1
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Alcantara M, Houillier C, Garff‐Tavernier M, Souchet L, Roos‐Weil D, Morel V, Uzunov M, Metz C, Nguyen‐Quoc S, Jacque N, Gauthier N, Cann M, Norol F, Willems L, Waultier Rascalou A, Salanoubat C, Fior R, Blonski M, Rubio M, Soussain C, Choquet S. CAR‐T CELL THERAPY IN PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL): THE EXPERIENCE OF THE FRENCH NETWORK FOR OCULO‐CEREBRAL LYMPHOMAS (LOC). Hematol Oncol 2021. [DOI: 10.1002/hon.74_2880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - C. Houillier
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | | | - L. Souchet
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - D. Roos‐Weil
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - V. Morel
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - M. Uzunov
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - C. Metz
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - S. Nguyen‐Quoc
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - N. Jacque
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - N. Gauthier
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - M. Cann
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | - F. Norol
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
| | | | | | - C. Salanoubat
- Centre Hospitalier Sud Francilien 91106 Corbeil Essonnes France
| | - R. Fior
- Hôpital Antoine‐Béclère 92140 Clamart France
| | - M. Blonski
- Centre Hospitalier Régional et Universitaire de Nancy 54035 Nancy France
| | - M.‐T. Rubio
- Centre Hospitalier Régional et Universitaire de Nancy 54035 Nancy France
| | | | - S. Choquet
- Hôpital Universitaire Pitié‐Salpêtrière 75013 Paris France
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2
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Choquet S, Lavaud A, Boussen I, Roos‐Weil D, Morel V, Uzunov M, Solorzano S, Garff M, Leblond V. USE OF METHOTREXATE, WHATEVER KIDNEY FUNCTION, WITH A SIMPLE ALGORITHM, RADICALLY CHANGES THE PROGNOSIS OF POST‐TRANSPLANT CNS LYMPHOMAS. Hematol Oncol 2021. [DOI: 10.1002/hon.72_2880] [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: 11/05/2022]
Affiliation(s)
- S. Choquet
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - A. Lavaud
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - I. Boussen
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - D. Roos‐Weil
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - V. Morel
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - M. Uzunov
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - S. Solorzano
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
| | - M. Garff
- Pitie‐Salpetriere Hospital biological hematology Paris France
| | - v. Leblond
- Pitie‐Salpetriere Hospital APHP‐Sorbonne Universite Clinical Hematology Paris France
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3
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Willekens C, Rahme R, Duchmann M, Vidal V, Saada V, Broutin S, Delahousse J, Renneville A, Marceau A, Clappier E, Uzunov M, Rossignol J, Pascal L, Simon L, Micol JB, Pasquier F, Raffoux E, Preudhomme C, Quivoron C, Itzykson R, Penard-Lacronique V, Paci A, Fenaux P, Attar EC, Frattini M, Braun T, Ades L, De Botton S. Effects of azacitidine in 93 patients with IDH1/2 mutated acute myeloid leukemia/myelodysplastic syndromes: a French retrospective multicenter study. Leuk Lymphoma 2020; 62:438-445. [PMID: 33043739 DOI: 10.1080/10428194.2020.1832661] [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
Isocitrate dehydrogenase 1 (IDH1) and 2 (IDH2) mutations in Myeloid Neoplams (MNs) exhibit DNA hypermethylation via 2-hydroxyglutarate (2HG) over-production. Clinical impact of azacitidine (AZA) remains inconsistent in IDH1/2-mutated MNs and the potential of serum 2HG as a suitable marker of response to AZA is unknown. To address these questions, we retrospectively analyzed 93 MNs patients (78 AML, 11 MDS, 4 CMML) with IDH1/2 mutations treated with AZA. After a median of 5 cycles of AZA, overall response rate was 28% (including 15% complete remission) and median OS was 12.3 months (significantly shorter in AML compared to MDS/CMML patients). In multivariate analysis of AML patients, DNMT3A mutation was associated with shorter OS while IDH1/2 mutation subtypes had no independent impact. No difference was observed in serum 2HG levels upon AZA treatment between responding and refractory patients suggesting that serum 2HG cannot be used as a surrogate marker of AZA response.
