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Mairiniac P, Rigolot L, Bertoli S, Tavitian S, Rieu JB, Canali A. A case of acute megakaryoblastic leukaemia following a mediastinal germ cell tumour. EJHaem 2024; 5:410-411. [PMID: 38633127 PMCID: PMC11020115 DOI: 10.1002/jha2.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/30/2023] [Indexed: 04/19/2024]
Affiliation(s)
| | - Lucie Rigolot
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Sarah Bertoli
- Department of HaematologyCancer University Institute of Toulouse – OncopoleToulouseFrance
- Cancer Research Centre of ToulousePaul Sabatier UniversityToulouseFrance
| | - Suzanne Tavitian
- Department of HaematologyCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Jean Baptiste Rieu
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Alban Canali
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
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2
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Gabellier L, Peterlin P, Thepot S, Hicheri Y, Paul F, Gallego-Hernanz MP, Bertoli S, Turlure P, Pigneux A, Guieze R, Ochmann M, Malfuson JV, Cluzeau T, Thomas X, Tavernier E, Jourdan E, Bonnet S, Tudesq JJ, Raffoux E. Hypomethylating agent monotherapy in core binding factor acute myeloid leukemia: a French multicentric retrospective study. Ann Hematol 2024; 103:759-769. [PMID: 38273140 PMCID: PMC10867066 DOI: 10.1007/s00277-024-05623-0] [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: 10/26/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024]
Abstract
Very few data are available about hypomethylating agent (HMA) efficiency in core binding factor acute myeloid leukemias (CBF-AML). Our main objective was to evaluate the efficacy and safety of HMA in the specific subset of CBF-AML. Here, we report the results of a multicenter retrospective French study about efficacy of HMA monotherapy, used frontline or for R/R CBF-AML. Forty-nine patients were included, and received a median of 5 courses of azacitidine (n = 46) or decitabine (n = 3). ORR was 49% for the whole cohort with a median time to response of 112 days. After a median follow-up of 72.3 months, median OS for the total cohort was 10.6 months. In multivariate analysis, hematological relapse of CBF-AML at HMA initiation was significantly associated with a poorer OS (HR: 2.13; 95%CI: 1.04-4.36; p = 0.038). Responders had a significantly improved OS (1-year OS: 75%) compared to non-responders (1-year OS: 15.3%; p < 0.0001). Hematological improvement occurred for respectively 28%, 33% and 48% for patients who were red blood cell or platelet transfusion-dependent, or who experienced grade 3/4 neutropenia at HMA initiation. Adverse events were consistent with the known safety profile of HMA. Our study highlights that HMA is a well-tolerated therapeutic option with moderate clinical activity for R/R CBF-AML and for patients who cannot handle intensive chemotherapy.
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Affiliation(s)
- Ludovic Gabellier
- Département d'Hématologie Clinique, CHU Montpellier, Université Montpellier-Nîmes, 80, Avenue Augustin Fliche, 34090, Montpellier, France.
| | - Pierre Peterlin
- Département d'Hématologie Clinique, CHU Nantes, Université de Nantes, Nantes, France
| | - Sylvain Thepot
- Département d'Hématologie Clinique, CHU Angers, Université d'Angers, Angers, France
| | - Yosr Hicheri
- Département d'Hématologie Clinique, Institut Paoli-Calmettes, Marseille, France
| | - Franciane Paul
- Département d'Hématologie Clinique, CHU Montpellier, Université Montpellier-Nîmes, 80, Avenue Augustin Fliche, 34090, Montpellier, France
| | | | - Sarah Bertoli
- Service d'Hématologie Clinique, CHU Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III - Paul Sabatier, Toulouse, France
| | - Pascal Turlure
- Département d'Hématologie Clinique, CHU Limoges, Université de Limoges, Limoges, France
| | - Arnaud Pigneux
- Département d'Hématologie Clinique, CHU Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Romain Guieze
- Département d'Hématologie Clinique, CHU Clermont-Ferrand, Université de Clermont-Ferrand, Clermont-Ferrand, France
| | - Marlène Ochmann
- Département d'Hématologie Clinique, Orléans, Orléans, CH, France
| | - Jean-Valère Malfuson
- Département d'Hématologie Clinique, Hôpital d'instruction Des Armées, Percy, France
| | - Thomas Cluzeau
- Département d'Hématologie Clinique, CHU Nice, Université de Nice, Nice, France
| | - Xavier Thomas
- Département d'Hématologie Clinique, Hospices Civils de Lyon, CHU Lyon, Université de Lyon, Lyon, France
| | - Emmanuelle Tavernier
- Département d'Hématologie Clinique, Institut de Cancérologie Lucien Neuwirth, Université de Saint-Etienne, Saint-Etienne, France
| | - Eric Jourdan
- Département d'Hématologie Clinique, CHU Nîmes, Université de Montpellier-Nîmes, Nîmes, France
| | - Sarah Bonnet
- Département d'Hématologie Clinique, CHU Montpellier, Université Montpellier-Nîmes, 80, Avenue Augustin Fliche, 34090, Montpellier, France
| | - Jean-Jacques Tudesq
- Département d'Hématologie Clinique, CHU Montpellier, Université Montpellier-Nîmes, 80, Avenue Augustin Fliche, 34090, Montpellier, France
| | - Emmanuel Raffoux
- Département d'Hématologie Clinique Adultes, Hôpital Saint-Louis, APHP, Université Paris Diderot, Paris, France
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3
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Leroy H, Gadaud N, Bérard E, Klein E, Luquet I, Vial J, Rieu J, Lechevalier N, Tavitian S, Leguay T, Largeaud L, Bidet A, Delabesse E, Sarry A, de Grande A, Récher C, Pigneux A, Bertoli S, Dumas P. Dismal outcome of refractory or relapsing patients with myelodysplasia-related acute myeloid leukemia partially alleviated by intensive chemotherapy. Cancer Med 2024; 13:e7003. [PMID: 38400682 PMCID: PMC10891460 DOI: 10.1002/cam4.7003] [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: 05/15/2023] [Revised: 01/08/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) with myelodysplasia-related characteristics is a heterogeneous subset of AML that has been challenged throughout the history of myeloid malignancies classifications, considered to have similar outcomes as intermediate- or adverse-risk AML depending on the subgroup. However, little is known about the fate of these patients in refractory or relapsed situation (R/R) after first line therapy. METHODS A large series of R/R AML patients, recorded in the French DATAML registry, have received either intensive chemotherapy (ICT), azacitidine (AZA) as single agent, or best supportive care (BSC). A cohort of 183 patients (median age 63-year-old) with what was called at the time AML-MRC has been explored, and data are reported here. RESULTS Patient status was refractory for 93, while 90 had relapsed. Respectively, 88, 34, and 61 were included in the three treatment arms. The median OS of the whole cohort was 4.2 months (95%CI: 3.1-5.6) with a mean 1-year overall survival of 24% ± 3.2%. There was no significant survival difference between refractory and relapsed patients. The BSC group had overall a significantly worse outcome (p = 0.0001), and this remained true in both refractory (p = 0.01) and relapsed (p = 0.002) patients. Similar survivals were observed in both groups comparing ICT and AZA. CONCLUSIONS These data, reporting about an ill-explored population, indicate the poor prognosis of this condition where both ICT and AZA can be proposed. The latter, which was demonstrated here to be a feasible option, should be added to new targeted therapies.
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Affiliation(s)
- Harmony Leroy
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
| | - Noémie Gadaud
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Emilie Bérard
- Centre Hospitalier Universitaire de Toulouse, Service d'Epidémiologie, CERPOP, Inserm, Université Toulouse III Paul SabatierToulouseFrance
| | - Emilie Klein
- CHU Bordeaux, Laboratoire d'Hématologie BiologiqueBordeauxFrance
| | - Isabelle Luquet
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Jean‐Baptiste Rieu
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Suzanne Tavitian
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Thibaut Leguay
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
| | - Laetitia Largeaud
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Audrey Bidet
- CHU Bordeaux, Laboratoire d'Hématologie BiologiqueBordeauxFrance
| | - Eric Delabesse
- Laboratoire d'HématologieCentre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Audrey Sarry
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | | | - Christian Récher
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
- Université de Bordeaux, Bordeaux, Institut National de la Santé et de la Recherche MédicaleBordeauxFrance
| | - Sarah Bertoli
- Service d'HématologieCentre Hospitalier Universitaire de ToulouseInstitut Universitaire du Cancer de Toulouse‐OncopoleToulouseFrance
| | - Pierre‐Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie CellulaireBordeauxFrance
- Université de Bordeaux, Bordeaux, Institut National de la Santé et de la Recherche MédicaleBordeauxFrance
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4
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Didi I, Alliot JM, Dumas PY, Vergez F, Tavitian S, Largeaud L, Bidet A, Rieu JB, Luquet I, Lechevalier N, Delabesse E, Sarry A, De Grande AC, Bérard E, Pigneux A, Récher C, Simoncini D, Bertoli S. Artificial intelligence-based prediction models for acute myeloid leukemia using real-life data: A DATAML registry study. Leuk Res 2024; 136:107437. [PMID: 38215555 DOI: 10.1016/j.leukres.2024.107437] [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: 08/29/2023] [Revised: 12/19/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
We designed artificial intelligence-based prediction models (AIPM) using 52 diagnostic variables from 3687 patients included in the DATAML registry treated with intensive chemotherapy (IC, N = 3030) or azacitidine (AZA, N = 657) for an acute myeloid leukemia (AML). A neural network called multilayer perceptron (MLP) achieved a prediction accuracy for overall survival (OS) of 68.5% and 62.1% in the IC and AZA cohorts, respectively. The Boruta algorithm could select the most important variables for prediction without decreasing accuracy. Thirteen features were retained with this algorithm in the IC cohort: age, cytogenetic risk, white blood cells count, LDH, platelet count, albumin, MPO expression, mean corpuscular volume, CD117 expression, NPM1 mutation, AML status (de novo or secondary), multilineage dysplasia and ASXL1 mutation; and 7 variables in the AZA cohort: blood blasts, serum ferritin, CD56, LDH, hemoglobin, CD13 and disseminated intravascular coagulation (DIC). We believe that AIPM could help hematologists to deal with the huge amount of data available at diagnosis, enabling them to have an OS estimation and guide their treatment choice. Our registry-based AIPM could offer a large real-life dataset with original and exhaustive features and select a low number of diagnostic features with an equivalent accuracy of prediction, more appropriate to routine practice.
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Affiliation(s)
| | | | - Pierre-Yves Dumas
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France; Université de Bordeaux, Bordeaux, France; Institut National de la Santé et de la Recherche Médicale, U1035 Bordeaux, France
| | - François Vergez
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Suzanne Tavitian
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - Laëtitia Largeaud
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Audrey Bidet
- CHU Bordeaux, Laboratoire d'Hématologie Biologique, F-33000 Bordeaux, France
| | - Jean-Baptiste Rieu
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France
| | - Isabelle Luquet
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France
| | - Nicolas Lechevalier
- CHU Bordeaux, Laboratoire d'Hématologie Biologique, F-33000 Bordeaux, France
| | - Eric Delabesse
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer Toulouse-Oncopole, Laboratoire d'hématologie, Toulouse, France; Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France
| | - Audrey Sarry
- Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - Anne-Charlotte De Grande
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Emilie Bérard
- Department of Epidemiology, Health Economics and Public Health, UMR 1295 CERPOP, University of Toulouse, INSERM, UPS, Toulouse University Hospital (CHU), Toulouse, France
| | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France; Université de Bordeaux, Bordeaux, France
| | - Christian Récher
- Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France; Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France
| | - David Simoncini
- IRIT UMR 5505-CNRS, Université Toulouse I Capitole, Toulouse, France
| | - Sarah Bertoli
- Centre de Recherches en Cancérologie de Toulouse, Université Toulouse 3 Paul Sabatier, Toulouse, France; Centre Hospitalo-Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Service d'hématologie, Toulouse, France.
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5
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Mouchel PL, Bérard E, Tavitian S, Gadaud N, Vergez F, Rieu JB, Luquet I, Sarry A, Huguet F, Largeaud L, Delabesse E, Huynh A, Bertoli S, Récher C. Vitamin C and D supplementation in acute myeloid leukemia. Blood Adv 2023; 7:6886-6897. [PMID: 37671973 PMCID: PMC10685150 DOI: 10.1182/bloodadvances.2023010559] [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: 04/26/2023] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 09/07/2023] Open
Abstract
Recent studies have highlighted the role of vitamin C and D in acute myeloid leukemia (AML). In 2018, we changed our practices to add both vitamins to the supportive care for all consecutive patients with AML undergoing intensive chemotherapy. In this study, we compared the outcomes of patients treated before and after this change in practice. From 2015 to 2020, 431 patients were included, 262 of whom received no supplementation and 169 of whom received vitamin supplementation. Vitamin C and vitamin D was administered from day 10 of chemotherapy until hematologic recovery from induction and consolidation. Most patients presented at diagnosis with low levels of vitamin C and D. Upon recovery from induction, vitamin D levels among the vitamin C/D group significantly increased compared with those at diagnosis, and pretransplant levels were significantly higher in the vitamin C/D group compared with the control group (median of 33 vs 19 ng/mL; P < .0001). During induction, the rates of bacterial or fungal infection, hemorrhage, or macrophage activation syndrome were lower in the vitamin C/D group, whereas there was no difference in response rate, relapse incidence, and overall survival (OS). However, the multivariate analysis for OS showed a significant interaction between vitamin C/D and NPM1 mutation, meaning that vitamin C/D supplementation was significantly and independently associated with better OS in patients with NPM1 mutations (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.30-0.90; P = .019) compared with patients with wild-type NPM1 (HR, 1.01; 95% CI, 0.68-1.51; P = .95). In conclusion, vitamin C/D supplementation is safe and could influence the outcomes of patients with AML undergoing intensive chemotherapy.
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Affiliation(s)
- Pierre Luc Mouchel
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Centre de Recherches en Cancérologie de Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Emilie Bérard
- Centre Hospitalier Universitaire de Toulouse, Service d'Epidémiologie, Toulouse, France
- UMR 1295 CERPOP, INSERM-Université de Toulouse III, Toulouse, France
| | - Suzanne Tavitian
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Noémie Gadaud
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - François Vergez
- Université Toulouse III Paul Sabatier, Toulouse, France
- Centre de Recherches en Cancérologie de Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Jean Baptiste Rieu
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Isabelle Luquet
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Audrey Sarry
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Françoise Huguet
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Laetitia Largeaud
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, Toulouse, France
- Centre de Recherches en Cancérologie de Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie, Toulouse, France
| | - Anne Huynh
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Centre de Recherches en Cancérologie de Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Centre de Recherches en Cancérologie de Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
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6
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Belhadj M, Burroni B, Kosmider O, Willems L, Temple M, Bertoli S, Orvain C, Dumas PY, Berthon C, Gabellier L, Marcais A, Raffoux E, Pautas C, Genthon A, Decroocq J, Birsen R, Tamburini J, Bouscary D, Contejean A. Clinico-biological features, treatment and prognosis of primary myeloid sarcoma: A French retrospective multi-centric observational study. Br J Haematol 2023; 202:e50-e53. [PMID: 37403204 DOI: 10.1111/bjh.18961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023]
Affiliation(s)
- Maya Belhadj
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Necker, Paris, France
| | - Barbara Burroni
- Department of Pathology, Centre de Recherche des Cordeliers UMRS U1138, GH Paris Centre APHP, Université de Paris Cité, Paris, France
| | - Olivier Kosmider
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Hôpital Cochin, Paris, France
| | - Lise Willems
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- The Organization for Partnerships in Leukemia, OPALE Carnot Institute, Paris, France
| | - Marie Temple
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Hôpital Cochin, Paris, France
| | - Sarah Bertoli
- Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Corentin Orvain
- Service Maladies du Sang, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Pierre-Yves Dumas
- Cellules Souches Hématopoïétiques Normales et Leucémiques, INSERM U1312 BRIC, Université de Bordeaux, Bordeaux, France
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Celine Berthon
- Service Maladies du Sang, Centre Hospitalier Universitaire de Lille, Lille, France
- UMR-S 1277-Canther-Cancer Heterogeneity, Plasticity and Resistance to Therapies, Université de Lille, Lille, France
| | - Ludovic Gabellier
- Service d'Hématologie Clinique, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Ambroise Marcais
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Necker, Paris, France
| | - Emmanuel Raffoux
- Service d'Hématologie Adultes, Hôpital Saint-Louis, Groupe hospitalo-universitaire AP-HP, Paris, France
| | - Cecile Pautas
- Service d'Hématologie Clinique, Hôpital Henri Mondor, Groupe hospitalo-universitaire AP-HP, Créteil, France
| | - Alexis Genthon
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint-Antoine, Groupe hospitalo-universitaire AP-HP, Paris, France
| | - Justine Decroocq
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
| | - Rudy Birsen
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- The Organization for Partnerships in Leukemia, OPALE Carnot Institute, Paris, France
| | - Jerome Tamburini
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Swiss Cancer Center Leman, Geneva, Switzerland
| | - Didier Bouscary
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- The Organization for Partnerships in Leukemia, OPALE Carnot Institute, Paris, France
| | - Adrien Contejean
- Faculté de Médecine Sorbonne Paris Cité, Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Université Paris Descartes, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
- Service d'Hématologie Clinique, Centre Hospitalier Annecy Genevois, Epagny Metz-Tessy, France
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7
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Courdy C, Platteeuw L, Ducau C, De Araujo I, Boet E, Sahal A, Saland E, Edmond V, Tavitian S, Bertoli S, Cougoul P, Granat F, Poillet L, Marty C, Plo I, Sarry JE, Manenti S, Mansat-De Mas V, Joffre C. Targeting PP2A-dependent autophagy enhances sensitivity to ruxolitinib in JAK2 V617F myeloproliferative neoplasms. Blood Cancer J 2023; 13:106. [PMID: 37423955 DOI: 10.1038/s41408-023-00875-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/02/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023] Open
Abstract
The Janus kinase 2 (JAK2)-driven myeloproliferative neoplasms (MPNs) are chronic malignancies associated with high-risk complications and suboptimal responses to JAK inhibitors such as ruxolitinib. A better understanding of cellular changes induced by ruxolitinib is required to develop new combinatory therapies to improve treatment efficacy. Here, we demonstrate that ruxolitinib induced autophagy in JAK2V617F cell lines and primary MPN patient cells through the activation of protein phosphatase 2A (PP2A). Inhibition of autophagy or PP2A activity along with ruxolitinib treatment reduced proliferation and increased the death of JAK2V617F cells. Accordingly, proliferation and clonogenic potential of JAK2V617F-driven primary MPN patient cells, but not of normal hematopoietic cells, were markedly impaired by ruxolitinib treatment with autophagy or PP2A inhibitor. Finally, preventing ruxolitinib-induced autophagy with a novel potent autophagy inhibitor Lys05 improved leukemia burden reduction and significantly prolonged the mice's overall survival compared with ruxolitinib alone. This study demonstrates that PP2A-dependent autophagy mediated by JAK2 activity inhibition contributes to resistance to ruxolitinib. Altogether, our data support that targeting autophagy or its identified regulator PP2A could enhance sensitivity to ruxolitinib of JAK2V617F MPN cells and improve MPN patient care.
