1
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Mahévas T, Osio A, Larcher L, Clappier E, Kempf W, Adès L, Fenaux P, Sébert M, Delaleu J, Jachiet M, Cordoliani F, Charvet E, Carpentier O, Itzykson RA, Weinborn M, Mardare N, Marco-Bonnet J, de Masson A, Duployez N, Huynh T, Bouaziz JD, Vignon-Pennamen MD, Battistella M. Cutaneous clonal mature plasmacytoid dendritic cell dermatosis in patients with myeloid neoplasms. Blood Adv 2024:bloodadvances.2023012489. [PMID: 38621250 DOI: 10.1182/bloodadvances.2023012489] [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: 12/21/2023] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024] Open
Affiliation(s)
- Thibault Mahévas
- Service de Dermatologie, Hôpital Saint-Louis, Paris, Paris, France
| | | | - Lise Larcher
- Service d'hématologie biologique, Hôpital Saint-Louis AP-HP, Paris ; France 4 Université Paris Cité, Génomes, biologie cellulaire et thérapeutique U944, INSERM, CNRS, F-75010 Paris, France, France
| | - Emmanuelle Clappier
- Service d'hématologie biologique, Hôpital Saint-Louis AP-HP, Paris ; France 4 Université Paris Cité, Génomes, biologie cellulaire et thérapeutique U944, INSERM, CNRS, F-75010 Paris, France, France
| | - Werner Kempf
- Kempf und Pfaltz Histologische Diagnostik, Zurich, Switzerland
| | | | | | | | | | | | | | - Estelle Charvet
- Service de Dermatologie, APHP, Hôpital Saint-Louis, Paris, Paris, France
| | | | | | - Marie Weinborn
- Laboratoire d'anatomie et cytologie pathologique, C .H. de Valenciennes, Valenciennes, France, Valenciennes, France
| | | | | | | | | | - Tony Huynh
- Hopital Saint-Louis, Universite de Paris-Cite, Paris, France
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2
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Sébert M, Freiman L, Chaffaut C, Guerci A, Peterlin P, Thépot S, Beyne-Rauzy O, Park S, Cluzeau T, Chermat F, Fenaux P, Preudhomme C, Clappier E, Chevret S, Adès L, Duployez N, Duchmann M. Clinical impact of genetic alterations including germline DDX41 mutations in MDS/low-blast count AML patients treated with azacitidine-based regimens. Leukemia 2024; 38:918-922. [PMID: 38368440 DOI: 10.1038/s41375-024-02180-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Affiliation(s)
- Marie Sébert
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France.
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France.
- Groupe Francophone des Myelodysplasies, Paris, France.
| | - Lucie Freiman
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Cendrine Chaffaut
- Biostatistics Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Agnès Guerci
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, CHU Brabois Vandoeuvre, Nancy, France
| | - Pierre Peterlin
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Sylvain Thépot
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, Angers University Hospital, Angers, France
| | - Odile Beyne-Rauzy
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, CHU de Toulouse, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Sophie Park
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, Grenoble University Hospital, Grenoble, France
| | - Thomas Cluzeau
- Groupe Francophone des Myelodysplasies, Paris, France
- Hematology Department, Nice University Hospital, Nice, France
| | | | - Pierre Fenaux
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
- Groupe Francophone des Myelodysplasies, Paris, France
| | - Claude Preudhomme
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Lille, France
| | - Emmanuelle Clappier
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Sylvie Chevret
- Biostatistics Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Lionel Adès
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
- Groupe Francophone des Myelodysplasies, Paris, France
| | - Nicolas Duployez
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, Institut National de la Santé et de la Recherche Médicale (INSERM), Lille, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Matthieu Duchmann
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France.
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
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3
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Freiman L, Larcher L, Tueur G, Vasquez N, Da Costa M, Duchmann M, Raffoux E, Adès L, Fenaux P, Soulier J, Duployez N, Clappier E, Sébert M. Germline CHEK2 mutations in patients with myeloid neoplasms. Leukemia 2024; 38:908-911. [PMID: 38378842 DOI: 10.1038/s41375-024-02179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Lucie Freiman
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Lise Larcher
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Giulia Tueur
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
| | - Nadia Vasquez
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
| | - Mélanie Da Costa
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
| | - Matthieu Duchmann
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Emmanuel Raffoux
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Lionel Adès
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Pierre Fenaux
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Jean Soulier
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Nicolas Duployez
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, Lille, France
| | - Emmanuelle Clappier
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
- INSERM U944/CNRS UMR7212, Paris, France
| | - Marie Sébert
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010, Paris, France.
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
- INSERM U944/CNRS UMR7212, Paris, France.
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4
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Urbino I, Lengliné E, Rabian F, Cerrano M, Kim R, Chevillon F, Ferrero D, Sébert M, Dhedin N, Itzykson RA, Adès L, Raffoux E, Dombret H, Audisio E, Clappier E, Boissel N. Blinatumomab Consolidation for Adult B-Cell Acute Lymphoblastic Leukemia in First and Second Complete Remission. Blood Adv 2024:bloodadvances.2023012139. [PMID: 38507689 DOI: 10.1182/bloodadvances.2023012139] [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: 11/08/2023] [Revised: 02/02/2024] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
| | | | | | - Marco Cerrano
- Department of Oncology, Division of Hematology, Presidio Molinette, AOU Città della Salute e della Scienza di Torino, Torino, Torino, Italy
| | - Rathana Kim
- Université Paris Cité - Hopital Saint-Louis APHP - INSERM U944, PARIS, France
| | - Florian Chevillon
- Department of Hematology, University Hospital Saint-Louis, AP-HP, Paris, France
| | | | | | | | | | - Lionel Adès
- AP-HP, Hôpital Saint Louis and University of Paris, and INSERM U944, Paris, France
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5
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Merz AMA, Sébert M, Sonntag J, Kubasch AS, Platzbecker U, Adès L. Phase to phase: Navigating drug combinations with hypomethylating agents in higher-risk MDS trials for optimal outcomes. Cancer Treat Rev 2024; 123:102673. [PMID: 38176221 DOI: 10.1016/j.ctrv.2023.102673] [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: 11/03/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/06/2024]
Abstract
Recent developments in high-risk Myelodysplastic Neoplasms (HR MDS) treatment are confronted with challenges in study design due to evolving drug combinations with Hypomethylating Agents (HMAs). The shift from the International Prognostic Scoring System (IPSS) to its molecular revision (IPSS-M) has notably influenced research and clinical practice. Introducing concepts like the MDS/AML overlap complicate classifications and including chronic myelomonocytic leukemia (CMML) in MDS studies introduces another layer of complexity. The International Consortium for MDS emphasizes aligning HR MDS criteria with the 2022 ELN criteria for AML. Differences in advancements between AML and MDS treatments and hematological toxicity in HR MDS underline the importance of detailed trial designs. Effective therapeutic strategies require accurate reporting of adverse events, highlighting the need for clarity in criteria like the Common Terminology Criteria for Adverse Events (CTCAE). We provide an overview on negative clinical trials in HR MDS, analyze possible reasons and explore possibilities to optimize future clinical trials in this challenging patient population.
