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Laribi K, Poulain S, Willems L, Merabet F, Herbaux C, Roos-Weil D, Laribi de Materre I, Roussel X, Nudel M, Tricot S, Dupuis J, Le Calloch R, Bareau B, Leblond V. Long-term results of Waldenström macroglobulinaemia treatment by bendamustine and rituximab: A study on behalf of the French Innovative Leukemia Organization (FILO). Br J Haematol 2024. [PMID: 38504454 DOI: 10.1111/bjh.19409] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/02/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
The bendamustine-rituximab (BR) schedule is an efficient first-line therapy in Waldenström macroglobulinaemia (WM). A previous analysis of 69 patients who received this treatment confirmed a high response rate and good progression-free (PFS) and overall survival (OS). With a median follow-up of 76.1 months (95% confidence interval [CI] 69.9-80.6), 5-year outcome is still excellent at 66.63% (95% CI 56.09-79.17) for PFS and 80.01% (95% CI 70.82-90.41) for OS. The rate of secondary cancers is 17.66% (IQR 7.99-27.64) at 66 months. Relapsed patients who received ibrutinib as second-line clearly benefited from this schedule. This confirms current recommendations suggesting BR long-term efficacy as first-line option in WM.
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Affiliation(s)
- Kamel Laribi
- Haematology Department, Le Mans Hospital, Le Mans, France
| | - Stéphanie Poulain
- Cellular Haematology, Biology and Pathology Center, Lille Regional and University Hospital and INSERM UMR 1172, IRCL, Lille, France
| | - Lise Willems
- Haematology Clinic, Cochin Hospital, APHP, Paris, France
| | - Fatiha Merabet
- Haematology and Oncology Clinic, André Mignot Hospital, Versailles Hospital, Versailles, France
| | - Charles Herbaux
- Haematology Clinic, Montpellier University Hospital, Montpellier, France
| | - Damien Roos-Weil
- Haematology Department, APHP, Sorbonne University, University Hospital La Pitié Salpêtrière-Charles Foix, Paris, France
| | | | - Xavier Roussel
- Haematology Department, University of Franche-Comté, INSERM UMR 1098, Besançon University Hospital, Besançon, France
| | - Morgane Nudel
- Haematology Department, Lille Regional and University Hospital, Lille, France
| | - Sabine Tricot
- Haematology Clinic, Valenciennes Hospital, Valenciennes, France
| | - Jehan Dupuis
- Lymphoid Malignancies Unit, APHP, Henri Mondor-Albert Chennevier Hospital, Créteil, France
| | - Ronan Le Calloch
- Internal Medicine, Infectiology and Blood Diseases, Cornouaille Hospital Center, Quimper, France
| | - Benoit Bareau
- Haematology and Internal Medicine Clinic, Sévigné Vivalto Santé Private Hospital, Cesson-Sévigné, France
| | - Véronique Leblond
- Haematology Department, APHP, Sorbonne University, University Hospital La Pitié Salpêtrière-Charles Foix, Paris, France
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2
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Laribi K, Leleu X, Texier N, Germain R, Touzeau C, Hammoud M, Payssot A, Schulmann S, Le Calloch R, Trebouet A, Chaoui D, David S, Benbrahim O, Benramdane R, Charvet‐Rumpler A, Jadeau C, Rouanet E, Decaux O, Perrot A. Real-life effectiveness of carfilzomib in patients with relapsed multiple myeloma receiving treatment in the context of early access: The CARMYN study. EJHaem 2024; 5:55-60. [PMID: 38406520 PMCID: PMC10887228 DOI: 10.1002/jha2.828] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 02/27/2024]
Abstract
The real-life retrospective observational study CARMYN aimed at investigating the long-term efficacy and safety of carfilzomib in combination with dexamethasone and lenalidomide (KRd, 159 patients). These patients (62% in first and 38% in second relapse, median age 62 yo) were treated between 02/2014 and 02/2017. Most had been pre-exposed to bortezomib (98.2%) and to an IMID (75.4%). At the time of collection, 90% had permanently discontinued carfilzomib. Data collection was conducted from January to July 2021 in 27 participating sites, after a median of 39 months follow-up. For patients treated with KRd, an overall response rate of 78.4% translated in a median progression free survival (PFS) of 24.0 months (95% CI 18.8-27.6) and a median overall survival (OS) of 51.1 months (95% CI 41.3-not reached). Results were poorer but difficult to interpret in the small cohort of Kd recipients. The study is one of the longest real-life studies of carfilzomib treatment in patients in first or second relapse. CARMYN confirmed the real-life long-term efficacy of carfilzomib in combination with lenalidomide and dexamethasone with results similar to those of clinical trials. The KRd regimen is thus an option to consider for late relapses in the current context of MM management.
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Affiliation(s)
| | | | | | | | - Cyrille Touzeau
- Hématologie Clinique, CHU de Nantes, CRCINA, INSERM, CNRS, Université d'Angers, Université de NantesNantesFrance
| | | | | | | | - Ronan Le Calloch
- Médecine Interne, Maladies Infectieuses et Maladies du Sang, CH de CornouailleQuimperFrance
| | | | | | - Selva David
- Hématologie, Polyclinique Le LanguedocNarbonneFrance
| | - Omar Benbrahim
- Hématologie Clinique, Nouvel Hôpital d'OrléansOrléansFrance
| | | | | | | | | | | | - Aurore Perrot
- Hématologie, CHU de Toulouse, IUC T‐OncopoleToulouseFrance
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3
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Vély A, Couturier MA, Delepine P, Le Calloch R, Ertault M, Gastinne T, Plichon C, Lebreton A, Lester MA, Larhantec G, Cormier N, Fouquet S, Houot R, Tanguy-Schmidt A, Hunault-Berger M, Orvain C. Comparison of efficacy and toxicity according to etoposide and cytarabine dosing in BEAM conditioning followed by autologous stem cell transplantation in Hodgkin lymphoma. Leuk Lymphoma 2023; 64:2178-2187. [PMID: 37615123 DOI: 10.1080/10428194.2023.2251073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/26/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
The combination of carmustine, etoposide, cytarabine, and melphalan (BEAM) followed by autologous stem cell transplantation (ASCT) is a commonly used intensification regimen for patients with Hodgkin lymphoma. As etoposide and cytarabine dosing are not defined, we conducted a retrospective, multicenter study, to compare efficacy and toxicity in 130 patients with Hodgkin lymphoma receiving etoposide and cytarabine at either 200 mg/m2/d (n = 50), 400 mg/m2/d (n = 35), or etoposide 200 mg/m2/d and cytarabine 400 mg/m2/d (n = 45). Progression-free survival and overall survival were not associated with the intensity of conditioning. Increased conditioning intensity was associated with longer duration of thrombocytopenia, a higher number of transfused RBC and platelet units and a higher frequency of mucositis, but serious adverse events or infectious complications were not increased. The intensity of BEAM regimen was not associated with survival but with the rate of cytopenia and mucositis advocating for the use of lower dosing in frail patients.