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Affiliation(s)
- Charly Courdy
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Loïc Platteeuw
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Charlotte Ducau
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Isabelle De Araujo
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Emeline Boet
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Ambrine Sahal
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Estelle Saland
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Valérie Edmond
- INSERM UMR1287, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Suzanne Tavitian
- Service d'hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Sarah Bertoli
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
- Service d'hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Pierre Cougoul
- Service de médecine interne, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Fanny Granat
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Laura Poillet
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Caroline Marty
- INSERM UMR1287, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Isabelle Plo
- INSERM UMR1287, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-Emmanuel Sarry
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France
| | - Stéphane Manenti
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France
| | - Véronique Mansat-De Mas
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France.
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France.
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse III Paul Sabatier, Toulouse, France.
| | - Carine Joffre
- Centre de Recherches en Cancérologie de Toulouse (CRCT), INSERM UMR1037, CNRS UMR 5071, Université de Toulouse, Toulouse, France.
- Equipe labellisée La Ligue contre le Cancer 2018, Toulouse, France.
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8
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Sabatier M, Birsen R, Lauture L, Mouche S, Angelino P, Dehairs J, Goupille L, Boussaid I, Heiblig M, Boet E, Sahal A, Saland E, Santos JC, Armengol M, Fernández-Serrano M, Farge T, Cognet G, Simonetta F, Pignon C, Graffeuil A, Mazzotti C, Avet-Loiseau H, Delos O, Bertrand-Michel J, Chedru A, Dembitz V, Gallipoli P, Anstee NS, Loo S, Wei AH, Carroll M, Goubard A, Castellano R, Collette Y, Vergez F, Mansat-De Mas V, Bertoli S, Tavitian S, Picard M, Récher C, Bourges-Abella N, Granat F, Kosmider O, Sujobert P, Colsch B, Joffre C, Stuani L, Swinnen JV, Guillou H, Roué G, Hakim N, Dejean AS, Tsantoulis P, Larrue C, Bouscary D, Tamburini J, Sarry JE. C/EBPα Confers Dependence to Fatty Acid Anabolic Pathways and Vulnerability to Lipid Oxidative Stress-Induced Ferroptosis in FLT3-Mutant Leukemia. Cancer Discov 2023; 13:1720-1747. [PMID: 37012202 DOI: 10.1158/2159-8290.cd-22-0411] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 01/19/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
Although transcription factor CCAAT-enhancer binding protein α (C/EBPα) is critical for normal and leukemic differentiation, its role in cell and metabolic homeostasis is largely unknown in cancer. Here, multiomics analyses uncovered a coordinated activation of C/EBPα and Fms-like tyrosine kinase 3 (FLT3) that increased lipid anabolism in vivo and in patients with FLT3-mutant acute myeloid leukemia (AML). Mechanistically, C/EBPα regulated the fatty acid synthase (FASN)-stearoyl-CoA desaturase (SCD) axis to promote fatty acid (FA) biosynthesis and desaturation. We further demonstrated that FLT3 or C/EBPα inactivation decreased monounsaturated FA incorporation to membrane phospholipids through SCD downregulation. Consequently, SCD inhibition enhanced susceptibility to lipid redox stress that was exploited by combining FLT3 and glutathione peroxidase 4 inhibition to trigger lipid oxidative stress, enhancing ferroptotic death of FLT3-mutant AML cells. Altogether, our study reveals a C/EBPα function in lipid homeostasis and adaptation to redox stress, and a previously unreported vulnerability of FLT3-mutant AML to ferroptosis with promising therapeutic application. SIGNIFICANCE FLT3 mutations are found in 30% of AML cases and are actionable by tyrosine kinase inhibitors. Here, we discovered that C/EBPα regulates FA biosynthesis and protection from lipid redox stress downstream mutant-FLT3 signaling, which confers a vulnerability to ferroptosis upon FLT3 inhibition with therapeutic potential in AML. This article is highlighted in the In This Issue feature, p. 1501.
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Affiliation(s)
- Marie Sabatier
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Rudy Birsen
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
- Université de Paris, Institut Cochin, CNRS U8104, Inserm U1016, Paris, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France
| | - Laura Lauture
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Sarah Mouche
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
| | - Paolo Angelino
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Jonas Dehairs
- Laboratory of Lipid Metabolism and Cancer, Department of Oncology, LKI-Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Léa Goupille
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Ismael Boussaid
- Université de Paris, Institut Cochin, CNRS U8104, Inserm U1016, Paris, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
| | - Maël Heiblig
- Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
- CIRI, Inserm U1111 CNRS 5308, Université Lyon 1, Lyon, France
| | - Emeline Boet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Ambrine Sahal
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Estelle Saland
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Juliana C Santos
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Marc Armengol
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | | | - Thomas Farge
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Guillaume Cognet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Federico Simonetta
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
| | - Corentin Pignon
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Antoine Graffeuil
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Céline Mazzotti
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Hervé Avet-Loiseau
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Océane Delos
- MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, University Paul Sabatier, Toulouse, France
| | - Justine Bertrand-Michel
- MetaboHUB-MetaToul, National Infrastructure of Metabolomics and Fluxomics, University Paul Sabatier, Toulouse, France
| | - Amélie Chedru
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé, MetaboHUB, Gif sur Yvette, France
| | - Vilma Dembitz
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Paolo Gallipoli
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Natasha S Anstee
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Australia
| | - Sun Loo
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Australia
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | - Andrew H Wei
- Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Australia
- Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | - Martin Carroll
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Armelle Goubard
- Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Rémy Castellano
- Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Yves Collette
- Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - François Vergez
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Véronique Mansat-De Mas
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Sarah Bertoli
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Suzanne Tavitian
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | - Muriel Picard
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service de Réanimation, Toulouse, France
| | - Christian Récher
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Toulouse, France
| | | | - Fanny Granat
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Olivier Kosmider
- Université de Paris, Institut Cochin, CNRS U8104, Inserm U1016, Paris, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
| | - Pierre Sujobert
- Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
- CIRI, Inserm U1111 CNRS 5308, Université Lyon 1, Lyon, France
| | - Benoit Colsch
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé, MetaboHUB, Gif sur Yvette, France
| | - Carine Joffre
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Lucille Stuani
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
| | - Johannes V Swinnen
- Laboratory of Lipid Metabolism and Cancer, Department of Oncology, LKI-Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Hervé Guillou
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, University Paul Sabatier, Toulouse, France
| | - Gael Roué
- Lymphoma Translational Group, Josep Carreras Leukaemia Research Institute, Badalona, Spain
| | - Nawad Hakim
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITy), Inserm UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France
| | - Anne S Dejean
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (INFINITy), Inserm UMR1291, CNRS UMR5051, Université Toulouse III, Toulouse, France
| | - Petros Tsantoulis
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Clément Larrue
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
| | - Didier Bouscary
- Université de Paris, Institut Cochin, CNRS U8104, Inserm U1016, Paris, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France
| | - Jerome Tamburini
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, and Swiss Cancer Center Leman, Geneva, Switzerland
- Université de Paris, Institut Cochin, CNRS U8104, Inserm U1016, Paris, France
- Equipe Labellisée Ligue Nationale Contre le Cancer, Paris, France
| | - Jean-Emmanuel Sarry
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm U1037, CNRS U5077, Toulouse, France
- LabEx Toucan, Toulouse, France
- Équipe Labellisée Ligue Nationale Contre le Cancer 2018, Toulouse, France
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9
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Mounie M, Dumas PY, Liva-Yonnet S, Fabre D, Leguay T, Galtier J, Berard E, Hanta R, Gilleron V, Bertoli S, Pigneux A, Récher C, Costa N. Cost comparison of post-remission strategies in younger and older AML patients in France. Blood Cancer J 2023; 13:100. [PMID: 37380651 DOI: 10.1038/s41408-023-00874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023] Open
Affiliation(s)
- Michael Mounie
- Unité d'Evaluation Médico-Economique, Centre Hospitalier Universitaire (CHU), Toulouse, France.
- Institut National de la Santé et de la Recherche Médicale, U1295, Toulouse, France.
| | - Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1312, Bordeaux, France
| | - Sandra Liva-Yonnet
- Département d'Information Médicale, Centre Hospitalier Universitaire (CHU), Toulouse, France
| | - Didier Fabre
- Département d'Information Médicale, Centre Hospitalier Universitaire (CHU), Toulouse, France
| | - Thibault Leguay
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France
| | - Jean Galtier
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France
| | - Emilie Berard
- Institut National de la Santé et de la Recherche Médicale, U1295, Toulouse, France
| | - Ramaroson Hanta
- Département d'Information Médicale, Centre Hospitalier Universitaire (CHU), Bordeaux, France
| | - Véronique Gilleron
- Département d'Information Médicale, Centre Hospitalier Universitaire (CHU), Bordeaux, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de la Recherche Scientifique, Toulouse, France
| | - Arnaud Pigneux
- Université de Bordeaux, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1312, Bordeaux, France
| | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.
- Université Toulouse III Paul Sabatier, Toulouse, France.
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de la Recherche Scientifique, Toulouse, France.
| | - Nadège Costa
- Unité d'Evaluation Médico-Economique, Centre Hospitalier Universitaire (CHU), Toulouse, France
- Institut National de la Santé et de la Recherche Médicale, U1295, Toulouse, France
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10
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Rieu JB, Canali A, Thene E, Tavitian S, Bertoli S. Acute promyelocytic leukaemia associated with atypical basophilia. Br J Haematol 2023. [PMID: 37096910 DOI: 10.1111/bjh.18793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/09/2023] [Accepted: 03/24/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Jean-Baptiste Rieu
- Haematology Laboratory, University Hospital of Toulouse - Cancer University Institute of Toulouse, Oncopole, France
| | - Alban Canali
- Haematology Laboratory, University Hospital of Toulouse - Cancer University Institute of Toulouse, Oncopole, France
| | - Emilie Thene
- Haematology Laboratory, University Hospital of Toulouse - Cancer University Institute of Toulouse, Oncopole, France
| | - Suzanne Tavitian
- Department of Haematology, University Hospital of Toulouse - Cancer University Institute of Toulouse, Oncopole, France
| | - Sarah Bertoli
- Department of Haematology, University Hospital of Toulouse - Cancer University Institute of Toulouse, Oncopole, France
- Cancer Research Center of Toulouse, Paul Sabatier University, Toulouse, 3, France
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11
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Othman J, Meggendorfer M, Tiacci E, Thiede C, Schlenk R, Dillon R, Stasik S, Venanzi A, Bertoli S, Delabesse E, Dumas PY, Pigneux A, Bidet A, Gilkes AF, Thomas I, Voso MT, Rambaldi A, Brunetti L, Perriello VM, Andresen V, Gjertsen BT, Martelli MP, Récher C, Röllig C, Bornhäuser M, Serve H, Müller-Tidow C, Baldus CD, Haferlach T, Russell N, Falini B. Overlapping features of therapy-related and de novo NPM1-mutated AML. Blood 2023; 141:1846-1857. [PMID: 36508705 DOI: 10.1182/blood.2022018108] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Abstract
NPM 1-mutated acute myeloid leukemia (AML) shows unique features. However, the characteristics of "therapy-related" NPM1-mutated AML (t-NPM1 AML) are poorly understood. We compared the genetics, transcriptional profile, and clinical outcomes of t-NPM1 AML, de novo NPM1-mutated AML (dn-NPM1 AML), and therapy-related AML (t-AML) with wild-type NPM1 (t-AML). Normal karyotype was more frequent in t-NPM1 AML (n = 78/96, 88%) and dn-NPM1 (n = 1986/2394, 88%) than in t-AML (n = 103/390, 28%; P < .001). DNMT3A and TET2 were mutated in 43% and 40% of t-NPM1 AML (n = 107), similar to dn-NPM1 (n = 88, 48% and 30%; P > 0.1), but more frequently than t-AML (n = 162; 14% and 10%; P < 0.001). Often mutated in t-AML, TP53 and PPM1D were wild-type in 97% and 96% of t-NPM1 AML, respectively. t-NPM1 and dn-NPM1 AML were transcriptionally similar, (including HOX genes upregulation). At 62 months of median follow-up, the 3-year overall survival (OS) for t-NPM1 AML (n = 96), dn-NPM1 AML (n = 2394), and t-AML (n = 390) were 54%, 60%, and 31%, respectively. In multivariable analysis, OS was similar for the NPM1-mutated groups (hazard ratio [HR] 0.9; 95% confidence interval [CI], 0.65-1.25; P = .45), but better in t-NPM1 AML than in t-AML (HR, 1.86; 95% CI, 1.30-2.68; P < .001). Relapse-free survival was similar between t-NPM1 and dn-NPM1 AML (HR, 1.02; 95% CI, 0.72-1.467; P = .90), but significantly higher in t-NPM1 AML versus t-AML (HR, 1.77; 95% CI, 1.19-2.64; P = .0045). t-NPM1 and dn-NPM1 AML have overlapping features, suggesting that they should be classified as a single disease entity.
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Affiliation(s)
- Jad Othman
- Department of Medical and Molecular Genetics, King's College, London, United Kingdom
- Department of Haematology, Guy's and St Thomas Hospitals NHS Trust, London, United Kingdom
| | | | - Enrico Tiacci
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Christian Thiede
- University Hospital, Medical Clinic I, Dresden University of Technology, Dresden, Germany
| | - Richard Schlenk
- Department of Hematology/Oncology and NCT Trial Center, Heidelberg University Hospital, and German Cancer Research Center, Heidelberg, Germany
| | - Richard Dillon
- Department of Medical and Molecular Genetics, King's College, London, United Kingdom
- Department of Haematology, Guy's and St Thomas Hospitals NHS Trust, London, United Kingdom
| | - Sebastian Stasik
- University Hospital, Medical Clinic I, Dresden University of Technology, Dresden, Germany
| | - Alessandra Venanzi
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | | | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Audrey Bidet
- Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Amanda F Gilkes
- Department of Hematology and Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ian Thomas
- Department of Hematology and Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | | | - Alessandro Rambaldi
- Department of Oncology and Hematology, University of Milan and Azienda Socio-Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | | | - Vincenzo M Perriello
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Vibeke Andresen
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
| | - Bjorn T Gjertsen
- Department of Clinical Science, Centre for Cancer Biomarkers, University of Bergen, Bergen, Norway
| | - Maria Paola Martelli
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Christoph Röllig
- University Hospital, Medical Clinic I, Dresden University of Technology, Dresden, Germany
| | - Martin Bornhäuser
- University Hospital, Medical Clinic I, Dresden University of Technology, Dresden, Germany
| | - Hubert Serve
- Department of Medicine, Hematology/Oncology, Goethe University Frankfurt, Frankfurt, Germany
| | - Carsten Müller-Tidow
- Department of Hematology/Oncology and NCT Trial Center, Heidelberg University Hospital, and German Cancer Research Center, Heidelberg, Germany
| | | | | | - Nigel Russell
- Department of Haematology, Guy's and St Thomas Hospitals NHS Trust, London, United Kingdom
- Nottingham University, Nottingham, United Kingdom
| | - Brunangelo Falini
- Institute of Hematology and Center for Hemato-Oncology Research (CREO), Department of Medicine and Surgery, University and Hospital of Perugia, Perugia, Italy
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12
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Canali A, Vergnolle I, Bertoli S, Largeaud L, Nicolau ML, Rieu JB, Tavitian S, Huguet F, Picard M, Bories P, Vial JP, Lechevalier N, Béné MC, Luquet I, Mansat-De Mas V, Delabesse E, Récher C, Vergez F. Prognostic Impact of Unsupervised Early Assessment of Bulk and Leukemic Stem Cell Measurable Residual Disease in Acute Myeloid Leukemia. Clin Cancer Res 2023; 29:134-142. [PMID: 36318706 DOI: 10.1158/1078-0432.ccr-22-2237] [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: 07/20/2022] [Revised: 09/24/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Acute myeloid leukemias (AML) are clonal diseases that develop from leukemic stem cells (LSC) that carry an independent prognostic impact on the initial response to induction chemotherapy, demonstrating the clinical relevance of LSC abundance in AML. In 2018, the European LeukemiaNet published recommendations for the detection of measurable residual disease (Bulk MRD) and suggested the exploration of LSC MRD and the use of multiparametric displays. EXPERIMENTAL DESIGN We evaluated the performance of unsupervised clustering for the post-induction assessment of bulk and LSC MRD in 155 patients with AML who received intensive conventional chemotherapy treatment. RESULTS The median overall survival (OS) for Bulk+ MRD patients was 16.7 months and was not reached for negative patients (HR, 3.82; P < 0.0001). The median OS of LSC+ MRD patients was 25.0 months and not reached for negative patients (HR, 2.84; P = 0.001). Interestingly, 1-year (y) and 3-y OS were 60% and 39% in Bulk+, 91% and 52% in Bulk-LSC+ and 92% and 88% in Bulk-LSC-. CONCLUSIONS In this study, we confirm the prognostic impact of post-induction multiparametric flow cytometry Bulk MRD in patients with AML. Focusing on LSCs, we identified a group of patients with negative Bulk MRD but positive LSC MRD (25.8% of our cohort) with an intermediate prognosis, demonstrating the interest of MRD analysis focusing on leukemic chemoresistant subpopulations.
