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Aubin L, Vilas Boas R, Daltro De Oliveira R, Le Brun V, Divoux M, Rey J, Mansier O, Ianotto JC, Pastoret C, Desmares A, Murati A, de Mas V, Tavitian S, Girodon F, Soret Dulphy J, Maslah N, Goncalves Monteiro V, Boyer F, Orvain C, Ranta D, Cayssials É, Le Clech L, Nicol C, Rottier C, Botin Lopez T, Castel B, Rispal P, Beziat G, Bescond C, Laribi K, Benajiba L, Ugo V, Lippert E, Cottin L, Luque Paz D. CALR-mutated patients with low allele burden represent a specific subtype of essential thrombocythemia: A study on behalf of FIM and GBMHM. Am J Hematol 2024; 99:1001-1004. [PMID: 38404143 DOI: 10.1002/ajh.27265] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Abstract
A low allele burden (i.e., <20%) of the CALR driver mutation is found in 10.8% of CALR-mutated MPNs, mostly in essential thrombocythemia, and correlates with a milder phenotype and a more indolent evolution compared to patients with an allele burden ≥20%.
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Affiliation(s)
- Laura Aubin
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
- Laboratoire d'Hématologie, CH St Malo, St Malo, France
- Laboratoire d'Hématologie, CHU Rennes, Rennes, France
| | | | | | | | - Marion Divoux
- Hématologie Clinique, CHU Nancy, Nancy, France
- Laboratoire d'Hématologie, CHU Nancy, Nancy, France
| | - Jérôme Rey
- Centre de Recherche en Cancérologie de Marseille (CRCM), Département d'Hématologie, Institut Paoli-Calmettes, CRCM, Inserm, Marseille, France
| | - Olivier Mansier
- Laboratoire d'Hématologie, CHU Bordeaux, Bordeaux, France
- Inserm U1034, Université de Bordeaux, Bordeaux, France
| | | | | | - Anne Desmares
- Laboratoire d'Hématologie, CHU Rennes, Rennes, France
| | - Anne Murati
- Centre de Recherche en Cancérologie de Marseille (CRCM), Département de Biopathologie et Département d'Oncologie Prédictive, Institut Paoli-Calmettes, Inserm, Marseille, France
| | - Véronique de Mas
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, CHU Toulouse, Toulouse, France
| | | | - Juliette Soret Dulphy
- INSERM U944/CNRS UMR7212, Hôpital Saint Louis APHP, Université de Paris, Paris, France
| | - Nabih Maslah
- Laboratoire de Biologie Cellulaire, Université Paris Cité, APHP, Hôpital Saint-Louis, Paris, France
| | | | | | | | - Dana Ranta
- Hématologie Clinique, CHU Nancy, Nancy, France
| | - Émilie Cayssials
- Service d'Oncologie Hématologique et Thérapie Cellulaire, CHU de Poitiers, Poitiers, France
| | | | | | - Camille Rottier
- Laboratoire d'oncobiologie moléculaire, CHU Amiens-Picardie, Amiens, France
| | | | - Brice Castel
- Service de Médecine Interne, CH de Bigorre, Tarbes, France
| | | | | | | | - Kamel Laribi
- Hématologie Clinique, CH Le Mans, Le Mans, France
| | - Lina Benajiba
- INSERM U944/CNRS UMR7212, Hôpital Saint Louis APHP, Université de Paris, Paris, France
| | - Valérie Ugo
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU Brest, Brest, France
- INSERM, U1078, Université de Brest, Brest, France
| | - Laurane Cottin
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
| | - Damien Luque Paz
- Univ Angers, Nantes Université, CHU Angers, Inserm, CNRS, CRCI2NA, Angers, France
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Notarantonio AB, Roth-Guépin G, Bonmati C, Divoux M, Kicki C, Pagliuca S, Campidelli A, Rubio MT, D'Aveni-Piney M. A new sequential conditioning regimen based on CPX- 351/Vyxeos ("Vyx-Seq") in patients with higher risk myelodysplastic syndromes. Leuk Res 2023; 135:107405. [PMID: 37864958 DOI: 10.1016/j.leukres.2023.107405] [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: 07/23/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023]
Affiliation(s)
- A B Notarantonio
- Hematology Department, University Hospital of Nancy, France; CNRS 7365, IMoPA, University of Lorraine, F-54000, France
| | - G Roth-Guépin
- Hematology Department, University Hospital of Nancy, France
| | - C Bonmati
- Hematology Department, University Hospital of Nancy, France
| | - M Divoux
- Genetic Department, University Hospital of Nancy, France
| | - C Kicki
- Hematology Department, University Hospital of Nancy, France
| | - S Pagliuca
- Hematology Department, University Hospital of Nancy, France; CNRS 7365, IMoPA, University of Lorraine, F-54000, France
| | - A Campidelli
- Hematology Department, University Hospital of Nancy, France
| | - M T Rubio
- Hematology Department, University Hospital of Nancy, France; CNRS 7365, IMoPA, University of Lorraine, F-54000, France
| | - M D'Aveni-Piney
- Hematology Department, University Hospital of Nancy, France; CNRS 7365, IMoPA, University of Lorraine, F-54000, France.