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Affiliation(s)
- C Willekens
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Inserm U1170, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - R Rahme
- Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris, France.,Inserm U944, Hôpital Saint-Louis, Paris, France
| | - M Duchmann
- Laboratoire d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - V Vidal
- Département d'Hématologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - V Saada
- Département de Biologie et Pathologie médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - S Broutin
- Département de Biologie et Pathologie médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - J Delahousse
- Département de Biologie et Pathologie médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - A Renneville
- Centre de Biologie-Pathologie, Laboratoire d'hématologie, Centre Hospitalier Universitaire de Lille, France
| | - A Marceau
- Centre de Biologie-Pathologie, Laboratoire d'hématologie, Centre Hospitalier Universitaire de Lille, France
| | - E Clappier
- Laboratoire d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - M Uzunov
- Département d'Hématologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J Rossignol
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Département d'Hématologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - L Pascal
- Hématologie, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lille, France
| | - L Simon
- Département d'Hématologie, Hôpital universitaire d'Amiens - Picardie, Amiens, France
| | - J B Micol
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Inserm U1170, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - F Pasquier
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Inserm U1170, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - E Raffoux
- Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris, France.,Inserm U944, Hôpital Saint-Louis, Paris, France
| | - C Preudhomme
- Centre de Biologie-Pathologie, Laboratoire d'hématologie, Centre Hospitalier Universitaire de Lille, France
| | - C Quivoron
- Inserm U1170, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - R Itzykson
- Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris, France.,Inserm U944, Hôpital Saint-Louis, Paris, France
| | | | - A Paci
- Département de Biologie et Pathologie médicales, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - P Fenaux
- Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris, France.,Inserm U944, Hôpital Saint-Louis, Paris, France
| | - E C Attar
- Agios Pharmaceuticals, Inc, Cambridge, MA, USA
| | | | - T Braun
- Département d'Hématologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - L Ades
- Département d'Hématologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Diderot, Paris, France.,Inserm U944, Hôpital Saint-Louis, Paris, France
| | - S De Botton
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Inserm U1170, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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4
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Cosson A, Chapiro E, Bougacha N, Lambert J, Herbi L, Cung HA, Algrin C, Keren B, Damm F, Gabillaud C, Brunelle-Navas MN, Davi F, Merle-Béral H, Le Garff-Tavernier M, Roos-Weil D, Choquet S, Uzunov M, Morel V, Leblond V, Maloum K, Lepretre S, Feugier P, Lesty C, Lejeune J, Sutton L, Landesman Y, Susin SA, Nguyen-Khac F. Gain in the short arm of chromosome 2 (2p+) induces gene overexpression and drug resistance in chronic lymphocytic leukemia: analysis of the central role of XPO1. Leukemia 2017; 31:1625-1629. [PMID: 28344316 DOI: 10.1038/leu.2017.100] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
MESH Headings
- Apoptosis
- Chromosomes, Human, Pair 2
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Gene Expression Regulation, Leukemic
- Humans
- Hydrazines/pharmacology
- Hydrazines/therapeutic use
- Karyopherins/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Receptors, Cytoplasmic and Nuclear/genetics
- Triazoles/pharmacology
- Triazoles/therapeutic use
- Exportin 1 Protein
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Affiliation(s)
- A Cosson
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - E Chapiro
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - N Bougacha
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - J Lambert
- Service de Biostatistique et Informatique Médicale, Hôpital Saint Louis, Paris, France
| | - L Herbi
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - H-A Cung
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - C Algrin
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - B Keren
- Département de génétique, GH Pitié-Salpêtrière, Paris, France
| | - F Damm
- INSERM U1170, Institut Gustave Roussy, Villejuif, France
| | - C Gabillaud
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - M-N Brunelle-Navas
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - F Davi
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - H Merle-Béral
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - M Le Garff-Tavernier
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - D Roos-Weil