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Affiliation(s)
- Almuth Maria Anni Merz
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany
| | - Marie Sébert
- Service Hématologie Séniors, Hôpital Saint-Louis (AP-HP), Paris Cité University and INSERM U944, Paris, France
| | - Jan Sonntag
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany
| | - Anne Sophie Kubasch
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy, Hemostaseology and Infectious Disease, University Hospital of Leipzig, Leipzig, Germany.
| | - Lionel Adès
- Service Hématologie Séniors, Hôpital Saint-Louis (AP-HP), Paris Cité University and INSERM U944, Paris, France.
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6
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Fandrei D, Huynh T, Sébert M, Aguinaga L, Bisio V, Kim R, Clappier E, Espéli M, Balabanian K, Moins-Teisserenc H, Toubert A, Dulphy N, Fenaux P, Adès L, Zhao LP. Lymphopenia confers poorer prognosis in Myelodysplastic Syndromes with very low and low IPSS-M. Blood Cancer J 2023; 13:193. [PMID: 38123548 PMCID: PMC10733334 DOI: 10.1038/s41408-023-00965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Affiliation(s)
- David Fandrei
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Tony Huynh
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
| | - Marie Sébert
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
- Université Paris Cité, INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France
| | - Lorea Aguinaga
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
| | - Valeria Bisio
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Rathana Kim
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Laboratoire d'Hématologie, Paris, France
| | - Emmanuelle Clappier
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Laboratoire d'Hématologie, Paris, France
| | - Marion Espéli
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Karl Balabanian
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | | | - Antoine Toubert
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Laboratoire d'Immunologie et Histocompatibilité, Paris, France
| | - Nicolas Dulphy
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Laboratoire d'Immunologie et Histocompatibilité, Paris, France
| | - Pierre Fenaux
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
- Université Paris Cité, INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France
| | - Lionel Adès
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
- Université Paris Cité, INSERM UMR 944, Institut de Recherche Saint-Louis, Paris, France
| | - Lin-Pierre Zhao
- Université Paris Cité, Assistance Publique des Hôpitaux de Paris (APHP) Nord, Hôpital Saint-Louis, Hématologie Seniors, Paris, France.
- Université Paris Cité, INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France.
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7
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Sébert M. Next-generation therapy for lower-risk MDS. Hematology Am Soc Hematol Educ Program 2023; 2023:59-64. [PMID: 38066862 PMCID: PMC10727062 DOI: 10.1182/hematology.2023000520] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Myelodysplastic syndromes (MDS) are malignant myeloid neoplasms characterized by ineffective clonal hematopoiesis leading to peripheral blood cytopenia and a variable risk of transformation to acute myeloid leukemia. In lower-risk (LR) MDS, as defined by prognostic scoring systems recently updated with the addition of a mutation profile, therapeutic options aim to reduce cytopenia, mainly anemia. Although options for reducing the transfusion burden have recently been improved, erythropoiesis-stimulating agents (ESAs), lenalidomide, hypomethylating agents, and, more recently, luspatercept have shown efficacy in rarely more than 50% of patients with a duration of response often far inferior to the patient's life expectancy. Nevertheless, several new therapies are currently under investigation aiming at improving cytopenia in patients with LR-MDS, mostly by targeting different biological pathways. Targeting ligands of the transforming growth factor β pathway has led to the approval of luspatercept in LR-MDS with ring sideroblasts or SF3B1 mutation, potentially replacing first-line ESAs in this population. Here, we also discuss the evolving standard of care for the treatment of LR-MDS and explore some of the most promising next-generation agents under investigation.
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Affiliation(s)
- Marie Sébert
- Saint-Louis Hospital (AP-HP) and Université de Paris Cité and INSERM U944, Paris, France
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8
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Socie G, Galimard JE, Raffoux E, Itzykson R, Debureaux PE, Michonneau D, Lengliné E, Robin M, De Fontbrune FS, Sébert M, Xhaard A, Kim R, Couprie A, Dhedin N, Dragani M, Lemaire P, Larcher L, Clappier E, Boissel N, Soulier J, Dombret H, Fenaux P, De Latour RP, Adès L. Allogeneic transplantation in acute myelogenous leukemia: a comprehensive single institution's experience. Haematologica 2023; 108:2369-2379. [PMID: 36951151 PMCID: PMC10483356 DOI: 10.3324/haematol.2023.282729] [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: 01/11/2023] [Accepted: 03/14/2023] [Indexed: 03/24/2023] Open
Abstract
Debates on the role and timing of allogeneic hemtopoietic stem cell transplantation (HSCT) in acute myelogenous leukemia (AML) have persisted for decades. Time to transplant introduces an immortal time and current treatment algorithm mainly relies on the European LeukemiaNet disease risk classification. Previous studies are also limited to age groups, remission status and other ill-defined parameters. We studied all patients at diagnosis irrespective of age and comorbidities to estimate the cumulative incidence and potential benefit or disadvantage of HSCT in a single center. As a time-dependent covariate, HSCT improved overall survival in intermediate- and poor-risk patients (hazard ratio =0.51; P=0.004). In goodrisk patients only eight were transplanted in first complete remission. Overall, the 4-year cumulative incidence of HSCT was only 21.9% but was higher (52.1%) for patients in the first age quartile (16-57 years old) and 26.4% in older patients (57-70 years old) (P<0.001). It was negligible in patients older than 70 years reflecting our own transplant policy but also barriers to transplantation (comorbidities and remission status). However, HSCT patients need to survive, be considered eligible both by the referring and the HSCT physicians and have a suitable donor to get transplantation. We, thus, comprehensively analyzed the complete decision-making and outcome of all our AML patients from diagnosis to last followup to decipher how patient allocation and therapy inform the value of HSCT. The role of HSCT in AML is shifting with broad access to different donors including haploidentical ones. Thus, it may (or may not) lead to increased numbers of allogeneic HSCT in AML in adults.
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Affiliation(s)
- Gerard Socie
- Université Paris Cité APHP, Hématologie Greffe, Hôpital Saint Louis; INSERM UMR 976, Hôpital Saint Louis.
