)
- Caroline Marmier-Savet
- INSERM, Université de Franche-Comte, IFR133, and Etablissement Français du Sang, Bourgogne/Franche-Comté, UMR 645, Besançon, France
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Brion A, Legrand F, Larosa F, Schillinger F, Garnache-Ottou F, Helias P, Fontan J, Heczko M, Delaby P, Daguindau E, Vuillier J, Chauchet A, Deconinck E. Intrathecal liposomal cytarabine (lipoCIT) administration in patients with leukemic or lymphomatous meningitis. Invest New Drugs 2011; 30:1697-702. [DOI: 10.1007/s10637-011-9632-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 01/03/2011] [Indexed: 11/25/2022]
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Hunault-Berger M, Leguay T, Thomas X, Legrand O, Huguet F, Bonmati C, Escoffre-Barbe M, Legros L, Turlure P, Chevallier P, Larosa F, Garban F, Reman O, Rousselot P, Dhédin N, Delannoy A, Lafage-Pochitaloff M, Béné MC, Ifrah N, Dombret H. A randomized study of pegylated liposomal doxorubicin versus continuous-infusion doxorubicin in elderly patients with acute lymphoblastic leukemia: the GRAALL-SA1 study. Haematologica 2010; 96:245-52. [PMID: 20971822 DOI: 10.3324/haematol.2010.027862] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The prognosis of acute lymphoblastic leukemia in the elderly is poor. The GRAALL-SA1 phase II, randomized trial compared the efficacy and toxicity of pegylated liposomal doxorubicin versus continuous-infusion doxorubicin in patients 55 years or older with Philadelphia chromosome-negative acute lymphoblastic leukemia. DESIGN AND METHODS Sixty patients received either continuous-infusion doxorubicin (12 mg/m(2)/day) and continuous-infusion vincristine (0.4 mg/day) on days 1-4 or pegylated liposomal doxorubicin (40 mg/m(2)) and standard vincristine (2 mg) on day 1, accompanied by dexamethasone, followed at day 28 by a second cycle, reinforced by cyclophosphamide. End-points were safety, outcome and prognostic factors. RESULTS Myelosuppression was reduced in the pegylated liposomal doxorubicin arm with shorter severe neutropenia (P=0.05), shorter severe thrombocytopenia (P=0.03), and fewer red blood cell transfusions (P=0.04). Grade 3/4 infections and Gram-negative bacteremia were reduced in the pegylated liposomal doxorubicin arm (P=0.04 and P=0.02, respectively). There was a trend towards fewer cardiac events among the patients who received pegylated liposomal doxorubicin (1/29 versus 6/31). The complete remission rate was 82% and, with a median follow-up of 4 years, median event-free survival and overall survival were 9 and 10 months, respectively. Despite the better tolerance of pegylated liposomal doxorubicin, no differences in survival were observed between the two arms, due to trends towards more induction refractoriness (17 versus 3%, P=0.10) and a higher cumulative incidence of relapse (52% versus 32% at 2 years, P=0.20) in the pegylated liposomal doxorubicin arm. CONCLUSIONS With the drug schedules used in this study, pegylated liposomal doxorubicin did not improve the outcome of elderly patients with acute lymphoblastic leukemia despite reduced toxicities.
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Legrand F, Grenouillet F, Larosa F, Dalle F, Saas P, Millon L, Deconinck E, Rohrlich PS. Diagnosis and treatment of digestive cryptosporidiosis in allogeneic haematopoietic stem cell transplant recipients: a prospective single centre study. Bone Marrow Transplant 2010; 46:858-62. [DOI: 10.1038/bmt.2010.200] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Larosa F, Maddens S, Legrand F, Pouthier F, Ferrand C, Saas P, Hayette S, Chabod J, Tiberghien P, Rohrlich PS, Deconinck E. Early immune reconstitution and efficient graft vs tumor effect after unrelated partially matched double cord blood transplantation in refractory 8p11 syndrome. Bone Marrow Transplant 2010; 46:622-4. [DOI: 10.1038/bmt.2010.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Millon L, Grenouillet F, Crouzet J, Larosa F, Loewert S, Bellanger AP, Deconinck E, Legrand F. False-positive Aspergillus real-time PCR assay due to a nutritional supplement in a bone marrow transplant recipient with GVH disease. Med Mycol 2010; 48:661-4. [PMID: 20392146 DOI: 10.3109/13693780903451836] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PCR screening for circulating DNA, especially when combined with antigen testing, has shown promise for the definitive diagnosis of invasive aspergillosis. False positives for Aspergillus real-time PCR assays have been described in several reports, but no sources of fungal DNA contamination could be clearly identified. We report a false-positive case for both galactomannan (GM) antigenemia and Aspergillus PCR due to nutritional supplement intake in a bone marrow transplant recipient with digestive graft-versus-host disease. Our case report also suggests that fungal DNA can pass into the serum from the intestinal tract in the same way as fungal GM. Clinicians should be aware of this possibility, so that the administration of costly, unnecessary antifungal treatments with potential adverse side-effects can be avoided.
