1
|
Chevalier S, Colombat P, Lejeune J, Guglielmin B, Bouquet M, Aubouin-Bonnaventure J, Coillot H, Fouquereau E. Recognition of radiographers in the workplace: Why it matters. Radiography (Lond) 2022; 28:648-653. [DOI: 10.1016/j.radi.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/25/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
|
2
|
Scaon S, Chasseigne G, Giraudeau C, Blouin P, Colombat P, Réveillère C. Éléments de qualité de vie individuelle pour une amélioration de la prise en charge en psycho-oncologie pédiatrique. PSYCHO-ONCOLOGIE 2017. [DOI: 10.1007/s11839-017-0619-1] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
3
|
Lamy T, Damaj G, Soubeyran P, Gyan E, Legouill S, Cartron G, Boubdallah K, Gressin R, Cornillon J, Banos A, Ledu K, Benchalal M, Moles M, Fleury J, Godmer P, Maisonneuve H, Deconninck E, Laribi K, Marolleau J, Tournilhac O, Deviller A, Fest T, Colombat P, Costes V, Bene M, Delwail V. R-CHOP +/-RADIOTHERAPY IN NON-BULKY LIMITED-STAGE DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL): FINAL RESULTS OF THE PROSPECTIVE RANDOMIZED PHASE III 02-03 TRIAL FROM THE LYSA/GOELAMS. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- T. Lamy
- Hematology; CHU de Rennes; Rennes France
| | - G. Damaj
- Hematology; CHU de Caen; Caen France
| | | | - E. Gyan
- Hematology; CHU de Tours; Tours France
| | | | - G. Cartron
- Hematology; CHU Montpellier; Montpellier France
| | | | - R. Gressin
- Hematology; CHU de Grenoble; Grenoble France
| | - J. Cornillon
- Hematology; Insitut de Cancerologie; Saint Etienne France
| | - A. Banos
- Hematology; CH BAyonne; Bayonne France
| | - K. Ledu
- Hematology; Clinique du Mans; Le Mans France
| | - M. Benchalal
- Radiotherapy; Centre Eugene Marquis; Rennes France
| | - M. Moles
- Hematology; CHU d'Angers; Angers France
| | - J. Fleury
- Hematology; Pole Sante Republique; Clermont Ferrand France
| | - P. Godmer
- Hematology; CH Vannes; Vannes France
| | - H. Maisonneuve
- Hematology; Centre Hospitalier de Vendee; La Roche sur Yon France
| | | | - K. Laribi
- Hematology; Le Mans Hospital; France
| | | | - O. Tournilhac
- Hematology; Clermont Hospital; Clermont Ferrand France
| | - A. Deviller
- Nuclear Medicine; Centre Eugene Marquis; France
| | - T. Fest
- Hematology Biology; CHU de Rennes; Rennes France
| | | | - V. Costes
- Pathology; CHU Montpellier; Montpellier France
| | - M. Bene
- Hematology Biology; CHU de Nantes; Nantes France
| | - V. Delwail
- Hematology; Poitiers Hospital; Poitiers France
| |
Collapse
|
4
|
Lafia E, Anani L, Glitho S, Bankole C, Fachinan H, Py JY, Domenech J, Martenot B, Colombat P, Chobli M, Zohoun I. Coopération Nord-Sud pour le renforcement des capacités du personnel de santé en hématologie et transfusion : expérience du Bénin. Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
5
|
Lafia E, Anani L, Glitho S, Bankole C, Fachinan H, Py JY, Domenech J, Martenot B, Colombat P, Chobli M, Zohoun I. [North-South cooperation on transfusion and hematology teaching: A Benin experience]. Transfus Clin Biol 2015; 22:80-2. [PMID: 26003606 DOI: 10.1016/j.tracli.2015.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 11/24/2022]
Abstract
Hematologic diseases are a significant part of health disorders in Benin. As an example, anemia is the second cause of hospitalization, measuring up to 7.9% all over the country (National Plan of Sanitary Development, 2009-2018). By contrast, there is only one active hematologist in the country. Thanks to two partnerships, on one hand between the health sciences faculty in Cotonou (Benin) and the medicine one in Tours (France), and on the other hand between the Beninese Blood Transfusion National Agency and the French Blood Establishment, a first blood transfusion and hematology formation was held in Cotonou on December 2014. Among other benefits, was created an hematology-transfusion network in order to facilitate relations between Beninese hospital doctors, with the support of the two French partner institutions. The article describes this progress.
Collapse
Affiliation(s)
- E Lafia
- Agence nationale pour la transfusion sanguine, place de l'Étoile-Rouge, 01 BP 511, Cotonou, Bénin.
| | - L Anani
- Agence nationale pour la transfusion sanguine, place de l'Étoile-Rouge, 01 BP 511, Cotonou, Bénin
| | - S Glitho
- Centre hospitalier départemental du Zou et des Collines, BP 49 Goho, Abomey, Bénin
| | - C Bankole
- Hôpital de Zone de Tanguiéta, BP 07, Tanguiéta, Bénin
| | - H Fachinan
- Hôpital d'instruction des armées, 02 BP 1324, Parakou, Bénin
| | - J-Y Py
- Établissement français du sang Centre-Atlantique, 50, avenue Marcel-Dassault, BP 40661, 37206 Tours cedex 3, France
| | - J Domenech
- Faculté de médecine de Tours, 10, boulevard Tonnelé, BP 3223, 37032 Tours cedex 1, France
| | - B Martenot
- Établissement français du sang Centre-Atlantique, 50, avenue Marcel-Dassault, BP 40661, 37206 Tours cedex 3, France
| | - P Colombat
- Faculté de médecine de Tours, 10, boulevard Tonnelé, BP 3223, 37032 Tours cedex 1, France
| | - M Chobli
- Faculté des sciences de la santé, campus du Champ-de-Foire, 01 BP 188, Cotonou, Bénin
| | - I Zohoun
- Faculté des sciences de la santé, campus du Champ-de-Foire, 01 BP 188, Cotonou, Bénin
| |
Collapse
|
6
|
Gouache E, Auvin C, Gillibert-Yvert M, Jourdain A, Blouin P, Colombat P, Maruani A. P-183 – Papillomavirus Humain et vaccination: que savent les adolescents? Leucémie aiguë myéloblastique congénitale révélée par des nodules cutanés. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30365-1] [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: 11/25/2022]
|
7
|
Gouache E, Auvin C, Gillibert-Yvert M, Jourdain A, Le Guellec C, Jonville-Bera A, Carpentier E, Colombat P. P-538 – Encéphalopathie postérieure réversible secondaire au méthotrexate: explorer la voie des folates? Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30713-2] [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]
|
8
|
El-Najjar I, Boumendil A, Luan J, Bouabdallah R, Thomson K, Mohty M, Colombat P, Biron P, Tilly H, Pfreundschuh M, Cordonnier C, Sureda A, Cahn J, Vernant J, Gribben J, Cook G, Haynes A, Ferrant A, Finel H, Montoto S, Dreger P. The impact of total body irradiation on the outcome of patients with follicular lymphoma treated with autologous stem-cell transplantation in the modern era: a retrospective study of the EBMT Lymphoma Working Party. Ann Oncol 2014; 25:2224-2229. [DOI: 10.1093/annonc/mdu440] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
|
9
|
Moret L, Anthoine E, Gillet N, Fouquereau E, Colombat P. Organisation du travail, démarche participative et satisfaction des patients hospitalisés : une évaluation dans 47 services d’oncohématologie. PSYCHO-ONCOLOGIE 2014. [DOI: 10.1007/s11839-014-0466-2] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
10
|
Robinson SP, Canals C, Luang JJ, Tilly H, Crawley C, Cahn JY, Pohlreich D, Le Gouill S, Gilleece M, Milpied N, Attal M, Biron P, Maury S, Rambaldi A, Maertens J, Capria S, Colombat P, Montoto S, Sureda A. The outcome of reduced intensity allogeneic stem cell transplantation and autologous stem cell transplantation when performed as a first transplant strategy in relapsed follicular lymphoma: an analysis from the Lymphoma Working Party of the EBMT. Bone Marrow Transplant 2013; 48:1409-14. [PMID: 23771004 DOI: 10.1038/bmt.2013.83] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 04/26/2013] [Accepted: 05/01/2013] [Indexed: 01/04/2023]
Abstract
Both auto-SCT and reduced intensity allo-SCT (RIST) are employed in the treatment of relapsed follicular lymphoma (FL). We have analysed the outcome of these two transplant procedures when used as a first transplant in this setting. We conducted a retrospective comparison of 726 patients who underwent an auto-SCT and 149 who underwent a RIST as a first transplant procedure for relapsed FL as reported to the Lymphoma Working Party of the European Bone Marrow Transplant. The non-relapse mortality (NRM) was significantly worse for patients undergoing a RIST (relative risk (RR) 4.0, P<0.001). The 1-year NRM was 15% for those undergoing a RIST compared with 3% for those undergoing an auto-SCT. Disease relapse or progression were significantly worse for those receiving an auto-SCT (RR 3.1, P<0.001). Patients undergoing a RIST had a 5-year relapse rate of 20% compared with 47% for those undergoing an auto-SCT. The PFS at 5 years was 57% for patients receiving a RIST compared with 48% for those receiving an auto-SCT. There was no significant difference in OS between the two groups. RIST is associated with a higher NRM and lower relapse rate in patients with relapsed FL.
