1
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Marouf A, Molinari N, Sibon D, Cottereau AS, Kanoun S, Antoine C, Debureaux PE, Cavalieri D, Fornecker LM, Casasnovas RO, Herbaux C, Amorim S, Rossi C, Bouscary D, Brice P, Ghesquieres H, Tamburini J, Deau B. Tandem haematopoietic stem cell transplantation versus single cell transplant and BV maintenance in relapsed/refractory Hodgkin lymphoma: A matched cohort analysis from the LYSA. Br J Haematol 2023. [PMID: 37192755 DOI: 10.1111/bjh.18859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023]
Abstract
Autologous hematopoietic stem cell transplant (ASCT) is the standard curative treatment for patients with high-risk relapsed/refractory Hodgkin lymphoma (R/R HL). The AETHERA study showed survival gain with Brentuximab Vedotin (BV) maintenance after ASCT in BV-naive patients, which was recently confirmed in the retrospective AMAHRELIS cohort, including a majority of BV-exposed patients. However, this approach has not been compared to intensive tandem auto/auto or auto/allo transplant strategies, which were used before BV approval. Here, we matched BV maintenance (AMAHRELIS) and tandem SCT (HR2009) cohorts, and observed that BV maintenance was associated with better survival outcome in patients with HR R/R HL.
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Affiliation(s)
- A Marouf
- Laboratoire U1163, Institut Imagine, Université Paris Cité, Inserm, Paris, France
- Service Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Groupe Hospitalier privé Ambroise Paré-Hartmann, Département Recherche Innovation, Neuilly-Sur-Seine, France
| | - N Molinari
- IDESP, INSERM, PreMEdical INRIA, Univ Montpellier, CHU Montpellier, Montpellier, France
| | - D Sibon
- Paris Est University, Créteil, France
- Service Hémopathies Lymphoïdes, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - A S Cottereau
- Laboratoire U1163, Institut Imagine, Université Paris Cité, Inserm, Paris, France
- Service de Médecine Nucléaire, AP-HP, Hôpital Cochin, Paris, France
| | - S Kanoun
- Centre de Recherche Clinique de Toulouse, Team 9, Toulouse, France
| | - C Antoine
- Lymphoma Academic Research Organization (LYSARC) Lymphoma Study Association Imaging, Hôpital Henri Mondor, Créteil, France
| | - P E Debureaux
- Saint Louis Research Institute, INSERM U1160, Paris, France
| | - D Cavalieri
- Service Hématologie, CHRU Lille, Lille, France
| | - L M Fornecker
- Université de Strasbourg, INSERM S-1113, Strasbourg, France
- Service Hématologie, Cancéropôle Est, Strasbourg, France
| | - R O Casasnovas
- UFR des Sciences de Santé, INSERM UMR 1231 CHU Dijon, Dijon, France
- Service Hématologie, CHU Dijon, Dijon, France
| | - C Herbaux
- Service Hématologie, CHU Montpellier, Montpellier, France
| | - S Amorim
- Service Hématologie, Hôpital Saint-Louis, Paris, France
| | - C Rossi
- Department of Hematology, Dijon-Bourgogne University Hospital, Dijon, France
- INSERM Unit 1231, University of Burgundy Franche-Comté, Besancon, France
- Department of Medicine, Divisions of Oncology and Hematology, Stanford University, Stanford, California, USA
| | - D Bouscary
- Laboratoire U1163, Institut Imagine, Université Paris Cité, Inserm, Paris, France
- Service Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Centre de Recherche des Cordeliers, INSERM U1016, Université Paris Cité, Inserm, Paris, France
| | - P Brice
- Service Hématologie, Hôpital Saint-Louis, Paris, France
| | - H Ghesquieres
- Service Hématologie, Hôpital Lyon Sud, Pierre-Bénite, France
| | - J Tamburini
- Laboratoire U1163, Institut Imagine, Université Paris Cité, Inserm, Paris, France
- Service Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Translational Research Centre in Onco-Hematology, Faculty of Medicine, University of Geneva, Geneva 4, Switzerland
| | - B Deau
- Laboratoire U1163, Institut Imagine, Université Paris Cité, Inserm, Paris, France
- Service Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Groupe Hospitalier privé Ambroise Paré-Hartmann, Département Recherche Innovation, Neuilly-Sur-Seine, France
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2
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Grignano E, Cantero-Aguilar L, Tuerdi Z, Chabane T, Vazquez R, Johnson N, Zerbit J, Decroocq J, Birsen R, Fontenay M, Kosmider O, Chapuis N, Bouscary D. Dihydroartemisinin-induced ferroptosis in acute myeloid leukemia: links to iron metabolism and metallothionein. Cell Death Discov 2023; 9:97. [PMID: 36928207 PMCID: PMC10020442 DOI: 10.1038/s41420-023-01371-8] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
Artemisinin is an anti-malarial drug that has shown anticancer properties. Recently, ferroptosis was reported to be induced by dihydroartemisinin (DHA) and linked to iron increase. In the current study, we determined the effect of DHA in leukemic cell lines on ferroptosis induction and iron metabolism and the cytoprotective effect triggered in leukemic cells. We found that treatment of DHA induces early ferroptosis by promoting ferritinophagy and subsequent iron increase. Furthermore, our study demonstrated that DHA activated zinc metabolism signaling, especially the upregulation of metallothionein (MT). Supportingly, we showed that inhibition MT2A and MT1M isoforms enhanced DHA-induced ferroptosis. Finally, we demonstrated that DHA-induced ferroptosis alters glutathione pool, which is highly dependent on MTs-driven antioxidant response. Taken together, our study indicated that DHA activates ferritinophagy and subsequent ferroptosis in AML and that MTs are involved in glutathione regenerating and antioxidant response.
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Affiliation(s)
- E Grignano
- INSERM U1016, Institut Cochin, Paris, France. .,CNRS UMR8104, Paris, France. .,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France. .,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France. .,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France.
| | - L Cantero-Aguilar
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - Z Tuerdi
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - T Chabane
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - R Vazquez
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Paris, France
| | - N Johnson
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France
| | - J Zerbit
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Pharmacie, Paris, France
| | - J Decroocq
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France
| | - R Birsen
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France
| | - M Fontenay
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Paris, France
| | - O Kosmider
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Paris, France
| | - N Chapuis
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Biologique, Paris, France
| | - D Bouscary
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie Clinique, Paris, France.,Member of OPALE Carnot Institute, The Organization for Partnerships in Leukemia, Paris, France
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3
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Comont T, Heiblig M, Riviere E, Terriou L, Rossignol J, Bouscary D, Rieu V, Le Guenno G, Mathian A, Aouba A, Vinit J, Dion J, Kosmider O, Terrier B, Georgin-Lavialle S, Fenaux P, Mekinian A. Utilisation de l’azacitidine dans le VEXAS chez des patients porteurs d’un syndrome myélodysplasique : données du registre Français VEXAS. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.250] [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: 10/19/2022]
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4
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Fouquet G, Wartski M, Dechmi A, Willems L, Deau‐Fischer B, Franchi P, Descroocq J, Deschamps P, Clerc J, Bouscary D, Barreau S, Chapuis N, Vignon M, Cottereau A. PREDICTIVE VALUE OF FDG PET/CT IN PATIENTS WITH RELAPSE/REFRACTORY MULTIPLE MYELOMA BEFORE TREATMENT WITH ANTI‐CD38 IMMUNOTHERAPY. Hematol Oncol 2021. [DOI: 10.1002/hon.99_2881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- G. Fouquet
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | - M. Wartski
- Cochin Hospital APHP, Paris Nuclear Medicine Paris France
| | - A. Dechmi
- Cochin Hospital APHP, Paris Nuclear Medicine Paris France
| | - L. Willems
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | | | - P. Franchi
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | - J. Descroocq
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | - P. Deschamps
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | - J. Clerc
- Cochin Hospital APHP, Paris Nuclear Medicine Paris France
| | - D. Bouscary
