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Choffat D, Legardeur H, Grandoni F, Alberio L, Surbone A, Baud D, Gavillet M. [Hematological workup in cases of recurrent early miscarriages: what evidences?]. Rev Med Suisse 2023; 19:1911-1914. [PMID: 37850803 DOI: 10.53738/revmed.2023.19.846.1911] [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: 10/19/2023]
Abstract
Recurrent miscarriages have a major psychological and somatic impact, as well as a significant economic burden. An etiological work-up should be offered after two or three miscarriages, the threshold varying from one scientific society to another. However, the proposed biological work-up must be justified by scientific evidence. A simple blood count, basic coagulation tests including fibrinogen assay and anti-phospholipid antibodies testing should be performed initially. Hereditary thrombophilia testing should only be carried out if there is a history of maternal thrombosis. In the event of an abnormality, management should be multidisciplinary, and the prescription of medication should follow recommended guidelines. Prophylactic treatment is not justified in the absence of a known etiology.
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Affiliation(s)
- Damien Choffat
- Service et Laboratoire central d'hématologie, Département d'oncologie et Département des laboratoires et de pathologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
- Service de médecine interne, Département de médecine, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Hélène Legardeur
- Service d'obstétrique, Département femme-mère-enfant, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Francesco Grandoni
- Service et Laboratoire central d'hématologie, Département d'oncologie et Département des laboratoires et de pathologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Lorenzo Alberio
- Service et Laboratoire central d'hématologie, Département d'oncologie et Département des laboratoires et de pathologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Anna Surbone
- Unité de médecine de la reproduction, Département femme-mère-enfant, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - David Baud
- Service d'obstétrique, Département femme-mère-enfant, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Mathilde Gavillet
- Service et Laboratoire central d'hématologie, Département d'oncologie et Département des laboratoires et de pathologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
- Centre de transfusion interrégionale (TIR), Biopôle Secteur Croisettes - Bâtiment Metio, Rte de la Corniche 2, 1066 Epalinges
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2
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Costanza M, Coutaz C, Cairoli A, Gavillet M. Pseudo-macrocytosis in chronic lymphocytic leukaemia. Int J Lab Hematol 2023; 45:623-624. [PMID: 37165763 DOI: 10.1111/ijlh.14091] [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: 02/11/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Mariangela Costanza
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Christine Coutaz
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Anne Cairoli
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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3
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Rovó A, Gavillet M, Drexler B, Keller P, Schneider JS, Colucci G, Beauverd Y, van Dorland HA, Pollak M, Schmidt A, De Gottardi A, Bissig M, Lehmann T, Duchosal MA, Zeerleder S. Swiss Survey on current practices and opinions on clinical constellations triggering the search for PNH clones. Front Med (Lausanne) 2023; 10:1200431. [PMID: 37564039 PMCID: PMC10410560 DOI: 10.3389/fmed.2023.1200431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/03/2023] [Indexed: 08/12/2023] Open
Abstract
This national survey investigated the current practice in Switzerland by collecting participants' opinions on paroxysmal nocturnal hemoglobinuria (PNH) clone assessment and clinical practice. Aim This study aimed to investigate clinical indications prompting PNH clones' assessment and physician's accessibility of a flow cytometry facility, and also to understand clinical attitudes on the follow-up (FU) of patients with PNH clones. Methods The survey includes 16 multiple-choice questions related to PNH and targets physicians with a definite level of experience in the topic using two screener questions. Opinion on clinical management was collected using hypothetical clinical situations. Each participant had the option of being contacted to further discuss the survey results. This was an online survey, and 264 physicians were contacted through email once a week for 5 weeks from September 2020. Results In total, 64 physicians (24.2%) from 23 institutions participated (81.3% hematologists and 67.2% from university hospitals). All had access to flow cytometry for PNH clone testing, with 76.6% having access within their own institution. The main reasons to assess for PNH clones were unexplained thrombosis and/or hemolysis, and/or aplastic anemia (AA). Patients in FU for PNH clones were more likely to be aplastic anemia (AA) and symptomatic PNH. In total, 61% of the participants investigated PNH clones repetitively during FU in AA/myelodysplastic syndromes patients, even when there was no PNH clone found at diagnosis, and 75% of the participants tested at least once a year during FU. Opinions related to clinical management were scattered. Conclusion The need to adhere to guidelines for the assessment, interpretation, and reporting of PNH clones emerges as the most important finding, as well as consensus for the management of less well-defined clinical situations. Even though there are several international guidelines, clear information addressing specific topics such as the type of anticoagulant to use and its duration, as well as the indication for treatment with complement inhibitors in some borderline situations are needed. The analysis and the discussion of this survey provide the basis for understanding the unmet needs of PNH clone assessment and clinical practice in Switzerland.