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Affiliation(s)
- Agathe Vély
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Angers, Angers, France
| | - Marie-Anne Couturier
- Service d'Hématologie Clinique, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | | | - Ronan Le Calloch
- Service d'Hématologie Clinique, Centre Hospitalier de Cornouaille, Quimper, France
| | - Marjan Ertault
- Service d'Hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Thomas Gastinne
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Chloé Plichon
- Service de Pharmacie, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Anne Lebreton
- Service de Pharmacie, Centre Hospitalier Universitaire de Angers, Angers, France
| | | | - Gaelle Larhantec
- Service de Pharmacie, Centre Hospitalier Régional et Universitaire de Brest, Brest, France
| | - Nicolas Cormier
- Service de Pharmacie, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | - Roch Houot
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Aline Tanguy-Schmidt
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Angers, Angers, France
- Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, Angers
- Federation hospitalo-universitaire « Grand Ouest against Leukemia »
| | - Mathilde Hunault-Berger
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Angers, Angers, France
- Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, Angers
- Federation hospitalo-universitaire « Grand Ouest against Leukemia »
| | - Corentin Orvain
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Angers, Angers, France
- Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, Angers
- Federation hospitalo-universitaire « Grand Ouest against Leukemia »
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Aubrais R, Bouabdallah K, Chartier L, Herbaux C, Banos A, Brice P, Sibon D, Schiano JM, Cluzeau T, Laribi K, Le Calloch R, Bellal M, Delapierre B, Daguindau N, Amorim S, Agbetiafa K, Chauchet A, Besson C, Durot E, Bonnet C, Fouillet L, Bijou F, Tournilhac O, Gaulard P, Parrens MC, Damaj G. Salvage therapy with brentuximab-vedotin and bendamustine for patients with R/R PTCL: a retrospective study from the LYSA group. Blood Adv 2023; 7:5733-5742. [PMID: 36477770 PMCID: PMC10539874 DOI: 10.1182/bloodadvances.2022008524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022] Open
Abstract
Patients with relapsed or refractory (R/R) peripheral T-cell lymphomas (PTCL) have a poor prognosis. Bendamustine (B) and brentuximab-vedotin (Bv) have shown interesting results in this setting. However, little information is available about their efficacy in combination. This multicenter and retrospective study aimed to evaluate the efficacy and safety of the combination of BBv in patients with noncutaneous R/R PTCL among 21 LYSA centers in France and Belgium. The primary objective was the overall response rate. A total of 82 patients with R/R PTCL were included. The best overall response rate (ORR) was 68%, with 49% of patients in complete response (CR). In multivariable analysis, only the disease status after the last regimen (relapse vs refractory) was associated with the response with an ORR of 83% vs 57%. Median duration of response was 15.4 months for patients in CR. With a median follow-up of 22 months, the median progression free survival (PFS) and overall survival (OS) were 8.3 and 26.3 months respectively. Moreover, patients in CR, who underwent an allogeneic transplant, had a better outcome than patients who did not with a median PFS and OS of 19.3 vs 4.8 months and not reached vs 12.4 months, respectively. Fifty-nine percent of patients experienced grade 3/4 adverse events that were mainly hematologic. BBv is highly active in patients with R/R PTCL and should be considered as a one of the best options of immunochemotherapy salvage combination in this setting and particularly as a bridge to allogeneic transplant for eligible patients.
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Affiliation(s)
- Raphaelle Aubrais
- Department of Hematology, Bordeaux University Hospital, Pessac, France
| | - Krimo Bouabdallah
- Department of Hematology, Bordeaux University Hospital, Pessac, France
| | - Loic Chartier
- Department of Biostatistics, The Lymphoma Academic Research Organization, Pierre-Bénite, France
| | - Charles Herbaux
- Department of Hematology, Montpellier University Hospital, Montpellier, France
| | - Anne Banos
- Department of Hematology, Centre Hospitalier de la Cote Basque Bayonne, Bayonne, France
| | - Pauline Brice
- Department of Hematology, Hôpital Saint-Louis, Paris, France
| | - David Sibon
- Department of Hematology, Hôpital Necker-Enfants maladies, Paris, France
| | - Jean Marc Schiano
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Thomas Cluzeau
- Department of Hematology, Nice University Hospital, Nice, France
| | - Kamel Laribi
- Department of Hematology, Centre Hospitalier du Mans, Le-Mans, France
| | - Ronan Le Calloch
- Department of Hematology, Centre Hospitalier de Cornouaille, Quimper, France
| | - Mathieu Bellal
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Baptiste Delapierre
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Nicolas Daguindau
- Department of Hematology, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Sandy Amorim
- Department of Hematology, Hopital Saint-Vincent, Lille, France
| | | | - Adrien Chauchet
- Department of Hematology, Besançon University Hospital, Besançon, France
| | - Caroline Besson
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - Eric Durot
- Department of Hematology, Reims University Hospital, Reims, France
| | - Christophe Bonnet
- Department of Hematology, Liège University Hospital, Liège, Belgique
| | - Ludovic Fouillet
- Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France
| | - Fontanet Bijou
- Department of Hematology, Institut Bergonie, Bordeaux, France
| | - Olivier Tournilhac
- Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France
| | - Philippe Gaulard
- Department of Pathology, Henri Mondor Hospital, Université Paris-Est, Créteil, France
| | | | - Gandhi Damaj
- Hematology Institute, University Hospital, Normandy University, Caen, France
| | - Lymphoma Study Association
- Department of Hematology, Bordeaux University Hospital, Pessac, France
- Department of Biostatistics, The Lymphoma Academic Research Organization, Pierre-Bénite, France
- Department of Hematology, Montpellier University Hospital, Montpellier, France
- Department of Hematology, Centre Hospitalier de la Cote Basque Bayonne, Bayonne, France
- Department of Hematology, Hôpital Saint-Louis, Paris, France
- Department of Hematology, Hôpital Necker-Enfants maladies, Paris, France
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
- Department of Hematology, Nice University Hospital, Nice, France
- Department of Hematology, Centre Hospitalier du Mans, Le-Mans, France