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Lannes R, Samur M, Perrot A, Mazzotti C, Divoux M, Cazaubiel T, Leleu X, Schavgoulidze A, Chretien ML, Manier S, Adiko D, Orsini-Piocelle F, Lifermann F, Brechignac S, Gastaud L, Bouscary D, Macro M, Cleynen A, Mohty M, Munshi N, Corre J, Avet-Loiseau H. In Multiple Myeloma, High-Risk Secondary Genetic Events Observed at Relapse Are Present From Diagnosis in Tiny, Undetectable Subclonal Populations. J Clin Oncol 2023; 41:1695-1702. [PMID: 36343306 PMCID: PMC10043564 DOI: 10.1200/jco.21.01987] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 06/22/2022] [Accepted: 09/22/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Multiple myeloma (MM) is characterized by copy number abnormalities (CNAs), some of which influence patient outcomes and are sometimes observed only at relapse(s), suggesting their acquisition during tumor evolution. However, the presence of micro-subclones may be missed in bulk analyses. Here, we use single-cell genomics to determine how often these high-risk events are missed at diagnosis and selected at relapse. MATERIALS AND METHODS We analyzed 81 patients with plasma cell dyscrasias using single-cell CNA sequencing. Sixty-six patients were selected at diagnosis, nine at first relapse, and six in presymptomatic stages. A total of 956 newly diagnosed patients with MM and patients with first relapse MM have been identified retrospectively with required cytogenetic data to evaluate enrichment of CNA risk events and survival impact. RESULTS A total of 52,176 MM cells were analyzed. Seventy-four patients (91%) had 2-16 subclones. Among these patients, 28.7% had a subclone with high-risk features (del(17p), del(1p32), and 1q gain) at diagnosis. In a patient with a subclonal 1q gain at diagnosis, we analyzed the diagnosis, postinduction, and first relapse samples, which showed a rise of the high-risk 1q gain subclone (16%, 70%, and 92%, respectively). In our clinical database, we found that the 1q gain frequency increased from 30.2% at diagnosis to 43.6% at relapse (odds ratio, 1.78; 95% CI, 1.58 to 2.00). We subsequently performed survival analyses, which showed that the progression-free and overall survival curves were superimposable between patients who had the 1q gain from diagnosis and those who seemingly acquired it at relapse. This strongly suggests that many patients had 1q gains at diagnosis in microclones that were missed by bulk analyses. CONCLUSION These data suggest that identifying these scarce aggressive cells may necessitate more aggressive treatment as early as diagnosis to prevent them from becoming the dominant clone.