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Affiliation(s)
- Alicia Rovó
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Beatrice Drexler
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | | | - Jenny Sarah Schneider
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland
| | | | - Yan Beauverd
- Division of Hematology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Matthias Pollak
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Adrian Schmidt
- Department of Internal Medicine, Clinic of Medical Oncology and Hematology, Municipal Hospital Zurich Triemli, Zürich, Switzerland
| | - Andrea De Gottardi
- Servizio di Gastroenterología e Epatologia, Ente Ospedaliero Cantonale, Università della Svizzera Italiana, Lugano, Switzerland
| | - Marina Bissig
- Department of Medical Oncology and Hematology, University Hospital of Zürich, Zürich, Switzerland
| | - Thomas Lehmann
- Kantonsspital St. Gallen, Clinic for Medical Oncology and Hematology, St. Gallen, Switzerland
| | - Michel A. Duchosal
- Service and Central Laboratory of Hematology, Department of Oncology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sacha Zeerleder
- Department of Hematology, Kantonsspital Luzern, Lucerne and University of Bern, Bern, Switzerland
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Gavillet M, Rufer N, Grandoni F, Rizzi M, Vulliemoz N, Baud D, Alberio L, Canellini G, Legardeur H. Successful outcome of pregnancy post-allogeneic stem cell transplant despite severe RH1 alloimmunization: A case report. Br J Haematol 2023; 201:581-584. [PMID: 36916418 DOI: 10.1111/bjh.18741] [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: 02/24/2023] [Accepted: 02/25/2023] [Indexed: 03/16/2023]
Affiliation(s)
- Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Interregional Blood Transfusion SRC, Epalinges, Switzerland
| | - Nathalie Rufer
- Interregional Blood Transfusion SRC, Epalinges, Switzerland
| | - Francesco Grandoni
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Mattia Rizzi
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Department "Woman-Mother-Child", Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - David Baud
- Materno-fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Lorenzo Alberio
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - Hélène Legardeur
- Materno-fetal and Obstetrics Research Unit, Department of Obstetrics and Gynecology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Legardeur H, Cuenoud A, Panchaud A, Grandoni F, Mesquita Sauvage AB, Alberio L, Baud D, Gavillet M. Shall we rethink the timing of epidural anesthesia in anticoagulated obstetrical patients? Am J Obstet Gynecol 2023; 228:257-260. [PMID: 36402599 DOI: 10.1016/j.ajog.2022.10.024] [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: 06/09/2022] [Revised: 09/13/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Hélène Legardeur
- Woman-Mother-Child Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Alexia Cuenoud
- Department of Anesthesia, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Francesco Grandoni
- Service and Central Laboratory of Hematology, Departments of Oncology and Laboratories and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ana Batista Mesquita Sauvage
- Service and Central Laboratory of Hematology, Departments of Oncology and Laboratories and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Lorenzo Alberio
- Service and Central Laboratory of Hematology, Departments of Oncology and Laboratories and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - David Baud
- Woman-Mother-Child Department, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Hematology, Departments of Oncology and Laboratories and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland; Interregional Blood Transfusion SRC, Epalinges, Switzerland.
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6
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Patxot M, Stojanov M, Ojavee SE, Gobert RP, Kutalik Z, Gavillet M, Baud D, Robinson MR. Haematological changes from conception to childbirth: An indicator of major pregnancy complications. Eur J Haematol 2022; 109:566-575. [PMID: 36059200 PMCID: PMC9825915 DOI: 10.1111/ejh.13844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND About 800 women die every day worldwide from pregnancy-related complications, including excessive blood loss, infections and high-blood pressure (World Health Organization, 2019). To improve screening for high-risk pregnancies, we set out to identify patterns of maternal hematological changes associated with future pregnancy complications. METHODS Using mixed effects models, we established changes in 14 complete blood count (CBC) parameters for 1710 healthy pregnancies and compared them to measurements from 98 pregnancy-induced hypertension, 106 gestational diabetes and 339 postpartum hemorrhage cases. RESULTS Results show interindividual variations, but good individual repeatability in CBC values during physiological pregnancies, allowing the identification of specific alterations in women with obstetric complications. For example, in women with uncomplicated pregnancies, haemoglobin count decreases of 0.12 g/L (95% CI -0.16, -0.09) significantly per gestation week (p value <.001). Interestingly, this decrease is three times more pronounced in women who will develop pregnancy-induced hypertension, with an additional decrease of 0.39 g/L (95% CI -0.51, -0.26). We also confirm that obstetric complications and white CBC predict the likelihood of giving birth earlier during pregnancy. CONCLUSION We provide a comprehensive description of the associations between haematological changes through pregnancy and three major obstetric complications to support strategies for prevention, early-diagnosis and maternal care.
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Affiliation(s)
- Marion Patxot
- Department of Computational BiologyUniversity of LausanneLausanneSwitzerland,Swiss Institute of BioinformaticsLausanneSwitzerland
| | - Miloš Stojanov
- Materno‐fetal and Obstetrics Research Unit, Department of Obstetrics and GynecologyCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
| | - Sven Erik Ojavee
- Department of Computational BiologyUniversity of LausanneLausanneSwitzerland,Swiss Institute of BioinformaticsLausanneSwitzerland
| | | | - Zoltán Kutalik
- Department of Computational BiologyUniversity of LausanneLausanneSwitzerland,Swiss Institute of BioinformaticsLausanneSwitzerland,Statistical GeneticsUniversity Center for Primary Care and Public HealthLausanneSwitzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and PathologyCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
| | - David Baud
- Materno‐fetal and Obstetrics Research Unit, Department of Obstetrics and GynecologyCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
| | - Matthew R. Robinson
- Medical GenomicsInstitute of Science and Technology AustriaKlosterneuburgAustria
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7
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Vecchio M, Guenot C, Staubli S, Gavillet M, Alberio L, Mazzolai L, Alatri A. [Venous thromboembolic disease during pregnancy : diagnosis, treatment and follow-up]. Rev Med Suisse 2021; 17:2135-2138. [PMID: 34878742] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Venous thromboembolism is a leading cause of maternal morbidity and mortality with an overall incidence of 1-2 cases per 1000 pregnancies. The purpose of this article is to summarize more recent recommendations for the management of venous thromboembolism during pregnancy and post-partum period.