Collapse
Affiliation(s)
- S P Robinson
- BMT Unit, Bristol Children's Hospital, Bristol, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Morschhauser F, Recher C, Milpied N, Gressin R, Salles G, Brice P, Vey N, Haioun C, Colombat P, Rossi J, Deconinck E, Lazreg F, Bergougnoux L, Delsol G, Attal M. A 4-weekly course of rituximab is safe and improves tumor control for patients with minimal residual disease persisting 3 months after autologous hematopoietic stem-cell transplantation: results of a prospective multicenter phase II study in patients with follicular lymphoma. Ann Oncol 2012; 23:2687-2695. [DOI: 10.1093/annonc/mds202] [Citation(s) in RCA: 22] [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] [Indexed: 11/14/2022] Open
|
12
|
Colombat P, Brousse N, Salles G, Morschhauser F, Brice P, Soubeyran P, Delwail V, Deconinck E, Haioun C, Foussard C, Sebban C, Tilly H, Thieblemont C, Bergougnoux L, Lazreg F, Solal-Celigny P. Rituximab induction immunotherapy for first-line low-tumor-burden follicular lymphoma: survival analyses with 7-year follow-up. Ann Oncol 2012; 23:2380-2385. [PMID: 22782332 DOI: 10.1093/annonc/mds177] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to report long-term results of rituximab induction monotherapy in patients with low-tumor-burden follicular lymphoma (LTBFL). PATIENTS AND METHODS Of 49 first-line LTBFL patients who received weekly doses of rituximab (375 mg/m(2)), 46 have been followed with a long-term analysis of clinical and molecular responses. RESULTS Best clinical response (at any staging within a year following treatment) was 80%, 24 (52%) patients had complete or unconfirmed complete response, 13 (28%) had partial response and 9 (20%) had stable or progressive disease. Of 31 patients having a positive bcl2-JH rearrangement, 15 (48%) became negative following treatment. After 83.9 months of follow-up (95% confidence interval 6.4-92.8 months), the median progression-free survival is 23.5 months and overall survival (OS) is 91.7%. Five patients died (one progression, one myelodysplasia, one diffuse large B-cell lymphoma and two solid tumors). Seven patients (15%) are progression-free including five who are bcl2 informative. No unexpected long-term adverse event has been observed. CONCLUSION A significant proportion of patients remain progression-free 7 years after a single 4-dose rituximab treatment in first-line LTBFL. The 7-year overall survivalOS is very high in this selected population of patients.
Collapse
Affiliation(s)
- P Colombat
- Department of Hematology and Cellular Therapy, Bretonneau University hospital, Tours.
| | - N Brousse
- Department of Pathology, Necker University hospital, Paris
| | - G Salles
- Department of Hematology/Oncology, Lyon Sud University hospital, Pierre-Bénit
| | - F Morschhauser
- Department of Hematology, Claude Huriez University hospital, Lille
| | - P Brice
- Department of Hematology, Saint-Louis University hospital, Paris
| | - P Soubeyran
- Department of Medicine, Bergonie Institute, Bordeaux
| | - V Delwail
- Department of Hematology, Poitiers University hospital, Poitiers
| | - E Deconinck
- Department of Hematology, Jean Minjoz University hospital, Besançon
| | - C Haioun
- Department of Hematology, Henri Mondor University hospital, Creteil
| | - C Foussard
- Department of Hematology, Hôtel Dieu University hospital, Angers
| | - C Sebban
- Department of Medical Oncology, Léon Bérard Center, Lyon
| | - H Tilly
- Department of Oncology, Henri Becquerel Center, Rouen
| | - C Thieblemont
- Department of Hematology, Saint-Louis University hospital, Paris
| | | | - F Lazreg
- Department of Hematology, Roche, Neuilly-sur-Seine
| | - P Solal-Celigny
- Oncoradiotherapy and Hematology center, Jean Bernard Center, Le Mans, France
| |
Collapse
|
13
|
Brion A, Mahé B, Kolb B, Audhuy B, Colombat P, Maisonneuve H, Foussard C, Bureau A, Ferrand C, Lesesve JF, Béné MC, Feugier P. Autologous transplantation in CLL patients with B and C Binet stages: final results of the prospective randomized GOELAMS LLC 98 trial. Bone Marrow Transplant 2011; 47:542-8. [DOI: 10.1038/bmt.2011.117] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
14
|
Colombat P, Altmeyer A, Rodrigues M, Barruel F, Blanchard P, Fouquereau E, Pronost AM. Management et souffrance des soignants en oncohématologie. PSYCHO-ONCOLOGIE 2011. [DOI: 10.1007/s11839-011-0319-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
15
|
Pettengell R, Schmitz N, Gisselbrecht C, Caballero D, Colombat P, Conde E, Metzner B, Walewski JA, Geisler C, Goldstone A. Randomized study of rituximab in patients with relapsed or resistant follicular lymphoma prior to high-dose therapy as in vivo purging and to maintain remission following high-dose therapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8005] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
16
|
Cartron G, Ohresser M, Salles G, Solal-Céligny P, Colombat P, Watier H. Neutrophil role in in vivo anti-lymphoma activity of rituximab: FCGR3B-NA1/NA2 polymorphism does not influence response and survival after rituximab treatment. Ann Oncol 2008; 19:1485-1487. [DOI: 10.1093/annonc/mdn163] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Roy P, Solal Céligny P, Andrieu JM, Colombat P, Colonna P, Riche B, Maucort-Boulch D. Construction des modèles et des scores pronostiques. Rev Epidemiol Sante Publique 2008. [DOI: 10.1016/j.respe.2008.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
18
|
|
19
|
Pronost AM, Le Gouge A, Leboul D, Gardembas-Pain M, Berthou C, Giraudeau B, Colombat P. Effet des caractéristiques des services en oncohématologie développant la démarche palliative et des caractéristiques sociodémographiques des soignants sur les indicateurs de santé: soutien social, stress perçu, stratégies de coping, qualité de vie au travail. ONCOLOGIE 2008. [DOI: 10.1007/s10269-007-0775-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
20
|
Herault B, Assari S, Colombat P, Binet C, Courtois F, Roubinet F. [Health care units in the French blood banks, why?]. Transfus Clin Biol 2007; 14:127-31. [PMID: 17521941 DOI: 10.1016/j.tracli.2007.03.013] [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] [Indexed: 11/26/2022]
Abstract
In France for several years, many patients have been treated in Blood Transfusion Centers belonging to the EFS. This partnership between public hospitals and EFS is appreciated by the patients who find a competent staff in transfusion and apheresis process, in a more pleasant environment than in hospital. There is a total of 93 Health Care Units in Blood Transfusion Centers. Sixty-three of these Health Care Units perform only transfusions and bleeding. In the remaining 30 Health Care Units apheresis, peripheral blood hematopoietic stem, cell harvesting, plasmatic exchanges and extracorporeal photopheresis are also performed. Despite the perfect fit between hospital needs, comfort and easiness for patients, an economical problem remains. At the present time, the reimbursement rate by national health insurance is below the real cost. If unsolved, this discrepancy could force an end to this beneficial partnership.
