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Stoevesandt D, Ludwig C, Mauz-Körholz C, Körholz D, Hasenclever D, McCarten K, Flerlage JE, Kurch L, Wohlgemuth WA, Landman-Parker J, Wallace WH, Fosså A, Vordermark D, Karlén J, Cepelová M, Klekawka T, Attarbaschi A, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Daw S, Steglich J. Pulmonary lesions in early response assessment in pediatric Hodgkin lymphoma: prevalence and possible implications for initial staging. Pediatr Radiol 2024; 54:725-736. [PMID: 38296856 PMCID: PMC11056341 DOI: 10.1007/s00247-024-05859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Disseminated pulmonary involvement in pediatric Hodgkin lymphoma (pHL) is indicative of Ann Arbor stage IV disease. During staging, it is necessary to assess for coexistence of non-malignant lung lesions due to infection representing background noise to avoid erroneously upstaging with therapy intensification. OBJECTIVE This study attempts to describe new lung lesions detected on interim staging computed tomography (CT) scans after two cycles of vincristine, etoposide, prednisolone, doxorubicin in a prospective clinical trial. Based on the hypothesis that these new lung lesions are not part of the underlying malignancy but are epiphenomena, the aim is to analyze their size, number, and pattern to help distinguish true lung metastases from benign lung lesions on initial staging. MATERIALS AND METHODS A retrospective analysis of the EuroNet-PHL-C1 trial re-evaluated the staging and interim lung CT scans of 1,300 pediatric patients with HL. Newly developed lung lesions during chemotherapy were classified according to the current Fleischner glossary of terms for thoracic imaging. Patients with new lung lesions found at early response assessment (ERA) were additionally assessed and compared to response seen in hilar and mediastinal lymph nodes. RESULTS Of 1,300 patients at ERA, 119 (9.2%) had new pulmonary lesions not originally detectable at diagnosis. The phenomenon occurred regardless of initial lung involvement or whether a patient relapsed. In the latter group, new lung lesions on ERA regressed by the time of relapse staging. New lung lesions on ERA in patients without relapse were detected in 102 (7.8%) patients. Pulmonary nodules were recorded in 72 (5.5%) patients, the majority (97%) being<10 mm. Consolidations, ground-glass opacities, and parenchymal bands were less common. CONCLUSION New nodules on interim staging are common, mostly measure less than 10 mm in diameter and usually require no further action because they are most likely non-malignant. Since it must be assumed that benign and malignant lung lesions coexist on initial staging, this benign background noise needs to be distinguished from lung metastases to avoid upstaging to stage IV disease. Raising the cut-off size for lung nodules to ≥ 10 mm might achieve the reduction of overtreatment but needs to be further evaluated with survival data. In contrast to the staging criteria of EuroNet-PHL-C1 and C2, our data suggest that the number of lesions present at initial staging may be less important.
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Affiliation(s)
- Dietrich Stoevesandt
- Department of Radiology, University Hospital Halle, Ernst-Grube-Straße 40, 06120, Halle/Salle, Germany.
| | - Christiane Ludwig
- Department of Internal Medicine, University Hospital Halle, Halle/Saale, Germany
| | - Christine Mauz-Körholz
- Department of Pediatric Hematology and Oncology, University Hospital Giessen-Marburg, Giessen, Germany
- Medical Faculty of the Martin-Luther-University of Halle-Wittenberg, Halle/Saale, Germany
| | - Dieter Körholz
- Department of Pediatric Hematology and Oncology, University Hospital Giessen-Marburg, Giessen, Germany
| | - Dirk Hasenclever
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Kathleen McCarten
- Diagnostic Imaging and Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI, USA
- Pediatric Radiology, IROCRI (Imaging and Radiation Oncology Core - Rhode Island), Lincoln, RI, USA
| | - Jamie E Flerlage
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Walter A Wohlgemuth
- Department of Radiology, University Hospital Halle, Ernst-Grube-Straße 40, 06120, Halle/Salle, Germany
| | | | - William H Wallace
- Department of Paediatric Haematology and Oncology, Royal Hospital for Children and Young People and University of Edinburgh, Edinburgh, UK
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Dirk Vordermark
- Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Jonas Karlén
- Karolinska University Hospital, Astrid Lindgrens Children's Hospital, Stockholm, Sweden
| | - Michaela Cepelová
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Tomasz Klekawka
- Department of Pediatric Oncology and Hematology, University Children's Hospital of Krakow, Kraków, Poland
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria and St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - Andrea Hraskova
- Department of Pediatric Hematology and Oncology, University Children's Hospital, Bratislava, Slovakia
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Louvain, Belgium
| | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Karin Dieckmann
- Department of Radio-Oncology, Medical University Vienna, Vienna, Austria
| | - Thierry Leblanc
- Service d'Hématologie Et d'Immunologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Stephen Daw
- Department of Pediatric Hematology and Oncology, University College London Hospitals, London, UK
| | - Jonas Steglich
- Department of Radiology, University Hospital Halle, Ernst-Grube-Straße 40, 06120, Halle/Salle, Germany
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Chaix J, Schleiermacher G, Corradini N, André N, Thebaud E, Gambart M, Defachelles AS, Entz-Werle N, Chastagner P, De Carli É, Ducassou S, Landman-Parker J, Adam-de-Beaumais T, Larive A, Michiels S, Vassal G, Valteau-Couanet D, Geoerger B, Berlanga P. Clinical trial inclusion in patients with relapsed/refractory neuroblastoma following the European Precision Cancer Medicine trial MAPPYACTS. Eur J Cancer 2024; 201:113923. [PMID: 38377775 DOI: 10.1016/j.ejca.2024.113923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Despite poor survival for patients with relapsed or refractory neuroblastoma, only 10-16% of patients are reported to be included in early phase trials. This study aimed to explore the impact of molecular profiling within the prospective precision cancer medicine trial MAPPYACTS (NCT02613962) on subsequent early phase trial recruitment and treatment by matched targeted therapies in this population. METHODS AND MATERIALS Clinical data from all French patients with relapsed/refractory neuroblastoma enrolled in MAPPYACTS were analyzed for subsequent matched/non-matched targeted treatment based on clinical tumor board (CMTB) recommendations. RESULTS From 93 patients with neuroblastoma included in French centers, 78 (84%) underwent whole exome and RNA sequencing and were discussed in the CMTB. Higher rate of successful sequencing analysis was observed in patients with relapsed disease compared to those with refractory disease (p = 0.0002). Among the 50 patients that presented with a new disease relapse/progression after the CMTB recommendations, 35 patients (70%) had at least one actionable alteration identified on the tumor at the time of relapse. Eighteen patients (36%) were included in an early phase clinical trial, 11 of these with a matched agent, 7 with a non-matched treatment; 13 patients were included in the AcSé ESMART trial. Five patients (10%) received a matched targeted therapy outside a clinical trial. CONCLUSION Patients with neuroblastoma in the European MAPPYACTS trial were more likely to be included in early phase trials compared to previous reports. Early deep sequencing at first treatment failure, comprehensive therapeutic discussions in molecular tumor boards and innovative trials like AcSé -ESMART improve access to innovative therapies for patients with relapsed/refractory neuroblastoma. CLINICAL TRIAL REGISTRATION NCT02613962.
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Affiliation(s)
- Jordane Chaix
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Gudrun Schleiermacher
- INSERM U830, Laboratoire de Génétique et Biologie des Cancers, Research Center, PSL Research University, Institut Curie, Paris, France; SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France
| | - Nadège Corradini
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique/Centre Léon Bérard, Lyon, France
| | - Nicolas André
- Department of Pediatric Hematology and Oncology, Hôpital de La Timone, AP-HM, Marseille, France; UMR Inserm 1068, CNRS UMR 7258, Aix Marseille Université U105, Marseille Cancer Research Center (CRCM), Marseille, France
| | - Estelle Thebaud
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Nantes, France
| | - Marion Gambart
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Toulouse, France
| | | | - Natacha Entz-Werle
- Department of Pediatric Oncology, Hospices Civils de Strasbourg, Strasbourg, France
| | - Pascal Chastagner
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Vandoeuvre les Nancy, France
| | - Émilie De Carli
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Angers, France
| | - Stéphane Ducassou
- Department of Pediatric Oncology, Centre Hospitalier Universitaire, Bordeaux, France
| | | | - Tiphaine Adam-de-Beaumais
- Clinical Research Direction, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Alicia Larive
- Biostatistics and Epidemiology Office, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Saclay, Villejuif, France
| | - Stefan Michiels
- Biostatistics and Epidemiology Office, Gustave Roussy Cancer Campus, INSERM U1018, CESP, Université Paris-Saclay, Villejuif, France
| | - Gilles Vassal
- Clinical Research Direction, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Dominique Valteau-Couanet
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Birgit Geoerger
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France; INSERM U1015, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France
| | - Pablo Berlanga
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Université Paris-Saclay, Villejuif, France.
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Pellé O, Moreno S, Lorenz MR, Riller Q, Fuehrer M, Stolzenberg MC, Maccari ME, Lenoir C, Cheminant M, Hinze T, Hebart HF, König C, Schvartz A, Schmitt Y, Vinit A, Henry E, Touzart A, Villarese P, Isnard P, Neveux N, Landman-Parker J, Picard C, Fouyssac F, Neven B, Grimbacher B, Speckmann C, Fischer A, Latour S, Schwarz K, Ehl S, Rieux-Laucat F, Rensing-Ehl A, Magérus A. Combined germline and somatic human FADD mutations cause autoimmune lymphoproliferative syndrome. J Allergy Clin Immunol 2024; 153:203-215. [PMID: 37793571 DOI: 10.1016/j.jaci.2023.09.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The autoimmune lymphoproliferative syndrome (ALPS) is a noninfectious and nonmalignant lymphoproliferative disease frequently associated with autoimmune cytopenia resulting from defective FAS signaling. We previously described germline monoallelic FAS (TNFRSF6) haploinsufficient mutations associated with somatic events, such as loss of heterozygosity on the second allele of FAS, as a cause of ALPS-FAS. These somatic events were identified by sequencing FAS in DNA from double-negative (DN) T cells, the pathognomonic T-cell subset in ALPS, in which the somatic events accumulated. OBJECTIVE We sought to identify whether a somatic event affecting the FAS-associated death domain (FADD) gene could be related to the disease onset in 4 unrelated patients with ALPS carrying a germline monoallelic mutation of the FADD protein inherited from a healthy parent. METHODS We sequenced FADD and performed array-based comparative genomic hybridization using DNA from sorted CD4+ or DN T cells. RESULTS We found homozygous FADD mutations in the DN T cells from all 4 patients, which resulted from uniparental disomy. FADD deficiency caused by germline heterozygous FADD mutations associated with a somatic loss of heterozygosity was a phenocopy of ALPS-FAS without the more complex symptoms reported in patients with germline biallelic FADD mutations. CONCLUSIONS The association of germline and somatic events affecting the FADD gene is a new genetic cause of ALPS.
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Affiliation(s)
- Olivier Pellé
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Solange Moreno
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Myriam Ricarda Lorenz
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Quentin Riller
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Marita Fuehrer
- Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Ulm, Germany; Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marie-Claude Stolzenberg
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Maria Elena Maccari
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christelle Lenoir
- University of Paris Cité, Paris, France; Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Morgane Cheminant
- Clinical Hematology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; French National Reference Centre for Primary Immunodeficiencies (CEREDIH), Paris, France
| | - Tanja Hinze
- Department of Pediatric Rheumatology and Immunology, University Hospital Münster, Münster, Germany
| | - Holger F Hebart
- Department of Internal Medicine, Kliniken Ostalb, Stauferklinikum, Mutlangen, Germany
| | - Christoph König
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Adrien Schvartz
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Yohann Schmitt
- University of Paris Cité, Paris, France; Genomics Core Facility, Institut Imagine-Structure Fédérative de Recherche Necker, INSERM U1163 and INSERM US24/CNRS UAR3633, Paris, France
| | - Angélique Vinit
- Sorbonne Université, UMS037, PASS, Plateforme de Cytométrie de la Pitié-Salpêtrière CyPS, Paris, France
| | - Emilie Henry
- Genomics Platform, Translational Research Department, Research Center, Institut Curie, Paris Sciences et Lettres (PSL) Research University, Paris, France
| | - Aurore Touzart
- Laboratory of Onco-Hematology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Institut Necker-Enfants Malades (INEM), INSERM U1151, Paris, France
| | - Patrick Villarese
- Laboratory of Onco-Hematology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Institut Necker-Enfants Malades (INEM), INSERM U1151, Paris, France
| | - Pierre Isnard
- Institut Necker-Enfants Malades (INEM), INSERM U1151, Paris, France; Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Nathalie Neveux
- Laboratory of Biological Nutrition, Faculty of Pharmacy, Paris University, Paris, France; Clinical Chemistry Department, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Judith Landman-Parker
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP) Armand Trousseau, Paris, France
| | - Capucine Picard
- University of Paris Cité, Paris, France; Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Imagine Institute, INSERM UMR 1163, Paris, France; Study Center for Primary Immunodeficiencies, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Fanny Fouyssac
- Pediatric Oncology and Hematology Unit, Children Hospital, Vandoeuvre-les-Nancy, Paris, France
| | - Bénédicte Neven
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Pediatric Immuno-hematology and Rheumatology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Bodo Grimbacher
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Carsten Speckmann
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alain Fischer
- University of Paris Cité, Paris, France; Pediatric Immuno-hematology and Rheumatology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France; Collège de France, Paris, France
| | - Sylvain Latour
- University of Paris Cité, Paris, France; Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France
| | - Klaus Schwarz
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Service Baden-Wuerttemberg-Hessen, Ulm, Germany
| | - Stephan Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frédéric Rieux-Laucat
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France.
| | - Anne Rensing-Ehl
- Institute for Immunodeficiency, Center for Chronic Immunodeficiency, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Aude Magérus
- University of Paris Cité, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Imagine Institute, INSERM UMR 1163, Paris, France; Imagine Institute, INSERM UMR 1163, Paris, France.
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4
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Khoury E, Maalouf H, Mendola A, Boutry S, Camboni A, D’Angiolella V, Choquet S, Landman-Parker J, Besson C, Poirel HA, Limaye N. CCNF (Cyclin F) as a Candidate Gene for Familial Hodgkin Lymphoma: Additional Evidence for the Importance of Mitotic Checkpoint Defects in Tumorigenesis. Hemasphere 2023; 7:e985. [PMID: 38026792 PMCID: PMC10656094 DOI: 10.1097/hs9.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Elsa Khoury
- Genetics of Autoimmune Diseases and Cancer, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Hiba Maalouf
- Genetics of Autoimmune Diseases and Cancer, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Antonella Mendola
- Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Simon Boutry
- Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Alessandra Camboni
- Pathology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Vincenzo D’Angiolella
- Department of Oncology, Medical Research Council Institute for Radiation Oncology, University of Oxford, United Kingdom
| | - Sylvain Choquet
- Service d’Hématologie, CHU La Pitié Salpétrière, Paris, France
- French Registry of Familial Lymphoid Neoplasms, Paris, France
| | - Judith Landman-Parker
- Service d’Hématologie et d’Oncologie Pédiatrique, Hôpital Armand Trousseau, Paris, France
| | - Caroline Besson
- Unité d’Hémato-Oncologie, Centre Hospitalier de Versailles, Le Chesnay, France
- Centre for Research in Epidemiology and Population Health (CESP), INSERM Unit 1018, Villejuif, France
| | | | - Nisha Limaye
- Genetics of Autoimmune Diseases and Cancer, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
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5
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Sereda S, Shankar A, Weber L, Ramsay AD, Hall GW, Hayward J, Wallace WHB, Landman-Parker J, Braeuninger A, Hasenclever D, Schneider A, Mauz-Koerholz C, Koerholz D, Gattenloehner S. Digital pathology in pediatric nodular lymphocyte-predominant Hodgkin lymphoma: correlation with treatment response. Blood Adv 2023; 7:6285-6289. [PMID: 37611165 PMCID: PMC10589766 DOI: 10.1182/bloodadvances.2023010652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/04/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Affiliation(s)
- Sergej Sereda
- Department of Pathology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Ananth Shankar
- Children and Young People’s Cancer Services, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Luise Weber
- Department of Pathology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Alan D. Ramsay
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Georgina W. Hall
- Paediatric and Adolescent Haematology & Oncology Unit, Children’s Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Janis Hayward
- School of Cancer Sciences, Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, United Kingdom
| | | | - Judith Landman-Parker
- Sorbonne University, Assistance Publique–Hôpitaux de Paris, Hôpital Armand-Trousseau, Paris, France
| | - Andreas Braeuninger
- Department of Pathology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Astrid Schneider
- Pediatric Hematology and Oncology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Christine Mauz-Koerholz
- Pediatric Hematology and Oncology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
- Medical Faculty of the Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Dieter Koerholz
- Pediatric Hematology and Oncology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Stefan Gattenloehner
- Department of Pathology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
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6
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Dourthe ME, Simonin M, Rigaud C, Haouy S, Montravers F, Ducou Le Pointe H, Garnier N, Minard-Colin V, Jo Molina T, Boudjemaa S, Leblanc T, Landman-Parker J. [Strategy of the French Society of Childhood Cancer (SFCE) for pediatric nodular lymphocyte predominant lymphoma]. Bull Cancer 2023; 110:968-977. [PMID: 37062647 DOI: 10.1016/j.bulcan.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 04/18/2023]
Abstract
Nodular Lymphocyte predominant Hodgkin lymphoma (NLPHL) are rare lymphomas in pediatric patients comprising less than 10 % of all Hodgkin lymphoma (HL). They are for the most part diagnosed at stage I or II and indolent with lymphadenopathy often preceding the diagnosis by many months/years. Survival is excellent. Historically, patients were treated according to classical HL protocols. Due to high toxicity and excellent prognosis, management of NLPHL shifted to de-escalation protocol with good results. No treatment beyond surgical resection was proposed for localized unique nodal disease completely resected. The closed European protocol (EuroNet PHL LP1) evaluated the efficacy of low intensity chemotherapy protocol based on CVP courses (cyclophosphamide vinblastine prednisone) for stage IA/IIA not fully resected. Final results are not yet available. Advanced stage NLPHL are rare and there is no clinical trial and no consensus treatment in children. The SFCE lymphoma committee recently established recommendations for staging and treatment of limited and advanced NLPHL in children based on current practices and published results. The goal was to allow homogeneous practice on a national scale. If incomplete resection for patients with stage I/IIA combination of low intensity chemotherapy (CVP) and rituximab is recommended. For intermediary and advanced stage intensification with AVD (adriamycine vinblastine dacarbazine) or CHOP courses (cyclophosphamide doxorubicine vincristine prednisone) combined with rituximab are advocated. In children, there is no indication for first-line local treatment with radiotherapy.