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Affiliation(s)
- Matteo Vecchio
- Service d'angiologie, Département cœur-vaisseaux, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Cécile Guenot
- Service d'obstétrique, Département femme-mère-enfant, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Samuel Staubli
- Service d'angiologie, Département cœur-vaisseaux, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Mathilde Gavillet
- Service et Laboratoire central d'hématologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Lorenzo Alberio
- Service et Laboratoire central d'hématologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Lucia Mazzolai
- Service d'angiologie, Département cœur-vaisseaux, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Adriano Alatri
- Service d'angiologie, Département cœur-vaisseaux, Centre hospitalier universitaire vaudois, 1011 Lausanne
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8
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Andolfo I, Martone S, Rosato BE, Marra R, Gambale A, Forni GL, Pinto V, Göransson M, Papadopoulou V, Gavillet M, Elalfy M, Panarelli A, Tomaiuolo G, Iolascon A, Russo R. Complex Modes of Inheritance in Hereditary Red Blood Cell Disorders: A Case Series Study of 155 Patients. Genes (Basel) 2021; 12:genes12070958. [PMID: 34201899 PMCID: PMC8304671 DOI: 10.3390/genes12070958] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/17/2021] [Accepted: 06/19/2021] [Indexed: 12/19/2022] Open
Abstract
Hereditary erythrocytes disorders include a large group of conditions with heterogeneous molecular bases and phenotypes. We analyzed here a case series of 155 consecutive patients with clinical suspicion of hereditary erythrocyte defects referred to the Medical Genetics Unit from 2018 to 2020. All of the cases followed a diagnostic workflow based on a targeted next-generation sequencing panel of 86 genes causative of hereditary red blood cell defects. We obtained an overall diagnostic yield of 84% of the tested patients. Monogenic inheritance was seen for 69% (107/155), and multi-locus inheritance for 15% (23/155). PIEZO1 and SPTA1 were the most mutated loci. Accordingly, 16/23 patients with multi-locus inheritance showed dual molecular diagnosis of dehydrated hereditary stomatocytosis/xerocytosis and hereditary spherocytosis. These dual inheritance cases were fully characterized and were clinically indistinguishable from patients with hereditary spherocytosis. Additionally, their ektacytometry curves highlighted alterations of dual inheritance patients compared to both dehydrated hereditary stomatocytosis and hereditary spherocytosis. Our findings expand the genotypic spectrum of red blood cell disorders and indicate that multi-locus inheritance should be considered for analysis and counseling of these patients. Of note, the genetic testing was crucial for diagnosis of patients with a complex mode of inheritance.
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Affiliation(s)
- Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
| | - Stefania Martone
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
| | - Barbara Eleni Rosato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
| | - Roberta Marra
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
| | - Antonella Gambale
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
- Department of Laboratory Medicine (DAIMedLab), UOC Medical Genetics, ‘Federico II’ University Hospital, 80131 Naples, Italy
| | - Gian Luca Forni
- Centro della Microcitemia e delle Anemie Congenite, Ospedale Galliera, 16128 Genoa, Italy; (G.L.F.); (V.P.)
| | - Valeria Pinto
- Centro della Microcitemia e delle Anemie Congenite, Ospedale Galliera, 16128 Genoa, Italy; (G.L.F.); (V.P.)
| | - Magnus Göransson
- Department of Paediatrics, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, 41345 Gothenburg, Sweden;
| | - Vasiliki Papadopoulou
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland; (V.P.); (M.G.)
| | - Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland; (V.P.); (M.G.)
| | - Mohsen Elalfy
- Thalassemia Centre, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt;
| | | | - Giovanna Tomaiuolo
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
- Department of Chemical Engineering, Materials and Industrial Production, ‘Federico II’ University of Naples, 80125 Naples, Italy
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
- CEINGE Biotecnologie Avanzate, 80145 Naples, Italy; (A.G.); (A.P.); (G.T.)
- Correspondence:
| | - Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (I.A.); (S.M.); (B.E.R.); (R.M.); (R.R.)
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9
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Bruttin JP, Gilet P, Grandoni F, Alberio L, Favre L, Gavillet M. [Vitamin B12 in practice: When to test ? How to test ? And who should be treated?]. Rev Med Suisse 2021; 17:582-587. [PMID: 33760421] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Vitamin B12 deficiency is common in outpatients and inpatient populations, with potentially severe neuropsychiatric and hematological impact, which requires timely diagnosis and treatment. The different diagnostic tests all have their limitations but can be combined, sequentially. We propose to review the treatment options according to the different etiologies of the deficiency, highlighting the costs of the therapies and their coverage by the health insurance.