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Affiliation(s)
- L Millon
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Besançon, France.
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Garnier A, Robin M, Larosa F, Golmard JL, Le Gouill S, Coiteux V, Tabrizi R, Bulabois CE, Cacheux V, Kuentz M, Dreyfus B, Dreger P, Rio B, Moles-Moreau MP, Bilger K, Bay JO, Leblond V, Blaise D, Tournilhac O, Dhédin N. Allogeneic hematopoietic stem cell transplantation allows long-term complete remission and curability in high-risk Waldenström’s macroglobulinemia. Results of a retrospective analysis of the Société Française de Greffe de Moelle et de Thérapie Cellulaire. Haematologica 2010; 95:950-5. [PMID: 20081058 DOI: 10.3324/haematol.2009.017814] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients with poor-risk Waldenström's macroglobulinemia have suboptimal response and early post-treatment relapse with conventional therapies. Hence, new therapeutic approaches such as allogeneic stem cell transplantation should be evaluated in these patients. DESIGN AND METHODS We examined the long-term outcome of allogeneic stem cell transplantation in Waldenström's macroglobulinemia by studying the records of 24 patients reported in the SFGM-TC database and one transplanted in the bone marrow unit in Hamburg. RESULTS Median age at the time of transplant was 48 years (range, 24-64). The patients had previously received a median of 3 lines of therapy (range, 1-6) and 44% of them had refractory disease at time of transplant. Allogeneic stem cell transplantation after myeloablative (n=12) or reduced-intensity (n=13) conditioning yielded an overall response rate of 92% and immunofixation-negative complete remission in 50% of evaluable patients. With a median follow-up of 64 months among survivors (range, 11-149 months), 5-year overall survival and progression-free survival rates were respectively, 67% (95% CI: 46-81) and 58% (95% CI: 38-75). The 5-year estimated risk of progression was 25% (95% CI: 10-36%), with only one relapse among the 12 patients who entered complete remission, versus 5 in the 12 patients who did not. Only one of the 6 relapses occurred more than three years post-transplant. CONCLUSIONS Allogeneic stem cell transplantation yields a high rate of complete remissions and is potentially curative in poor-risk Waldenström's macroglobulinemia.
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Affiliation(s)
- Alice Garnier
- Service d'Hématologie et de Thérapie Cellulaire, CHU Clermont-Ferrand, Hôpital Hotel Dieu, and Univ Clermont 1, EA3846 France Clermont-Ferrand, France
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Saint-Marcoux F, Royer B, Debord J, Larosa F, Legrand F, Deconinck E, Kantelip JP, Marquet P. Pharmacokinetic modelling and development of Bayesian estimators for therapeutic drug monitoring of mycophenolate mofetil in reduced-intensity haematopoietic stem cell transplantation. Clin Pharmacokinet 2009; 48:667-75. [PMID: 19743888 DOI: 10.2165/11317140-000000000-00000] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Mycophenolate mofetil, a prodrug of mycophenolic acid (MPA), is used during non-myeloablative and reduced-intensity conditioning haematopoetic stem cell transplantation (HCT) to improve engraftment and reduce graft-versus-host disease (GVHD). However, information about MPA pharmacokinetics is sparse in this context and its use is still empirical. OBJECTIVES To perform a pilot pharmacokinetic study and to develop maximum a posteriori Bayesian estimators (MAP-BEs) for the estimation of MPA exposure in HCT. PATIENTS AND METHODS Fourteen patients administered oral mycophenolate mofetil 15 g/kg three times daily were included. Two consecutive 8-hour pharmacokinetic profiles were performed on the same day, 3 days before and 4 days after the HCT. One 8-hour pharmacokinetic profile was performed on day 27 after transplantation. For these 8-hour pharmacokinetic profiles, blood samples were collected predose and 20, 40, 60, 90 minutes and 2, 4, 6 and 8 hours post-dose. Using the iterative two-stage (ITS) method, two different one-compartment open pharmacokinetic models with first-order elimination were developed to describe the data: one with two gamma laws and one with three gamma laws to describe the absorption phase. For each pharmacokinetic profile, the Akaike information criterion (AIC) was calculated to evaluate model fitting. On the basis of the population pharmacokinetic parameters, MAP-BEs were developed for the estimation of MPA pharmacokinetics and area under the plasma concentration-time curve (AUC) from 0 to 8 hours at the different studied periods using a limited-sampling strategy. These MAP-BEs were then validated using a data-splitting method. RESULTS The ITS approach allowed the development of MAP-BEs based either on 'double-gamma' or 'triple-gamma' models, the combination of which allowed correct estimation of MPA pharmacokinetics and AUC on the basis of a 20 minute-90 minute-240 minute sampling schedule. The mean bias of the Bayesian versus reference (trapezoidal) AUCs was <5% with <16% of the patients with absolute bias on AUC >20%. AIC was systematically calculated for the choice of the most appropriate model fitting the data. CONCLUSION Pharmacokinetic models and MAP-BEs for mycophenolate mofetil when administered to HCT patients have been developed. In the studied population, they allowed the estimation of MPA exposure based on three blood samples, which could be helpful in conducting clinical trials for the optimization of MPA in reduced-intensity HCT. However, prior studies will be needed to validate them in larger populations.
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Sirvent A, Dhedin N, Michallet M, Mounier N, Faucher C, Yakoub-Agha I, Mohty M, Robin M, Tabrizi R, Clement L, Bilger K, Larosa F, Contentin N, Huyn A, François S, Bulabois CE, Ceballos P, Bourrhis JH, Buzyn A, Cornillon J, Guillerm G, de Revel T, Bay JO, Guilhot F, Milpied N. Low nonrelapse mortality and prolonged long-term survival after reduced-intensity allogeneic stem cell transplantation for relapsed or refractory diffuse large B cell lymphoma: report of the Société Française de Greffe de Moelle et de Thérapie Cellulaire. Biol Blood Marrow Transplant 2009; 16:78-85. [PMID: 19744569 DOI: 10.1016/j.bbmt.2009.09.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Accepted: 09/01/2009] [Indexed: 01/18/2023]
Abstract
Patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) have a very poor prognosis. However, they may achieve long-term survival by undergoing allogeneic stem cell transplantation (SCT). The purpose of this study was to assess the outcome of all adult patients with DLBCL whose treatment included a reduced-intensity conditioning (RIC) regimen for allogeneic SCT and whose data were reported in the French Society of Marrow Transplantation and Cellular Therapy registry. Sixty-eight patients (median age: 48 years) were transplanted from October 1998 to January 2007. They had received a median of 2 regimens of therapy prior to allogeneic SCT, and 54 (79%) had already undergone SCT. Prior to transplantation, 32 patients (47%) were in complete remission (CR). For all patients but 1, conditioning regimens were based on fludarabine (Flu), which was combined with other chemotherapy drugs in 50 cases (74%) and with total body irradiation (TBI) in 17 (25%). For 56 patients (82%), the donor was an HLA-matched sibling, and peripheral blood was the most widely used source of stem cells (57 patients, 84%). With a median follow-up of 49 months, estimated 2-year overall survival (OS), progression-free survival (PFS), and the cumulative incidence of relapse were 49%, 44%, and 41%, respectively. The 1-year cumulative incidence of nonrelapse mortality (NRM) was 23%. According to multivariate analysis, the patients in CR before transplantation had a significantly longer PFS and a lower CI of relapse than patients transplanted during partial remission or stable or progressive disease. These results suggest that reduced-intensity allergenic transplantation is an attractive therapeutic option for patients with high-risk DLBCL.