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Affiliation(s)
- Marie Emilie Dourthe
- Université Paris Cité, hôpital universitaire Robert Debré, AP-HP, service d'immunologie et d'hématologie pédiatrique, Paris, France.
| | - Mathieu Simonin
- Sorbonne université Paris, hôpital Armand Trousseau, AP-HP, service d'hématologie pédiatrique, Paris, France
| | - Charlotte Rigaud
- Université Paris-Saclay, Gustave Roussy, département d'oncologie de l'enfant et de l'adolescent, Villejuif, France
| | - Stéphanie Haouy
- Hôpital universitaire de Montpellier, service d'hématologie et oncologie pédiatrique, Montpellier, France
| | | | - Hubert Ducou Le Pointe
- Sorbonne université, hôpital Armand Trousseau, AP-HP, service de radiologie, Paris, France
| | - Nathalie Garnier
- Hospices Civils de Lyon, institut d'hématologie et d'oncologie pédiatrique, Lyon, France
| | - Véronique Minard-Colin
- Université Paris-Saclay, Gustave Roussy, département d'oncologie de l'enfant et de l'adolescent, Villejuif, France
| | - Thierry Jo Molina
- Université Paris Cité, hôpitaux universitaires Necker Enfants Malades et Robert Debré, service d'anatomie pathologique, Paris, France
| | - Sabah Boudjemaa
- Sorbonne université, hôpital Armand Trousseau, AP-HP, service d'anatomie pathologique, Paris, France
| | - Thierry Leblanc
- Université Paris Cité, hôpital universitaire Robert Debré, AP-HP, service d'immunologie et d'hématologie pédiatrique, Paris, France
| | - Judith Landman-Parker
- Sorbonne université Paris, hôpital Armand Trousseau, AP-HP, service d'hématologie pédiatrique, Paris, France
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7
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Franke FC, Damek A, Steglich J, Kurch L, Hasenclever D, Georgi TW, Wohlgemuth WA, Mauz-Körholz C, Körholz D, Kluge R, Landman-Parker J, Wallace WH, Fosså A, Vordermark D, Karlen J, Fernández-Teijeiro A, Cepelova M, Klekawka T, Attarbaschi A, Ceppi F, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Moellers M, Buerke B, Stoevesandt D. Differentiation between rebound thymic hyperplasia and thymic relapse after chemotherapy in pediatric Hodgkin lymphoma. Pediatr Blood Cancer 2023; 70:e30421. [PMID: 37243889 DOI: 10.1002/pbc.30421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Rebound thymic hyperplasia (RTH) is a common phenomenon caused by stress factors such as chemotherapy (CTX) or radiotherapy, with an incidence between 44% and 67.7% in pediatric lymphoma. Misinterpretation of RTH and thymic lymphoma relapse (LR) may lead to unnecessary diagnostic procedures including invasive biopsies or treatment intensification. The aim of this study was to identify parameters that differentiate between RTH and thymic LR in the anterior mediastinum. METHODS After completion of CTX, we analyzed computed tomographies (CTs) and magnetic resonance images (MRIs) of 291 patients with classical Hodgkin lymphoma (CHL) and adequate imaging available from the European Network for Pediatric Hodgkin lymphoma C1 trial. In all patients with biopsy-proven LR, an additional fluorodeoxyglucose (FDG)-positron emission tomography (PET)-CT was assessed. Structure and morphologic configuration in addition to calcifications and presence of multiple masses in the thymic region and signs of extrathymic LR were evaluated. RESULTS After CTX, a significant volume increase of new or growing masses in the thymic space occurred in 133 of 291 patients. Without biopsy, only 98 patients could be identified as RTH or LR. No single finding related to thymic regrowth allowed differentiation between RTH and LR. However, the vast majority of cases with thymic LR presented with additional increasing tumor masses (33/34). All RTH patients (64/64) presented with isolated thymic growth. CONCLUSION Isolated thymic LR is very uncommon. CHL relapse should be suspected when increasing tumor masses are present in distant sites outside of the thymic area. Conversely, if regrowth of lymphoma in other sites can be excluded, isolated thymic mass after CTX likely represents RTH.
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Affiliation(s)
| | - Adrian Damek
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Jonas Steglich
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Dirk Hasenclever
- Institute of Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Thomas W Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - Christine Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany
| | - Dieter Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - William Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, UK
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Dirk Vordermark
- Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Jonas Karlen
- Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden
| | | | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Tomasz Klekawka
- Pediatric Oncology and Hematology Department, University Children's Hospital of Krakow, Krakow, Poland
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Francesco Ceppi
- Division of Pediatrics, Department of Woman-Mother-Child, Pediatric Hematology-Oncology Unit, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Andrea Hraskova
- Department of Pediatric Hematology and Oncology, National Institute of Paediatric Diseases, Bratislava, Slovakia
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Auke Beishuizen
- Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Karin Dieckmann
- Department of Radiation Oncology, University Hospital Vienna, Vienna, Austria
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Martin Moellers
- Department Department of Pediatric Radiology, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Boris Buerke
- Department of Clinical Radiology, University Hospital of Münster, Münster, Germany
| | - Dietrich Stoevesandt
- Department of Radiology, University Hospital Halle (Saale), Halle (Saale), Germany
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8
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Körholz D, Mauz-Körholz C, Wallace WH, Landman-Parker J, Kluge R, Hasenclever D. Radiotherapy for children and adolescents with early-stage classical Hodgkin lymphoma - Authors' reply. Lancet Oncol 2023; 24:e231. [PMID: 37269849 DOI: 10.1016/s1470-2045(23)00235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 06/05/2023]
Affiliation(s)
- Dieter Körholz
- Department of Paediatric Oncology, Justus-Liebig-University Giessen, Giessen, Germany
| | | | - W Hamish Wallace
- Department of Paediatric Haematology and Oncology, Royal Hospital for Children and Young People, University of Edinburgh, Edinburgh EH16 4TJ, UK.
| | - Judith Landman-Parker
- Department of Paediatric Haematology-Oncology, Sorbonne Université and Assistance Publique des Hopitaux de Paris, Hôpital a Trousseau, Paris, France
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
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9
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Boussard C, Delage L, Gajardo T, Kauskot A, Batignes M, Goudin N, Stolzenberg MC, Brunaud C, Panikulam P, Riller Q, Moya-Nilges M, Solarz J, Repérant C, Durel B, Bordet JC, Pellé O, Lebreton C, Magérus A, Pirabakaran V, Vargas P, Dupichaud S, Jeanpierre M, Vinit A, Zarhrate M, Masson C, Aladjidi N, Arkwright PD, Bader-Meunier B, Baron Joly S, Benadiba J, Bernard E, Berrebi D, Bodemer C, Castelle M, Charbit-Henrion F, Chbihi M, Debray A, Drabent P, Fraitag S, Hié M, Landman-Parker J, Lhermitte L, Moshous D, Rohrlich P, Ruemmele F, Welfringer-Morin A, Tusseau M, Belot A, Cerf-Bensussan N, Roelens M, Picard C, Neven B, Fischer A, Callebaut I, Ménager M, Sepulveda FE, Adam F, Rieux-Laucat F. DOCK11 deficiency in patients with X-linked actinopathy and autoimmunity. Blood 2023; 141:2713-2726. [PMID: 36952639 DOI: 10.1182/blood.2022018486] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/28/2023] [Accepted: 03/19/2023] [Indexed: 03/25/2023] Open
Abstract
Dedicator of cytokinesis (DOCK) proteins play a central role in actin cytoskeleton regulation. This is highlighted by the DOCK2 and DOCK8 deficiencies leading to actinopathies and immune deficiencies. DOCK8 and DOCK11 activate CDC42, a Rho-guanosine triphosphate hydrolases involved in actin cytoskeleton dynamics, among many cellular functions. The role of DOCK11 in human immune disease has been long suspected but, to the best of our knowledge, has never been described to date. We studied 8 male patients, from 7 unrelated families, with hemizygous DOCK11 missense variants leading to reduced DOCK11 expression. The patients were presenting with early-onset autoimmunity, including cytopenia, systemic lupus erythematosus, skin, and digestive manifestations. Patients' platelets exhibited abnormal ultrastructural morphology and spreading as well as impaired CDC42 activity. In vitro activated T cells and B-lymphoblastoid cell lines from patients exhibited aberrant protrusions and abnormal migration speed in confined channels concomitant with altered actin polymerization during migration. Knock down of DOCK11 recapitulated these abnormal cellular phenotypes in monocytes-derived dendritic cells and primary activated T cells from healthy controls. Lastly, in line with the patients' autoimmune manifestations, we also observed abnormal regulatory T-cell (Treg) phenotype with profoundly reduced FOXP3 and IKZF2 expression. Moreover, we found reduced T-cell proliferation and impaired STAT5B phosphorylation upon interleukin-2 stimulation of the patients' lymphocytes. In conclusion, DOCK11 deficiency is a new X-linked immune-related actinopathy leading to impaired CDC42 activity and STAT5 activation, and is associated with abnormal actin cytoskeleton remodeling as well as Treg phenotype, culminating in immune dysregulation and severe early-onset autoimmunity.
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Affiliation(s)
- Charlotte Boussard
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Laure Delage
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Tania Gajardo
- Université Paris Cité, Paris, France
- Laboratory of Molecular Basis of Altered Immune Homeostasis, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Alexandre Kauskot
- INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Maxime Batignes
- Université Paris Cité, Paris, France
- Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Institut Imagine, Atip-Avenir Team, INSERM UMR 1163, Paris, France
| | - Nicolas Goudin
- Université Paris Cité, Paris, France
- Necker Bio-image Analysis Platform, Structure Fédérative de Recherche Necker, INSERM US24, CNRS UMS3633, Paris, France
| | - Marie-Claude Stolzenberg
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Camille Brunaud
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Patricia Panikulam
- Université Paris Cité, Paris, France
- Laboratory of Molecular Basis of Altered Immune Homeostasis, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Quentin Riller
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | | | - Jean Solarz
- INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | | | - Béatrice Durel
- Université Paris Cité, Paris, France
- Cell Imaging Platform, Structure Fédérative de Recherche Necker, INSERM US24, CNRS UMS3633, Paris, France
| | - Jean-Claude Bordet
- Laboratoire d'Hémostase, Centre de Biologie Est, Hospices Civils de Lyon, Bron, France
| | - Olivier Pellé
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
- Flow Cytometry Core Facility, Structure Fédérative de Recherche Necker INSERM US24, CNRS UMS3633, Paris, France
| | - Corinne Lebreton
- Université Paris Cité, Paris, France
- Laboratory of Intestinal Immunity, Université Paris Cité, Imagine Institute, INSERM UMR-S_1163, Paris, France
| | - Aude Magérus
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Vithura Pirabakaran
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Pablo Vargas
- Université Paris Cité, Paris, France
- Institut Necker Enfants Malades, INSERM U1151/CNRS UMR 8253, Université de Paris, Paris, France
| | | | - Marie Jeanpierre
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Angélique Vinit
- Sorbonne Université, UMS037, PASS, Plateforme de cytométrie de la Pitié-Salpêtrière CyPS, Paris, France
| | - Mohammed Zarhrate
- Université Paris Cité, Paris, France
- Genomics Core Facility, Institut Imagine-Structure Fédérative de Recherche Necker, INSERM U1163 et INSERM US24/CNRS UAR3633, Université Paris Cité, Paris, France
| | - Cécile Masson
- Université Paris Cité, Paris, France
- Bioinformatics Core Facility, Institut Imagine-Structure Fédérative de Recherche Necker, INSERM U1163 et INSERM US24/CNRS UAR3633, Université Paris Cité, Paris, France
| | - Nathalie Aladjidi
- Centre de Référence National des Cytopénies Auto-immunes de l'Enfant, Bordeaux, France
- Pediatric Oncology Hematology Unit, University Hospital, Plurithématique CIC, Centre d'Investigation Clinique, 1401, INSERM, Bordeaux, France
| | - Peter D Arkwright
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester & Department of Pediatric Allergy and Immunology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Brigitte Bader-Meunier
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Reference Centre for Rheumatic, AutoImmune and Systemic Diseases in Children, Paris, France
| | | | - Joy Benadiba
- Department of Pediatric Hematology-Oncology, Nice University Hospital, Nice, France
| | - Elise Bernard
- Departement of General Pediatrics, Centre Hospitalier de Mayotte, Mamoudzou, France
| | - Dominique Berrebi
- Department of Pediatric Pathology, Hôpital Robert-Debré, Hôpital Universitaire Robert-Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christine Bodemer
- Université Paris Cité, Paris, France
- Department of Dermatology, Referral Center for Genodermatoses and Rare Skin Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Martin Castelle
- Université Paris Cité, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabienne Charbit-Henrion
- Laboratory of Intestinal Immunity, Université Paris Cité, Imagine Institute, INSERM UMR-S_1163, Paris, France
- Department of Pediatric Gastroenterology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
- Department of Genomic Medecine for Rare Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference Centre for Rheumatic, AutoImmune and Systemic Diseases in Children, Hôpital Femme Mère Enfant, CHU Lyon, Bron, France
| | - Marwa Chbihi
- Université Paris Cité, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Agathe Debray
- Departement of General Pediatrics and Infectious Diseases, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Philippe Drabent
- Université Paris Cité, Paris, France
- Department of Anatomopathology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Sylvie Fraitag
- Université Paris Cité, Paris, France
- Department of Anatomopathology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Miguel Hié
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière, Service de Médecine Interne 2, Institut E3M, INSERM UMRS 1135, Centre d'Immunologie et des Maladies Infectieuses-Paris, Paris, France
| | - Judith Landman-Parker
- Sorbonne Université, Department of Pediatric Hematology Oncology, Hôpital Armand-Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Ludovic Lhermitte
- Université Paris Cité, Paris, France
- Laboratory of Onco-Haematology, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Institut Necker-Enfants Malades, INSERM UMR 1151, Paris, France
| | - Despina Moshous
- Université Paris Cité, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Laboratory of Genome Dynamics in the Immune System, Université Paris Cité, Imagine Institute, INSERM UMR 1163, Paris, France
- French National Reference Center for Primary Immune Deficiencies, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Rohrlich
- Department of Pediatric Hematology-Oncology, Nice University Hospital, Nice, France
| | - Frank Ruemmele
- Université Paris Cité, Paris, France
- Laboratory of Intestinal Immunity, Université Paris Cité, Imagine Institute, INSERM UMR-S_1163, Paris, France
- Department of Pediatric Gastroenterology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Anne Welfringer-Morin
- Université Paris Cité, Paris, France
- Department of Dermatology, Referral Center for Genodermatoses and Rare Skin Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Maud Tusseau
- Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France
| | - Alexandre Belot
- Centre International de Recherche en Infectiologie, Univ Lyon, Inserm U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007, Lyon, France
- Department of Pediatric Nephrology, Rheumatology, Dermatology, Reference Centre for Rheumatic, AutoImmune and Systemic Diseases in Children, Hôpital Femme Mère Enfant, CHU Lyon, Bron, France
| | - Nadine Cerf-Bensussan
- Université Paris Cité, Paris, France
- Laboratory of Intestinal Immunity, Université Paris Cité, Imagine Institute, INSERM UMR-S_1163, Paris, France
| | - Marie Roelens
- Université Paris Cité, Paris, France
- Study Center for Primary Immunodeficiencies, Hôpital Necker-Enfants Malades University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Capucine Picard
- Université Paris Cité, Paris, France
- French National Reference Center for Primary Immune Deficiencies, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Study Center for Primary Immunodeficiencies, Hôpital Necker-Enfants Malades University, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris Cité, Imagine Institute, INSERM UMR 1163, Paris, France
| | - Bénédicte Neven
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Alain Fischer
- Université Paris Cité, Paris, France
- Université Paris Cité, Imagine Institute, INSERM UMR 1163, Paris, France
- Department of Pediatric Immuno-Haematology and Rheumatology, Reference Center for Rheumatic, AutoImmune and Systemic Diseases in Children, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Collège de France, Paris, France
| | - Isabelle Callebaut
- Sorbonne Université, Muséum National d'Histoire Naturelle, CNRS UMR 7590, Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Paris, France
| | - Mickaël Ménager
- Université Paris Cité, Paris, France
- Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Institut Imagine, Atip-Avenir Team, INSERM UMR 1163, Paris, France
- Labtech Single-Cell@Imagine, Imagine Institute, INSERM UMR-S_1163, Paris, France
| | - Fernando E Sepulveda
- Université Paris Cité, Paris, France
- Laboratory of Molecular Basis of Altered Immune Homeostasis, Institut Imagine, INSERM UMR-S_1163, Paris, France
| | - Frédéric Adam
- INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Frédéric Rieux-Laucat
- Université Paris Cité, Paris, France
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Institut Imagine, INSERM UMR-S_1163, Paris, France
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10
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Knörr F, Schellekens KPJ, Schoot RA, Landman-Parker J, Teltschik HM, Förster J, Riquelme A, Huitema ADR, Van Eijkelenburg NKA, Beishuizen A, Zwaan CM, Woessmann W, Van der Lugt J. Combination therapy with crizotinib and vinblastine for relapsed or refractory pediatric ALK-positive anaplastic large cell lymphoma. Haematologica 2023; 108:1442-1446. [PMID: 36519329 PMCID: PMC10153539 DOI: 10.3324/haematol.2022.281896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Fabian Knörr
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg, Germany; Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg.
| | - Kim P J Schellekens
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | | | - Judith Landman-Parker
- Pediatric Hematology, Immunology, Oncology, Sorbonne université, Hôpital Armand Trousseau, APHP, Paris
| | | | - Jan Förster
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
| | - Amambay Riquelme
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
| | - Alwin D R Huitema
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Dept. Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Dept. Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | - C Michel Zwaan
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands; Erasmus Medical Center, Sophia Children's Hospital, Rotterdam
| | - Wilhelm Woessmann
- Pediatric Hematology and Oncology, University Medical Center Hospital Hamburg-Eppendorf, Hamburg
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11
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Mauz-Körholz C, Landman-Parker J, Fernández-Teijeiro A, Attarbaschi A, Balwierz W, Bartelt JM, Beishuizen A, Boudjemaa S, Cepelova M, Ceppi F, Claviez A, Daw S, Dieckmann K, Fosså A, Gattenlöhner S, Georgi T, Hjalgrim LL, Hraskova A, Karlén J, Kurch L, Leblanc T, Mann G, Montravers F, Pears J, Pelz T, Rajić V, Ramsay AD, Stoevesandt D, Uyttebroeck A, Vordermark D, Körholz D, Hasenclever D, Wallace WH, Kluge R. Response-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration study. Lancet Oncol 2023; 24:252-261. [PMID: 36858722 DOI: 10.1016/s1470-2045(23)00019-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Children and adolescents with early-stage classical Hodgkin lymphoma have a 5-year event-free survival of 90% or more with vincristine, etoposide, prednisone, and doxorubicin (OEPA) plus radiotherapy, but late complications of treatment affect survival and quality of life. We investigated whether radiotherapy can be omitted in patients with adequate morphological and metabolic responses to OEPA. METHODS The EuroNet-PHL-C1 trial was designed as a titration study and recruited patients at 186 hospital sites across 16 European countries. Children and adolescents with newly diagnosed stage IA, IB, and IIA classical Hodgkin lymphoma younger than 18 years of age were assigned to treatment group 1 to be treated with two cycles of OEPA (vincristine 1·5 mg/m2 intravenously, capped at 2 mg, on days 1, 8, and 15; etoposide 125 mg/m2 intravenously, on days 1-5; prednisone 60 mg/m2 orally on days 1-15; and doxorubicin 40 mg/m2 intravenously on days 1 and 15). If no adequate response (a partial morphological remission or greater and PET negativity) had been achieved after two cycles of OEPA, involved-field radiotherapy was administered at a total dose of 19·8 Gy (usually in 11 fractions of 1·8 Gy per day). The primary endpoint was event-free survival. The primary objective was maintaining a 5-year event-free survival rate of 90% in patients with an adequate response to OEPA without radiotherapy. We performed intention-to-treat and per-protocol analyses. The trial was registered at ClinicalTrials.gov (NCT00433459) and with EUDRACT, (2006-000995-33) and is completed. FINDINGS Between Jan 31, 2007, and Jan 30, 2013, 2131 patients were registered and 2102 patients were enrolled onto EuroNet-PHL-C1. Of these 2102 patients, 738 with early-stage disease were allocated to treatment group 1. Median follow-up was 63·3 months (IQR 60·1-69·8). We report on 714 patients assigned to and treated on treatment group 1; the intention-to-treat population comprised 713 patients with 323 (45%) male and 390 (55%) female patients. In 440 of 713 patients in the intention-to-treat group who had an adequate response and did not receive radiotherapy, 5-year event-free survival was 86·5% (95% CI 83·3-89·8), which was less than the 90% target rate. In 273 patients with an inadequate response who received radiotherapy, 5-year event-free survival was 88·6% (95% CI 84·8-92·5), for which the 95% CI included the 90% target rate. The most common grade 3-4 adverse events were neutropenia (in 597 [88%] of 680 patients) and leukopenia (437 [61%] of 712). There were no treatment-related deaths. INTERPRETATION On the basis of all the evidence, radiotherapy could be omitted in patients with early-stage classical Hodgkin lymphoma and an adequate response to OEPA, but patients with risk factors might need more intensive treatment. FUNDING Deutsche Krebshilfe, Elternverein für Krebs-und leukämiekranke Kinder, Gießen, Kinderkrebsstiftung Mainz of the Journal Oldtimer Markt, Tour der Hoffnung, Menschen für Kinder, Mitteldeutsche Kinderkrebsforschung, Programme Hospitalier de Recherche Clinique, and Cancer Research UK.