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Affiliation(s)
- Alban Canali
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Inès Vergnolle
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Marie-Laure Nicolau
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Muriel Picard
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean Philippe Vial
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Nicolas Lechevalier
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Marie Christine Béné
- Laboratoire d'Hématologie, CHU de Nantes, Nantes, CRCI²NA INSERM UMR1307, CNRS UMR 6075, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique Mansat-De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - François Vergez
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
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13
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Dumas PY, Raffoux E, Bérard E, Bertoli S, Hospital MA, Heiblig M, Desbrosses Y, Bonmati C, Pautas C, Lambert J, Orvain C, Banos A, Pasquier F, Peterlin P, Marchand T, Uzunov M, Frayfer J, Turlure P, Cluzeau T, Jourdan E, Himberlin C, Tavernier E, Villate A, Haiat S, Chretien ML, Carre M, Chantepie S, Vaida I, Wemeau M, Chebrek S, Guillerm G, Guièze R, Debarri H, Gehlkopf E, Laribi K, Marcais A, Santagostino A, Béné MC, Mineur A, Pigneux A, Dombret H, Récher C. Gilteritinib activity in refractory or relapsed FLT3-mutated acute myeloid leukemia patients previously treated by intensive chemotherapy and midostaurin: a study from the French AML Intergroup ALFA/FILO. Leukemia 2023; 37:91-101. [PMID: 36376378 DOI: 10.1038/s41375-022-01742-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/12/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
The real-world efficacy and safety of gilteritinib was assessed in an ambispective study that included 167 R/R FLT3-mutated AML patients. Among them, 140 received gilteritinib as single agent (cohort B), including 67 previously treated by intensive chemotherapy and midostaurin (cohort C). The main differences in patient characteristics in this study compared to the ADMIRAL trial were ECOG ≥ 2 (83.6% vs. 16.6%), FLT3-TKD mutation (21.0% vs. 8.5%), primary induction failure (15.0% vs. 40.0%) and line of treatment (beyond 2nd in 37.1% vs. 0.0%). The rates of composite complete remission, excluding those that occurred after hematopoietic stem cell transplantation (HSCT), were similar at respectively 25.4% and 27.5% in cohorts B and C. Median overall survival (OS) for these two groups was also similar at respectively 6.4 and 7.8 months. Multivariate analyses for prognostic factors associated with OS identified female gender (HR 1.61), adverse cytogenetic risk (HR 2.52), and allogenic HSCT after gilteritinib (HR 0.13). Although these patients were more heavily pretreated, these real-world data reproduce the results of ADMIRAL and provide new insights into the course of patients previously treated by intensive chemotherapy and midostaurin and beyond the 2nd line of treatment who can benefit from treatment in an outpatient setting.
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Affiliation(s)
- Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France.
| | - Emmanuel Raffoux
- Hôpital Saint Louis, APHP, service d'hématologie adultes, Paris, France
| | - Emilie Bérard
- Centre Hospitalier Universitaire de Toulouse, Service d'Epidémiologie, CERPOP, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Maël Heiblig
- Hospices Civils de Lyon, Hôpital Lyon Sud, Service d'Hématologie clinique, Pierre Bénite, France
| | | | - Caroline Bonmati
- Service d'Hématologie, CHU Nancy Brabois, 54500, Vandoeuvre les Nancy, France
| | - Cécile Pautas
- CHU Henri-Mondor, Service d'Hématologie Clinique et de Thérapie Cellulaire; 1, rue Gustave Eiffel, 94010, Créteil, France
| | - Juliette Lambert
- Centre hospitalier de Versailles, Service Hématologie, Le Chesnay, France
| | - Corentin Orvain
- Service des maladies du sang, CHU d'Angers, France/Fédération hospitalo-universitaire « Grand Ouest against Leukemia »/Université d'Angers, Inserm UMR 1307, CNRS UMR 6075, Nantes Université, CRCI2NA, F-49000, Angers, France
| | - Anne Banos
- Service Hématologie, Centre Hospitalier de la Côte Basque, 64100, Bayonne, France
| | - Florence Pasquier
- Département d'Hématologie, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Tony Marchand
- Service d'hématologie Clinique, CHU de Rennes, 35000, Rennes, France
| | - Madalina Uzunov
- Hôpital Pitié Salpetrière, Service d'hématologie, Paris, France
| | | | - Pascal Turlure
- CHU limoges, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-87000, Limoges, France
| | - Thomas Cluzeau
- Université Cote d'Azur, CHU de Nice, Département d'hématologie clinique, Nice, France
| | - Eric Jourdan
- Department of Hematology, Nîmes University Hospital, Nîmes, France
| | - Chantal Himberlin
- Centre Hospitalier Universitaire de Reims, Hôpital Robert Debré, Reims, France
| | - Emmanuelle Tavernier
- CHU Saint Etienne. Service d'hématologie clinique et thérapie cellulaire, 42 000, Saint Etienne, France
| | - Alban Villate
- Hématologie et thérapie cellulaire, CHRU de Tours, Tours, France
| | - Stephanie Haiat
- Centre hospitalier Sud francilien, Service d'hématologie clinique, Corbeil-Essonnes, France
| | | | | | | | - Ioana Vaida
- Centre Hospitalier René Dubos, Service d'hématologie et thérapie cellulaire, Cergy-Pontoise, France
| | - Mathieu Wemeau
- CH Roubaix, service d'hématologie, F-59100, Roubaix, France
| | - Safia Chebrek
- CH Avignon, service d'onco-hématologie, Avignon, France
| | - Gaelle Guillerm
- CHU Brest, Hôpital Morvan, Service de cancérologie-hématologie, Brest, France
| | - Romain Guièze
- Service d'hématologie clinique et de thérapie cellulaire, CHU de Clermont-Ferrand, Clermont-Ferrand, France; EA 7453 (CHELTER), Université Clermont Auvergne, Clermont-Ferrand, France
| | - Houria Debarri
- CHR Metz-Thionville, Hôpital Mercy, service d'hématologie, Metz, France
| | - Eve Gehlkopf
- Hôpital Saint Eloi CHU Montpellier, Service d'Hématologie Clinique, 34295, Montpellier, France
| | - Kamel Laribi
- Department of Haematology, Centre hospitalier Le Mans, Le Mans, France
| | - Ambroise Marcais
- Service Hématologie Adultes, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université Paris Cité, Paris, France
| | | | | | - Ariane Mineur
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France
| | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000, Bordeaux, France
| | - Hervé Dombret
- Hôpital Saint Louis, APHP, service d'hématologie adultes, Paris, France
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
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14
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Picard M, Silva Sifontes S, Récher C, Bertoli S. Urgences en hématologie maligne. Méd Intensive Réa 2022. [DOI: 10.37051/mir-00135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Les patients atteints d’hémopathie maligne représentent une proportion croissante des patients en réanimation avec un pronostic qui s’est globalement amélioré sur les dernières décennies grâce notamment à une admission plus précoce de ces patients en réanimation mais aussi grâce à l’émergence de nouvelles thérapeutiques hématologiques (thérapies ciblées, immunothérapie). De ce fait, à côté des complications classiques liées aux hémopathies malignes (compression et/ou infiltration d’organes, syndrome de lyse tumorale, coagulation intravasculaire disséminée, syndrome d’activation lympho-histiocytaire) et aux chimiothérapies conventionnelles (complications infectieuses au premier plan), les urgences de ces patients se complexifient avec un cortège de complications dites « inflammatoires » que le réanimateur doit apprendre à reconnaître. La stratégie thérapeutique est alors différente, reposant sur des immunosuppresseurs (corticostéroïdes en première intention le plus souvent). Cette diversification des urgences en hémopathie maligne nécessite une collaboration étroite avec l’équipe d’hématologie afin d’adopter une stratégie diagnostique et thérapeutique la plus rapidement appropriée.
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15
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Laloi L, Billotey NC, Dumas P, Paul F, Villate A, Simand C, Fornecker L, Puisset F, Bertoli S, Simonet MB, Laribi K, Houyou D, Santagostino A, Michel C, Guepin GR, Guerineau E, Tabrizi R, Hunault M, Giltat A, Kaphan E, Bulabois C, Cartet E, Rocher C, Lachenal F, Morisset S, Récher C, Pigneux A, Belhabri A, Michallet M, Michallet A. Retrospective, real‐life study of venetoclax plus azacitidine or low‐dose cytarabine in French patients with acute myeloid leukemia ineligible for intensive chemotherapy. Cancer Med 2022; 12:7175-7181. [PMID: 36482507 PMCID: PMC10067034 DOI: 10.1002/cam4.5459] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recently, the combination of venetoclax plus a hypomethylating agent (HMA; azacitidine ordecitabine) or low-dose cytarabine (LDAC) showed promise in Phase III trials in previously untreated AML. In France at the time of this study, venetoclax was not yet approved for AML and there were therefore no formal usage recommendations. Here we report the first study in a French cohort that assessed venetoclax in combination with existing treatments for AML under real-life conditions. METHOD This retrospective, real-life study collected data on venetoclax use and management in a French cohort with acute myeloid leukemia (AML) ineligible for intensive chemotherapy. RESULT Of 118 patients, 81 were in second line/beyond (71.6% also hypomethylating agent [HMA]; 23.5% lowdose cytarabine [LDAC]) and 37 in first line. For venetoclax initiation, 57.3% underwent ramp up and 74.6% were hospitalized. Median venetoclax duration was 2.5 months (range 0.03-16.2). With all treatment lines and regimens, most common grade 3/4 adverse events were hematologic (overall 96.4% of patients) and infections (57.1%). Dosage adjustments for drug interactions and safety varied between centers. In second-line/beyond, median progression-free survival was 4.0 months (95% confidence interval [CI] 2.7-12.8) with venetoclax-HMA and 3.4 months (1.3-8.9) with venetoclax-LDAC; overall response rate was 51.9% and 41.2%, respectively. Thus, we showed that venetoclax-based treatment yields promising findings in patients with AML, but to address treatment complexity, practice harmonization is needed.
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Affiliation(s)
- Louise Laloi
- Department of Pharmacy Centre Léon Bérard Lyon France
| | | | - Pierre‐Yves Dumas
- Department of Hematology University Hospital of Bordeaux Bordeaux France
| | - Franciane Paul
- Department of Hematology University Hospital of Montpellier Montpellier France
| | - Alban Villate
- Department of Hematology University Hospital of Tours Tours France
| | - Célestine Simand
- Department of Hematology University Hospital of Strasbourg Strasbourg France
| | - Luc Fornecker
- Department of Hematology University Hospital of Strasbourg Strasbourg France
| | - Florent Puisset
- Department of Pharmacy Institut Universitaire du Cancer Oncopole Toulouse France
| | - Sarah Bertoli
- Department of Hematology Institut Universitaire du Cancer Oncopole Toulouse France
| | | | - Kamel Laribi
- Department of Hematology Hospital of Le Mans Le Mans France
| | - Dyhia Houyou
- Department of Clinical Research Hospital of Troyes Troyes France
| | | | - Claire Michel
- Department of Hematology University Hospital of Nancy Nancy France
| | | | - Elodie Guerineau
- Department of Clinical Research Hospital of Mont de Marsan Mont de Marsan France
| | - Reza Tabrizi
- Department of Hematology Hospital of Mont de Marsan Mont de Marsan France
| | - Mathilde Hunault
- Department of Hematology University Hospital of Angers Angers France
| | - Aurélien Giltat
- Department of Hematology University Hospital of Angers Angers France
| | - Eléonore Kaphan
- Department of Hematology University Hospital of Grenoble Grenoble France
| | - Claude Bulabois
- Department of Hematology University Hospital of Grenoble Grenoble France
| | - Elodie Cartet
- Department of Pharmacy Hospital of Bourgoin‐Jallieu Bourgoin‐Jallieu France
| | - Clément Rocher
- Department of Hematology Hospital of Bourgoin‐Jallieu Bourgoin‐Jallieu France
| | - Florence Lachenal
- Department of Hematology Hospital of Bourgoin‐Jallieu Bourgoin‐Jallieu France
| | | | - Christian Récher
- Department of Hematology Institut Universitaire du Cancer Oncopole Toulouse France
| | - Arnaud Pigneux
- Department of Hematology University Hospital of Bordeaux Bordeaux France
| | - Amine Belhabri
- Department of Hematology and Medical Oncology Centre Léon Bérard Lyon France
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16
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Marmouset V, Decroocq J, Garciaz S, Etienne G, Belhabri A, Bertoli S, Gastaud L, Simand C, Chantepie S, Uzunov M, Genthon A, Berthon C, Chiche E, Dumas PY, Vargaftig J, Salmeron G, Lemasle E, Tavernier E, Delage J, Loirat M, Morineau N, Blanc-Durand F, Pautier P, Vergé V, Auger N, Thomas M, Stefani L, Lepelley M, Boyer T, Thepot S, Gourin MP, Bourquard P, Duchmann M, Morice PM, Michallet M, Adès L, Fenaux P, Récher C, Dombret H, Pagès A, Marzac C, Leary A, Micol JB. Therapy-related Myeloid Neoplasms Following PARP Inhibitors: Real-life Experience. Clin Cancer Res 2022; 28:5211-5220. [PMID: 36201165 DOI: 10.1158/1078-0432.ccr-22-1622] [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: 05/24/2022] [Revised: 07/27/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE To provide insights into the diagnosis and management of therapy-related myeloid neoplasms (t-MN) following PARP inhibitors (PARPi). EXPERIMENTAL DESIGN In a French cancer center, we identified and described the profiles of 13 t-MN diagnosed among 37 patients with ovarian cancer referred to hematology consultation for cytopenia under PARPi. Next, we described these 13 t-MN post-PARPi among 37 t-MN post ovarian cancer according to PARPi exposure. Finally, we described 69 t-MN post-PARPi in a national cohort. RESULTS From 2016 to 2021, cumulative incidence of t-MN was 3.5% (13/373) among patients with ovarian cancer treated with PARPi. At time of hematologic consultation, patients with t-MN had a longer PARPi exposure (9 vs. 3 months, P = 0.01), lower platelet count (74 vs. 173 G/L, P = 0.0005), and more cytopenias (2 vs. 1, P = 0.0005). Compared with t-MN not exposed to PARPi, patients with t-MN-PARPi had more BRCA1/2 germline mutation (61.5% vs. 0%, P = 0.03) but similar overall survival (OS). In the national cohort, most t-MN post-PARPi had a complex karyotype (61%) associated with a high rate of TP53 mutation (71%). Median OS was 9.6 months (interquartile range, 4-14.6). In multivariate analysis, a longer time between end of PARPi and t-MN (HR, 1.046; P = 0.02), olaparib compared with other PARPi (HR, 5.82; P = 0.003) and acute myeloid leukemia (HR, 2.485; P = 0.01) were associated with shorter OS. CONCLUSIONS In a large series, we described a high incidence of t-MN post-PARPi associated with unfavorable cytogenetic and molecular abnormalities leading to poor OS. Early detection is crucial, particularly in cases of delayed cytopenia.