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Affiliation(s)
- Romain Lannes
- Myeloma Oncogenesis Lab, IUC-Oncopole, Toulouse, France
- CRCT, INSERM U1037, Toulouse, France
| | - Mehmet Samur
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Aurore Perrot
- CRCT, INSERM U1037, Toulouse, France
- Hematology Department, IUC-Oncopole, Toulouse, France
| | - Celine Mazzotti
- Myeloma Oncogenesis Lab, IUC-Oncopole, Toulouse, France
- CRCT, INSERM U1037, Toulouse, France
| | - Marion Divoux
- Hematology Department, University Hospital, Nancy, France
| | | | - Xavier Leleu
- Hematology Department, University Hospital, Poitiers, France
| | - Anaïs Schavgoulidze
- Myeloma Oncogenesis Lab, IUC-Oncopole, Toulouse, France
- CRCT, INSERM U1037, Toulouse, France
| | | | - Salomon Manier
- Hematology Department, University Hospital, Lille, France
| | - Didier Adiko
- Hematology Department, General Hospital, Libourne, France
| | | | | | | | | | - Didier Bouscary
- Hematology Department, Cochin University Hospital, Paris, France
| | - Margaret Macro
- Hematology Department, University Hospital, Caen, France
| | - Alice Cleynen
- Institut Montpellierain Alexander Grothendieck, CNRS, Montpellier University, Montpellier, France
| | - Mohamad Mohty
- Hematology Department, Saint-Antoine University Hospital, Paris, France
| | - Nikhil Munshi
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Jill Corre
- Myeloma Oncogenesis Lab, IUC-Oncopole, Toulouse, France
- CRCT, INSERM U1037, Toulouse, France
| | - Hervé Avet-Loiseau
- Myeloma Oncogenesis Lab, IUC-Oncopole, Toulouse, France
- CRCT, INSERM U1037, Toulouse, France
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Schavgoulidze A, Talbot A, Perrot A, Cazaubiel T, Leleu X, Manier S, Buisson L, Mahéo S, Do Souto Ferreira L, Pavageau L, Hulin C, Marolleau JP, Voillat L, Belhadj K, Divoux M, Slama B, Brechignac S, Macro M, Stoppa AM, Sanhes L, Orsini-Piocelle F, Fontan J, Chretien ML, Demarquette H, Mohty M, Avet-Loiseau H, Corre J. Biallelic deletion of 1p32 defines ultra-high-risk myeloma, but monoallelic del(1p32) remains a strong prognostic factor. Blood 2023; 141:1308-1315. [PMID: 36375118 PMCID: PMC10163308 DOI: 10.1182/blood.2022017863] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
Cytogenetic abnormalities (CAs) are known to be the preponderant prognostic factor in multiple myeloma. Our team has recently developed a prognostic score based on 6 CAs, with which del(1p32) appears to be the second worst abnormality after del(17p). This study aimed to confirm the adverse effect of 1p32 deletion in patients with newly diagnosed multiple myeloma (NDMM). Among 2551 patients with newly diagnosed multiple myeloma, 11% were harboring del(1p32). Their overall survival (OS) was significantly inferior compared with patients without del(1p32) (median OS: 49 months vs 124 months). Likewise, progression-free survival was significantly shorter. More importantly, biallelic del(1p32) conferred a dramatically poorer prognosis than a monoallelic del(1p32) (median OS: 25 months vs 60 months). As expected, the OS of patients with del(1p32) significantly decreased when this abnormality was associated with other high-risk CAs [del(17p), t(4;14), or gain(1q)]. In the multivariate analysis, del(1p32) appeared as a negative prognostic factor; after adjustment for age and treatment, the risk of progression was 1.3 times higher among patients harboring del(1p32), and the risk of death was 1.9 times higher. At the dawn of risk-adapted treatment strategies, we have confirmed the adverse effect of del(1p32) in multiple myeloma and the relevance of its assessment at diagnosis.