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Affiliation(s)
| | - Judith Landman-Parker
- Department of Paediatric Haematology-Oncology, Sorbonne Université and Assistance Publique des Hopitaux de Paris, Hôpital a Trousseau, Paris, France
| | | | - Andishe Attarbaschi
- Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Walentyna Balwierz
- Department of Paediatric Oncology and Haematology, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Jörg M Bartelt
- Department of Radiology, University Hospital Halle, Halle, Germany
| | - Auke Beishuizen
- Princess Máxima Centre for Paediatric Oncology, Utrecht and Erasmus, Sophia Children's Hospital, Rotterdam, Netherlands
| | - Sabah Boudjemaa
- Department of Pathology, Armand Trousseau Hospital, Paris, France
| | - Michaela Cepelova
- Department of Paediatric Haematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - Francesco Ceppi
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department Woman-Mother-Child, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Alexander Claviez
- Department of Paediatrics, University of Schleswig-Holstein, Kiel, Germany
| | - Stephen Daw
- Children and Young People's Cancer Service, University College Hospital London, London, UK
| | - Karin Dieckmann
- Strahlentherapie Allgemeines Krankenhaus Wien, Medizinische Universitätsklinik Wien, Vienna, Austria
| | | | | | - Thomas Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lisa L Hjalgrim
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Andrea Hraskova
- Department of Paediatric Haematology and Oncology, National Institute of Children's Disease and Comenius University, Bratislava, Slovakia
| | - Jonas Karlén
- Department of Paediatric Oncology at Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Georg Mann
- St Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Francoise Montravers
- Department of Nuclear Medicine, Tenon Hospital, APHP and Sorbonne Université, Paris, France
| | - Jane Pears
- Our Lady's Hospital for Children's Health, Dublin, Ireland
| | - Tanja Pelz
- Medical Faculty (Prof C Mauz-Körholz) and Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Vladan Rajić
- Clinical Department of Paediatric Haematology, Oncology, and Stem Cell Transplantation, University Medical Centre Ljubljana and University Children's Hospital, Ljubljana, Slovenia
| | - Alan D Ramsay
- Department of Cellular Pathology, University College Hospital London, London, UK
| | | | - Anne Uyttebroeck
- Paediatric Haematology and Oncology, Department of Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dirk Vordermark
- Medical Faculty (Prof C Mauz-Körholz) and Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Dieter Körholz
- Department of Paediatric Oncology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - William H Wallace
- Department of Paediatric Haematology and Oncology, Royal Hospital for Children and Young People, University of Edinburgh, Edinburgh, UK.
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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12
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Pereira V, Boudjemaa S, Besson C, Leblanc T, Rigaud C, Leruste A, Garnier N, Lambilliotte A, Simonin M, Curtillet C, Bonneau-Lagacherie J, Coulomb A, Landman-Parker J. Epstein-Barr Virus in Childhood and Adolescent Classic Hodgkin Lymphoma in a French Cohort of 301 Patients. J Pediatr Hematol Oncol 2022; 44:e1033-e1038. [PMID: 35091521 DOI: 10.1097/mph.0000000000002403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/06/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim was to analyze the role of Epstein-Barr virus (EBV) in the bioclinical characteristics of patients treated for classic Hodgkin lymphoma (cHL) in France. METHODS Biopathologic data of 301 patients treated for a cHL in/or according to the EuroNet PHL-C1 trial between November 2008 and February 2013 were centrally reviewed. RESULTS Median age at diagnosis was 14 (3 to 18) years and the F/M ratio 0.86, 0.47 before 10 years and 0.9 from 11 to 18. CHL subtypes were nodular sclerosis for 266/301 (88%) patients, mixed cellularity for 22/301 (7%), lymphocyte rich for 2/301 (1%), and 11/301 were unclassified. EBV positivity by in situ hybridization was observed for 68/301 (23%) patients, significantly associated with mixed cellularity subtype and male sex, particularly overrepresented in boys below 10 years: 15/23 (65%) versus 28/139 among other male patients (20%). EBV viral load was detectable in 22 of 108 (22%) tested cases and was overrepresented in EBV cHL (13/28) versus non-EBV cHL (9/80) patients. Detailed semiquantitative histologic analysis showed a high number of B-cell residual follicles in EBV cHL relative to EBV-negative HL. CONCLUSION Distribution of EBV cHL in children and adolescents is associated with young age and male sex, suggesting a specific physiopathology and may require a differential therapeutic approach.
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Affiliation(s)
- Victor Pereira
- Department of Pediatric Hematology and Oncology, Besançon University Hospital, Besançon
| | | | - Caroline Besson
- Department of Hematology Versailles University Hospital, Versailles
| | - Thierry Leblanc
- Department of Pediatric Hematology and Immunology, APHP, Robert Debré Hospital
- Paris Diderot University
| | - Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif
| | - Amaury Leruste
- SIREDO, Pediatric Cancer Center, Institut Curie, PSL Research University, Paris
| | - Nathalie Garnier
- Department of Pediatric Hematology and Oncology, Pediatric Hematology and Oncology Institute, Hospices Civils de Lyon, Lyon
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Lille University Hospital, Lille
| | | | - Catherine Curtillet
- Department of Pediatric Hematology and Oncology, APHM, La Timone Hospital, Marseille
| | | | | | - Judith Landman-Parker
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, APHP, Sorbonne University, UMRs938
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13
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Dreyling M, André M, Gökbuget N, Tilly H, Jerkeman M, Gribben J, Ferreri A, Morel P, Stilgenbauer S, Fox C, Maria Ribera J, Zweegman S, Aurer I, Bödör C, Burkhardt B, Buske C, Dollores Caballero M, Campo E, Chapuy B, Davies A, de Leval L, Doorduijn J, Federico M, Gaulard P, Gay F, Ghia P, Grønbæk K, Goldschmidt H, Kersten MJ, Kiesewetter B, Landman-Parker J, Le Gouill S, Lenz G, Leppä S, Lopez-Guillermo A, Macintyre E, Mantega MVM, Moreau P, Moreno C, Nadel B, Okosun J, Owen R, Pospisilova S, Pott C, Robak T, Spina M, Stamatopoulos K, Stary J, Tarte K, Tedeschi A, Thieblemont C, Trappe RU, Trümper LH, Salles G. The EHA Research Roadmap: Malignant Lymphoid Diseases. Hemasphere 2022; 6:e726. [PMID: 35620592 PMCID: PMC9126526 DOI: 10.1097/hs9.0000000000000726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/21/2022] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Marc André
- Université Catholique de Louvain, CHU UcL Namur, Yvoir, Belgium
| | - Nicola Gökbuget
- Department of Medicine II, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Hervé Tilly
- INSERM U1245, Department of Hematology, Centre Henri Becquerel and Université de Rouen, France
| | | | - John Gribben
- Barts Cancer Institute, Queen Mary University of London, United Kingdom
| | - Andrés Ferreri
- Lymphoma Unit, Department of Onco-hematology, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Pierre Morel
- Service Hematologie Clinique Therapie Cellulaire, CHU Amiens Picardie, Amiens, France
| | - Stephan Stilgenbauer
- Comprehensive Cancer Center Ulm (CCCU), Sektion CLL Klinik für Innere Medizin III, Universität Ulm, Germany
| | - Christopher Fox
- School of Medicine, University of Nottingham, United Kingdom
| | - José Maria Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain
| | - Sonja Zweegman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, the Netherlands
| | - Igor Aurer
- University Hospital Centre Zagreb and Medical School, University of Zagreb, Croatia
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Birgit Burkhardt
- Experimentelle und Translationale päd. Hämatologie u Onkologie, Leitung der Bereiche Lymphome und Stammzelltransplantation, Universitätsklinikum Münster (UKM), Klinik für Kinder- und Jugendmedizin, Pädiatrische Hämatologie und Onkologie, Munich, Germany
| | - Christian Buske
- Institute of Experimental Cancer Research, CCC Ulm, University Hospital Ulm, Germany
| | - Maria Dollores Caballero
- Clinical and Transplant Unit, University Hospital of Salamanca, Spain
- Department of Medicine at the University of Salamanca, Spain
- El Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Elias Campo
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Bjoern Chapuy
- Department of Hematology, Oncology and Tumor Immunology, Charité, University Medical Center Berlin, Campus Benjamin Franklin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Andrew Davies
- Southampton NCRI/UK Experimental Cancer Medicines Centre, Faculty of Medicine, University of Southampton, United Kingdom
| | - Laurence de Leval
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Jeanette Doorduijn
- Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Philippe Gaulard
- Département de Pathologie, Hôpital Henri Mondor, AP-HP, Créteil, France
| | - Francesca Gay
- Clinical Trial Unit, Division of Hematology 1, AOU Città Della Salute e Della Scienza, University of Torino, Italy
| | - Paolo Ghia
- Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Kirsten Grønbæk
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
- Biotech Research & Innovation Centre (BRIC), University of Copenhagen, Denmark
| | - Hartmut Goldschmidt
- University Hospital Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Marie-Jose Kersten
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam and LYMMCARE, Amsterdam, the Netherlands
| | - Barbara Kiesewetter
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Austria
| | - Judith Landman-Parker
- Pediatric Hematology Oncology, Sorbonne Université APHP/hôpital A Trousseau, Paris, France
| | - Steven Le Gouill
- Service d’Hématologie, Clinique du Centre Hospitalier Universitaire (CHU) de Nantes, France
| | - Georg Lenz
- Medical Department A for Hematology, Oncology and Pneumology, University Hospital Münster, Germany
| | - Sirpa Leppä
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre, Helsinki, Finland
| | | | - Elizabeth Macintyre
- Onco-hematology, Université de Paris and Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, France
| | | | - Philippe Moreau
- Hematology Department, University Hospital Hotel-Dieu, Nantes, France
| | - Carol Moreno
- Hospital de la Santa Creu I Sant Pau, Autonomous University of Barcelona, Spain
| | - Bertrand Nadel
- Aix Marseille Univ, CNRS, INSERM, CIML, Marseille, France
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, United Kingdom
| | - Roger Owen
- St James’s Institute of Oncology, Leeds, United Kingdom
| | - Sarka Pospisilova
- Department of Internal Medicine—Hematology and Oncology and Department of Medical Genetics and Genomics, Faculty of Medicine, Masaryk University and University Hospital Brno, Czech Republic
| | - Christiane Pott
- Klinisch-experimentelle Hämatologie, Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Germany
| | | | - Michelle Spina
- Division of Medical Oncology and Immune-related Tumors, National Cancer Institute, Aviano, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Jan Stary
- Department of Pediatric Hematology and Oncology 2nd Faculty of Medicine, Charles University Prague University Hospital, Prague, Czech Republic
| | - Karin Tarte
- Immunology and Cell Therapy Lab at Rennes University Hospital, Rennes, France
| | | | - Catherine Thieblemont
- Department of Hemato-Oncology, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Ralf Ulrich Trappe
- Department of Internal Medicine II: Haematology and Oncology, DIAKO Hospital Bremen, Germany
| | - Lorenz H. Trümper
- Hematology and Medical Oncology, University Medicine Goettingen, Germany
| | - Gilles Salles
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, New York, NY, USA
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14
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Mauz-Körholz C, Landman-Parker J, Balwierz W, Ammann RA, Anderson RA, Attarbaschi A, Bartelt JM, Beishuizen A, Boudjemaa S, Cepelova M, Claviez A, Daw S, Dieckmann K, Fernández-Teijeiro A, Fosså A, Gattenlöhner S, Georgi T, Hjalgrim LL, Hraskova A, Karlén J, Kluge R, Kurch L, Leblanc T, Mann G, Montravers F, Pears J, Pelz T, Rajić V, Ramsay AD, Stoevesandt D, Uyttebroeck A, Vordermark D, Körholz D, Hasenclever D, Wallace WH. Response-adapted omission of radiotherapy and comparison of consolidation chemotherapy in children and adolescents with intermediate-stage and advanced-stage classical Hodgkin lymphoma (EuroNet-PHL-C1): a titration study with an open-label, embedded, multinational, non-inferiority, randomised controlled trial. Lancet Oncol 2022; 23:125-137. [PMID: 34895479 PMCID: PMC8716340 DOI: 10.1016/s1470-2045(21)00470-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Children and adolescents with intermediate-stage and advanced-stage classical Hodgkin lymphoma achieve an event-free survival at 5 years of about 90% after treatment with vincristine, etoposide, prednisone, and doxorubicin (OEPA) followed by cyclophosphamide, vincristine, prednisone, and procarbazine (COPP) and radiotherapy, but long-term treatment effects affect survival and quality of life. We aimed to investigate whether radiotherapy can be omitted in patients with morphological and metabolic adequate response to OEPA and whether modified consolidation chemotherapy reduces gonadotoxicity. METHODS Our study was designed as a titration study with an open-label, embedded, multinational, non-inferiority, randomised controlled trial, and was carried out at 186 hospital sites across 16 European countries. Children and adolescents with newly diagnosed intermediate-stage (treatment group 2) and advanced-stage (treatment group 3) classical Hodgkin lymphoma who were younger than 18 years and stratified according to risk using Ann Arbor disease stages IIAE, IIB, IIBE, IIIA, IIIAE, IIIB, IIIBE, and all stages IV (A, B, AE, and BE) were included in the study. Patients with early disease (treatment group 1) were excluded from this analysis. All patients were treated with two cycles of OEPA (1·5 mg/m2 vincristine taken intravenously capped at 2 mg, on days 1, 8, and 15; 125 mg/m2 etoposide taken intravenously on days 1-5; 60 mg/m2 prednisone taken orally on days 1-15; and 40 mg/m2 doxorubicin taken intravenously on days 1 and 15). Patients were randomly assigned to two (treatment group 2) or four (treatment group 3) cycles of COPP (500 mg/m2 cyclophosphamide taken intravenously on days 1 and 8; 1·5 mg/m2 vincristine taken intravenously capped at 2 mg, on days 1 and 8; 40 mg/m2 prednisone taken orally on days 1 to 15; and 100 mg/m2 procarbazine taken orally on days 1 to 15) or COPDAC, which was identical to COPP except that 250 mg/m2 dacarbazine administered intravenously on days 1 to 3 replaced procarbazine. The method of randomisation (1:1) was minimisation with stochastic component and was centrally stratified by treatment group, country, trial sites, and sex. The primary endpoint was event-free survival, defined as time from treatment start until the first of the following events: death from any cause, progression or relapse of classical Hodgkin lymphoma, or occurrence of secondary malignancy. The primary objectives were maintaining 90% event-free survival at 5 years in patients with adequate response to OEPA treated without radiotherapy and to exclude a decrease of 8% in event-free survival at 5 years in the embedded COPDAC versus COPP randomisation to show non-inferiority of COPDAC. Efficacy analyses are reported per protocol and safety in the intention-to-treat population. The trial is registered with ClinicalTrials.gov (trial number NCT00433459) and EUDRACT (trial number 2006-000995-33), and is closed to recruitment. FINDINGS Between Jan 31, 2007, and Jan 30, 2013, 2102 patients were recruited. 737 (35%) of the 2102 recruited patients were in treatment group 1 (early-stage disease) and were not included in our analysis. 1365 (65%) of the 2102 patients were in treatment group 2 (intermediate-stage disease; n=455) and treatment group 3 (advanced-stage disease; n=910). Of these 1365, 1287 (94%) patients (435 [34%] of 1287 in treatment group 2 and 852 [66%] of 1287 in treatment group 3) were included in the titration trial per-protocol analysis. 937 (69%) of 1365 patients were randomly assigned to COPP (n=471) or COPDAC (n=466) in the embedded trial. Median follow-up was 66·5 months (IQR 62·7-71·7). Of 1287 patients in the per-protocol group, 514 (40%) had an adequate response to treatment and were not treated with radiotherapy (215 [49%] of 435 in treatment group 2 and 299 [35%] of 852 in treatment group 3). 773 (60%) of 1287 patients with inadequate response were scheduled for radiotherapy (220 [51%] of 435 in the treatment group 2 and 553 [65%] of 852 in treatment group 3. In patients who responded adequately, event-free survival rates at 5 years were 90·1% (95% CI 87·5-92·7). event-free survival rates at 5 years in 892 patients who were randomly assigned to treatment and analysed per protocol were 89·9% (95% CI 87·1-92·8) for COPP (n=444) versus 86·1% (82·9-89·4) for COPDAC (n=448). The COPDAC minus COPP difference in event-free survival at 5 years was -3·7% (-8·0 to 0·6). The most common grade 3-4 adverse events (intention-to-treat population) were decreased haemoglobin (205 [15%] of 1365 patients during OEPA vs 37 [7%] of 528 treated with COPP vs 20 [2%] of 819 treated with COPDAC), decreased white blood cells (815 [60%] vs 231 [44%] vs 84 [10%]), and decreased neutrophils (1160 [85%] vs 223 [42%] vs 174 [21%]). One patient in treatment group 2 died of sepsis after the first cycle of OEPA; no other treatment-related deaths occurred. INTERPRETATION Our results show that radiotherapy can be omitted in patients who adequately respond to treatment, when consolidated with COPP or COPDAC. COPDAC might be less effective, but is substantially less gonadotoxic than COPP. A high proportion of patients could therefore be spared radiotherapy, eventually reducing the late effects of treatment. With more refined criteria for response assessment, the number of patients who receive radiotherapy will be further decreased. FUNDING Deutsche Krebshilfe, Elternverein für Krebs-und leukämiekranke Kinder Gießen, Kinderkrebsstiftung Mainz, Tour der Hoffnung, Menschen für Kinder, Programme Hospitalier de Recherche Clinique, and Cancer Research UK.