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Affiliation(s)
- Vincent Marmouset
- Department of Hematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Justine Decroocq
- Assistance Publique-Hôpitaux de Paris, Centre-Université de Paris, Service d'Hématologie Clinique, Hôpital Cochin, Paris, France
| | - Sylvain Garciaz
- Institut Paoli Calmettes, Marseille, France
- Cancer Research Center of Marseille, INSERM U1068, Aix-Marseille University, Marseille, France
| | | | - Amine Belhabri
- Department of Oncology, Centre Leon Berard, Lyon, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Célestine Simand
- Department of Hematology, Institute for Cancer Strasbourg-Europe (ICANS), Strasbourg University, Strasbourg, France
| | - Sylvain Chantepie
- Department of Clinical Hematology, Caen University Hospital, Caen, France
| | - Madalina Uzunov
- Service d'hématologie adulte, Hôpital Pitié-Salpêtrière, Paris, France
| | - Alexis Genthon
- Department of Clinical Hematology, Saint Antoine Hospital, Sorbonne University, INSERM UMR-S 938, Paris, France
| | - Céline Berthon
- Department of Hematology, CHU Lille, Lille, France
- University of Lille, CNRS, Inserm, CHU Lille, IRCL, UMR9020 - UMR1277 - Canther - Cancer heterogeneity, plasticity and resistance to therapies, Lille, France
| | | | - Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | | | | | - Emilie Lemasle
- Département d'hématologie, Hôpital Henri Becquerel, Rouen, France
| | - Emmanuelle Tavernier
- Hématologie, Institut de Cancérologie-Hématologie Universitaire de Saint Etienne, France
| | - Jérémy Delage
- Département d'hématologie clinique, Saint Eloi, Montpellier, France
| | - Marion Loirat
- Service d'hématologie, Hôpital Saint Nazaire, Saint-Nazaire, France
| | | | - Félix Blanc-Durand
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Patricia Pautier
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Véronique Vergé
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Nathalie Auger
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | | | | | - Marion Lepelley
- Centre Régional de Pharmacovigilance - Addictovigilance, CHU de Grenoble-Alpes, France
| | - Thomas Boyer
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | | | | | | | - Matthieu Duchmann
- Université de Paris, Génomes, Biologie Cellulaire et Thérapeutique Unité (U)944, INSERM, Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Pierre-Marie Morice
- Department of Clinical Hematology, Caen University Hospital, Caen, France
- UNICAEN, INSERM U1086 ANTICIPE (Interdisciplinary Research Unit for Cancer Prevention and Treatment), Normandie University, Caen, France
| | | | - Lionel Adès
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| | - Pierre Fenaux
- Hématologie Sénior Hôpital Saint Louis, Assistance publique hôpitaux de paris, and Université de Paris Cité, Paris, France
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Hervé Dombret
- Adult Hematology Department, Saint-Louis Hospital, APHP, URP3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Arnaud Pagès
- Bureau de Biostatistique et d'Épidémiologie - Gustave Roussy Équipe Oncostat - CESP U1018 - Inserm, France
| | - Christophe Marzac
- Department of Biology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Alexandra Leary
- Department of Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U981, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-Baptiste Micol
- Department of Hematology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- Interception Program, Personalized Cancer Prevention Center, Gustave Roussy, Université Paris-Saclay, Villejuif, France
- INSERM U1287, Gustave Roussy, Université Paris-Saclay, Villejuif, France
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17
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Vergez F, Largeaud L, Bertoli S, Nicolau ML, Rieu JB, Vergnolle I, Saland E, Sarry A, Tavitian S, Huguet F, Picard M, Vial JP, Lechevalier N, Bidet A, Dumas PY, Pigneux A, Luquet I, Mansat-De Mas V, Delabesse E, Carroll M, Danet-Desnoyers G, Sarry JE, Récher C. Phenotypically-defined stages of leukemia arrest predict main driver mutations subgroups, and outcome in acute myeloid leukemia. Blood Cancer J 2022; 12:117. [PMID: 35973983 PMCID: PMC9381519 DOI: 10.1038/s41408-022-00712-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
Classifications of acute myeloid leukemia (AML) patients rely on morphologic, cytogenetic, and molecular features. Here we have established a novel flow cytometry-based immunophenotypic stratification showing that AML blasts are blocked at specific stages of differentiation where features of normal myelopoiesis are preserved. Six stages of leukemia differentiation-arrest categories based on CD34, CD117, CD13, CD33, MPO, and HLA-DR expression were identified in two independent cohorts of 2087 and 1209 AML patients. Hematopoietic stem cell/multipotent progenitor-like AMLs display low proliferation rate, inv(3) or RUNX1 mutations, and high leukemic stem cell frequency as well as poor outcome, whereas granulocyte-monocyte progenitor-like AMLs have CEBPA mutations, RUNX1-RUNX1T1 or CBFB-MYH11 translocations, lower leukemic stem cell frequency, higher chemosensitivity, and better outcome. NPM1 mutations correlate with most mature stages of leukemia arrest together with TET2 or IDH mutations in granulocyte progenitors-like AML or with DNMT3A mutations in monocyte progenitors-like AML. Overall, we demonstrate that AML is arrested at specific stages of myeloid differentiation (SLA classification) that significantly correlate with AML genetic lesions, clinical presentation, stem cell properties, chemosensitivity, response to therapy, and outcome.
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Affiliation(s)
- François Vergez
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France. .,Université Toulouse III Paul Sabatier, Toulouse, France. .,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France. .,Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Sarah Bertoli
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France.,Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Marie-Laure Nicolau
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Inès Vergnolle
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Estelle Saland
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Muriel Picard
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Jean-Philippe Vial
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Nicolas Lechevalier
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Audrey Bidet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Pierre-Yves Dumas
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Arnaud Pigneux
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique Mansat-De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Martin Carroll
- Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Gwenn Danet-Desnoyers
- Stem Cell and Xenograft Core, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Jean-Emmanuel Sarry
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France.,Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Christian Récher
- Université Toulouse III Paul Sabatier, Toulouse, France. .,Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France. .,Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.
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18
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Bérard E, Röllig C, Bertoli S, Pigneux A, Tavitian S, Kramer M, Serve H, Bornhäuser M, Platzbecker U, Müller-Tidow C, Baldus CD, Martínez-Cuadrón D, Serrano J, Martínez-Sánchez P, Arbolí ER, Gil C, Bergua J, Bernal T, de la Fuente Burguera A, Delabesse E, Bidet A, Dumas PY, Montesinos P, Récher C. A scoring system for AML patients aged 70 years or older, eligible for intensive chemotherapy: a study based on a large European data set using the DATAML, SAL, and PETHEMA registries. Blood Cancer J 2022; 12:107. [PMID: 35821023 PMCID: PMC9276717 DOI: 10.1038/s41408-022-00700-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 04/07/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/09/2022] Open
Abstract
In a context of therapeutic revolution in older adults with AML, it is becoming increasingly important to select patients for the various treatment options by taking account of short-term efficacy and toxicity as well as long-term survival. Here, the data from three European registries for 1,199 AML patients aged 70 years or older treated with intensive chemotherapy were used to develop a prognostic scoring system. The median follow-up was 50.8 months. In the training set of 636 patients, age, performance status, secondary AML, leukocytosis, and cytogenetics, as well as NPM1 mutations (without FLT3-ITD), were all significantly associated with overall survival, albeit not to the same degree. These factors were used to develop a score that predicts long-term overall survival. Three risk-groups were identified: a lower, intermediate and higher-risk score with predicted 5-year overall survival (OS) probabilities of ≥12% (n = 283, 51%; median OS = 18 months), 3-12% (n = 226, 41%; median OS = 9 months) and <3% (n = 47, 8%; median OS = 3 months), respectively. This scoring system was also significantly associated with complete remission, early death and relapse-free survival; performed similarly in the external validation cohort (n = 563) and showed a lower false-positive rate than previously published scores. The European Scoring System ≥70, easy for routine calculation, predicts long-term survival in older AML patients considered for intensive chemotherapy.
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Affiliation(s)
- Emilie Bérard
- Centre Hospitalier Universitaire de Toulouse, Service d'Epidémiologie, CERPOP, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Christoph Röllig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum TU Dresden, Dresden, Germany
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale, U1035, 33000, Bordeaux, France
| | - Suzanne Tavitian
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Michael Kramer
- Medizinische Klinik und Poliklinik I, Universitätsklinikum TU Dresden, Dresden, Germany
| | - Hubert Serve
- Medizinische Klinik 2, Universitätsklinikum Frankfurt, Frankfurt/Main, Germany
| | - Martin Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum TU Dresden, Dresden, Germany
| | - Uwe Platzbecker
- Klinik und Poliklinik für Hämatologie, Zelltherapie und Hämostaseologie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Carsten Müller-Tidow
- Klinik für Hämatologie, Onkologie und Rheumatologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Claudia D Baldus
- Klinik für Innere Medizin II, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia, Spain; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | | | | | | | - Cristina Gil
- Hospital General Universitario de Alicante, Alicante, Spain
| | - Juan Bergua
- Hospital San Pedro Alcántara, Cáceres, Spain
| | - Teresa Bernal
- Hospital Universitario Central de Asturias, Asturias, Spain
| | | | - Eric Delabesse
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d'Hématologie Biologique, Toulouse, France
| | - Audrey Bidet
- CHU Bordeaux, Laboratoire d'Hématologie Biologique, F-33000, Bordeaux, France
| | - Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale, U1035, 33000, Bordeaux, France
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain; Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Christian Récher
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université Toulouse III Paul Sabatier, Toulouse, France.
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19
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Marmouset V, Decroocq J, Garciaz S, Etienne G, Belhabri A, Gastaud L, Bertoli S, Simand C, Uzunov M, Chantepie S, Genthon A, Berthon C, Chiche E, Dumas PY, Blanc-Durand F, Pautier P, Pages A, Marzac C, Leary A, Micol JB. Therapy related myeloid neoplasms (t-MNs) following PARP inhibitors (PARPi): Real-life experience. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.7057] [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
7057 Background: PARPi have shown promising results in several cancers, especially breast (BC) and ovarian cancer (OC), but may be associated with an increased risk of t-MNs. A careful monitoring of hematologic toxicity to exclude this risk is necessary. Here we described, in a real-life setting, the management of these adverse effect. Methods: First,we described, in a large cancer center, the profile of t-MN patients among OC patients treated with PARPi addressed in hematological consultation for cytopenias. Secondly, we compared t-MN post OC characteristics according to previous exposition to PARPi. Lastly, we described a large national observatory of 69 t-MNs post PARPi to decipher specific characteristics of these t-MNs. Results: From 2016 to 2021, among 373 PARPi treated patients for OC, 37 (10%) were explored for cytopenia’s leading to 13 (3,5%) t-MNs diagnosis. No differences were seen in terms of age, BRCA1/2 status, type of PARPi, hemoglobin level but patients with t-MNs developed delayed cytopenias post-PARPi initiation (11 months vs to 4 months, p = 0.01), had a longer PARPi exposition (9 months vs 3 months, p = 0.01), lower platelets level (74 G/L vs 173 G/L, p = 0.0005), more cytopenias (2 vs 1, p = 0.0005). 77% of t-MNs patients had a TP53 mutated t-MNs, 33% of patients w/o t-MNs had TP53 mutated clonal hematopoiesis. In the last 20 years, 37 patients were addressed for t-MN post OC at our institute, with an increased incidence of 50% during the last 6 years. Compared to t-MN not exposed to PARPi, t-MN-PARPi patients had more BRCA1/2 predisposition (61.5% vs 0% p = 0.03), their OC tended to be non-progressive (CR/PR/SD = 62.5% vs 38.5%, p = 0.3) and tend to have more TP53 mutated t-MNs (77% vs 47%, p = 0.1). Median OS for t-MNs post PARPi was poor at 8.2 months (CI95% [2.03-18.7]) but not significantly different form other t-MNs (p = 0.8). We then studied 69 t-MNs-PARPi including 28 AML and 41 MDS in patient with history of OC (75%), BC (9%) or both (16%). Median age was 64 years, 80% received Olaparib, 72.5% had a BRCA1/2 predisposition. Median time between cancer diagnosis and initiation of PARPi was 44 months and median duration of PARPi treatment was 14 months. History of haematological toxicity secondary to PARPi was reported in 51% of patients. Karyotype was often complex (61%) associated with a high rate of TP53 mutation (70.5%). Median OS was 9.7 months (CI95%, 5.3-13.9). In multivariate analysis, a longer delay between the end of PARPi treatment and t-NM diagnosis (HR 1.046, p = 0.02), as well Olaparib treatment compared to others PARPi (HR 5.82, p = 0.003 and AML diagnosis (HR 2.485, p = 0.01) were associated with shorter OS. Conclusions: We describe in a large series a higher incidence of t-MNs post PARPi than previously reported. Unfavorable cytogenetic and molecular abnormalities associated with these t-MNS explained the poor OS. Early detection is crucial particularly in case of delayed appearance of cytopenias.
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Affiliation(s)
| | | | | | | | | | | | - Sarah Bertoli
- Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | | | | | - Sylvain Chantepie
- Institut d’Hématologie de Basse-Normandie, Centre Hospitalier Universitaire de Caen, Caen, France
| | | | | | | | | | | | - Patricia Pautier
- GINECO, French Sarcoma Group and Gustave Roussy Cancer Center, Villejuif, France
| | | | | | - Alexandra Leary
- Gustave-Roussy Cancer Campus, Villejuif, and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens, Villejuif, France
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20
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Dumas PY, Bertoli S, Bonmati C, Carre M, Lambert J, Ojeda-Uribe M, Chantepie S, Paul F, Jourdan E, Haiat S, Tavernier E, Peterlin P, Marolleau JP, Laribi K, Orvain C, Cabrera Q, Turlure P, Girault S, Balsat M, Bernard M, Bene MC, Pigneux A, Dombret H, Récher C. Characteristics and clinical outcomes of SARS-CoV-2 infection in adult patients with acute leukemia in France. Leuk Res 2022; 120:106901. [PMID: 35872338 PMCID: PMC9212547 DOI: 10.1016/j.leukres.2022.106901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/08/2022] [Accepted: 06/12/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Pierre-Yves Dumas
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000 Bordeaux, France; BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, Univ. Bordeaux, F-33000 Bordeaux, France.
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Caroline Bonmati
- Service d'Hématologie, CHU Nancy Brabois, 54500 Vandoeuvre les Nancy, France
| | - Martin Carre
- Service d'Hématologie clinique, CHU Grenoble Alpes, 38700 La Tronche, France
| | - Juliette Lambert
- Service d'Hématologie, CH de Versailles, 78150 Le Chesnay, France
| | - Mario Ojeda-Uribe
- GHRMSA, Hôpital E Muller, Service d'Hématologie Clinique et Unité de Thérapie Cellulaire, 68070 Mulhouse, France
| | | | - Franciane Paul
- Départment d'Hématologie clinique, CHU de Montpellier, 34905 Montpellier, France
| | - Eric Jourdan
- Hématologie Clinique, Institut de Cancérologie du Gard - CHU de Nîmes, 30029 Nîmes, France
| | - Stéphanie Haiat
- Service d'Hématologie, CH Sud Francilien, 91106 Corbeil Essonnes, France
| | | | - Pierre Peterlin
- Service d'Hématologie clinique, Nantes University Hospital, Nantes, France
| | - Jean-Pierre Marolleau
- Service d'Hématologie clinique et Thérapie cellulaire, CHU Amiens-Picardie, Amiens, France
| | - Kamel Laribi
- Department of Hematology, Centre Hospitalier Le Mans, Le Mans, France
| | - Corentin Orvain
- CHU d'Angers, Maladies du Sang, Angers, France; Univ Angers, Inserm, CRCINA, F-49000 Angers, France
| | - Quentin Cabrera
- CHU Réunion Sud - Site de Saint-Pierre, Saint-Pierre, France
| | - Pascal Turlure
- Service d'Hématologie et Thérapie Cellulaire du CHU Dupuytren, Limoges, France
| | | | - Marie Balsat
- Service d'Hématologie, Hospices civils de Lyon, Lyon, France
| | - Marc Bernard
- Service d'Hématologie clinique, CHU de Rennes, Rennes, France
| | | | - Arnaud Pigneux
- CHU Bordeaux, Service d'Hématologie Clinique et de Thérapie Cellulaire, F-33000 Bordeaux, France; BRIC (BoRdeaux Institute of onCology), UMR1312, INSERM, Univ. Bordeaux, F-33000 Bordeaux, France
| | - Hervé Dombret
- Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France; Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France; Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France.
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21
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Michallet M, Sobh M, Morisset S, Deloire A, Raffoux E, de Botton S, Caillot D, Chantepie S, Girault S, Berthon C, Bertoli S, Lepretre S, Leguay T, Castaigne S, Marolleau JP, Pautas C, Malfuson JV, Veyn N, Braun T, Gastaud L, Suarez F, Schmidt A, Gressin R, Bonmati C, Celli-Lebras K, El-Hamri M, Ribaud P, Dombret H, Thomas X, Bergeron A. Antifungal Prophylaxis in AML Patients Receiving Intensive Induction Chemotherapy: A Prospective Observational Study From the Acute Leukaemia French Association (ALFA) Group. Clin Lymphoma Myeloma Leuk 2022; 22:311-318. [PMID: 34895843 DOI: 10.1016/j.clml.2021.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although recommended in patients with acute myeloblastic leukaemia (AML) after induction chemotherapy, real-life use of antifungal prophylaxis (AFP) is different among centres. MATERIALS AND METHODS This is an ancillary study to a randomized trial on intensive induction chemotherapy in AML patients (ALFA-0702/NCT00932412), where AFP with posaconazole was recommended. IFIs were graded by investigators and by central reviewers according to the revised EORTC definitions. Experts conclusions were compared to the investigators' ones. RESULTS A total of 677 patients were included. Four AFP strategies were reported: Group-1: no AFP (n = 203, 30%), Group-2: posaconazole (n = 241, 36%), Group-3: posaconazole with other AFP (n = 142, 21%), Group-4: other AFP (n = 91, 13%). Experts graded more IFI than investigators: proven/probable IFI, 9.0% (n = 61) versus 6.2% (n = 42). The cumulative incidence at day60 of probable/proven IFI was 13.9% (Group-1); 7.9% (Group-2); 5.6% (Group-3); and 6.6% (Group-4). IFI onset was 26 (19-31) days after induction in Groups 2-3, versus 16 (9-25) days in Group 1 and 20 (12-24) days in Group 4 (P< .001). After a median follow-up of 27.5 months (0.4-73.4), the mortality rate was 38.3%, with 5.4% attributed to IFI. In multivariate analysis, IFI occurrence was an independent risk of death (HR5.63, 95%-CI 2.62-12.08, P< .001). EORTC recommendations were applied in only 57% of patients. In patients without IFI, the rate of AML complete remission was higher. CONCLUSIONS In AML patients, AFP delayed the onset of IFI in addition of decreasing their rate. The frequent misidentification of IFI impacts their appropriate management according to recommendations. hematological remission was more frequent in patients without IFI.
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Affiliation(s)
| | - Mohamad Sobh
- Hematology department, Anticancer Centre Léon Bérard, Lyon, France
| | | | | | | | | | - Denis Caillot
- Hématologie Clinique, Dijon University Hospital, Dijon, France
| | | | | | | | - Sarah Bertoli
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopole, CHU de Toulouse, Toulouse, France
| | - Stephane Lepretre
- Inserm U1245 and Department of Hematology, Centre Henri Becquerel and Normandie Univ UNIROUEN, Rouen, France
| | | | | | | | | | | | - Norbert Veyn
- Hematology, Institut Paoli-Calmettes, Marseille, France
| | | | | | - Felipe Suarez
- Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | | | | | | | | | - Mohamed El-Hamri
- Haematology Department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | | | - Herve Dombret
- Hematology Department, Saint Louis Hospital, Paris, France
| | - Xavier Thomas
- Haematology Department 1G, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - Anne Bergeron
- Pneumology department, Saint Louis Hospital, AP-HP, Paris, France
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22
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Floucaud V, Poupblanc S, Grandjean H, Bertoli S, Lauwers V. [Approach of the spiritual dimension through the nursing care interview in oncohaematology]. Soins 2022; 67:54-57. [PMID: 35995504 DOI: 10.1016/j.soin.2022.05.016] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Responding to the existential questions of patients faced with a serious hematological disease does not go without saying for a caregiver not trained for this purpose. It is however essential to accompany them in this tragic moment of their life. The research project here aims to develop a process of relational and spiritual care to best meet their quest.