- Department of Hematology, Centre Hospitalier de Cornouaille, Quimper, France
- Hematology Institute, University Hospital, Normandy University, Caen, France
- Department of Hematology, Centre Hospitalier Annecy Genevois, Annecy, France
- Department of Hematology, Hopital Saint-Vincent, Lille, France
- Department of Hematology, Institut Curie, Paris, France
- Department of Hematology, Besançon University Hospital, Besançon, France
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
- Department of Hematology, Reims University Hospital, Reims, France
- Department of Hematology, Liège University Hospital, Liège, Belgique
- Department of Hematology, Institut de Cancérologie Lucien Neuwirth, Saint-Etienne, France
- Department of Hematology, Institut Bergonie, Bordeaux, France
- Department of Hematology, Estaing University Hospital, Clermont-Ferrand, France
- Department of Pathology, Henri Mondor Hospital, Université Paris-Est, Créteil, France
- Department of Pathology, Bordeaux University Hospital, Pessac, France
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5
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Talbot A, Bobin A, Tabone L, Lambert J, Boccaccio C, Deal C, Petillon MO, Allangba O, Agape P, Arnautou P, Belkhir R, Cailleres S, Chaoui D, Chrétien ML, Decaux O, Schulmann S, Frenzel L, Gastaud L, Huart A, Hulin C, Karlin L, Laribi K, Le Calloch R, Lenain P, Macro M, Manier S, Montes L, Moreau S, Moreau P, Morel V, Norwood J, Piocelle FO, Perrot A, Pica GM, Rey P, Schmitt A, Stoppa AM, Tiab M, Touzeau C, Vidal V, Vignon M, Vincent L, Van De Wyngaert Z, Zarnitsky C, Kerbouche N, Paka P, Leleu X, Arnulf B, Avet-Loiseau H, Du Myélome IIF. Real-world study of the efficacy and safety of belantamab mafodotin (GSK2857916) in relapsed or refractory multiple myeloma based on data from the nominative ATU in France: the IFM 2020-04 study. Haematologica 2023; 108:2774-2782. [PMID: 37078253 PMCID: PMC10543185 DOI: 10.3324/haematol.2022.281772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
Belantamab mafodotin (BM) is an anti-BCMA antibody-drug conjugate (GSK2857916) that represents an alternative option in multiple myeloma. We sought to assess the efficacy and safety of BM in a real-world setting in patients who benefited from an early access program. We conducted an observational, retrospective, multicenter study. Eligibility criteria were treatment of relapsed or refractory multiple myeloma (RRMM) in monotherapy in adult patients who have received at least three lines of therapy previously, including at least one immunomodulatory agent (IMiD), a proteasome inhibitor (PI) and an anti-CD38 monoclonal antibody, and whose disease progressed during the last treatment period. The primary endpoint of the study is to assess the overall survival (OS). Between November 2019 and December 2020, 106 patients were treated with BM; 97 were eligible for the efficacy evaluation and 104 for safety. The median age was 66 (range, 37-82) years. High-risk cytogenetics were identified in 40.9% of patients. Fifty-five (56.7%) patients were triple-class refractory and 11 (11.3%) were penta-class refractory. The median number of prior lines of treatment was five (range, 3-12). The median number of BM cycles administered was three (range, 1-22). The overall response rate at best response was 38.1% (37/97). The median OS was 9.3 months (95% confidence interval [CI]: 5.9-15.3), and median progression-free survival was 3.5 months (95% CI: 1.9-4.7). The median duration of response was 9 months (range, 4.65-10.4). Treatment was delayed for 55 (52.9%) patients including 36.5% for treatment-related toxicity. Ophthalmic adverse events, mainly grade ≤2, were the most common toxicity (48%). The occurrence of keratopathy was 37.5%. Overall, our data are concordant with the results from DREAMM-2 in terms of efficacy and safety on a non-biased population.
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Affiliation(s)
- Alexis Talbot
- Hôpital Saint Louis, APHP, Immuno-Hématologie, INSERM U976, équipe 5.
| | - Arthur Bobin
- CHU de Poitiers, Service d'Hématologie et Thérapie cellulaire, CIC U1402, Poitiers
| | | | - Jérôme Lambert
- ECSTRA, Centre de Recherche en Epidémiologie et Statistiques, INSERM UMR 1153
| | | | | | | | - Olivier Allangba
- Centre Hospitalier Yves Le Foll, Hématologie-Oncologie, Saint Brieuc
| | | | - Pierre Arnautou
- Hôpital d'Instruction des Armées Percy, Hématologie, Clamart
| | | | - Sylvie Cailleres
- Centre Hospitalier du Pays d'Aix, Service hématologie oncologie, Aix-enProvence
| | - Driss Chaoui
- Centre Hospitalier Victor Dupouy, Hématologie, Argenteuil
| | | | | | | | - Laurent Frenzel
- APHP, Hôpital Universitaire Necker Enfants Malades, Hématologie adultes
| | - Lauris Gastaud
- Centre Antoine Lacassagne, service onco-hématologie, Nice
| | - Antoine Huart
- CHU Toulouse - Hôpital de Rangueil, Néphrologie, Toulouse
| | - Cyrille Hulin
- CHU Bordeaux, Hématologie et thérapie cellulaire, Bordeaux
| | | | - Kamel Laribi
- Centre Hospitalier du Mans, Hématologie clinique, Le Mans
| | - Ronan Le Calloch
- Centre Hospitalier de Quimper Cornouaille, Service d'hématologie, Quimper
| | | | | | | | | | - Stéphane Moreau
- CHU de Limoges, Hématologie clinique et thérapie cellulaire, Limoges
| | | | | | | | | | - Aurore Perrot
- CHU de Toulouse, IUCT-O, Service Hématologie, Université de Toulouse UPS, Toulouse
| | | | | | | | | | - Mourad Tiab
- CHD Vendée, Médecine Interne, La Roche-sur-Yon
| | | | | | | | - Laure Vincent
- CHU Montpellier - Hôpital Saint Eloi, Hématologie, Montpellier
| | | | | | | | | | - Xavier Leleu
- CHU de Poitiers, Service d'Hématologie et Thérapie cellulaire, CIC U1402, Poitiers
| | - Bertrand Arnulf
- Hôpital Saint Louis, APHP, Immuno-Hématologie, INSERM U976, équipe 5
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Le Calloch R, Arnaud B, Le Clech L, Hutin P, Salmon F, Garnache Ottou F, Ianotto JC, Laribi K. Achievement of rapid complete remission in an 87-year-old female patient with azacytidine-venetoclax for blastic plasmacytoid dendritic cell neoplasm. Ann Hematol 2022; 101:1347-1349. [DOI: 10.1007/s00277-021-04718-2] [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] [Received: 10/05/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022]
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7
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Herbreteau L, Le Calloch R, Arnaud B, Cassou N, Rizcallah MJ, Hutin P, Le Clech L. Eculizumab, a real-life successful treatment for refractory cold agglutinin-mediated auto-immune hemolytic anemia secondary to lymphoproliferative disorders. Ann Hematol 2021; 100:2105-2106. [PMID: 34003325 DOI: 10.1007/s00277-021-04557-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Herbreteau
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France.