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Affiliation(s)
- Christine Mauz-Körholz
- Department of Paediatric Oncology, Justus-Liebig- University Giessen, Giessen, Germany; Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Judith Landman-Parker
- Department of Paediatric Haematology-Oncology, Sorbonne Université and APHP-SIRIC CURAMUS Hôpital a Trousseau, Paris, France
| | - Walentyna Balwierz
- Department of Paediatric Oncology and Haematology, Institute of Paediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Roland A Ammann
- Paediatric Haematology and Oncology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern Switzerland
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Andische Attarbaschi
- Department of Paediatric Haematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Jörg M Bartelt
- Department of Radiology, University Hospital Halle, Halle, Germany
| | - Auke Beishuizen
- Princess Máxima Centre for Paediatric Oncology, Utrecht and Erasmus, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Sabah Boudjemaa
- Department of Pathology, Armand Trousseau Hospital, Paris, France
| | - Michaela Cepelova
- Department of Paediatric Haematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - Alexander Claviez
- Department of Paediatrics, University of Schleswig-Holstein, Kiel, Germany
| | - Stephen Daw
- Children and Young People's Cancer Service, University College Hospital London, London, UK
| | - Karin Dieckmann
- Strahlentherapie AKH Wien Medizinische, Universitätsklinik Wien, Vienna, Austria
| | | | | | | | - Thomas Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lisa L Hjalgrim
- Department of Paediatrics and Adolescent Medicine, The Juliane Marie Centre, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Andrea Hraskova
- Department of Paediatric Haematology and Oncology, National Institute of Children's Disease and Comenius University, Bratislava, Slovakia
| | - Jonas Karlén
- Department of Paediatric Oncology at Astrid Lindgrens Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Thiery Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Georg Mann
- St Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Francoise Montravers
- Department of Nuclear Medicine, Tenon Hospital, APHP and Sorbonne Université, Paris, France
| | - Jean Pears
- Our Lady's Hospital for Children's Health, Dublin, Ireland
| | - Tanja Pelz
- Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Vladan Rajić
- Clinical Department of Paediatric Haematology, Oncology, and Stem Cell Transplantation, University Medical Centre Ljubljana and University Children's Hospital, Ljubljana, Slovenia
| | - Alan D Ramsay
- Department of Cellular Pathology, University College Hospital London, London, UK
| | | | - Anne Uyttebroeck
- Paediatric Haematology and Oncology, Department of Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dirk Vordermark
- Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Dieter Körholz
- Department of Paediatric Oncology, Justus-Liebig- University Giessen, Giessen, Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - William Hamish Wallace
- Department of Paediatric Haematology and Oncology, Royal Hospital for Children and Young People and University of Edinburgh, Edinburgh, UK.
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15
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Bastard P, Galerne A, Lefevre-Utile A, Briand C, Baruchel A, Durand P, Landman-Parker J, Gouache E, Boddaert N, Moshous D, Gaudelus J, Cohen R, Deschenes G, Fischer A, Blanche S, de Pontual L, Neven B. Different Clinical Presentations and Outcomes of Disseminated Varicella in Children With Primary and Acquired Immunodeficiencies. Front Immunol 2021; 11:595478. [PMID: 33250898 PMCID: PMC7674974 DOI: 10.3389/fimmu.2020.595478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Primary infection with varicella-zoster virus (VZV) causes chickenpox, a benign and self-limited disease in healthy children. In patients with primary or acquired immunodeficiencies, primary infection can be life-threatening, due to rapid dissemination of the virus to various organs [lung, gastrointestinal tract, liver, eye, central nervous system (CNS)]. We retrospectively described and compared the clinical presentations and outcomes of disseminated varicella infection (DV) in patients with acquired (AID) (n= 7) and primary (PID) (n= 12) immunodeficiencies. Patients with AID were on immunosuppression (mostly steroids) for nephrotic syndrome, solid organ transplantation or the treatment of hemopathies, whereas those with PID had combined immunodeficiency (CID) or severe CID (SCID). The course of the disease was severe and fulminant in patients with AID, with multiple organ failure, no rash or a delayed rash, whereas patients with CID and SICD presented typical signs of chickenpox, including a rash, with dissemination to other organs, including the lungs and CNS. In the PID group, antiviral treatment was prolonged until immune reconstitution after bone marrow transplantation, which was performed in 10/12 patients. Four patients died, and three experienced neurological sequelae. SCID patients had the worst outcome. Our findings highlight substantial differences in the clinical presentation and course of DV between children with AID and PID, suggesting differences in pathophysiology. Prevention, early diagnosis and treatment are required to improve outcome.
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Affiliation(s)
- Paul Bastard
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Aurélien Galerne
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France
| | - Alain Lefevre-Utile
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,INSERM U976-Human Systems Immunology and Inflammatory Networks, Institut de Recherche de Saint Louis, Paris, France.,Université de Paris, Paris, France
| | - Coralie Briand
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France
| | - André Baruchel
- Université de Paris, Paris, France.,Département d'Hématologie Pédiatrique, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Philippe Durand
- Service de Réanimation Pédiatrique, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre, France.,Université Paris XI, AP-HP, Paris.,Université Paris Saclay, Saint-Aubin, France
| | - Judith Landman-Parker
- Sorbonne Université, Service de d'Hématologie Oncologie Pédiatrique, Hôpital Armand Trousseau, AP-HP, Paris, France
| | - Elodie Gouache
- Sorbonne Université, Service de d'Hématologie Oncologie Pédiatrique, Hôpital Armand Trousseau, AP-HP, Paris, France
| | - Nathalie Boddaert
- Université de Paris, Paris, France.,Service de Radiologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
| | - Despina Moshous
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
| | - Joel Gaudelus
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Sorbonne Paris Nord University, Bobigny, France
| | - Robert Cohen
- ACTIV Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Georges Deschenes
- Service de Néphrologie Pédiatrique, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Alain Fischer
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France.,Experimental Medicine, Collège de France, Paris, France
| | - Stéphane Blanche
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - Loïc de Pontual
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Sorbonne Paris Nord University, Bobigny, France
| | - Bénédicte Neven
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
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16
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Kurch L, Mauz-Körholz C, Fosså A, Georgi TW, Kluge R, Bartelt JM, Kunze C, Wohlgemuth WA, Pelz T, Vordermark D, Plößl S, Hasenclever D, Sabri O, Landman-Parker J, Wallace WH, Karlen J, Fernández-Teijeiro A, Cepelova M, Klekawka T, Løndalen AM, Steiner D, Krombach G, Attarbaschi A, Hoffmann M, Ceppi F, Pears J, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Daw S, Körholz D, Stoevesandt D. Assessment of Waldeyer's ring in pediatric and adolescent Hodgkin lymphoma patients-Importance of multimodality imaging: Results from the EuroNet-PHL-C1 trial. Pediatr Blood Cancer 2021; 68:e28903. [PMID: 33538093 DOI: 10.1002/pbc.28903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/29/2020] [Accepted: 12/30/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging. PATIENTS, MATERIALS, AND METHODS The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from 18 F-fluorodeoxyglucose positron emission tomography, contrast-enhanced computed tomography, and/or magnetic resonance imaging. For verification purposes, the imaging-based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment. RESULTS The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient. CONCLUSIONS The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.
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Affiliation(s)
- Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Christine Mauz-Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany.,Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | | | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Jörg Martin Bartelt
- Department of Radiology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Christian Kunze
- Department of Radiology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | | | - Tanja Pelz
- Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Dirk Vordermark
- Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
| | - Sebastian Plößl
- Department of Ear, Nose and Throat Medicine, Hospital Martha-Maria Halle, Halle (Saale), Germany
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | | | - William Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, UK
| | - Jonas Karlen
- Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden
| | | | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and, Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Tomasz Klekawka
- Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | | | - Dagmar Steiner
- Department of Nuclear Medicine, Justus-Liebig University Giessen, Giessen, Germany
| | - Gabriele Krombach
- Department of Radiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | | | - Francesco Ceppi
- Division of Pediatrics, Department of Woman-, Mother-Child, Pediatric Hematology-Oncology Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Jane Pears
- Department of Pediatric Hematology and Oncology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Andrea Hraskova
- Department of Pediatric Hematology and Oncology, University Children's Hospital, Bratislava, Slovakia
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Auke Beishuizen
- Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.,Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Karin Dieckmann
- Department of Radiation Oncology, University Hospital Vienna, Vienna, Austria
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Stephen Daw
- Department of Pediatric Hematology and Oncology, University College London Hospitals, London, UK
| | - Dieter Körholz
- Department of Pediatric Hematology and Oncology, Justus-Liebig University, Gießen, Germany
| | - Dietrich Stoevesandt
- Department of Radiology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany
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17
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Pincez T, Fernandes H, Leblanc T, Michel G, Barlogis V, Bertrand Y, Neven B, Chahla WA, Pasquet M, Guitton C, Marie-Cardine A, Pellier I, Armari-Alla C, Benadiba J, Blouin P, Jeziorski E, Millot F, Paillard C, Thomas C, Cheikh N, Bayart S, Fouyssac F, Piguet C, Deparis M, Briandet C, Dore E, Picard C, Rieux-Laucat F, Landman-Parker J, Leverger G, Aladjidi N. Long term follow-up of pediatric-onset Evans syndrome: broad immunopathological manifestations and high treatment burden. Haematologica 2021; 107:457-466. [PMID: 33440924 PMCID: PMC8804581 DOI: 10.3324/haematol.2020.271106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Indexed: 11/12/2022] Open
Abstract
Pediatric-onset Evans syndrome (pES) is defined by both immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA) before the age of 18 years. There have been no comprehensive long-term studies of this rare disease, which can be associated to various immunopathological manifestations (IM). We report outcomes of the 151 patients with pES and more than 5 years of follow-up from the nationwide French prospective OBS’CEREVANCE cohort. Median age at final follow-up was 18.5 years (range, 6.8–50.0 years) and the median follow-up period was 11.3 years (range, 5.1–38.0 years). At 10 years, ITP and AIHA were in sustained complete remission in 54.5% and 78.4% of patients, respectively. The frequency and number of clinical and biological IM increased with age: at the age of 20 years, 74% had at least one clinical IM (cIM). A wide range of cIM occurred, mainly lymphoproliferation, dermatological, gastrointestinal/hepatic and pneumological IM. The number of cIM was associated with a subsequent increase in the number of second-line treatments received (other than steroids and immunoglobulins; hazard ratio 1.4, 95% Confidence Interval: 1.15–1.60, P=0.0002, Cox proportional hazards method). Survival at 15 years after diagnosis was 84%. Death occurred at a median age of 18 years (range, 1.7–31.5 years), and the most frequent cause was infection. The number of second-line treatments and severe/recurrent infections were independently associated with mortality. In conclusion, long-term outcomes of pES showed remission of cytopenias but frequent IM linked to high second-line treatment burden. Mortality was associated to drugs and/or underlying immunodeficiencies, and adolescents-young adults are a high-risk subgroup.
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Affiliation(s)
- Thomas Pincez
- Centre de Référence National des Cytopénies Auto-immunes de l'Enfant (CEREVANCE), Bordeaux, France; Division of Pediatric Hematology-Oncology, Charles-Bruneau Cancer Center, Department of Pediatrics, Sainte-Justine University Hospital, Université de Montréal, Montréal, Québec
| | - Helder Fernandes
- Centre de Référence National des Cytopénies Auto-immunes de l'Enfant (CEREVANCE), Bordeaux, France; Pediatric Oncology Hematology Unit, University Hospital, Plurithématique CIC (CICP), Centre d'Investigation Clinique (CIC) 1401, INSERM Bordeaux
| | - Thierry Leblanc
- Pediatric Hematology Unit, Robert Debré University Hospital, AP-HP, Paris
| | - Gérard Michel
- Department of Pediatric Hematology, La Timone Hospital, Marseille University Hospital, Marseille
| | - Vincent Barlogis
- Department of Pediatric Hematology, La Timone Hospital, Marseille University Hospital, Marseille
| | - Yves Bertrand
- Institute of Pediatric Hematology and Oncology, Lyon University Hospital, Lyon
| | - Bénédicte Neven
- Pediatric Immuno-Hematology and Rheumatology Department, Necker-Enfants Malades University Hospital, AP-HP, Paris, France; Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Paris, France; Imagine Institute, UMR 1163 INSERM and Paris University, Paris
| | - Wadih Abou Chahla
- Department of Pediatric Hematology, Jeanne de Flandre Hospital, Lille University Hospital, Lille
| | - Marlène Pasquet
- Pediatric Oncology Immunology Hematology Unit, Children's University Hospital, Toulouse
| | - Corinne Guitton
- Department of Pediatrics, Bicêtre University Hospital, AP-HP, Le Kremlin-Bicêtre
| | - Aude Marie-Cardine
- Department of Pediatric Hematology and Oncology, Rouen University Hospital, Rouen
| | | | | | - Joy Benadiba
- Department of Hemato-Oncology Pediatric, Nice University Hospital, Nice
| | - Pascale Blouin
- Department of Pediatric Hematology-Oncology, Clocheville Hospital, Tours University Hospital, Tours
| | - Eric Jeziorski
- Pediatric Oncology Hematology Unit, Arnaud de Villeneuve University Hospital, Montpellier
| | - Frédéric Millot
- Department of Pediatric Hematology, Poitiers University Hospital, Poitiers
| | - Catherine Paillard
- Department of Pediatric Hematology and Oncology, Hautepierre University Hospital, Strasbourg
| | - Caroline Thomas
- Pediatric Hematology Unit, Nantes University Hospital, Nantes
| | - Nathalie Cheikh
- Department of Pediatric Hematology-Oncology, Besanc_on University Hospital, Besanc_on
| | - Sophie Bayart
- Pediatric Hematology Unit, Rennes University Hospital, Rennes
| | - Fanny Fouyssac
- Pediatric Hematology Unit, Nancy University Hospital, Nancy
| | - Christophe Piguet
- Pediatric Oncology Hematology Unit, Limoges University Hospital, Limoges
| | - Marianna Deparis
- Pediatric Oncology-Hematology Unit Department, Caen University Hospital, Caen
| | | | - Eric Dore
- Pediatric Unit, Clermont-Ferrand University Hospital, Clermont-Ferrand
| | - Capucine Picard
- Imagine Institute, UMR 1163 INSERM and Paris University, Paris, France; Study Center for Primary Immunodeficiencies, Necker-Enfants Malades University Hospital, AP-HP, Paris
| | - Frédéric Rieux-Laucat
- Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Paris, France; Imagine Institute, UMR 1163 INSERM and Paris University, Paris
| | - Judith Landman-Parker
- Pediatric Oncology Immunology Hematology Unit, Armand-Trousseau University Hospital, AP-HP, Paris
| | - Guy Leverger
- Pediatric Oncology Immunology Hematology Unit, Armand-Trousseau University Hospital, AP-HP, Paris
| | - Nathalie Aladjidi
- Centre de Référence National des Cytopénies Auto-immunes de l'Enfant (CEREVANCE), Bordeaux, France; Pediatric Oncology Hematology Unit, University Hospital, Plurithématique CIC (CICP), Centre d'Investigation Clinique (CIC) 1401, INSERM Bordeaux.
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18
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Hamdi L, Creidy R, Boudjemaa S, Hendel-Chavez H, Hugues P, Taoufik Y, Leblanc T, Coulomb A, Krzysiek R, Landman-Parker J, Besson C. Frequent altered distribution of peripheral B-lymphocyte subsets in pediatric and adolescent patients with classical Hodgkin lymphoma. Leuk Lymphoma 2020; 62:300-307. [PMID: 33095090 DOI: 10.1080/10428194.2020.1834090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Peripheral lymphopenia is a well-known negative prognostic marker in classical Hodgkin lymphoma (cHL). We characterized the peripheral B-cell compartment in a prospective cohort of 83 pediatric cHL patients. We observed significantly low total B-cell counts (<100 cells/µl) in 31 of 83 patients (37%). More specifically, there was a smaller peripheral IgDhighCD27- naïve B-cell pool among B-cell lymphopenic patients than for non-B-cell lymphopenic patients (p < 0.01). The B-cell count was lower in patients without in situ Epstein Barr Virus (EBV) expression than among those with in situ EBV expression (p = 0.03). Peripheral B-cell lymphopenia was associated with the presence of poor prognostic features, such as advanced lymphoma stage (p < 0.01) and the presence of B symptoms (p = 0.04). Of interest, B-cell lymphopenia resolved in all six studied patients in long-term remission. Our findings support that cHL tumor-associated factors interfere with the distribution of peripheral B-cell subsets.
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Affiliation(s)
| | - Rita Creidy
- Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Sabah Boudjemaa
- Service d'Anatomie et de Cytologie Pathologiques, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
| | - Houria Hendel-Chavez
- Service d'Hématologie Biologique, Hôpital Bicêtre, Assistance Publique-Hôpitaux de, Le Kremlin-Bicêtre, Paris, France
| | - Patricia Hugues
- Universite Paris-Saclay, Communaute Paris-Saclay, Villejuif, France
| | - Yassine Taoufik
- Service d'Hématologie Biologique, Hôpital Bicêtre, Assistance Publique-Hôpitaux de, Le Kremlin-Bicêtre, Paris, France
| | - Thierry Leblanc
- Service d'hemato-immunologie; Pole de Pediatrie Medicale, CHU Paris-Hopital Robert Debre, Paris
| | - Aurore Coulomb
- Service d'Anatomie et de Cytologie Pathologiques, Sorbonne Université, Hôpital Armand Trousseau, Paris, France
| | - Roman Krzysiek
- Service d'Hématologie Biologique, Hôpital Bicêtre, Assistance Publique-Hôpitaux de, Le Kremlin-Bicêtre, Paris, France
| | - Judith Landman-Parker
- Service d'hematologie oncologie pediatrique, Sorbonne Universite, Hopital Armand-Trousseau APHP, Paris
| | - Caroline Besson
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France.,Hematology-Oncology Unit, Centre Hospitalier de Versailles, Le Chesnay, France
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19
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Hijiya N, Zwaan CM, Rizzari C, Foà R, Abbink F, Lancaster D, Landman-Parker J, Millot F, Moppett J, Nelken B, Caterina Putti M, Tian X, Sinclair K, Santanastasio H, Buchbinder A, Kearns P. Pharmacokinetics of Nilotinib in Pediatric Patients with Philadelphia Chromosome-Positive Chronic Myeloid Leukemia or Acute Lymphoblastic Leukemia. Clin Cancer Res 2020; 26:812-820. [PMID: 31676669 DOI: 10.1158/1078-0432.ccr-19-0090] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/11/2019] [Accepted: 10/29/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE We investigated nilotinib exposure in pediatric patients with chronic myeloid leukemia (CML) or Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) resistant to, relapsed on, refractory to, or intolerant of previous treatment. PATIENTS AND METHODS Fifteen patients (aged 1-<18 years) with CML resistant to or intolerant of imatinib and/or dasatinib (n = 11) or Ph+ ALL relapsed on or refractory to standard therapy (n = 4) enrolled in this phase I study. Nilotinib (230 mg/m2 twice daily; equivalent to the adult 400-mg twice-daily dose) was administered orally in 12 or 24 cycles of 28 days. The primary objective was to characterize the pharmacokinetics of nilotinib in pediatric patients. RESULTS The area under the concentration-time curve at steady state was slightly lower in pediatric patients versus adults (14,751.4 vs. 17,102.9 ng/h/mL); the geometric mean ratio (GMR; pediatric:adult) was 0.86 [90% confidence interval (CI), 0.70-1.06]. Body surface area-adjusted systemic clearance was slightly higher in pediatric versus adult patients (GMR, 1.30; 90% CI, 1.04-1.62). Nilotinib was generally well tolerated. The most common adverse events were headache, vomiting, increased blood bilirubin, and rash. Three patients with CML achieved major molecular response, and three with Ph+ ALL achieved complete remission. CONCLUSIONS Nilotinib 230 mg/m2 twice daily in pediatric patients provided a pharmacokinetics and safety profile comparable with the adult reference dose; clinical activity was demonstrated in both CML and Ph+ ALL. This dose is recommended for further evaluation in pediatric patients. The safety profile was consistent with that in adults.