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Chevallier P, Hunault-Berger M, Larosa F, Dauriac C, Garand R, Harousseau JL. A phase II trial of high-dose imatinib mesylate for relapsed or refractory c-kit positive and Bcr-Abl negative acute myeloid leukaemia: The AFR-15 trial. Leuk Res 2009; 33:1124-6. [DOI: 10.1016/j.leukres.2008.09.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 09/29/2008] [Accepted: 09/29/2008] [Indexed: 11/28/2022]
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Piton G, Larosa F, Minello A, Becker MC, Mantion G, Aubin F, Deconinck E, Hillon P, Di Martino V. Infliximab treatment for steroid-refractory acute graft-versus-host disease after orthotopic liver transplantation: a case report. Liver Transpl 2009; 15:682-5. [PMID: 19562700 DOI: 10.1002/lt.21793] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Acute graft-versus-host disease (GVHD) following orthotopic liver transplantation is a rare but severe disease with a 75% death rate in adults. Various therapeutic strategies have been proposed for steroid-refractory GVHD, but there is still no consensus. Tumor necrosis factor-alpha is a key inflammatory cytokine involved in acute GVHD physiopathology, and infliximab has shown encouraging results for the treatment of acute GVHD following hematopoietic stem cell transplantation. We report the first case of acute GVHD following liver transplantation that was refractory to steroids and anti-lymphocyte globulin but was successfully treated with infliximab.
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Affiliation(s)
- Gaël Piton
- Service d'Hépatologie, Université de Franche Comté et Centre Hospitalier Universitaire de Besançon, Besançon, France
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Royer B, Larosa F, Legrand F, Gerritsen-van Schieveen P, Bérard M, Kantelip JP, Deconinck E. Pharmacokinetics of mycophenolic acid administered 3 times daily after hematopoietic stem cell transplantation with reduced-intensity regimen. Biol Blood Marrow Transplant 2009; 15:1134-9. [PMID: 19660728 DOI: 10.1016/j.bbmt.2009.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Accepted: 04/18/2009] [Indexed: 12/16/2022]
Abstract
Mycophenolate mofetil (MMF) is an immunosuppressive drug used as a prophylactic agent to prevent acute graft-versus-host disease (aGVHD) after hematopoietic stem cell transplantation (HSCT). After reduced-intensity conditioning (RIC) regimen, administration of MMF orally 3 times a day (tid) seems to be more beneficial than twice a day (bid). However, information regarding the pharmacokinetic (PK) parameters of mycophenolic acid (MPA), the active metabolite of MMF, administered in this regimen are very limited. We performed a prospective study in 15 patients for whom 3 sets of sampling were performed: at the beginning of the treatment, after 1 week, and after 1 month. Two consecutive 8-hour sets of sampling were performed at day 0 (D0) and D7. Plasma concentrations of MPA were quantified and areas under the curve for 8hours (AUC(0-8)), and maximal and through concentrations were calculated. The results show that AUC(0-8) increases between the beginning of treatment and the end of the first week, but remains stable thereafter. Moreover, a trend to lower AUC(0-8) was observed for the patients who experienced GVHD > or =2 compared to those patients who did not. The other PK parameters are not associated with pharmacodynamic events. A limited sampling strategy with Bayesian estimators is currently under investigation to confirm these data and the role of D7 AUC(0-8) as a potential target of therapeutic drug monitoring (TDM).
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Grenouillet F, Botterel F, Crouzet J, Larosa F, Hicheri Y, Forel JM, Helias P, Ranque S, Delhaes L. Scedosporium prolificans: an emerging pathogen in France? Med Mycol 2008; 47:343-50. [PMID: 19085456 DOI: 10.1080/13693780802454761] [Citation(s) in RCA: 28] [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: 10/21/2022] Open
Abstract
For the last ten years, non-Aspergillus mold species have been increasingly involved in human invasive infections, probably as a consequence of more intense immunosuppression and prolonged patient survival, and of selective pressure since antifungal agents are currently used for prophylaxis or therapy. Scedosporium prolificans, one of these emerging fungi, has been isolated in a broad spectrum of clinical presentations in humans, including respiratory-tract colonization, superficial or locally invasive infections, and disseminated infections in immunocompromised patients. Here, we report the recent emergence of invasive infections due to S. prolificans in France, and describe four new cases diagnosed during the last six years. Only one disseminated scedosporiosis has been reported before this in France, in 1994. Three out of our four cases were breakthrough infections in immunocompromised patients receiving posaconazole or voriconazole therapy. The aims of the present review were thus to gain a better understanding of scedosporiosis epidemiology and clinical features, and to review recent advances in multimodal management of these infections, including surgery, recovery and/or enhancement of immunity, and antifungal combinations, especially voriconazole plus terbinafine.