- Cochin Hospital APHP, Paris, France Hematology Paris France
| | - S. Barreau
- Hôpital Cochin APHP Service d'hématologie biologique Paris France
| | - N. Chapuis
- Hôpital Cochin APHP Service d'hématologie biologique Paris France
| | - M. Vignon
- Cochin Hospital APHP, Paris, France Hematology Paris France
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5
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Marouf A, Cottereau AS, Kanoun S, Deschamps P, Franchi P, Meignan M, Sibon D, Gastinne T, Borel C, Hammoud M, Sicard G, Gille R, Cavalieri D, Stamatoullas A, Clement L, Lazarovici J, Chauchet A, Fornecker LM, Amorin S, Rocquet M, Raus N, Burroni B, Rubio MT, Casasnovas O, Cartron G, Bouscary D, Brice P, Ghesquieres H, Tamburini J, Deau B. AMAHRELIS : ADCETRIS MAINTENANCE AFTER AUTOLOGOUS STEM CELL TRANSPLANTATION IN HODGKIN LYMPHOMA : A REAL LIFE STUDY FROM SFGMTC AND LYSA GROUPS. Hematol Oncol 2021. [DOI: 10.1002/hon.101_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- A. Marouf
- Cochin Hospital Paris University Hematology Unit Paris France
| | - A. S. Cottereau
- Cochin Hospital Assistance Publique‐Hôpitaux de Paris (AP‐HP) Paris Descartes University Department of Nuclear Medicine Paris France
| | - S. Kanoun
- Institut universitaire du cancer Toulouse‐Oncopole Nuclear Medecine Unit, Toulouse France
| | - P. Deschamps
- Cochin Hospital Paris University Hematology Unit Paris France
| | - P. Franchi
- Cochin Hospital Paris University Hematology Unit Paris France
| | - M. Meignan
- Hôpital Henri Mondor Paris Est University Lymphoma Study Association Imaging Créteil France
| | - D. Sibon
- Necker Hospital Paris University Department of Hematology Paris France
| | - T. Gastinne
- Nantes University Hospital Department of Hematology Nantes France
| | - C. Borel
- Institut universitaire du cancer Toulouse‐ Oncopole Hematology Toulouse France
| | - M. Hammoud
- Lymphoid Malignancies Unit Hôpital Henri Mondor Hematology Creteil France
| | - G. Sicard
- Aix‐Marseille University Hematology Marseille France
| | - R. Gille
- Centre Léon Berard Hematology Lyon France
| | - D. Cavalieri
- Centre Hospitalier Universitaire Estaing Hematology Clermont Ferrand France
| | | | - L. Clement
- CHRU Nancy Brabois Hematology Vandoeuvre Les Nancy France
| | | | | | - L. M. Fornecker
- Strasbourg University Hospital INSERM S‐1113 Hematology Strasbourg France
| | - S. Amorin
- Hopital Saint Vincent de Paul Hematology Lille France
| | - M. Rocquet
- Cochin Hospital Paris University Hematology Unit Paris France
| | - N. Raus
- Hopital Lyon Sud Hematology Pierre Benite France
| | - B. Burroni
- Cochin Hospital APHP, Centre de recherche des Cordeliers Sorbonne University INSERM, Paris University Pathology Paris France
| | - M. T. Rubio
- CHRU Nancy CNRS UMR 7365 Équipe 6 Biopôle de L'Université de Lorraine Hematology Vandoeuvre Les Nancy France
| | - O. Casasnovas
- Dijon University Hospital INSERM UMR 1231 Hematology Dijon France
| | - G. Cartron
- University of Montpellier Hematology Montpellier France
| | - D. Bouscary
- Cochin Hospital Paris University Hematology Unit Paris France
| | - P. Brice
- Saint Louis Hospital Paris university Hematology Paris France
| | | | - J. Tamburini
- Université de Paris Institut Cochin INSERM U1016, F‐75014 Paris Translational Research Centre in Onco‐hematology Faculty of Medicine University of Geneva Hematology 1211 Geneva Switzerland
| | - B. Deau
- Cochin Hospital Paris University Hematology Unit Paris France
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6
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Fabien M, Schernberg A, Arsene Henry A, Vignon M, Bouscary D, Kirova Y. OC-0462: Solitary plasmacytoma treated by Lenalidomide-Dexamethasone in combination with radiation therapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00484-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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7
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Contejean A, Jaffrelot L, Benaboud S, Treluyer J, Grignano E, Willems L, Gauzit R, Bouscary D, Hirt D, Kerneis S. Un modèle pharmacocinétique du méropénème chez le patient traité pour une hémopathie maligne. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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8
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Contejean A, Jaffrelot L, Benaboud S, Tréluyer JM, Grignano E, Willems L, Gauzit R, Bouscary D, Gana I, Boujaafar S, Kernéis S, Hirt D. A meropenem pharmacokinetics model in patients with haematological malignancies. J Antimicrob Chemother 2020; 75:2960-2968. [DOI: 10.1093/jac/dkaa275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023] Open
Abstract
Abstract
Background
Optimal dosing of antibiotics is critical in immunocompromised patients suspected to have an infection. Data on pharmacokinetics (PK) of meropenem in patients with haematological malignancies are scarce.
Objectives
To optimize dosing regimens, we aimed to develop a PK population model for meropenem in this population.
Methods
Patients aged ≥18 years, hospitalized in the haematology department of our 1500 bed university hospital for a malignant haematological disease and who had received at least one dose of meropenem were eligible. Meropenem was quantified by HPLC. PK were described using a non-linear mixed-effect model and external validation performed on a distinct database. Monte Carlo simulations estimated the PTA, depending on renal function, duration of infusion and MIC. Target for free trough concentration was set at >4× MIC.
Results
Overall, 88 patients (181 samples) were included, 66 patients (75%) were in aplasia and median Modification of Diet in Renal Disease (MDRD) CLCR was 117 mL/min/1.73 m2 (range: 35–359). Initial meropenem dosing regimen ranged from 1 g q8h to 2 g q8h over 30 to 60 min. A one-compartment model with first-order elimination adequately described the data. Only MDRD CLCR was found to be significantly associated with CL. Only continuous infusion achieved a PTA of 100% whatever the MIC and MDRD CLCR. Short duration of infusion (<60 min) failed to reach an acceptable PTA, except for bacteria with MIC < 0.25 mg/L in patients with MDRD CLCR below 90 mL/min/1.73 m2.
Conclusions
In patients with malignant haematological diseases, meropenem should be administered at high dose (6 g/day) and on continuous infusion to reach acceptable trough concentrations.
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Affiliation(s)
- A Contejean
- Service d’Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Equipe mobile d’infectiologie, AP-HP, Centre Université de Paris—Cochin, Paris, France
| | - L Jaffrelot
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
| | - S Benaboud
- Université de Paris, Faculté de Médecine, Paris, France
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
| | - J -M Tréluyer
- Université de Paris, Faculté de Médecine, Paris, France
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
- CIC-1419 Inserm, Cochin-Necker, Paris, France
| | - E Grignano
- Service d’Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Université de Paris, Faculté de Médecine, Paris, France
| | - L Willems
- Service d’Hématologie, AP-HP, Hôpital Cochin, Paris, France
| | - R Gauzit
- Equipe mobile d’infectiologie, AP-HP, Centre Université de Paris—Cochin, Paris, France
| | - D Bouscary
- Service d’Hématologie, AP-HP, Hôpital Cochin, Paris, France
- Université de Paris, Faculté de Médecine, Paris, France
| | - I Gana
- Université de Paris, Faculté de Médecine, Paris, France
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
| | - S Boujaafar
- Université de Paris, Faculté de Médecine, Paris, France
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
| | - S Kernéis
- Université de Paris, Faculté de Médecine, Paris, France
- Equipe mobile d’infectiologie, AP-HP, Centre Université de Paris—Cochin, Paris, France
| | - D Hirt
- Université de Paris, Faculté de Médecine, Paris, France
- Service de Pharmacologie Clinique, AP-HP, Hôpital Cochin, Paris, France
- INSERM, U1018, Université Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
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9
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Affiliation(s)
- P E Debureaux
- Department of Medical Oncology, CERTIM Group, Cochin Port-Royal Hospital, AP-HP, University Paris Descartes, Paris; Department of Oncology, Paris Descartes University, Sorbonne Paris Cité, Paris
| | - J Arrondeau
- Department of Medical Oncology, CERTIM Group, Cochin Port-Royal Hospital, AP-HP, University Paris Descartes, Paris; Department of Oncology, Paris Descartes University, Sorbonne Paris Cité, Paris.