| | | | - Emmanuel Raffoux
- Université Paris Cité APHP, Hématologie Adultes, Hôpital Saint Louis
| | - Raphael Itzykson
- Université Paris Cité APHP, Hématologie Adultes, Hôpital Saint Louis
| | | | - David Michonneau
- Université Paris Cité APHP, Hématologie Greffe, Hôpital Saint Louis; INSERM UMR 976, Hôpital Saint Louis
| | | | - Marie Robin
- APHP, Hématologie Greffe, Hôpital Saint Louis
| | | | | | | | - Rathana Kim
- APHP, Hématologie Séniors, Hôpital Saint Louis
| | | | - Nathalie Dhedin
- APHP, Hématologie Adolescents Jeunes Adultes, Hôpital Saint Louis
| | | | | | - Lise Larcher
- Université Paris Cité APHP, Laboratoire d'Hématologie, Hôpital Saint Louis
| | | | - Nicolas Boissel
- Université Paris Cité APHP, Hématologie Adolescents Jeunes Adultes, Hôpital Saint Louis
| | - Jean Soulier
- Université Paris Cité APHP, Laboratoire d'Hématologie, Hôpital Saint Louis
| | - Hervé Dombret
- Université Paris Cité APHP, Hématologie Adultes, Hôpital Saint Louis
| | - Pierre Fenaux
- Université Paris Cité APHP, Hématologie Séniors, Hôpital Saint Louis
| | | | - Lionel Adès
- Université Paris Cité APHP, Hématologie Séniors, Hôpital Saint Louis
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9
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Zhao LP, Sébert M, Mékinian A, Fain O, Espéli M, Balabanian K, Dulphy N, Adès L, Fenaux P. What role for somatic mutations in systemic inflammatory and autoimmune diseases associated with myelodysplastic neoplasms and chronic myelomonocytic leukemias? Leukemia 2023:10.1038/s41375-023-01890-4. [PMID: 37024519 DOI: 10.1038/s41375-023-01890-4] [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: 01/27/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/08/2023]
Affiliation(s)
- Lin-Pierre Zhao
- Université Paris Cité, APHP, Hôpital Saint-Louis, Hématologie Seniors, Paris, France.
- INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France.
| | - Marie Sébert
- Université Paris Cité, APHP, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
| | - Arsène Mékinian
- Sorbonne Université, APHP, Hôpital Saint-Antoine, service de Médecine Interne, Paris, France
| | - Olivier Fain
- Sorbonne Université, APHP, Hôpital Saint-Antoine, service de Médecine Interne, Paris, France
| | - Marion Espéli
- INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Karl Balabanian
- INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Nicolas Dulphy
- INSERM UMR 1160, Institut de Recherche Saint-Louis, Paris, France
| | - Lionel Adès
- Université Paris Cité, APHP, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
| | - Pierre Fenaux
- Université Paris Cité, APHP, Hôpital Saint-Louis, Hématologie Seniors, Paris, France
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10
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Cerrano M, Chevret S, Raffoux E, Rabian F, Sébert M, Valade S, Itzykson R, Lemiale V, Adès L, Boissel N, Dombret H, Azoulay E, Lengliné E. Benefits of dexamethasone on early outcomes in patients with acute myeloid leukemia with hyperleukocytosis: a propensity score matched analysis. Ann Hematol 2023; 102:761-768. [PMID: 36773040 PMCID: PMC9919741 DOI: 10.1007/s00277-023-05119-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/31/2023] [Indexed: 02/12/2023]
Abstract
Hyperleukocytosis is associated with a significant early mortality rate in patients with acute myeloid leukemia (AML). To date, no controlled trial has ever evaluated a strategy to reduce this risk, and the initial management of these patients remains heterogeneous worldwide. The aim of the present study was to evaluate the influence of a short course of intravenous dexamethasone on the early outcomes of patients with hyperleukocytic AML with white blood cell (WBC) count above 50 × 109/L. Clinical and biological data of all consecutive patients (1997-2017) eligible for intensive chemotherapy from a single center were retrospectively collected. A total of 251 patients with a median age of 51 years and a median WBC count of 120 × 109/L were included, 95 of whom received dexamethasone. Patients treated with dexamethasone had higher WBC count and a more severe disease compared with those who did not, and they presented more often with leukostasis and hypoxemia, resulting in a more frequent need for life-sustaining therapies (p < 0.001). To account for these imbalances, patients were compared after adjusting for a propensity score, which included all variables with a prognostic influence in the overall cohort. In the matched cohort, dexamethasone was associated with lower early death (OR = 0.34, p = 0.0026) and induction failure rate (OR = 0.44, p = 0.02) and better overall survival (HR = 0.60, p = 0.011), with no impact on relapse risk (cHR = 0.73, p = 0.39). The overall survival benefit was confirmed among all tested subgroups. This study suggests that dexamethasone administration is safe and associated with a lower risk of induction mortality in patients with hyperleukocytic AML and deserves prospective evaluation.
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Affiliation(s)
- Marco Cerrano
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France.,Department of Oncology, Division of Haematology, AOU Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Sylvie Chevret
- Service de Biostatistique Et Information Médicale, Hôpital Saint-Louis, Paris, France
| | - Emmanuel Raffoux
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France
| | - Florence Rabian
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France
| | - Marie Sébert
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France.,INSERM U944, Université de Paris, Paris, France
| | - Sandrine Valade
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Raphael Itzykson
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France.,INSERM U944, Université de Paris, Paris, France
| | - Virginie Lemiale
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Lionel Adès
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France.,INSERM U944, Université de Paris, Paris, France
| | - Nicolas Boissel
- Hématologie Adolescents Et Jeunes Adultes, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Hervé Dombret
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France.,INSERM U944, Université de Paris, Paris, France
| | - Elie Azoulay
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Etienne Lengliné
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, 1 Avenue Claude Vellefaux 75010, Paris, France.
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11
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Duployez N, Largeaud L, Duchmann M, Kim R, Rieunier J, Lambert J, Bidet A, Larcher L, Lemoine J, Delhommeau F, Hirsch P, Fenwarth L, Kosmider O, Decroocq J, Bouvier A, Le Bris Y, Ochmann M, Santagostino A, Adès L, Fenaux P, Thomas X, Micol JB, Gardin C, Itzykson R, Soulier J, Clappier E, Recher C, Preudhomme C, Pigneux A, Dombret H, Delabesse E, Sébert M. Prognostic impact of DDX41 germline mutations in intensively treated acute myeloid leukemia patients: an ALFA-FILO study. Blood 2022; 140:756-768. [PMID: 35443031 PMCID: PMC9389637 DOI: 10.1182/blood.2021015328] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/01/2022] [Indexed: 11/20/2022] Open
Abstract
DDX41 germline mutations (DDX41MutGL) are the most common genetic predisposition to myelodysplastic syndrome and acute myeloid leukemia (AML). Recent reports suggest that DDX41MutGL myeloid malignancies could be considered as a distinct entity, even if their specific presentation and outcome remain to be defined. We describe here the clinical and biological features of 191 patients with DDX41MutGL AML. Baseline characteristics and outcome of 86 of these patients, treated with intensive chemotherapy in 5 prospective Acute Leukemia French Association/French Innovative Leukemia Organization trials, were compared with those of 1604 patients with DDX41 wild-type (DDX41WT) AML, representing a prevalence of 5%. Patients with DDX41MutGL AML were mostly male (75%), in their seventh decade, and with low leukocyte count (median, 2 × 109/L), low bone marrow blast infiltration (median, 33%), normal cytogenetics (75%), and few additional somatic mutations (median, 2). A second somatic DDX41 mutation (DDX41MutSom) was found in 82% of patients, and clonal architecture inference suggested that it could be the main driver for AML progression. DDX41MutGL patients displayed higher complete remission rates (94% vs 69%; P < .0001) and longer restricted mean overall survival censored at hematopoietic stem cell transplantation (HSCT) than 2017 European LeukemiaNet intermediate/adverse (Int/Adv) DDX41WT patients (5-year difference in restricted mean survival times, 13.6 months; P < .001). Relapse rates censored at HSCT were lower at 1 year in DDX41MutGL patients (15% vs 44%) but later increased to be similar to Int/Adv DDX41WT patients at 3 years (82% vs 75%). HSCT in first complete remission was associated with prolonged relapse-free survival (hazard ratio, 0.43; 95% confidence interval, 0.21-0.88; P = .02) but not with longer overall survival (hazard ratio, 0.77; 95% confidence interval, 0.35-1.68; P = .5).