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Affiliation(s)
- Anaïs Schavgoulidze
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Alexis Talbot
- Hematology Department, Saint-Louis University Hospital, University of Paris, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Aurore Perrot
- Hematology Department, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse, France
| | - Titouan Cazaubiel
- Hematology Department, Bordeaux University Hospital, Bordeaux, France
| | - Xavier Leleu
- Hematology Department, Poitiers University Hospital, Poitiers, France
| | - Salomon Manier
- Hematology Department, Lille University Hospital, Lille, France
| | - Laure Buisson
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Sabrina Mahéo
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Laura Do Souto Ferreira
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Luka Pavageau
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Cyrille Hulin
- Hematology Department, Bordeaux University Hospital, Bordeaux, France
| | | | - Laurent Voillat
- Hematology Department, Chalon-sur-Saône Hospital, Chalon-sur-Saône, France
| | - Karim Belhadj
- Hematology Department, Créteil University Hospital, Créteil, France
| | - Marion Divoux
- Hematology Department, Nancy University Hospital, Nancy, France
| | - Borhane Slama
- Hematology Department, Avignon Hospital, Avignon, France
| | | | - Margaret Macro
- Hematology Department, Caen University Hospital, Caen, France
| | | | - Laurence Sanhes
- Hematology Department, Perpignan Hospital, Perpignan, France
| | | | - Jean Fontan
- Hematology Department, Besançon University Hospital, Besançon, France
| | | | | | - Mohamad Mohty
- Hematology Department, Saint-Antoine University Hospital, Paris, France
| | - Hervé Avet-Loiseau
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
| | - Jill Corre
- Unit for Genomics in Myeloma, University Hospital IUC-Oncopole and Toulouse Cancer Research Center-Oncopole, Toulouse University, INSERM UMR1037, Toulouse, France
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Schavgoulidze A, Lauwers-Cances V, Perrot A, Cazaubiel T, Chretien ML, Moreau P, Facon T, Leleu X, Karlin L, Stoppa AM, Decaux O, Belhadj K, Arnulf B, Mohty M, Ariette CM, Fohrer-Sonntag C, Lenain P, Marolleau JP, Tiab M, Araujo C, Orsini-Piocelle F, Jaccard A, Roussel M, Benboubker L, Eveillard JR, Dib M, Divoux M, Attal M, Avet-Loiseau H, Corre J. Heterogeneity in long term outcomes for R-ISS stage II in newly diagnosed multiple myeloma patients. Haematologica 2022; 108:1374-1384. [PMID: 36172814 PMCID: PMC10153521 DOI: 10.3324/haematol.2021.280566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Indexed: 11/09/2022] Open
Abstract
In the era of personalized treatment in multiple myeloma, high-risk patients must be accurately defined. The International Myeloma Working Group recommends using the Revised International Staging System (R-ISS) to identify high-risk patients. The main purpose of our work was to explore the heterogeneity of outcome among R-ISS stage II patients assessing the impact of ISS, chromosomal abnormalities (CA) and LDH level in this subgroup. Data were issued from 1,343 newly diagnosed myeloma patients up to 65 years, enrolled in 3 clinical trials implemented by the Intergroupe Francophone du Myelome. All patients were eligible to an intensive treatment. Patients R-ISS stage II but ISS stage I had 1.6 times more risk of death than patients R-ISS stage I (adjusted HR 1.6; 95% CI, 1.1 to 2.2; P = .01) and patients R-ISS stage II but ISS stage III had a better overall survival than patients R-ISS stage III (adjusted HR 0.7; 95% CI, 0.4 to 0.9, P = .02). However, among patients classified in R-ISS II, ISS stage and CA (del(17p) and t(4;14)) were still relevant prognostic factors for death. Dividing R-ISS stage II into 3 subgroups: ISS I with standard risk CA, ISS II or III with standard risk CA and, high risk CA patients, median overall survivals were respectively not reached, 112 and 71 months (P < 0.001). In conclusion, stratification of patients in the R-ISS stage II group can be improved by taking into account CA and ISS. However, this does not improve predictive performance of survival models.
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Affiliation(s)
- Anais Schavgoulidze
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse
| | | | - Aurore Perrot
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse
| | | | | | | | | | - Xavier Leleu
- Centre Hospitalier Universitaire Poitiers, Poitiers
| | | | | | | | | | - Bertrand Arnulf
- Centre Hospitalier Universitaire, Hopital Saint Louis, Paris
| | - Mohamad Mohty
- Centre Hospitalier Universitaire, Hopital Saint-Antoine, Paris
| | | | | | - Pascal Lenain
- Centre de Lutte Contre le Cancer - Centre Henri Becquerel, Rouen
| | | | - Mourad Tiab
- Centre Hospitalier Departemental Vendee, La Roche-sur-Yon
| | | | | | | | - Murielle Roussel
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse
| | | | | | - Mamoun Dib
- Centre Hospitalier Universitaire Angers, Angers
| | - Marion Divoux
- Centre Hospitalier Regional Universitaire Nancy Vandoeuvre les Nancy, Nancy
| | - Michel Attal
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse
| | - Herve Avet-Loiseau
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse
| | - Jill Corre
- Institut Universitaire du Cancer de Toulouse-Oncopole and Centre de Recherches en Cancerologie de Toulouse Institut National de la Sante et de la Recherche Medicale, Toulouse.