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Affiliation(s)
- Jean-Philippe Bruttin
- Service et laboratoire central d'hématologie, Département d'oncologie et département de médecine de laboratoire et pathologie, CHUV, 1011 Lausanne
- Service de médecine interne, CHUV, 1011 Lausanne
| | - Patricia Gilet
- Service d'endocrinologie, diabétologie et métabolisme, Consultation de prévention et traitement de l'obésité, CHUV, 1011 Lausanne
| | - Francesco Grandoni
- Service et laboratoire central d'hématologie, Département d'oncologie et département de médecine de laboratoire et pathologie, CHUV, 1011 Lausanne
| | - Lorenzo Alberio
- Service et laboratoire central d'hématologie, Département d'oncologie et département de médecine de laboratoire et pathologie, CHUV, 1011 Lausanne
| | - Lucie Favre
- Service d'endocrinologie, diabétologie et métabolisme, Consultation de prévention et traitement de l'obésité, CHUV, 1011 Lausanne
| | - Mathilde Gavillet
- Service et laboratoire central d'hématologie, Département d'oncologie et département de médecine de laboratoire et pathologie, CHUV, 1011 Lausanne
- Transfusion interrégionale CRS, Route de la Corniche 2, 1066 Epalinges
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10
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Dewarrat N, Gavillet M, Angelillo-Scherrer A, Naveiras O, Grandoni F, Tsakiris DA, Alberio L, Blum S. Acquired haemophilia A in the postpartum and risk of relapse in subsequent pregnancies: A systematic literature review. Haemophilia 2021; 27:199-210. [PMID: 33550699 DOI: 10.1111/hae.14233] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND About 1%-5% of acquired haemophilia A cases affect mothers in the postpartum setting. AIMS This study delineates the characteristics of this disease, specific to the postpartum setting, notably relapse in subsequent pregnancies. METHODS Report of two cases and literature study (1946-2019), yielding 73 articles describing 174 cases (total 176 cases). RESULTS Patients were aged 29.9 years (17-41) and 69% primigravidae. Diagnosis was made at a median of 60 days after delivery (range 0-308). Bleeding types were obstetrical (43.4%), cutaneous (41.3%), and muscular (36.7%). In >90% of the cases, FVIII at diagnosis was <1% (range 0%-8%). FVIII inhibitor was documented in 75.4% cases (median titre of 20 BU/ml, range 1-621). Haemostatic treatment was necessary in 57.1% using fresh frozen plasma (16%), factor concentrate (27.6%) and/or bypassing agents (37.4%). Immunosuppressive treatment was administered in 90.8%, mostly steroids (85.3%), alone or combined with immunosuppressants (27%). Rituximab was used mostly as a second line treatment. Only 24 patients (13.6%) had documented subsequent pregnancies and 6 (22.2%) suffered haemophilia recurrence during pregnancy. CONCLUSION This study allows better definition of: (1) clinical and laboratory characteristics of postpartum acquired haemophilia, (2) response to therapy, and (3) the risk of relapse for subsequent pregnancies.
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Affiliation(s)
- Natacha Dewarrat
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Anne Angelillo-Scherrer
- Department of Haematology and Central Haematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Olaia Naveiras
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Francesco Grandoni
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | | | - Lorenzo Alberio
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
| | - Sabine Blum
- Service and Central Laboratory of Haematology, Department of Oncology and Department of Laboratories and Pathology, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland
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11
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Gavillet M, Rolnik DL, Hoffman MK, Panchaud A, Baud D. Should we stop aspirin prophylaxis in pregnant women diagnosed with COVID-19? Ultrasound Obstet Gynecol 2020; 55:843-844. [PMID: 32349165 PMCID: PMC7267269 DOI: 10.1002/uog.22063] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 05/05/2023]
Affiliation(s)
- M. Gavillet
- Service and Central Laboratory of Hematology, Department of Oncology and Department of Laboratories and PathologyLausanne University Hospital (CHUV)LausanneSwitzerland
| | - D. L. Rolnik
- Department of Obstetrics and GynaecologyMonash UniversityMelbourneAustralia
| | - M. K. Hoffman
- Department of Obstetrics and GynecologyChristiana CareNewark, DEUSA
| | - A. Panchaud
- Center for Research and Innovation in Clinical Pharmaceutical SciencesInstitute of Pharmaceutical Sciences of Western Switzerland, Lausanne University Hospital and University of Lausanne, University of GenevaGenevaSwitzerland
- Pharmacy ServiceLausanne University Hospital and University of LausanneLausanneSwitzerland
| | - D. Baud
- Materno‐fetal and Obstetrics Research Unit, Department Woman‐Mother‐ChildLausanne University HospitalLausanneSwitzerland
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12
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Gavillet M, Rufer N, Grandoni F, Carr Klappert J, Zermatten MG, Cairoli A, Canellini G, Alberio L, Duchosal MA, Spertini O, Blum S. [Hematology in the time of COVID-19]. Rev Med Suisse 2020; 16:823-826. [PMID: 32348044] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The COVID-19 pandemic impacts the hematology practice. Intensive chemotherapies for high-grade lymphomas and acute leukemias, multiple myeloma treatments and most hematopoietic stem cell transplantations should be performed as usual. Low-grade lymphomas should only be treated when strictly indicated, maintenance can be postponed. Other myeloid neoplasia and their therapies cause imunosupression; dose adjustment is recommended but no brisk stopping. Sickle cell anemia patients are highly succeptible to severe COVID-19 course. Thrombocytopenia and procoagulant state are associated with severe courses of COVID-19, requiring an individualized therapy. No data indicate a risk of SARS-CoV-2 transmission through blood product transfusion.