Collapse
Affiliation(s)
- B Herault
- Etablissement français du sang Centre-Atlantique, 2 boulevard Tonnellé, 37020 Tours cedex 1, France.
| | | | | | | | | | | |
Collapse
|
21
|
Colombat P, Lemevel A, Bertrand P, Delwail V, Rachieru P, Brion A, Berthou C, Bay JO, Delepine R, Desablens B, Camilleri-Broët S, Linassier C, Lamy T. High-dose chemotherapy with autologous stem cell transplantation as first-line therapy for primary CNS lymphoma in patients younger than 60 years: a multicenter phase II study of the GOELAMS group. Bone Marrow Transplant 2006; 38:417-20. [PMID: 16951691 DOI: 10.1038/sj.bmt.1705452] [Citation(s) in RCA: 143] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The optimum treatment of primary CNS lymphoma (PCNSL) is not yet determined. The objective of this study was to assess the safety and efficacy of initial methotrexate-based chemotherapy followed by high-dose chemotherapy (HDT) with autologous stem cell transplantation (ASCT) in patients with newly diagnosed PCNSL. Twenty-five patients received two courses of initial chemotherapy combining methotrexate, etoposide, carmustine and methylprednisolone, and one course of ifosfamide-cytarabine followed by peripheral stem cell collection. Seventeen responsive patients then received HDT using carmustine, etoposide, cytarabine and melphalan with autologous stem cell rescue. After ASCT for responding patients or after salvage therapy for non-responders, whole brain radiation therapy at a dose of 30 Gy was delivered. The objective response rate to the induction chemotherapy was 84%. Four of the 21 responding patients did not have ASCT because of toxicity or refusal. With a median follow-up time of 34 months, the projected event free survival rate is 46% at 4 years. Projected overall survival is 64% at 4 years. Sixteen patients are actually in continuous complete response. No evidence of late treatment-related toxicity was observed. This treatment approach appears feasible in newly diagnosed PCNSL with encouraging results.
Collapse
|
22
|
Laccourreye L, Desablens B, Le Maignan C, Le Mevel A, Berthou C, Lamy T, Gandour C, Guilhot F, Ifrah N, Colombat P, Goelams. Long term outcome of 135 high grade non-Hodgkin’s lymphoma of the head and neck (HN NHL) treated with high dose CHOP regimen and involved field radiotherapy. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.7550] [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] [Indexed: 11/20/2022] Open
Abstract
7550 Background: We present the results of a prospective study conducted by the GOELAMS group and evaluating long-term clinical outcome in a series of 135 patients with a HN NHL undergoing chemotherapy and radiotherapy. Methods: From 1986 through 1998, 135 patients aged from 17 to 69 years were enrolled in a prospective multicenter study for primary treatment of HN localized stage I/II high-grade NHL. Treatment regimen consisted in 3 VCAP + 40 Gy locoregional irradiation. Results: The median age was 48.5 years (17–69) with 36 patients being 60 or over. The main localization was Waldeyer’s ring (57) including tonsil (35), nasopharynx (14), whole Waldeyer (8), neck (49), nasal cavities (14), thyroid (8) salivary gland (5), mandibular bone (2). According to the WFC, histological subtype were as F (21%), G (57%) and H (20%) and unclassified (2%). Ann Harbor classification included 80 stage 1 and 55 stage II. The IPI score was 0 (49.7%), 1 (22.3%), 2 (10.4%), 3 (2.3%) undetermined (16.3%). PS>2 and bulk (≥ 5 cm) were observed in 7.5% and 43% of patients respectively. 94% achieved CR. 2 patients died during treatment. Relapses occurred in 23/127 (18.1%) at a median time of 31 months (5.5–80). 16 of these relapses occurred before 3 years of CR, 5 between 3 and 6 years and 2 after 6 years of CR. With a median follow up of 65 month (7–146) OS and EFS were 81.5% and 77% respectively. In univariate analysis age≥ 60, extension, PS≥2, Bulk≥5 cm, erythrocyte sedimentation rate≥ 40, high serum LDH,IPI≥2 and salivary gland or panwaldeyer localization significantly decrease EFS (P = 0.055, 0.017, 0.006, 0.0001, 0.04, 0.028, 0.014 and 0.043 or 0.0001 respectively). In multivariate analysis only the bulk≥5 cm, the erythrocyte sedimentation rate≥40 and the localization to salivary gland significantly decrease EFS (P = 0.004, 0.004 and 0.033 respectively). Conclusions: This study underlines the high efficiency of this protocol in treating HN NHL. HN NHL localized to the salivary glands or with a bulk ≥ 5 cm should be included in new therapeutic trials in order to improve their outcome. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- L. Laccourreye
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - B. Desablens
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - C. Le Maignan
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - A. Le Mevel
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - C. Berthou
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - T. Lamy
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - C. Gandour
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - F. Guilhot
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - N. Ifrah
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - P. Colombat
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| | - Goelams
- CHU Angers, Angers, France; CHU Amiens, Amiens, France; HEGP, Paris, France; CAC R. Gauducheau, Nantes, France; CHU Brest, Brest, France; CHU Rennes, Rennes, France; CAC Rennes, Rennes, France; CHU Poitiers, Poitiers, France; CHU Tours, Tours, France
| |
Collapse
|
23
|
Herault O, Gallay N, Domenech J, Colombat P, Binet C. Pharmacological doses of all-trans retinoic acid promote G0/G1 transition and G1 arrest of normal human marrow CD34+ cells. Cell Death Differ 2005; 11 Suppl 2:S207-9. [PMID: 15309027 DOI: 10.1038/sj.cdd.4401471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
24
|
Cartron G, Orhesser M, Solal-Celigny P, Salles G, Colombat P, Varoqueaux N, Watier H. Long term efficacy of rituximab in follicular lymphoma (FL) and polymorphism in IgG Fc receptor FcγRIIIa/FcγRIIa genes. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.6598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Cartron
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - M. Orhesser
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - P. Solal-Celigny
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - G. Salles
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - P. Colombat
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - N. Varoqueaux
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| | - H. Watier
- EA 3853 IPGA, Tours, France; Université de Tours, Tours, France; Clin Victor Hugo, Le Mans, France; Ctr Hospitalier Lyon Sud, Pierre Bénite, Lyon, France; CHU Bretonneau, Tours, France; Roche, Neuilly sur Seine, France
| |
Collapse
|
25
|
Foussard C, Colombat P, Maisonneuve H, Berthou C, Gressin R, Rousselet MC, Rachieru P, Pignon B, Mahé B, Ghandour C, Desablens B, Casassus P, Lamy T, Delwail V, Deconinck E. Long-term follow-up of a randomized trial of fludarabine–mitoxantrone, compared with cyclophosphamide, doxorubicin, vindesine, prednisone (CHVP), as first-line treatment of elderly patients with advanced, low-grade non-Hodgkin's lymphoma before the era of monoclonal antibodies. Ann Oncol 2005; 16:466-72. [PMID: 15695500 DOI: 10.1093/annonc/mdi091] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This randomized study compared the efficacy and safety of fludarabine-mitoxantrone (FM) with mini-CHVP (cyclophosphamide, doxorubicin, vindesine, prednisone) in elderly patients with advanced, low-grade non-Hodgkin's lymphoma. PATIENTS AND METHODS End points were remission rates [overall response (OR) and complete response (CR)], failure-free survival (FFS), survival and toxicity. One hundred and fifty-five patients were randomized, 144 were evaluable for safety and 142 for response. Each treatment arm was given as six monthly cycles, followed by three bimonthly cycles. FM comprised fludarabine (20 mg/m(2) i.v.), days 1-5, plus mitoxantrone (10 mg/m(2) i.v.), day 1. CHVP cycles comprised cyclophosphamide (750 mg/m(2) i.v. infusion), doxorubicin (25 mg/m(2) i.v.) and vindesine (3 mg/m(2) i.v.) on day 1, and prednisone (50 mg/m(2)) on days 1-5. RESULTS FM therapy resulted in superior remission rates (OR 81% versus 64%, CR 49% versus 17%; P = 0.0004). Median FFS for FM patients was 36 months, compared with 19 months for CHVP patients, and has not yet been reached for early CR patients at 53 months. Treatment arm was the major risk factor influencing survival. Both treatments were well tolerated, with only few infectious complications. CONCLUSION FM was more effective than CHVP in achieving OR and CR, and favorably affected the outcome.