| | - D Bouscary
- Department of Oncology, Paris Descartes University, Sorbonne Paris Cité, Paris; Hematology Department, Hospital Cochin, Paris, France
| | - F Goldwasser
- Department of Medical Oncology, CERTIM Group, Cochin Port-Royal Hospital, AP-HP, University Paris Descartes, Paris; Department of Oncology, Paris Descartes University, Sorbonne Paris Cité, Paris
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10
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de Forceville L, Deau-Fischer B, Franchi P, Arsène-Henry A, Cassou Mounat T, Bouscary D, Kirova YM. Radiotherapy in combination with nivolumab for relapsed/refractory classical Hodgkin lymphoma: About two cases. Cancer Radiother 2019; 23:232-239. [PMID: 31147173 DOI: 10.1016/j.canrad.2018.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/09/2018] [Accepted: 12/18/2018] [Indexed: 12/22/2022]
Abstract
Hodgkin lymphoma is a highly curable malignancy involving lymph nodes and the lymphatic system. Even at late stage disease, about 70% of patients will be cured with standard first line therapy. For patients who experience relapse or refractory classical Hodgkin lymphoma, the standard treatment option is high-dose chemotherapy followed by autologous stem cell rescue or transplant. However about 50% of patients will have recurrence after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and have worse prognosis with median overall survival of 32% at 5 years. The anti-PD1 checkpoints inhibitors pembrolizumab and nivolumab have remarkably improved outcomes of patients with relapse of refractory classical Hodgkin lymphoma after high-dose chemotherapy followed by autologous stem cell rescue or transplantation. On the other hand, radiotherapy is an entire component of salvage therapy and its efficacy is now well established in term of local disease control in sites of relapsed or refractory Hodkin lymphoma. Defining the optimal modality and timing of radiotherapy as these new agents arrive is a challenge. An interesting approach is the combination of radiotherapy with checkpoint inhibitor and the possibility of stopping the treatment when complete response is achieved. We add to the literature two new cases of combination of radiotherapy with immunotherapy in patients who relapsed after high-dose chemotherapy followed by autologous stem cell rescue or transplantation and consolidation with brentuximab vedotin, resulting in excellent outcomes.
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Affiliation(s)
- L de Forceville
- Medical oncology department, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - B Deau-Fischer
- Clinical hematology department, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - P Franchi
- Clinical hematology department, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - A Arsène-Henry
- Radiation oncology department, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - T Cassou Mounat
- Nuclear medicine department, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - D Bouscary
- Clinical hematology department, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - Y M Kirova
- Radiation oncology department, institut Curie, 26, rue d'Ulm, 75005 Paris, France
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11
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Legendre P, Chahwan D, Mohty M, Hermine O, Kahn J, Lortholary O, Bouscary D, Dougados M, Durand-Zaleski I, Godeau B, Mouthon L. Utilisation des immunoglobulines intraveineuses et sous-cutanées chez des patients atteints de déficits Immunitaires secondaires : analyse rétrospective (ULTIMATE). Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Grignano E, Laurent J, Deau-Fisher B, Burroni B, Bouscary D, Kirova Y. The Role of Radiation Therapy in Refractory or Relapsing Diffuse Large B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.830] [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: 10/28/2022]
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13
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Grignano É, Deau-Fischer B, Loganadane G, Breton M, Burroni B, Bouscary D, Kirova YM. Radiotherapy of relapse-refractory follicular lymphoma. Cancer Radiother 2018; 22:126-130. [PMID: 29477304 DOI: 10.1016/j.canrad.2017.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 07/25/2017] [Revised: 08/24/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE To assess the efficacy of treatment and outcomes of patients with relapsed or refractory follicular lymphoma treated with external beam irradiation. PATIENTS AND METHODS Fifteen patients who received external beam radiotherapy for relapsed or refractory follicular lymphoma were studied. The median age was 68.3 years (range: 37.9-87.08 years) with four men and 11 women. Seven patients had early stage (I or II); eight advanced stage (III or IV). Median FLIPI score was 2. Two patients had high tumour bulk disease. Six patients had extranodal invasion, with five patients having bone marrow invasion. RESULTS The median time of follow-up after relapse or first-line treatment in case of refractory disease was 61.9 months (range: 9.1-119.7 months). Complete response after external beam radiotherapy was seen in 11 cases (73%) and partial response in two (13%), with a median dose of 30Gy (range: 2-40Gy) and median number of fractions of 15 (range: 2-20). Eight patients (53%) relapsed after external beam radiation therapy in a median of 20.2 months, mostly out of irradiated volumes. Most patients (66%) had a disease control after one or two courses of external beam radiation therapy. At last follow-up, 86% of patients were in remission including those with salvage chemotherapy. The toxicity profile was favourable with toxicity higher than grade 1. In univariate analysis, a Follicular Lymphoma International Prognostic Index (FLIPI) score above 2 was the only predicting factor for non-control disease. CONCLUSION For relapsed and refractory follicular lymphoma, external beam radiotherapy should be considered as an effective modality when integrated in a multimodality approach. Randomised studies are warranted to validate this strategy.
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Affiliation(s)
- É Grignano
- Department of radiation oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - B Deau-Fischer
- Hôpital Cochin, rue du Faubourg-Saint-Jacques, 75005 Paris, France
| | - G Loganadane
- Department of radiation oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - M Breton
- Department of radiation oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - B Burroni
- Hôpital Cochin, rue du Faubourg-Saint-Jacques, 75005 Paris, France
| | - D Bouscary
- Hôpital Cochin, rue du Faubourg-Saint-Jacques, 75005 Paris, France
| | - Y M Kirova
- Department of radiation oncology, institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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14
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Hunault-Berger M, Maillard N, Himberlin C, Recher C, Schmidt-Tanguy A, Choufi B, Bonmati C, Carré M, Couturier MA, Daguindau E, Marolleau JP, Orsini-Piocelle F, Delaunay J, Tavernier E, Lissandre S, Ojeda-Uribe M, Sanhes L, Sutton L, Banos A, Fornecker LM, Bernard M, Bouscary D, Saad A, Puyade M, Rouillé V, Luquet I, Béné MC, Hamel JF, Dreyfus F, Ifrah N, Pigneux A. Maintenance therapy with alternating azacitidine and lenalidomide in elderly fit patients with poor prognosis acute myeloid leukemia: a phase II multicentre FILO trial. Blood Cancer J 2017; 7:e568. [PMID: 28574488 PMCID: PMC5520397 DOI: 10.1038/bcj.2017.50] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- M Hunault-Berger
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - N Maillard
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - C Himberlin
- Service d'Hématologie, CHU Reims, Reims, France
| | - C Recher
- Hématologie Clinique, CHU, Institut Universitaire du Cancer Toulouse-Oncopole, CRCT UMR1037, Université de Toulouse III, Toulouse, France
| | - A Schmidt-Tanguy
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - B Choufi
- Service d'Hématologie, CH Boulogne, Boulogne, France
| | - C Bonmati
- Service d'Hématologie, CHU Nancy, Nancy, France
| | - M Carré
- Service d'Hématologie, UMR 5525, CHU Grenoble Alpes, La Tronche, France
| | - M-A Couturier
- Institut d'Hématologie et de Cancérologie, Hôpital Augustin Morvan, Brest, France
| | - E Daguindau
- Service d'Hématologie, CHU Besançon, Besançon, France
| | | | | | - J Delaunay
- Service d'Hématologie, CHU Nantes, Nantes, France
| | - E Tavernier
- Service d'Hématologie, Institut de Cancérologie de la Loire, Saint Etienne, France
| | - S Lissandre
- Service d'Hématologie et thérapie cellulaire, CHU, Tours, France
| | - M Ojeda-Uribe
- Service d'Hématologie, CH Mulhouse, Mulhouse, France
| | - L Sanhes
- Service d'Hématologie, CH Perpignan, Perpignan, France
| | - L Sutton
- Service d'Hématologie, CH Argenteuil, Argenteuil, France
| | - A Banos
- Service d'Hématologie, CH Côte Basque, Bayonne, France
| | - L M Fornecker
- Département d'Hématologie et d'Oncologie, CHU Hautepierre, Strasbourg, France
| | - M Bernard
- Hématologie Clinique, Hôpital Pontchaillou, Rennes, France
| | - D Bouscary
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - A Saad
- Hématologie, CH Béziers, Béziers, France
| | - M Puyade
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - V Rouillé
- Service Hématologie, Hôpital Lapeyronie, Montpellier, France
| | - I Luquet
- Hématologie Biologique, CHU, IUC Toulouse-Oncopole, Toulouse, France
| | - M C Béné
- Hématologie Biologique, CHU de Nantes, Nantes, France
| | - J-F Hamel
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - F Dreyfus
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - N Ifrah
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - A Pigneux
- Hématologie Clinique, CHU Bordeaux, Inserm 1035, Bordeaux, France
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15
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Poulain L, Sujobert P, Zylbersztejn F, Barreau S, Stuani L, Lambert M, Palama TL, Chesnais V, Birsen R, Vergez F, Farge T, Chenevier-Gobeaux C, Fraisse M, Bouillaud F, Debeissat C, Herault O, Récher C, Lacombe C, Fontenay M, Mayeux P, Maciel TT, Portais JC, Sarry JE, Tamburini J, Bouscary D, Chapuis N. High mTORC1 activity drives glycolysis addiction and sensitivity to G6PD inhibition in acute myeloid leukemia cells. Leukemia 2017; 31:2326-2335. [PMID: 28280275 DOI: 10.1038/leu.2017.81] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 02/13/2017] [Accepted: 02/27/2017] [Indexed: 01/03/2023]
Abstract
Alterations in metabolic activities are cancer hallmarks that offer a wide range of new therapeutic opportunities. Here we decipher the interplay between mTORC1 activity and glucose metabolism in acute myeloid leukemia (AML). We show that mTORC1 signaling that is constantly overactivated in AML cells promotes glycolysis and leads to glucose addiction. The level of mTORC1 activity determines the sensitivity of AML cells to glycolysis inhibition as switch-off mTORC1 activity leads to glucose-independent cell survival that is sustained by an increase in mitochondrial oxidative phosphorylation. Metabolic analysis identified the pentose phosphate pathway (PPP) as an important pro-survival pathway for glucose metabolism in AML cells with high mTORC1 activity and provided a clear rational for targeting glucose-6-phosphate dehydrogenase (G6PD) in AML. Indeed, our analysis of the cancer genome atlas AML database pinpointed G6PD as a new biomarker in AML, as its overexpression correlated with an adverse prognosis in this cohort. Targeting the PPP using the G6PD inhibitor 6-aminonicotinamide induces in vitro and in vivo cytotoxicity against AML cells and synergistically sensitizes leukemic cells to chemotherapy. Our results demonstrate that high mTORC1 activity creates a specific vulnerability to G6PD inhibition that may work as a new AML therapy.