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Affiliation(s)
- Mathilde Gavillet
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Nathalie Rufer
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
- Transfusion Interrégionale CRS, Route de la Corniche 2, 1066 Epalinges
| | - Francesco Grandoni
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Jeanette Carr Klappert
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Maxime G Zermatten
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Anne Cairoli
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Giorgia Canellini
- Transfusion Interrégionale CRS, Route de la Corniche 2, 1066 Epalinges
- Institut Central des Hôpitaux, Avenue du Grand-Champsec 86, 1951 Sion
| | - Lorenzo Alberio
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Michel A Duchosal
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Olivier Spertini
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
| | - Sabine Blum
- Service et Laboratoire central d'Hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, 1011 Lausanne
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13
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Blum S, Gavillet M. [Not Available]. Rev Med Suisse 2020; 16:809. [PMID: 32348040] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Sabine Blum
- Médecin associé, Service d'hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, Lausanne
| | - Mathilde Gavillet
- Cheffe de clinique, Service d'hématologie, Département d'Oncologie et Département des Laboratoires et de Pathologie, CHUV, Lausanne
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14
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Affiliation(s)
- Mathilde Gavillet
- Service and Central Laboratory of Hematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | - Jeanette Carr Klappert
- Service and Central Laboratory of Hematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Olivier Spertini
- Service and Central Laboratory of Hematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sabine Blum
- Service and Central Laboratory of Hematology, Department of Oncology and Department of Laboratory Medicine and Pathology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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15
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Dewarrat N, Kaiser J, Baud D, Alberio L, Gavillet M. Pregnancy with Chuvash Polycythaemia and Other Congenital Erythrocytosis. Acta Haematol 2019; 143:69-72. [PMID: 31167179 DOI: 10.1159/000499861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/22/2019] [Indexed: 11/19/2022]
Abstract
This original report describes the management of a pregnant woman with congenital erythrocytosis (Chuvash polycythaemia) and reviews the scarce data available in the literature. Therapy consisted of low-dose aspirin and phlebotomies to maintain haematocrit <50% while monitoring iron stores to avoid severe deficiency detrimental to the foetus. Despite normal initial foetal growth, the pregnancy was complicated by preterm birth due to chorioamnionitis. The placenta showed no signs of thrombotic events. The published reports cover 13 pregnancies in 8 patients, showing 1 first-trimester miscarriage, 5 infants with intrauterine growth restriction and/or preterm birth and 1 maternal thrombotic event. These cases were managed with phlebotomies, low-dose aspirin and/or low-molecular-weight heparin, although inconsistently.
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Affiliation(s)
- Natacha Dewarrat
- Service and Central Laboratory of Haematology, Department of Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Julie Kaiser
- Service and Central Laboratory of Haematology, Department of Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
- Haematology Department, Institute Central des Hôpitaux (ICH), Sion, Switzerland
| | - David Baud
- Materno-Foetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant," University Hospital, Lausanne, Switzerland
| | - Lorenzo Alberio
- Service and Central Laboratory of Haematology, Department of Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of Haematology, Department of Oncology, University Hospital of Lausanne (CHUV), Lausanne, Switzerland,
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16
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D'Cruz AA, Speir M, Bliss-Moreau M, Dietrich S, Wang S, Chen AA, Gavillet M, Al-Obeidi A, Lawlor KE, Vince JE, Kelliher MA, Hakem R, Pasparakis M, Williams DA, Ericsson M, Croker BA. The pseudokinase MLKL activates PAD4-dependent NET formation in necroptotic neutrophils. Sci Signal 2018; 11:11/546/eaao1716. [PMID: 30181240 DOI: 10.1126/scisignal.aao1716] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neutrophil extracellular trap (NET) formation can generate short-term, functional anucleate cytoplasts and trigger loss of cell viability. We demonstrated that the necroptotic cell death effector mixed lineage kinase domain-like (MLKL) translocated from the cytoplasm to the plasma membrane and stimulated downstream NADPH oxidase-independent ROS production, loss of cytoplasmic granules, breakdown of the nuclear membrane, chromatin decondensation, histone hypercitrullination, and extrusion of bacteriostatic NETs. This process was coordinated by receptor-interacting protein kinase-1 (RIPK1), which activated the caspase-8-dependent apoptotic or RIPK3/MLKL-dependent necroptotic death of mouse and human neutrophils. Genetic deficiency of RIPK3 and MLKL prevented NET formation but did not prevent cell death, which was because of residual caspase-8-dependent activity. Peptidylarginine deiminase 4 (PAD4) was activated downstream of RIPK1/RIPK3/MLKL and was required for maximal histone hypercitrullination and NET extrusion. This work defines a distinct signaling network that activates PAD4-dependent NET release for the control of methicillin-resistant Staphylococcus aureus (MRSA) infection.