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Affiliation(s)
- Valérie Floucaud
- Institut universitaire du cancer de Toulouse-Oncopole, centre hospitalier universitaire de Toulouse, 1 avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - Séverine Poupblanc
- Centre hospitalier de Mont-de-Marsan, avenue Pierre-de-Coubertin, BP 417, 40024 Mont-de-Marsan cedex, France
| | - Hélène Grandjean
- Inserm, délégation régionale Occitanie Pyrénées, centre hospitalier universitaire Purpan, BP 3048, 31024 Toulouse cedex 3, France
| | - Sarah Bertoli
- Institut universitaire du cancer de Toulouse-Oncopole, centre hospitalier universitaire de Toulouse, 1 avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Valérie Lauwers
- Unité de soutien méthodologique à la recherche clinique, université Paul-Sabatier, faculté de médecine, 37 allées Jules-Guesde, 31073 Toulouse cedex, France
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23
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Frattini F, Pino A, Matarese A, Carrano FM, Gambetti A, Boni L, Ierardi AM, Carrafiello G, Rausei S, Bertoli S, Dionigi G. Portomesenteric vein thrombosis following sleeve gastrectomy: Case report focusing on the role of pathogenetic factors. Obes Res Clin Pract 2022; 16:170-173. [PMID: 35396195 DOI: 10.1016/j.orcp.2022.03.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Sleeve gastrectomy has currently become the most commonly performed bariatric. procedure worldwide according to the last IFSO survey, overtaking gastric bypass with. a share of more than 50% of all primary bariatric-metabolic surgery. Gastric leak, intraluminal bleeding, bleeding from the staple-line and strictures are the most common complications. Portomesenteric vein thrombosis (PMVT)after sleeve gastrectomy is. another complication that has been increasingly reported in case-series in recent.years, although it remains uncommon. In this case report is described an extended portomesenteric vein thrombosis after. sleeve gastrectomy interesting splenic vein too with a favorable course and an. uneventful follow-up. We try to search in this case for pathogenetic factors involved in. this complication. CASE REPORT A 42-year old man, with a body mass index (BMI) of 45 kg/m2, with a medical history of Obstructive Sleep Apnea Sindrome (OSAS) underwent laparoscopic sleeve gastrectomy. Early postoperative course was uneventful. Six days after discharge he complained abdominal pain and was admitted at the Emergency Department. A CT scan with intravenous contrast showed an occlusion of the portal vein, of the intrahepatic major branches and an extension to the superior mesenteric vein and the splenic vein. The patient received heparin and oral anticoagulation together with intravenous hydration and proton pump inhibitors. Considering the favourable course the patient was discharged after six days with long-term oral anticoagulation therapy. Anticoagulation with acenocumarol was continued for six months after a CT scan showed resolution of the PMVT without cavernoma. He had no recurrence of symptoms. DISCUSSION Porto-mesenteric thrombosis after sleeve gastrectomy is a rare complication but it has been increasingly reported over the last 10 years along with the extensive use of sleeve gastrectomy. Because PMVT is closely associated with sleeve gastrectomy in comparison with other bariatric procedures, we need to investigate what pathogenetic factors are involved in sleeve gastrectomy. Thrombophylic state, prolonged duration of surgery, high levels of pneumoperitoneum, thermal injury of the gastroepiploic vessels during greater curvature dissection, high intragastric pressure, inadequate antithrombotic prophylaxis and delayed mobilization of the patient after surgery have been reported as pathogenetic factors of portmesenteric vein thrombosis. Most of the cases presented in the literature such as our clinical case resolve with medical therapy, although portal vein thrombus extends into the superior mesenteric vein and the splenic vein. CONCLUSION Portomesenteric venous thrombosis is a rare but serious complication of bariatric surgery, especially associated with sleeve gastrectomy. Diagnosis is based on CT examination with intravenous contrast, and initial therapy is anticoagulation. Etiologic factors reported in the literature include a long duration of surgery, a high degree of pneumoperitoneum, high intragastric pressure after sleeve gastrectomy and thermal injury to the short gastric vessels and gastroepiploic arcade. Limited operative time, controlled values of pneumoperitoneum, careful dissection with energy device of gastric greater curvature, appropriate prophylaxis with low molecular weight heparin may be useful tools to prevent and limit this complication. Nonetheless we have to search which factors may condition the evolution of an extended PMVT as that described in this case towards resolution or to a further worsening clinical state. Early diagnosis? Correct treatment? Undiscovered patientrelated factors?
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Affiliation(s)
- F Frattini
- Department of Surgery, ASST Settelaghi, Varese, Italy.
| | - A Pino
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Università di Messina, Italy.
| | - A Matarese
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Università di Milano, Italy.
| | - F M Carrano
- Department of Surgical Sciences, University of Rome "Tor Vergata", Rome, Italy.
| | - A Gambetti
- Division of Surgery, IRCCS Istituto Auxologico Italiano Milan, Italy.
| | - L Boni
- Department of Surgery, IRCCS Fondazione Cà granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - A M Ierardi
- Operative Unit of Radiology, IRCCS Fondazione Cà Granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - G Carrafiello
- Operative Unit of Radiology, IRCCS Fondazione Cà Granda, Policlinico Hospital of Milan, University of Milan, Italy.
| | - S Rausei
- Department of Surgery, ASST Valleolona, Gallarate, Italy.
| | - S Bertoli
- Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Obesity Unit and Laboratory of Nutrition and Obesity Research, University of Milan, Milan, Italy.
| | - G Dionigi
- Division of Surgery, Endocrine Surgery Unit, IRCCS, Istituto Auxologico Milan, University of Milan, Italy.
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24
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Gadaud N, Leroy H, Bérard E, Tavitian S, Leguay T, Dimicoli-Salazar S, Rieu JB, Luquet I, Largeaud L, Bidet A, Delabesse E, Klein E, Sarry A, de Grande AC, Bories P, Pigneux A, Récher C, Dumas PY, Bertoli S. Azacitidine, intensive chemotherapy or best supportive care in relapsed or refractory acute myeloid leukemia, a DATAML registry study. Leuk Lymphoma 2022; 63:1398-1406. [DOI: 10.1080/10428194.2021.2022140] [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: 10/19/2022]
Affiliation(s)
- Noémie Gadaud
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Harmony Leroy
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Emilie Bérard
- Service d’Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- CERPOP, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Suzanne Tavitian
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Thibaut Leguay
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Sophie Dimicoli-Salazar
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Jean-Baptiste Rieu
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Laetitia Largeaud
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Audrey Bidet
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, Bordeaux, France
| | - Eric Delabesse
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Emilie Klein
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, Bordeaux, France
| | - Audrey Sarry
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Anne-Charlotte de Grande
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
| | - Pierre Bories
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, Bordeaux, France
| | - Christian Récher
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
| | - Pierre-Yves Dumas
- Centre Hospitalier Universitaire de Bordeaux, Service d’Hématologie Clinique et de Thérapie Cellulaire, Bordeaux, France
- Université de Bordeaux, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, Bordeaux, France
| | - Sarah Bertoli
- Service d’Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, Toulouse, France
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25
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Sabatier M, Boet E, Zaghdoudi S, Guiraud N, Hucteau A, Polley N, Cognet G, Saland E, Lauture L, Farge T, Sahal A, Pancaldi V, Chu-Van E, Castelli F, Bertoli S, Bories P, Récher C, Boutzen H, Mansat-De Mas V, Stuani L, Sarry JE. Activation of Vitamin D Receptor Pathway Enhances Differentiating Capacity in Acute Myeloid Leukemia with Isocitrate Dehydrogenase Mutations. Cancers (Basel) 2021; 13:cancers13205243. [PMID: 34680392 PMCID: PMC8533831 DOI: 10.3390/cancers13205243] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Around 15% of acute myeloid leukemia (AML) patients harbor mutations in isocitrate dehydrogenases (IDH), which lead to the production of the oncometabolite 2-hydroxyglutarate (2-HG). Inhibitors of mutant IDH enzymes and their 2-HG production have been approved by the FDA to be used in patients. However, 60% of IDH mutant AML patients do not respond to these inhibitors or develop mechanisms of resistance, leading to relapse. Among these mechanisms, some produce a 2-HG rebound. Alternative therapies exploiting the 2-HG-dependent molecular effects could therefore be of clinical interest. In this study, we demonstrate that 2-HG specifically activates vitamin D receptor (VDR) in IDH mutant AML cells leading to increased sensitivity to the combination of vitamin D (or VDR agonist) and all-trans retinoic acid and revealing a new therapeutic approach that can be readily applied to AML patients in this subgroup. Abstract Relapses and resistance to therapeutic agents are major barriers in the treatment of acute myeloid leukemia (AML) patients. These unfavorable outcomes emphasize the need for new strategies targeting drug-resistant cells. As IDH mutations are present in the preleukemic stem cells and systematically conserved at relapse, targeting IDH mutant cells could be essential to achieve a long-term remission in the IDH mutant AML subgroup. Here, using a panel of human AML cell lines and primary AML patient specimens harboring IDH mutations, we showed that the production of an oncometabolite (R)-2-HG by IDH mutant enzymes induces vitamin D receptor-related transcriptional changes, priming these AML cells to differentiate with pharmacological doses of ATRA and/or VD. This activation occurs in a CEBPα-dependent manner. Accordingly, our findings illuminate potent and cooperative effects of IDH mutations and the vitamin D receptor pathway on differentiation in AML, revealing a novel therapeutic approach easily transferable/immediately applicable to this subgroup of AML patients.
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Affiliation(s)
- Marie Sabatier
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Emeline Boet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Sonia Zaghdoudi
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Nathan Guiraud
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Alexis Hucteau
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Nathaniel Polley
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Guillaume Cognet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Estelle Saland
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Laura Lauture
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Thomas Farge
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Ambrine Sahal
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Vera Pancaldi
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
| | - Emeline Chu-Van
- CEA/DSV/iBiTec-S/SPI, Laboratoire d’Etude du Métabolisme des Médicaments, MetaboHUB-Paris, 91191 Gif-sur-Yvette, France; (E.C.-V.); (F.C.)
| | - Florence Castelli
- CEA/DSV/iBiTec-S/SPI, Laboratoire d’Etude du Métabolisme des Médicaments, MetaboHUB-Paris, 91191 Gif-sur-Yvette, France; (E.C.-V.); (F.C.)
| | - Sarah Bertoli
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
- Département d’Hématologie, University of Toulouse, CEDEX 6, 31013 Toulouse, France
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, CHU de Toulouse, CEDEX 9, 31059 Toulouse, France
| | - Pierre Bories
- Réseau Régional de Cancérologie Onco-Occitanie, CEDEX 9, 31059 Toulouse, France;
| | - Christian Récher
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
- Département d’Hématologie, University of Toulouse, CEDEX 6, 31013 Toulouse, France
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, CHU de Toulouse, CEDEX 9, 31059 Toulouse, France
| | - Héléna Boutzen
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
| | - Véronique Mansat-De Mas
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
- Département d’Hématologie, University of Toulouse, CEDEX 6, 31013 Toulouse, France
| | - Lucille Stuani
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
- Correspondence: (L.S.); (J.-E.S.); Tel.: +33-582-741-632 (J.-E.S.)
| | - Jean-Emmanuel Sarry
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, Centre National de Recherche Scientifique, CEDEX 1, 31037 Toulouse, France; (M.S.); (E.B.); (S.Z.); (N.G.); (A.H.); (N.P.); (G.C.); (E.S.); (L.L.); (T.F.); (A.S.); (V.P.); (S.B.); (C.R.); (H.B.); (V.M.-D.M.)
- LabEx Toucan, 31037 Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2018, 31037 Toulouse, France
- Correspondence: (L.S.); (J.-E.S.); Tel.: +33-582-741-632 (J.-E.S.)
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Comont T, Nicolau-Travers ML, Bertoli S, Recher C, Vergez F, Treiner E. MAIT cells numbers and frequencies in patients with acute myeloid leukemia at diagnosis: association with cytogenetic profile and gene mutations. Cancer Immunol Immunother 2021; 71:875-887. [PMID: 34477901 DOI: 10.1007/s00262-021-03037-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/12/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022]
Abstract
Harnessing or monitoring immune cells is actually a major topic in pre-clinical and clinical studies in acute myeloid leukemia (AML). Mucosal-Associated Invariant T cells (MAIT) constitute one of the largest subset of innate-like, cytotoxic T cell subsets in humans. Despite some papers suggesting a role for MAIT cells in cancer, their specific involvement remains unclear, especially in myeloid malignancies. This prospective monocentric study included 216 patients with a newly diagnosed AML. Circulating MAIT cells were quantified by flow cytometry at diagnosis and during intensive chemotherapy. We observed that circulating MAIT cells show a specific decline in AML patients at diagnosis compared to healthy donors. Post-induction monitored patients presented with a drastic drop in MAIT cell numbers, with recovery after one month. We also found correlation between decrease in MAIT cells number and adverse cytogenetic profile. FLT3-ITD and IDH ½ mutations were associated with higher MAIT cell numbers. Patients with high level of activated MAIT cells are under-represented within patients with a favorable cytogenetic profile, and over-represented among patients with IDH1 mutations or bi-allelic CEBPA mutations. We show for the first time that circulating MAIT cells are affected in newly diagnosed AML patients, suggesting a link between MAIT cells and AML progression. Our work fosters new studies to deepen our knowledge about the role of MAIT cells in cancer.
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Affiliation(s)
- Thibault Comont
- Department of Internal Medicine, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Laboratory of Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
| | | | - Sarah Bertoli
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- Department of Clinical Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Christian Recher
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- Department of Clinical Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Francois Vergez
- Laboratory of Hematology, IUCT-Oncopole, CHU Toulouse, Toulouse, France
- Cancer Research Center of Toulouse, Unité Mixte de Recherche (UMR) 1037 INSERM, ERL5294 Centre National de La Recherche Scientifique, Toulouse, France
- University Paul Sabatier III, Toulouse, France
| | - Emmanuel Treiner
- Laboratory of Immunology, CHU Toulouse, Toulouse, France.
- University Paul Sabatier III, Toulouse, France.
- Infinity, Inserm UMR1291, 330 Avenue de Grande Bretagne, 31000, Toulouse, France.
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Malard F, Vekhoff A, Lapusan S, Isnard F, D'incan-Corda E, Rey J, Saillard C, Thomas X, Ducastelle-Lepretre S, Paubelle E, Larcher MV, Rocher C, Recher C, Tavitian S, Bertoli S, Michallet AS, Gilis L, Peterlin P, Chevallier P, Nguyen S, Plantamura E, Boucinha L, Gasc C, Michallet M, Dore J, Legrand O, Mohty M. Gut microbiota diversity after autologous fecal microbiota transfer in acute myeloid leukemia patients. Nat Commun 2021; 12:3084. [PMID: 34035290 PMCID: PMC8149453 DOI: 10.1038/s41467-021-23376-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 09/25/2020] [Accepted: 04/22/2021] [Indexed: 12/20/2022] Open
Abstract
Acute myeloid leukemia (AML) intensive chemotherapy combined with broad-spectrum antibiotics, leads to gut microbiota dysbiosis promoting pathological conditions and an increased incidence of complications. Here we report findings from a phase II single-arm, multicenter study evaluating autologous fecal microbiota transfer (AFMT) in 25 AML patients treated with intensive chemotherapy and antibiotics (ClinicalTrials.gov number: NCT02928523). The co-primary outcomes of the study are to evaluate the efficacy of AFMT in dysbiosis correction and multidrug-resistant bacteria eradication. The main secondary outcomes are to define a dysbiosis biosignature, to evaluate the effect of dysbiosis correction on patient clinical status, to assess the short and mid-term safety of AFMT in this immunocompromised population, and to evaluate the feasibility of the AFMT procedure and acceptability by the patient. Intensive induction chemotherapy induces a dramatic decrease of α-diversity indices, and a microbial dysbiosis with a significant shift of the microbial communities and domination of pro-inflammatory families. After AFMT treatment, α-diversity indices return to their initial mean levels and the similarity index shows the restoration of microbial communities. The trial meets pre-specified endpoints. AFMT appears to be safe and may be effective for gut microbiota restoration in AML patients receiving intensive chemotherapy and antibiotics, with an excellent gut microbiota reconstruction based on both richness and diversity indices at the species level. The combination of chemotherapy and broad-spectrum antibiotics induces gut microbiota (GM) dysbiosis in acute myeloid leukaemia (AML) leading to additional complications. Here, the authors report the efficacy in GM restoration and safety of autologous faecal microbiota transfer in treated AML patients in a phase II clinical trial.