| | - Ronan Le Calloch
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
| | - Bertrand Arnaud
- Laboratory of Hematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
| | - Nicolas Cassou
- Department of Pharmacy, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
| | - Marie-Jeanne Rizcallah
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
| | - Pascal Hutin
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
| | - Lenaïg Le Clech
- Department of Internal Medicine, Infectious Diseases and Haematology, Cornouaille Hospital, 14, avenue Yves Thépot, 29200, Quimper, France
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8
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Vantyghem S, Peterlin P, Thépot S, Ménard A, Dubruille V, Debord C, Guillaume T, Garnier A, Le Bourgeois A, Wuilleme S, Godon C, Theisen O, Eveillard M, Delaunay J, Maisonneuve H, Morineau N, Villemagne B, Vigouroux S, Subiger F, Lestang E, Loirat M, Parcelier A, Godmer P, Mercier M, Trebouet A, Luque Paz D, Le Calloch R, Le Clech L, Bossard C, Moreau A, Ugo V, Hunault M, Moreau P, Le Gouill S, Chevallier P, Béné MC, Le Bris Y. Diagnosis and prognosis are supported by integrated assessment of next-generation sequencing in chronic myeloid malignancies. A real-life study. Haematologica 2021; 106:701-707. [PMID: 32241844 PMCID: PMC7927891 DOI: 10.3324/haematol.2019.242677] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Indexed: 12/15/2022] Open
Abstract
Next-generation sequencing (NGS) is used to investigate the presence of somatic mutations. The utility of incorporating routine sequencing to guide diagnosis and therapeutic decisions remains unclear. We report the findings of an observational, multicenter study that aimed to assess the impact of somatic mutation testing by NGS in a reallife setting of chronic myeloid malignancies. A total of 177 patients were enrolled, partitioned into two overlapping groups. In group A (n=94), the indication was to search for clonal hematopoiesis, in a context of suspected myelodysplastic syndrome or myeloproliferative neoplasia. In group B (n=95), the theranostic impact of somatic mutations was studied. A panel of 34 genes was used on DNA extracted from blood or bone marrow samples. Within group A, the detection of clonal hematopoiesis supported the diagnosis of chronic myeloid malignancies for 31 patients while the absence of clonal hematopoiesis ruled out the suspected diagnosis in 47 patients. Within group B, NGS identified prognostically relevant somatic mutations in 32 patients, which had a therapeutic impact in 18 cases. By determining the presence or absence of somatic mutations, the application of NGS in daily practice was found to be useful for an integrated final diagnosis in 83% of the patients. Moreover, the search for somatic mutations had a prognostic impact that led to treatment modification in 19% of the cases. This study outlines the fact that adequate implementation of new investigations may have a significant positive medico-economic impact by enabling appropriate management of patients.
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Affiliation(s)
| | | | - Sylvain Thépot
- Hematology Clinic, Angers University Hospital, Angers,CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire
| | - Audrey Ménard
- Hematology Biology, Nantes University Hospital, Nantes
| | | | | | | | - Alice Garnier
- Hematology Clinic, Nantes University Hospital, Nantes
| | | | | | | | | | - Marion Eveillard
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire,Hematology Biology, Nantes University Hospital, Nantes
| | | | | | | | | | | | | | - Elsa Lestang
- Hematology Clinic, Saint Nazaire Hospital, Saint Nazaire
| | - Marion Loirat
- Hematology Clinic, Saint Nazaire Hospital, Saint Nazaire
| | | | - Pascal Godmer
- Hematology Clinic, Bretagne Atlantique Hospital, Vannes
| | | | | | - Damien Luque Paz
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire,Hematology Biology, Angers University Hospital, Angers
| | | | | | - Céline Bossard
- Pathology Department, Nantes University Hospital, Nantes, France
| | - Anne Moreau
- Pathology Department, Nantes University Hospital, Nantes, France
| | - Valérie Ugo
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire,Hematology Biology, Angers University Hospital, Angers
| | - Mathilde Hunault
- Hematology Clinic, Angers University Hospital, Angers,CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire
| | - Philippe Moreau
- Hematology Clinic, Nantes University Hospital, Nantes,CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire
| | - Steven Le Gouill
- Hematology Clinic, Nantes University Hospital, Nantes,CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire
| | - Patrice Chevallier
- Hematology Clinic, Nantes University Hospital, Nantes,CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire
| | - Marie C Béné
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire,Hematology Biology, Nantes University Hospital, Nantes
| | - Yannick Le Bris
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Pays de la Loire,Hematology Biology, Nantes University Hospital, Nantes
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9
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Oberic L, Peyrade F, Puyade M, Bonnet C, Dartigues-Cuillères P, Fabiani B, Ruminy P, Maisonneuve H, Abraham J, Thieblemont C, Feugier P, Salles G, Bijou F, Pica GM, Damaj G, Haioun C, Casasnovas RO, Farhat H, Le Calloch R, Waultier-Rascalou A, Malak S, Paget J, Gat E, Tilly H, Jardin F. Subcutaneous Rituximab-MiniCHOP Compared With Subcutaneous Rituximab-MiniCHOP Plus Lenalidomide in Diffuse Large B-Cell Lymphoma for Patients Age 80 Years or Older. J Clin Oncol 2021; 39:1203-1213. [PMID: 33444079 DOI: 10.1200/jco.20.02666] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The prognosis of elderly patients with diffuse large B-cell lymphoma (DLBCL) is worse than that of young patients. An attenuated dose of chemotherapy-cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (R-miniCHOP)-is a good compromise between efficacy and safety in very elderly patients. In combination with R-CHOP (R2-CHOP), lenalidomide has an acceptable level of toxicity and may mitigate the negative prognosis of the non-germinal center B-cell-like phenotype. The Lymphoma Study association conducted a multicentric, phase III, open-label, randomized trial to compare R-miniCHOP and R2-miniCHOP. PATIENTS AND METHODS Patients of age 80 years or older with untreated DLBCL were randomly assigned into the R-miniCHOP21 group or the R2-miniCHOP21 group for six cycles and stratified according to CD10 expression and age. The first cycle of rituximab was delivered by IV on D1 after a prephase and then delivered subcutaneously on D1 of cycles 2-6. Lenalidomide was delivered at a dose of 10 mg once daily on D1-D14 of each cycle. The primary end point was overall survival (OS). RESULTS A total of 249 patients with new DLBCL were randomly assigned (127 R-miniCHOP and 122 R2-miniCHOP). The median age was 83 years (range, 80-96), and 55% of the patients were classified as non-GCB. The delivered dose for each R-miniCHOP compound was similar in both arms. Over a median follow-up of 25.1 months, the intention-to-treat analysis revealed that R2-miniCHOP did not improve OS (2-year OS 66% in R-miniCHOP and 65.7% in R2-miniCHOP arm, P = .98) in the overall population or in the non-GCB population. Grade 3-4 adverse events occurred in 53% of patients with R-miniCHOP and in 81% of patients with R2-miniCHOP. CONCLUSION The addition of lenalidomide to R-miniCHOP does not improve OS. Rituximab delivered subcutaneously was safe in this population.