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Affiliation(s)
- Nicolas Duployez
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | - Laëtitia Largeaud
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Matthieu Duchmann
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Rathana Kim
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Julie Rieunier
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | | | - Audrey Bidet
- Hematology Laboratory, CHU de Bordeaux, Bordeaux, France
| | - Lise Larcher
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean Lemoine
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - François Delhommeau
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Laboratoire d'hématologie biologique, Hôpital Saint-Antoine, Paris, France
| | - Pierre Hirsch
- Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, Laboratoire d'hématologie biologique, Hôpital Saint-Antoine, Paris, France
| | - Laurène Fenwarth
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | | | | | - Anne Bouvier
- Hematology Laboratory, CHU Angers, Angers, France
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital, Nantes, France
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | | | | | - Lionel Adès
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Pierre Fenaux
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Xavier Thomas
- Hematology Department, Hospices Civils de Lyon, Lyon-Sud Hospital, Lyon, France
| | - Jean-Baptiste Micol
- Hematology Department, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Claude Gardin
- Hematology Department, Avicenne Hospital, AP-HP, Bobigny, France
- Unité 3518, Saint-Louis Institute for Research, Université de Paris, Paris, France
| | - Raphael Itzykson
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
| | - Jean Soulier
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Emmanuelle Clappier
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Laboratory, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France; and
| | - Claude Preudhomme
- Hematology Laboratory, Unité 1277-Cancer Heterogeneity Plasticity and Resistance to Therapies (CANTHER), Centre Hospitalier Universitaire (CHU) de Lille, University of Lille, INSERM, Lille, France
| | - Arnaud Pigneux
- Hematology Department, CHU de Bordeaux, Bordeaux, France
| | - Hervé Dombret
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
- Unité 3518, Saint-Louis Institute for Research, Université de Paris, Paris, France
| | - Eric Delabesse
- Hematology Laboratory, CHU de Toulouse-Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Marie Sébert
- Université de Paris, Unité 944/7212-GenCellDi, INSERM and Centre National de la Recherche Scientifique (CNRS), Paris, France
- Hematology Department, Saint Louis Hospital, AP-HP, Paris, France
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12
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Fodil S, Chevret S, Rouzaud C, Valade S, Rabian F, Mariotte E, Raffoux E, Itzykson R, Boissel N, Sébert M, Adès L, Zafrani L, Azoulay E, Lengliné E. Post-remission outcomes in AML patients with high hyperleukocytosis and inaugural life-threatening complications. PLoS One 2022; 17:e0270744. [PMID: 35797337 PMCID: PMC9262217 DOI: 10.1371/journal.pone.0270744] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/16/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Patients with hyperleukocytic (HL) acute myeloid leukemia (AML) are at higher risk of early death. Initial management of these patients is challenging, not fully codified and heterogenous. Retrospective studies showed that several symptomatic measures might decrease early death rate but long-term data are scarce. We aimed to analyze whether the therapeutic measures carried out urgently at diagnosis may influence the outcome among HL AML patients having achieved who survived inaugural complications. Methods We retrospectively reviewed all medical charts from patients admitted to Saint-Louis Hospital between January, 1st 1997 and December, 31st 2018 with newly diagnosed AML and white blood cell (WBC) count above 50x109/L. Outcome measures were cumulative incidence of relapse (CIR), treatment-related mortality (TRM) defined as relapse-free death, and overall survival. Univariate and multivariate analyses were performed using Cox proportional hazards models. Results A total of 184 patients with HL AML in complete remission (CR) were included in this study. At 2 years after CR. 62.5% of patients were alive, at 5 years, cumulated incidence of relapse was 55.8%. We found that every therapeutic measure, including life-sustaining therapies carried out in the initial phase of the disease, did not increase the relapse risk. The use of hydroxyurea for more than 4 days was associated with a higher risk of relapse. At the end of the study, 94 patients (51.1%) were still alive including 23 patients out of 44 aged less than 60 yo that were able to return to work. Conclusion We show that the use of emergency measures including life sustaining therapies does not come at the expense of a higher risk of relapse or mortality, except in the case of prolonged use of hydroxyurea. Patients with HL AML should be able to benefit from all available techniques, regardless of their initial severity.
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Affiliation(s)
- Sofiane Fodil
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
- Sorbonne Université, Paris, France
| | - Sylvie Chevret
- Service de Biostatistique et Information Médicale, Hôpital Saint-Louis, Paris, France
| | - Camille Rouzaud
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Sandrine Valade
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Florence Rabian
- Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Eric Mariotte
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Emmanuel Raffoux
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Raphael Itzykson
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Nicolas Boissel
- Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Marie Sébert
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
- Université de Paris and INSERM U944, Paris, France
| | - Lionel Adès
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
- Université de Paris and INSERM U944, Paris, France
| | - Lara Zafrani
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Elie Azoulay
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Etienne Lengliné
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
- * E-mail:
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13
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Delplanque M, Aouba A, Hirsch P, Fenaux P, Graveleau J, Malard F, Roos-Weil D, Belfeki N, Drevon L, Oganesyan A, Groh M, Mahévas M, Razanamahery J, Maigne G, Décamp M, Miranda S, Quemeneur T, Rossignol J, Sailler L, Sébert M, Terriou L, Sevoyan A, Hakobyan Y, Georgin-Lavialle S, Mekinian A. USAID Associated with Myeloid Neoplasm and VEXAS Syndrome: Two Differential Diagnoses of Suspected Adult Onset Still's Disease in Elderly Patients. J Clin Med 2021; 10:jcm10235586. [PMID: 34884286 PMCID: PMC8658409 DOI: 10.3390/jcm10235586] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 09/30/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Patients with solid cancers and hematopoietic malignancy can experience systemic symptoms compatible with adult-onset Still’s disease (AOSD). The newly described VEXAS, associated with somatic UBA1 mutations, exhibits an overlap of clinical and/or biological pictures with auto inflammatory signs and myelodysplastic syndrome (MDS). Objectives: To describe a cohort of patients with signs of undifferentiated systemic autoinflammatory disorder (USAID) concordant with AOSD and MDS/chronic myelomonocytic leukemia (CMML) and the prevalence of VEXAS proposed management and outcome. Methods: A French multicenter retrospective study from the MINHEMON study group also used for other published works with the support of multidisciplinary and complementary networks of physicians and a control group of 104 MDS/CMML. Results: Twenty-six patients were included with a median age at first signs of USAID of 70.5 years with male predominance (4:1). Five patients met the criteria for confirmed AOSD. The most frequent subtypes were MDS with a blast excess (31%) and MDS with multilineage dysplasia (18%). Seven patients presented with acute myeloid leukemia and twelve died during a median follow-up of 2.5 years. Six out of 18 tested patients displayed a somatic UBA1 mutation concordant with VEXAS, including one woman. High-dose corticosteroids led to a response in 13/16 cases and targeted biological therapy alone or in association in 10/12 patients (anakinra, tocilizumab, and infliximab). Azacytidine resulted in complete or partial response in systemic symptoms for 10/12 (83%) patients including 3 VEXAS. Conclusions: Systemic form of VEXAS syndrome can mimic AOSD. The suspicion of USAID or AOSD in older males with atypia should prompt an evaluation of underlying MDS and assessment of somatic UBA1 mutation.