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MESH Headings
- Adolescent
- Child
- Child, Preschool
- Drug Administration Schedule
- Drug Resistance, Neoplasm
- Female
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Protein Kinase Inhibitors/pharmacokinetics
- Protein Kinase Inhibitors/therapeutic use
- Pyrimidines/pharmacokinetics
- Pyrimidines/therapeutic use
- Tissue Distribution
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Affiliation(s)
- Nobuko Hijiya
- Department of Pediatrics, Columbia University Medical Center, New York, New York
| | - C Michel Zwaan
- Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Carmelo Rizzari
- Pediatric Hematology-Oncology Unit, Department of Pediatrics, University of Milano-Bicocca, Monza, Italy
| | - Robin Foà
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Rome, Italy
| | - Floor Abbink
- Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, the Netherlands
| | - Donna Lancaster
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Judith Landman-Parker
- AP-HP, Service d'Hématologie et d'Oncologie Pédiatrique, Hôpital Armand Trousseau, Paris, France
| | - Frédéric Millot
- Centre d'Investigation Clinique 1402, INSERM, University Hospital Poitiers, Poitiers, France
| | - John Moppett
- Bristol Royal Hospital for Children, Bristol, United Kingdom
| | - Brigitte Nelken
- Pediatric Hematology Department, CHU Lille, Jeanne de Flandre Hospital, Lille, France
| | - Maria Caterina Putti
- Clinic of Pediatric Onco-Hematology, Department SDB, Università di Padova, Padova, Italy
| | - Xianbin Tian
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | | | | | - Aby Buchbinder
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Pamela Kearns
- Institute of Cancer and Genomic Sciences, NIHR Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, United Kingdom.
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Daw S, Hasenclever D, Mascarin M, Fernández-Teijeiro A, Balwierz W, Beishuizen A, Burnelli R, Cepelova M, Claviez A, Dieckmann K, Landman-Parker J, Kluge R, Körholz D, Mauz-Körholz C, Wallace WH, Leblanc T. Risk and Response Adapted Treatment Guidelines for Managing First Relapsed and Refractory Classical Hodgkin Lymphoma in Children and Young People. Recommendations from the EuroNet Pediatric Hodgkin Lymphoma Group. Hemasphere 2020; 4:e329. [PMID: 32072145 PMCID: PMC7000476 DOI: 10.1097/hs9.0000000000000329] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/14/2019] [Accepted: 11/22/2019] [Indexed: 01/21/2023] Open
Abstract
The objective of this guideline is to aid clinicians in making individual salvage treatment plans for pediatric and adolescent patients with first relapse or refractory (R/R) classical Hodgkin lymphoma (cHL). While salvage with standard dose chemotherapy followed by high dose chemotherapy and autologous stem cell transplant is often considered the standard of care in adult practice, pediatric practice adopts a more individualized risk stratified and response adapted approach to salvage treatment with greater use of non-transplant salvage. Here, we present on behalf of the EuroNet Pediatric Hodgkin Lymphoma group, evidence and consensus-based guidelines for standardized diagnostic, prognostic and response procedures to allocate children and adolescents with R/R cHL to stratified salvage treatments.
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Affiliation(s)
- Stephen Daw
- Children and Young People's Cancer Services, University College Hospital London, London, UK
| | - Dirk Hasenclever
- Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Maurizio Mascarin
- AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy
| | - Ana Fernández-Teijeiro
- Unit of Pediatric Onco-Hematology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Auke Beishuizen
- Prinses Máxima Centrum voor Kinderoncologie, Utrecht, The Netherlands
| | - Roberta Burnelli
- Section of Pediatrics, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol, Czech Republic
| | - Alexander Claviez
- University Hospital Schleswig Holstein, Department of Pediatric and Adolescent Medicine, Pediatric Hematology, Oncology and Stem Cell Transplantation, Kiel, Germany
| | - Karin Dieckmann
- Department of Radiation Oncology, Medical University of Vienna, Vienna
| | | | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Dieter Körholz
- Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Christine Mauz-Körholz
- Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, Gießen, Germany
| | | | - Thierry Leblanc
- University of Edinburgh and Department of Pediatrics, Royal Hospital for Sick Children, Edinburgh, Scotland, UK
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Rigaud C, Auperin A, Jourdain A, Haouy S, Couec ML, Aladjidi N, Gandemer V, Lambliotte A, Plat G, Landman-Parker J, Michon J, Leblanc T, Patte C, Minard-Colin V. Outcome of relapse in children and adolescents with B-cell non-Hodgkin lymphoma and mature acute leukemia: A report from the French LMB study. Pediatr Blood Cancer 2019; 66:e27873. [PMID: 31207026 DOI: 10.1002/pbc.27873] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION In order to describe relapsed B-cell non-Hodgkin lymphoma and mature acute leukemia in children/adolescents treated with the Lymphomes Malins B (LMB) regimen and their outcome in the rituximab era, relapses in the French LMB2001 study were reviewed. METHODS Between February 2001 and December 2011, 33 patients out of 773 (4.3%) relapsed; 27 had Burkitt lymphoma and six large B-cell histology. Median age at diagnosis was 10.1 years. One patient was initially treated in risk group A, 21 in group B, and 11 in group C. RESULTS Median time to relapse after diagnosis was 4.5 months (range 2.4-13.6). Thirty-two patients received salvage therapy. Twenty-seven received rituximab mainly in addition to high-dose cytarabine and etoposide (n = 18) and/or ifosfamide, carboplatin, and etoposide (n = 7). First-line salvage chemotherapy response rate was 66% with 47% being complete remission (CR). Twenty-one patients received high-dose chemotherapy (HDC) followed by autologous (n = 13) or allogeneic (n = 8) transplant. With a median follow-up of 6.8 years, the 5-year survival rate after relapse was 36.4% (95% confidence interval [CI] 22-53%). Twelve patients were still alive; all but one (group A) received consolidation treatment. Achieving CR before consolidation was significantly associated with better survival, with a 5-year survival rate of 75% (95% CI 46.8-91.1%) for patients in CR before HDC, 33% (95% CI 9.7-70%) for patients in partial remission, and 0% for nonresponders (P = .033). CONCLUSION Survival of children/adolescents with mature B-cell lymphoma/leukemia remains poor after relapse with no apparent improvement with rituximab. Response rates to salvage chemo-immunotherapies are insufficient and new drugs are urgently needed to improve disease control.
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Affiliation(s)
- Charlotte Rigaud
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Auperin
- Department of Statistics, Gustave Roussy Cancer Campus, Villejuif, France
| | - Anne Jourdain
- Department of Pediatric Oncology and Haematology, University Hospital of Tours, Tours, France
| | - Stephanie Haouy
- Department of Pediatric Oncology and Haematology, University Hospital of Montpellier, Montpellier, France
| | - Marie-Laure Couec
- Department of Pediatric Oncology and Haematology, University Hospital of Nantes, Nantes, France
| | - Nathalie Aladjidi
- Department of Pediatric Oncology and Haematology, University Hospital of Bordeaux, Bordeaux, France
| | - Virginie Gandemer
- Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
| | - Anne Lambliotte
- Department of Pediatric Oncology and Haematology, Centre Oscar Lambret, Lille, France
| | - Geneviève Plat
- Department of Pediatric Oncology and Haematology, University Hospital of Toulouse, Toulouse, France
| | - Judith Landman-Parker
- Department of Pediatric Oncology and Haematology, Hospital Armand Trousseau, Paris, France
| | - Jean Michon
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | - Thierry Leblanc
- Department of Pediatric Oncology and Haematology, Hospital Robert Debré, Paris, France
| | - Catherine Patte
- Department of Pediatric Oncology, Gustave Roussy Cancer Campus, Villejuif, France
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22
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Landman-Parker J. I feel pain here! Arch Pediatr 2019; 26:252-253. [DOI: 10.1016/j.arcped.2019.05.003] [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] [Received: 04/23/2019] [Accepted: 05/30/2019] [Indexed: 11/26/2022]
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Khoury E, Mendola A, Choquet S, Landman-Parker J, Veiga da Cunha M, Besson C, Limaye N, Poirel H. GENETIC PREDISPOSITION OF FAMILIAL HODGKIN LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.28_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- E. Khoury
- De Duve Institute; UCLouvain; Brussels Belgium
| | - A. Mendola
- De Duve Institute; UCLouvain; Brussels Belgium
| | - S. Choquet
- Service d'Hématologie; CHU La Pitié Salpétrière; Paris France
| | - J. Landman-Parker
- Service d'Hématologie et d'Oncologie Pédiatrique; Hôpital Armand Trousseau; Paris France
| | | | - C. Besson
- Unité d'Hémato-Oncologie - INSERM Unit 1018; Centre Hospitalier de Versailles - Université Versailles Saint Quentin en Yvelines; Versailles France
| | - N. Limaye
- De Duve Institute; UCLouvain; Brussels Belgium
| | - H.A. Poirel
- Hematology and Genetics; Belgian Cancer Registry; Brussels Belgium
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24
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Boilève A, Carlo MI, Barthélémy P, Oudard S, Borchiellini D, Voss MH, George S, Chevreau C, Landman-Parker J, Tabone MD, Chism DD, Amin A, Bilen MA, Bosse D, Coulomb-L'hermine A, Su X, Choueiri TK, Tannir NM, Malouf GG. Immune checkpoint inhibitors in MITF family translocation renal cell carcinomas and genetic correlates of exceptional responders. J Immunother Cancer 2018; 6:159. [PMID: 30591082 PMCID: PMC6307255 DOI: 10.1186/s40425-018-0482-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/13/2018] [Indexed: 01/05/2023] Open
Abstract
Background Microphthalmia Transcription Factor (MITF)family translocation renal cell carcinoma (tRCC) is a rare RCC subtype harboring TFE3/TFEB translocations. The prognosis in the metastatic (m) setting is poor. Programmed death ligand-1 expression was reported in 90% of cases, prompting us to analyze the benefit of immune checkpoint inhibitors (ICI) in this population. Patients and methods This multicenter retrospective study identified patients with MITF family mtRCC who had received an ICI in any of 12 referral centers in France or the USA. Response rate according to RECIST criteria, progression-free survival (PFS), and overall survival (OS) were analyzed. Genomic alterations associated with response were determined for 8 patients. Results Overall, 24 patients with metastatic disease who received an ICI as second or later line of treatment were identified. Nineteen (82.6%) of these patients had received a VEGFR inhibitor as first-line treatment, with a median PFS of 3 months (range, 1–22 months). The median PFS for patients during first ICI treatment was 2.5 months (range, 1–40 months); 4 patients experienced partial response (16,7%) and 3 (12,5%) had stable disease. Of the patients whose genomic alterations were analyzed, two patients with mutations in bromodomain-containing genes (PBRM1 and BRD8) had a clinical benefit. Resistant clones in a patient with exceptional response to ipilimumab showed loss of BRD8 mutations and increased mutational load driven by parallel evolution affecting 17 genes (median mutations per gene, 3), which were enriched mainly for O-glycan processing (29.4%, FDR = 9.7 × 10− 6). Conclusions MITF family tRCC is an aggressive disease with similar responses to ICIs as clear-cell RCC. Mutations in bromodomain-containing genes might be associated with clinical benefit. The unexpected observation about parallel evolution of genes involved in O-glycosylation as a mechanism of resistance to ICI warrants exploration.
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Affiliation(s)
- A Boilève
- Department of Medical Oncology, Hôpital Universitaire Pitié-Salpétrière, Paris, France
| | - M I Carlo
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - P Barthélémy
- Service d'Hématologie et d'Oncologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - S Oudard
- Oncology Department, European Georges Pompidou Hospital, René Descartes University, Paris, France.,Association pour la Recherche sur les Thérapeutiques Innovantes en Cancérologie, Paris, France.,U790 PARCC, European Georges Pompidou Hospital, René Descartes University, Paris, France
| | | | - M H Voss
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - S George
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - C Chevreau
- IUCT-Oncopole, Institut Claudius-Regaud, Toulouse, France
| | - J Landman-Parker
- Service d'Hématologie et d'Oncologie Pédiatrique, Hopital Armand-Trousseau, Paris, France
| | - M-D Tabone
- Service d'Hématologie et d'Oncologie Pédiatrique, Hopital Armand-Trousseau, Paris, France
| | - D D Chism
- Division of Hematology and Oncology, Department of Medicine, Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - A Amin
- Carolinas Healthcare System, Levine Cancer Institute, Charlotte, NC, USA
| | - M A Bilen
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - D Bosse
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - T K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nizar M Tannir
- Department of Genitourinary Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Gabriel G Malouf
- Department of Medical Oncology, Hôpital Universitaire Pitié-Salpétrière, Paris, France. .,Service d'Hématologie et d'Oncologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France. .,Department of Functional Genomics and Cancer, Institut de Génétique et de Biologie Moléculaire et Cellulaire, Illkirch, France. .,Department of Hematology and Oncology, Centre Hospitalier Universitaire de Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France.
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25
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Locatelli F, Mauz-Koerholz C, Neville K, Llort A, Beishuizen A, Daw S, Pillon M, Aladjidi N, Klingebiel T, Landman-Parker J, Medina-Sanson A, August K, Sachs J, Hoffman K, Kinley J, Song S, Song G, Zhang S, Suri A, Gore L. Brentuximab vedotin for paediatric relapsed or refractory Hodgkin's lymphoma and anaplastic large-cell lymphoma: a multicentre, open-label, phase 1/2 study. The Lancet Haematology 2018; 5:e450-e461. [DOI: 10.1016/s2352-3026(18)30153-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022]
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26
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Pincez T, Guitton C, Landman-Parker J, Brousse V, Gauthier F, Da Costa L, Ghazal K, Dufillot D, Tchernia G, Picard V, Garçon L. Subtotal and total splenectomy for hereditary pyropoikilocytosis: Benefits and outcomes. Am J Hematol 2018; 93:E340-E342. [PMID: 30035308 DOI: 10.1002/ajh.25223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Thomas Pincez
- Service de Pédiatrie Générale; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
| | - Corinne Guitton
- Service de Pédiatrie Générale; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
| | | | - Valentine Brousse
- Service de Pédiatrie Générale; CHU Necker-Enfants Malades, AP-HP; Paris France
| | - Frédéric Gauthier
- Service de Chirurgie Pédiatrique; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
| | - Lydie Da Costa
- Service d'Hématologie Biologique; CHU Robert-Debré, AP-HP; Paris France
| | - Kaldoun Ghazal
- Service de Biochimie; CHU Bicêtre, HUPS, AP-HP; Le Kremlin-Bicêtre France
| | | | - Gil Tchernia
- Service d'Hématologie Biologique; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
| | - Véronique Picard
- Service d'Hématologie Biologique; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
| | - Loïc Garçon
- Service d'Hématologie Biologique; CHU Bicêtre, AP-HP; Le Kremlin-Bicêtre France
- Service d'Hématologie Biologique; CHU Amiens; France
- Laboratoire EA HEMATIM; Université Picardie Jules-Verne; Amiens France
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27
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Georgi TW, Kluge R, Kurch L, Chavdarova L, Hasenclever D, Stoevesandt D, Pelz T, Landman-Parker J, Wallace WH, Karlen J, Fernández-Teijeiro A, Cepelova M, Fosså A, Balwierz W, Attarbaschi A, Ammann RA, Pears J, Hraskova A, Uyttebroeck A, Beishuizen A, Dieckmann K, Leblanc T, Daw S, Baumann J, Körholz D, Sabri O, Mauz-Körholz C. 18F-FDG PET Response of Skeletal (Bone Marrow and Bone) Involvement After Induction Chemotherapy in Pediatric Hodgkin Lymphoma: Are Specific Response Criteria Required? J Nucl Med 2018; 59:1524-1530. [PMID: 29653979 DOI: 10.2967/jnumed.117.205633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/23/2018] [Indexed: 11/16/2022] Open
Abstract
To determine whether the current 18F-FDG PET response criterion for skeletal involvement in Hodgkin lymphoma (HL) is suitable, we performed a systematic evaluation of the different types of skeletal involvement and their response on PET after 2 cycles of chemotherapy (PET-2). A secondary objective was to observe the influence of the initial uptake intensity (measured as qPET) and initial metabolic tumor volume (MTV) of skeletal lesions on the PET-2 response. Methods: The initial PET scans of 1,068 pediatric HL patients from the EuroNet-PHL-C1 trial were evaluated for skeletal involvement by central review. Three types of skeletal lesions were distinguished: PET-only lesions (those detected on PET only), bone marrow (BM) lesions (as confirmed by MRI or BM biopsy), and bone lesions. qPET and MTV were calculated for each skeletal lesion. All PET-2 scans were assessed for residual tumor activity. The rates of complete metabolic response for skeletal and nodal involvement on PET-2 were compared. Results: Of the 1,068 patients, 139 (13%) showed skeletal involvement (44 PET-only, 32 BM, and 63 bone). Of the 139 patients with skeletal involvement, 101 (73%) became PET-2-negative in the skeleton and 94 (68%) became PET-2-negative in the lymph nodes. The highest number of PET-2-negative scans in the skeleton was 42 (95%) in the 44 PET-only patients, followed by 22 skeletal lesions (69%) in the 32 BM patients and 37 (59%) in the 63 bone patients. Lesions that became PET-2-negative showed a lower initial median qPET (2.74) and MTV (2 cm3) than lesions that remained PET-2-positive (3.84 and 7 cm3, respectively). Conclusion: In this study with pediatric HL patients, the complete response rate for skeletal involvement on PET-2 was similar to that for nodal involvement. Bone flare seemed to be irrelevant. Overall, the current skeletal PET response criterion-comparison with the local skeletal background-is well suited. The initial qPET and MTV of skeletal lesions were predictive of the PET-2 result. Higher values for both parameters were associated with a worse PET-2 response.