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Affiliation(s)
- Lucie Oberic
- Department of Hematology, Institut Universitaire du Cancer, Toulouse-Oncopole, Toulouse, France
| | - Frederic Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Mathieu Puyade
- Department of Oncology-Haematology and Cell Therapy, CHU, Poitiers, INSERM, Inserm CIC 1402, Poitiers, France
| | - Christophe Bonnet
- Clinical Hematology Unit, CHU Liège, Liège Université, Campus Universitaire de Sart Tilman, Liège, Belgique
| | - Peggy Dartigues-Cuillères
- Anapath Research Unit (EA) EA4340 and Pathology Laboratory, Versailles University and APHP, Ambroise Paré Hospital, Boulogne, France
| | - Bettina Fabiani
- Department of Pathology, Hopital Saint-Antoine, APHP, Paris, France
| | | | - Hervé Maisonneuve
- Department of Clinical Hematology, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France
| | - Julie Abraham
- Department of Hematology, CHU Dupuytren, Limoges, France
| | - Catherine Thieblemont
- APHP, Hopital Saint-Louis, Hemato-oncologie; Université de Paris, Paris Diderot, Paris, France
| | - Pierre Feugier
- Department of Haematology, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre Les Nancy, France
| | - Gilles Salles
- Department of Hematology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre Benite, France
| | - Fontanet Bijou
- Department of Hematology, Hospital Bergonié, Bordeaux, France
| | - Gian-Matteo Pica
- Department of Hematology, Centre Hospitalier Métropole Savoie, Chambery, France
| | - Gandhi Damaj
- Department of Hematology, CHU Caen, Caen, France
| | - Corinne Haioun
- Department of Hematology, Henri Mondor University Hospital, UPEC, Creteil, France
| | | | - Hassan Farhat
- Department of Hematology, Centre Hospitalier de Versailles André Mignot, Versailles, France
| | - Ronan Le Calloch
- Centre hospitalier de Quimper Cornouaille/Université de Bretagne Occidentale, France
| | | | - Sandra Malak
- Department of Hematology, CLCC Rene Huguenin Institut Curie, Saint-Cloud, France
| | - Jerome Paget
- LYSARC, The Lymphoma Academic Research Organisation, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Elodie Gat
- LYSARC, The Lymphoma Academic Research Organisation, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Hervé Tilly
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, University of Normandy, INSERM U1245, Rouen, France
| | - Fabrice Jardin
- Department of Hematology, Centre Henri Becquerel, UNIROUEN, University of Normandy, INSERM U1245, Rouen, France
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10
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Laribi K, Baugier de Materre A, Sobh M, Cerroni L, Valentini CG, Aoki T, Suzuki R, Takeuchi K, Frankel AE, Cota C, Ghez D, Le Calloch R, Pagano L, Petrella T. Blastic plasmacytoid dendritic cell neoplasms: results of an international survey on 398 adult patients. Blood Adv 2020; 4:4838-4848. [PMID: 33027528 PMCID: PMC7556130 DOI: 10.1182/bloodadvances.2020002474] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study is to describe the clinical and prognostic features and to evaluate the outcome of different therapeutic approaches among patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN) who have been diagnosed and treated in different institutions. A total of 398 patients from 75 centers were included in the study. Treatment consisted of non-Hodgkin lymphoma (NHL)-like regimens in 129 (32.8%) patients and acute leukemia (AL)-like regimens in 113 (23.5%) patients. In 61 (15.5%) and 16 (4.1%) patients, chemotherapy was followed by allogeneic and autologous hematopoietic stem cell transplantation (HSCT), respectively. Twenty-seven (6.9%) patients received radiotherapy, 6 (1.5%) received new agents, and 62 (15.7%) received palliative care. After a median follow-up of 12 months, median overall survival (OS) was 18 months. Patients who received NHL/AL-like regimens, followed by allogeneic HSCT, had the best outcome; median OS was not reached. OS was 65 months for patients who underwent autologous HSCT; 18 months and 14 months, respectively, for those treated with AL-like and NHL-like regimens without consolidation; and 4 months for those receiving palliative care (P < .001). In BPDCN, chemotherapy with lymphoma- or AL-like regimens, followed by transplantation, represents the therapeutic strategy associated with the best outcome. Consolidation with allogeneic HSCT, when feasible, appears superior to autologous HSCT.
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Affiliation(s)
- Kamel Laribi
- Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France
| | | | - Mohamad Sobh
- Hematology, BMT Program, The Ottawa Hospital, Ottawa, ON, Canada
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | | | - Tomohiro Aoki
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Ritsuro Suzuki
- Department of Oncology/Hematology, Shimane University Hospital, Izumo, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets and Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Arthur E Frankel
- University of South Alabama Mitchell Cancer Institute, Mobile, AL
| | - Carlo Cota
- Department of Dermatology, IRCCS INRCA, Ancona, Italy
| | - David Ghez
- Department of Hematology, Institut Gustave Roussy, Villejuif, France
| | - Ronan Le Calloch
- Service de Médecine Interne-Maladies du Sang-Maladies Infectieuses, Centre Hospitalier de Cornouaille, Quimper, France; and
| | - Livio Pagano
- Fondazione Policlinico Universitario A. Gemelli, IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Tony Petrella
- Department of Pathology, University of Montréal, Hospital Maisonneuve-Rosemont, Montreal, QC, Canada
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11
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Kohn M, Karras A, Zaidan M, Bénière C, de Fréminville JB, Laribi K, Perrin MC, Malphettes M, Le Calloch R, Anglaret B, Martiniuc J, Bailly S, Chevret S, Molina T, Thervet E, Thieblemont C. Lymphomas with kidney involvement: the French multicenter retrospective LyKID study. Leuk Lymphoma 2020; 61:887-895. [PMID: 32037948 DOI: 10.1080/10428194.2019.1697811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The LyKID study is a nationwide survey in France of lymphoma patients with renal involvement based on biopsy and/or imaging, to evaluate its impact on disease outcome and renal function. A total of 87 adult cases of B or T-cell lymphomas were retrospectively analyzed. Interstitial topography was observed in most of the kidney biopsies (54/66; 80%). Kidney failure (glomerular filtration rate <60 mL/min/1.73 m2) was present in 47% of patients and was associated with non-significantly different outcome. After lymphoma treatment, 44% of patients had persistent chronic kidney failure (CKF); kidney failure at diagnosis was the only parameter associated with CKF in multivariate analysis. DLBCL (diffuse large B-cell lymphomas) represented half of the series, with noticeably CNS (central neurological system) relapse in 17% patients, while fewer than one of two patients had received CNS prophylaxis. To our knowledge, the LyKID study represents the largest published non-autopsy lymphoma series with renal involvement.
