1
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Bardwell B, Bay J, Colburn Z. The clinical applications of immunosequencing. Curr Res Transl Med 2024; 72:103439. [PMID: 38447267 DOI: 10.1016/j.retram.2024.103439] [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: 11/23/2022] [Revised: 03/20/2023] [Accepted: 01/11/2024] [Indexed: 03/08/2024]
Abstract
Technological advances in high-throughput sequencing have opened the door for the interrogation of adaptive immune responses at unprecedented scale. It is now possible to determine the sequences of antibodies or T-cell receptors produced by individual B and T cells in a sample. This capability, termed immunosequencing, has transformed the study of both infectious and non-infectious diseases by allowing the tracking of dynamic changes in B and T cell clonal populations over time. This has improved our understanding of the pathology of cancers, autoimmune diseases, and infectious diseases. However, to date there has been only limited clinical adoption of the technology. Advances over the last decade and on the horizon that reduce costs and improve interpretability could enable widespread clinical use. Many clinical applications have been proposed and, while most are still undergoing research and development, some methods relying on immunosequencing data have been implemented, the most widespread of which is the detection of measurable residual disease. Here, we review the diagnostic, prognostic, and therapeutic applications of immunosequencing for both infectious and non-infectious diseases.
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Affiliation(s)
- B Bardwell
- Department of Clinical Investigation, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USA
| | - J Bay
- Department of Medicine, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USA
| | - Z Colburn
- Department of Clinical Investigation, Madigan Army Medical Center, 9040 Jackson Ave, Tacoma, WA 98431, USA.
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2
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Homo RL, Colby DJ, Romo ML, Moreland S, Follen H, Hernandez B, Robinson D, Liesemer K, Paudel M, Crowell TA, Martin A, Armendi IF, Martinez-Bucki E, Bay J, Faestel P, Sainato R. COVID-19 mRNA vaccination and myocarditis/pericarditis in the setting of active surveillance at a military treatment facility. BMJ Mil Health 2023:e002599. [PMID: 37973371 DOI: 10.1136/military-2023-002599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Richelle L Homo
- Pediatrics, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - D J Colby
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - M L Romo
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - S Moreland
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - H Follen
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - B Hernandez
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - D Robinson
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - K Liesemer
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - M Paudel
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - T A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Global Infectious Diseases, Henry M Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, USA
| | - A Martin
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - I F Armendi
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - E Martinez-Bucki
- Pediatrics, Brooke Army Medical Center, Fort Sam Houston, Texas, USA
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - J Bay
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - P Faestel
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
| | - R Sainato
- Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA
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3
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Lemal R, Poulain S, Ledoux‐Pilon A, Veronese L, Tchirkov A, Lebecque B, Tassin T, Bay J, Charlotte F, Nguyen‐Khac F, Berger M, Godfraind C, Ysebaert L, Davi F, Pereira B, Leblond V, Hermine O, Guièze R, Pagès F, Tournilhac O. Mast cell density and its clinical relevance in Waldenström's macroglobulinemia. EJHaem 2022; 3:371-378. [PMID: 35846063 PMCID: PMC9176068 DOI: 10.1002/jha2.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 06/15/2023]
Abstract
The presence of numerous mast cells (MCs) mixed with tumor cells in the bone marrow (BM) is a hallmark of the diagnosis of Waldenström's macroglobulinemia (WM). MCs have been shown to support lymphoplasmacytic cell growth, but there is thus far no demonstration of the prognostic impact of BM MC density in WM. We investigated BM MC density by sensitive and specific digital quantification, allowing the analysis of a large area infiltrated by BM tumor cells. A total of 65 WM patients were investigated, including 54 at diagnosis and 11 at relapse. Tryptase and CD20 immunohistochemisty staining was performed on contiguous sections of deparaffinized BM trephine biopsies. After numerization of each section, the BM surface area was manually marked out, excluding the bone framework and adipocytes to limit the analyses to only hematopoietic tissue. MCs were assessed using a digital tool previously used to quantify immune-cell infiltrates on tumor-tissue sections. Deep next-generation sequencing and allele-specific PCR were used to explore the MYD88 and CXCR4 mutational status. MC density was heterogeneous among the WM patients. An optimal MC density threshold (> 56 MC.mm-2) was defined according to ROC curve analysis of overall survival. A higher MC density (> 56 MC.mm-2) was associated with greater BM involvement by WM lymphoplasmacytic cells and less hepatosplenic involvement (p = 0.023). Furthermore, MC density significantly correlated with a higher ISSWM score (p = 0.0003) in symptomatic patients. Patients with a higher MC density showed shorter median OS (56.5 months vs. nonreached, p = 0.0004), even in multivariate analysis after controlling for other predictive variables, such as age, ISSWM score, and CXCR4 mutational status. In conclusion, MC density can be accurately measured in WM patients using a specific digital tool on well-outlined hematopoietic tissue surfaces. High MC density is associated with aggressive features and a poor clinical outcome, emphasizing the need for further investigation of the involvement of MCs in the pathophysiology of WM.
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Affiliation(s)
- Richard Lemal
- Laboratoire d'Histocompatibilité, Centre de Biologie, CHU de Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | - Stéphanie Poulain
- “CANcer HeterogeneityPlasticity and Resistance to THERapies” INSERM 1277‐CNRS 9020 UMRS 12University of LilleLilleFrance
- Service d'Hématologie CellulaireCentre de Biologie PathologieLilleFrance
| | - Albane Ledoux‐Pilon
- Anatomie PathologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Lauren Veronese
- Service de Cytogénétique MédicaleCHU Clermont‐FerrandINSERM U1240 IMOSTUniversité Clermont AuvergneClermont FerrandFrance
| | - Andrei Tchirkov
- Service de Cytogénétique MédicaleCHU Clermont‐FerrandINSERM U1240 IMOSTUniversité Clermont AuvergneClermont FerrandFrance
| | - Benjamin Lebecque
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Thomas Tassin
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Jacques‐Olivier Bay
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | | | - Florence Nguyen‐Khac
- Service d‘Hématologie BiologiqueSorbonne UniversitéHôpital Pitié‐SalpêtrièreCentre de Recherche des CordeliersParisFrance
| | - Marc Berger
- Service d'Hématologie BiologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | - Catherine Godfraind
- Anatomie PathologiqueCHU Clermont‐FerrandUniversité Clermont AuvergneClermont FerrandFrance
| | | | - Frédéric Davi
- La Pitié SalpêtrièreAPHPLaboratoire d'HématologieParisFrance
| | - Bruno Pereira
- Direction de la recherche cliniqueUnité BiostatistiqueClermont FerrandFrance
| | | | - Olivier Hermine
- Hématologie CliniqueAPHP, IMAGINE InstituteNecker‐Enfants MaladesParisFrance
| | - Romain Guièze
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
| | - Franck Pagès
- Immunomonitoring PlateformAPHPHôpital Européen Georges PompidouParisFrance
| | - Olivier Tournilhac
- Hématologie Clinique et Thérapie CellulaireCHU Clermont‐FerrandEA7453 CHELTERCIC1405Université Clermont AuvergneClermont FerrandFrance
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4
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Bossard J, Beuscart J, Robin M, Mohty M, Barraco F, Chevallier P, Marchand T, Rubio M, Charbonnier A, Blaise D, Bay J, Botella‐Garcia C, Damaj G, Beckerich F, Ceballos P, Cluzeau T, Cornillon J, Meunier M, Orvain C, Duhamel A, Garnier F, Kiladjian J, Yakoub‐Agha I. Splenectomy before allogeneic hematopoietic cell transplantation for myelofibrosis: A French nationwide study. Am J Hematol 2021; 96:80-88. [PMID: 33108024 DOI: 10.1002/ajh.26034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022]
Abstract
The value of pretransplant splenectomy in patients with myelofibrosis (MF) is subject to debate, since the procedure may preclude subsequent allogeneic hematopoietic cell transplantation (allo-HCT). To determine the impact of pretransplant splenectomy on the incidence of allo-HCT, we conducted a comprehensive retrospective study of all patients with MF for whom an unrelated donor search had been initiated via the French bone marrow transplantation registry (RFGM) between 1 January 2008 and 1 January 2017. Additional data were collected from the patients' medical files and a database held by the French-Language Society for Bone Marrow Transplantation and Cell Therapy (SFGM-TC). We used a multistate model with four states ("RFGM registration"; "splenectomy"; "death before allo-HCT", and "allo-HCT") to evaluate the association between splenectomy and the incidence of allo-HCT. The study included 530 patients from 57 centers. With a median follow-up time of 6 years, we observed 81 splenectomies, 99 deaths before allo-HCT (90 without splenectomy and nine after), and 333 allo-HCTs (268 without splenectomy and 65 after). In a bivariable analysis, the hazard ratio [95% confidence interval (CI)] for the association of splenectomy with allo-HCT was 7.2 [5.1-10.3] in the first 4 months and 1.18 [0.69-2.03] thereafter. The hazard ratio [95% CI] for death associated with splenectomy was 1.58 [0.79-3.14]. These reassuring results suggest that splenectomy does not preclude allo-HCT in patients with MF.