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Affiliation(s)
- Florent Malard
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France.
| | - Anne Vekhoff
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Simona Lapusan
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Francoise Isnard
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | | | - Jérôme Rey
- Service d'hématologie, Institut Paoli Calmettes, Marseille, France
| | - Colombe Saillard
- Service d'hématologie, Institut Paoli Calmettes, Marseille, France
| | - Xavier Thomas
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | | | - Etienne Paubelle
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Marie-Virginie Larcher
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Clément Rocher
- Service d'hématologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Christian Recher
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | - Suzanne Tavitian
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | - Sarah Bertoli
- CHU de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Université de Toulouse III Paul Sabatier, Service d'hématologie, Toulouse, France
| | | | - Lila Gilis
- Service d'hématologie, Centre Léon Bérard, Lyon, France
| | | | | | - Stéphanie Nguyen
- Service d'hématologie clinique, Hôpital de la Pitié Salpétrière, APHP, Sorbonne Université, Paris, France
| | | | | | | | | | - Joel Dore
- Université Paris-Saclay, INRAE, MetaGenoPolis, AgroParisTech, MICALIS, Jouy-en-Josas, France
| | - Ollivier Legrand
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Mohamad Mohty
- Service d'hématologie clinique et de thérapie cellulaire, Hôpital Saint Antoine, APHP, Sorbonne Université, INSERM UMRs 938, Paris, France
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Fodil S, Raffoux E, Dumas PY, Desbrosses Y, Larosa F, Chantepie S, Larcher MV, Mear JB, Peterlin P, Hunault-Berger M, Hospital MA, Morel V, Lucas N, Vidal V, Salanoubat C, Michel J, Mediavilla C, Ojeda-Uribe M, Alexis M, Frayfer J, Carré M, Maillard N, Redjoul R, Banos A, Detrait M, Cluzeau T, Wickenhauser S, Chaoui D, Elassy M, Pigneux A, Dombret H, Récher C, Bertoli S. Data from French named patient program of quizartinib in relapsed/refractory acute myeloid leukemia. Leuk Lymphoma 2021; 62:1756-1760. [PMID: 33596765 DOI: 10.1080/10428194.2021.1881505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- S Fodil
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - E Raffoux
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - P Y Dumas
- Service d'Hématologie, CHU Bordeaux, F-33000, Bordeaux, France
| | - Y Desbrosses
- Service d'Hématologie, CHRU Jean Minjoz, Besançon, France
| | - F Larosa
- Service d'Hématologie, CHU de Dijon, Dijon, France
| | - S Chantepie
- Service d'Hématologie, Institut d'Hématologie de Basse-Normandie CHU de Caen, Caen, France
| | - M V Larcher
- Service d'Hématologie, Hospices civils de Lyon, CHU de Lyon, Lyon, France
| | - J B Mear
- Service d'Hématologie, CHU de Rennes - Hôpital Pontchaillou, Rennes, France
| | - P Peterlin
- Service d'Hématologie, CHU de Nantes, Nantes, France
| | - M Hunault-Berger
- Service des Maladies du Sang, Centre Hospitalier Universitaire, FHU GOAL, CRCINA, INSERM, Angers, France
| | - M A Hospital
- Service d'Hématologie, Institut Paoli-Calmettes, Marseille, France
| | - V Morel
- Service d'Hématologie, Hôpital Pitié-Salpêtrière AP-HP, Paris, France
| | - N Lucas
- Service d'Hématologie, Institut Gustave Roussy, Villejuif, France
| | - V Vidal
- Service d'Hématologie, Hôpital Avicenne AP-HP, Bobigny, France
| | - C Salanoubat
- Service d'Hématologie, C.H. Sud Francilien, Corbeil-Essonnes, France
| | - J Michel
- Service d'Hématologie, C.H.R. - Hôpital Félix Maréchal, Metz-Thionville, France
| | - C Mediavilla
- Service d'Hématologie, Hôpital Saint-Antoine AP-HP, Paris, France
| | - M Ojeda-Uribe
- Service d'Hématologie, Groupe Hospitalier Régional Mulhouse Sud-Alsace, Mulhouse, France
| | - M Alexis
- Service d'Hématologie, CHR Orléans, Orléans, France
| | - J Frayfer
- Service d'Hématologie, Grand Hôpital de l'Est Francilien - Site de Meaux, Meaux, France
| | - M Carré
- Service d'Hématologie, CHU Grenoble Alpes, La Tronche, France
| | - N Maillard
- Service d'Hématologie, CHU de Poitiers, Poitiers, France
| | - R Redjoul
- Service d'Hématologie, CHU Henri Mondor, AP-HP et UPEC, Créteil, France
| | - A Banos
- Service d'Hématologie, Centre hospitalier de la côte basque, Bayonne, France
| | - M Detrait
- Service d'Hématologie, CHRU de Nancy, Nancy, France
| | - T Cluzeau
- Département d'Hématologie, Université Cote d'Azur, CHU de Nice, Nice, France
| | | | - D Chaoui
- Service d'Hématologie, CH d'Argenteuil, Argenteuil, France
| | - M Elassy
- Service d'Hématologie, CH d'Auxerre, Auxerre, France
| | - A Pigneux
- Service d'Hématologie, CHU Bordeaux, F-33000, Bordeaux, France
| | - H Dombret
- Service d'Hématologie adulte, Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
| | - C Récher
- Service d'Hématologie, CHU de Toulouse, Centre de Recherches en Cancérologie de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
| | - S Bertoli
- Service d'Hématologie, CHU de Toulouse, Centre de Recherches en Cancérologie de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole, Université de Toulouse 3 Paul Sabatier, Toulouse, France
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29
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Medrano C, Oberic L, Puisset F, Recher C, Larrieu-Ciron D, Ysebaert L, Protin C, Picard M, Perriat S, Chatelut E, Bertoli S, Huguet F, Tavitian S, Faguer S. Life-threatening complications after high-dose methotrexate and the benefits of glucarpidase as salvage therapy: a cohort study of 468 patients. Leuk Lymphoma 2020; 62:846-853. [PMID: 33179543 DOI: 10.1080/10428194.2020.1846733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/23/2022]
Abstract
The aims of this study were to characterize the incidence and outcomes of severe toxicities following the administration of high-dose methotrexate (HD-MTX; ≥1 g/m2). Among the 468 patients included in the study, 69 (14.9%) developed at least one episode of acute kidney injury (AKI; 138/1264 HD-MTX administrations), including 34 (7.2%) who developed KDIGO stage 2-3 AKI. The three baseline factors independently associated with the risk of developing AKI were age, body mass index and a diagnosis of acute lymphoblastic leukemia. Higher plasma MTX concentration was associated with AKI and extra-renal toxicities. Notwithstanding potentially confounding factors, most patients with AKI who received glucarpidase (n = 41) developed extra-renal toxicity (leading to the death of two patients) despite early administration. Thus, severe toxicity and death can occur whether or not glucarpidase is administered, which confirms the need for further interventional studies to provide greater precision on its role in the management of HD-MTX toxicity.
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Affiliation(s)
- Chloé Medrano
- Département de Néphrologie et Transplantation d'organes - Unité de Réanimation, Centre Hospitalier Universitaire de Toulouse, French Intensive Care Renal Network, Toulouse, France
| | - Lucie Oberic
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Florent Puisset
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Loïc Ysebaert
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Caroline Protin
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Muriel Picard
- Département d'anesthésie et de réanimation, Réanimation Médicale, Institut Universitaire du Cancer de Toulouse - Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Sophie Perriat
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Etienne Chatelut
- Laboratoire de Pharmacologie, Institut Claudius-Regaud, Institut Universitaire du Cancer de Toulouse - Oncopôle, and Centre de Recherche sur la Cancer de Toulouse, INSERM UMR-1037, Toulouse, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse - Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d'organes - Unité de Réanimation, Centre Hospitalier Universitaire de Toulouse, French Intensive Care Renal Network, Toulouse, France.,INSERM U1048 (Institut des Maladies Métaboliques et Cardiovasculaires, équipe 12), Hôpital Rangueil, Toulouse, France.,Université Paul Sabatier - Toulouse III, Toulouse, France
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30
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Rieu J, Coster L, Corre J, Tavitian S, Recher C, Huynh A, Picard M, Derreumaux C, Bertoli S, Vergez F, Largeaud L. A case of cup-like blasts associated with B-lymphoblastic leukemia without NPM1 and FLT3 internal tandem duplication mutations. EJHaem 2020; 1:589-592. [PMID: 35845019 PMCID: PMC9175993 DOI: 10.1002/jha2.91] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Jean‐Baptiste Rieu
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Lucie Coster
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Jill Corre
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Suzanne Tavitian
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Christian Recher
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Anne Huynh
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Muriel Picard
- Intensive Care UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Celine Derreumaux
- Intensive Care UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Sarah Bertoli
- Clinical Haematology UnitCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Francois Vergez
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
| | - Laetitia Largeaud
- Haematology LaboratoryCancer University Institute of Toulouse – OncopoleToulouseFrance
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31
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Bories P, Prade N, Lagarde S, Cabarrou B, Largeaud L, Plenecassagnes J, Luquet I, De Mas V, Filleron T, Cassou M, Sarry A, Fornecker LM, Simand C, Bertoli S, Recher C, Delabesse E. Impact of TP53 mutations in acute myeloid leukemia patients treated with azacitidine. PLoS One 2020; 15:e0238795. [PMID: 33001991 PMCID: PMC7529302 DOI: 10.1371/journal.pone.0238795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/24/2020] [Indexed: 12/31/2022] Open
Abstract
Hypomethylating agents are a classical frontline low-intensity therapy for older patients with acute myeloid leukemia. Recently, TP53 gene mutations have been described as a potential predictive biomarker of better outcome in patients treated with a ten-day decitabine regimen., However, functional characteristics of TP53 mutant are heterogeneous, as reflected in multiple functional TP53 classifications and their impact in patients treated with azacitidine is less clear. We analyzed the therapeutic course and outcome of 279 patients treated with azacitidine between 2007 and 2016, prospectively enrolled in our regional healthcare network. By screening 224 of them, we detected TP53 mutations in 55 patients (24.6%), including 53 patients (96.4%) harboring high-risk cytogenetics. The identification of any TP53 mutation was associated with worse overall survival but not with response to azacitidine in the whole cohort and in the subgroup of patients with adverse karyotype. Stratification of patients according to three recent validated functional classifications did not allow the identification of TP53 mutated patients who could benefit from azacitidine. Systematic TP53 mutant classification will deserve further exploration in the setting of patients treated with conventional therapy and in the emerging field of therapies targeting TP53 pathway.
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MESH Headings
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic/therapeutic use
- Azacitidine/therapeutic use
- Biomarkers, Tumor/genetics
- Female
- France/epidemiology
- Genes, p53
- Humans
- Kaplan-Meier Estimate
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Male
- Middle Aged
- Mutation
- Prognosis
- Prospective Studies
- Registries
- Tumor Suppressor Protein p53/genetics
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Affiliation(s)
- Pierre Bories
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- Réseau Onco-occitanie, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
- * E-mail:
| | - Naïs Prade
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Stéphanie Lagarde
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Bastien Cabarrou
- Unité de biostatistique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Julien Plenecassagnes
- Unité de bioinformatique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Thomas Filleron
- Unité de biostatistique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Manon Cassou
- Unité de bioinformatique, Institut Claudius Régaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Luc-Matthieu Fornecker
- Service d'Onco-Hématologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Célestine Simand
- Service d'Onco-Hématologie, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Christian Recher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
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Largeaud L, Cornillet-Lefebvre P, Hamel JF, Dumas PY, Prade N, Dufrechou S, Plenecassagnes J, Luquet I, Blanchet O, Banos A, Béné MC, Bernard M, Bertoli S, Bonmati C, Fornecker LM, Guièze R, Haddaoui L, Hunault M, Ianotto JC, Jourdan E, Ojeda M, Peterlin P, Vey N, Zerazhi H, Yosr H, Mineur A, Cahn JY, Ifrah N, Récher C, Pigneux A, Delabesse E. Lomustine is beneficial to older AML with ELN2017 adverse risk profile and intermediate karyotype: a FILO study. Leukemia 2020; 35:1291-1300. [PMID: 32943750 DOI: 10.1038/s41375-020-01031-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/23/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022]
Abstract
We previously reported the benefit of lomustine addition to conventional chemotherapy in older acute myeloid leukemias with nonadverse chromosomal aberrations in the LAM-SA 2007 randomized clinical trial (NCT00590837). A molecular analysis of 52 genes performed in 330 patients included in this trial, 163 patients being treated with lomustine in combination with idarubicin and cytarabine and 167 without lomustine, identified 1088 mutations with an average of 3.3 mutations per patient. NPM1, FLT3, and DNMT3A were the most frequently mutated genes. A putative therapeutic target was identified in 178 patients (54%). Among five molecular classifications analyzed, the ELN2017 risk classification has the stronger association with the clinical evolution. Patients not treated with lomustine have an expected survival prognosis in agreement with this classification regarding the overall and event-free survivals. In strong contrast, lomustine erased the ELN2017 classification prognosis. The benefit of lomustine in nonadverse chromosomal aberrations was restricted to patients with RUNX1, ASXL1, TP53, and FLT3-ITDhigh/NPM1WT mutations in contrast to the intermediate and favorable ELN2017 patients. This post-hoc analysis identified a subgroup of fit elderly AML patients with intermediate cytogenetics and molecular markers who may benefit from lomustine addition to intensive chemotherapy.
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Affiliation(s)
- Laetitia Largeaud
- Hematology Biology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | | | - Pierre-Yves Dumas
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | - Naïs Prade
- Hematology Biology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Stéphanie Dufrechou
- Hematology Biology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Julien Plenecassagnes
- Bioinformatic Department, Claudius Regaud Institute, Institut Universitaire du Cancer de Toulouse Oncopôle, Toulouse, France
| | - Isabelle Luquet
- Hematology Biology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Odile Blanchet
- Hematology Biology, Angers University Hospital, Angers University, Inserm, CRCINA, Angers, France
| | - Anne Banos
- Clinical Hematology, Cote Basque General Hospital, Bayonne, France
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Marc Bernard
- Clinical Hematology, Rennes University Hospital, Rennes, France
| | - Sarah Bertoli
- Clinical Hematology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | | | | | - Romain Guièze
- Clinical Hematology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Lamya Haddaoui
- FILO Tumor Bank, Pitié-Salpêtrière Hospital, Paris, France
| | - Mathilde Hunault
- Clinical Hematology, Angers University Hospital, INSERM U 892/CNRS 6299, Angers, France
| | - Jean Christophe Ianotto
- Clinical Hematology, Institute of Oncology and Hematology, Brest University Hospital, Brest, France
| | - Eric Jourdan
- Clinical Hematology, Nîmes University Hospital, Nîmes, France
| | - Mario Ojeda
- Clinical Hematology, GHRMSA, Hôpital E Muller, Mulhouse, France
| | - Pierre Peterlin
- Clinical Hematology, Nantes University Hospital, Nantes, France
| | - Norbert Vey
- Clinical Hematology, Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Hacene Zerazhi
- Clinical Hematology, Avignon General Hospital, Avignon, France
| | - Hicheri Yosr
- Clinical Hematology, Aix-Marseille University, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France.,Clinical Hematology, Montpellier University Hospital, Montpellier, France
| | - Ariane Mineur
- Clinical Research Unit, Bordeaux University Hospital, Bordeaux, France.,FILO, Tours University Hospital, Tours, France
| | - Jean-Yves Cahn
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | - Norbert Ifrah
- Clinical Hematology, Angers University Hospital, INSERM U 892/CNRS 6299, Angers, France
| | - Christian Récher
- Clinical Hematology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Arnaud Pigneux
- Clinical Hematology, Bordeaux University Hospital, Bordeaux University, Inserm 1035, Bordeaux, France
| | - Eric Delabesse
- Hematology Biology, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, Université Toulouse III Paul Sabatier, Toulouse, France.
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33
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Bosc C, Broin N, Fanjul M, Saland E, Farge T, Courdy C, Batut A, Masoud R, Larrue C, Skuli S, Espagnolle N, Pagès JC, Carrier A, Bost F, Bertrand-Michel J, Tamburini J, Récher C, Bertoli S, Mansat-De Mas V, Manenti S, Sarry JE, Joffre C. Autophagy regulates fatty acid availability for oxidative phosphorylation through mitochondria-endoplasmic reticulum contact sites. Nat Commun 2020; 11:4056. [PMID: 32792483 PMCID: PMC7426880 DOI: 10.1038/s41467-020-17882-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [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: 06/13/2019] [Accepted: 07/22/2020] [Indexed: 12/14/2022] Open
Abstract
Autophagy has been associated with oncogenesis with one of its emerging key functions being its contribution to the metabolism of tumors. Therefore, deciphering the mechanisms of how autophagy supports tumor cell metabolism is essential. Here, we demonstrate that the inhibition of autophagy induces an accumulation of lipid droplets (LD) due to a decrease in fatty acid β-oxidation, that leads to a reduction of oxidative phosphorylation (OxPHOS) in acute myeloid leukemia (AML), but not in normal cells. Thus, the autophagic process participates in lipid catabolism that supports OxPHOS in AML cells. Interestingly, the inhibition of OxPHOS leads to LD accumulation with the concomitant inhibition of autophagy. Mechanistically, we show that the disruption of mitochondria–endoplasmic reticulum (ER) contact sites (MERCs) phenocopies OxPHOS inhibition. Altogether, our data establish that mitochondria, through the regulation of MERCs, controls autophagy that, in turn finely tunes lipid degradation to fuel OxPHOS supporting proliferation and growth in leukemia. How autophagy supports tumor cell metabolism is not fully clear. Here, the authors show that autophagy regulates lipid availability to support mitochondrial oxidative metabolism through mitochondria-endoplasmic reticulum contact sites, necessary for cell proliferation in AML.
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Affiliation(s)
- Claudie Bosc
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Nicolas Broin
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Marjorie Fanjul
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Estelle Saland
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Thomas Farge
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Charly Courdy
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Aurélie Batut
- MetaToul-MetaboHUB, National Infrastructure of Metabolomics and Fluxomics, Toulouse, F-31077, France
| | - Rawand Masoud
- Aix Marseille Université, CNRS, INSERM, Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille, Marseille, France
| | - Clément Larrue
- Translational Research Centre in Onco-hematology, Faculty of Medicine, University of Geneva, 1211, Geneva, Switzerland
| | - Sarah Skuli
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.,Division of Hematology and Oncology, Hospital of The University of Pennsylvania, Philadelphia, PA, USA
| | - Nicolas Espagnolle
- STROMALab, Université de Toulouse, CNRS ERL5311, EFS, INP-ENVT, Inserm U1031, UPS, Toulouse, France
| | - Jean-Christophe Pagès
- STROMALab, Université de Toulouse, CNRS ERL5311, EFS, INP-ENVT, Inserm U1031, UPS, Toulouse, France
| | - Alice Carrier
- Aix Marseille Université, CNRS, INSERM, Institut Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille, Marseille, France
| | - Frédéric Bost
- Inserm U1065, C3M, Team Cellular and Molecular Physiopathology of Obesity and Diabetes, Université Nice Côte d'Azur, Inserm, Nice, France
| | - Justine Bertrand-Michel
- MetaToul-MetaboHUB, National Infrastructure of Metabolomics and Fluxomics, Toulouse, F-31077, France
| | - Jérôme Tamburini
- Translational Research Centre in Onco-hematology, Faculty of Medicine, University of Geneva, 1211, Geneva, Switzerland.,Université de Paris, Institut Cochin, CNRS UMR8104, INSERM U1016, F-75014, Paris, France
| | - Christian Récher
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.,Service d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Sarah Bertoli
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.,Service d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Véronique Mansat-De Mas
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.,Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Stéphane Manenti
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France
| | - Jean-Emmanuel Sarry
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France. .,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.
| | - Carine Joffre
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France. .,Equipe labellisée, La Ligue contre le Cancer, Toulouse, France.