Collapse
Affiliation(s)
- C Foussard
- Hematology Department, CHU Angers, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Cartron G, Binet C, Hérault O, Cailliot C, Bernard MC, Estienne MH, Clément N, Colombat P, Domenech J. Proliferation of human progenitor cells in a long-term culture system is more efficiently sustained by the addition of Flt-3 ligand or megakaryocyte growth and development factor than by Kit ligand. Int J Hematol 2003; 77:133-41. [PMID: 12627848 DOI: 10.1007/bf02983212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION We compared the effects of the early-acting growth factors (GF), Flt-3 ligand (FL), c-Kit ligand (KL), and leukemia inhibitory factor (LIF), and the late-acting GF, granulocyte-colony stimulating factor (G-CSF) and megakaryocyte growth and development factor (MGDF), added alone in human long-term marrow culture (LTMC). MATERIALS AND METHODS The GF were used in primary cultures of mononuclear cells (MNC) and in cocultures of CD34+ cells on murine preestablished MS-5 stromal layers. GF activity was assessed as nonadherent and adherent progenitor cell production and cobblestone area formation at week 5. RESULTS In this system, only FL, KL, and MGDF significantly stimulated early stages of hematopoiesis, whereas only G-CSF stimulated the proliferation of mature progenitor cells within the granulo-monocyte lineage and no effect was observed with LIF. FL displayed the strongest activity, and MGDF was more efficient than KL, both in primary cultures of MNC and in cocultures of CD34+ cells. However, the stimulatory effects of these GF used alone were dependent on the presence of a stromal layer. CONCLUSION These LTMC data emphasize the particular roles for FL and MGDF in the stimulation of primitive hematopoiesis.
Collapse
Affiliation(s)
- G Cartron
- Laboratory of Hematology, CHRU Bretonneau, Tours, France
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Vigouroux S, Milpied N, Andrieu JM, Colonna P, Ifrah N, Colombat P, Desablens B, Abgrall JF, Casassus P, Guilhot F, Briere J, Le Mevel A, Moreau P, Mechinaud F, Mahe B, Morineau N, Vigier M, Rapp MJ, Harousseau JL. Front-line high-dose therapy with autologous stem cell transplantation for high risk Hodgkin's disease: comparison with combined-modality therapy. Bone Marrow Transplant 2002; 29:833-42. [PMID: 12058233 DOI: 10.1038/sj.bmt.1703547] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2001] [Accepted: 02/08/2002] [Indexed: 11/09/2022]
Abstract
This retrospective study compares high-dose therapy (HDT) with autologous stem cell transplantation and combined-modality treatment (CT) as a first-line therapy for Hodgkin's disease (HD) for patients with both a clinical stage (CS) IV and/or a mediastinal mass > or =0.45 of the thoracic diameter (MM > or =0.45) at diagnosis, and an incomplete response after the first-line chemotherapy. Data on 42 grafted patients (GP) in Nantes Hospital, France and on 108 combined-modality treated patients (CTP) from two protocols of the GOELAMS group, France (POF 81 and H90) was analyzed. Both groups were comparable except for pulmonary disease in excess in the grafted group (P = 0.01). Among GP, 95% were in complete response at the end of first-line treatment and 77% among CTP. Median follow-up was 53 months (range, 7 to 128 months) for GP and 88 months (range, 25 to 181 months) for CTP. The 5-year freedom from progression (FFP) and event-free survival (EFS) rates were better for GP (87% vs 55% for FFP: P = 0.0004 and 81% vs 51% for EFS: P = 0.0004) whereas the overall survival (OS) rates did not differ significantly (85% for GP vs 71% for CTP: P = 0.06). Similar results were obtained for the groups with a response > or =50% after initial chemotherapy: 91% vs 65% for FFP, P = 0.01; 87% vs 61% for EFS, P = 0.02; and 92% vs 77% for OS, P = 0.2; and for the groups with a response <50%: 80% vs 22% for FFP, P = 0.0003; 72% vs 13% for EFS, P = 0.0001; and 76% vs 46% for OS, P = 0.04. This study shows a better control of the disease with HDT.
Collapse
|
28
|
Domenech J, Cartron G, Clement N, Estienne MH, Herault O, Truglio D, Benboubker L, Roingeard F, Desbois I, Colombat P, Binet C. Persistent decrease in proliferative potential of marrow CD34(+)cells exposed to early-acting growth factors after autologous bone marrow transplantation. Bone Marrow Transplant 2002; 29:557-62. [PMID: 11979303 DOI: 10.1038/sj.bmt.1703512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2001] [Accepted: 01/04/2002] [Indexed: 11/09/2022]
Abstract
Post-graft hematopoiesis is characterized by long-term quantitative deficiency in marrow progenitor cells in both autologous and allogenic settings. In order to evaluate the function of post-graft progenitor cells, the proliferative capacity of marrow CD34(+) cells was evaluated in 10 patients 6 months after autologous bone marrow transplantation (ABMT) for non-Hodgkin's lymphoma and compared to that of 10 patients before ABMT and 10 normal controls. Immuno-selected CD34(+) cells were cultured for 7 days in liquid serum-free medium with a combination of early-acting GF consisting of stem cell factor, IL-3 and IL-1beta. Clonogenic efficiency of unselected cells for CFU-GM and BFU-E was decreased in post-graft patients compared to pre-graft and control patients. However, clonogenic efficiency of selected CD34(+) cells for CFU-GM was not different in post-graft, pre-graft and control patients but BFU-E values of post-graft patients remained lower than those of control patients. Decreased percentages of CD34(+) CD38(-) cells were observed in both post-graft and pre-graft patients while those of CD34(+) c-kit(+) cells were similar in all three patient groups. After 7-day liquid culture, expansion yields of total progenitor cells were significantly lower in post-graft patients (147 +/- 28%) than in pre-graft (255 +/- 27%) and control patients (246 +/- 23%). Post-graft deficiency in progenitor cell expansion was particularly marked for BFU-E (61 +/- 24%) compared to pre-graft patients (220 +/- 82%) and to controls (349 +/- 82%). These results indicate impaired proliferative potential of marrow CD34(+) cells several months after ABMT involving erythroid progenitor cells and/or commitment towards erythroid lineage from a more immature stage (pre-CFU).
Collapse
Affiliation(s)
- J Domenech
- UPRES-EA 3249, Laboratory of Hematology, University Hospital of Tours, Tours, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Linassier C, Destrieux C, Benboubker L, Alcaraz L, Bergemer-Fouquet AM, Jan M, Calais G, Colombat P. [Role of high-dose chemotherapy with hemopoietic stem-cell support in the treatment of adult patients with high-grade glioma]. Bull Cancer 2001; 88:871-6. [PMID: 11604360] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Despite surgery, post-operative irradiation and adjuvant conventional chemotherapy, prognosis of high-grade gliomas remains poor. Carmustine (BCNU) has been shown to have limited activity at conventional dosage but is still the standard chemotherapy. Activity of chemotherapy is limited by the blood-brain barrier impermeability and high levels of expression of multidrug resistance proteins on tumor and/or endothelial cells. Despite high response rates, development of intra-arterial chemotherapy remains limited because of frequent acute brain toxicity related to drug administration. High-dose intravenous chemotherapy rescued by autologous hemopoietic stem cell transplantation is an alternative that might increase drug delivery through the blood-brain barrier and tumor control. Several phase I-II trials using high-dose BCNU were published. The maximum tolerated dose seems to be 800 mg/m2 and interstitial pneumonitis and hepatitis are dose-limiting toxicities. Few phase I-II trials of high-dose therapy were published using drug combinations. High response rates in patients with progressive tumor were observed and in adjuvant setting, encouraging results in terms of median survival time and long survivors were published. No phase III trial was reported to date. Future investigations should include randomized trials comparing high-dose and conventional-dose chemotherapy and development of new high-dose regimens that incorporate new drugs such as temozolomide.