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Affiliation(s)
- Jean‐Baptiste Bossard
- University of Lille, CHU Lille, ULR 2694 ‐ METRICS: Évaluation des technologies de santé et des pratiques médicales Lille France
- Department of Hematology CHU Lille Lille France
| | - Jean‐Baptiste Beuscart
- University of Lille, CHU Lille, ULR 2694 ‐ METRICS: Évaluation des technologies de santé et des pratiques médicales Lille France
| | - Marie Robin
- Hôpital Saint‐Louis, APHP Université Paris 7 Paris France
| | - Mohamad Mohty
- Hématologie Clinique Saint‐Antoine Hospital and University Pierre & Marie Curie Paris France
| | - Fiorenza Barraco
- Departement d'Hématologie, Centre Hospitalier Lyon Sud Hospices Civils de Lyon Lyon France
| | | | | | | | | | | | - Jacques‐Olivier Bay
- Hématologie Clinique Centre Hospitalier Universitaire de Clermont‐Ferrand Clermont Ferrand France
| | | | - Gandhi Damaj
- Hematology Institute University Hospital Caen France
| | - Florence Beckerich
- Henri Mondor & Assistance Publique‐Hôpitaux de Paris Université Paris‐Est Créteil Créteil France
| | - Patrice Ceballos
- Département d'Hématologie Clinique CHU Lapeyronie Montpellier France
| | | | - Jérôme Cornillon
- Department of Clinical Hematology Institut de Cancérologie Lucien Neuwirth Saint‐Priest‐en‐Jarez France
| | | | | | - Alain Duhamel
- University of Lille, CHU Lille, ULR 2694 ‐ METRICS: Évaluation des technologies de santé et des pratiques médicales Lille France
| | | | - Jean‐Jacques Kiladjian
- Centre d'investigations cliniques Hôpital Saint‐Louis Paris France
- Université de Paris Paris France
- Inserm CIC1427 Paris France
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5
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Solari A, Giordano A, Sastre-Garriga J, Köpke S, Rahn AC, Kleiter I, Aleksovska K, Battaglia MA, Bay J, Copetti M, Drulovic J, Kooij L, Mens J, Meza Murillo ER, Milanov I, Milo R, Pekmezovic T, Vosburgh J, Silber E, Veronese S, Patti F, Voltz R, Oliver D. EAN guideline on palliative care of people with severe, progressive multiple sclerosis. Eur J Neurol 2020; 27:1510-1529. [PMID: 32469447 DOI: 10.1111/ene.14248] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 03/03/2020] [Accepted: 03/25/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Patients with severe, progressive multiple sclerosis (MS) have complex physical and psychosocial needs, typically over several years. Few treatment options are available to prevent or delay further clinical worsening in this population. The objective was to develop an evidence-based clinical practice guideline for the palliative care of patients with severe, progressive MS. METHODS This guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation methodology. Formulation of the clinical questions was performed in the Patients-Intervention-Comparator-Outcome format, involving patients, carers and healthcare professionals (HPs). No uniform definition of severe MS exists: in this guideline, constant bilateral support required to walk 20 m without resting (Expanded Disability Status Scale score > 6.0) or higher disability is referred to. When evidence was lacking for this population, recommendations were formulated using indirect evidence or good practice statements were devised. RESULTS Ten clinical questions were formulated. They encompassed general and specialist palliative care, advance care planning, discussing with HPs the patient's wish to hasten death, symptom management, multidisciplinary rehabilitation, interventions for caregivers and interventions for HPs. A total of 34 recommendations (33 weak, 1 strong) and seven good practice statements were devised. CONCLUSIONS The provision of home-based palliative care (either general or specialist) is recommended with weak strength for patients with severe, progressive MS. Further research on the integration of palliative care and MS care is needed. Areas that currently lack evidence of efficacy in this population include advance care planning, the management of symptoms such as fatigue and mood problems, and interventions for caregivers and HPs.
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Affiliation(s)
- A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - A Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.,Department of Psychology, University of Turin, Turin, Italy
| | - J Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Köpke
- Institute of Clinical Nursing Science, University of Cologne, Cologne, Germany.,Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A C Rahn
- Institute of Neuroimmunology and Multiple Sclerosis, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - I Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
| | | | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - J Bay
- Multiple Sclerosis International Federation, People with MS Advisory Committee, Copenhagen, Denmark
| | - M Copetti
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - J Drulovic
- Clinic of Neurology, CCS, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Kooij
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Mens
- Nieuw Unicum, Zandvoort, The Netherlands
| | - E R Meza Murillo
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Milanov
- Medical University of Sofia, Sofia, Bulgaria
| | - R Milo
- Department of Neurology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - T Pekmezovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Vosburgh
- Israel Multiple Sclerosis Society, Tel-Aviv, Israel
| | - E Silber
- Department of Neurology, King's College Hospital NHS Foundation Trust, London, UK
| | - S Veronese
- FARO Charitable Foundation, Turin, Italy
| | - F Patti
- Neurology Clinic, Multiple Sclerosis Centre, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - R Voltz
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.,Center for Health Services Research (ZVFK), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - D Oliver
- The Tizard Centre, University of Kent, Canterbury, UK
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6
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Nudel M, Baran‐Marszak F, Bossard J, Dubois R, Dapvril H, Dupuis J, Laribi K, Bay J, Tomowiak C, Dreyfus B, Lepretre S, Demarquette H, Wallyn F, Wemeau L, Wemeau M, Poulain S, Morschhauser F, Cymbalista F, Herbaux C. Characterisation of a new clinical presentation of chronic lymphocytic leukaemia: symptomatic bronchial involvement, a study from the
FILO
group. Br J Haematol 2019; 186:e126-e130. [DOI: 10.1111/bjh.15966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Morgane Nudel
- Hématologie Clinique Centre Hospitalier Régional Universitaire de Lille Lille France
| | | | - Jean‐Baptiste Bossard
- Hématologie Clinique Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Romain Dubois
- Anatomopathologie Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Héloïse Dapvril
- Radiologie Thoracique Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Jehan Dupuis
- Hématologie Clinique CHU Henri Mondor CréteilFrance
| | - Kamel Laribi
- Hématologie Clinique Centre Hospitalier Le Mans Le MansFrance
| | - Jacques‐Olivier Bay
- Hématologie Clinique Centre Hospitalier Universitaire de Clermont‐Ferrand Clermont FerrandFrance
| | - Cécile Tomowiak
- Hématologie Clinique Centre Hospitalier Universitaire Poitiers PoitiersFrance
| | - Brigitte Dreyfus
- Hématologie Clinique Centre Hospitalier Universitaire Poitiers PoitiersFrance