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Dumas PY, Bertoli S, Bérard E, Largeaud L, Bidet A, Delabesse E, Leguay T, Leroy H, Gadaud N, Rieu JB, Vial JP, Vergez F, Lechevalier N, Luquet I, Klein E, Sarry A, de Grande AC, Pigneux A, Récher C. Real-World Outcomes of Patients with Refractory or Relapsed FLT3-ITD Acute Myeloid Leukemia: A Toulouse-Bordeaux DATAML Registry Study. Cancers (Basel) 2020; 12:cancers12082044. [PMID: 32722211 PMCID: PMC7465142 DOI: 10.3390/cancers12082044] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/15/2022] Open
Abstract
Two recent phase 3 trials showed that outcomes for relapsed/refractory (R/R) FLT3-mutated acute myeloid leukemia (AML) patients may be improved by a single-agent tyrosine kinase inhibitor (TKI) (i.e., quizartinib or gilteritinib). In the current study, we retrospectively investigated the characteristics and real-world outcomes of R/R FLT3-internal tandem duplication (ITD) acute myeloid leukemia (AML) patients in the Toulouse-Bordeaux DATAML registry. In the study, we included 316 patients with FLT3-ITD AML that received intensive chemotherapy as a first-line treatment. The rate of complete remission (CR) or CR without hematological recovery (CRi) was 75.2%, and 160 patients were R/R after a first-line TKI-free treatment (n = 294). Within the subgroup of R/R patients that fulfilled the main criteria of the QUANTUM-R study, 48.9% received an intensive salvage regimen; none received hypomethylating agents or low-dose cytarabine. Among the R/R FLT3-ITD AML patients with CR1 durations < 6 months who received intensive TKI-free treatment, the rate of CR or CRi after salvage chemotherapy was 52.8%, and these results allowed a bridge to be transplanted in 39.6% of cases. Finally, in this QUANTUM-R standard arm-matched cohort, the median overall survival (OS) was 7.0 months and 1-, 3- and 5-year OS were 30.2%, 23.7% and 21.4%, respectively. To conclude, these real-world data show that the intensity of the second-line treatment likely affects response and transplantation rates. Furthermore, the results indicate that including patients with low-intensity regimens, such as low-dose cytarabine or hypomethylating agents, in the control arm of a phase 3 trial may be counterproductive and could compromise the results of the study.
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Affiliation(s)
- Pierre-Yves Dumas
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
- Correspondence: ; Tel.: +33-557-656-511; Fax: +33-557-656-514
| | - Sarah Bertoli
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
| | - Emilie Bérard
- Service d’Epidémiologie, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France;
- INSERM-Université de Toulouse III, UMR 1027, 31000 Toulouse, France
| | - Laetitia Largeaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Audrey Bidet
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Thibaut Leguay
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Harmony Leroy
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Noémie Gadaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Jean Baptiste Rieu
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Jean-Philippe Vial
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - François Vergez
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Nicolas Lechevalier
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Isabelle Luquet
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Emilie Klein
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Audrey Sarry
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Anne-Charlotte de Grande
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Arnaud Pigneux
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
| | - Christian Récher
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
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35
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Tavitian S, Uzunov M, Bérard E, Bouscary D, Thomas X, Raffoux E, Leguay T, Gallego Hernanz MP, Berceanu A, Leprêtre S, Hicheri Y, Chevallier P, Bertoli S, Lhéritier V, Dombret H, Huguet F. Ponatinib-based therapy in adults with relapsed or refractory Philadelphia chromosome-positive acute lymphoblastic leukemia: results of the real-life OPAL study. Leuk Lymphoma 2020; 61:2161-2167. [DOI: 10.1080/10428194.2020.1762876] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Suzanne Tavitian
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - Madalina Uzunov
- Department of Hematology, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Emilie Bérard
- CHU de Toulouse, UMR 1027, INSERM-Université Toulouse III, Toulouse, France
| | | | - Xavier Thomas
- Department of Hematology, CHU de Lyon Sud, Pierre-Bénite, France
| | - Emmanuel Raffoux
- AP-HP, Hopital Saint-Louis, Service Hematologie Adulte, Paris, France
| | - Thibaut Leguay
- Service d'hématologie clinique et thérapie cellulaire, Hôpital du Haut-Lévèque, CHU de Bordeaux, Bordeaux, France
| | | | - Ana Berceanu
- Department of Hematology, CHU Besancon, Besancon, France
| | | | | | | | - Sarah Bertoli
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
| | - Véronique Lhéritier
- Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL), Lyon, France
| | - Hervé Dombret
- Hospital Saint-Louis, Hématologie Adulte, Paris, France
| | - Françoise Huguet
- Department of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse, Toulouse, France
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36
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Beziat G, Tavitian S, Bertoli S, Huguet F, Largeaud L, Luquet I, Vergez F, Rieu J, Bories P, Delabesse E, Récher C. Dactinomycin in acute myeloid leukemia with NPM1 mutations. Eur J Haematol 2020; 105:302-307. [DOI: 10.1111/ejh.13438] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Guillaume Beziat
- Service d'Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Suzanne Tavitian
- Service d'Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Sarah Bertoli
- Service d'Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
- Université Toulouse III Paul Sabatier Toulouse France
| | - Françoise Huguet
- Service d'Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Laetitia Largeaud
- Université Toulouse III Paul Sabatier Toulouse France
- Laboratoire d’Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Isabelle Luquet
- Laboratoire d’Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - François Vergez
- Laboratoire d’Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Jean‐Baptiste Rieu
- Laboratoire d’Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Pierre Bories
- Réseau Onco‐Occitanie Institut Universitaire du Cancer de Toulouse‐Oncopole Toulouse France
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier Toulouse France
- Laboratoire d’Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
| | - Christian Récher
- Service d'Hématologie Institut Universitaire du Cancer de Toulouse Oncopole Centre Hospitalier Universitaire de Toulouse Toulouse France
- Université Toulouse III Paul Sabatier Toulouse France
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Bertoli S, Rieu JB, Récher C, Vergez F. Large granular lymphocytosis during quizartinib therapy. Br J Haematol 2020; 189:7. [PMID: 32162314 DOI: 10.1111/bjh.16373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/12/2019] [Accepted: 10/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sarah Bertoli
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, CHU de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Christian Récher
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, CHU de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - François Vergez
- Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France.,Laboratoire d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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38
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Bertoli S, Tavitian S, Bérard E, Mansat-De Mas V, Largeaud L, Gadaud N, Rieu JB, Vergez F, Luquet I, Huguet F, Sarry A, Delabesse E, Récher C. More than ten percent of relapses occur after five years in AML patients with NPM1 mutation. Leuk Lymphoma 2020; 61:1226-1229. [PMID: 32022605 DOI: 10.1080/10428194.2019.1706733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sarah Bertoli
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Emilie Bérard
- Service d'Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,UMR 1027, INSERM-Université de Toulouse III, Toulouse, France
| | - Véronique Mansat-De Mas
- Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France.,Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Laetitia Largeaud
- Université Toulouse III Paul Sabatier, Toulouse, France.,Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Noémie Gadaud
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Jean-Baptiste Rieu
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - François Vergez
- Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France.,Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France.,Laboratoire d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Christian Récher
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
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Sueur G, Boutet A, Gotanègre M, Mansat-De Mas V, Besson A, Manenti S, Bertoli S. STAT5-dependent regulation of CDC25A by miR-16 controls proliferation and differentiation in FLT3-ITD acute myeloid leukemia. Sci Rep 2020; 10:1906. [PMID: 32024878 PMCID: PMC7002454 DOI: 10.1038/s41598-020-58651-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 07/24/2019] [Accepted: 01/14/2020] [Indexed: 01/10/2023] Open
Abstract
We recently identified the CDC25A phosphatase as a key actor in proliferation and differentiation in acute myeloid leukemia expressing the FLT3-ITD mutation. In this paper we demonstrate that CDC25A level is controlled by a complex STAT5/miR-16 transcription and translation pathway working downstream of this receptor. First, we established by CHIP analysis that STAT5 is directly involved in FLT3-ITD-dependent CDC25A gene transcription. In addition, we determined that miR-16 expression is repressed by FLT3-ITD activity, and that STAT5 participates in this repression. In accordance with these results, miR-16 expression was significantly reduced in a panel of AML primary samples carrying the FLT3-ITD mutation when compared with FLT3wt cells. The expression of a miR-16 mimic reduced CDC25A protein and mRNA levels, and RNA interference-mediated down modulation of miR-16 restored CDC25A expression in response to FLT3-ITD inhibition. Finally, decreasing miR-16 expression partially restored the proliferation of cells treated with the FLT3 inhibitor AC220, while the expression of miR-16 mimic stopped this proliferation and induced monocytic differentiation of AML cells. In summary, we identified a FLT3-ITD/STAT5/miR-16/CDC25A axis essential for AML cell proliferation and differentiation.
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Affiliation(s)
- Gabrielle Sueur
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée La Ligue contre le Cancer 2016, Toulouse, France
| | - Alison Boutet
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée La Ligue contre le Cancer 2016, Toulouse, France
| | - Mathilde Gotanègre
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France
| | - Véronique Mansat-De Mas
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France.,Equipe labellisée La Ligue contre le Cancer 2016, Toulouse, France.,Laboratoire d'hématologie, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France
| | - Arnaud Besson
- Laboratoire de Biologie Cellulaire et Moléculaire du Contrôle de la Prolifération, Centre de Biologie Intégrative, Université de Toulouse, UPS and CNRS, Toulouse, France
| | - Stéphane Manenti
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France. .,Equipe labellisée La Ligue contre le Cancer 2016, Toulouse, France.
| | - Sarah Bertoli
- Cancer Research Center of Toulouse (CRCT), INSERM U1037, CNRS ERL5294, University of Toulouse, Toulouse, France. .,Equipe labellisée La Ligue contre le Cancer 2016, Toulouse, France. .,Université Toulouse III Paul Sabatier, Toulouse, France. .,Service d'hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O), Toulouse, France.
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40
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Angenendt L, Röllig C, Montesinos P, Martínez-Cuadrón D, Barragan E, García R, Botella C, Martínez P, Ravandi F, Kadia T, Kantarjian HM, Cortes J, Juliusson G, Lazarevic V, Höglund M, Lehmann S, Recher C, Pigneux A, Bertoli S, Dumas PY, Dombret H, Preudhomme C, Micol JB, Terré C, Ráčil Z, Novák J, Žák P, Wei AH, Tiong IS, Wall M, Estey E, Shaw C, Exeler R, Wagenführ L, Stölzel F, Thiede C, Stelljes M, Lenz G, Mikesch JH, Serve H, Ehninger G, Berdel WE, Kramer M, Krug U, Schliemann C. Chromosomal Abnormalities and Prognosis in NPM1-Mutated Acute Myeloid Leukemia: A Pooled Analysis of Individual Patient Data From Nine International Cohorts. J Clin Oncol 2019; 37:2632-2642. [PMID: 31430225 PMCID: PMC8462529 DOI: 10.1200/jco.19.00416] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Nucleophosmin 1 (NPM1) mutations are associated with a favorable prognosis in acute myeloid leukemia (AML) when an internal tandem duplication (ITD) in the fms-related tyrosine kinase 3 gene (FLT3) is absent (FLT3-ITDneg) or present with a low allelic ratio (FLT3-ITDlow). The 2017 European LeukemiaNet guidelines assume this is true regardless of accompanying cytogenetic abnormalities. We investigated the validity of this assumption. METHODS We analyzed associations between karyotype and outcome in intensively treated patients with NPM1mut/FLT3-ITDneg/low AML who were prospectively enrolled in registry databases from nine international study groups or treatment centers. RESULTS Among 2,426 patients with NPM1mut/FLT3-ITDneg/low AML, 2,000 (82.4%) had a normal and 426 (17.6%) had an abnormal karyotype, including 329 patients (13.6%) with intermediate and 83 patients (3.4%) with adverse-risk chromosomal abnormalities. In patients with NPM1mut/FLT3-ITDneg/low AML, adverse cytogenetics were associated with lower complete remission rates (87.7%, 86.0%, and 66.3% for normal, aberrant intermediate, and adverse karyotype, respectively; P < .001), inferior 5-year overall (52.4%, 44.8%, 19.5%, respectively; P < .001) and event-free survival (40.6%, 36.0%, 18.1%, respectively; P < .001), and a higher 5-year cumulative incidence of relapse (43.6%, 44.2%, 51.9%, respectively; P = .0012). These associations remained in multivariable mixed-effects regression analyses adjusted for known clinicopathologic risk factors (P < .001 for all end points). In patients with adverse-risk chromosomal aberrations, we found no significant influence of the NPM1 mutational status on outcome. CONCLUSION Karyotype abnormalities are significantly associated with outcome in NPM1mut/FLT3-ITDneg/low AML. When adverse-risk cytogenetics are present, patients with NPM1mut share the same unfavorable prognosis as patients with NPM1 wild type and should be classified and treated accordingly. Thus, cytogenetic risk predominates over molecular risk in NPM1mut/FLT3-ITDneg/low AML.
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Affiliation(s)
- Linus Angenendt
- University Hospital Münster, Münster, Germany,Linus Angenendt, MD, Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany; e-mail:
| | - Christoph Röllig
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - Eva Barragan
- Hospital Universitari i Politècnic La Fe, Valencia; Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | | | | | | | - Farhad Ravandi
- University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tapan Kadia
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Jorge Cortes
- University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Martin Höglund
- Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | - Sören Lehmann
- Uppsala University, Uppsala University Hospital, Uppsala, Sweden
| | | | - Arnaud Pigneux
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Bordeaux, France
| | - Sarah Bertoli
- Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre-Yves Dumas
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Haut-Lévèque, Bordeaux, France
| | | | - Claude Preudhomme
- Institut National de la Santé et de la Recherche Médicale Lille, Lille, France
| | | | | | - Zdeněk Ráčil
- Masaryk University, University Hospital Brno, Brno, Czech Republic
| | - Jan Novák
- University Hospital Kralovske Vinohrady, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Žák
- University Hospital Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Andrew H. Wei
- The Alfred Hospital, Monash University, Melbourne, Australia
| | - Ing S. Tiong
- The Alfred Hospital, Monash University, Melbourne, Australia
| | | | - Elihu Estey
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Carole Shaw
- University of Washington, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Lisa Wagenführ
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Friedrich Stölzel
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Christian Thiede
- University Hospital of the Technical University Dresden, Dresden, Germany
| | | | - Georg Lenz
- University Hospital Münster, Münster, Germany
| | | | - Hubert Serve
- University Hospital Frankfurt, Frankfurt, Germany
| | - Gerhard Ehninger
- University Hospital of the Technical University Dresden, Dresden, Germany
| | | | - Michael Kramer
- University Hospital of the Technical University Dresden, Dresden, Germany
| | - Utz Krug
- Klinikum Leverkusen, Leverkusen, Germany
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Zaglia T, Prando V, Bertoli S, Favaro G, Di Mauro V, Guescini M, Di Bona A, Lo Verso F, Soares R, Da Costa Martins P, Catalucci D, Mongillo M, Sandri M. 262Circulating muscle-derived mir-206 links skeletal muscle dysfunction to cardiac autonomic denervation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0078] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
Recent studies and our preliminary data demonstrate that muscle-specific ablation of the autophagy-related protein Atg7, leads to block of autophagy, sarcopenia and destabilization of the neuro-muscular junction (NMJ). In addition, Atg7 knock-out (Atg7 KO) muscle fibers release exosomes containing the muscle specific, miR-206, which is consistently elevated in the plasma. Interestingly, we found that miR-206 content was elevated in the heart, suggesting cardiac uptake of the miR-carrying circulating exosomes. We thus aimed at defining the effects of miR-206 on heart homeostasis.
Methods
Here, we analyzed the cardiac phenotype of adult (12mo.) and aged (24mo.) Atg7 KO mice, as well as of adult C57BL/6J mice injected, via tail vein, with scramble- or miR-206-loaded exosomes. Exosomes were isolated from EDL muscle of control and Atg7 KO mice, as well as from HEK293 cells. Heart function was assessed by echocardiography and ECG-telemetry. Confocal IF, whole-mount IF on heart blocks and multiphoton imaging were used to assess heart structure and sympathetic innervation. Bioinformatics, molecular and biochemical analyses were performed to identify novel targets of miR-206. IF, BRET assay and imaging of TrKA translocation were performed in cultured sympathetic neurons (SNs).
Results
We demonstrate that circulating exosomes, containing miR-206, are taken up by the heart leading to sympathetic dysinnervation, accompanied to reduction in the neurogenic control of cardiac rhythm and increased arrhythmogenesis. In vitro assays demonstrated that exosome-carried miR-206 targets cardiac SNs (cSNs), compromising cell structure and function. Indeed, increased miR-206 expression is accompanied by cSN atrophy, irregular axonal distribution of the active neurotransmitter release sites, and reduction in axonal sprouting. These effects are likely attributed to the miR-206-mediated down-regulation of the NGF receptor p75, as demonstrated by bioinformatics, luciferase assay, molecular and biochemical analyses in vitro and ex vivo. BRET assay, performed in cultured SNs treated with exosomes carrying miR-206, showed reduced formation of p75/TrkA complexes, which generate high-affinity binding sites for NGF and enhance neurotrophin responsiveness. Consistent with impaired NGF retrograde transport, miR-206 over-expressing SNs displayed reduced NGF protein content and decreased phosphorylation of Akt, which is an NGF downstream target, regulating neuronal survival. Interestingly, these latter results were confirmed in the stellate ganglia from Atg KO and miR-206 treated mice.
miR-206 causes heart dysinnervation
Conclusions
We identify miR-206 as a key molecular player in the “muscle-to-heart” communication. miR-206 may participate to the pathogenesis of secondary cardiac dysfunction in skeletal muscle diseases associated to increased circulating levels of miR-206, ranging from ageing to neurodegenerative disorders (i.e. ALS, DMD).