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Affiliation(s)
- Akshay A D'Cruz
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Mary Speir
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Meghan Bliss-Moreau
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Sylvia Dietrich
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Shu Wang
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA
| | - Alyce A Chen
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Mathilde Gavillet
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.,Department of Hematology, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Arshed Al-Obeidi
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA
| | - Kate E Lawlor
- Walter and Eliza Hall Institute of Medical Research, University of Melbourne, Parkville 3052, Australia
| | - James E Vince
- Walter and Eliza Hall Institute of Medical Research, University of Melbourne, Parkville 3052, Australia
| | - Michelle A Kelliher
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Razq Hakem
- Ontario Cancer Institute, University Health Network, and Department of Medical Biophysics, University of Toronto, Toronto, Ontario M5G 2M9, Canada
| | - Manolis Pasparakis
- Institute for Genetics, Center for Molecular Medicine, and Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, 50931 Cologne, Germany
| | - David A Williams
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Maria Ericsson
- Department of Cell Biology, Harvard Medical School, Boston, MA 02115, USA
| | - Ben A Croker
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA 02115, USA. .,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
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17
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Gavillet M, Spertini O, Blum S. Pseudo Chediak-Higashi anomaly in blasts from acute lymphoblastic leukemia. Leuk Res 2018; 70:87-90. [PMID: 29906671 DOI: 10.1016/j.leukres.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 10/14/2022]
Affiliation(s)
- M Gavillet
- Service and Central Laboratory of Hematology, CHUV, University Hospital of Lausanne, Lausanne, Switzerland.
| | - O Spertini
- Service and Central Laboratory of Hematology, CHUV, University Hospital of Lausanne, Lausanne, Switzerland
| | - S Blum
- Service and Central Laboratory of Hematology, CHUV, University Hospital of Lausanne, Lausanne, Switzerland
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18
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Gavillet M, Martinod K, Renella R, Wagner DD, Williams DA. A key role for Rac and Pak signaling in neutrophil extracellular traps (NETs) formation defines a new potential therapeutic target. Am J Hematol 2018; 93:269-276. [PMID: 29124783 DOI: 10.1002/ajh.24970] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/13/2022]
Abstract
NET formation in mice (NETosis) is supported by reactive oxygen species (ROS) production by NADPH oxidase and histone hypercitrullination by peptidylarginine deiminase 4 (PAD4). Rac1 and Rac2, expressed in polymorphonuclear neutrophils (PMNs), regulate the cytoskeleton, cell shape, adhesion, and migration and are also essential components of the NADPH oxidase complex. We aimed to explore the role of the Rac signaling pathway including the upstream guanosine exchange factor (GEF) activator, Vav, and a downstream effector, the p21-activated kinase, Pak, on NETosis in PMNs using a previously described flow-cytometry-based assay. Rac2-/- PMNs showed reduced levels of citrullinated histone H3 (H3Cit)-positive cells and defective NETosis. Rac1Δ/Δ ; Rac2-/- PMNs demonstrated a further reduction in PMA-induced H3Cit levels and a more profound impairment of NETosis than deletion of Rac2 alone, suggesting an overlapping role of these two highly related proteins. Genetic knockouts of Vav1, or Vav2, did not impair H3Cit response to phorbol myristate ester (PMA) or NETosis. Combined, Vav1 and Vav3 deletions decreased H3Cit response and caused a modest but significant impairment of NETosis. Pharmacologic inhibition of Pak by two inhibitors with distinct mechanisms of action, led to reduced H3Cit levels after PMA stimulation, as well as significant inhibition of NETosis. We validated the importance of Pak using Pak2Δ/Δ PMNs, which demonstrated significantly impaired histone H3 citrullination and NETosis. These data confirm and more comprehensively define the key role of the Rac signaling pathway in PMN NETosis. The Rac signaling cascade may represent a valuable target for inhibition of NETosis and related pathological processes.
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Affiliation(s)
- Mathilde Gavillet
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA; Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Department of Hematology; Lausanne University Hospital; Switzerland
| | - Kimberly Martinod
- Program in Cellular and Molecular Medicine; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
| | - Raffaele Renella
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA; Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Pediatric Hematology-Oncology Unit, Division of Pediatrics; Lausanne University Hospital; Switzerland
| | - Denisa D. Wagner
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA; Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Program in Cellular and Molecular Medicine; Boston Children's Hospital; Boston Massachusetts
| | - David A. Williams
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA; Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Harvard Stem Cell Institute; Cambridge Massachusetts
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19
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Noetzli J, Gavillet M, Masouridi‐Levrat S, Duchosal M, Spertini O. T315I clone selection in a Ph+ all patient under low-dose ponatinib maintenance. Clin Case Rep 2017; 5:1320-1322. [PMID: 28781850 PMCID: PMC5538043 DOI: 10.1002/ccr3.1032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/27/2017] [Accepted: 04/28/2017] [Indexed: 01/30/2023] Open
Abstract
We report here the clinical course of a Ph+ ALL patient who was treated with ponatinib 15 mg/day, as maintenance therapy, and developed a BCR‐ABL T315I mutation leading to ALL relapse. This clonal evolution was reversed, without adverse effects, by increasing ponatinib to 45 mg/day. To our knowledge, we have been confronted with the first clinical case of a T315I clonal selection of ALL caused by subeffective therapeutic level of the drug. This single patient experience highlights the risk of T315I clone selection in Ph+ ALL treated with reduced dose ponatinib.