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Affiliation(s)
- L Poulain
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - P Sujobert
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - F Zylbersztejn
- INSERM UMR1163, Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutic Implications, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - S Barreau
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - L Stuani
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - M Lambert
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - T L Palama
- Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France.,LISBP, Université de Toulouse, CNRS, INRA, INSA, Toulouse, France
| | - V Chesnais
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - R Birsen
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - F Vergez
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - T Farge
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - C Chenevier-Gobeaux
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service de Diagnostic Biologique Automatisé, Paris, France
| | - M Fraisse
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - F Bouillaud
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | | | | | - C Récher
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - C Lacombe
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - M Fontenay
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie biologique, F-75014 Paris, France
| | - P Mayeux
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France
| | - T T Maciel
- INSERM UMR1163, Laboratory of Cellular and Molecular Mechanisms of Haematological Disorders and Therapeutic Implications, Paris, France.,Paris Descartes-Sorbonne Paris Cité University, Imagine Institute, Paris, France
| | - J-C Portais
- Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France.,LISBP, Université de Toulouse, CNRS, INRA, INSA, Toulouse, France
| | - J-E Sarry
- INSERM, UMR1037, Cancer Research Center of Toulouse, Toulouse, France.,Université de Toulouse III Paul Sabatier, INSA, UPS, INP, LISBP, Toulouse, France
| | - J Tamburini
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie clinique, F-75014 Paris, France
| | - D Bouscary
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie clinique, F-75014 Paris, France
| | - N Chapuis
- INSERM U1016, Institut Cochin, Paris, France.,CNRS UMR8104, Paris, France.,Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Paris, France.,Equipe Labellisée Ligue Nationale Contre le Cancer (LNCC), Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Service d'Hématologie clinique, F-75014 Paris, France
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16
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Le Ray E, Belin L, Plancher C, Bouscary D, Kirova Y. Intensity Modulated Radiation Therapy by Tomotherapy (IMRT) Concurrent With a Short Systemic Treatment for Solitary Plasmacytoma of the Bone (SPB) With Improvement of Progression-Free Survival. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.066] [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: 10/20/2022]
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17
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Gagliardi L, Szwebel TA, Hugol D, Rousset P, Bouscary D, Le Jeunne C, Aslangul E. Myosite neutrophilique chez un patient neutropénique. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Vignon M, Michonneau D, Baixench MT, Al-Nawakil C, Bouscary D, Buzyn A, Salmon D, Paugam A. Disseminated Scopulariopsis brevicaulis infection in an allogeneic stem cell recipient. Bone Marrow Transplant 2010; 46:1276-7. [PMID: 21113187 DOI: 10.1038/bmt.2010.292] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Scotland S, Boutzen H, Wang Z, Green A, Micklow E, Danet-Desnoyers G, Bouscary D, Tamburini J, Récher C, Selak M, Carroll M, Sarry J. R45: Metformine comme traitement adjuvant de la leucémie aiguë myéloïde. Bull Cancer 2010. [DOI: 10.1016/s0007-4551(15)30962-0] [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: 12/01/2022]
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20
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Chapuis N, Tamburini J, Green AS, Willems L, Bardet V, Park S, Lacombe C, Mayeux P, Bouscary D. Perspectives on inhibiting mTOR as a future treatment strategy for hematological malignancies. Leukemia 2010; 24:1686-99. [PMID: 20703258 DOI: 10.1038/leu.2010.170] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Mammalian target of rapamycin (mTOR) is a protein kinase implicated in the regulation of various cellular processes, including those required for tumor development, such as the initiation of mRNA translation, cell-cycle progression and cellular proliferation. In a wide range of hematological malignancies, the mTORC1 signaling pathway has been found to be deregulated and has been designed as a major target for tumor therapy. Given that pre-clinical studies have clearly established the therapeutic value of mTORC1 inhibition, numerous clinical trials of rapamycin and its derivates (rapalogs) are ongoing for treatment of these diseases. At this time, although disease stabilization and tumor regression have been observed, objective responses in some tumor types have been modest. Nevertheless, some of the mechanisms underlying cancer-cell resistance to rapamycin have now been described, thereby leading to the development of new strategy to efficiently target mTOR signaling in these diseases. In this review, we discuss the rationale for using mTOR inhibitors as novel therapies for a variety of hematological, malignancies with a focus on promising new perspectives for these approaches.
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Affiliation(s)
- N Chapuis
- Département d'Immunologie-Hématologie, Institut Cochin, Université Paris Descartes, CNRS, UMR8104, Paris, France
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21
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Chevallier P, Fornecker L, Lioure B, Béné MC, Pigneux A, Recher C, Witz B, Fegueux N, Bulabois CE, Daliphard S, Bouscary D, Vey N, Delain M, Bay JO, Turlure P, Bernard M, Himberlin C, Luquet I, Ifrah N, Harousseau JL. Tandem versus single autologous peripheral blood stem cell transplantation as post-remission therapy in adult acute myeloid leukemia patients under 60 in first complete remission: results of the multicenter prospective phase III GOELAMS LAM-2001 trial. Leukemia 2010; 24:1380-5. [PMID: 20508614 DOI: 10.1038/leu.2010.111] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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22
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Krauter J, Ottmann OG, Schlenk RF, Schaich M, Bouscary D, Dombret H, Lüdicke F, Weber HJ, Winiger IJ. A phase Ib study of oral panobinostat (LBH589) in combination with cytarabine (ARA-C) and mitoxantrone (MT) as salvage therapy for refractory or relapsed acute myeloid leukemia (AML). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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23
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Lopez I, Guerci A, Bouscary D, Lacombe C, Botella A, Melle J, Dreyfus F, Fontenay-Roupie M. Elevated thrombopoietin serum concentrations in myelodysplasias. Platelets 2009; 9:287-90. [PMID: 16793751 DOI: 10.1080/09537109876519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Thrombopoietin (TPO) serum levels were quantified in patients with myelodysplastic syndromes using an ELISA test for TPO. We found that TPO levels were significantly elevated in the whole group of patients as compared with normal healthy donors (521.9 75.3 pg/ml vs 160.1 19.6 pg/ml; P = 0.011). TPO serum levels were inversely correlated with the megakaryocyte mass in both the RA/RARS and RAEB/RAEBt subgroups ( P = 0.012 and P = 0.031, respectively). Two subsets of patients with a possible dysregulation of TPO production were identified.