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Affiliation(s)
- Milena Kohn
- Hémato-Oncologie, APHP, Hôpital Saint-Louis, Paris, France
| | - Alexandre Karras
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
| | | | | | | | | | | | - Marion Malphettes
- Immuno-Pathologie Clinique, APHP, Hôpital Saint-Louis, Paris, France
| | - Ronan Le Calloch
- Service des Maladies du Sang, Médecine Interne, Maladies Infectieuses, CH de Quimper Cornouailles, Quimper, France
| | | | | | - Sarah Bailly
- Hématologie, Cliniques Universitaires Saint Luc Université catholique de Louvain, Bruxelles, Belgium
| | - Sylvie Chevret
- Biostatistiques, APHP, Hôpital Saint-Louis, Paris, France
| | | | - Eric Thervet
- Néphrologie, APHP, Hôpital Européen Georges Pompidou, Paris, France
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12
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Gendron N, de Fontbrune FS, Guyard A, Fadlallah J, Chantepie S, D'Aveni M, Le Calloch R, Garnier A, Couturier MA, Morel V, Bernard C, Terriou L, Lazaro E, Socié G, de Latour RP. Aplastic anemia related to thymoma: a survey on behalf of the French reference center of aplastic anemia and a review of the literature. Haematologica 2019; 105:e333-e336. [PMID: 31727769 DOI: 10.3324/haematol.2019.226134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Nicolas Gendron
- Laboratoire d'Hématologie, Hôpital Bichat - Claude Bernard, AP-HP, Paris.,Université de Paris, Paris
| | - Flore Sicre de Fontbrune
- Université de Paris, Paris.,Service d'Hématologie Greffe, Centre de référence des aplasies médullaires acquises et constitutionnelles, Hôpital Saint Louis, AP-HP, Paris
| | - Alice Guyard
- Université de Paris, Paris.,Service d'Anatomo-Pathologie, Hôpital Bichat - Claude Bernard, AP-HP, Paris
| | - Jehane Fadlallah
- Université de Paris, Paris.,Service d'Immunologie Clinique, Hôpital Saint Louis, AP-HP, Paris
| | | | | | - Ronan Le Calloch
- Service de Médecine Interne - Maladies du sang - Maladies Infectieuses, Centre Hospitalier de Cornouaille, Quimper
| | | | | | | | - Claire Bernard
- Service de Médecine Interne, Hôpital de la Croix-Rousse, Hospices civils de Lyon, Lyon
| | | | | | - Gérard Socié
- Université de Paris, Paris.,Service d'Hématologie Greffe, Centre de référence des aplasies médullaires acquises et constitutionnelles, Hôpital Saint Louis, AP-HP, Paris
| | - Régis Peffault de Latour
- Université de Paris, Paris.,Service d'Hématologie Greffe, Centre de référence des aplasies médullaires acquises et constitutionnelles, Hôpital Saint Louis, AP-HP, Paris
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13
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Le Gall-Ianotto C, Le Calloch R, Couturier MA, Chauveau A, Lippert E, Carré JL, Misery L, Ianotto JC. Aquagenic pruritus in essential thrombocythemia is associated with a higher risk of thrombosis. J Thromb Haemost 2019; 17:1950-1955. [PMID: 31344312 DOI: 10.1111/jth.14588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/21/2019] [Accepted: 07/22/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Thromboses and phenotypic evolutions (leukemia, myelofibrosis) are the most frequent complications in polycythemia vera (PV) and essential thrombocythemia (ET). Aquagenic pruritus (AP) is not only PV symptom, but is also present in ET. The presence of pruritus in PV is associated with a lower risk of arterial thrombosis. AIMS To date, no equivalent study has been done to analyse the impact of AP for ET patients. MATERIALS & METHODS We used the data from our cohort of patients with myeloproliferative neoplasms seen in our institution (OBENE database, NCT02897297). We collect information at diagnosis, presence or not of AP and all types of complications during their follow-up. To avoid masked PV, all JAK2 positive cases were tested isotopic red mass cell if appropriate. RESULTS Among 396 ET patients, presence of AP was found in 42 (10.6%). ET patients with AP were more proliferative, more symptomatic at diagnosis and more difficult to treat. Furthermore, they presented increased risk of thromboses (30.9 versus 17%, P = .03; OR = 2.2 [1.01;4.66]) and phenotypic evolutions (33.3 versus 13.3%, P = .0007; OR = 3.2 [1.44;6.77]), during follow-up. DISCUSSION Aquagenic pruritus is classically associated to PV. But we confirmed here that AP is also present in ET and characterizes patients with higher risk of morbidity (thrombotic events and phenotypic evolutions). CONCLUSIONS The systematic determination of the presence of AP in ET patients should permit us to better identify these high-risk patients for better management and follow-up.
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Affiliation(s)
- Christelle Le Gall-Ianotto
- Department of Dermatology, University Hospital of Brest, Brest, France
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
| | - Ronan Le Calloch
- Department of Internal Medicine-Hematology, Hospital of Cornouaille, Quimper, France
| | | | - Aurélie Chauveau
- Laboratory of Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
| | - Eric Lippert
- Laboratory of Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
| | - Jean-Luc Carré
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
- Laboratory of Biochemistry, University Hospital of Brest, Brest, France
| | - Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
- Laboratory of Interactions Neurons-Keratinocytes, University of Brest, Brest, France
| | - Jean-Christophe Ianotto
- Department of Clinical Hematology, University Hospital of Brest, Brest, France
- France Intergroup of Myeloproliferative Neoplasms (FIM), France
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14
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Laribi K, Poulain S, Willems L, Merabet F, Le Calloch R, Eveillard JR, Herbaux C, Roos‐Weil D, Chaoui D, Roussel X, Tricot S, Dupuis J, Dartigeas C, Bareau B, Bene MC, Baugier de Materre A, Leblond V. Bendamustine plus rituximab in newly‐diagnosed Waldenström macroglobulinaemia patients. A study on behalf of the French Innovative Leukaemia Organization (FILO). Br J Haematol 2018; 186:146-149. [DOI: 10.1111/bjh.15718] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kamel Laribi
- Department of Haematology Centre hospitalier Le Mans Le MansFrance
| | - Stéphanie Poulain
- Service d'Hématologie Cellulaire Centre de Biologie et Pathologie CHRU de Lille, France INSERM UMR 1172 IRCL LilleFrance
| | - Lise Willems