| | - Stéphane Lepretre
- Hématologie Clinique Centre Hospitalier Universitaire Rouen RouenFrance
| | - Hélène Demarquette
- Hématologie Clinique Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Frédéric Wallyn
- Pneumologie Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Lidwine Wemeau
- Pneumologie Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Mathieu Wemeau
- Hématologie Clinique Centre Hospitalier de Roubaix RoubaixFrance
| | - Stéphanie Poulain
- Laboratoire D'Hématologie Centre Hospitalier Régional Universitaire de Lille Lille France
| | - Franck Morschhauser
- Hématologie Clinique Centre Hospitalier Régional Universitaire de Lille Lille France
| | | | - Charles Herbaux
- Hématologie Clinique Centre Hospitalier Régional Universitaire de Lille Lille France
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7
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Köpke S, Giordano A, Veronese S, Christin Rahn A, Kleiter I, Basedow-Rajwich B, Fornari A, Battaglia MA, Drulovic J, Kooij L, Koops J, Mens J, Meza Murillo ER, Milanov I, Milo R, Patti F, Pekmezovic T, Sastre-Garriga J, Vosburgh J, Voltz R, Bay J, Oliver DJ, Solari A. Patient and caregiver involvement in the formulation of guideline questions: findings from the European Academy of Neurology guideline on palliative care of people with severe multiple sclerosis. Eur J Neurol 2018; 26:41-50. [PMID: 30035845 DOI: 10.1111/ene.13760] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 02/26/2018] [Accepted: 07/16/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE Patient and public involvement in clinical practice guideline development is recommended to increase guideline trustworthiness and relevance. The aim was to engage multiple sclerosis (MS) patients and caregivers in the definition of the key questions to be answered in the European Academy of Neurology guideline on palliative care of people with severe MS. METHODS A mixed methods approach was used: an international online survey launched by the national MS societies of eight countries, after pilot testing/debriefing on 20 MS patients and 18 caregivers, focus group meetings of Italian and German MS patients and caregivers. RESULTS Of 1199 participants, 951 (79%) completed the whole online survey and 934 from seven countries were analysed: 751 (80%) were MS patients (74% women, mean age 46.1) and 183 (20%) were caregivers (36% spouses/partners, 72% women, mean age 47.4). Participants agreed/strongly agreed on inclusion of the nine pre-specified topics (from 89% for 'advance care planning' to 98% for 'multidisciplinary rehabilitation'), and <5% replied 'I prefer not to answer' to any topic. There were 569 free comments: 182 (32%) on the pre-specified topics, 227 (40%) on additional topics (16 guideline-pertinent) and 160 (28%) on outcomes. Five focus group meetings (three of MS patients, two of caregivers, and overall 35 participants) corroborated the survey findings. In addition, they allowed an explanation of the guideline production process and the exploration of patient-important outcomes and of taxing issues. CONCLUSIONS Multiple sclerosis patient and caregiver involvement was resource and time intensive, but rewarding. It was the key for the formulation of the 10 guideline questions and for the identification of patient-important outcomes.
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Affiliation(s)
- S Köpke
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - A Giordano
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - S Veronese
- FARO Charitable Foundation, Turin, Italy
| | - A Christin Rahn
- Institut für Neuroimmunologie und Multiple Sklerose (INIMS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - I Kleiter
- Kempfenhausen Centre for Treatment of Multiple Sclerosis, Marianne-Strauß-Klinik, Berg, Germany
| | - B Basedow-Rajwich
- Kempfenhausen Centre for Treatment of Multiple Sclerosis, Marianne-Strauß-Klinik, Berg, Germany
| | - A Fornari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - M A Battaglia
- Department of Life Sciences, University of Siena, Siena, Italy
| | - J Drulovic
- Clinic of Neurology, CSS, Faculty of Medicine, University Hospital of Belgrade, Belgrade, Serbia
| | - L Kooij
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Koops
- Nieuw Unicum, Zandvoort, The Netherlands
| | - J Mens
- Nieuw Unicum, Zandvoort, The Netherlands
| | - E R Meza Murillo
- MS Centre of Catalonia (Cemcat), University Hospital Vall d'Hebron, Barcelona, Spain
| | - I Milanov
- Neurology Clinic, Medical University of Sofia, Sofia, Bulgaria
| | - R Milo
- Department of Neurology, Barzilai Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - F Patti
- Neurology Clinic, Multiple Sclerosis Centre, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - T Pekmezovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - J Sastre-Garriga
- MS Centre of Catalonia (Cemcat), University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Vosburgh
- Israel Multiple Sclerosis Society, Tel-Aviv, Israel
| | - R Voltz
- Department of Palliative Medicine, University Hospital Cologne, Cologne, Germany
| | - J Bay
- Multiple Sclerosis International Federation, People with MS Advisory Committee, Copenhagen, Denmark
| | - D J Oliver
- The Tizard Centre, University of Kent, Canterbury, UK
| | - A Solari
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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8
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Bay J, Bojsen-Møller J, Nordsborg NB. Reliable and sensitive physical testing of elite trapeze sailors. Scand J Med Sci Sports 2017; 28:919-927. [PMID: 29027266 DOI: 10.1111/sms.12993] [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] [Accepted: 10/05/2017] [Indexed: 11/26/2022]
Abstract
It was investigated whether a newly developed discipline-specific test for elite-level trapeze sailors is reliable and sensitive. Furthermore, the physical demands of trapeze sailing were examined. In part 1, 9 national team athletes were accustomed to a simulated sailing test, which subsequently was completed on 4 occasions to determine test reliability and sensitivity to manipulations in body weight. Rope-pulling mean power output (MPO), oxygen consumption (VO2 ), heart rate (HR), and blood lactate values were acquired in all trials. In part 2, 6 sailors completed on-water racing with concurrent measurements of VO2 , HR, and blood lactate. VO2max was determined during an incremental treadmill running test. Typical error, minimal difference, and ICC for average MPO in the test were 1.3%, 1.7%, and 0.99%, respectively. Adding 4 kg of external body weight caused a decrease in average MPO (270 ± 45W vs 265 ± 45W, P < .05) and an increase in VO2 (2.44 ± 0.23 L·min-1 vs 2.55 ± 0.26 L·min-1 , P < .01). VO2 , HR, and blood lactate during on-water sailing were 54.5% ± 7.2% VO2max , 75.1% ± 3.1% HRmax , and 5.8 ± 2.7 mmol·L-1 , respectively. However, VO2 and HR were substantially higher for periods of the race as peak values were 83.5% ± 11.4% and 89.9% ± 1.7% of max, respectively. In conclusion, the present test is reliable and sensitive, thus providing a sailing-specific alternative to traditional physical testing of elite trapeze sailors. Additionally, on-water racing requires moderate aerobic energy production, although oxygen consumption can approach maximal levels for short periods of time.