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Affiliation(s)
- Marion Delplanque
- Service de Médecine Interne, Centre de Référence des Maladies Autoinflammatoires et des Amyloses (CEREMAIA), AP-HP, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (M.D.); (S.G.-L.)
| | - Achille Aouba
- Service de Médecine Interne, CHU de Caen, Hôpital de la Côte de Nacre, 14033 Caen, France; (A.A.); (G.M.)
| | - Pierre Hirsch
- Service d’Hématologie Biologique, INSERM, Centre de Recherche Saint-Antoine, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, 75012 Paris, France; (P.H.); (F.M.); (L.D.)
| | - Pierre Fenaux
- Service d’Hématologie Seniors, AP-HP, Hôpital Saint-Louis, 75010 Paris, France; (P.F.); (M.S.)
| | - Julie Graveleau
- Service de Médecine Interne, Centre Hospitalier Georges Charpak, 44600 Saint Nazaire, France;
| | - Florent Malard
- Service d’Hématologie Biologique, INSERM, Centre de Recherche Saint-Antoine, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, 75012 Paris, France; (P.H.); (F.M.); (L.D.)
| | - Damien Roos-Weil
- Service d’Hématologie, AP-HP, Hôpital Pitié Salpêtrière, 75013 Paris, France;
| | - Nabil Belfeki
- Service de Médecine Interne, Centre Hospitalier Marc Jacquet, 77000 Melun, France;
| | - Louis Drevon
- Service d’Hématologie Biologique, INSERM, Centre de Recherche Saint-Antoine, AP-HP, Hôpital Saint-Antoine, Sorbonne Université, 75012 Paris, France; (P.H.); (F.M.); (L.D.)
| | - Artem Oganesyan
- Department of Hematology and Transfusion Medicine, National Institute of Health, Yerevan 0051, Armenia; (A.O.); (A.S.); (Y.H.)
| | - Matthieu Groh
- Service de Médecine Interne, Hôpital Foch, 92150 Suresnes, France;
| | - Matthieu Mahévas
- Service de Médecine Interne, CHU Hôpital Henri Mondor, 94000 Créteil, France;
| | | | - Gwenola Maigne
- Service de Médecine Interne, CHU de Caen, Hôpital de la Côte de Nacre, 14033 Caen, France; (A.A.); (G.M.)
| | - Matthieu Décamp
- Laboratoire de Génétique CHU de Caen, Hôpital de la Côte de Nacre, 14000 Care, France;
| | - Sébastien Miranda
- Service de Médecine Interne, CHU Hôpital Charles Nicolle, 76000 Rouen, France;
| | - Thomas Quemeneur
- Service de Médecine Interne, CH de Valenciennes, 59300 Valenciennes, France;
| | - Julien Rossignol
- Service d’Hématologie Adultes, AP-HP, Hôpital Necker-Enfants Malades, 75015 Paris, France;
| | - Laurent Sailler
- Service de Médecine Interne, CHU Hôpital Purpan, 31059 Toulouse, France;
| | - Marie Sébert
- Service d’Hématologie Seniors, AP-HP, Hôpital Saint-Louis, 75010 Paris, France; (P.F.); (M.S.)
| | - Louis Terriou
- Service de Médecine Interne, CHR Lille, Sorbonne Université, 75005 Paris, France;
| | - Anna Sevoyan
- Department of Hematology and Transfusion Medicine, National Institute of Health, Yerevan 0051, Armenia; (A.O.); (A.S.); (Y.H.)
| | - Yervand Hakobyan
- Department of Hematology and Transfusion Medicine, National Institute of Health, Yerevan 0051, Armenia; (A.O.); (A.S.); (Y.H.)
| | - Sophie Georgin-Lavialle
- Service de Médecine Interne, Centre de Référence des Maladies Autoinflammatoires et des Amyloses (CEREMAIA), AP-HP, Hôpital Tenon, Sorbonne Université, 75020 Paris, France; (M.D.); (S.G.-L.)
| | - Arsène Mekinian
- Service de Médecine Interne, AP-HP, Hôpital Saint Antoine, Sorbonne Université, 75012 Paris, France
- Correspondence: ; Tel.: +33-1-49-28-23-92; Fax: +33-1-49-28-28-85
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14
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Zakine E, Schell B, Battistella M, Vignon-Pennamen MD, Chasset F, Mahévas T, Cordoliani F, Adès L, Sébert M, Delaleu J, Jachiet M, Lepelletier C, Lemaire P, Chauvel C, Dhouaieb B, Kim R, Cassius C, Georgin-Lavialle S, Mekinian A, Bagot M, Braun T, Rousset L, Begon E, de Masson A, Fenaux P, Clappier E, Bouaziz JD. UBA1 Variations in Neutrophilic Dermatosis Skin Lesions of Patients With VEXAS Syndrome. JAMA Dermatol 2021; 157:1349-1354. [PMID: 34495287 DOI: 10.1001/jamadermatol.2021.3344] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Importance VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) is a recently described severe adult-onset autoinflammatory disease that is associated with myeloid lineage-restricted ubiquitin-activating enzyme 1 (UBA1) somatic variations that primarily affect the skin (Sweet syndrome), cartilage, and bone marrow. Skin symptoms have been poorly described. Objective To better describe clinical and pathological skin manifestations and their pathophysiology in VEXAS syndrome. Design, Setting, and Participants This multicenter retrospective case series study of clinical and histological features of 8 patients with VEXAS syndrome and skin involvement was conducted in France from December 2007 to March 2021, with molecular data obtained from March to April 2022. Any UBA1 variations were detected by Sanger or next-generation sequencing that was performed on bone marrow and formalin-fixed paraffin-embedded tissue sections of skin lesion biopsies. Results All 8 patients were men, and the median age at symptom onset was 65.5 years (interquartile range, 54-76 years). All patients had neutrophilic dermatosis skin lesions, including tender red or violaceous papules, sometimes edematous, without fever, arthralgia, recurrence or pathergy, inflammatory edematous papules on the neck and trunk (sometimes umbilicated), and firm erythematous purpuric or pigmented infiltrated plaques and nodules. Three patients had livedo racemosa. The infiltrates were perivascular and consisted of mature neutrophils with leukocytoclasia, which were admixed with myeloperoxidase-positive CD163-positive myeloid cells with indented nuclei and lymphoid cells in all cases. A sequencing analysis of paired bone marrow samples and skin lesion biopsies identified the same loss-of-function UBA1 variation in both samples for all patients. Conclusions and Relevance This case series study describes the different clinical presentations of skin lesions found in VEXAS syndrome, which is characterized histologically by neutrophilic dermatosis. The findings suggested that the dermal infiltrates seen in VEXAS skin lesions are derived from the pathological myeloid clone. This suggests that using therapies that target the pathological clone may be effective in the long-term management of the disease.