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Affiliation(s)
- Thomas W Georgi
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Regine Kluge
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Lidia Chavdarova
- Department of Nuclear Medicine, National Hospital for Active Treatment in Oncology, Sofia, Bulgaria
| | - Dirk Hasenclever
- Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
| | | | - Tanja Pelz
- Department of Radiotherapy, University of Halle, Halle (Saale), Germany
| | | | - W Hamish Wallace
- Department of Paediatric Oncology, Royal Hospital for Sick Children, University of Edinburgh, Edinburgh, United Kingdom
| | - Jonas Karlen
- Karolinska University Hospital, Astrid Lindgrens Childrens Hospital, Stockholm, Sweden
| | - Ana Fernández-Teijeiro
- Pediatric Oncology Unit, Hospitales Universitarios Virgen Macarena y Virgen del Rocio, Sevilla, Spain
| | - Michaela Cepelova
- Department of Pediatric Hematology and Oncology, University Hospital Motol and Second Medical Faculty of Charles University, Prague, Czech Republic
| | - Alexander Fosså
- Department of Medical Oncology and Radiotherapy, Oslo University Hospital, Oslo, Norway
| | - Walentyna Balwierz
- Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Roland A Ammann
- Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Jane Pears
- Our Lady's Children's Hospital, Dublin, Ireland
| | | | | | - Auke Beishuizen
- Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Karin Dieckmann
- Universitätsklinik für Strahlentherapie und Strahlenbiologie, Medizinische Universität Wien, Wien, Austria
| | - Thierry Leblanc
- Service d'Hématologie Pédiatrique, Hôpital Robert-Debré, Paris, France
| | - Stephen Daw
- University College London Hospitals, London, United Kingdom; and
| | - Julia Baumann
- Department of Pediatric Oncology, Justus-Liebig-University, Giessen, Germany
| | - Dieter Körholz
- Department of Pediatric Oncology, Justus-Liebig-University, Giessen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Gore L, Kearns PR, de Martino ML, Lee, De Souza CA, Bertrand Y, Hijiya N, Stork LC, Chung NG, Cardos RC, Saikia T, Fagioli F, Seo JJ, Landman-Parker J, Lancaster D, Place AE, Rabin KR, Sacchi M, Swanink R, Zwaan CM. Dasatinib in Pediatric Patients With Chronic Myeloid Leukemia in Chronic Phase: Results From a Phase II Trial. J Clin Oncol 2018; 36:1330-1338. [PMID: 29498925 DOI: 10.1200/jco.2017.75.9597] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Safe, effective treatments are needed for pediatric patients with chronic myeloid leukemia in chronic phase (CML-CP). Dasatinib is approved for treatment of adults and children with CML-CP. A phase I study determined suitable dosing for children with Philadelphia chromosome-positive (Ph+) leukemias. Methods CA180-226/NCT00777036 is a phase II, open-label, nonrandomized prospective trial of patients < 18 years of age receiving dasatinib. There are three cohorts: (1) imatinib-resistant/intolerant CML-CP, (2) imatinib-resistant/intolerant CML in accelerated/blast phase or Ph+ acute lymphoblastic leukemia (n = 17), and (3) newly diagnosed CML-CP treated with tablets or powder for oral suspension. Major cytogenetic response > 30% for imatinib-resistant/intolerant patients and complete cytogenetic response (CCyR) > 55% for newly diagnosed patients were of clinical interest. Results Of 113 patients with CML-CP, 14 (48%) who were imatinib-resistant/intolerant and 61 (73%) who were newly diagnosed remained on treatment at time of analysis. Major cytogenetic response > 30% was reached by 3 months in the imatinib-resistant/intolerant group and CCyR > 55% was reached by 6 months in the newly diagnosed CML-CP group. CCyR and major molecular response by 12 months, respectively, were 76% and 41% in the imatinib-resistant/intolerant group and 92% and 52% in newly diagnosed CML-CP group. Progression-free survival by 48 months was 78% and 93% in the imatinib-resistant/intolerant and newly diagnosed CML-CP groups, respectively. No dasatinib-related pleural or pericardial effusion, pulmonary edema, or pulmonary arterial hypertension were reported. Bone growth and development events were reported in 4% of patients. Conclusion In the largest prospective trial to date in children with CML-CP, we demonstrate that dasatinib is a safe, effective treatment of pediatric CML-CP. Target responses to first- or second-line dasatinib were met early, and deep molecular responses were observed. Safety of dasatinib in pediatric patients was similar to that observed in adults; however, no cases of pleural or pericardial effusion or pulmonary arterial hypertension were reported.
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Affiliation(s)
- Lia Gore
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Pamela R Kearns
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Maria Lucia de Martino
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Lee
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Carmino Antonio De Souza
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Yves Bertrand
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Nobuko Hijiya
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Linda C Stork
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Nack-Gyun Chung
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Rocio Cardenas Cardos
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Tapan Saikia
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Franca Fagioli
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Jong Jin Seo
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Judith Landman-Parker
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Donna Lancaster
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Andrew E Place
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Karen R Rabin
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Mariana Sacchi
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - Rene Swanink
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
| | - C Michel Zwaan
- Lia Gore, University of Colorado School of Medicine/Children's Hospital Colorado, Aurora, CO; Pamela R. Kearns, University of Birmingham, Birmingham, West Midlands; Donna Lancaster, Royal Marsden Hospital, Sutton, Surrey, United Kingdom; Maria Lucia de Martino Lee, Support Group for Children and Adolescents with Cancer; Carmino Antonio De Souza, University of Campinas, São Paulo, Brazil; Yves Bertrand, L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France; Nobuko Hijiya, Ann and Robert H. Lurie Children's Hospital of Chicago, and Northwestern University Feinberg School of Medicine, Chicago, IL; Linda C. Stork, Oregon Health & Science University, Portland, OR; Nack-Gyun Chung, The Catholic University of Korea, Seoul St. Mary's Hospital; Jong Jin Seo, University of Ulsan College of Medicine, and Asan Medical Center, Seoul, Republic of Korea; Rocio Cardenas Cardos, Instituto Nacional De Pediatria, Mexico City, Mexico; Tapan Saikia, Prince Aly Khan Hospital, Mumbai, India; Franca Fagioli, Regina Margherita Hospital, Turin, Italy; Judith Landman-Parker, Hôpital Enfants Armand-Trousseau, Paris, France; Andrew E. Place, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA; Karen R. Rabin, Texas Children's Cancer Center, and Baylor College of Medicine, Houston, TX; Mariana Sacchi and Rene Swanink, Bristol-Myers Squibb, Princeton, NJ; C. Michel Zwaan, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands; Pamela R. Kearns and C. Michel Zwaan, Innovative Therapies for Children with Cancer Consortium, European Union
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29
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Poglio S, Lewandowski D, Calvo J, Caye A, Gros A, Laharanne E, Leblanc T, Landman-Parker J, Baruchel A, Soulier J, Ballerini P, Clappier E, Pflumio F. Speed of leukemia development and genetic diversity in xenograft models of T cell acute lymphoblastic leukemia. Oncotarget 2018; 7:41599-41611. [PMID: 27191650 PMCID: PMC5173081 DOI: 10.18632/oncotarget.9313] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 04/22/2016] [Indexed: 11/25/2022] Open
Abstract
T cell acute lymphoblastic leukemia (T-ALL) develops through accumulation of multiple genomic alterations within T-cell progenitors resulting in clonal heterogeneity among leukemic cells. Human T-ALL xeno-transplantation in immunodeficient mice is a gold standard approach to study leukemia biology and we recently uncovered that the leukemia development is more or less rapid depending on T-ALL sample. The resulting human leukemia may arise through genetic selection and we previously showed that human T-ALL development in immune-deficient mice is significantly enhanced upon CD7+/CD34+ leukemic cell transplantations. Here we investigated the genetic characteristics of CD7+/CD34+ and CD7+/CD34− cells from newly diagnosed human T-ALL and correlated it to the speed of leukemia development. We observed that CD7+/CD34+ or CD7+/CD34− T-ALL cells that promote leukemia within a short-time period are genetically similar, as well as xenograft-derived leukemia resulting from both cell fractions. In the case of delayed T-ALL growth CD7+/CD34+ or CD7+/CD34− cells were either genetically diverse, the resulting xenograft leukemia arising from different but branched subclones present in the original sample, or similar, indicating decreased fitness to mouse micro-environment. Altogether, our work provides new information relating the speed of leukemia development in xenografts to the genetic diversity of T-ALL cell compartments.
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Affiliation(s)
- Sandrine Poglio
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DSV-IRCM-SCSR-LSHL, UMR 967, Fontenay-aux-Roses, France.,INSERM, U967, Fontenay-aux-Roses, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 967, Fontenay-aux-Roses, France.,Université Paris-Sud, UMR 967, Fontenay-aux-Roses, France
| | - Daniel Lewandowski
- INSERM, U967, Fontenay-aux-Roses, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 967, Fontenay-aux-Roses, France.,Université Paris-Sud, UMR 967, Fontenay-aux-Roses, France.,CEA, DSV-IRCM-SCSR-LRTS, UMR 967, Fontenay-aux-Roses, France
| | - Julien Calvo
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DSV-IRCM-SCSR-LSHL, UMR 967, Fontenay-aux-Roses, France.,INSERM, U967, Fontenay-aux-Roses, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 967, Fontenay-aux-Roses, France.,Université Paris-Sud, UMR 967, Fontenay-aux-Roses, France
| | - Aurélie Caye
- Université Paris Diderot, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Département de Génétique, UF de Génétique Moléculaire, Hôpital Robert Debré Paris, France
| | - Audrey Gros
- INSERM, UMR1053 Bordeaux Research in Translational Oncology (BaRITOn), Bordeaux, France.,Université de Bordeaux, Bordeaux, France
| | - Elodie Laharanne
- INSERM, UMR1053 Bordeaux Research in Translational Oncology (BaRITOn), Bordeaux, France.,Université de Bordeaux, Bordeaux, France
| | - Thierry Leblanc
- AP-HP, Service d'hématologie Pédiatrique, Hôpital Robert Debré, Paris, France
| | | | - André Baruchel
- AP-HP, Service d'hématologie Pédiatrique, Hôpital Robert Debré, Paris, France
| | - Jean Soulier
- Université Paris Diderot, Paris, France.,AP-HP, Laboratoire d'Hématologie, Hôpital Saint-Louis, Paris, France.,Team Genome and Cancer, U944 INSERM, Paris, France
| | - Paola Ballerini
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DSV-IRCM-SCSR-LSHL, UMR 967, Fontenay-aux-Roses, France.,INSERM, U967, Fontenay-aux-Roses, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 967, Fontenay-aux-Roses, France.,Université Paris-Sud, UMR 967, Fontenay-aux-Roses, France.,AP-HP, Service d'hématologie Pédiatrique, Hôpital Armand Trousseau, Paris, France
| | - Emmanuelle Clappier
- Université Paris Diderot, Paris, France.,AP-HP, Laboratoire d'Hématologie, Hôpital Saint-Louis, Paris, France.,Team Genome and Cancer, U944 INSERM, Paris, France
| | - Françoise Pflumio
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA), DSV-IRCM-SCSR-LSHL, UMR 967, Fontenay-aux-Roses, France.,INSERM, U967, Fontenay-aux-Roses, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR 967, Fontenay-aux-Roses, France.,Université Paris-Sud, UMR 967, Fontenay-aux-Roses, France
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30
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Besnard C, Levy E, Aladjidi N, Stolzenberg MC, Magerus-Chatinet A, Alibeu O, Nitschke P, Blanche S, Hermine O, Jeziorski E, Landman-Parker J, Leverger G, Mahlaoui N, Michel G, Pellier I, Suarez F, Thuret I, de Saint-Basile G, Picard C, Fischer A, Neven B, Rieux-Laucat F, Quartier P. Pediatric-onset Evans syndrome: Heterogeneous presentation and high frequency of monogenic disorders including LRBA and CTLA4 mutations. Clin Immunol 2018; 188:52-57. [PMID: 29330115 DOI: 10.1016/j.clim.2017.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 12/16/2017] [Accepted: 12/20/2017] [Indexed: 12/11/2022]
Abstract
Evans syndrome (ES) is defined by the combination of autoimmune hemolytic anemia and immune thrombocytopenia. Clinical presentation includes manifestations of immune dysregulation, found in primary immune deficiencies, autoimmune lymphoproliferative syndrome with FAS (ALPS-FAS), Cytotoxic T Lymphocyte Antigen-4 (CTLA-4) and Lipopolysaccharide-Responsive vesicle trafficking Beige-like and Anchor protein (LRBA) defects. We report the clinical history and genetic results of 18 children with ES after excluding ALPS-FAS. Thirteen had organomegaly, five lymphocytic infiltration of non-lymphoid organs, nine hypogammaglobulinemia and fifteen anomalies in lymphocyte phenotyping. Seven patients had genetic defects: three CTLA4 mutations (c.151C>T; c.109+1092_568-512del; c.110-2A>G) identified by Sanger sequencing and four revealed by Next Generation Sequencing: LRBA (c.2450+1C>T), STAT3 gain-of-function (c.2147C>T; c.2144C>T) and KRAS (c.37G>T). No feature emerged to distinguish patients with or without genetic diagnosis. Our data on pediatric-onset ES should prompt physicians to perform extensive screening for mutations in the growing pool of genes involved in primary immune deficiencies with autoimmunity.
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Affiliation(s)
- Caroline Besnard
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France; Sorbonne Universités, UPMC université Paris 06, Paris, France
| | - Eva Levy
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Nathalie Aladjidi
- Pediatric Hematology Oncology Immunology, Centre de Référence National des Cytopénies Auto-immunes de l'enfant, CEREVANCE, CIC 1401, CHU Bordeaux, France
| | - Marie-Claude Stolzenberg
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Aude Magerus-Chatinet
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Olivier Alibeu
- Genomic Platform, INSERM UMR 1163, Paris Descartes Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - Patrick Nitschke
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; INSERM UMR 1163, Bioinformatics Department, Imagine Institute, Paris, France
| | - Stéphane Blanche
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France
| | - Olivier Hermine
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Hematology, Immunology, Infectiology, Hôpital Necker-Enfants Malades, Assistance publique - Hôpitaux de Paris, Paris, France
| | - Eric Jeziorski
- Pediatrics, Infectiology, Rhumatology, Hôpital Arnaud de Villeneuve, CHRU de Montpellier, France
| | - Judith Landman-Parker
- Sorbonne Universités, UPMC université Paris 06, Paris, France; Pediatric hematology, Immunology, Oncology, Hôpital d'Enfants Armand Trousseau, Assistance publique - Hôpitaux de Paris, Paris, France
| | - Guy Leverger
- Pediatric hematology, Immunology, Oncology, Hôpital d'Enfants Armand Trousseau, Assistance publique - Hôpitaux de Paris, Paris, France
| | - Nizar Mahlaoui
- Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France
| | - Gérard Michel
- Department of Pediatric Hematology and Oncology, Research Unit EA 3279, Aix-Marseille University, Timone Hospital, Marseille, France
| | - Isabelle Pellier
- Pediatric Oncology, Hematology, Immunology, CHU d'Angers, Angers, France
| | - Felipe Suarez
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Adult hematology, Necker-Enfants Malades University Hospital, APHP, Paris, France; Inserm U1163, CNRS ERL 8254, Imagine Institute, Paris, France
| | - Isabelle Thuret
- Pediatrics and Pediatric hematology, Hôpital de la Timone, Marseille, France
| | - Geneviève de Saint-Basile
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; INSERM UMR 1163, Laboratory of Normal and pathological homeostasis of the immune system, Paris, France; Study Center for Primary Immunodeficiencies, Necker-Enfants Malades Hospital, Assistance Publique Hôpitaux de Paris (APHP), Necker Medical School, Paris, France
| | - Capucine Picard
- Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France; Study Center for Primary Immunodeficiencies, Necker-Enfants Malades Hospital, Assistance Publique Hôpitaux de Paris (APHP), Necker Medical School, Paris, France
| | - Alain Fischer
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France; Collège de France, Paris, France
| | - Bénédicte Neven
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France
| | - Frédéric Rieux-Laucat
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France.
| | - Pierre Quartier
- INSERM UMR 1163, Laboratory of Immunogenetics of pediatric autoimmune diseases, Paris, France; Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France; Pediatric immuno-hematology and rhumatology unit, RAISE reference centre for pediatric inflammatory rheumatic diseases and systemic autoimmune diseases, Necker-Enfants Malades University Hospital, Assistance publique - Hôpitaux de Paris, France
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31
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Affiliation(s)
- Judith Landman-Parker
- Hôpital Armand Trousseau Assistance Publique-Hôpitaux de Paris/Pierre et Marie Curie University, Paris, France
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32
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Flerlage JE, Kelly KM, Beishuizen A, Cho S, De Alarcon PA, Dieckmann U, Drachtman RA, Hoppe BS, Howard SC, Kaste SC, Kluge R, Kurch L, Landman-Parker J, Lewis J, Link MP, McCarten K, Punnett A, Stoevesandt D, Voss SD, Wallace WH, Mauz-Körholz C, Metzger ML. Staging Evaluation and Response Criteria Harmonization (SEARCH) for Childhood, Adolescent and Young Adult Hodgkin Lymphoma (CAYAHL): Methodology statement. Pediatr Blood Cancer 2017; 64. [PMID: 28097818 DOI: 10.1002/pbc.26421] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 11/25/2016] [Indexed: 01/05/2023]
Abstract
International harmonization of staging evaluation and response criteria is needed for childhood, adolescence, and young adulthood Hodgkin lymphoma. Two Hodgkin lymphoma protocols from cooperative trials in Europe and North America were compared for areas in need of harmonization, and an evidence-based approach is currently underway to harmonize staging and response evaluations with a goal to enhance comparisons, expedite identification of effective therapies, and aid in the approval process for new agents by regulatory agencies.