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Affiliation(s)
- J Bay
- Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark
| | - J Bojsen-Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - N B Nordsborg
- Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark
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Le Bourgeois A, Labopin M, Blaise D, Ceballos P, Vigouroux S, Peffault De Latour R, Suarez F, Bulabois C, Bay J, Chantepie S, Deconinck E, Daguindau E, Contentin N, Yakoub-Agha I, Cornillon J, Francois S, Turlure P, Charbonnier A, Rohrlich P, N'Guyen S, Maillard N, Marchand T, Mohty M, Chevalllier P. REDUCED INTENSITY (FB2) VS REDUCED TOXICITY MYELOABLATIVE (FB3-4) FLUDARABINE/BUSULFAN-BASED CONDITIONING REGIMENS FOR NON-HODGKIN LYMPHOMA (NHL) ALLOGRAFTED PATIENTS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - M. Labopin
- Department of Hematology; Hôpital Saint Antoine; Paris France
| | - D. Blaise
- Centre de Recherche en Cancérologie de Marseille; Department of Hematology; Marseille France
| | - P. Ceballos
- Department of Hematology; CHU Saint Eloi; Montpellier France
| | - S. Vigouroux
- Department of Hematology, CHU de Bordeaux; Bordeaux France
| | | | - F. Suarez
- Department of Hematology; Hôpital Neker-Enfants Malades; Paris France
| | - C. Bulabois
- Department of Hematology, CHU Grenoble; Grenoble France
| | - J. Bay
- Department of Hematology, CHU de Clermont Ferrand; Clermont Ferrand France
| | | | - E. Deconinck
- Department of Hematology, CHU de Besançon; Besançon France
| | - E. Daguindau
- Department of Hematology, CHU de Besançon; Besançon France
| | - N. Contentin
- Department of Hematology, Centre Henri Becquerel; Rouen France
| | | | - J. Cornillon
- Department of Hematology; Institut de Cancérologie Lucien Neuwirth; Saint Etienne France
| | - S. Francois
- Department of Hematology, CHU Angers; Angers France
| | - P. Turlure
- Department of Hematology, CHU de Limoges; Limoges France
| | - A. Charbonnier
- Department of Hematology, CHU d'Amiens Sud; Amiens France
| | - P. Rohrlich
- Department of Hematology, CHU Nice; Nice France
| | - S. N'Guyen
- Department of Hematology; Hôpital Salpétrière; Paris France
| | - N. Maillard
- Department of Hematology; Hôpital La Miletrie; Poitiers France
| | - T. Marchand
- Department of Hematology, CHU Rennes; Rennes France
| | - M. Mohty
- Department of Hematology; Hôpital Saint Antoine; Paris France
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Abstract
The hypothesis, that sailing upwind in wind speeds above 12 knots causes fatigue, which manifests as a reduction in exerted hiking strap force and/or maximal isometric voluntary contraction force (MVC) of the knee extensors, was evaluated. Additionally, it was investigated if a relationship exists between maximal exerted hiking force (hMVC) and sailing performance. In part 1 of the study, 12 national level athletes sailed upwind for 2 × 10 min while hiking strap forces were continuously acquired. Before, in between and after sailing periods, the MVC of the knee extensors was measured. In part 2 of the study, hMVC was measured dry land in a hiking bench and correlated with the overall results at a national championship. Hiking strap force decreased from the first to the last minute in both 10 min sailing periods (430 ± 131 vs. 285 ± 130 N, P < .001 and 369 ± 74 vs. 267 ± 97 N, P < .001, respectively), but MVC was similar before, between and after the two 10 min sailing periods (878 ± 215 vs. 852 ± 202 vs. 844 ± 211 130 N). In part 2, a significant positive correlation (r2 = 0.619, P < .01) was observed between hMVC and regatta results. In conclusion, upwind sailing in wind speeds above 12 knots causes sailing-specific fatigue as evidenced by a marked reduction in exerted hiking strap force. However, MVC of the knee extensors was not compromised ∼45 s after hiking was terminated. Additionally, sailing performance is related to maximal hiking force.
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Affiliation(s)
- R Buchardt
- a Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark
| | - J Bay
- a Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark
| | - J Bojsen-Møller
- b Department of Physical Performance , Norwegian School of Sport Sciences , Oslo , Norway
| | - N B Nordsborg
- a Department of Nutrition, Exercise and Sport , University of Copenhagen , Copenhagen , Denmark
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11
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Bay J, Mikita C. P099 Acute angioedema associated with iron deficiency anemia. Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.108] [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: 10/20/2022]
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Le Cesne A, Blay J, Ryckewaert T, Chevreau C, Bertucci F, Delcambre C, Saada E, Piperno-Neumann S, Bay J, Mir O, Domont J, Ray-Coquard I, Valentin T, Tresch E, Clisant S, Isambert N, Italiano A, Clisant S, Badri N, Penel N. Benefit of Maintenance Therapy with Trabectedin (T) Beyond the 6 First Cycles: Results of a Prospective Randomized Phase Ii Trial Comparing Interruption Vs. Continuation of T in Patients (Pts) with Advanced Soft Tissue Sarcoma (Asts): an Update. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.3] [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: 11/13/2022] Open
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13
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Falk A, Moureau-Zabotto L, Penel N, Italiano A, Bay J, Sunyach M, Ducassou M, Olivier T, Thyss A, Thariat J. Improved Outcomes With Iterative Local Treatments of Oligometastases in Sarcomas: A French Sarcoma Group Study. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Selle F, Fizazi K, Biron P, Gravis-Mescam G, Bui B, Bay J, Flechon A, Dubot C, Caty A, Burcoveanu D, Delva R, de Revel T, Miclea J, Gaulet M, Horn E, Provent S, Temby I, Brindel I, Khalil J, Gligorov J, Lotz JP. The TAXIF II Protocol Final Results: A Phase II Trial of High-Dose Chemotherapy Supported by Haematopoietic Stem Cell Transplantation in Patients with Disseminated Germ-Cell Tumors Failing Chemotherapy and with Adverse Prognostic Factors. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33414-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Duffaud F, Ray-Coquard IL, Blesius A, Huynh TK, Boucher E, Bouche O, Bay J, Marchal F, Spano J, Bertucci F, Bui Nguyen B, Collard O, Chaigneau L, Isambert N, Adenis A, Mancini J, Le Cesne A, Blay J. Gastrointestinal stromal tumors (GIST) of the duodenum: A French Sarcoma Group (FSG) retrospective review of 90 patients (pts). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10053] [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] [Indexed: 11/20/2022] Open
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Bompas E, Campion L, Italiano A, Cesne AL, Giaj Levra M, Chevreau C, Piperno-Neumann S, Isambert N, Thyss A, Rios M, Kurtz J, Delcambre C, Bay J, Duffaud F, Trassard M, Soulie P, Blay J. Outcome of 157 adult rhabdomyosarcoma (RMS) patients: A retrospective study from the French Group Sarcoma (GSF-GETO). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10070] [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: 11/20/2022] Open
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Isambert N, Ray-Coquard IL, Bui Nguyen B, Rios M, Kerbrat P, Blouet A, Chaigneau L, Duffaud F, Piperno-Neumann S, Kurtz J, Thariat J, Girard N, Collard O, Bompas E, Penel N, Bay J, Guillemet C, Collin F, Blay J, Le Cesne A. Management and outcomes for primary cardiac sarcomas (PCS): A retrospective study of the French Sarcoma Group (FSG). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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18
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Amela E, Italiano A, Ray-Coquard IL, Chaigneau L, Delcambre C, Bui Nguyen B, Bertucci F, Isambert N, Cupissol D, Bompas E, Bay J, Duffaud F, Guillemet C, Corradini N, Cassier PA, Chevreau C, Blay J, Penel N. Metastatic angiosarcomas (mAS): Identification of treatments that significantly improve the outcome. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Escudier BJ, Negrier S, Perol D, Gravis G, Delva R, Bay J, Geoffrois L, Legouffe E, Metzger S, Ferlay C. Prognostic factors for progression-free survival (PFS) in patients with metastatic renal cell carcinoma (mRCC): Results from the French randomized phase II study TORAVA. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15118] [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: 11/20/2022] Open
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Escudier BJ, Perol D, Ferlay C, Gravis G, Chevreau C, Delva R, Bay J, Geoffrois L, Blanc E, Negrier S. TORAVA trial: Lessons from this trial in the two control arms, sunitinib and bevacizumab in combination with interferon. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