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Affiliation(s)
- T Zaglia
- University of Padova, Dept of Cardiac, Thoracic and Vascular Sciences and Public Health, Padova, Italy
| | - V Prando
- Department of Biomedical Sciences, Padova, Italy
| | - S Bertoli
- Department of Biomedical Sciences, Padova, Italy
| | - G Favaro
- Venetian Institute of Molecular Medicine, Padova, Italy
| | - V Di Mauro
- UOS of Milan and Humanitas Clinical and Research Center, Milan, Italy
| | - M Guescini
- University of Urbino, Department of molecular Sciences, Urbino, Italy
| | - A Di Bona
- University of Padova, Dept of Cardiac, Thoracic and Vascular Sciences and Public Health, Padova, Italy
| | - F Lo Verso
- Venetian Institute of Molecular Medicine, Padova, Italy
| | - R Soares
- Venetian Institute of Molecular Medicine, Padova, Italy
| | - P Da Costa Martins
- Maastricht University, Department of Cardiology, Faculty of Health, Medicine and Life Sciences, Maastricht, Netherlands (The)
| | - D Catalucci
- UOS of Milan and Humanitas Clinical and Research Center, Milan, Italy
| | - M Mongillo
- Department of Biomedical Sciences, Padova, Italy
| | - M Sandri
- Department of Biomedical Sciences, Padova, Italy
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42
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Largeaud L, Bertoli S, Bérard E, Dufrechou S, Prade N, Gadaud N, Tavitian S, Bories P, Luquet I, Sarry A, Mas VD, Huguet F, Delabesse E, Récher C. Outcome of relapsed/refractory AML patients with IDH1 R132 mutations in real life before the era of IDH1 inhibitors. Leuk Lymphoma 2019; 61:473-476. [PMID: 31566052 DOI: 10.1080/10428194.2019.1668937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Laetitia Largeaud
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,UMR1037-INSERM, ERL5294 CNRS, Cancer Research Center of Toulouse, Toulouse, France
| | - Sarah Bertoli
- Université Toulouse III Paul Sabatier, Toulouse, France.,UMR1037-INSERM, ERL5294 CNRS, Cancer Research Center of Toulouse, Toulouse, France.,Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Emilie Bérard
- Service D'Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,UMR 1027, INSERM-Université de Toulouse III, Toulouse, France
| | - Stéphanie Dufrechou
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Naïs Prade
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Noémie Gadaud
- Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Réseau Onco-Occitanie, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Audrey Sarry
- Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Véronique De Mas
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,UMR1037-INSERM, ERL5294 CNRS, Cancer Research Center of Toulouse, Toulouse, France
| | - Françoise Huguet
- Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,UMR1037-INSERM, ERL5294 CNRS, Cancer Research Center of Toulouse, Toulouse, France
| | - Christian Récher
- Université Toulouse III Paul Sabatier, Toulouse, France.,UMR1037-INSERM, ERL5294 CNRS, Cancer Research Center of Toulouse, Toulouse, France.,Service D'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
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Sibaud V, Mouchel PL, Touhouche A, Huguet F, Bertoli S. [Ponatinib-induced ichthyosiform eruption]. Ann Dermatol Venereol 2019; 146:661-663. [PMID: 31540674 DOI: 10.1016/j.annder.2019.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/17/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Affiliation(s)
- V Sibaud
- Oncodermatologie, institut universitaire du cancer Toulouse oncopole, institut Claudius-Regaud, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - P-L Mouchel
- Hématologie, institut universitaire du cancer Toulouse oncopole, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex 9, France
| | - A Touhouche
- Oncodermatologie, institut universitaire du cancer Toulouse oncopole, institut Claudius-Regaud, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex 9, France
| | - F Huguet
- Hématologie, institut universitaire du cancer Toulouse oncopole, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex 9, France
| | - S Bertoli
- Hématologie, institut universitaire du cancer Toulouse oncopole, 1, avenue Irène Joliot-Curie, 31059 Toulouse cedex 9, France
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Berger E, Delpierre C, Despas F, Bertoli S, Bérard E, Bombarde O, Bories P, Sarry A, Laurent G, Récher C, Lamy S. Are social inequalities in acute myeloid leukemia survival explained by differences in treatment utilization? Results from a French longitudinal observational study among older patients. BMC Cancer 2019; 19:883. [PMID: 31488077 PMCID: PMC6729078 DOI: 10.1186/s12885-019-6093-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023] Open
Abstract
Background Evidences support social inequalities in cancer survival. Studies on hematological malignancies, and more specifically Acute Myeloid Leukemia (AML), are sparser. Our study assessed: 1/ the influence of patients’ socioeconomic position on survival, 2/ the role of treatment in this relationship, and 3/ the influence of patients’ socioeconomic position on treatment utilization. Methods This prospective multicenter study includes all patients aged 60 and older, newly diagnosed with AML, excluding promyelocytic subtypes, between 1st January 2009 to 31st December 2014 in the South-West of France. Data came from medical files. Patients’ socioeconomic position was measured by an ecological deprivation index, the European Deprivation Index. We studied first, patients’ socioeconomic position influence on overall survival (n = 592), second, on the use of intensive chemotherapy (n = 592), and third, on the use of low intensive treatment versus best supportive care among patients judged unfit for intensive chemotherapy (n = 405). Results We found an influence of patients’ socioeconomic position on survival (highest versus lowest position HRQ5: 1.39 [1.05;1.87] that was downsized to become no more significant after adjustment for AML ontogeny (HRQ5: 1.31[0.97;1.76] and cytogenetic prognosis HRQ5: 1.30[0.97;1.75]). The treatment was strongly associated with survival. A lower proportion of intensive chemotherapy was observed among patients with lowest socioeconomic position (ORQ5: 0.41[0.19;0.90]) which did not persist after adjustment for AML ontogeny (ORQ5: 0.59[0.25;1.40]). No such influence of patients’ socioeconomic position was found on the treatment allocation among patients judged unfit for intensive chemotherapy. Conclusions Finally, these results suggest an indirect influence of patients’ socioeconomic position on survival through AML initial presentation. Electronic supplementary material The online version of this article (10.1186/s12885-019-6093-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eloïse Berger
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.
| | - Cyrille Delpierre
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Fabien Despas
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
| | - Sarah Bertoli
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France
| | - Emilie Bérard
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service d'Epidemiologie, CHU de Toulouse, Toulouse, France
| | - Oriane Bombarde
- Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
| | - Pierre Bories
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France.,Réseau régional de cancérologie Onco-Occitanie, Institut Universitaire du Cancer de Toulouse Oncopôle, Toulouse, France
| | - Audrey Sarry
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France
| | - Guy Laurent
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France
| | - Christian Récher
- Service d'hématologie, Institut Universitaire du Cancer de Toulouse - Oncopôle, CHU de Toulouse, Toulouse, France.,Centre de Recherche en Cancérologie de Toulouse UMR 1037 Inserm / ERL5294 CNRS, University of Toulouse 3 Paul Sabatier, Toulouse, France
| | - Sébastien Lamy
- LEASP, UMR 1027, Equipe labellisée Ligue Nationale Contre le Cancer, Faculté de médecine de Purpan, Inserm-Université Toulouse III Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France.,Service de Pharmacologie Clinique, CHU de Toulouse, Toulouse, France
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45
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Giaquinto E, Bassano M, Foppiani A, De Amicis R, Leone A, Mastella C, Baranello G, Battezzati A, Bertoli S. OR52: Food Habits and Dietary Intake in Italian Children with Spinal Muscular Atrophy Type 1 and 2. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32524-5] [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: 10/26/2022]
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46
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Bertoli S, Tavitian S, Bories P, Luquet I, Delabesse E, Comont T, Sarry A, Huguet F, Bérard E, Récher C. Outcome of patients aged 60-75 years with newly diagnosed secondary acute myeloid leukemia: A single-institution experience. Cancer Med 2019; 8:3846-3854. [PMID: 31173485 PMCID: PMC6639188 DOI: 10.1002/cam4.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/09/2019] [Accepted: 01/16/2019] [Indexed: 12/19/2022] Open
Abstract
A recent phase 3 trial showed that outcome of older patients with secondary acute myeloid leukemia (AML) may be improved by a liposomal encapsulation of cytarabine and daunorubicin (CPX‐351). This phase 3 study represents a unique example of prospective data in this rare subgroup providing basis for comparison with real life data. Here, we retrospectively assessed characteristics and outcome of patients aged 60‐75 years with secondary or therapy‐related AML in real life. Out of 218 patients that fulfilled CPX‐351 study criteria, 181 patients (83.0%) received antileukemic treatment either intensive chemotherapy (n = 121) or hypomethylating agents (HMA, n = 60). As compared with patients treated by chemotherapy, HMA‐treated patients were older, had lower WBC, more often AML with antecedent myelodysplastic syndrome and adverse cytogenetic risk. In chemotherapy‐treated patients, the complete response rate was 69%, median overall survival (OS) was 11 months whereas 3‐year and 5‐year OS was 21% and 17%, respectively. In HMA‐treated patients, the complete response rate was 15%, median OS was 11 months whereas 3‐year and 5‐year OS was 15% and 2%, respectively. In conclusion, although outcome of older patients with high‐risk AML is very poor, a significant proportion of patients treated by standard intensive chemotherapy but not HMA are long‐term survivors.
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Affiliation(s)
- Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Réseau Onco-occitanie, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France.,Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Thibault Comont
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Emilie Bérard
- Service d'Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,UMR 1027, INSERM-Université de Toulouse III, Toulouse, France
| | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France.,Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
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Comont T, Delavigne K, Cougoul P, Bertoli S, Delabesse E, Fenaux P, Beyne-Rauzy O. [Management of myelodysplastic syndromes in 2019: An update]. Rev Med Interne 2019; 40:581-589. [PMID: 31054780 DOI: 10.1016/j.revmed.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/13/2019] [Accepted: 04/10/2019] [Indexed: 01/04/2023]
Abstract
Myelodysplastic syndromes are a heterogeneous group of clonal myeloid disorders characterized by peripheral cytopenias and an increased risk of progression to acute myeloid leukemia. Inflammatory, auto-immune or syndromic symptoms can make the diagnosis difficult. Diagnosis is currently based on bone marrow cytology but cytogenetics and molecular features are currently overpassing their initial prognostic function (allowing early diagnosis and prediction of therapeutic response). The prognostic classification is based on the Revised International Prognostic Scoring System, which also provides guidance for therapeutic management. The treatment of low-risk myelodysplastic syndromes is based on the correction of cytopenias (erythropoiesis stimulating agents, transfusions, lenalidomide, etc.), whereas in high-risk group, the goal is the control of the leukemic clone (hypomethylating agents, allograft of hematopoietic stem cell transplantation). Other molecules are used to manage complications of cytopenias or transfusion (anti-infectious prophylaxis and treatments, martial chelation). New molecules are being studied with some interesting results (luspatercept, venetoclax). This article aims to provide an update on the knowledge that an internist should know for the practical management of myelodysplastic syndromes in 2019.
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Affiliation(s)
- T Comont
- Service de médecine interne et immunopathologie, institut universitaire du Cancer de Toulouse Oncopôle, centre hospitalier universitaire de Toulouse, 31100 Toulouse, France; UFR Purpan, université Toulouse III Paul Sabatier, 31400 Toulouse, France; UMR1037-Inserm, ERL5294 CNRS, centre de recherche en cancérologie de Toulouse, 31100 Toulouse, France.
| | - K Delavigne
- Service de médecine interne et immunopathologie, institut universitaire du Cancer de Toulouse Oncopôle, centre hospitalier universitaire de Toulouse, 31100 Toulouse, France
| | - P Cougoul
- Service de médecine interne et immunopathologie, institut universitaire du Cancer de Toulouse Oncopôle, centre hospitalier universitaire de Toulouse, 31100 Toulouse, France
| | - S Bertoli
- UFR Purpan, université Toulouse III Paul Sabatier, 31400 Toulouse, France; UMR1037-Inserm, ERL5294 CNRS, centre de recherche en cancérologie de Toulouse, 31100 Toulouse, France; Service d'hématologie, institut universitaire du Cancer de Toulouse Oncopôle, centre hospitalier universitaire de Toulouse, 31100 Toulouse, France
| | - E Delabesse
- Laboratoire d'hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopôle, 31100 Toulouse, France
| | - P Fenaux
- Service d'hématologie, hôpital Saint-Louis, AP-HP, 75010 Paris, France
| | - O Beyne-Rauzy
- Service de médecine interne et immunopathologie, institut universitaire du Cancer de Toulouse Oncopôle, centre hospitalier universitaire de Toulouse, 31100 Toulouse, France; UFR Purpan, université Toulouse III Paul Sabatier, 31400 Toulouse, France; UMR1037-Inserm, ERL5294 CNRS, centre de recherche en cancérologie de Toulouse, 31100 Toulouse, France
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Largeaud L, Bérard E, Bertoli S, Dufrechou S, Prade N, Gadaud N, Tavitian S, Bories P, Luquet I, Sarry A, De Mas V, Huguet F, Delabesse E, Récher C. Outcome of AML patients with IDH2 mutations in real world before the era of IDH2 inhibitors. Leuk Res 2019; 81:82-87. [PMID: 31055247 DOI: 10.1016/j.leukres.2019.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/02/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 11/28/2022]
Abstract
Describing the prognosis of sub-groups of acute myeloid leukemia (AML) patients treated in real world with current therapies is becoming increasingly relevant to estimate the benefit that new targeted drugs will bring in the field. This is particularly the case when novel drugs are registered on the basis of non-randomized studies. IDH2 inhibitors have recently emerged as promising drugs in patients with IDH2R140 or IDH2R172 mutations. Enasidenib, a first-in-class IDH2 inhibitor, has been approved following promising results of a phase 1-2 clinical trial in relapsed or refractory AML patients with IDH2 mutations. In this study, we described the characteristics, treatments and outcome of 75 IDH2 mutated patients both at diagnosis and relapse or refractory disease. Among the 33 relapsed/refractory AML patients with either IDH2R140 or IDH2R172, 28 (84.8%) patients received salvage therapy and 14 achieved a complete response (50%). Median duration of response was 15.2 months. Median, 1-y, 3-y and 5-y OS were 15.1 months (IQR, 4.6-37.7), 53.1% (95% CI, 33.2-69.5), 29.2% (95% CI, 12.6-48.1) and 24.4% (95% CI, 9.3-43.1), respectively. In responding patients, median OS was 37.7 months and 1-y, 3-y and 5-y OS was 85.7%, 57.1% and 47.6%, respectively. In non-responding patients, median OS was 5.0 months (IQR, 4.5-8.6) and 1-y and 3-y OS was 17.9% and 0%, respectively. Thus, a substantial number of R/R AML patients with IDH2 mutations can be salvaged by current treatments and benefit from prolonged survival. It is expected that novel targeted agents such as enasidenib will further improve efficacy and safety in the next future.
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Affiliation(s)
- Laetitia Largeaud
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France; Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Emilie Bérard
- Service d'Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; UMR 1027, INSERM-Université de Toulouse III, Toulouse, France
| | - Sarah Bertoli
- Université Toulouse III Paul Sabatier, Toulouse, France; Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France; Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Stéphanie Dufrechou
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Naïs Prade
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Noémie Gadaud
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Pierre Bories
- Réseau Onco-occitanie, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Audrey Sarry
- Service d'Epidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Véronique De Mas
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France; Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France
| | - Eric Delabesse
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France; Université Toulouse III Paul Sabatier, Toulouse, France; Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France
| | - Christian Récher
- Université Toulouse III Paul Sabatier, Toulouse, France; Cancer Research Center of Toulouse, UMR1037-INSERM, ERL5294 CNRS, Toulouse, France; Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France.
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49
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Bertoli S, Tavitian S, Picard M, Huguet F, Vergez F, Delabesse E, Sarry A, Bérard E, Récher C. Hydroxyurea prior to intensive chemotherapy in AML with moderate leukocytosis. Leuk Res 2018; 75:7-10. [DOI: 10.1016/j.leukres.2018.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/23/2018] [Accepted: 10/29/2018] [Indexed: 10/28/2022]
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50
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Bertoli S, Paubelle E, Bérard E, Saland E, Thomas X, Tavitian S, Larcher M, Vergez F, Delabesse E, Sarry A, Huguet F, Larrue C, Bosc C, Farge T, Sarry JE, Michallet M, Récher C. Ferritin heavy/light chain (FTH1/FTL) expression, serum ferritin levels, and their functional as well as prognostic roles in acute myeloid leukemia. Eur J Haematol 2018; 102:131-142. [DOI: 10.1111/ejh.13183] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Sarah Bertoli
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
- Université Toulouse III Paul Sabatier Toulouse France
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | | | - Emilie Bérard
- Service d'Epidémiologie Centre Hospitalier Universitaire de Toulouse Toulouse France
- UMR 1027 INSERM‐Université de Toulouse III Toulouse France
| | - Estelle Saland
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | | | - Suzanne Tavitian
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
| | | | - François Vergez
- Université Toulouse III Paul Sabatier Toulouse France
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier Toulouse France
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
| | - Audrey Sarry
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
| | - Françoise Huguet
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
| | - Clément Larrue
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | - Claudie Bosc
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | - Thomas Farge
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | - Jean Emmanuel Sarry
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
| | | | - Christian Récher
- Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse Institut Universitaire du Cancer de Toulouse Oncopole Toulouse France
- Université Toulouse III Paul Sabatier Toulouse France
- Centre de Recherches en Cancérologie de Toulouse UMR1037‐INSERM, ERL5294 CNRS Toulouse France
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