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Affiliation(s)
- I Lopez
- Department of Hematology and INSERM U363, ICGM, Hôpital Cochin, Paris, France
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24
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Tamburini J, Elie C, Park S, Beyne-Rauzy O, Gardembas M, Berthou C, Mahe B, Sanhes L, Stamatoullas A, Vey N, Aouba A, Slama B, Quesnel B, Vekhoff A, Sotto J, Vassilief D, Al-Nawakil C, Fenaux P, Dreyfus F, Bouscary D. Effectiveness and tolerance of low to very low dose thalidomide in low-risk myelodysplastic syndromes. Leuk Res 2009; 33:547-50. [DOI: 10.1016/j.leukres.2008.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2008] [Revised: 06/02/2008] [Accepted: 06/03/2008] [Indexed: 12/01/2022]
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25
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Kelaidi C, Park S, Brechignac S, Mannone L, Vey N, Dombret H, Aljassem L, Stamatoullas A, Adès L, Giraudier S, de Botton S, Raynaud S, Lepelley P, Picard F, Leroux G, Daniel MT, Bouscary D, Dreyfus F, Fenaux P. Treatment of myelodysplastic syndromes with 5q deletion before the lenalidomide era; the GFM experience with EPO and thalidomide. Leuk Res 2008; 32:1049-53. [PMID: 18191202 DOI: 10.1016/j.leukres.2007.11.037] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2007] [Revised: 11/27/2007] [Accepted: 11/30/2007] [Indexed: 10/22/2022]
Abstract
Anemia in MDS with 5q deletion was generally considered, until the advent of lenalidomide, unresponsive to available treatments. We analyzed erythroid response to erythropoetin (EPO) or darbepoetin (DAR) and thalidomide in MDS with 5q deletion treated by French centers (GFM) and in whom karyotype was successfully performed. Of 345 patients treated with EPO or DAR+/-G-CSF, 48 had 5q deletion. The response rate was 46% (31% major, 15% minor) according to International Working Group (IWG) 2000 criteria versus 64% in patients without 5q deletion (p=0.03). According to IWG 2006 criteria, the response rate in patients with 5q deletion was 39% versus 52% in patients without 5q deletion (p=0.10). Mean duration of response was 14 months versus 25 months (IWG 2000) and 13 months versus 27 months (IWG 2006) in 5q deletion and non-5q deletion patients (p=0.019 and 0.003, respectively). Of 120 MDS treated with thalidomide, all of whom had successful cytogenetic analysis, 37% of the 24 patients with 5q deletion responded (IWG 2000 criteria, 20% major, 17% minor) with a mean duration of 9.5 months, versus 32% (18% major, 14% minor) in MDS without 5q deletion and a mean response duration of 9 months (p=NS). Our results confirm that response rates to EPO or DAR and thalidomide are clearly inferior to those obtained with lenalidomide.
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Affiliation(s)
- C Kelaidi
- GFM, Service d'Hématologie Clinique, Hôpital Avicenne-(AP-HP) Université Paris 13, 125 rue de Stalingrad, 93009 Bobigny, France
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26
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Park S, Borderie D, Cormier C, Bouscary D, Roux C, Job-Deslandre C, Merlat A, Cherreau B, Souberbielle JC, Dreyfus F. Effect of spacing intravenous bisphosphonates in patients with multiple myeloma in plateau phase. Leukemia 2007; 21:1596-9. [PMID: 17460702 DOI: 10.1038/sj.leu.2404715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Bardet V, Costa LD, Elie C, Malinge S, Demur C, Tamburini J, Lefebvre PC, Witz F, Lioure B, Jourdan E, Pigneux A, Ifrah N, Attal M, Dreyfus F, Mayeux P, Lacombe C, Bennaceur-Griscelli A, Bernard OA, Bouscary D, Récher C. Nucleophosmin status may influence the therapeutic decision in de novo acute myeloid leukemia with normal karyotype. Leukemia 2006; 20:1644-6. [PMID: 16791266 DOI: 10.1038/sj.leu.2404294] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cornillet-Lefebvre P, Cuccuini W, Bardet V, Tamburini J, Gillot L, Ifrah N, Nguyen P, Dreyfus F, Mayeux P, Lacombe C, Bouscary D. Constitutive phosphoinositide 3-kinase activation in acute myeloid leukemia is not due to p110delta mutations. Leukemia 2006; 20:374-6. [PMID: 16341041 DOI: 10.1038/sj.leu.2404054] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Viguié F, Aboura A, Bouscary D, Ramond S, Delmer A, Tachdjian G, Marie JP, Casadevall N. Common 4q24 deletion in four cases of hematopoietic malignancy: early stem cell involvement? Leukemia 2005; 19:1411-5. [PMID: 15920487 DOI: 10.1038/sj.leu.2403818] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We determined bone marrow karyotype at diagnosis in four female acute myeloid leukemia (AML) or myelodysplasia patients, aged between 52 and 56 years. In each case, we observed chromosome rearrangement involving the same 4q24 band. Three patients had a balanced reciprocal translocation as the sole abnormality - t(3;4)(q26;q24), t(4;5)(q24;p16) and t(4;7)(q24;q21) - and the fourth had del(4)(q23q24), +4. We used a set of 4q BAC probes for fluorescent in situ hybridization (FISH) in these four cases. We found a 4q24 submicroscopic deletion in all three translocations, with a common deletion of approximately 0.5 Mb. In three cases, we concluded that rearrangement occurred in an early hematopoietic stem cell, as it was detected, in mosaic with a normal karyotype, in a fraction of remission bone marrow cells, peripheral T and B lymphocytes, malignant lymph node T-lymphoma cells in one case and B-lymphoblastoid cell lines established in two cases. Moreover, one of 10 additional AML patients tested by FISH had a normal karyotype and deletion of one of the commonly deleted probe sequences. A tumor suppressor gene may therefore be involved, especially as two patients developed malignant lymphoma at the same time as myeloid proliferation.
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Affiliation(s)
- F Viguié
- Laboratoire de Cytogénétique Onco-Hématologique, Hôpital Hôtel-Dieu, Paris, France.
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Buffet M, Dupin N, Carlotti A, De Muret A, Tulliez M, Calmus Y, Sirinelli A, Bouscary D, Escande JP, Vaillant L. Plasmocytomes cutanés associés au virus Epstein-Barr chez les transplantés d’organes. Ann Dermatol Venereol 2004; 131:1085-91. [PMID: 15692444 DOI: 10.1016/s0151-9638(04)93846-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Post-transplantation lymphoproliferative disorders develop in 1 to 10p. 100 of organ transplant recipients and are frequently associated with Epstein-Barr virus (EBV). Among post-transplantation lymphoproliferative disorders, plasmacytoma with cutaneous involvement is exceptional. Association with EBV has been rarely reported in post-transplantation plasmacytomas and the latency type of EBV has never been characterized. We report 2 new cases of cutaneous monotype EBV-related plasmacytomas. CASE-REPORTS Clinical presentation was a sub-cutaneous tumor on the thigh in the first case and an ulcerated nodule of the leg in the second case, occurring respectively 7 and 8 years after organ transplantation (liver transplantation and heart transplantation). In both lesions, tumor cells exhibited lambda light chain restriction and the association with EBV was confirmed using immunohistochemistry and in situ hybridization. The expression of EBV genes in tumor cells demonstrated type III latency. DISCUSSION The classification of post-transplantation lymphoproliferative disorders is not well defined and some authors retain 3 categories. Among the latter, plasmacytomas have been rarely described. Cutaneous involvement is reported in 4 cases and an association with EBV in only 2 cases without description of viral latency. Clinical and histological features of post-transplantation plasmacytomas appear polymorphic. We report EBV-association in both cases, with a type III latency clearly demonstrated in one case, as has been reported in other lymphoproliferative diseases in patients with congenital or acquired immunodeficiency. We also discuss various possible therapeutic strategies for post-transplantation lymphoproliferative disorders.
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Affiliation(s)
- M Buffet
- Service de Dermato-Vénéréologie, Groupe Hospitalier Tarnier-Cochin, AP-HP Paris.
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Kelaidi C, Rollot F, Park S, Tulliez M, Christoforov B, Calmus Y, Podevin P, Bouscary D, Sogni P, Blanche P, Dreyfus F. Response to antiviral treatment in hepatitis C virus-associated marginal zone lymphomas. Leukemia 2004; 18:1711-6. [PMID: 15284859 DOI: 10.1038/sj.leu.2403443] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A link between chronic hepatitis C virus (HCV) infection and low-grade B-cell lymphomas has been suggested by epidemiological studies. Marginal zone lymphomas (MZLs) including splenic lymphomas with villous lymphocytes are among the most frequently reported subgroups in the setting of chronic HCV infection. In this study, we examined the effect of antiviral treatment in eight patients with HCV-associated MZL. We found that five out of eight patients have responded to interferon alpha and ribavirin. In some cases, hematologic responses were correlated to virologic responses. In addition, we report a case of large granular lymphocyte leukemia occurring in association with MZL and HCV, and responding to interferon and ribavirin. We suggest that there is an etiologic link between HCV and antigen-driven lymphoproliferative disorders.