315 Background: The TORAVA trial, reported at ASCO 2010, was a randomized phase II study aimed to determine the efficacy and safety of temsirolimus and bevacizumab combination. Both efficacy and safety were demonstrated as insufficient. Interestingly, 2 control arms were used in this study, sunitinib (arm B) or bevacizumab and a-interferon (arm C). Both PFS and RR were higher in arm C than arm B (16.8 mths and 39% vs. 8.6 mths and 23.8%). Post-hoc analysis were thus performed to determine the predictive factors for better efficacy. Methods: Overall, 171 pts were randomized in this study, 42 in arm B and 41 in arm C. The study was stratified on PS only, 0–1 vs 2. These 83 pts were analyzed regarding baseline characteristics, and dose reduction. Results: Some important differences were detected in the 2 arms, in favor of arm C: DFI>12mths (29 vs. 39%), good MSKCC risk (31 vs. 39%), Fuhrman grade 1–2 (32 vs. 38%), liver metastases (19 vs. 14.6%), high LDH (17.1 vs. 7.9%). Interestingly, pts who had dose reduction of interferon (27/41 pts) had a longer PFS than those who did not reduced the dose. Updated analyses will be presented. Conclusions: Small randomized trials such as randomized phase II trials are not guaranteed to balance predictive/ prognostic factors across treatment arms. Before interpreting RR and PFS in mRCC, careful analysis of pt characteristics should be performed. However, this study will probably help to determine a population more likely to benefit from bevacizumab-interferon combination. [Table: see text]
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Affiliation(s)
- B. J. Escudier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - D. Perol
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - C. Ferlay
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - G. Gravis
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - C. Chevreau
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - R. Delva
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - J. Bay
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - L. Geoffrois
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - E. Blanc
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
| | - S. Negrier
- Medical Oncology Department, Institut Gustave Roussy, Villejuif, France; Centre Léon Bérard, Lyon, France; Department of Medical Oncology, Institut Paoli Calmettes, INSERM UMR 891, Marseille, France; Institut Claudius Regaud, Toulouse, France; Gineco, Angers, France; Centre Jean Perrin and Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France; Department of Medical Oncology, Centre Alexis Vautrin, Nancy, Belgium; Service de Cancérologie Médicale, Centre Léon Bérard, Lyon, France
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Penel N, Ray-Coquard I, Cioffi A, Bompas E, Chevreau C, Italiano A, Bay J, Isambert N, Clisant S, Blay J. A stratified phase II trial investigating sorafenib (SORA) in patients (pts) with metastatic or locally advanced angiosarcoma (AS). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10026] [Citation(s) in RCA: 3] [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] [Indexed: 11/20/2022] Open
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22
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Bay J, Le Cesne A, Cioffi A, Penel N, Duffaud F, Cupissol D, Piperno-Neumann S, Cropet C, Bouclier L, Ray-Coquard I. A national registry for the off-label use of targeted therapies in patients (pts) with malignant mesenchymal tumors: A retrospective study from the GSF-GETO. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.10097] [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: 11/20/2022] Open
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23
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Escudier BJ, Negrier S, Gravis G, Chevreau C, Delva R, Bay J, Geoffrois L, Legouffe E, Blanc E, Ferlay C. Can the combination of temsirolimus and bevacizumab improve the treatment of metastatic renal cell carcinoma (mRCC)? Results of the randomized TORAVA phase II trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4516] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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24
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Binh NN, Chevreau C, Penel N, Bay J, Coindre J, Mathoulin-Pelissier S, Ray-Coquard I, Italiano A, Genève J, Blay J. Consolidation with high-dose chemotherapy for responding patients to standard chemotherapy in advanced, metastatic soft tissue sarcoma (STS): A randomized trial from FNCLCC-French Sarcoma Group. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10505 Background: Whether high dose (HD) chemotherapy improves disease-free (DFS) or overall (OS) survival has been suggested in phase II trial, but never explored in a randomized setting. This randomized, open, phase III study was designed to assess whether or not an HD chemotherapy with peripheral blood stem cells (PBSC) would improve OS in patients with advanced or metastatic STS responding to MAID chemotherapy. Methods: Pts aged 18 to 65 and with advanced STS were enrolled. After 4 courses of MAID, patients in PR or CR, or in whom complete surgical removal of all lesions was performed, were proposed for randomisation between 2 more cycles of MAID (control arm) vs 1 MAID followed by an intensification with MICE, ie: mesna (3.6g/m2, d1–5), ifosfamide (4g/m2, d1–4), carboplatin (UCA5, d2–4) and etoposide (300mg/m2, d1–4), followed by PBSC (HD arm). The primary endpoint was OS and the study was designed to detect by logrank test a 25% difference between the arms. Results: From 03/00 to 06/08, 266 patients were included and 87 were randomised (15 centres); low accrual and new treatment concepts lead to an IDMC in 11/08 who analysed 45 treated in the control arm (41 with full treatment) and 40 in the HD arm [only 21 received MICE, because consent withdrawal (6), insufficient PBSC harvest (5), tumor reprogression (4)]. Baseline characteristics (pts and tumors) were similar between treatment arms. With a 39 months follow-up, 25 pts were alive in the control arm, and 19 in the HD arm. The 3 years OS was 45.5% for control arm versus 35.8 for HD arm (HR = 1.12; 95% CI 0.58, 2.14; p = 0.72 Intention to treat analysis); PFS was 29.9% and 12.1 respectively (HR = 1.48; 95% CI 0.87, 2.53; p = 0.14). Higher rate of grade 3 - 4 hematologic (87% vs 46%), and digestive toxicity (33% vs 0%) were observed in the HD arm. Two treatment-related deaths occurred, both in the HD arm. Conclusions: In this study, HD chemotherapy for STS patients didn't improve OS and DFS. Consolidations with new concepts have to be explored. [Table: see text]
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Affiliation(s)
- N. N. Binh
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - C. Chevreau
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - N. Penel
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - J. Bay
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - J. Coindre
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - S. Mathoulin-Pelissier
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - I. Ray-Coquard
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - A. Italiano
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - J. Genève
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
| | - J. Blay
- PALSAR02 Clinical Trial Group; Institut Bergonié, Bordeaux, France; Institut Claudius Regaud, Toulouse, France; Centre Oscar Lambret, Lille, France; Centre Jean Perrin, Clermont-Ferrand, France; Centre Léon Bérard, Lyon, France; FNCLCC, Paris, France
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Lotz J, Selle F, Fizazi K, Gravis G, Bui B, Delva R, Bay J, Baron A, Robain M, Biron P. A phase II trial of high-dose chemotherapy (HDCT) supported by haematopoietic stem cell transplantation (HSCT) in patients (pts) with disseminated germ-cell tumors (GCTs) failing chemotherapy and with adverse prognostic factors: The TAXIF II protocol. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5028 Background: HDCT using the etoposide-carboplatin ± ifosfamide regimen is able to circumvent resistance in GCT pts, even when used as third-line or later therapy (Lotz, Ann Onco.l 2005 / Einhorn, N Eng J Med. 2007). Pts whose relapses occur more than 4 w after CDDP-based CT are probably the best candidates for HDCT. Epirubicine (E) and paclitaxel (P) possess interesting activity in GCTs. Thiotepa (TTP) and P can be safely combined at HD with good efficacy. The ICE regimen is a well-known worldwide used regimen. Methods: Non-resistant/refractory GCTs pts failing CT and with adverse prognostic factors were planned to receive 2 cycles combining (mg/m2) E (100) and P (250), given on day 1 and 14 supported by filgrastim (F), followed by 3 consecutive HDCTs [1 course combining a 3-d combination of P (360) + TTP (720), followed by 2 ICE regimens (IFM, 12 g/m2, CBDCA, AUC 20, VP16, 1,500 mg/m2), given on 5 days with HSCT and F]. Inclusion criterias were mainly: radiologically and/or biologically mesurable disease, seminomatous GCT in relapse after 2 lines of CT (BEP/VeIP), non-seminomatous GCT in relapse after 1 or 2 lines of CT or in PR after 1 line of CT, primary mediastinal GCT in first relapse. Resistant / refractory pts were excluded. PBSC were collected after the first ± the second courses of EP (aim: 9x10E6 CD34+/kg BW). We report herein on the preliminary results of this multicentric study. Results: From 09/04 to 12/07, 45 pre-treated (BEP ± VeIP) pts with gonadal (89%) or extra-gonadal T (11%) were treated in second-line (27%), 3rd-line (44 %) or more (29 %). Thirty-five pts received 1 HDCT, 29 two HDCTs and 21 pts could receive the whole protocol. At the time of analysis (12/08), the final overall response rate was 47%, 10 pts were in continuous CR (median time, 8 m; range, 1–18), and 37 pts (82%) were alive at a median F/U of 9 m (range, 1–26). The 1-y survival rate was 90%. The 1-y PFS rate was 62%. One pt died of multi-organ failure and 7 died of disease progression. Conclusions: This HDCT program preceded by 2 semi-intensive cycles of E-P is highly effective in non-resistant/refractory pts with disseminated GCTS failing CT and with adverse prognostic factors. No significant financial relationships to disclose.