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Affiliation(s)
- Eve Zakine
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | - Bérénice Schell
- Université de Paris, Paris, France.,Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maxime Battistella
- Université de Paris, Paris, France.,Pathology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - François Chasset
- Dermatology Department, Sorbonne Université and Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thibault Mahévas
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Florence Cordoliani
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Lionel Adès
- Hematology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Sébert
- Hematology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jérémie Delaleu
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie Jachiet
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Clémence Lepelletier
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Lemaire
- Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Clémentine Chauvel
- Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bedis Dhouaieb
- Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rathana Kim
- Université de Paris, Paris, France.,Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles Cassius
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | - Sophie Georgin-Lavialle
- Sorbonne University, Internal Medicine Department and Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Arsène Mekinian
- Internal Medicine Department, Hôpital Saint Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Martine Bagot
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | - Thorsten Braun
- Hematology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Laurie Rousset
- Dermatology Department, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France
| | - Edouard Begon
- Dermatology Department, Hôpital René Dubos, Pontoise, France
| | - Adèle de Masson
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
| | - Pierre Fenaux
- Hematology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuelle Clappier
- Université de Paris, Paris, France.,Hematology Laboratory, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-David Bouaziz
- Dermatology Department, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université de Paris, Paris, France
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15
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Del Galy AS, Marouf A, Raffoux E, Robin M, Michonneau D, Sébert M, Sicre de Fontebrune F, Xhaard A, Lengline E, Itzykson R, Frieri C, Dombret H, Fenaux P, Peffault de Latour R, Adès L, Socié G. Allogeneic hematopoietic stem cell transplantation in elderly patients with acute myeloid leukemia or myelodysplastic syndromes: myth and reality. Leukemia 2020; 35:225-228. [PMID: 32733010 DOI: 10.1038/s41375-020-1004-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/16/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022]
Affiliation(s)
- A Sutra Del Galy
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France.,University of Paris, Paris, France
| | - A Marouf
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France
| | - E Raffoux
- Adult Hematology, AP-HP Hospital St Louis, Paris, France
| | - M Robin
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France
| | - D Michonneau
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France.,University of Paris, Paris, France.,INSERM UMR 976, Paris, France
| | - M Sébert
- Hematology Senior, AP-HP Hospital St Louis, Paris, France
| | | | - A Xhaard
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France
| | - E Lengline
- Adult Hematology, AP-HP Hospital St Louis, Paris, France
| | - R Itzykson
- University of Paris, Paris, France.,Adult Hematology, AP-HP Hospital St Louis, Paris, France
| | - C Frieri
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France.,University of Paris, Paris, France
| | - H Dombret
- University of Paris, Paris, France.,Adult Hematology, AP-HP Hospital St Louis, Paris, France
| | - P Fenaux
- University of Paris, Paris, France.,Hematology Senior, AP-HP Hospital St Louis, Paris, France
| | - R Peffault de Latour
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France.,University of Paris, Paris, France
| | - L Adès
- University of Paris, Paris, France.,Hematology Senior, AP-HP Hospital St Louis, Paris, France
| | - G Socié
- Hematology-Transplantation, AP-HP Hospital St Louis, Paris, France. .,University of Paris, Paris, France. .,INSERM UMR 976, Paris, France.
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16
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Cerrano M, Seegers V, Raffoux E, Rabian F, Sébert M, Itzykson R, Lemiale V, Adès L, Boissel N, Dombret H, Azoulay E, Lengliné E. Predictors and outcomes associated with hydroxyurea sensitivity in acute myeloid leukemia patients with high hyperleukocytosis. Leuk Lymphoma 2019; 61:737-740. [PMID: 31710255 DOI: 10.1080/10428194.2019.1683735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Marco Cerrano
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France.,Department of Oncology, Division of Hematology, AOU Città Della Salute e Della Scienza di Torino, Turin, Italy
| | - Valérie Seegers
- Institut de Cancérologie de l'Ouest - Paul Papin, Direction de la Recherche clinique et de l'innovation, Angers, France
| | - Emmanuel Raffoux
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Florence Rabian
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Marie Sébert
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Raphael Itzykson
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Virginie Lemiale
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Lionel Adès
- Hématologie Seniors, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Nicolas Boissel
- Hématologie Adolescents et Jeunes Adultes, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Hervé Dombret
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Elie Azoulay
- Medical Intensive Care Unit, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
| | - Etienne Lengliné
- Hématologie Adulte, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
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17
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Adès L, Sébert M, Fenaux P. Non-allogeneic immunotherapy in acute myeloid leukaemia. Lancet Haematol 2019; 6:e443-e444. [PMID: 31400960 DOI: 10.1016/s2352-3026(19)30159-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 06/20/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Lionel Adès
- Hôpital Saint Louis, Assistance publique Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U944, Paris, France.