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Affiliation(s)
- C Kelaidi
- 1Department of Hematology, Hôpital Cochin, Université Paris V, Assistance Publique Hôpitaux de Paris, Paris, France
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Abad S, Gyan E, Moachon L, Bouscary D, Sicard D, Dreyfus F, Blanche P. Tuberculosis due to Mycobacterium bovis after alemtuzumab administration. Clin Infect Dis 2003; 37:e27-8. [PMID: 12856232 DOI: 10.1086/375690] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2002] [Accepted: 02/26/2003] [Indexed: 11/03/2022] Open
Abstract
We describe a patient with relapsing B chronic lymphocytic leukemia who developed systemic bacille Calmette-Guérin infection (BCGitis) after administration of alemtuzumab (Campath-1H).
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MESH Headings
- Aged
- Alemtuzumab
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/administration & dosage
- Antibodies, Neoplasm/adverse effects
- Antibodies, Neoplasm/therapeutic use
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Male
- Mycobacterium bovis
- Tuberculosis/etiology
- Tuberculosis/microbiology
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Affiliation(s)
- S Abad
- Service de Médecine Interne 2, Hôpital Cochin-Saint Vincent de Paul, Université René Descartes, Paris, France.
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Damaj G, Verkarre V, Delmer A, Solal-Celigny P, Yakoub-Agha I, Cellier C, Maurschhauser F, Bouabdallah R, Leblond V, Lefrère F, Bouscary D, Audouin J, Coiffier B, Varet B, Molina T, Brousse N, Hermine O. Primary follicular lymphoma of the gastrointestinal tract: a study of 25 cases and a literature review. Ann Oncol 2003; 14:623-9. [PMID: 12649111 DOI: 10.1093/annonc/mdg168] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND To describe better the clinical, biological, endoscopic and pathological presentations, as well as the outcome, of primary follicular lymphoma (FL) of the gastrointestinal (GI) tract. PATIENTS AND METHODS From November 1983 to February 2001, 25 eligible patients with primary FL of the GI tract were retrieved from several French Departments of Pathology departments based on histological diagnosis and immunophenotype. Median age was 56 years (range 44-71) with a sex ratio female/male of 2 (17/8). RESULTS Abdominal pain was the main presenting symptom followed by intestinal obstruction. The small intestine was the most common site of involvement. Lesions were unifocal in the majority of patients (15/25). A pattern similar to lymphomatous polyposis was observed in 50% (7/14) of patients. Twelve patients had stage I, 10 patients stage II and three patients stage IV disease, and there was minimal extra intestinal involvement. Lymphoma tissues were composed of neoplastic follicles, most of which were grade 1 according to the World Health Organization (WHO) classification. The immunophenotype of the lymphoma cells was CD20+, CD10+, bcl2+ and CD5-. In tissue samples, IgH/bcl2 rearrangement at the MBR locus was present in 11 of 14 patients tested. Seven patients did not receive any treatment; four of them progressed after a median follow-up of 37.5 months. Treatment was otherwise heterogeneous, and complete remission was obtained in 15 patients which lasted for a median of 31 months. Relapses were either in the GI tract (n = 3) or outside the GI tract (n = 3). After a median follow-up of 34 months (range 5-203), 22 patients were still alive (complete remission, 11; partial remission, three; stable disease, six; progressive disease, two). CONCLUSIONS Primary FL of the GI tract is a predominantly female lymphoma that most frequently involves the small intestine. Since the endoscopic and clinical presentation may not be different from lymphomatous polyposis, which is often associated with mantle cell origin of tumor cells, it is mandatory to perform an immunohistological and, if possible, a molecular analysis of GI lymphoma. The course of the disease is indolent and does not differ from nodal FL. Thus, therapy may not be required unless significant clinical symptoms are present or until disease progression.
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Affiliation(s)
- G Damaj
- Hôpital Necker Enfants-Malades, Paris, France.
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Abad S, Moachon L, Gyan E, Bouscary D, Reyfus F, Blanche P. Tuberculose atypique après traitement par anticorps monoclonaux anti-CD52. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80623-3] [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: 12/01/2022]
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35
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Kelaïdi C, Tulliez M, Lecoq-Lafon C, Pham XV, Kahan A, Dreyfus F, Bouscary D. Long-term remission of an EBV-positive B cell lymphoproliferative disorder associated with rheumatoid arthritis under methotrexate with anti-CD20 monoclonal antibody (Rituximab) monotherapy. Leukemia 2002; 16:2173-4. [PMID: 12357380 DOI: 10.1038/sj.leu.2402588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2002] [Accepted: 04/09/2002] [Indexed: 11/08/2022]
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36
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Bouscary D, Lecoq-Lafon C, Chrétien S, Zompi S, Fichelson S, Muller O, Porteu F, Dusanter-Fourt I, Gisselbrecht S, Mayeux P, Lacombe C. Role of Gab proteins in phosphatidylinositol 3-kinase activation by thrombopoietin (Tpo). Oncogene 2001; 20:2197-204. [PMID: 11402314 DOI: 10.1038/sj.onc.1204317] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2000] [Revised: 01/22/2001] [Accepted: 01/30/2001] [Indexed: 12/18/2022]
Abstract
In this study, we show that upon thrombopoietin (Tpo) stimulation the two adapter proteins Gab1 and Gab2 are strongly tyrosine phosphorylated and associated with Shc, SHP2, PI 3-kinase and Grb2 in mpl-expressing UT7 cells. Although Gab1 and Gab2 seem to mediate overlapping biological signals in many cells, only Gab1 is expressed and phosphorylated in response to Tpo in primary human megakaryocytic progenitors; furthermore, it associates with the same proteins. Although a low level of tyrosine phosphorylated IRS-2 protein is also detected in PI 3-kinase immunoprecipitates, Gab proteins are the essential proteins associated with PI 3-kinase after Tpo stimulation. We demonstrate that, albeit no association is detected between the Tpo receptor mpl and Gab proteins, Y112 located in the C-terminal cytoplasmic domain of mpl is required for Gab1/2 tyrosine phosphorylation. Gab proteins are not tyrosine phosphorylated after Tpo stimulation of UT-7 and Ba/F3 cells expressing a mpl mutant lacking Y112. Moreover, no activation of the PI 3-kinase/Akt pathway is observed in cells expressing this mpl mutant. Finally, we show that this mutant does not allow cell proliferation, thereby confirming that PI 3-kinase activation is required for Tpo-induced cell proliferation.
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Affiliation(s)
- D Bouscary
- Institut Cochin de Génétique Moléculaire (ICGM), Institut National de la Santé et de la Recherche Médicale (INSERM U363), Université René Descartes, France
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37
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Zompi S, Legrand O, Bouscary D, Blanc CM, Picard F, Casadevall N, Dreyfus F, Marie JP, Viguié F. Therapy-related acute myeloid leukaemia after successful therapy for acute promyelocytic leukaemia with t(15;17): a report of two cases and a review of the literature. Br J Haematol 2000; 110:610-3. [PMID: 10997972 DOI: 10.1046/j.1365-2141.2000.02240.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe two patients with positive t(15;17) acute promyelocytic leukaemia (APL) that developed into a therapy-related myelodysplasia 2-2.5 years after complete remission (CR) and then evolved into therapy-related acute myeloid leukaemia (t-AML). Both patients received anthracyclines as potential leukaemogenic drugs. In both cases, cytogenetic changes usually occurring after use of alkylating agents were noticed: monosomy 7 associated with monosomy 5 or 5q- chromosome. A review of the literature on t-AML occurring after successful therapy for APL showed only one report similar to these two cases. These observations suggest that anthracyclines can cause t-AML similar to that induced by alkylating agents.