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Affiliation(s)
- J. Lotz
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - F. Selle
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - K. Fizazi
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - G. Gravis
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - B. Bui
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - R. Delva
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - J. Bay
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - A. Baron
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - M. Robain
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
| | - P. Biron
- Hôpital Tenon, Service D’Oncologie Medicale, APREC, Paris, France; Institut Gustave Roussy, Villejuif, France; Institut Paoli Calmette, Marseille, France; Institut Bergonié, Bordeaux, France; Centre Paul Papin, Angers, France; CHU, Clermont-Ferrand, France; Hôpital Tenon, Service D’Oncologie Medicale, Paris, France; 3ES-Cegedim Strategic Data, Boulogne, France; Centre Léon Bérard, Lyon, France
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Blaise D, Tabrizi R, Faucher C, Mohty M, Bay J, Marit G, Furst S, Charbonnier A, Chabannon C, Vey N. Allogeneic immunotherapy by hematopoietic stem cell transplantation (ASCT) after reduced intensity conditioning (RIC) following high-dose chemotherapy for patients with acute myeloblastic leukemia (AML) in first complete remission (CR1): Reduced toxicity. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7098 Background: RIC-based ASCT can be used after intensive chemotherapy in pts with CR1AML(Blaise, Cancer, 2005). Initial disease control was high and was not related to selection bias (Mohty, Leukemia, 2005).Here, we investigated if this control was maintained after a long follow-up. Methods: 37 pts (age: 51 (26–60)) with high risk clinical characteristics (70%) (Age = 50 (N=22, 59%); severe comorbidity (30%)) and/or poor risk leukemic features (65%) (Cytogenetics (35%); 2 induction courses (27%); secondary leukemia (11%), High white blood cell counts(14%) or partial remission (3%)) were treated. After CR1, pts received at least either 1 course of high dose cytarabine (24 g/m2) and anthracycline (HIDAC: N=21) or HIDAC + 1 course of. melphalan (140 mg/m2) (HDMEL) with auto-SCT Pts (HIDAC +HDM N=16). All pts were then scheduled to receive ASCT prepared with RIC (fludarabine (180 mg/m2), busulfan (8 mg/kg), Thymoglobulin (2.5 to 10 mg/kg)) followed with BMT (28%) or PBSC (72%). Results: With a Median follow-up of 3 years (16–70 mths). 15 pts experienced aGVHD (grade 2–4 aGVHD cumulative incidence (CI):22% (9–35). 10 and 14 pts presented a limited and extensive cGVHD respectively (CI cGVHD:65 % (50–80). 3 deaths were attributed to non-relapse causes (NRD) (AGVHD: 1; CGVHD: 2° (NRD CI: 8% (0–17). In all, 9 pts relapsed at 5 mths (2–19) (24% (9–35). Relapse was associated with the absence of cGVHD (cGVHD: 8 (0–19), no cGVHD 44% (12–76), p=.05). 25 pts are still alive in CR1 for overall survival and leukemia-free survival (LFS) probability estimates at 4 years of 65 % (48–79%) and 66% (49–80%) respectively. When restricting the analysis to the 33 pts evaluable for cGVHD, cGVHD remained the only independent risk factor positively influencing LFS (cGVHD: 81% (59–92); no cGVHD (56% (27–81), p=.05) Conclusions: We conclude that RIC Allo-SCT preceded by adequate prior intensive chemotherapy might offers a relatively low NRD while exerting a sustained leukemia control even in high risk pts deserving prospective evaluation against standard strategy of conventional Allo SCT. No significant financial relationships to disclose.
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Affiliation(s)
- D. Blaise
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - R. Tabrizi
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - C. Faucher
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - M. Mohty
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - J. Bay
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - G. Marit
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - S. Furst
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - A. Charbonnier
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - C. Chabannon
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
| | - N. Vey
- Institut Paoli-Calmettes, Marseille, France; Hopital Haut Leveque, Bordeaux, France; Centre Jean Perrin, Clermont Ferrand, France
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Frappaz D, Pierga J, Bay J, Fabbro M, Djafari L, Sunyach M. Phase I of high dose (HD) temozolomide (TMZ) with peripheral blood stem cell support (PBSCS) rescue in recurrent high grade glioma (HGG). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
12518 Background: Despite improvements obtained with frontline treatments prognosis of recurrent HGG still remains dismal. HD chemotherapy (CT) suggested a dose-effect relationship in lymphoma and germ cell tumors. HD of TMZ could be a promising way to overcome resistance of HGG to standard schedule of CT Methods: This phase I had as principal objective to determine the Maximal Tolerated Dose (MTD) of HD of TMZ with PBSCS rescue in patients with recurrent HGG under 60 year. The MTD was defined as dose level which 50% of patients (pts) treated experienced a DLT (Dose Limiting Toxicity).The dose escalation was planned for eight dose levels from 300 to 650mg/m2/day over 5 days with CSP reinfusion at D7 according to the Modified Continual Reassessment Method (MCRM). Treatment was administered for one cycle. Results: Eighteen eligible pts were treated with HD of TMZ, all had received prior radiotherapy, 11 pts previous CT. Overall HD TMZ was well tolerated for the 7 evaluated dose levels. The MTD was not yet reached. Not dose limiting toxicities were reported in 12 pts: grade 2: fatigue (6pts), cephalalgia (3pts), nausea (3pts) , skin eruption (2pts), mucositis, FUO, vomiting, diarrhea, zoster, dental abcess, lung infection, septicemia, hepatic. grade 3 bilirubinemia, grade 4 neutropenia (13pts) and thrombocytopenia (4pts). Dose Limiting Toxicities were reported in 2 pts, gr3 cytolysis at level 3 (400mg/m2/day ) 1pt and gr 3 arthritis at level 7 (600mg/m2) 1pt respectively . Main hematological toxicities were gr 4 neutropenia in 13 pts median duration was 8 days, 4 pts had gr4 thrombocytopenia lasting 5 days. All patients were evaluable for tumor response, 2 partial responses were observed at 550 and 600mg/m2 level, 5 pts had a stabilization and a disease progression was reported in 11 patients. Conclusions: This interim analysis demonstrated that HD of TMZ with CSP reinfusion is feasible and well tolerated in patients with recurrent HGG. Nevertheless limited activity reported could be related to a less depletion of O6 alkylguanine transferase with HD than with a protracted schedule. Accrual is still ongoing. No significant financial relationships to disclose.