- INSERM U1170, Institut Gustave Roussy, Villejuif, France
| | - S Choquet
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - M Uzunov
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - V Morel
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - V Leblond
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - K Maloum
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - S Lepretre
- Département d'Hématologie, Hôpital Becquerel, Rouen, France
| | - P Feugier
- Pôle d'Hématologie, Hôpital Brabois, Vandoeuvre-les-Nancy, France
| | - C Lesty
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
| | - J Lejeune
- Service de Biostatistique et Informatique Médicale, Hôpital Saint Louis, Paris, France
| | - L Sutton
- Service d'Hématologie Clinique, Hôpital d'Argenteuil, Argenteuil, France
| | | | - S A Susin
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
| | - F Nguyen-Khac
- INSERM UMR_S 1138, Cell Death and Drug Resistance in Lymphoproliferative Disorders Team, Centre de Recherche des Cordeliers, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France
- Service d'Hématologie Biologique, GH Pitié-Salpêtrière, Paris, France
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5
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Nguyen S, Achour A, Souchet L, Vigouroux S, Chevallier P, Furst S, Sirvent A, Bay JO, Socié G, Ceballos P, Huynh A, Cornillon J, Francois S, Legrand F, Yakoub-Agha I, Michel G, Maillard N, Margueritte G, Maury S, Uzunov M, Bulabois CE, Michallet M, Clement L, Dauriac C, Bilger K, Lejeune J, Béziat V, Rocha V, Rio B, Chevret S, Vieillard V. Clinical impact of NK-cell reconstitution after reduced intensity conditioned unrelated cord blood transplantation in patients with acute myeloid leukemia: analysis of a prospective phase II multicenter trial on behalf of the Société Française de Greffe de Moelle Osseuse et Thérapie Cellulaire and Eurocord. Bone Marrow Transplant 2017. [PMID: 28650455 DOI: 10.1038/bmt.2017.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Unrelated cord blood transplantation (UCBT) after a reduced intensity conditioning regimen (RIC) has extended the use of UCB in elderly patients and those with co-morbidities without an HLA-identical donor, although post-transplant relapse remains a concern in high-risk acute myeloid leukemia (AML) patients. HLA incompatibilities between donor and recipient might enhance the alloreactivity of natural killer (NK) cells after allogeneic hematopoietic stem-cell transplantation (HSCT). We studied the reconstitution of NK cells and KIR-L mismatch in 54 patients who underwent a RIC-UCBT for AML in CR in a prospective phase II clinical trial. After RIC-UCBT, NK cells displayed phenotypic features of both activation and immaturity. Restoration of their polyfunctional capacities depended on the timing of their acquisition of phenotypic markers of maturity. The incidence of treatment-related mortality (TRM) was correlated with low CD16 expression (P=0.043) and high HLA-DR expression (P=0.0008), whereas overall survival was associated with increased frequency of NK-cell degranulation (P=0.001). These features reflect a general impairment of the NK licensing process in HLA-mismatched HSCT and may aid the development of future strategies for selecting optimal UCB units and enhancing immune recovery.
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Affiliation(s)
- S Nguyen
- AP-HP, Hôpital Pitié Salpêtrière (AP-HP), Service d'Hématologie Clinique, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, INSERM U1135, CNRS ERL8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - A Achour
- Sorbonne Universités, UPMC Univ Paris 06, INSERM U1135, CNRS ERL8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - L Souchet
- AP-HP, Hôpital Pitié Salpêtrière (AP-HP), Service d'Hématologie Clinique, Paris, France
| | - S Vigouroux
- CHU de Bordeaux Hôpital du Haut-Lévèque, Service d'hématologie clinique et de thérapie cellulaire, Pessac, France
| | - P Chevallier
- CHU de Nantes, Hematology Department, Nantes, France
| | - S Furst
- Institut Paoli Calmettes, Service de greffe de moelle, Marseille, France
| | - A Sirvent
- Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - J-O Bay
- CHU Estaing Service d'Hématologie Clinique, Clermont-Ferrand, France
| | - G Socié
- AP-HP, Hôpital Saint-Louis, Service d'Hématologie et de Transplantation, Paris, France
| | | | - A Huynh
- CHU de Toulouse, Hématologie Clinique, Toulouse, France
| | - J Cornillon
- Institut de Cancérologie de la Loire, Service d'Hématologie, Saint-Priest-en-Jarez, France
| | | | - F Legrand
- CHU de Nice, Service d'Hématologie, Nice, France
| | | | - G Michel
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Research Unit EA 3279 Aix-Marseille University, Marseille, France
| | | | | | - S Maury
- Hôpital Henri Mondor, Service d'Hématologie, Créteil, France
| | - M Uzunov
- AP-HP, Hôpital Pitié Salpêtrière (AP-HP), Service d'Hématologie Clinique, Paris, France
| | | | | | - L Clement
- University Hospital de Bordeaux, Bordeaux, France
| | | | - K Bilger
- CHRU de Strasbourg, Strasbourg, France