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Affiliation(s)
- Jasmine Noetzli
- Service and Central Laboratory of HematologyUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland
| | - Mathilde Gavillet
- Service and Central Laboratory of HematologyUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland
| | | | - Michel Duchosal
- Service and Central Laboratory of HematologyUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland
| | - Olivier Spertini
- Service and Central Laboratory of HematologyUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland
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20
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Parliteanu C, Gavillet M, Gié O, Bize P, Maillard MH. [Diagnostic and treatment of mesenteric ischemia]. Rev Med Suisse 2016; 12:1419-1423. [PMID: 28675281] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mesenteric ischemia results from acute or chronic blood flow reduction in the mesenteric arterial or venous vascular supply. This is usually due to an embolus, thrombosis or intestinal hypoperfusion. Radiologic and / or endoscopic imaging and histology allow for diagnosis in high-risk patients with suggestive clinical symptoms and signs. Treatment aims at preventing multi-organ failure through medical treatment, saving intestinal integrity and resecting necrotic bowel segments. Rapid and multidisciplinary management is key in order to optimize treatment and avoid long-term debilitating consequences.
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Affiliation(s)
| | | | - Olivier Gié
- Service de chirurgie viscérale, CHUV, 1011 Lausanne
| | - Pierre Bize
- Service de radiodiagnostic et de radiologie interventionnelle, CHUV, 1011 Lausanne
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21
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Williams DA, Gavillet M. Response to correspondence: Flow cytometric quantification of neutrophil extracellular traps: Limitations of the methodological approach by Ciepiela et al. Am J Hematol 2016; 91:E10. [PMID: 26749259 DOI: 10.1002/ajh.24292] [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] [Received: 12/28/2015] [Accepted: 12/30/2015] [Indexed: 02/05/2023]
Affiliation(s)
- David A. Williams
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatric Oncology; Dana-Farber Cancer Institute; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
| | - Mathilde Gavillet
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
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22
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Gavillet M, Martinod K, Renella R, Harris C, Shapiro NI, Wagner DD, Williams DA. Flow cytometric assay for direct quantification of neutrophil extracellular traps in blood samples. Am J Hematol 2015; 90:1155-8. [PMID: 26347989 DOI: 10.1002/ajh.24185] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/04/2015] [Indexed: 12/17/2022]
Abstract
Neutrophil extracellular traps (NETs) contribute to innate immunity as well as numerous diseases processes such as deep vein thrombosis, myocardial ischemia, and autoimmune disease. To date, most knowledge on NETs formation has been gathered via the qualitative microscopic examination of individual neutrophils in vitro, or aggregate structures in vivo. Here we describe a novel flow cytometry (FLOW)-based assay to identify and quantify NETs using antibodies against key NETs constituents, specifically DNA, modified histones, and granular enzymes. This method is applicable to both murine and human samples for the assessment of induced NETs in vitro, or detection of NETosis in vivo in blood samples. This FLOW-based method was validated by comparison with the well-established microscopy assay using two genetic mouse models previously demonstrated to show defective NETosis. It was then used on healthy human neutrophils for detection of ex vivo induced NETs and on blood samples from patients with sepsis for direct assessment of in vivo NET-forming neutrophils. This new methodology allows rapid and robust assessment of several thousand cells per sample and is independent of potential observer-bias, the two main limitations of the microscopic quantification. Using this new technology facilitates the direct detection of in vivo circulating NETs in blood samples and purification of NETting neutrophils by fluorescence-activated cell sorting (FACS) for further analysis.
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Affiliation(s)
- Mathilde Gavillet
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
| | - Kimberly Martinod
- Program in Cellular and Molecular Medicine; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
| | - Raffaele Renella
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Department of Pediatric Oncology; Dana-Farber Cancer Institute; Boston Massachusetts
| | - Chad Harris
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
| | - Nate I. Shapiro
- Program of Translational Research, Beth Israel Deaconess Medical Center Harvard Medical School; Boston Massachusetts
| | - Denisa D. Wagner
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
- Program in Cellular and Molecular Medicine; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
| | - David A. Williams
- Division of Hematology/Oncology; Boston Children's Hospital; Boston Massachusetts
- Department of Pediatrics; Harvard Medical School; Boston Massachusetts
- Department of Pediatric Oncology; Dana-Farber Cancer Institute; Boston Massachusetts
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23
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De Vita S, Schneider RK, Garcia M, Wood J, Gavillet M, Ebert BL, Gerbaulet A, Roers A, Levine RL, Mullally A, Williams DA. Loss of function of TET2 cooperates with constitutively active KIT in murine and human models of mastocytosis. PLoS One 2014; 9:e96209. [PMID: 24788138 PMCID: PMC4008566 DOI: 10.1371/journal.pone.0096209] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 04/04/2014] [Indexed: 12/27/2022] Open
Abstract
Systemic Mastocytosis (SM) is a clonal disease characterized by abnormal accumulation of mast cells in multiple organs. Clinical presentations of the disease vary widely from indolent to aggressive forms, and to the exceedingly rare mast cell leukemia. Current treatment of aggressive SM and mast cell leukemia is unsatisfactory. An imatinib-resistant activating mutation of the receptor tyrosine kinase KIT (KIT D816V) is most frequently present in transformed mast cells and is associated with all clinical forms of the disease. Thus the etiology of the variable clinical aggressiveness of abnormal mast cells in SM is unclear. TET2 appears to be mutated in primary human samples in aggressive types of SM, suggesting a possible role in disease modification. In this report, we demonstrate the cooperation between KIT D816V and loss of function of TET2 in mast cell transformation and demonstrate a more aggressive phenotype in a murine model of SM when both mutations are present in progenitor cells. We exploit these findings to validate a combination treatment strategy targeting the epigenetic deregulation caused by loss of TET2 and the constitutively active KIT receptor for the treatment of patients with aggressive SM.