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Affiliation(s)
- D. Frappaz
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
| | - J. Pierga
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
| | - J. Bay
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
| | - M. Fabbro
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
| | - L. Djafari
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
| | - M. Sunyach
- Centre Leon Berard, Lyon, France; Institut Curie, Paris, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Val d’Aurelle, Montpellier, France; Schering-Plough, Levallois-Perret, France
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Friedl R, Preisack M, Schefer M, Klas W, Tremper J, Rose T, Bay J, Albers J, Engels P, Guilliard P, Vahl CF, Hannekum A. CardioOp: an integrated approach to teleteaching in cardiac surgery. Stud Health Technol Inform 2000; 70:76-82. [PMID: 10977587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
INTRODUCTION/PURPOSE The complexity of cardiac surgery requires continuous training, education and information addressing different individuals: physicians (cardiac surgeons, residents, anaesthesiologists, cardiologists), medical students, perfusionists and patients. Efficacy and efficiency of education and training will likely be improved by the use of multimedia information systems. Nevertheless, computer-based education is facing some serious disadvantages: 1) multimedia productions require tremendous financial and time resources; 2) the obtained multimedia data are only usable for one specific target user group in one specific instructional context; 3) computer based learning programs often show deficiencies in the support of individual learning styles and in providing individual information adjusted to the learner's individual needs. In this paper we describe a computer-system, providing multiple re-use of multimedia-data in different instructional sceneries and providing flexible composition of content to different target user groups. TOOLS AND METHODS The ZYX document model has been developed, allowing the modelling and flexible on-the-fly composition of multimedia fragments. It has been implemented as a DataBlade module into the object-relational database system Informix Dynamic Server and allows for presentation-neutral storage of multimedia content from the application domain, delivery and presentation of multimedia material, content based retrieval, re-use and composition of multimedia material for different instructional settings. Multimedia data stored in the repository, that can be processed and authored in terms of our identified needs is created by using a next generation authoring environment called CardioOP-Wizard. High-quality intra-operative video is recorded using a video-robot. Difficult surgical procedures are visualized with generic and CT-based 3D-animations. RESULTS An on-line architecture for multiple re-use and flexible composition of media data has been established. The system contains the following instructional applications (prototypically implemented): a multimedia textbook on operative techniques, an interactive module for problem based-training, a module for creation and presentation of lectures and a module for patient information. Principles of cognitive psychology and knowledge management have been employed in the program. These instructional applications provide information ranging from basic knowledge at the beginner's level, procedural knowledge for the advanced level to implicit knowledge for the professional level. For media-annotation with meta-data a metainformation system, the CardioOP-Clas has been developed. The prototype focuses on aortocoronary bypass grafting and heart transplantation. CONCLUSION The demonstrated system reflects an integrated approach in terms of information technology and teaching by means of multiple re-use and composition of stored media-items to the individual user and the chosen educational setting on different instructional levels.
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Affiliation(s)
- R Friedl
- Dept. of Cardiac Surgery, Univ. Ulm
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Uhrhammer N, Bay J, Pernin D, Rio P, Grancho M, Kwiatkowski F, Gosse-Brun S, Daver A, Bignon Y. Loss of heterozygosity at the ATM locus in colorectal carcinoma. Oncol Rep 1999; 6:655-8. [PMID: 10203610 DOI: 10.3892/or.6.3.655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Patients homozygous for mutation of the ATM gene exhibit constitutional genetic instability and have a high risk of cancer. A-T heterozygotes also have an increased tendency to develop adenocarcinomas. Colorectal cancer (CRC) is the second most common cancer in western populations, and tumors of the right colon are typically highly genetically unstable. The DNA mismatch repair genes mutated in most familial and some sporadic CRCs account for one route by which cells acquire additional oncogenic mutations during the progression of malignancy. Mismatch repair defects, however, do not seem to account for the majority of CRCs. Because of its role in maintaining genomic stability, and the high risk of cancer to homozygotes, ATM is a candidate gene for inactivation in the evolution of chromosomal instability in tumor cells. We have examined 114 CRC patients for loss of heterozygosity (LOH) using six microsatellite markers tightly linked to the ATM locus. Our data suggest that LOH of this region is not associated with cancer of the proximal colon. In the distal colon, LOH was found in 23-31% of cases, which is moderately elevated above the non-specific LOH reported in tumors of this tissue. No correlations were found with regard to clinicopathological variables aside from tumor location.
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Affiliation(s)
- N Uhrhammer
- Laboratoire d'Oncologie Moléculaire, INSERM CRI 9502 and EA 2145, Centre J. Perrin, BP 392, 63011 Clermont-Fd, France
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Vidal V, Bay J, Champomier F, Grancho M, Beauville L, Glowaczower C, Lemery D, Ferrara M, Bignon Y. The 1396del a mutation and a missense mutation or a rare polymorphism of the WRN gene detected in a French Werner family with a severe phenotype and a case of an unusual vulvar cancer. Hum Mutat 1998. [DOI: 10.1002/(sici)1098-1004(1998)11:5<413::aid-humu18>3.3.co;2-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Bernardgallon D, Ralliere C, Essioux L, Gosse S, Cure H, Bay J, Schraub S, Bonaitipellie C, Sobol H, Bignon Y. Linkage analyses of 3 French families to Loci on chromosome-2p and chromosome-3p predisposing to hereditary nonpolyposis colon-cancer. Int J Oncol 1995; 6:699-703. [PMID: 21556592 DOI: 10.3892/ijo.6.3.699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Hereditary, non-polyposis colon cancer (HNPCC) is caused by mutations in different loci. One gene causing HNPCC was mapped to chromosome 2p and recently a tight linkage between a polymorphic marker on the chromosome 3p and the disease locus has been demonstrated and these families also manifest signs of a general DNA replicator disorder. We report detailed genetic studies of three French HNPCC families with D2S123 and D3S1029. In one of the families (F 230), the segregation pattern for markers on chromosomes 2 and 3 suggests absence of linkage. The two other families are not informative enough to conclude on linkage status with chromosomes 2 and 3. If confirmed, this result would mean that the inherited colon cancer in this family is linked to another HNPCC gene. Implication for genetic counselling is discussed. Even with cloned genes, linkage analysis with flanking microsatellite markers for informative families may help to avoid tedious work of seeking point mutations in HNPCC genes.
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Affiliation(s)
- D Bernardgallon
- CTR JEAN PERRIN,UNITE PREVENT & DEPISTAGE CANC,ONCOL MOLEC LAB,F-63011 CLERMONT FERRAND,FRANCE. INSERM,U155,F-75016 PARIS,FRANCE. HOP JEAN MINJOZ,F-25030 BESANCON,FRANCE. INST J PAOLI I CALMETTES,F-13273 MARSEILLE 9,FRANCE. CTR LEON BERARD,UNITE ONCOL GENET,F-69373 LYON,FRANCE. LAB IMMUNOL,F-63170 CLERMONT FERRAND,FRANCE
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Bernardgallon D, Gosse S, Essioux L, Laurentpuig P, Ralliere C, Cure H, Bay J, Schraub S, Bonaitipellie C, Sobol H, Bignon Y. Analyses of linkage to 17q11-q23 in 3 French hereditary nonpolyposis colon-cancer families. Int J Oncol 1995; 6:693-697. [PMID: 21556591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Hereditary non-polyposis colorectal cancer (HNPCC) is an autosomal dominant disease, accounting for approximately 6% of colorectal cancers. We performed linkage analyses with the aim of proving or excluding the existence of a susceptibility locus on 17q. Three HNPCC families (102 collected members, 25 colorectal cancers, 9 other cancers and 6 colorectal adenomas) were studied with 7 polymorphic DNA markers Mfd15, THRA 1, D17S800, D17S855, Mfd 188, 42D6, 46E6 localized in the 17q11-q23 region. After in vitro enzymatic amplification, the different alleles were separated by classic vertical poly-acrylamide gel electrophoresis or analyzed with the automatic sequencing machine 373A (Applied Biosystems). Results showed that none of the 7 studied markers of the chromosome 17q were linked to the HNPCC disease.