Collapse
Affiliation(s)
- C Linassier
- Comité multi-disciplinaire de neuro-oncologie, CHU Bretonneau, 2, boulevard Tonnellé, Tours Cedex 01
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Regina S, Colombat P, Fimbel B, Guerois C, Gruel Y. Acquired inhibitor to factor VIII in a patient with Hodgkin's disease following treatment with interferon-alpha. Haemophilia 2001; 7:526-7. [PMID: 11554946 DOI: 10.1046/j.1365-2516.2001.00555.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe a young woman who developed acquired haemophilia after 18 months of interferon (IFN-)-alpha therapy. This patient had been monitored since 1992 for Hodgkin's disease initially treated by chemotherapy. After two relapses, she received intensive chemotherapy followed by an autologous peripheral progenitor cell graft. IFN-alpha was then administered for 18 months. Bleeding of the limbs and tongue occurred 1 month after withdrawal of IFN-alpha and high titres (123 Bethesda units) of autoantibody to factor VIII (FVIII):C were measured. Prednisone (1 mg kg(-1) day(-1)) achieved rapid cessation of the bleeding and FVIII autoantibodies were undetectable 5 months later. This case report suggests that the activated partial thromboplastin time should be regularly checked in every patient treated with IFN-alpha in cases of unexplained bleeding, together testing for antibodies to FVIII if the bleeding is prolonged.
Collapse
Affiliation(s)
- S Regina
- Department of Hematology-Haemostasis, University Hospital, Tours, France
| | | | | | | | | |
Collapse
|
31
|
Pouplard C, Iochmann S, Renard B, Herault O, Colombat P, Amiral J, Gruel Y. Induction of monocyte tissue factor expression by antibodies to heparin-platelet factor 4 complexes developed in heparin-induced thrombocytopenia. Blood 2001; 97:3300-2. [PMID: 11342462 DOI: 10.1182/blood.v97.10.3300] [Citation(s) in RCA: 154] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The pathogenesis of thrombosis in heparin-induced thrombocytopenia (HIT) was studied by investigating whether antibodies to heparin-platelet factor 4 (H-PF4) induced tissue factor (TF) synthesis by monocytes. Plasma from 5 patients with HIT containing IgG to H-PF4 was incubated with peripheral blood mononuclear cells without or with purified PF4 and heparin. Significant TF-dependent procoagulant activity (PCA) expressed by monocytes, measured with a factor Xa-based chromogenic assay, was induced after incubation of each HIT plasma sample. This monocyte PCA required the presence of PF4 and was inhibited by high concentrations of heparin. Furthermore, purified HIT IgG added to whole blood with PF4 and heparin also provoked significant synthesis of TF mRNA by monocytes, demonstrated by RT-PCR, and this effect was not observed with normal IgG. These findings strongly support the hypothesis that antibodies to PF4 developed in HIT trigger the production of tissue factor by monocytes, and this effect could account in vivo for hypercoagulability and thrombotic complications in affected patients.
Collapse
Affiliation(s)
- C Pouplard
- Department of Hematology, Faculté de Médecine, Tours, and Hyphen Biomed, Andresy, France
| | | | | | | | | | | | | |
Collapse
|
32
|
Benboubker L, Watier H, Carion A, Georget MT, Desbois I, Colombat P, Bardos P, Binet C, Domenech J. Association between the SDF1-3'A allele and high levels of CD34(+) progenitor cells mobilized into peripheral blood in humans. Br J Haematol 2001; 113:247-50. [PMID: 11328308 DOI: 10.1046/j.1365-2141.2001.02717.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Some patients unexpectedly fail to mobilize sufficient numbers of haematopoietic progenitor cells (HPCs) into the peripheral blood for autologous transplantation. Considering the important role of the chemokine stromal cell-derived factor 1 (SDF-1) in HPC homing, we investigated a possible relationship between SDF1 gene polymorphism and HPC mobilization capacity in 63 patients with malignancy. Some 67% of the good mobilizers (> or = 50 CD34(+) cells/microl) and only 36% of the intermediate/poor mobilizers were SDF1-3'A allele carriers (P = 0.032). In multivariate analysis, the presence of the SDF1-3'A allele was the only factor predictive of good CD34(+) cell mobilization (P = 0.025). This is the first report showing the involvement of genetic factors for HPC mobilization in humans and suggests a significant role for SDF-1 in this process.
Collapse
Affiliation(s)
- L Benboubker
- UPRES-EA Haematopoietic Cells, Haemostasis and Transplantation, University of Tours, France
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Cartron G, Voillat L, Desablens B, Le Maignan C, Milpied N, Foussard C, Dugay J, Maakaroun A, De Muret A, Colombat P. Continuous infusion of vincristine-doxorubicin with bolus of dexamethasone(VAD) alternated with CHEP in the treatment of patients over 60 years old with aggressive non-Hodgkin's lymphoma. Leuk Lymphoma 2001; 40:529-40. [PMID: 11426526 DOI: 10.3109/10428190109097652] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This prospective study was undertaken to evaluate the efficacy and toxicity of combination chemotherapy with alternating cycles of vincristine, doxorubicin and dexamethasone (VAD) and cyclophophamide, doxorubicin, etoposide and prednisone (CHEP) in patients over 60 years old with previously untreated and advanced non-Hodgkin's lymphoma (NHL) of intermediate- and high-grade malignancy. Eighty one consecutive, patients with NHL referred from April 1992 to October 1997 to GOELAMS centers were enrolled in this study and their outcome updated to June 1, 1999. Of 81 enrolled patients, 77 were eligible and assessable for response. The median age was 70 years (61 to 78), 85.7% were stage III or IV, 39% were of performance status > or = 2, 27.3% > or = 2 involved extra-nodal sites and 57.3% had higher LDH levels than normal. The immunophenotype was B in 87% and T in 13%. Fifty-one (66.2%) patients received the scheduled eight cycles of therapy and treatment was withdrawn in only 6 patients (7.8%) because of toxicity. Neutropenia grade 3-4 occurred in 11.1% after VAD courses vs 40.6% after CHEP courses. The mean cumulative dose of doxorubicin was 269 mg/m2 and the relative dose intensity was 84%. The overall response and complete response rates were 66.2% and 51.9% respectively, and after a median follow-up of 52 months the 3 year overall survival (OS) and event-free survival rates (EFS) were 43.5% and 33.0% respectively. In multivariate analysis, OS and EFS were statistically influenced by IPI (p = 3 x 10(-3); p < 1 x 10(-4)) and phenotype (p = 2 x 10(-3); p < 1 x 10(-4)). Our findings support the alternation of 4 courses of VAD and CHEP as it is well tolerated in patients over 60 years old with advanced intermediate- or high-grade NHL and provides response and survival rates comparable to 6 courses of CHOP.
Collapse
Affiliation(s)
- G Cartron
- Department of Hematology of Tours, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Colombat P, Salles G, Brousse N, Eftekhari P, Soubeyran P, Delwail V, Deconinck E, Haïoun C, Foussard C, Sebban C, Stamatoullas A, Milpied N, Boué F, Taillan B, Lederlin P, Najman A, Thièblemont C, Montestruc F, Mathieu-Boué A, Benzohra A, Solal-Céligny P. Rituximab (anti-CD20 monoclonal antibody) as single first-line therapy for patients with follicular lymphoma with a low tumor burden: clinical and molecular evaluation. Blood 2001; 97:101-6. [PMID: 11133748 DOI: 10.1182/blood.v97.1.101] [Citation(s) in RCA: 425] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The clinical activity of rituximab, a chimeric monoclonal antibody which binds to the CD20 antigen, was evaluated as a single first-line therapy for patients with follicular non-Hodgkin lymphoma (NHL). Fifty patients with follicular CD20(+) NHL and a low tumor burden were analyzed for clinical and molecular responses. They received 4 weekly infusions of rituximab at a dose of 375 mg/m(2). The response rate a month after treatment (day 50) was 36 of 49 (73%), with 10 patients in complete remission, 3 patients in complete remission/unconfirmed, and 23 patients in partial remission. Ten patients had stable disease, and the disease progressed in 3 patients. One of 13 (8%) patients in complete remission, 9 of 23 (39%) patients in partial remission, and 5 of 10 (50%) patients with stable disease exhibited disease progression during the first year. Within the study population, 32 patients were initially informative for polymerase chain reaction (PCR) data on bcl-2-J(H) rearrangement. On day 50, 17 of 30 patients (57%) were negative for bcl-2-J(H) rearrangement in peripheral blood, and 9 of 29 (31%) were negative in bone marrow; a significant association was observed between molecular and clinical responses (P <.0001). At month 12, 16 of 26 patients (62%) were PCR negative in peripheral blood. These results indicate that early molecular responses can be sustained for up to 12 months and that this response is highly correlated with progression-free survival. Rituximab has a high clinical activity and a low toxicity and induces a high complete molecular response rate in patients with follicular lymphoma and a low tumor burden.