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Abgrall JF, Guibaud I, Bastie JN, Flesch M, Rossi JF, Lacotte-Thierry L, Boyer F, Casassus P, Slama B, Berthou C, Rodon P, Leporrier M, Villemagne B, Himberlin C, Ghomari K, Larosa F, Rollot F, Dugay J, Allard C, Maigre M, Isnard F, Zerbib R, Cauvin JM. Thalidomide versus placebo in myeloid metaplasia with myelofibrosis: a prospective, randomized, double-blind, multicenter study. Haematologica 2006; 91:1027-32. [PMID: 16885042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In non-randomized studies, thalidomide appeared to be effective in myeloid metaplasia with myelofibrosis (MMM). We compared thalidomide to placebo for treatment of anemia in MMM. DESIGN AND METHODS A prospective phase II B, randomized double-blind multicenter trial comparing thalidomide 400 mg/d with placebo for 180 days was conducted in 52 anemic patients (hemoglobin pounds Sterling 9 g/dL or transfused). The main outcome measure was a 2 g/L increase in hemoglobin or 20% reduction in transfusions. RESULTS In the thalidomide group only 10 patients completed 6 months of treatment. At 180 days, in an intention-to-treat analysis, no difference was observed between the thalidomide and placebo groups as regards improvement of hemoglobin levels (one patient in each group) or reduction of red blood cell transfusions (three vs five patients, respectively). The spleen size, determined by ultrasonography, increased significantly less in the thalidomide group than in the placebo group (p < 0.05). Thalidomide had no apparent benefit on the Dupriez score, the severity score, survival, death, or any other clinical or biological parameter. Somnolence, gastro-intestinal signs, weight gain, and edema were significantly more frequent in the thalidomide group. Outpatient discontinuation of thalidomide was significantly correlated with a high severity score > 4 (odds ratio, OR = 16; p < 0.01), and g-glutamyl transferase levels > 40 IU/L (OR = 12; p < 0.05). INTERPRETATION AND CONCLUSIONS Thalidomide (200-400 mg/d) does not demonstrate substantial efficacy in anemic MMM patients. The natural history of disease in the placebo group revealed spontaneous periods of remission of anemia. Tolerance of thalidomide was significantly correlated wih the severity and liver involvement of the disease.
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Larosa F, Marmier C, Robinet E, Ferrand C, Saas P, Deconinck E, Bulabois CE, Rohrlich PS, Ledu K, Helias P, Tiberghien P, Cahn JY. Peripheral T-cell expansion and low infection rate after reduced-intensity conditioning and allogeneic blood stem cell transplantation. Bone Marrow Transplant 2005; 35:859-68. [PMID: 15765116 DOI: 10.1038/sj.bmt.1704889] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Peripheral blood stem cell transplantation after reduced-intensity conditioning (RIC-PBSCT) regimen is an alternative to conventional regimens with less immediate toxicity. Since immune recovery is of crucial importance for the control of infections, we retrospectively studied the recovery of T-, B- and NK cell subsets in 20 consecutive patients undergoing RIC-PBSCT. We also studied the thymic output using T-cell receptor excision circle assay. Engraftment was rapid and few infectious complications were seen: three early (before 2.5 months) cases of asymptomatic cytomegalovirus reactivation, two late Gram-negative bacterial infections and no fungal infection. While CD4+ T-cell reconstitution was slow, CD8+ T-cell counts were close to normal values at 4 months. Median CD19+ B-cell counts reached normal values at 11 months. Rapid CD56+ NK cell reconstitution was noticed as early as 1.5 months. Low T-cell receptor excision circle numbers and preponderance of memory-type subsets among T cells further suggested that CD8+ T-cell reconstitution resulted predominantly from peripheral expansion and that thymic-dependent reconstitution was severely impaired. In conclusion, large peripheral T-cell expansion may compensate for late thymic-dependent lymphopoiesis, and may, with other factors such as NK and B-cell reconstitution and careful antiinfectious prophylaxis, help limit the incidence of severe infections after RIC-PBSCT.
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Affiliation(s)
- F Larosa
- Department of Hematology. Centre Hospitalo-Universitaire Jean Minjoz, Besançon Cedex, France.