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Affiliation(s)
- Jamie E Flerlage
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kara M Kelly
- Roswell Park Cancer Institute, University of Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Auke Beishuizen
- Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Steve Cho
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Ute Dieckmann
- Klinik für Strahlenheilkunde, Universitätsklinik Freiburg, Freiburg, Germany
| | - Richard A Drachtman
- Division of Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Bradford S Hoppe
- Department of Radiation Oncology, University of Florida, Gainesville, Florida
| | - Scott C Howard
- University of Memphis School of Health Studies, Memphis, Tennessee
| | - Sue C Kaste
- Department of Diagnostic Imaging, University of Tennessee Health Sciences Center, Memphis, Tennessee
| | - Regine Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Lars Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Judith Landman-Parker
- Department of Paediatric Haematology & Oncology, Hôpital Trousseau AP-HP & Université Pierre et Marie Curie, Paris, France
| | - Jocelyn Lewis
- Division of Pediatric Hematology Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Michael P Link
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Kathleen McCarten
- Rhode Island Hospital/Warren Alpert Medical School at Brown University, Providence, Rhode Island
| | - Angela Punnett
- Division of Haematology/Oncology, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
| | | | - Stephan D Voss
- Department of Radiology, Boston Children's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Christine Mauz-Körholz
- Department of Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, Gießen, Germany.,Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany
| | - Monika L Metzger
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
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33
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Locatelli F, Mauz-Koerholz C, Neville K, Llort A, Beishuizen A, Daw S, Pillon M, Aladjidi N, Klingebiel T, Landman-Parker J, Medina-Sanson A, August K, Huebner D, Sachs J, Hoffman K, Kinley J, Song S, Song G, Zhang S, Gore L. A PHASE 1/2 STUDY OF BRENTUXIMAB VEDOTIN IN PEDIATRIC PATIENTS WITH RELAPSED/REFRACTORY (R/R) SYSTEMIC ANAPLASTIC LARGE-CELL LYMPHOMA (SALCL) OR R/R HODGKIN LYMPHOMA (HL). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- F. Locatelli
- Department of Pediatric Haematology-Oncology; University of Pavia; Rome Italy
| | - C. Mauz-Koerholz
- Pediatric Hematology and Oncology; University Hospital Giessen, Justus-Liebig University of Giessen; Giessen Germany
| | - K. Neville
- Division of Hematology and Oncology; Arkansas Children's Hospital; Little Rock USA
| | - A. Llort
- Laboratory of Translational Research in Pediatric Cancer; Vall d'Hebron Research Institute; Barcelona Spain
| | - A. Beishuizen
- Department of Pediatric Oncology/Hematology; Erasmus MC-Sophia Children's Hospital; Rotterdam Netherlands
| | - S. Daw
- Department Paediatric and Adolescent Oncology; University College London Hospital NHS Foundation Trust; London UK
| | - M. Pillon
- Clinic of Paediatric Haemato-Oncology, Department of Women's and Children's Health; University of Padova; Padova Italy
| | - N. Aladjidi
- Pediatric Hematology Unit, CIC 1401 Inserm CICP, Centre de Référence National des Cytopénies Auto-immunes de l'Enfant (CEREVANCE) Hôpital des Enfants; Hôpital Pellegrin; CHU Bordeaux France
| | - T. Klingebiel
- Clinic for Pediatric and Adolescent Medicine; University Hospital; Frankfurt Germany
| | - J. Landman-Parker
- Service d'Hématologie et d'Oncologie Pédiatrique, Hopital A, Trousseau; University of Paris; Paris France
| | - A. Medina-Sanson
- Departamento de Hemato-Oncología; Hospital Infantil de México Federico Gómez, Secretaria de Salud (SS); Ciudad de México Mexico
| | - K. August
- Pediatrics; Children's Mercy Hospital and Clinics; Kansas City USA
| | - D. Huebner
- Oncology; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - J. Sachs
- Oncology Clinical Research; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - K. Hoffman
- Clinical Operations; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - J. Kinley
- Oncology Clinical Research; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - S. Song
- Translational Medicine, Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - G. Song
- Oncology Statistics; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - S. Zhang
- Quantitative Clinical Pharmacology; Millennium Pharmaceuticals, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited Inc.; Cambridge USA
| | - L. Gore
- Department of Pediatrics; University of Colorado School of Medicine and Center for Cancer and Blood Disorders, Childrens Hospital Colorado; Aurora USA
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34
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Gore L, Kearns P, Lee ML, De Souza CA, Bertrand Y, Hijiya N, Stork LC, Chung NG, Cardenas-Cardos R, Saikia T, Fagioli F, Seo JJ, Landman-Parker J, Lancaster D, Place AE, Rabin KR, Sacchi M, Swanink R, Zwaan M. Phase II trial of dasatinib (DAS) in pediatric patients (pts) with chronic myeloid leukemia in chronic phase (CML-CP). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.10511] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10511 Background: Safe and effective treatment options for newly diagnosed (ND) or imatinib (IM) resistant/intolerant (R/I) pediatric CML pts are limited, and a large prospective study is needed. DAS has proven safety and efficacy in adults with ND or IM-R/I CML and is now being evaluated in a phase II trial of pediatric pts. Methods: CA180-226/NCT00777036 is an open-label nonrandomized prospective study of pts aged <18 y in 3 cohorts: (1) CML-CP R/I to IM treated with DAS tablets 60 mg/m2 QD, (2) IM-R/I CML-AP/BP or Ph+ ALL (enrollment closed early due to poor response), and (3) ND CML-CP treated with DAS tablets 60 mg/m2 or DAS 72 mg/m2powder for oral suspension (PFOS) QD. Primary objectives were major cytogenetic response (MCyR) for CML-CP R/I to IM and complete cytogenetic response (CCyR) for ND CML-CP (MCyR >30% and CCyR >55% considered of clinical interest). Results: 113 pediatric CML-CP pts were treated. Cumulative rate of MCyR >30% was reached as early as 3 mo (55%; [95% CI 36, 74]) for IM-R/I CML-CP. Cumulative rate of CCyR >55% was reached as early as 6 mo (64% [95% CI 53, 74] for ND CML-CP; 61% [95% CI 46, 74] for pts on tablets and 70% [95% CI 51, 84] for pts on PFOS). Estimated PFS by 48 mo was >75% for CML-CP R/I to IM and >90% for ND CML-CP. One CML-CP pt R/I to IM died 1 y after stopping DAS from gastrointestinal bleeding. AEs were consistent with those observed in adults, except no DAS-related pleural/pericardial effusion or pulmonary arterial hypertension (PAH) were reported here. Conclusions: In the largest prospective trial of pediatric pts with CML-CP, target responses were met early and increased over time with DAS treatment. The efficacy and safety of DAS were consistent with previous reports in adults, except no cases of pleural/pericardial effusion or PAH were observed. These results suggest DAS is safe and highly effective in the first- or second-line treatment of pediatric CML-CP. Clinical trial information: NCT00777036. [Table: see text]
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Affiliation(s)
- Lia Gore
- University of Colorado School of Medicine/Children’s Hospital Colorado, Aurora, CO
| | - Pamela Kearns
- University of Birmingham, Birmingham, United Kingdom
| | - Maria Lucia Lee
- Support Group for Children and Adolescents with Cancer, Sao Paulo, Brazil
| | | | - Yves Bertrand
- L'Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Nobuko Hijiya
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | | | - Nack-Gyun Chung
- The Catholic University of Korea, St. Mary's Hospital, Seoul, Republic of Korea
| | | | | | | | - Jong-Jin Seo
- University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | | | | | | | | | | | | | - Michel Zwaan
- Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
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Shankar AG, Roques G, Kirkwood AA, Lambilliotte A, Freund K, Leblanc T, Hayward J, Abbou S, Ramsay AD, Schmitt C, Gorde-Grosjean S, Pacquement H, Haouy S, Boudjemaa S, Aladjidi N, Hall GW, Landman-Parker J. Advanced stage nodular lymphocyte predominant Hodgkin lymphoma in children and adolescents: clinical characteristics and treatment outcome - a report from the SFCE & CCLG groups. Br J Haematol 2017; 177:106-115. [PMID: 28220934 DOI: 10.1111/bjh.14518] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 11/07/2016] [Indexed: 12/21/2022]
Abstract
Advanced stage nodular lymphocyte predominant Hodgkin lymphoma (nLPHL) is extremely rare in children and as a consequence, optimal treatment for this group of patients has not been established. Here we retrospectively evaluated the treatments and treatment outcomes of 41 of our patients from the UK and France with advanced stage nLPHL. Most patients received chemotherapy, some with the addition of the anti CD20 antibody rituximab or radiotherapy. Chemotherapy regimens were diverse and followed either classical Hodgkin lymphoma or B non-Hodgkin lymphoma protocols. All 41 patients achieved a complete remission with first line treatment and 40 patients are alive and well in remission. Eight patients subsequently relapsed and 1 patient died of secondary cancer (9 progression-free survival events). The median time to progression for those who progressed was 21 months (5·9-73·8). The median time since last diagnosis is 87·3 months (8·44-179·20). Thirty-six (90%), 30 (75%) and 27 (68%) patients have been in remission for more than 12, 24 and 36 months, respectively. Overall, the use of rituximab combined with multi-agent chemotherapy as first line treatment seems to be a reasonable therapeutic option.
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Affiliation(s)
- Ananth G Shankar
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Amy A Kirkwood
- Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK
| | | | - Katja Freund
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Janis Hayward
- Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK
| | | | - Alan D Ramsay
- Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | - Sabah Boudjemaa
- Service d'hématologie et d'oncologie pédiatrique, Hopital A, Trousseau, 75571 APHP/UPMC Univ Paris 06, Paris, France
| | | | - Georgina W Hall
- Paediatric Haematology/Oncology Unit, Children's Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Judith Landman-Parker
- Service d'hématologie et d'oncologie pédiatrique, Hopital A, Trousseau, 75571 APHP/UPMC Univ Paris 06, Paris, France
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Jorgov L, Montravers F, Balogova S, Landman-Parker J, Talbot JN. Reply. Eur J Nucl Med Mol Imaging 2017; 44:172. [DOI: 10.1007/s00259-016-3535-x] [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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Seror E, Donadieu J, Pacquement H, Abbou S, Lambilliotte A, Schell M, Curtillet C, Gandemer V, Pasquet M, Aladjidi N, Lutz P, Schmitt C, Deville A, Minckes O, Vanier JP, Armari-Alla C, Thomas C, Gorde-Grosjean S, Millot F, Blouin P, Garnier N, Coze C, Devoldere C, Reguerre Y, Helfre S, Claude L, Clavel J, Oberlin O, Landman-Parker J, Leblanc T. Combined therapy in children and adolescents with classical Hodgkin's lymphoma: A report from the SFCE on MDH-03 national guidelines. Pediatr Hematol Oncol 2016; 33:423-437. [PMID: 27960645 DOI: 10.1080/08880018.2016.1247393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hodgkin's lymphoma (HL) in children and adolescents is highly curable, but children are at risk of long-term toxicity. The MDH-03 guidelines were established in order to decrease the burden of treatment in good-responder patients, and this report should be considered a step toward further optimization of treatment within large collaborative trials. We report the therapy and long-term outcomes of 417 children and adolescents treated according to the national guidelines, which were applied between 2003 and 2007 in France. The patients were stratified into three groups according to disease extension. Chemotherapy consisted of four cycles of VBVP (vinblastine, bleomycin, VP16, prednisone) in localized stages (G1/95 pts/23%), four cycles of COPP/ABV (cyclophosphamide, vincristine, procarbazine, prednisone, adriamycin, bleomycin, vinblastine) cycles in intermediate stages (G2/184 pts/44%) and three cycles of OPPA (vincristine, procarbazine, prednisone, adriamycin) plus three cycles of COPP in advanced stages (G3/138 pts/33%). Radiation therapy of the involved field was given to 97% of the patients, with the dose limited to 20 Gy in good responders (88%). With a median follow-up of 6.6 years, the 5-year event-free survival (EFS) and overall survival (OS) were 86.7% (83.1-89.7%) and 97% (94.5-98.1%), respectively. EFS and OS for G1, G2, and G3 were 98% and 100%, 81% and 97%, and 87% and 95%, respectively. Low-risk patients treated without alkylating agents and anthracycline had excellent outcomes and a low expected incidence of late effects. Intensification with a third OPPA cycle in high-risk group patients, including stage IV patients, allowed for very good outcomes, without increased toxicity.
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Affiliation(s)
- E Seror
- a Department of Pediatric Hematology , Robert-Debré Hospital , Paris , France
| | - J Donadieu
- b Armand-Trousseau Hospital , Paris , France
| | | | - S Abbou
- d Institut Gustave Roussy , Villejuif , France
| | | | - M Schell
- f CAC Centre Léon Bérard , Lyon , France
| | | | | | | | | | - P Lutz
- k CHU Strasbourg , Strasbourg , France
| | | | | | | | | | | | | | | | - F Millot
- s CHU Poitiers , Poitiers , France
| | | | | | - C Coze
- g CHU La Timone , Marseille , France
| | | | - Y Reguerre
- w CHU St Denis, La Réunion , Saint-Denis , France
| | - S Helfre
- c Institut Curie , Paris , France
| | - L Claude
- f CAC Centre Léon Bérard , Lyon , France
| | - J Clavel
- x Unité INSERM UMRS 1153 , Université Paris Descartes , Paris , France
| | - O Oberlin
- d Institut Gustave Roussy , Villejuif , France
| | | | - T Leblanc
- a Department of Pediatric Hematology , Robert-Debré Hospital , Paris , France
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Vassal G, Landman-Parker J, Baruchel A, Bergeron C, Rubie H, Coze C, Chastagner P, Leverger G, Bertrand Y, Valteau-Couanet D, Michon J, Couanet D, Rivière AM, Avenell D, Pérel Y, Doz F. Multidisciplinarité et formation des spécialistes à l’oncologie et à l’hématologie maligne pédiatrique. Arch Pediatr 2015; 22:1217-22. [DOI: 10.1016/j.arcped.2015.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 07/17/2015] [Accepted: 09/12/2015] [Indexed: 11/28/2022]
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Merlin E, Mouy R, Pereira B, Mouthon L, Bourmaud A, Piette JC, Landman-Parker J, Chellun P, Layadi M, Thomas C, Guillevin L, Prieur AM, Quartier P. Long-term outcome of children with pediatric-onset cutaneous and visceral polyarteritis nodosa. Joint Bone Spine 2015; 82:251-7. [PMID: 25887252 DOI: 10.1016/j.jbspin.2015.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 01/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To assess the prognostic impact of clinical presentation in children with polyarteritis nodosa (PAN). METHODS Children diagnosed between 1986 and 2006 in a tertiary care pediatric rheumatology center were classified as "cutaneous PAN" (group 1), "cutaneous PAN with significant extra-cutaneous features" (group 2) or "visceral childhood PAN" (group 3). OUTCOME MEASURES (1) clinical remission off-therapy at last follow-up, (2) requirement and length of glucocorticoid therapy, (3) presence of disease-related sequelae. RESULTS Twenty-nine children were included. Sixteen met the Ankara criteria for PAN. Nine patients were qualified as group 1, 11 as group 2, and 9 as group 3. At last follow-up, 15 children were in clinical remission off-therapy: 4 from group 1 (44%), 4 from group 2 (36%) and 7 from group 3 (78%). Glucocorticoid therapy was required for 8 (89%), 7 (64%) and 7 (78%) patients from groups 1, 2 and 3, respectively. Seven children did not require any glucocorticoid therapy. Time-dependent probability of achieving glucocorticoid-free clinical remission was similar between the three groups. Three patients (one from each group) had digital ischemia leading to amputation. There were no significant between-group differences in outcome based on the three outcome measures addressed. CONCLUSION Outcome was not strikingly predictable from initial presentation in children with PAN. The organ distribution-based distinction between cutaneous and visceral PAN had little prognostic power in this series.
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Affiliation(s)
- Etienne Merlin
- Service de Pédiatrie, CHU Clermont-Ferrand, Clermont-Ferrand, France; Inserm CIC 1405, Centre de Recherche Chez l'Enfant, Clermont-Ferrand, France
| | - Richard Mouy
- Unité d'Immunologie, Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades, Paris, France
| | - Bruno Pereira
- Service de Pédiatrie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Luc Mouthon
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, AP-HP, Paris, France; Université Paris-Descartes, Paris, France
| | - Aurélie Bourmaud
- Département de Santé Publique, Institut Cancérologique de la Loire, Saint-Étienne, France
| | - Jean-Charles Piette
- Service de Médecine Interne, Université Pierre-et-Marie-Curie, Paris-6, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | | | | | - Mustapha Layadi
- Service de Pédiatrie, hôpital Mère-Enfant, CHU de Limoges, Limoges, France
| | - Caroline Thomas
- Service d'Hématologie-Oncologie, Hôpital Mère-Enfants, Nantes, France
| | - Loïc Guillevin
- Service de Médecine Interne, Hôpital Cochin, Centre de Référence pour les Vascularites Nécrosantes et la Sclérodermie Systémique, AP-HP, Paris, France; Université Paris-Descartes, Paris, France
| | - Anne-Marie Prieur
- Unité d'Immunologie, Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades, Paris, France
| | - Pierre Quartier
- Unité d'Immunologie, Hématologie et Rhumatologie Pédiatrique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades, Paris, France; Université Paris-Descartes, Paris, France; Institut Hospitalo-Universitaire IMAGINE, Paris, France.
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Cahu X, Calvo J, Prade N, Poglio S, Uzan B, Leblanc T, Baruchel A, Landman-Parker J, Petit A, Baleydier F, Ballerini P, Ghysdael J, Delabesse E, Pflumio F. Declined Presentation. Exp Hematol 2014. [DOI: 10.1016/j.exphem.2014.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Alby-Laurent F, Vu Thien H, Quinet B, Moissenet D, Salauze B, Cassuto P, Petit A, Landman-Parker J, Leverger G, Meyran D. SFP P-037 – Colonisation à entérobactéries BLSE et carbapénèmes en hémato-oncologie pédiatrique. Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)72007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Uzan B, Poglio S, Gerby B, Wu CL, Gross J, Armstrong F, Calvo J, Cahu X, Deswarte C, Dumont F, Passaro D, Besnard-Guérin C, Leblanc T, Baruchel A, Landman-Parker J, Ballerini P, Baud V, Ghysdael J, Baleydier F, Porteu F, Pflumio F. Interleukin-18 produced by bone marrow-derived stromal cells supports T-cell acute leukaemia progression. EMBO Mol Med 2014; 6:821-34. [PMID: 24778454 PMCID: PMC4203358 DOI: 10.1002/emmm.201303286] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Development of novel therapies is critical for T-cell acute leukaemia (T-ALL). Here, we investigated the effect of inhibiting the MAPK/MEK/ERK pathway on T-ALL cell growth. Unexpectedly, MEK inhibitors (MEKi) enhanced growth of 70% of human T-ALL cell samples cultured on stromal cells independently of NOTCH activation and maintained their ability to propagate in vivo. Similar results were obtained when T-ALL cells were cultured with ERK1/2-knockdown stromal cells or with conditioned medium from MEKi-treated stromal cells. Microarray analysis identified interleukin 18 (IL-18) as transcriptionally up-regulated in MEKi-treated MS5 cells. Recombinant IL-18 promoted T-ALL growth in vitro, whereas the loss of function of IL-18 receptor in T-ALL blast cells decreased blast proliferation in vitro and in NSG mice. The NFKB pathway that is downstream to IL-18R was activated by IL-18 in blast cells. IL-18 circulating levels were increased in T-ALL-xenografted mice and also in T-ALL patients in comparison with controls. This study uncovers a novel role of the pro-inflammatory cytokine IL-18 and outlines the microenvironment involvement in human T-ALL development.