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MESH Headings
- Adult
- Antibiotics, Antineoplastic/adverse effects
- Antibiotics, Antineoplastic/therapeutic use
- Child
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 7
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/genetics
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Middle Aged
- Monosomy
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- S Zompi
- Services d'Hématologie biologique et clinique, Hôpital Hôtel-Dieu, and Services d'Hématologie biologique et clinique, Hôpital Cochin, Paris, France
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38
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Bouscary D, Chen YL, Guesnu M, Picard F, Viguier F, Lacombe C, Dreyfus F, Fontenay-Roupie M. Activity of the caspase-3/CPP32 enzyme is increased in "early stage" myelodysplastic syndromes with excessive apoptosis, but caspase inhibition does not enhance colony formation in vitro. Exp Hematol 2000; 28:784-91. [PMID: 10907640 DOI: 10.1016/s0301-472x(00)00179-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Excessive apoptosis may have a role in the ineffective hematopoiesis and cytopenias observed in myelodysplastic syndromes. The goals of this study were 1) to quantify apoptosis in patients with "early stage" myelodysplasia [including patients with refractory anemia (RA), RA with ringed sideroblasts (RARS), RA with excess blasts and with less than 10% blasts (RAEB(<10))], and in patients with "late stage" myelodysplasia [including RAEB with more than 10% blasts (RAEB(>10)), RAEB in transformation (RAEB-t), and acute myeloid leukemia secondary to myelodysplasia (LAM2)]; 2) to study the activation of the caspase-3/CPP32 enzyme, a major "effector" caspase in hematopoiesis, in patients with "early stage" myelodysplasia, and 3) to evaluate the effect of caspase inhibition on the apoptotic phenotype and clonogenicity of hematopoietic progenitors in vitro in these patients. MATERIALS AND METHODS PATIENTS Fifty-four patients with myelodysplastic syndromes, including 30 with "early stage" myelodysplasia and 24 with "late stage" myelodysplasia were studied. Study of apoptosis: TUNEL assay performed on bone marrow smears and/or quantification of annexin V positive bone marrow mononuclear cells by flow cytometric analysis. Caspacse-3/CPP32 activity: Quantitative measurement of caspase-3/CPP32 activity on total bone marrow mononuclear cells using a fluorogenic substrate. Effect of the caspase-inhibitor Z-VAD-FMK: 1) on the apoptotic phenotype of total bone marrow mononuclear cells and 2) on the clonogenicity of hematopoietic progenitor cells. RESULTS The group of 30 patients with "early stage" myelodysplasia had statistically increased apoptosis compared to the group of 24 patients with "late stage" myelodysplasia (44.1% +/- 4.8 vs 21.8% +/- 3.6; p = 0.02) using the TDT-mediated dUTP nick-end labeling (TUNEL) assay. In the group of patients with RAEB, those with MDS(RAEB<10) had excessive apoptosis compared to those with MDS(RAEB>10) (44.0% +/- 3.5% vs 29.5% +/- 3.6%;p = 0.042) The median caspase-3 activity in 20 "early stage" myelodysplasia patients was 19,000 U (range 3,460-41,000) and significantly increased compared to normal individuals (4,256 U, range 3,200-5,200; p = 0.032) Bone marrow mononuclear cells from 12 "early stage" MDS patients (including 11 from the 20 studied for caspase-3 activity) were incubated with or without the broad-spectrum caspase inhibitor Z-VAD-FMK. In 4 of 9 evaluable patients (44.4%) with excessive apoptosis, the number of annexin V positive cells decreased in a dose-dependent manner in the presence of Z-VAD-FMK. However, in none of these patients was caspase inhibition with Z-VAD-FMK able to enhance colony formation in vitro. CONCLUSION These results confirm that a major characteristic of patients with "early stage" myelodysplasia is increased apoptosis. The results also indicate that excessive apoptosis in these patients is accompanied by increased caspase-3/CPP32 activity. However, caspase inhibition with the broad-spectrum inhibitor Z-VAD-FMK cannot improve hematopoiesis in this group of patients, even when apoptosis is attenuated.
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Affiliation(s)
- D Bouscary
- Service d'Hématologie, Hôpital Cochin, AP-HP, Université René Descartes, Paris, France.
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Viguié F, Aboura A, Ramond S, Bouscary D, Baudard M, Chomienne C, Marie JP. Submicroscopic insertion of RARalpha gene into chromosome 15 in two cases of acute promyelocytic leukemia. Cancer Genet Cytogenet 2000; 119:162-4. [PMID: 10867154 DOI: 10.1016/s0165-4608(99)00232-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Acute promyelocytic leukemia (APL) is characterized by a specific translocation (15;17)(q22;q21), resulting in the formation of PML/RARalpha chimeric transcripts. We report two female patients with PML/RARalpha-positive classical APL, whose leukemic cells expressed a variant translocation, t(5;15)(q13;q22) and t(15;17)(q22;p13), respectively. Both translocations were confirmed by whole chromosome painting which revealed no apparent involvement of 17q. A two-color fluorescence in situ hybridization with a 5' PML and a 3' RARalpha probe showed, in both cases, the presence of a PML-RARalpha fusion gene, on the der(15)t(5;15) long arm, and on the der(17)t(15;17) short arm, respectively. These two complex rearrangements resulted most probably from a two-step mechanism: (1) a submicroscopic insertion into 15q of a 17q segment including the 3' part of the RARalpha gene; (2) a reciprocal translocation between der(15) and a variable chromosome arm, with a breakpoint distal and proximal to RARalpha insertion in the case of t(5;15) and t(15;17), respectively. Molecular and prognosis significance of these variant translocations are discussed.
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MESH Headings
- Aged
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 15/ultrastructure
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 5/genetics
- Chromosomes, Human, Pair 5/ultrastructure
- Fatal Outcome
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Promyelocytic, Acute/genetics
- Middle Aged
- Mutagenesis, Insertional
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Translocation, Genetic
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Affiliation(s)
- F Viguié
- Département d'Hématologie, Laboratoire de Cytogénétique, Hôpital Hôtel-Dieu, Paris, France
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40
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Le Tessier D, Dupont JM, Fichelson S, Bouscary D, Lebbar A, Dreyfus F, Rabineau D. Clonal chromosomal abnormalities identified by interphase fluorescence in situ hybridization on collagen cultured hematopoietic stem cells. Leukemia 2000; 14:949-50. [PMID: 10803534 DOI: 10.1038/sj.leu.2401739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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41
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42
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Milpied N, Vasseur B, Parquet N, Garnier JL, Antoine C, Quartier P, Carret AS, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa AM, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-Boue A, Leblond V. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: a retrospective analysis on 32 patients. Ann Oncol 2000; 11 Suppl 1:113-6. [PMID: 10707791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND B-lymphoproliferative post-transplant disorder (BLPD) is a severe complication of organ and bone marrow transplantation. The reduction of immuno-suppressive therapy or surgery for localized disease may cure some BLPDs. Other therapeutic approaches such as chemotherapy and antiviral drugs are toxic and of limited efficacy. Adoptive immunotherapy with donor T-cell infusions has yielded promising results but is, at the present time, easily applicable only in bone marrow-transplanted patients. Anti-B-cell Murine monoclonal antibodies (MoAbs) have proven effective but are no longer available for human use. We report the activity of a humanized anti CD 20 Mo Ab (Rituximab-MABTHERA Roche) in 32 episodes of BLPD treated in 14 French centers. PATIENTS AND METHODS Between November 1997 and September 1998, 32 patients were diagnosed with BLPD. Twenty-six patients had undergone solid organ transplants (liver 8, kidney 8, heart 4, lung 3, heart lung 1, kidney-pancreas 1, liver-kidney 1) and six patients had received bone marrow transplantations. The median age of the patients was 34 years (3-67 years) and the median delay between graft and tumor 5 months (1-156 months). In organ recipients, tumors were classified as polymorphic and monomorphic in 10 and 15 cases, respectively; 4 of 6 bone marrow transplant recipients were treated without pathology documentation because of a rise in EBV load, fever and lymph node enlargement. Tumors were associated with EBV in 22 of 26 tested cases. Rituximab was used as first-line therapy in 30 patients (after reduction of immunosuppressive treatment in 27 patients) and as salvage therapy in 2 patients (after failure of chemotherapy). The median time from diagnosis of BLPD to treatment with Rituximab was 14 days (1-110 days). Two patients received eight infusions, twenty-six patients four infusions, one patient three infusions and three patients two infusions of 375 mg/m2. RESULTS The tolerance of rituximab was good. The overall response rate was 69%, with 20 complete responses and 2 partial responses. In solid organ transplant the response rate was 65% (15 CR and 2 PR) while it was 83% in bone marrow-transplanted patients (5 CR). With a median follow-up of 8 months (1-16 months) 24 patients are still alive. The one-year projected survival is 73%. Of the 22 patients who achieved response, 15 patients (11 solid organ transplant and 4 bone marrow transplant) are alive with no evidence of disease, 4 patients relapsed a median of 7 months (3-10 months) after treatment and 3 died while in CR of concurrent diseases. Of the 10 patients who did not respond to Rituximab 5 are alive with no evidence of disease after salvage therapy. CONCLUSIONS The use of rituximab appears to be a safe and relatively efficient therapy in BLPDs. The results need to be confirmed in a prospective multicentric trial.