Collapse
|
35
|
Rodon P, Linassier C, Gauvain JB, Benboubker L, Goupille P, Maigre M, Luthier F, Dugay J, Lucas V, Colombat P. Multiple myeloma in elderly patients: presenting features and outcome. Eur J Haematol 2001; 66:11-7. [PMID: 11168502 DOI: 10.1034/j.1600-0609.2001.00301.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Few studies have been performed regarding multiple myeloma (MM) in elderly patients. We report a retrospective series of 130 unselected patients with MM aged 75 yr or more at diagnosis. Presenting features were identical to those reported in younger patients, except for a higher rate of infection. Heavy comorbidity was characteristic of unselected geriatric patients. Ninety-four patients received conventional chemotherapy. The response rate was 62%. Treatment toxicity was mild. Median survival was 22 months. Durie-Salmon (DS) clinical stages II and III MM were severe and often led to death, while significantly more patients with DS stage I MM died from unrelated causes (p<0.0001). Univariate analysis showed that age > or = 85 yr, performance status > or = 2, creatinine level > or = 120 micromol/l, beta 2 microglobulin level > 4 mg/l, C-reactive protein level > 6 mg/l, platelet count < 100 x 10(9)/l, presence of infection and lack of response to chemotherapy were adverse prognostic factors for survival. In Cox multivariate regression analysis, age > or = 85 yr (p<0.0001), performance status > or = 2 (p<0.0001) and creatinine level > or = 120 micromol/l (p<0.0001) were independent factors in predicting short survival. This study provides evidence that in patients with symptomatic MM age should not be considered as a major obstacle to active treatment. Prospective clinical trials are needed in this population of patients and should include an assessment of quality of life.
Collapse
Affiliation(s)
- P Rodon
- Department of Internal Medicine and Haematology, Centre Hospitalier Général, Blois, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Limat S, Woronoff-Lemsi MC, Milpied N, Chartrin I, Ifrah N, Deconinck E, Gressin R, Colombat P, Cahn JY, Arveux P. Effect of cell determinant (CD)34+ cell dose on the cost and consequences of peripheral blood stem cell transplantation for non-Hodgkin's lymphoma patients in front-line therapy. Eur J Cancer 2000; 36:2360-7. [PMID: 11094310 DOI: 10.1016/s0959-8049(00)00327-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to assess the effect of cell determinant (CD)34+ cell dose on the cost and consequences of peripheral blood stem cell transplantation for non-Hodgkin's lymphoma (NHL) patients in front-line therapy. Resource utilisation, length of aplasia, overall (OS) and event-free survival (EFS) were assessed for 63 patients. Economic data were calculated taking into account harvest, hospitalisation, blood product requirements and drugs required until discharge. The point of view of the Hospital Institution was chosen. A significantly earlier haematopoietic engraftment was achieved in patients with a count of more than 5 x 10(6) CD34+/kg. There were no differences for OS and EFS. A high CD34+ cell content resulted in a total cost saving of $4210. This was principally related to a significant reduction in the length of hospitalisation (-$3010) and platelet and red blood cell transfusions (-$815), although the latter was not significant. Several sensitivity analyses showed the robustness of our results. A CD34+ cell dose higher than 5 x 10(6)/kg appeared to be optimal for clinical and economic considerations in NHL patients undergoing transplantation in front-line therapy.
Collapse
Affiliation(s)
- S Limat
- Department of Pharmacy, Besançon University Hospital, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Colombat P, Cornillet P, Deconinck E, Tourani JM, Gardembas M, Delain M, Abgrall JF, Kootz C, Milpied N. Value of autologous stem cell transplantation with purged bone marrow as first-line therapy for follicular lymphoma with high tumor burden: a GOELAMS phase II study. Bone Marrow Transplant 2000; 26:971-7. [PMID: 11100276 DOI: 10.1038/sj.bmt.1702631] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This prospective phase II study was undertaken to evaluate the efficacy and toxicity of early intensive therapy followed by purged autologous bone marrow transplantation (ABMT) in patients with follicular lymphoma with high tumor burden. All patients received the VCAP regimen (vindesine, cyclophosphamide, doxorubicin and prednisone) as conventional chemotherapy and DHAP as second-line therapy. Twenty-nine consecutive patients were included in the study. Twenty-seven patients were grafted, seven in first complete remission (CR) and 20 in first partial remission (PR). Preparative therapy consisted of cyclophosphamide and total body irradiation (TBI) in all the patients. With a median follow-up of 6 years, the actuarial overall survival is 64% and the actuarial event-free survival is 55%. Two treatment-related early deaths were observed. Eleven patients were informative for serial PCR analysis of minimal residual disease after ABMT: two relapsed, four remained disease-free with PCR positivity and five were disease-free with PCR negativity. These encouraging results lay the basis of future prospective randomized trials comparing autologous stem cell transplantation as front-line treatment with conventional chemotherapy for patients with bad prognostic factors.
Collapse
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Bone Marrow Purging
- Cisplatin/administration & dosage
- Cisplatin/adverse effects
- Combined Modality Therapy
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- Dexamethasone/administration & dosage
- Dexamethasone/adverse effects
- Disease-Free Survival
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Female
- Genes, Immunoglobulin
- Genes, bcl-2
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Lung Diseases, Interstitial/etiology
- Lymphoma, Follicular/drug therapy
- Lymphoma, Follicular/genetics
- Lymphoma, Follicular/mortality
- Lymphoma, Follicular/pathology
- Lymphoma, Follicular/therapy
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/mortality
- Lymphoma, Non-Hodgkin/pathology
- Lymphoma, Non-Hodgkin/therapy
- Male
- Middle Aged
- Neoplasm, Residual
- Neutropenia/etiology
- Polymerase Chain Reaction
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Recurrence
- Remission Induction
- Sepsis/etiology
- Survival Analysis
- Thrombocytopenia/etiology
- Translocation, Genetic
- Transplantation Conditioning/adverse effects
- Transplantation, Autologous
- Treatment Outcome
- Vincristine/administration & dosage
- Vincristine/adverse effects
Collapse
Affiliation(s)
- P Colombat
- Department of Hematology, CHU Bretonneau, Tours, France
| | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Benboubker L, Valat C, Linassier C, Cartron G, Delain M, Bout M, Fetissof F, Lefranq T, Lamagnere JP, Colombat P. A new serologic index for low-grade non-Hodgkin's lymphoma based on initial CA125 and LDH serum levels. Ann Oncol 2000; 11:1485-91. [PMID: 11142490 DOI: 10.1023/a:1026789232033] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Serum CA125 (sCA125) was recently reported to be of clinical value in the staging and follow-up of patients with non-Hodgkin's lymphoma (NHL). This report aims to investigate the prognostic value of a new serologic index combining sCA125 and LDH serum levels. PATIENTS AND METHODS One hundred thirty-seven patients were studied, sixty-three with histologically proven low-grade NHL, and seventy-four with a high-grade subtype. RESULTS sCA125 and LDH levels were elevated in more than one third of patients. sCA125 was more frequently increased than LDH in low-grade NHL. In this group, complete remission (CR) was achieved in 87, 45, and 0% (P = <2 x 10(-6)) of patients with normal sCA125 and LDH serum levels (Low-risk group), one parameter increased (Intermediate-risk group), and increased sCA125 and LDH serum levels (high-risk group), respectively. The estimated five-year overall survival was 97%, 67% and 22% for low, intermediate, and high-risk groups, respectively. This combination was the only parameter predictive of RFS and OS in multivariate analysis (P < 0.0001). CONCLUSIONS In this study the combination of s-LDH and sCA125 levels (normal vs. abnormal) was found to be an important prognostic factor in low-grade lymphoma and may be used in the selection of appropriate therapeutic approaches for individual patients.