| | - Marie Sébert
- Hôpital Saint Louis, Assistance publique Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U944, Paris, France
| | - Pierre Fenaux
- Hôpital Saint Louis, Assistance publique Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U944, Paris, France
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18
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Sébert M, Renneville A, Bally C, Peterlin P, Beyne-Rauzy O, Legros L, Gourin MP, Sanhes L, Wattel E, Gyan E, Park S, Stamatoullas A, Banos A, Laribi K, Jueliger S, Bevan L, Chermat F, Sapena R, Nibourel O, Chaffaut C, Chevret S, Preudhomme C, Adès L, Fenaux P. A phase II study of guadecitabine in higher-risk myelodysplastic syndrome and low blast count acute myeloid leukemia after azacitidine failure. Haematologica 2019; 104:1565-1571. [PMID: 30733271 PMCID: PMC6669173 DOI: 10.3324/haematol.2018.207118] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 10/05/2018] [Accepted: 02/07/2019] [Indexed: 11/22/2022] Open
Abstract
High-risk myelodysplastic syndrome/acute myeloid leukemia patients have a very poor survival after azacitidine failure. Guadecitabine (SGI-110) is a novel subcutaneous hypomethylating agent which results in extended decitabine exposure. This multicenter phase II study evaluated the efficacy and safety of guadecitabine in high-risk myelodysplastic syndrome and low blast count acute myeloid leukemia patients refractory or relapsing after azacitidine. We included 56 patients with a median age of 75 years [Interquartile Range (IQR) 69-76]. Fifty-five patients received at least one cycle of guadecitabine (60 mg/m2/d subcutaneously days 1-5 per 28-day treatment cycles), with a median of 3 cycles (range, 0-27). Eight (14.3%) patients responded, including two complete responses; median response duration was 11.5 months. Having no or few identified somatic mutations was the only factor predicting response (P=0.035). None of the 11 patients with TP53 mutation responded. Median overall survival was 7.1 months, and 17.9 months in responders (3 of whom had overall survival >2 years). In multivariate analysis, IPSS-R (revised International Prognostic Scoring System) score other than very high (P=0.03) primary versus secondary azacitidine failure (P=0.01) and a high rate of demethylation in blood during the first cycle of treatment (P=0.03) were associated with longer survival. Thus, guadecitabine can be effective, sometimes yielding relatively prolonged survival, in a small proportion of high-risk myelodysplastic syndrome/low blast count acute myeloid leukemia patients who failed azacitidine. (Trial registered at clinicaltrials.gov identifier: 02197676)
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Affiliation(s)
- Marie Sébert
- Groupe Francophone des Myélodysplasies, Paris, France.,Hématologie Clinique, Hôpital Saint Louis, Paris, France
| | | | - Cécile Bally
- Hématologie Clinique, Hôpital Saint Louis, Paris, France
| | - Pierre Peterlin
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU de Nantes, France
| | - Odile Beyne-Rauzy
- Groupe Francophone des Myélodysplasies, Paris, France.,IUCT ONCOPOLE Toulouse, France
| | - Laurence Legros
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU de Nice, France
| | - Marie-Pierre Gourin
- Groupe Francophone des Myélodysplasies, Paris, France.,CHRU de Limoges, France
| | - Laurence Sanhes
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU de Perpignan, France
| | - Eric Wattel
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU Lyon Sud, Lyon, France
| | - Emmanuel Gyan
- Groupe Francophone des Myélodysplasies, Paris, France.,CHRU de Tours, France
| | - Sophie Park
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU de Grenoble, France
| | - Aspasia Stamatoullas
- Groupe Francophone des Myélodysplasies, Paris, France.,Centre Henri Becquerel, Rouen, France
| | - Anne Banos
- Groupe Francophone des Myélodysplasies, Paris, France.,CH de la Côte Basque, France
| | - Kamel Laribi
- Groupe Francophone des Myélodysplasies, Paris, France.,CHU Côte de Nacre, Caen, France
| | | | - Luke Bevan
- Astex Pharmaceuticals Inc., Cambridge, UK
| | | | - Rosa Sapena
- Groupe Francophone des Myélodysplasies, Paris, France
| | | | - Cendrine Chaffaut
- Service de Biostatistiques, Hôpital Saint-Louis, APHP, Paris, France
| | - Sylvie Chevret
- Service de Biostatistiques, Hôpital Saint-Louis, APHP, Paris, France
| | | | - Lionel Adès
- Groupe Francophone des Myélodysplasies, Paris, France.,Hématologie Clinique, Hôpital Saint Louis, Paris, France
| | - Pierre Fenaux
- Groupe Francophone des Myélodysplasies, Paris, France .,Hématologie Clinique, Hôpital Saint Louis, Paris, France
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19
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Sébert M, Komrokji RS, Sekeres MA, Prebet T, Cluzeau T, Santini V, Gyan E, Sanna A, Ali NHA, Hobson S, Eclache V, List A, Fenaux P, Adès L. Impact of baseline cytogenetic findings and cytogenetic response on outcome of high-risk myelodysplastic syndromes and low blast count AML treated with azacitidine. Leuk Res 2017; 63:72-77. [DOI: 10.1016/j.leukres.2017.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/06/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
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20
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Duchmann M, Braun T, Micol J, Platzbecker U, Park S, Pilorge S, Beyne-Rauzy O, Vey N, Sébert M, Gruson B, Dumas P, Guieze R, Chretien M, Laribi K, Chait Y, Legros L, Hirsch P, Solary E, Fenaux P, Itzykson R. A Retrospective Validation of International Consortium for MDS/MPN Response Criteria in CMML Treated with Hypomethylating Agents. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30157-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Bigenwald C, Harel S, Chevignon F, Roos-Weil D, Bernard OA, Amorim S, Brice P, Adès L, Nloga AM, Sébert M, Braun T, Eclache V, Thieblemont C, Fenaux P. Are myelodysplastic syndromes and acute myeloid leukaemia occurring during the course of lymphoma always therapy related? Br J Haematol 2016; 180:304-308. [DOI: 10.1111/bjh.14323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Camille Bigenwald
- Onco-Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Stéphanie Harel
- Onco-Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Florian Chevignon
- Haematology Department; Hôpital Avicenne; Paris 13 university; Paris France
| | | | | | - Sandy Amorim
- Onco-Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Pauline Brice
- Onco-Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Lionel Adès
- Senior Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Anne Marie Nloga
- Senior Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Marie Sébert
- Senior Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
| | - Thorsten Braun
- Haematology Department; Hôpital Avicenne; Paris 13 university; Paris France
| | - Virginie Eclache
- Haematology Biology Department; Hôpital Avicenne; Paris 13 university; Paris France
| | | | - Pierre Fenaux
- Senior Haematology Department; Hôpital Saint Louis; Paris 7 university; Paris France
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22
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Gyan E, Andrieu V, Sanna A, Caille A, Schemenau J, Sudaka I, Siguret V, Malet M, Park S, Bordessoule D, Mairesse J, Gelsi-Boyer V, Cheze S, Beyne-Rauzy O, Sébert M, Sapena R, Zerazhi H, Legros L, Guerci-Bresler A, Amé SN, Germing U, Santini V, Salvi F, Gioia D, Lunghi M, Dreyfus F, Fenaux P. Myelodysplastic syndromes with single neutropenia or thrombocytopenia are rarely refractory cytopenias with unilineage dysplasia by World Health Organization 2008 criteria and have favourable prognosis. Br J Haematol 2016; 175:975-979. [DOI: 10.1111/bjh.13902] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Emmanuel Gyan
- Service d'hématologie et thérapie cellulaire; CHU de Tours; Tours France