| | - J Lejeune
- Department de Bioinformatique et Statistique Médicale, Hôpital Saint-Louis, Paris, France
| | - V Béziat
- Sorbonne Universités, UPMC Univ Paris 06, INSERM U1135, CNRS ERL8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - V Rocha
- Eurocord Office, Hôpital Saint-Louis, Paris, France
| | - B Rio
- Hôpital Saint-Antoine, Hématologie Clinique et Thérapie Cellulaire, Paris, France
| | - S Chevret
- Department de Bioinformatique et Statistique Médicale, Hôpital Saint-Louis, Paris, France
| | - V Vieillard
- Sorbonne Universités, UPMC Univ Paris 06, INSERM U1135, CNRS ERL8255, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
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6
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Imbert S, Gauthier L, Joly I, Brossas JY, Uzunov M, Touafek F, Brun S, Mazier D, Datry A, Gay F, Fekkar A. Aspergillus PCR in serum for the diagnosis, follow-up and prognosis of invasive aspergillosis in neutropenic and nonneutropenic patients. Clin Microbiol Infect 2016; 22:562.e1-8. [PMID: 26899830 PMCID: PMC7129605 DOI: 10.1016/j.cmi.2016.01.027] [Citation(s) in RCA: 54] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 01/24/2016] [Accepted: 01/29/2016] [Indexed: 12/12/2022]
Abstract
We evaluated the usefulness of a serum Aspergillus PCR assay for the diagnosis and prognosis of invasive aspergillosis in a study involving 941 patients for a total of 5146 serum samples. Fifty-one patients had proven/probable aspergillosis. We compared galactomannan (GM), PCR and mycologic analysis of pulmonary samples in both neutropenic and nonneutropenic patients. PCR performed in serum yielded 66.7% sensitivity, 98.7% specificity, 75.6% positive predictive value and 98.0% negative predictive value, while the GM index yielded 78.4% sensitivity, 87.5% specificity, 27% positive predictive value and 98.6% negative predictive value. The inclusion of PCR in the European Organization for Research and Treatment of Cancer (EORTC) and the Mycosis Study Group (MSG) mycologic criteria permitted the reclassification of nine other cases from possible to probable aspergillosis and increased the sensitivity to 71.7%. Combining the GM index with serum PCR increased the detection rate of invasive aspergillosis with 88.2% sensitivity. PCR was systematically negative in 16 patients with noninvasive forms of aspergillosis (namely aspergilloma and chronic aspergillosis). Remaining PCR positive after a period of 14 to 20 days of treatment was related to poor outcome at 30 and 90 days. Our results also indicate that, unlike the determination of the GM index, the initial fungus load as determined by PCR was highly predictive of 90-day mortality, with the rate of the latter being 15.8% for patients with <150 copies/mL vs. 73.2% for patients at or above that cutoff (p <0.0001). Therefore, PCR appears to be a powerful and interesting tool for the identification of patients with invasive aspergillosis who might benefit from more intense care.
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Affiliation(s)
- S Imbert
- Service de Parasitologie Mycologie, France
| | - L Gauthier
- Service de Parasitologie Mycologie, France
| | - I Joly
- Service de Parasitologie Mycologie, France
| | - J-Y Brossas
- Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, France
| | - M Uzunov
- Service d'Hématologie, AP-HP, Groupe hospitalier Pitié-Salpêtrière, France
| | - F Touafek
- Service de Parasitologie Mycologie, France
| | - S Brun
- Service de Parasitologie Mycologie, France
| | - D Mazier
- Service de Parasitologie Mycologie, France; Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - A Datry
- Service de Parasitologie Mycologie, France
| | - F Gay
- Service de Parasitologie Mycologie, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - A Fekkar
- Service de Parasitologie Mycologie, France; Centre d'Immunologie et des Maladies Infectieuses, CIMI-Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
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7
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Loiseau C, Lemonnier F, Randrianarivelo O, Itzykson R, Becquemin M, Nguyen Quoc S, Uzunov M, Catherinot E, Rivaud E, Sutton L, Vernant J, Couderc L, Dhedin N. Bronchiolite oblitérante post-allogreffe de cellules souches hématopoïétiques : intérêt diagnostique d’une surveillance par spiromètre portable au domicile ? Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.715] [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: 10/22/2022]
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8
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Mamez AC, Souchet L, Roos-Weil D, Uzunov M, Brun AL, Algrin C, Leblond V, Nguyen S. Graft-versus-T-cell lymphoma effect: a sustained CR after tapering immunosuppressive drugs in a patient with angioimmunoblastic T-cell lymphoma in relapse after allogeneic transplantation. Bone Marrow Transplant 2014; 50:304-6. [PMID: 25365069 DOI: 10.1038/bmt.2014.243] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A C Mamez
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - L Souchet
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - D Roos-Weil