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Ysebaert L, Deconinck E, Larosa F, Caillot D, Tiberghien P, Casasnovas RO, Cahn JY. Polyvisceral arteritis in chronic graft-versus-host disease: antiphospholipid-negative thrombotic syndrome mimicking polyarteritis nodosa. Bone Marrow Transplant 2002; 29:873-4. [PMID: 12058239 DOI: 10.1038/sj.bmt.1703560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2001] [Accepted: 01/24/2002] [Indexed: 11/09/2022]
Abstract
A case of polyarteritis is reported in an 18-year old woman, occurring 2 years after an allogeneic bone marrow transplant. The clinical manifestations were similar to those of polyarteritis nodosa (PAN) with a wide range of organs involved including life-threatening cardiac and mesenteric problems requiring plasmapheresis and intravenous immunoglobulin (IgIV).
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Affiliation(s)
- L Ysebaert
- Service d'Hématologie, CHU Bocage, Dijon, France
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Zlotnik A, Roberts WK, Vasil A, Blumenthal E, Larosa F, Leibson HJ, Endres RO, Graham SD, White J, Hill J, Henson P, Klein JR, Bevan MJ, Marrack P, Kappler JW. Coordinate production by a T cell hybridoma of gamma interferon and three other lymphokine activities: multiple activities of a single lymphokine? J Immunol 1983; 131:794-800. [PMID: 6223094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The T cell hybridoma FS7-20, produced by the fusion of normal B10.BR T cells to the AKR thymoma BW5147, was found when stimulated with concanavalin A (Con A) to produce the lymphokines: interleukin 2 (IL 2), interferon-gamma (IFN gamma), macrophage-activating factor (MAF), Ia induction factor IaIF), and the B cell helper factor interleukin X (IL X). The clones and subclones of FS7-20 varied dramatically in their ability to produce these lymphokines, presumably because of karyotypic variations. The ability to produce IL 2 segregated independently from the ability to produce the four other lymphokine activities; however, production of the latter activities showed a strong correlation. This coordinate production of IFN gamma, MAF, IaIF, and IL X was also observed with a cloned normal cytotoxic T cell line, cr15. These results suggest either that IFN gamma, MAF, IaIF, and IL X are all manifestations of a single molecular species or that, although these activities are different structurally, their production is controlled by a common genetic mechanism. In support of the first possibility, the IFN gamma, MAF, IaIF, and IL X activity produced by FS7-20 were all found to be equally sensitive to inactivation at pH 2. These results illustrate the usefulness of using T cell hybridomas for the study of lymphokines.
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Zlotnik A, Roberts WK, Vasil A, Blumenthal E, Larosa F, Leibson HJ, Endres RO, Graham SD, White J, Hill J, Henson P, Klein JR, Bevan MJ, Marrack P, Kappler JW. Coordinate production by a T cell hybridoma of gamma interferon and three other lymphokine activities: multiple activities of a single lymphokine? The Journal of Immunology 1983. [DOI: 10.4049/jimmunol.131.2.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
The T cell hybridoma FS7-20, produced by the fusion of normal B10.BR T cells to the AKR thymoma BW5147, was found when stimulated with concanavalin A (Con A) to produce the lymphokines: interleukin 2 (IL 2), interferon-gamma (IFN gamma), macrophage-activating factor (MAF), Ia induction factor IaIF), and the B cell helper factor interleukin X (IL X). The clones and subclones of FS7-20 varied dramatically in their ability to produce these lymphokines, presumably because of karyotypic variations. The ability to produce IL 2 segregated independently from the ability to produce the four other lymphokine activities; however, production of the latter activities showed a strong correlation. This coordinate production of IFN gamma, MAF, IaIF, and IL X was also observed with a cloned normal cytotoxic T cell line, cr15. These results suggest either that IFN gamma, MAF, IaIF, and IL X are all manifestations of a single molecular species or that, although these activities are different structurally, their production is controlled by a common genetic mechanism. In support of the first possibility, the IFN gamma, MAF, IaIF, and IL X activity produced by FS7-20 were all found to be equally sensitive to inactivation at pH 2. These results illustrate the usefulness of using T cell hybridomas for the study of lymphokines.
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Larosa F, Vittore D, Mazzarisi A, Molfetta L. [Joint pain crises and chronic inflammatory-reactive phenomena: a unitary approach with proglumetacin]. Minerva Med 1983; 74:1535-8. [PMID: 6856165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Nineteen patients with acute joint pain and 12 patients with chronic rheumatic disorders were treated with 450 mg/day of proglumetacin for a period ranging between 15 and 30 days. The overall results revealed a satisfactory response to treatment, and tolerance was rated as "good" or "very good" in all patients.
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