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Affiliation(s)
- D Bernardgallon
- INSERM,U155,F-75016 PARIS,FRANCE. INST CURIE,F-75005 PARIS,FRANCE. HOP JEAN MINJOZ,F-25030 BESANCON,FRANCE. INST J PAOLI I CALMETTES,F-13273 MARSEILLE 9,FRANCE. CTR LEON BERARD,UNITE ONCOL GENET,F-69373 LYON,FRANCE. LAB IMMUNOL,F-63170 CLERMONT FERRAND,FRANCE. CTR JEAN PERRIN,UNITE PREVENT & DEPISTAGE CANC,ONCOL MOLEC LAB,F-63011 CLERMONT FERRAND,FRANCE
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Ashton JT, Bay J. Investigating narcotic diversion. Nurs Manag (Harrow) 1994; 25:35-37. [PMID: 8134038] [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: 05/22/2023]
Abstract
Management is responsible for developing policies and procedures not only for handling of narcotics but also for investigating and intervening in drug-related incidents. Both nurse managers and peers often feel ill-prepared to deal with drug impairment. Nurses who suspect a peer of substance abuse should notify the manager, who must cross-check all medication documentation and look for the many tell-tale signs of narcotic diversion. If sufficient evidence is discovered, the nurse must be confronted and directed to some type of peer assistance or other recovery program.
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Papay F, Vibeon T, Eliachar I, Bay J. Esophageal foreign body as a complication of transnasal transphenoidal hypophysectomy. Ear Nose Throat J 1988; 67:272-3. [PMID: 3383765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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Hissa E, Boumphrey F, Bay J. Spinal epidural hematoma and ankylosing spondylitis. Clin Orthop Relat Res 1986:225-7. [PMID: 3720127] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A typical case of ankylosing spondylitis (AS) in a 53-year-old man illustrates the high risk of spinal injury. When compared to the healthy subjects, patients with ankylosing spondylitis are at risk even after trivial injury. Spinal epidural hematoma is rare and generally associated with significant osseous spinal column involvement. Although rare, hematoma should be considered in ankylosing spondylitis patients, when a patient develops progressive neurologic symptoms and signs. An aggressive approach, including early decompression, affords the best chance for recovery.
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Abstract
A series of 66 spinal cord neurofibromas was analyzed for history, signs, surgical approach, and outcome. The tumors presented primarily with sensory symptoms. Plain films were abnormal in 1/2 of cases and 1/2 had a complete block. They were primarily intradural, and primarily thoracic. A conservative exam system was used for follow-up and 85% with pain had complete relief; 50% with motor loss had normal motor function, and 88% had normal sensation who had prior sensory loss. In comparison to meningiomas, the principal differences were that neurofibromas had an even sex distribution, a lower incidence of cord signs and symptoms, more frequent findings on plain x-rays, and higher cerebrospinal fluid protein. Surgical outcome was similar. Sacrifice of the involved root during removal usually did not produce a deficit. The series is compared with a similar series of meningiomas from the same institution over the same time period.
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Abstract
Twelve patients were admitted to a Phase II study on the treatment of recurrent glioblastoma multiforme with interferon-beta (IFN-beta). All patients had previously undergone craniotomy and received a standard course of radiation therapy. Recurrence was inferred from enlargement of the lesion on computerized tomography (CT) scanning and in each case was confirmed by CT-guided stereotaxic biopsy. Treatment consisted of combined intravenous (10 X 10(6) IU/day) and intratumoral (1 X 10(6) IU every other day) administration of IFN-beta over three 10-day cycles. This regimen was well tolerated, with toxicity requiring temporary dose modifications in five patients. As judged from data from historical cases, however, the patients admitted to this study demonstrated no clear improvement in mean survival time. The findings of this study also emphasize the importance of distinguishing between radiation necrosis and tumor recurrence.
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Ngo F, Thomas F, Gahbauer R, Bay J, Weinstein W, Antunez A, Dudley A, Meaney T. Magnetic resonance imaging of brain glioma following surgery and combined photon-neutron radiotherapy. Int J Radiat Oncol Biol Phys 1984. [DOI: 10.1016/0360-3016(84)90666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Mortimer JE, Hewlett JS, Bay J, Livingston RB. High dose BCNU with autologous bone marrow rescue in the treatment of recurrent malignant gliomas. J Neurooncol 1983; 1:269-73. [PMID: 6088718 DOI: 10.1007/bf00165611] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Eleven patients with malignant gliomas recurring after surgery and radiation therapy, were treated with high dose BCNU 1 050-1 200 mg/M2 with autologous bone marrow rescue. Four patients also received concomitant 5-fluorouracil 1 000 mg/M2/24 hr daily for three days. Eight of ten evaluable patients demonstrated improvement on CAT scan as well as a decrease in steroid requirement. All patients surviving longer than two weeks after BCNU administration experienced full hematologic recovery. No delayed myelosuppression was seen after a single course of high dose therapy. Two patients died as a result of therapy, one following a second induction of BCNU for a total cumulative BCNU dose of 2 400 mg/M2 and one of infection while cytopenic. Additional toxicity includes one steroid-responsive interstitial pneumonitis, one centrilobular necrosis of the liver which spontaneously resolved and one episode of deep vein thrombosis. With limitation on the maximum BCNU dose and distribution of the total dose over three days, high dose BCNU can be administered with acceptable toxicity. This approach may offer a higher response rate than that expected for standard dose BCNU.
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Abstract
The authors present a retrospective analysis of 97 cases of spinal meningioma. Age, sex, tumor location, and clinical presentation are similar to that reported by others. Importantly, even among paraplegic patients, one-third eventually walked. Other findings of note were poor results among those with calcified or recurrent tumors, and a high incidence of invasiveness among the rare epidural lesions. Males do not show the preference for a thoracic location that is found among females, and cervical tumors are almost all anterior to the cord. This last point suggests a different surgical approach in some cases. A large percentage of cases carried other diagnoses before tumor was recognized.
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Abstract
Abstract
The eighth case of axial melanotic nerve sheath tumor involving the thoracic spinal cord is reported. The literature is reviewed, and proposed theories on the origin of these tumors are discussed. The present study further supports the melanogenic capacity of neoplastic Schwann cells.
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Abstract
A series of 18 primitive neuroectodermal tumors in children (15 cerebral and three spinal) is reported. These are highly malignant neoplasms, both histologically and clinically. They are rapidly growing tumors, with a brief duration of symptoms and a rapidly progressive course. Forty percent of the patients were alive at 6 months, only 10% at 1 year, and all patients had died within 2 years following diagnosis.
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Prys-Roberts C, Kelman GR, Greenbaum R, Kain ML, Bay J. Hemodynamics and alveolar-arterial PO2 differences at varying PaCO2 in anesthetized man. J Appl Physiol (1985) 1968; 25:80-7. [PMID: 4873481 DOI: 10.1152/jappl.1968.25.1.80] [Citation(s) in RCA: 48] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Bay J, Jensen JK. [Prophylactic use of Lasonil to prevent infusion thrombophlebitis]. Nord Med 1967; 78:867-8. [PMID: 4165806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Bay J, Nunn JF. Oxygen consumption during recovery from anaesthesia. Br J Anaesth 1967; 39:518. [PMID: 6027963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Greenbaum R, Bay J, Hargreaves MD, Kain ML, Kelman GR, Nunn JF, Prys-Roberts C, Siebold K. Effects of higher oxides of nitrogen on the anaesthetized dog. Br J Anaesth 1967; 39:393-404. [PMID: 6026454 DOI: 10.1093/bja/39.5.393] [Citation(s) in RCA: 80] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Andreesen IH, Bay J. Halothane concentrations obtained by the combined use of the Manley ventilator and the Fluotec vaporizer. Br J Anaesth 1966; 38:641-5. [PMID: 5917228 DOI: 10.1093/bja/38.8.641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Bay J. [The EMO inhaler and controlled respiration]. Ugeskr Laeger 1965; 127:682-684. [PMID: 5841550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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