- Unité Fonctionnelle d'Hématologie Hôpital Cochin Assistance Publique Hôpitaux de Paris ParisFrance
| | - Fatiha Merabet
- Service Hématologie et Oncologie Hôpital André Mignot Centre Hospitalier de Versailles VersaillesFrance
| | - Ronan Le Calloch
- Service de médecine interne, maladies du sang et infectiologie Cornouaille Hospital Center QuimperFrance
| | | | - Charles Herbaux
- Service des Maladies du Sang Centre Hospitalier Universitaire (CHU) Lille LilleFrance
| | - Damien Roos‐Weil
- Haematology Department Sorbonne Universités UPMC Univ Paris 06, GRC‐11 Assistance Publique‐Hôpitaux de Paris University Hospital La Pitié Salpêtrière‐Charles Foix ParisFrance
| | - Driss Chaoui
- Service d'Hématologie Centre Hospitalier Universitaire BesançonFrance
| | - Xavier Roussel
- Service d'Hématologie Centre Hospitalier Universitaire BesançonFrance
| | - Sabine Tricot
- Service d'Hématologie Clinique CH de Valenciennes ValenciennesFrance
| | - Jehan Dupuis
- Lymphoid Malignancies Unit Groupe Hospitalier Henri Mondor‐Albert Chennevier APHP CreteilFrance
| | - Caroline Dartigeas
- Hématologie et Thérapie Cellulaire Hôpital Bretonneau CHU Tours ToursFrance
| | - Benoit Bareau
- Service d'hématologie et médecine interne Hôpital privé Sévigné, Vivalto Santé Cesson‐SévignéFrance
| | - Marie C. Bene
- Haematology Biology Nantes University Hospital NantesFrance
| | | | - Véronique Leblond
- Service d'Hématologie Hôpital Pitié Salpêtrière APHP Sorbonne Universités Paris France
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15
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Babey H, Quéré G, Descourt R, Le Calloch R, Lanfranco L, Nousbaum JB, Cornec D, Tison A, Chouaid C. Immune-checkpoint inhibitors to treat cancers in specific immunocompromised populations: a critical review. Expert Rev Anticancer Ther 2018; 18:981-989. [PMID: 29995451 DOI: 10.1080/14737140.2018.1499468] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Because of their efficacy against numerous cancers, immune-checkpoint inhibitors (ICIs), anti-cytotoxic T-lymphocyte antigen-4, and anti-programmed cell death monoclonal antibodies are being used ever more often in oncology. However, some patients were excluded from clinical trials because of their comorbidities despite their potentially higher cancer frequencies, as is the case for immunocompromised patients. Areas covered: We analyzed reported preclinical and clinical information and evaluated the risk/benefit ratio for four immunocompromised populations: people living with human immunodeficiency virus (PLHs), solid-organ transplant recipients, recipients of hematopoietic stem-cell allografts, and patients with autoimmune diseases. Expert commentary: Information available in the literature is fragmentary and scarce, making it difficult to evaluate the risk/benefit ratio. It can, nonetheless, be noted that ICI use in PLHs seems possible. For solid-organ transplant recipients, the risk for the graft seems elevated. For the other two populations, it is difficult to conclude at this time.
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Affiliation(s)
- Hélène Babey
- a Institut de Cancerologie de Bretagne occidentale , Centre Hospitalier Universitaire de Brest , Brest , France
| | - Gilles Quéré
- a Institut de Cancerologie de Bretagne occidentale , Centre Hospitalier Universitaire de Brest , Brest , France
| | - Renaud Descourt
- a Institut de Cancerologie de Bretagne occidentale , Centre Hospitalier Universitaire de Brest , Brest , France
| | - Ronan Le Calloch
- b Service des maladies du sang, médecine interne, maladies infectieuses (MIIS) , Centre Hospitalier de Quimper Cornouaille , Quimper , France.,c Université de Brest , Fédération Inter Hospitalier d'Immuno-Hématologie de Bretagne Occidentale (FIHBO) , Brest , France
| | - Luca Lanfranco
- d Service de néphrologie , Centre Hospitalier Universitaire de Brest , Brest , France.,e UMR1227, Lymphocytes B et Autoimmunité, Inserm, LabEx IGO , Université de Brest , Brest , France
| | - Jean-Baptiste Nousbaum
- f Service d'Hépato-gastroentérologie , Centre Hospitalier Universitaire de Brest , Brest , France.,g Registre Finistérien des Tumeurs Digestives, EA 7479 SPURBO , Université de Bretagne Occidentale , Brest , France
| | - Divi Cornec
- e UMR1227, Lymphocytes B et Autoimmunité, Inserm, LabEx IGO , Université de Brest , Brest , France.,h Rhumatologie et Centre National de Référence des Maladies Auto-Immunes Rares CERAINO , CHRU de Brest , Brest , France
| | - Alice Tison
- e UMR1227, Lymphocytes B et Autoimmunité, Inserm, LabEx IGO , Université de Brest , Brest , France.,h Rhumatologie et Centre National de Référence des Maladies Auto-Immunes Rares CERAINO , CHRU de Brest , Brest , France
| | - Christos Chouaid
- i Service de pneumologie , Centre Hospitalier Intercommunal de Créteil , Créteil , France
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16
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Mollard LM, Chauveau A, Boyer-Perrard F, Douet-Guilbert N, Houot R, Quintin-Roué I, Couturier MA, Dagorne A, Malou M, Le Calloch R, Luycx O, Thepot S, Hunault M, Guillerm G, Berthou C, Ugo V, Lippert É, Ianotto JC. Outcome of Ph negative myeloproliferative neoplasms transforming to accelerated or leukemic phase. Leuk Lymphoma 2018; 59:2812-2820. [PMID: 29616837 DOI: 10.1080/10428194.2018.1441408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Myeloproliferative neoplasms (MPN) are chronic disorders that can sometimes evolve into accelerated or leukemic phases. We retrospectively identified 122 patients with such blastic phases. The overall median survival was four months: 10.2 months for patients treated with intensive treatments compared to three months for best supportive care (p = .005). Azacytidine, intensive chemotherapies, or allogeneic stem cell transplantation gave the highest median survivals with 9, 10.2, and 19.4 months, respectively. Accelerated phases (AP) had a longer median survival compared to acute leukemia (4.8 months vs. 3.1 months; p = .02). In this retrospective and observational study, we observe that the longest survivals are seen in patients eligible for intensive treatments. Azacytidine shows interesting results in patients non-fit for intensive chemotherapy. Supportive care should probably be restricted to elderly patients and those with unfavorable karyotype. An early diagnosis of AP could also result in a better survival rate.