- Faculté de Médecine; Université François-Rabelais; UMR CNRS 7292; Tours France
| | - Valérie Andrieu
- Département Hématologie et Immunologie; Hôpital Bichat; Assistance Publique-Hôpitaux de Paris (AP-HP); Paris 7 University; Paris France
| | - Alessandro Sanna
- Unità Funzionale di Ematologia; Università degli Studi di Firenze; AOU Careggi; Florence Italy
| | - Agnès Caille
- INSERM; CIC 1415; Tours France
- Université François-Rabelais de Tours; PRES Centre-Val de Loire Université; Tours France
- CHU de Tours; Tours France
| | - Jennifer Schemenau
- Department of Haematology, Oncology and Clinical Immunology; Medical Faculty; University of Düsseldorf; Düsseldorf Germany
| | - Isabelle Sudaka
- Laboratoire d'hématologie; CHU de Nice; Hospital Cimiez; Nice France
| | - Virginie Siguret
- Hématologie biologique - Hémostase - Thrombose; Hôpital Lariboisière; INSERM UMR-S-1140; AP-HP; Paris France
| | - Michèle Malet
- Service d'hématologie biologique; CHU de Caen; Caen France
| | - Sophie Park
- Service d'hématologie; Centre Hospitalier Universitaire; Grenoble France
| | | | - Jacques Mairesse
- Clinique Saint Pierre d'Ottignies; Service de Biopathologie; Ottignies Belgium
| | | | - Stéphane Cheze
- Service d'hématologie; Centre Hospitalier Universitaire; Caen France
| | - Odile Beyne-Rauzy
- Service de Médecine Interne; Centre hospitalier universitaire; Toulouse France
| | - Marie Sébert
- Service d'Hématologie clinique; Hôpital Saint-Louis; Assistance Publique Hôpitaux de Paris (APHP); Paris 7 University; Paris France
| | - Rosa Sapena
- Groupe Francophone des Myélodysplasies; Hôpital Saint-Louis; AP-HP; Paris France
| | - Hacene Zerazhi
- Service d'onco-hématologie; Centre Hospitalier; Avignon France
| | - Laurence Legros
- Service d'hématologie clinique; Centre Hospitalier Universitaire; Nice France
| | | | - Shanti Natarjan Amé
- Département d'Hématologie et d'Oncologie; Centre Hospitalier Universitaire; Strasbourg France
| | - Ulrich Germing
- Department of Haematology, Oncology and Clinical Immunology; Medical Faculty; University of Düsseldorf; Düsseldorf Germany
| | - Valeria Santini
- Unità Funzionale di Ematologia; Università degli Studi di Firenze; AOU Careggi; Florence Italy
| | - Flavia Salvi
- Haematology Unit; SS. Antonio e Biagio e Cesare Arrigo Hospital; Alessandria Italy
| | - Daniela Gioia
- Fondazione Italiana Sindromi Mielodisplastiche (FISM) Onlus; Alessandria Italy
| | - Monia Lunghi
- Haematology; AOU Maggiore della Carità; Novara Italy
| | - François Dreyfus
- Service d'hématologie; Hôpital Cochin; AP-HP; Université Paris 5; Paris France
| | - Pierre Fenaux
- Service d'Hématologie clinique; Hôpital Saint-Louis; Assistance Publique Hôpitaux de Paris (APHP); Paris 7 University; Paris France
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23
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Boehrer S, Galluzzi L, Lainey E, Bouteloup C, Tailler M, Harper F, Pierron G, Adès L, Thépot S, Sébert M, Gardin C, de Botton S, Fenaux P, Kroemer G. Erlotinib antagonizes constitutive activation of SRC family kinases and mTOR in acute myeloid leukemia. Cell Cycle 2014; 10:3168-75. [DOI: 10.4161/cc.10.18.16599] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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24
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Lainey E, Sébert M, Thépot S, Scoazec M, Bouteloup C, Leroy C, De Botton S, Galluzzi L, Fenaux P, Kroemer G. Erlotinib antagonizes ABC transporters in acute myeloid leukemia. Cell Cycle 2012; 11:4079-92. [PMID: 23095522 DOI: 10.4161/cc.22382] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Erlotinib was originally developed as an epidermal growth factor receptor (EGFR)-specific inhibitor for the treatment of solid malignancies, yet also exerts significant EGFR-independent antileukemic effects in vitro and in vivo. The molecular mechanisms underlying the clinical antileukemic activity of erlotinib as a standalone agent have not yet been precisely elucidated. Conversely, in preclinical settings, erlotinib has been shown to inhibit the constitutive activation of SRC kinases and mTOR, as well as to synergize with the DNA methyltransferase inhibitor azacytidine (a reference therapeutic for a subset of leukemia patients) by promoting its intracellular accumulation. Here, we show that both erlotinib and gefitinib (another EGFR inhibitor) inhibit transmembrane transporters of the ATP-binding cassette (ABC) family, including P-glycoprotein (P-gp), multidrug resistance-associated proteins (MRPs) and breast cancer resistance protein (BCRP), also in acute myeloid leukemia (AML) cells that do not overexpress these pumps. Thus, inhibition of drug efflux by erlotinib and gefitinib selectively exacerbated (in a synergistic or additive fashion) the cytotoxic response of KG-1 cells to chemotherapeutic agents that are normally extruded by ABC transporters (e.g., doxorubicin and etoposide). Erlotinib limited drug export via ABC transporters by multiple mechanisms, including the downregulation of surface-exposed pumps and the modulation of their ATPase activity. The effects of erlotinib on drug efflux and its chemosensitization profile persisted in patient-derived CD34+ cells, suggesting that erlotinib might be particularly efficient in antagonizing leukemic (stem cell) subpopulations, irrespective of whether they exhibit or not increased drug efflux via ABC transporters.
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25
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Lainey E, Thépot S, Bouteloup C, Sébert M, Adès L, Tailler M, Gardin C, de Botton S, Baruchel A, Fenaux P, Kroemer G, Boehrer S. Tyrosine kinase inhibitors for the treatment of acute myeloid leukemia: Delineation of anti-leukemic mechanisms of action. Biochem Pharmacol 2011; 82:1457-66. [DOI: 10.1016/j.bcp.2011.05.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 05/11/2011] [Accepted: 05/12/2011] [Indexed: 11/24/2022]
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26
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Thépot S, Lainey E, Cluzeau T, Sébert M, Leroy C, Adès L, Tailler M, Galluzzi L, Baran-Marszak F, Roudot H, Eclache V, Gardin C, de Botton S, Auberger P, Fenaux P, Kroemer G, Boehrer S. Hypomethylating agents reactivate FOXO3A in acute myeloid leukemia. Cell Cycle 2011; 10:2323-30. [PMID: 21654193 DOI: 10.4161/cc.10.14.16399] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The deregulation of the DNA damage response (DDR) can contribute to leukemogenesis and favor the progression from myelodysplastic syndrome (MDS) to acute myeloid leukemia (AML). Since hypomethylating agent, notably azacitidine, constitute an efficient therapy for patients with high-risk MDS, we assessed whether such compounds can activate the DDR in malignant blasts. While azacitidine and decitabine had moderate effects on apoptosis and cell cycle progression, both agents induced profound changes in the expression and functionality of DDR-related proteins. Decitabine, and to a lesser degree azacitidine, induced the activation of checkpoint kinases Chk-1 and Chk-2 and the phosphorylation of the DDR-sensor H2AX. In addition, hypomethylating agents were found to cause the dephosphorylation of the transcriptional regulator forkhead box O3, best known as FOXO3A, whose phosphorylation has been related to poor prognosis in AML. The dephoasphorylation of FOXO3A induced by azacitidine or decitabine in malignant blasts was accompanied by the translocation of FOXO3A from the cytoplasm to the nucleus. Upon stimulation with azacitidine, MDS/AML-derived, azacitidine-sensitive SKM-1S cells upregulated FOXO3A and the pro-apoptotic FOXO3A targets BIM and PUMA, and this effect was attenuated or abolished in azacitidine-resistant SMK-1R cells. Altogether, our results suggest that the reactivation of FOXO3A may contribute to the effects of hypomethylating agents in malignant blasts.
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