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6
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Divoux M, Plocque A, Sevin M, Voillat L, Feugier P, Guerci‐Bresler A, Girodon F, Broséus J. Efficacy of lenalidomide in myelodysplastic/myeloproliferative neoplasms with ring sideroblasts and an extreme platelet count. Clin Case Rep 2020; 8:1774-1780. [PMID: 32983494 PMCID: PMC7495870 DOI: 10.1002/ccr3.3026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/24/2020] [Accepted: 05/10/2020] [Indexed: 11/06/2022] Open
Abstract
Lenalidomide is efficient in reducing red blood cell transfusion dependency and markedly lowering platelet counts in MDS/MPN-RS-T in the context of major platelet counts.
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Affiliation(s)
- Marion Divoux
- Université de Lorraine, CHRU‐Nancy, Service d'Hématologie Clinique, Pôle Spécialités Médicales, FranceNancyFrance
| | | | - Margaux Sevin
- Inserm U1231University of Bourgogne Franche‐ComtéDijonFrance
| | - Laurent Voillat
- Haemato‐Oncology DepartmentHospital of Chalon‐sur‐SaôneChalon‐sur‐SaôneFrance
| | - Pierre Feugier
- Université de Lorraine, CHRU‐Nancy, Service d'Hématologie Clinique, Pôle Spécialités Médicales, FranceNancyFrance
| | - Agnès Guerci‐Bresler
- Université de Lorraine, CHRU‐Nancy, Service d'Hématologie Clinique, Pôle Spécialités Médicales, FranceNancyFrance
| | - Francois Girodon
- Haematology LaboratoryUniversity HospitalDijonFrance
- Inserm U1231University of Bourgogne Franche‐ComtéDijonFrance
| | - Julien Broséus
- Université de Lorraine, CHRU‐Nancy, Service d'Hématologie Biologique, Pôle Laboratoires, FranceNancyFrance
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7
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D'Aveni-Piney M, Divoux M, Busby-Venner H, Muller M, Broséus J, Feugier P. Idelalisib in a patient with refractory Waldenström's macroglobulinemia complicated by anuric renal failure: a case report. J Med Case Rep 2018; 12:164. [PMID: 29890999 PMCID: PMC5996512 DOI: 10.1186/s13256-018-1694-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/07/2018] [Indexed: 11/28/2022] Open
Abstract
Background Waldenström’s macroglobulinemia is a rare B-cell lymphoma. The gold standard treatment for Waldenström’s macroglobulinemia is an anti-CD20 antibody (rituximab) in combination with alkylating agents and dexamethasone. Treatment targeting the B-cell receptor such as ibrutinib (but not idelalisib) is currently approved for treatment of patients with relapsed or refractory Waldenström’s macroglobulinemia. Case presentation We report a case of a 71-year-old white French man with Waldenström’s macroglobulinemia who presented with acute renal failure and hyperviscosity syndrome. His Waldenström’s macroglobulinemia was refractory to first-line treatment with rituximab, cyclophosphamide, and dexamethasone. Because of his hemorrhagic syndrome and medical history of recent myocardial infarction, we decided to treat him with idelalisib 150 mg twice daily instead of ibrutinib. We observed a very quick improvement in the patient’s clinical status without need for dose adjustment. Conclusion Our patient’s case provides the first evidence, to the best of our knowledge, that idelalisib may be an efficient treatment option for patients with Waldenström’s macroglobulinemia complicated by anuric renal failure and in whom ibrutinib is contraindicated.
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Affiliation(s)
- M D'Aveni-Piney
- Hematology Department, University Hospital of Nancy, 1, allée du Morvan, 54511, Vandoeuvre Cedex, France.
| | - M Divoux
- Hematology Department, University Hospital of Nancy, 1, allée du Morvan, 54511, Vandoeuvre Cedex, France
| | - H Busby-Venner
- Department of Pathology, University Hospital of Nancy, Vandoeuvre Cedex, France
| | - M Muller
- Genetics Laboratory, University Hospital of Nancy, Vandoeuvre Cedex, France
| | - J Broséus
- Biological Laboratory, University Hospital of Nancy, Vandoeuvre Cedex, France
| | - P Feugier
- Hematology Department, University Hospital of Nancy, 1, allée du Morvan, 54511, Vandoeuvre Cedex, France
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