Collapse
Affiliation(s)
- L Benboubker
- Department of Hematology/Oncology, H pital Bretonneau, Tours, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Linassier C, Barin C, Calais G, Letortorec S, Brémond JL, Delain M, Petit A, Georget MT, Cartron G, Raban N, Benboubker L, Leloup R, Binet C, Lamagnère JP, Colombat P. Early secondary acute myelogenous leukemia in breast cancer patients after treatment with mitoxantrone, cyclophosphamide, fluorouracil and radiation therapy. Ann Oncol 2000; 11:1289-94. [PMID: 11106118 DOI: 10.1023/a:1008375016038] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The topoisomerase II-targeted drugs, epipodophyllotoxins and anthracyclines, have been shown to induce therapy-related AML (t-AML) characterized by a short latency period after chemotherapy, the absence of prior myelodysplastic syndrome and stereotyped chromosome aberrations. Few reports have been published on patients treated with the anthracenedione mitoxantrone which also targets topoisomerase II. We observed 10 cases of such t-AML over a 7-year-period in breast cancer patients treated with mitoxantrone combined with fluorouracil, cyclophosphamide and regional radiotherapy, and in three cases with vindesine. PATIENTS AND METHODS We retrospectively analyzed patients referred to our hospital for AML with a past history of polychemotherapy for breast cancer, including mitoxantrone, either as adjuvant (8 patients)/neoadjuvant (1 patient) therapy or for metastatic disease (1 patient). We studied the probability of developing t-AML in a prospective series of 350 patients treated with an adjuvant FNC regimen (mitoxantrone, fluorouracil, cyclophosphamide) and radiation therapy. RESULTS The median age was 45 years (range 35-67). t-AML developed 13-36 months (median 16) after beginning chemotherapy for breast cancer, and 4-28 months (median 10.5) after ending treatment. As described in t-AML following treatment with epipodophyllotoxins or anthracyclines, we found a majority of FAB M4, M5 and M3 phenotypes (7 of 10), and characteristic karyotype abnormalities that also can be found in de novo AML: breakpoint on chromosome 11q23 (3 patients), inv(16)(p13q22) (2 patients), t(15;17)(q22;q11) (1 patient), t(8;21)(q22;q22) (1 patient) and del(20q)(q11) (1 patient). The prognosis was poor. All patients died of AML shortly after diagnosis. Since two patients had been enrolled in a prospective trial for the treatment of breast cancer which included 350 patients, the probability of developing t-AML was calculated to be 0.7% from 25-40 months, using the Kaplan-Meier method (95%, confidence interval (95% CI): 0.1-4.5). CONCLUSIONS The combination of mitoxantrone with cyclophosphamide, fluorouracil, and radiation therapy can induce t-AML, as with other topoisomerase II-targeted drugs. Despite a low incidence, the prognosis appears to be poor.
Collapse
Affiliation(s)
- C Linassier
- C. H. R. U. Bretonneau, Tours, France. linassier2med.univ-tours.fr
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Colombat P. [Therapeutic obstinacy, place of scientific basis in decision making in nursing]. Soins Gerontol 2000:9-11. [PMID: 11309865] [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: 02/19/2023]
Affiliation(s)
- P Colombat
- Service oncologie médicale et maladies du sang, Unité mobile de soins palliatifs, CHU Bretonneau, Tours
| |
Collapse
|
41
|
Benboubker L, Watier H, Domenech J, Carion A, Cartron G, Georget M, Herault O, Desbois I, Delain M, Bardos P, Colombat P, Binet C. Levels of CD34+ progenitor cells mobilized into peripheral blood are associated with SDF1 Gene variants. Exp Hematol 2000. [DOI: 10.1016/s0301-472x(00)00245-9] [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: 11/29/2022]
|
42
|
Deconinck E, Lamy T, Foussard C, Gaillard F, Delwail V, Colombat P, Casassus P, Lemevel A, Brion A, Milpied N. Autologous stem cell transplantation for anaplastic large-cell lymphomas: results of a prospective trial. Br J Haematol 2000; 109:736-42. [PMID: 10929023 DOI: 10.1046/j.1365-2141.2000.02098.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Autologous stem cell transplantation (ASCT) in the front line treatment of non-Hodgkin's lymphoma (NHL) remains controversial. Anaplastic large-cell lymphoma (ALCL) is known to have its own clinical and biological features. The outcome of ALCL patients treated with high-dose chemotherapy and ASCT as part of their first-line therapy was analysed in 202 intermediate or high-grade NHL patients in a prospective randomized trial. First-line chemotherapy comprised two alternating anthracycline-containing regimens. Responding patients were autografted after a BEAM (BCNU, cytarabine, etoposide and melphalan) regimen. Patients with bulky or residual masses were irradiated. Fifteen patients with ALCL were identified by morphological and immunological features (CD30 was expressed in 14 out of 15 patients, three patients expressed B-cell markers, five patients expressed T-cell markers and seven patients did not express cell markers). Anaplastic lymphoma kinase (ALK) expression was confirmed in seven cases. The median age was 39 years with a predominant male sex ratio (2.75). Thirteen patients were stage >/= III and six presented with two or more adverse prognostic factors. According to the international age-adjusted prognostic index, the expected complete remission (CR), event-free survival (EFS) and overall survival (OS) rates were 69%, 71% and 69%. Two deaths were observed (one due to interstitial pneumonitis, one due to pulmonary carcinoma). All patients entered CR, no relapse occurred and EFS and survival reached 87% with a follow-up of more than 5 years. These results differ significantly from those observed in the other 176 lymphoma patients: event-free survival was only 53 +/- 5% and OS reached 60 +/- 4% with a median follow-up of 56 months (P = 0.006). Intensified chemotherapy with autologous stem cell support appeared effective in the treatment of ALCL, offering patients the real chance of a cure.
Collapse
Affiliation(s)
- E Deconinck
- Department of Haematology, Jean Minjoz University Hospital, Besançon, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
|
44
|
Senecal D, Pichon E, Dubois F, Delain M, Linassier C, Colombat P. Acute hepatitis B after autologous stem cell transplantation in a man previously infected by hepatitis B virus. Bone Marrow Transplant 1999; 24:1243-4. [PMID: 10642815 DOI: 10.1038/sj.bmt.1702039] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We report a case of acute hepatitis B after autologous stem cell transplantation (ASCT) in a patient with low-grade non-Hodgkin's lymphoma. At diagnosis of the hematological disease, the patient had the characteristic serology of a previous hepatitis B infection, being Ag HBs negative, hepatitis B virus core antibody positive (anti-HBC) and hepatitis B virus surface antibody weakly positive. He developed fatal hepatitis B after autologous stem cell transplantation, suggesting reactivation consequent to immunosuppression.
Collapse
Affiliation(s)
- D Senecal
- Department of Hematology, CHU Bretonneau, Tours, France
| | | | | | | | | | | |
Collapse
|
45
|
Cartron G, Roingeard P, Benboubker L, Vaillant L, Tartas S, Delain M, Lefranc T, Brémond JL, Bout M, Linassier C, Colombat P. Sezary syndrome in a patient with multiple myeloma: demonstration of a clonally distinct second malignancy. Eur J Haematol 1999; 63:354-7. [PMID: 10580568 DOI: 10.1111/j.1600-0609.1999.tb01139.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
46
|
Milligan DW, Ruiz De Elvira MC, Kolb HJ, Goldstone AH, Meloni G, Rohatiner AZ, Colombat P, Schmitz N. Secondary leukaemia and myelodysplasia after autografting for lymphoma: results from the EBMT. EBMT Lymphoma and Late Effects Working Parties. European Group for Blood and Marrow Transplantation. Br J Haematol 1999; 106:1020-6. [PMID: 10520006 DOI: 10.1046/j.1365-2141.1999.01627.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Between 1978 and 1996 more than 7500 lymphoma transplants have been reported to the European Bone Marrow Transplantation (EBMT) Lymphoma Registry. This has been examined to establish the incidence of secondary leukaemia and myelodysplasia and to relate this to possible prognostic factors. 131 centres representing 4998 patients responded to a questionnaire. This identified 66 patients with post transplant myelodysplastic syndrome (MDS)/acute myeloid leukaemia (AML). The actuarial risk for MDS/AML at 5 years post-transplant (+/-95% CI) was 4.6% (3.1-6.8) for Hodgkin's disease and 3.0% (2.0-4. 3) for non-Hodgkin's lymphoma. Multivariate analysis for all patients demonstrated an effect of age at transplant, radiotherapy at conditioning, number of transplants and interval between diagnosis and transplant as risk factors. For patients with NHL, grade of histology was important (low grade > intermediate or high-grade); for Hodgkin's disease, female sex was identified as a risk factor. These findings suggest that the incidence of MDS/AML may not be greater following an autograft than after conventional chemotherapy.