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Affiliation(s)
- Benjamin Uzan
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Sandrine Poglio
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Bastien Gerby
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Ching-Lien Wu
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Julia Gross
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Florence Armstrong
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Julien Calvo
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Xavier Cahu
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
| | - Caroline Deswarte
- Service D'hématologie Pédiatrique, Assistance Publique - Hôpitaux de Paris Hôpital A. Trousseau, Paris, France
| | - Florent Dumont
- INSERM U1016 Institut Cochin, Paris, France CNRS UMR8104, Paris, France Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Diana Passaro
- Institut Curie Centre Universitaire, Orsay, France CNRS UMR 3306, Orsay, France Institut National de la Santé et de la Recherche Médicale U1005, Orsay, France
| | - Corinne Besnard-Guérin
- INSERM U1016 Institut Cochin, Paris, France CNRS UMR8104, Paris, France Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Thierry Leblanc
- Service D'hématologie Pédiatrique, Assistance Publique - Hôpitaux de Paris Hôpital Robert Debré, Paris, France
| | - André Baruchel
- Service D'hématologie Pédiatrique, Assistance Publique - Hôpitaux de Paris Hôpital Robert Debré, Paris, France
| | - Judith Landman-Parker
- Service D'hématologie Pédiatrique, Assistance Publique - Hôpitaux de Paris Hôpital A. Trousseau, Paris, France
| | - Paola Ballerini
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France Service D'hématologie Pédiatrique, Assistance Publique - Hôpitaux de Paris Hôpital A. Trousseau, Paris, France
| | - Véronique Baud
- INSERM U1016 Institut Cochin, Paris, France CNRS UMR8104, Paris, France Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Jacques Ghysdael
- Institut Curie Centre Universitaire, Orsay, France CNRS UMR 3306, Orsay, France Institut National de la Santé et de la Recherche Médicale U1005, Orsay, France
| | - Frédéric Baleydier
- Institut d'Hématologie et Oncologie Pédiatrique Hospices Civils de Lyon et Université Claude Bernard, Lyon, France
| | - Francoise Porteu
- INSERM U1016 Institut Cochin, Paris, France CNRS UMR8104, Paris, France Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Francoise Pflumio
- Commissariat à l'Energie Atomique et aux Energies Alternatives (CEA) DSV-IRCM-SCSR-LSHL Equipe Labellisée Ligue Contre le Cancer UMR 967, Fontenay-aux-Roses, France INSERM U967, Fontenay-aux-Roses, France Université Paris Diderot Sorbonne Paris Cité UMR 967, Fontenay-aux-Roses, France Université Paris-Sud UMR 967, Fontenay-aux-Roses, France
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Seror E, Lambilliotte A, Pacquement H, Gaspar N, Schell M, Plat G, Curtillet C, Reguerre Y, Vaudre G, Haouy S, Helfre S, Gorde-Grosjean S, Schmitt C, Aladjidi N, Boudjemaah S, Claude L, Donadieu J, Landman-Parker J, Leblanc T. Treatment of Children and Adolescents with Classical Hodgkin Lymphoma: Final Results of SFCE MDH03 Study. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Locatelli F, Neville K, Rosolen A, Landman-Parker J, Aladjidi N, Beishuizen A, Daw S, Gore L, Franklin ARK, Fasanmade A, Wang J, Sachs J, Mauz-Körholz C. Phase 1/2 Study of Brentuximab Vedotin in Pediatric Pts with Relapsed/Refractory (R/R) Hodgkin Lymphoma (HL) or Systemic Anaplastic Large-Cell Lymphoma (sALCL): Preliminary Phase 2 HL Data. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371149] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Besson C, Boudjemaa S, Hamdi L, Creidy R, Leblanc T, Lambilliote A, Dainese L, Doukoure B, Krziesek R, Coulomb A, Landman-Parker J. Hodgkin Lymphoma Subtypes and Peripheral B-cell Lymphopenia are Associated with EBV Status in Children and Adolescents in France: A Preliminary Report of the EuroNet LH EPI Project. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hasenclever D, Kurch L, Mauz-Körholz C, Elsner A, Georgi T, Wallace H, Landman-Parker J, Moryl-Bujakowska A, Cepelová M, Karlén J, Álvarez Fernández-Teijeiro A, Attarbaschi A, Fosså A, Pears J, Hraskova A, Bergsträsser E, Beishuizen A, Uyttebroeck A, Schomerus E, Sabri O, Körholz D, Kluge R. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma. Eur J Nucl Med Mol Imaging 2014; 41:1301-8. [PMID: 24604592 DOI: 10.1007/s00259-014-2715-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/20/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. OBJECTIVES With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. PATIENTS AND METHODS SUVpeak of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. RESULTS Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. CONCLUSIONS qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity.
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Affiliation(s)
- Dirk Hasenclever
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
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Pasmant E, Gilbert-Dussardier B, Petit A, de Laval B, Luscan A, Gruber A, Lapillonne H, Deswarte C, Goussard P, Laurendeau I, Uzan B, Pflumio F, Brizard F, Vabres P, Naguibvena I, Fasola S, Millot F, Porteu F, Vidaud D, Landman-Parker J, Ballerini P. SPRED1, a RAS MAPK pathway inhibitor that causes Legius syndrome, is a tumour suppressor downregulated in paediatric acute myeloblastic leukaemia. Oncogene 2014; 34:631-8. [PMID: 24469042 DOI: 10.1038/onc.2013.587] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 11/11/2013] [Accepted: 12/03/2013] [Indexed: 01/10/2023]
Abstract
Constitutional dominant loss-of-function mutations in the SPRED1 gene cause a rare phenotype referred as neurofibromatosis type 1 (NF1)-like syndrome or Legius syndrome, consisted of multiple café-au-lait macules, axillary freckling, learning disabilities and macrocephaly. SPRED1 is a negative regulator of the RAS MAPK pathway and can interact with neurofibromin, the NF1 gene product. Individuals with NF1 have a higher risk of haematological malignancies. SPRED1 is highly expressed in haematopoietic cells and negatively regulates haematopoiesis. SPRED1 seemed to be a good candidate for leukaemia predisposition or transformation. We performed SPRED1 mutation screening and expression status in 230 paediatric lymphoblastic and acute myeloblastic leukaemias (AMLs). We found a loss-of-function frameshift SPRED1 mutation in a patient with Legius syndrome. In this patient, the leukaemia blasts karyotype showed a SPRED1 loss of heterozygosity, confirming SPRED1 as a tumour suppressor. Our observation confirmed that acute leukaemias are rare complications of the Legius syndrome. Moreover, SPRED1 was significantly decreased at RNA and protein levels in the majority of AMLs at diagnosis compared with normal or paired complete remission bone marrows. SPRED1 decreased expression correlated with genetic features of AML. Our study reveals a new mechanism which contributes to deregulate RAS MAPK pathway in the vast majority of paediatric AMLs.
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Affiliation(s)
- E Pasmant
- 1] UMR_S745 INSERM, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes Sorbonne Paris Cité, Paris, France [2] Service de Biochimie et Génétique Moléculaire, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - A Petit
- 1] Service d'Hématologie-Oncologie, Hôpital A Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France [2] Université Pierre et Marie Curie Paris 6, Paris, France [3] UMR938, Université Paris 6, Pierre et Marie Curie, Paris, France
| | - B de Laval
- INSERM 1016, Institut Cochin, CNRS UMR8104, Université Paris Descartes, Paris, France
| | - A Luscan
- 1] UMR_S745 INSERM, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes Sorbonne Paris Cité, Paris, France [2] Service de Biochimie et Génétique Moléculaire, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - A Gruber
- UMR_S745 INSERM, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - H Lapillonne
- 1] UMR938, Université Paris 6, Pierre et Marie Curie, Paris, France [2] Service d'Hématologie Biologique, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Deswarte
- 1] Service d'Hématologie-Oncologie, Hôpital A Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France [2] Université Pierre et Marie Curie Paris 6, Paris, France [3] UMR938, Université Paris 6, Pierre et Marie Curie, Paris, France
| | - P Goussard
- Service de Biochimie et Génétique Moléculaire, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - I Laurendeau
- UMR_S745 INSERM, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - B Uzan
- UMR967, CEA, Université Paris 7, Fontenay aux Roses, France
| | - F Pflumio
- UMR967, CEA, Université Paris 7, Fontenay aux Roses, France
| | - F Brizard
- Laboratoire d'Hématologie Biologique, C.H.U. de Poitiers, Poitiers, France
| | - P Vabres
- Service de Dermatologie, C.H.U. de Dijon et EA 4271, Université de Bourgogne, France
| | - I Naguibvena
- UMR967, CEA, Université Paris 7, Fontenay aux Roses, France
| | - S Fasola
- 1] Service d'Hématologie-Oncologie, Hôpital A Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France [2] Université Pierre et Marie Curie Paris 6, Paris, France
| | - F Millot
- Service de Pédiatrie, C.H.U de Poitiers, Poitiers, France
| | - F Porteu
- INSERM 1016, Institut Cochin, CNRS UMR8104, Université Paris Descartes, Paris, France
| | - D Vidaud
- 1] UMR_S745 INSERM, Faculté des Sciences Pharmaceutiques et Biologiques, Université Paris Descartes Sorbonne Paris Cité, Paris, France [2] Service de Biochimie et Génétique Moléculaire, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France [3] Service de Génétique, C.H.U. de Poitiers, Poitiers, France
| | - J Landman-Parker
- 1] Service d'Hématologie-Oncologie, Hôpital A Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France [2] Université Pierre et Marie Curie Paris 6, Paris, France [3] UMR938, Université Paris 6, Pierre et Marie Curie, Paris, France
| | - P Ballerini
- Service d'Hématologie Biologique, Hôpital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
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Di Giannatale A, Dias-Gastellier N, Devos A, Mc Hugh K, Boubaker A, Courbon F, Verschuur A, Ducassoul S, Malekzadeh K, Casanova M, Amoroso L, Chastagner P, Zwaan CM, Munzer C, Aerts I, Landman-Parker J, Riccardi R, Le Deley MC, Geoerger B, Rubie H. Phase II study of temozolomide in combination with topotecan (TOTEM) in relapsed or refractory neuroblastoma: a European Innovative Therapies for Children with Cancer-SIOP-European Neuroblastoma study. Eur J Cancer 2013; 50:170-7. [PMID: 24021349 DOI: 10.1016/j.ejca.2013.08.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 08/07/2013] [Accepted: 08/12/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess objective response rate (ORR) after two cycles of temozolomide in combination with topotecan (TOTEM) in children with refractory or relapsed neuroblastoma. PATIENTS AND METHODS This multicenter, non-randomised, phase II study included children with neuroblastoma according to a two-stage Simon design. Eligibility criteria included relapsed or refractory, measurable or metaiodobenzylguanidine (mIBG) evaluable disease, no more than two lines of prior treatment. Temozolomide was administered orally at 150mg/m(2) followed by topotecan at 0.75mg/m(2) intravenously for five consecutive days every 28days. Tumour response was assessed every two cycles according to International Neuroblastoma Response Criteria (INRC), and reviewed independently. RESULTS Thirty-eight patients were enroled and treated in 15 European centres with a median age of 5.4years. Partial tumour response after two cycles was observed in 7 out of 38 evaluable patients [ORR 18%, 95% confidence interval (CI) 8-34%]. The best ORR whatever the time of evaluation was 24% (95% CI, 11-40%) with a median response duration of 8.5months. Tumour control rate (complete response (CR)+partial response (PR)+mixed response (MR)+stable disease (SD)) was 68% (95% CI, 63-90%). The 12-months Progression-Free and Overall Survival were 42% and 58% respectively. Among 213 treatment cycles (median 4, range 1-12 per patient) the most common treatment-related toxicities were haematologic. Grade 3/4 neutropenia occurred in 62% of courses in 89% of patients, grade 3/4 thrombocytopenia in 47% of courses in 71% of patients; three patients (8%) had febrile neutropenia. CONCLUSION Temozolomide-Topotecan combination results in very encouraging ORR and tumour control in children with heavily pretreated recurrent and refractory neuroblastoma with favourable toxicity profile.
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Affiliation(s)
- Angela Di Giannatale
- Institut Gustave Roussy, Université Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Nathalie Dias-Gastellier
- Institut Gustave Roussy, Université Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Annick Devos
- Sophia Children's Hospital/Erasmus MC Rotterdam, 60 Dr. Molewaterplein, 3015 GJ Rotterdam, The Netherlands
| | - Kieran Mc Hugh
- Great Ormond Street Hospital, 34 Great Ormond Street, Bloomsbury, London WC1N 3JH, United Kingdom
| | - Ariane Boubaker
- Centre Hospitalier Universitaire Vaudois, 46 Rue du Bugnon, 1011 Lausanne, Switzerland
| | - Frederic Courbon
- Institut Claudius Regaud, 20-24 Rue du pont Saint-Pierre, 31052 Toulouse Cedex, France
| | - Arnaud Verschuur
- Hôpital de la Timone, 264 Rue Saint Pierre, 13385 Marseille Cedex 5, France
| | - Stéphane Ducassoul
- Centre Hospitalier Pellegrin Hôpital des Enfants, Place Amélie Raba-Léon, 33076 Bordeaux, France
| | - Katty Malekzadeh
- Institut Gustave Roussy, Université Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Michela Casanova
- Fondazione IRCCS Istituto Nazionale Tumori, 1 Via Venezian, 20133 Milano, Italy
| | - Loredana Amoroso
- Istituto Giannina Gaslini, 5 Via Gerolamo Gaslini, 16147 Genova, Italy
| | | | - Christian M Zwaan
- Sophia Children's Hospital/Erasmus MC Rotterdam, 60 Dr. Molewaterplein, 3015 GJ Rotterdam, The Netherlands
| | - Caroline Munzer
- Hôpital des Enfants, 330 Avenue de Grande Bretagne, 31059 Toulouse Cedex 9, France
| | - Isabelle Aerts
- Universita Cattolica, Gemelli, Largo A. Gemelli 8, 00168 Roma, Italy
| | | | - Riccardo Riccardi
- Hôpital d'Enfants Armand-Trousseau, 26 Avenue du Docteur Arnold Netter, 75571 Paris, France
| | - Marie-Cecile Le Deley
- Institut Gustave Roussy, Université Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Birgit Geoerger
- Institut Gustave Roussy, Université Paris-Sud, 114 Rue Edouard Vaillant, 94805 Villejuif, France
| | - Hervé Rubie
- Hôpital des Enfants, 330 Avenue de Grande Bretagne, 31059 Toulouse Cedex 9, France.
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Chappuy H, Bouazza N, Minard-Colin V, Patte C, Brugières L, Landman-Parker J, Auvrignon A, Davous D, Pacquement H, Orbach D, Tréluyer JM, Doz F. Parental comprehension of the benefits/risks of first-line randomised clinical trials in children with solid tumours: a two-stage cross-sectional interview study. BMJ Open 2013; 3:bmjopen-2013-002733. [PMID: 23793670 PMCID: PMC3657641 DOI: 10.1136/bmjopen-2013-002733] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To analyse the parental understanding of informed consent information in first-line randomised clinical trials (RCTs) including children with malignant solid tumours and to assess parents' needs for decision-making. DESIGN Observational prospective study. SETTING 3 paediatric oncology centres in the Parisian region in France. PARTICIPANTS 53 parents were approached to participate in a RCT for their child with malignant solid tumour, over a 1-year period. 40 parents have been interviewed in our study. PRIMARY AND SECONDARY OUTCOME MEASURES Parental understanding of information in RCTs, parents' needs for decision-making. Parents were questioned by a psychologist, independent of the paediatric oncology teams, using a semidirected interview, 1 (M1) and 6 months (M6) after the consent was sought. RESULTS 18 parents (45%) did not understand the concept of randomisation. Half of the parents could explain neither the aim of the clinical trial nor the potential benefit to their child of inclusion. 35 parents (87.5%) expressed very few specific risks related to the trial. Being mostly French-speaking (p=0.03) and the reading of the information sheet by the parents (p=0.0025) improved their understanding. The parental comprehension did not differ between M1 and M6. The principal factors underlying their decision were confidence in the medical team (39%), wish to access to the best treatment (37%) and the best quality of life (37%). CONCLUSIONS Despite medical explanations, parents have limited knowledge in some areas in first-line RCTs and improvements of information process are required. The risks specific to the randomised trial are underestimated by parents and the unproven nature of the treatment is not well-known or understood.
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Affiliation(s)
- Hélène Chappuy
- Pediatric Emergency Department, Hôpital Necker Enfants Malades, Université Paris descartes, Paris, France
| | - Naim Bouazza
- Clinical Research Unit Paris centre, APHP, Paris, France
| | | | - Catherine Patte
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, Paris, France
| | - Laurence Brugières
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, Paris, France
| | | | - Anne Auvrignon
- Departement of Pediatric Oncology, Hôpital Armand Trousseau, Paris, France
| | - Dominique Davous
- Association Apprivoiser l'absence, Cent pour Sang la Vie, Paris, France
| | | | - Daniel Orbach
- Department of Pediatric Oncology, Institut Curie, Paris, France
| | | | - François Doz
- Department of Pediatric Oncology, Institut Curie, Paris, France
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Neville K, Gore L, Mauz-Körholz C, Rosolen A, Landman-Parker J, Sanchez de Toledo J, Beishuizen A, Keating Franklin AR, Fasanmade A, Wang J, Huebner D, Locatelli F. Phase I/II study of brentuximab vedotin in pediatric patients (pts) with relapsed or refractory (RR) Hodgkin lymphoma (HL) or systemic anaplastic large-cell lymphoma (sALCL): Interim phase (ph) I safety data. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.10028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10028 Background: Brentuximab vedotin (ADCETRIS) is a novel antibody-drug conjugate that targets CD30, a cell surface antigen expressed by HL and sALCL. The ph 1 portion of this study evaluated safety, pharmacokinetics (PK), and recommended ph 2 dose (RP2D) of brentuximab vedotin in pediatric pts with RR CD30-expressing tumors. Methods: Ph 1/2, open-label, multicenter study in pts aged 2 to <18 years with RR HL or sALCL (5 to <18 years for HL). Pts received brentuximab vedotin by IV infusion once every 21 days (Q3wk). Ph 1 start dose was 1.4 mg/kg escalated to 1.8 mg/kg in a traditional 3+3 design. Results: 12 pts (median age 14.5 y; 10 HL; 2 sALCL) received brentuximab vedotin in the ph 1 portion (mg/kg/dose [n]: 1.4, [3]; 1.8 [9]). 1.8 mg/kg cohort was expanded from 6 to 9 pts to raise the ph 1 pediatric experience to 12 pts before the ph 2 portion. At data cut, pts had received a median of 3 cycles (range, 1–8). 11 pts (92%) had ≥1 treatment-emergent adverse event (TEAE): 2 at 1.4 mg/kg, 9 at 1.8 mg/kg. 6 pts (50%) had Gr ≥3 TEAE: 1 at 1.4 mg/kg, 5 at 1.8 mg/kg. The most frequent (≥15%) TEAE were nausea (50%), abdominal pain, diarrhea (25% each), upper abdominal pain, cough, fatigue, hypokalemia, leukopenia, decreased lymphocyte count, pain, paresthesia, vomiting, weight loss (17% each). 1 pt (8%) discontinued due to TEAE (Gr 3 hepatotoxicity). 7 serious AE (SAE) were reported in 4 pts at 1.8 mg/kg: Gr 2 supraventricular tachycardia unrelated to treatment in 1 pt; Gr 3 febrile neutropenia, Gr 3 hepatotoxicity and Gr 3 cardiac failure (not a cardiac event per later analysis) in 1 pt; Gr 3 bronchospasm and Gr 2 laryngeal edema in 1 pt; 1 cardiac arrest resulting in death, unrelated to treatment. 2 dose limiting toxicities were reported in 1 pt in the 1.8 mg/kg cohort (SAE: prolonged Gr 3 liver event, Gr 3 febrile neutropenia). PK data will be presented. Conclusions: Brentuximab vedotin is generally well tolerated in pediatric pts with RR CD30-positive HL or sALCL up to 1.8 mg/kg Q3wk. For the majority of pts, toxicities were generally mild to moderate and did not lead to discontinuation. 1.8 mg/kg is the RP2D for pediatric and adult pts. The ph 2 portion is ongoing. Clinical trial information: NCT01492088.
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Affiliation(s)
| | - Lia Gore
- Children’s Hospital Colorado, Aurora, CO
| | | | | | | | | | - Auke Beishuizen
- Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands
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