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MESH Headings
- Animals
- Azacitidine/analogs & derivatives
- Azacitidine/therapeutic use
- Blotting, Western
- Bone Marrow Cells/metabolism
- Bone Marrow Cells/pathology
- Cell Line, Tumor
- Cell Proliferation/genetics
- Cells, Cultured
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Dasatinib
- Decitabine
- Dioxygenases
- Disease Models, Animal
- Drug Therapy, Combination
- Enzyme Inhibitors/therapeutic use
- Esophagus/metabolism
- Esophagus/pathology
- Gastric Mucosa/metabolism
- Humans
- Mast Cells/metabolism
- Mast Cells/pathology
- Mastocytosis, Systemic/drug therapy
- Mastocytosis, Systemic/genetics
- Mastocytosis, Systemic/metabolism
- Mice, Knockout
- Mice, Transgenic
- Mutation, Missense
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Proto-Oncogene Proteins c-kit/genetics
- Proto-Oncogene Proteins c-kit/metabolism
- Pyrimidines/therapeutic use
- RNA Interference
- Skin/metabolism
- Skin/pathology
- Stomach/pathology
- Thiazoles/therapeutic use
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Affiliation(s)
- Serena De Vita
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Rebekka K. Schneider
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Michael Garcia
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Jenna Wood
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mathilde Gavillet
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Benjamin L. Ebert
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alexander Gerbaulet
- Institute for Immunology, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Axel Roers
- Institute for Immunology, Medical Faculty Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
| | - Ross L. Levine
- Human Oncology and Pathogenesis Program, and Leukemia Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Ann Mullally
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - David A. Williams
- Division of Hematology/Oncology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Gavillet M, Tissot JD, Canellini G. Blood donation associated risks: data from a Swiss regional haemovigilance program. Transfus Med 2013; 23:269-71. [DOI: 10.1111/tme.12066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Revised: 03/25/2013] [Accepted: 06/18/2013] [Indexed: 11/27/2022]
Affiliation(s)
- M. Gavillet
- Service Régional Vaudois de Transfusion Sanguine; Epalinges; Switzerland
| | - J.-D. Tissot
- Service Régional Vaudois de Transfusion Sanguine; Epalinges; Switzerland
| | - G. Canellini
- Service Régional Vaudois de Transfusion Sanguine; Epalinges; Switzerland
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Gavillet M, Noetzli J, Blum S, Duchosal MA, Spertini O, Lambert JF. Transfusion independence and survival in patients with acute myeloid leukemia treated with 5-azacytidine. Haematologica 2012; 97:1929-31. [PMID: 22875616 DOI: 10.3324/haematol.2012.065151] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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26
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Gavillet M, Abbal C, Schmidt S, Nötzli J, Lambert JF, Angelillo-Scherrer A. Life-threatening bleeding under vitamin K antagonists in spite of an INR in the therapeutic range. J Thromb Thrombolysis 2011; 32:232-7. [DOI: 10.1007/s11239-011-0580-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gavillet M, Maillard Dewarrat G, Petitpierre S, Vollenweider P. [Unusual cause for a dyspnea.]. Praxis (Bern 1994) 2010; 99:1157-1162. [PMID: 20859880 DOI: 10.1024/1661-8157/a000235] [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: 05/29/2023]
Abstract
We report the case of a patient presenting with late onset systemic lupus erythematosus presenting as a haemolytic anemia and pleuritis. We describe the clinical features, diagnosis, prognosis and treatment of the disease with special focus on haematological and pulmonary involvement.
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Affiliation(s)
- Mathilde Gavillet
- Service de médecine interne, Département de médecine interne, CHUV, Lausanne.
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Michalik L, Desvergne B, Dreyer C, Gavillet M, Laurini RN, Wahli W. PPAR expression and function during vertebrate development. Int J Dev Biol 2002; 46:105-14. [PMID: 11902671] [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] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The peroxisome proliferator activated receptors (PPARs) are ligand activated receptors which belong to the nuclear hormone receptor family. As with other members of this superfamily, it is thought that the ability of PPAR to bind to a ligand was acquired during metazoan evolution. Three different PPAR isotypes (PPARalpha, PPARbeta, also called 6, and PPARgamma) have been identified in various species. Upon binding to an activator, these receptors stimulate the expression of target genes implicated in important metabolic pathways. The present article is a review of PPAR expression and involvement in some aspects of Xenopus laevis and rodent embryonic development. PPARalpha and beta are ubiquitously expressed in Xenopus early embryos but become more tissue restricted later in development. In rodents, PPARalpha, PPARbeta and PPARgamma show specific time- and tissue-dependent patterns of expression during fetal development and in the adult animals. PPARs are implicated in several aspects of tissue differentiation and rodent development, such as differentiation of the adipose tissue, brain, placenta and skin. Particular attention is given to studies undertaken by us and others on the implication of PPARalpha and beta in rodent epidermal differentiation.
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Affiliation(s)
- Liliane Michalik
- Institut de Biologie Animale, Université de Lausanne, Switzerland
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