Collapse
Affiliation(s)
- D W Milligan
- Department of Haematology, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Delain M, Cartron G, Bout M, Benboubker L, Linassier C, Lamagnere JP, Colombat P. Intensive therapy with autologous stem cell transplantation as first-line therapy in poor-risk Hodgkin's disease and analysis of predictive factors of outcome. Leuk Lymphoma 1999; 34:305-13. [PMID: 10439367 DOI: 10.3109/10428199909050955] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The value of high-dose therapy with autologous stem cell transplantation as first-line therapy in poor prognosis Hodgkin's disease is controversial and we report the results of evaluation of twenty-six patients who were selected for this procedure from February 1989 to July 1994. They were all patients with stage IV at diagnosis with at least two other unfavourable characteristics, i.e. B symptoms, mediastinal mass greater than 0.45 of the thoracic diameter, two or more extranodal sites, bone marrow involvement, inguinal node involvement, serum lactic dehydrogenase greater than 400 IU/L, or low hematocrit. At the time of transplantation, 19 patients were in complete remission and 10 were in partial remission > or = 50%. Procedure-related mortality in the first 90 days post-graft was 7% overall. Of the 24 evaluable patients, 22 (92%) were assessed as complete responders, and 2 (8%) had progression of disease at 6 months. The actuarial overall survival (OS), disease-free survival (DFS) and event-free survival (EFS) at 5 years were 69%, 79% and 58%, respectively. The Cox proportional hazards model was used to assess prognostic factors. In univariate analysis only one prognostic factor was found to be significantly associated with improved DFS, i.e. low serum lactic dehydrogenase (LDH) (DFS at 5 years: 92% if LDH < 400 IU/L vs 44% if LDH 400 IU/L, P = 0.007). DFS rates between first complete remission and first partial remission groups were not significantly different (DFS at 5 years: 87% vs 66%, p = 0.15). These first results are encouraging but randomized studies are needed.
Collapse
Affiliation(s)
- M Delain
- Department of Hematology/Oncology, Bretonneau Hospital, Tours, France
| | | | | | | | | | | | | |
Collapse
|
48
|
D'Alteroche L, Mor C, Durand V, De Muret A, Benbouker L, Colombat P, Danquechin Dorval E. [Gastric granulocytic sarcoma revealed by a massive digestive hemorrhage]. Gastroenterol Clin Biol 1999; 23:779-82. [PMID: 10470535] [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: 02/13/2023]
Abstract
We report the case of a 37-year-old-man having a chronic myelogenous leukemia, who presented, one month after a splenic acutization, massive gastrointestinal bleeding from ulcerated nodules of the gastric fundus. The histologic examination of one of these nodules showed granulocytic sarcoma. In spite of an endoscopic treatment by sclerotherapy with adrenalined serum, the death occurred during a hemorrhagic recurrence. This observation, which is the third case reported of gastric granulocytic sarcoma during the acutization of a myelogenous chronic leukemia, and the first revealed by fatal gastrointestinal bleeding, shows the particular gravity of gastrointestinal bleeding complicating granulocytic sarcoma.
Collapse
Affiliation(s)
- L D'Alteroche
- Service d'Hépato-Gastroentérologie, CHU Trousseau, Tours
| | | | | | | | | | | | | |
Collapse
|
49
|
Herault O, Colombat P, Domenech J, Degenne M, Bremond JL, Sensebe L, Bernard MC, Binet C. A rapid single-laser flow cytometric method for discrimination of early apoptotic cells in a heterogenous cell population. Br J Haematol 1999; 104:530-7. [PMID: 10086791 DOI: 10.1046/j.1365-2141.1999.01203.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
A recently reported cytometric method described the possibility of discriminating apoptotic from necrotic cells using FITC-labelled annexin V and propidium iodide (PI). Nevertheless, the brightness of PI-staining and its extensive spectral emission overlap with phycoerythrin (PE) does not permit the study of a subset of a heterogenous cell population with single laser instrumentation. The surface staining of a subset with PE in a heterogenous cell population therefore requires another exclusion dye to detect necrotic cells. We used 7-amino-actinomycin D (7-AAD) that can be excited by the 488 nm argon laser line. 7-AAD emits in the far red range of the spectrum and 7-AAD spectral emission can be separated from the emissions of FITC and PE. The fluorescence parameters allow characterization of necrotic (7-AAD+ annexin V-FITC+ cells), apoptotic (7-AAD-annexin V-FITC+ cells) and viable cells (7-AAD- annexin V-FITC- cells) in a subset of PE+ cells. The value of this method was demonstrated by measuring apoptosis and necrosis in a model of HL-60 cells exposed to different inducers of cell death. The method was validated by fluorescent cell sorting in combination with morphologic examination of the sorted cells. The technique we present is particularly valuable in a clinical setting because it enables rapid multiparameter analysis of necrosis and early apoptosis in combination with cell surface phenotyping with a single laser. We present the effects of haemopoietic growth factor deprivation on myeloid progenitor CD34+ cells as an example of its application.
Collapse
Affiliation(s)
- O Herault
- Faculty of Medicine, Laboratory of Haematology, Tours, France
| | | | | | | | | | | | | | | |
Collapse
|
50
|
André M, Henry-Amar M, Pico JL, Brice P, Blaise D, Kuentz M, Coiffier B, Colombat P, Cahn JY, Attal M, Fleury J, Milpied N, Nedellec G, Biron P, Tilly H, Jouet JP, Gisselbrecht C. Comparison of high-dose therapy and autologous stem-cell transplantation with conventional therapy for Hodgkin's disease induction failure: a case-control study. Société Francaise de Greffe de Moelle. J Clin Oncol 1999; 17:222-9. [PMID: 10458237 DOI: 10.1200/jco.1999.17.1.222] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine the prognostic factors and outcome of first-line induction failure Hodgkin's disease patients who were treated with a salvage regimen of high-dose chemotherapy and autologous stem-cell transplantation, and to compare them with matched, conventionally treated patients. PATIENTS AND METHODS We retrospectively analyzed data relating to 86 Hodgkin's disease patients who underwent autologous stem-cell transplantation after failure of the first chemotherapy regimen, either because they did not enter a complete remission and experienced progression of disease less than 3 months after the end of their first-line treatment or because they showed evidence of disease progression during first-line therapy. Graft patients were matched with 258 conventionally treated patients (three controls per case) for age, sex, clinical stage, B symptoms, and time at risk; patient data were obtained from international databases. RESULTS Among the 86 graft patients, the median age at diagnosis was 29 years (range, 14 to 57 years). Thirty-nine percent of patients had stage II disease, 23% had stage III disease, and 38% had stage IV disease. Seventy percent of the patients received chemotherapy and 30% received combined modality therapy; 60% of the patients received a seven- or eight-drug regimen. After this first-line treatment, 91% had disease progression and 9% had a brief partial response. Eighty patients received a second-line treatment; pretransplantation status was as follows: 24% of patients had a complete remission, 38% had a partial remission (PR), 14% had stable disease, and disease progression occurred in 24%. With a median follow-up of 22 months (range, 4 to 105 months) from diagnosis, the 5-year event-free survival and overall survival rates from transplantation were 25% and 35% (95% confidence intervals, 15 to 36 and 23 to 49), respectively. In multivariate analysis, the pretransplantation disease status after salvage therapy was the only significant prognostic factor for survival (PR: relative risk = 2.8, P = .017; progressive disease: relative risk (RR) = 5.26, P < .001). From diagnosis, the 6-year overall survival rates of the graft patients and 258 matched conventionally treated patients were 38% and 29%, respectively (P = .058). CONCLUSION Autologous stem-cell transplantation represents the best therapeutic option currently available for patients with primary induction failure and is associated with acceptable toxicity. Response to second-line treatment before high-dose chemotherapy is the only prognostic factor that can be correlated with survival.
Collapse
Affiliation(s)
- M André
- Hematology Institute, Hôpital Saint-Louis, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|