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Affiliation(s)
- Lise-Marie Mollard
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | | | | | | | - Roch Houot
- e Laboratoire d'Anatomo-Pathologie, CHRU Brest , Brest , France
| | | | | | - Anaig Dagorne
- h Service d'Hématologie Clinique, CH de Morlaix , Brest , France
| | - Mohamed Malou
- i Service de Médecine Interne, CH de Quimper , Brest , France
| | | | - Odile Luycx
- k Laboratoire d'Hématologie, CHU d'Angers , Brest , France
| | - Sylvain Thepot
- c Service des Maladies du Sang, CHU d'Angers , Brest , France
| | | | - Gaelle Guillerm
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | - Christian Berthou
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
| | - Valérie Ugo
- i Service de Médecine Interne, CH de Quimper , Brest , France
| | - Éric Lippert
- b Laboratoire d'Hématologie, CHRU de Brest , Brest , France
| | - Jean-Christophe Ianotto
- a Service d'Hématologie Clinique, Institut de Cancéro-Hématologie, CHRU de Brest , Brest , France
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Le Clech L, Talarmin JP, Couturier MA, Ianotto JC, Nicol C, Le Calloch R, Dos Santos S, Hutin P, Tandé D, Cogulet V, Berthou C, Guillerm G. Early discontinuation of empirical antibacterial therapy in febrile neutropenia: the ANTIBIOSTOP study. Infect Dis (Lond) 2018; 50:539-549. [PMID: 29451055 DOI: 10.1080/23744235.2018.1438649] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia. METHODS In the first phase of the study, empirical antibiotic therapy in FUO patients was stopped after 48 h of apyrexia, in accordance with European Conference on Infections in Leukaemia guidelines (n = 45). In the second phase of the study, antibiotics were stopped no later than day 5 for all FUO patients, regardless of body temperature or leukocyte count (n = 37). RESULTS Two hundred and thirty-eight cases of febrile neutropenia in 123 patients were included. Neither the composite endpoint (p = .11), nor each component (in-hospital mortality (p = .80), intensive care unit admission (p = 0.48), relapse of infection ≤48 h after discontinuation of antibiotics (p = .82)) differed between the two FUO groups. Violation of protocol occurred in 17/82 episodes of FUO without any major impact on statistical results. Twenty-six (57.3%) and 22 (59.5%) FUO episodes did not relapse during hospital-stay (p = 1), and nine (20%) and five (13.5%) presented another FUO, respectively. One hundred and fifty-six episodes of febrile neutropenia (65.5%) were clinically or microbiologically documented, including 85 bacteremia. CONCLUSIONS These results suggest that early discontinuation of empirical antibiotics in FUO is safe for afebrile neutropenic patients.
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Affiliation(s)
- Lenaïg Le Clech
- a Department of Haematology , Brest Teaching Hospital , Brest , France.,b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | - Jean-Philippe Talarmin
- b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | | | | | - Christophe Nicol
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | - Ronan Le Calloch
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | | | - Pascal Hutin
- b Department of Internal Medicine, Infectious Diseases and Haematology , Cornouaille Hospital Quimper , Quimper , France
| | - Didier Tandé
- c Laboratory of Bacteriology , Brest Teaching Hospital , Brest , France
| | - Virginie Cogulet
- d Department of Pharmacy , Brest Teaching Hospital , Brest , France
| | - Christian Berthou
- a Department of Haematology , Brest Teaching Hospital , Brest , France
| | - Gaëlle Guillerm
- a Department of Haematology , Brest Teaching Hospital , Brest , France
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18
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Le Calloch R, Lacut K, Le Gall-Ianotto C, Nowak E, Abiven M, Tempescul A, Dalbies F, Eveillard JR, Ugo V, Giraudier S, Guillerm G, Lippert E, Berthou C, Ianotto JC. Non-adherence to treatment with cytoreductive and/or antithrombotic drugs is frequent and associated with an increased risk of complications in patients with polycythemia vera or essential thrombocythemia (OUEST study). Haematologica 2017; 103:607-613. [PMID: 29246923 PMCID: PMC5865440 DOI: 10.3324/haematol.2017.180448] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/15/2017] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to identify the incidence, causes and impact of non-adherence to oral and subcutaneous chronic treatments for patients with polycythemia vera or essential thrombocythemia. Patients receiving cytoreductive drugs for polycythemia vera or essential thrombocythemia were recruited at our institution (Observatoire Brestois des Néoplasies Myéloprolifératives registry). They completed a one-shot questionnaire designed by investigators (Etude de l’Observance Thérapeutique et des Effets Secondaires des Traitements study). Data about complications (thrombosis, transformation and death) at any time in the patient’s life (before diagnosis, up until consultation and after the completion of the questionnaire) were collected. Sixty-five (22.7%) of 286 patients reported poor adherence (<90%) to their treatment with cytoreductive drugs and 46/255/18%) also declared non-adherence to antithrombotic drugs. In total, 85/286 patients (29.7%) declared they did not adhere to their treatment. Missing an intake was rare and was mostly due to forgetfulness especially during occupational travel and holidays. Patients who did not adhere to their treatment were characterized by younger age, living alone, having few medications but a high numbers of pills and determining their own schedule of drug intake. Having experienced thrombosis or hematologic evolution did not influence the adherence rate. Non-adherence to oral therapy was associated with a higher risk of phenotypic evolution (7.3 versus 1.8%, P=0.05). For patients treated for polycythemia vera or essential thrombocythemia, non-adherence to cytoreductive and/or antithrombotic therapies is frequent and is influenced by age, habitus and concomitant treatments, but not by disease history or treatment side effects. Phenotypic evolution seems to be more frequent in the non-adherent group.
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Affiliation(s)
- Ronan Le Calloch
- Service de Médecine Interne-Maladies du Sang-Maladies Infectieuses (MIIS), CHIC de Quimper, France.,Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France
| | - Karine Lacut
- CIC 1412, INSERM, Brest, France.,EA3878 G.E.T.B.O, Université de Bretagne Occidentale, Brest, France.,Département de Médecine Interne et Pneumologie, CHRU de Brest, France
| | | | | | | | - Adrian Tempescul
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Florence Dalbies
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Jean-Richard Eveillard
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Valérie Ugo
- Laboratoire d'Hématologie, CHU d'Angers, France
| | | | - Gaëlle Guillerm
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Eric Lippert
- Laboratoire d'Hématologie, CHRU de Brest and Equipe ECLA, INSERM U1078, Université de Bretagne Occidentale, Brest, France
| | - Christian Berthou
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
| | - Jean-Christophe Ianotto
- Fédération Inter Hospitalière d'Immuno-Hématologie de Bretagne Occidentale (FIHBO), France .,EA3878 G.E.T.B.O, Université de Bretagne Occidentale, Brest, France.,Service d'Hématologie Clinique, Institut de Cancérologie et Hématologie, CHRU de Brest, France
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Montelescaut E, Bailly P, Le Calloch R, Thill C, Aries P, Ben Salem D. Une cause rare d’hémorragie méningée. Presse Med 2016; 45:470-3. [DOI: 10.1016/j.lpm.2016.01.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/04/2016] [Accepted: 01/13/2016] [Indexed: 11/24/2022] Open
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Abstract
Aplastic anaemia is a rare and serious disease characterised by severe immunosuppression due to prolonged neutropenia and the use of immunosuppressants such as corticosteroids, cyclosporine and antithymocyte globulin. Candida species are pathogens of low virulence colonising the skin and the digestive tract of many healthy individuals. Nonetheless, the incidence of invasive candidal infection is increasing. The widespread use of central intravascular catheters, invasive procedures, broad-spectrum antibiotics and immunosuppresion predisposes patients to these infections. Eye, skin, cardiac, liver, spleen and brain infection are the most common sites of invasive candidiasis. Bone and joint infections are less frequent and Candida hip septic arthritis is extremely rare. We present here a patient treated for aplastic anaemia, who developed fungal arthritis of the hip and systemic candidaemia.
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