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - M Uzunov
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - A L Brun
- Service de Radiologie, Hôpital Pitié Salpêtrière, Paris, France
| | - C Algrin
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - V Leblond
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
| | - S Nguyen
- Service d'Hématologie, Hôpital Pitié Salpêtrière, Paris, France
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Fekkar A, Dannaoui E, Meyer I, Imbert S, Brossas JY, Uzunov M, Mellon G, Nguyen S, Guiller E, Caumes E, Leblond V, Mazier D, Fievet MH, Datry A. Emergence of echinocandin-resistant Candida spp. in a hospital setting: a consequence of 10 years of increasing use of antifungal therapy? Eur J Clin Microbiol Infect Dis 2014; 33:1489-96. [PMID: 24715154 DOI: 10.1007/s10096-014-2096-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/16/2014] [Indexed: 11/28/2022]
Abstract
Since their introduction in the 2000s, echinocandin drugs have become widely used for the treatment and prophylaxis of invasive fungal infections and, notably, invasive candidiasis. Although cases of breakthrough candidiasis in patients receiving echinocandins have been reported, clinical failure during echinocandin treatment due to the acquisition of resistance by a normally susceptible Candida spp. isolate is considered rare. To date, no publications have been published correlating the use of echinocandins and the emergence of echinocandin resistance among Candida species. So, our goal is to report an initial analysis of echinocandin use in relation to the emergence of resistant Candida isolates. We report here a single-centre experience of the emergence of eight resistant isolates belonging to normally susceptible Candida species in six patients receiving echinocandins. We describe the context and analyse the use of echinocandins over the previous decade. For seven of these isolates, we identified FKS gene mutations involved in decreased susceptibility. Seven isolates were obtained in 2011, on the heels of a ten-fold increase in caspofungin use over the preceding decade. In contrast, in 2012, the use of echinocandins decreased in our institution by 19.5 % and, in that year, only one Candida-resistant isolate was detected, despite the stable global epidemiology of invasive candidaemia. This work underlines the necessity of improving the prescription of antifungal drugs. Improvement in the monitoring of strain susceptibility should also be considered in order to better detect the emergence of resistant or non-susceptible yeast strains.
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Affiliation(s)
- A Fekkar
- Service de Parasitologie Mycologie, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France,
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10
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Roos-Weil D, Nguyen S, Uzunov M, Bories D, Chapiro E, Nguyen-Khac F, Vernant JP, Dhédin N. Therapy-related myelodysplastic syndrome after allogeneic BMT: successful treatment by donor lymphocyte infusions. Bone Marrow Transplant 2010; 45:1471-3. [DOI: 10.1038/bmt.2009.369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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11
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Fekkar A, Brun S, D’Ussel M, Uzunov M, Cracco C, Dhédin N, Buffet P, Mazier D, Datry A. Serum Cross‐Reactivity withAspergillusGalactomannan and Cryptococcal Antigen during Fatal DisseminatedTrichosporon dermatisInfection. Clin Infect Dis 2009; 49:1457-8. [DOI: 10.1086/644499] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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12
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Beziat V, Nguyen S, Lapusan S, Hervier B, Dhedin N, Bories D, Uzunov M, Boudifa A, Trebeden-Negre H, Norol F, Marjanovic Z, Marie JP, Vernant JP, Debre P, Rio B, Vieillard V. Fully functional NK cells after unrelated cord blood transplantation. Leukemia 2009; 23:721-8. [PMID: 19151772 DOI: 10.1038/leu.2008.343] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Promising results of umbilical cord blood transplantation (UCBT) from unrelated donors have been reported in patients with hematologic disorders. These transplants, having potential to trigger beneficial donor-versus-recipient natural killer (NK) cell-mediated alloreaction, we have conducted the first extensive analysis of the phenotypic and functional properties of NK cells after UCBT. NK cells from 25 patients with high-risk hematologic malignancies were compared with cells derived from both healthy adult and CB cells. We found that following UCBT, NK cells display not only some phenotypic features associated with maturity but also unique characteristics that make them fully functional against leukemic blasts. We propose that this full functionality of alloreactive donor-derived NK may drive graft-versus-leukemia reactions after UCBT.
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Affiliation(s)
- V Beziat
- INSERM U543, Hôpital Pitié-Salpêtrière, Paris, France
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