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Zompi S, Tulliez M, Conti F, Leblond V, Gaulard P, Blanche P, Durand F, Ghandi D, Dreyfus F, Louvel A, Calmus Y, Bouscary D. Rituximab (anti-CD20 monoclonal antibody) for the treatment of patients with clonal lymphoproliferative disorders after orthotopic liver transplantation: a report of three cases. J Hepatol 2000; 32:521-7. [PMID: 10735625 DOI: 10.1016/s0168-8278(00)80406-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Post-transplant lymphoproliferative disorders (PT-LPD) are a well-known complication of organ transplantation. Their incidence after liver transplantation in adults ranges from 1.8 to 4%. Reduction of immunosuppression led to remission in a few cases. Other treatments include chemotherapy, interferon alpha therapy and/or intravenous-immunoglobulins, or antiviral drugs. However, monoclonal antibodies directed against B-cell specific antigens have rarely been used in those patients. Our aim was to study the feasibility and efficacy of Rituximab, a new, promising human chimeric antibody that recognizes the CD20 antigen, for the treatment of patients with clonal lymphoproliferative disorders after orthotopic liver transplantation. METHODS Rituximab (IDEC-C2HB8; Roche Laboratories, Neuilly-sur-Seine, France) was administered at a 375 mg/m2 dose on days 1, 8, 15, and 22, in an outpatient setting, in three patients with PT-LPD. The tumor was classified as polymorphic PT-LPD in two cases and PT-LPD with features of large cell lymphoma in one case. All the tumors expressed the CD20 antigen and were EBV-related, and the clonality was confirmed in all three cases. The 4 injections of the anti-CD20 monoclonal antibody were associated with reduced immunosuppression in the three patient. RESULTS The treatment with Rituximab was well tolerated without any side effects. The two patients with polymorphic PT-LPDs underwent rapid complete remission, whereas the treatment modalities were ineffective in the patient with the large-cell non-Hodgkin-lymphoma. CONCLUSION These results must be confirmed in a larger cohort of liver transplant recipients suffering from lymphoproliferation. However, they indicate rapid efficiency of Rituximab in association with reduced immunosuppression in these disorders.
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Affiliation(s)
- S Zompi
- Service d'Hématologie, Hôpital Cochin, Paris, France
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Milpied N, Vasseur B, Parquet N, Garnier JL, Antoine C, Quartier P, Carret AS, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa AM, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-boue A, Leblond V. Ann Oncol 2000; 11:113-116. [DOI: 10.1023/a:1008372814223] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Milpied N, Vasseur B, Parquet N, Garnier J, Antoine C, Quartier P, Carret A, Bouscary D, Faye A, Bourbigot B, Reguerre Y, Stoppa A, Bourquard P, Hurault de Ligny B, Dubief F, Mathieu-Boue A, Leblond V. Humanized anti-CD20 monoclonal antibody (Rituximab) in post transplant B-lymphoproliferative disorder: A retrospective analysis on 32 patients. Ann Oncol 2000. [DOI: 10.1093/annonc/11.suppl_1.s113] [Citation(s) in RCA: 166] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Breban M, Dougados M, Picard F, Zompi S, Marolleau JP, Bocaccio C, Heshmati F, Mezieres M, Dreyfus F, Bouscary D. Intensified-dose (4 gm/m2) cyclophosphamide and granulocyte colony-stimulating factor administration for hematopoietic stem cell mobilization in refractory rheumatoid arthritis. Arthritis Rheum 1999; 42:2275-80. [PMID: 10555020 DOI: 10.1002/1529-0131(199911)42:11<2275::aid-anr3>3.0.co;2-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate the feasibility, safety, and efficacy of intensified-dose cyclophosphamide (ID-CYC), followed by granulocyte colony-stimulating factor (G-CSF) administration for collection of peripheral blood hematopoietic stem cells (HSC), for patients with severe, refractory rheumatoid arthritis (RA). METHODS Four patients with severe refractory RA were enrolled in this open study. They received a single infusion of CYC (4 gm/m2) at day 0 followed by G-CSF (5 microg/kg/day) from day 6 until the last day of leukapheresis (performed at the time of hematopoietic recovery) to harvest peripheral blood HSC. Patients were monitored for disease activity, adverse effects, and hematopoietic reconstitution following this procedure. RESULTS For all patients, administration of ID-CYC induced an early, dramatic improvement of disease activity. Long-term followup indicates that partial disease relapse was observed for all patients. No adverse effect was directly attributable to the treatment procedure. For most patients, HSC collection was sufficient to provide a graft enriched in CD34+ cells by positive selection as well as an unselected rescue graft. CONCLUSION Patients with severe, refractory RA can benefit from ID-CYC. This procedure, followed by G-CSF administration, appears safe and technically suitable. In addition, it allows immediate improvement of RA activity that can occasionally persist beyond 6 months.
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Affiliation(s)
- M Breban
- Cochin Hospital, Université René Descartes, Paris, France
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Farge D, Breban M, Guillevin L, Piette JC, Cabane J, Cherin P, Cosserat J, Sicard D, Ribaud P, Marolleau JP, Bouscary D, Mariette X, Gisselbrecht C, Gluckman E. [Bone marrow transplantation in the treatment of autoimmune diseases. ISAMAIR Group]. Presse Med 1999; 28:1488-94. [PMID: 10520323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
EXPERIMENTAL BASIS AND CLINICAL OBSERVATIONS: Remission of an autoimmune disease has been observed in certain patients after bone marrow allograft from a healthy donor. Autoimmune disease in the donor can also be transmitted to an unaffected recipient. These phenomena would be hematopoietic-dependent. BONE MARROW ALLOGRAFTS: Indications for the treatment of refractory autoimmune diseases are exceptional due to the related mortality even in patients without malignant hematologic disease. A NEW THERAPEUTIC CONCEPT: Therapeutic intensification, followed with autologous peripheral stem cell grafts, a procedure with a mortality below 3% in 1997, constitutes a therapeutic alternative in these difficult indication concerning severe refractory autoimmune diseases including: sclerodermia, vasculitis, lupus, inflammatory myositis, autoimmune cyopenia.
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Affiliation(s)
- D Farge
- Service de Médecine interne, Hôpital Saint Louis, Paris
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Blanche P, Bouscary D, Gombert B, Stieltjes N, Dreyfus F, Sicard D. Successful treatment of acquired factor VIII inhibitor with fludarabine and cyclophosphamide in chronic lymphoid leukemia. Leukemia 1999; 13:1294. [PMID: 10450761 DOI: 10.1038/sj.leu.2401461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Fontenay-Roupie M, Bouscary D, Guesnu M, Picard F, Melle J, Lacombe C, Gisselbrecht S, Mayeux P, Dreyfus F. Ineffective erythropoiesis in myelodysplastic syndromes: correlation with Fas expression but not with lack of erythropoietin receptor signal transduction. Br J Haematol 1999; 106:464-73. [PMID: 10460607 DOI: 10.1046/j.1365-2141.1999.01539.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Ineffective erythropoiesis in myelodysplasia is characterized by a defect in erythroid progenitor growth and by abnormal erythroid differentiation. Increased apoptosis of erythroid, granulocytic and megakaryocytic lineages is thought to account for cytopenias. Erythropoietin (Epo)-induced BFU-E and CFU-E growth was studied in 25 myelodysplastic syndrome (MDS) marrow specimens and found to be drastically diminished. To investigate the functionality of Epo-R in MDS marrow, we focused on Epo-induced STAT5 activation. Epo was able to stimulate STAT5 DNA binding activity in all normal and 12/24 MDS marrows tested, with no correlation between the level of STAT5 activation and the development of erythroid colonies in response to Epo. In contrast, impaired proliferation of erythroid progenitors was related to an increased expression of the transmembrane mediator of apoptotic cell death Fas/CD95 on the glycophorin A+ subpopulation. Therefore we conclude that the stimulation of pro-apoptotic signals rather than the defect of anti-apoptotic pathways resulting from Epo-stimulated Jak2-STAT5 pathway, predominantly accounts for ineffective erythropoiesis in myelodysplasia.
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Affiliation(s)
- M Fontenay-Roupie
- Département d'Hématologie, AP-HP, INSERM U363, Université René Descartes, Hôpital Cochin, Paris, France
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50
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Bouscary D, Jondeau K, Viguié F, Zompi S, Fontenay-Roupie M, Quarre MC, Vassilief D, Dreyfus F, Casadevall N. Aplastic anemia responsive to cyclosporine complicating the evolution of polycythemia vera. Leuk Lymphoma 1999; 33:607-11. [PMID: 10342591 DOI: 10.3109/10428199909058468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report here a very unusual patient with Polycythemia vera treated with Pipobroman who developed severe aplastic anemia following administration of the drug. Six months later, because of lack of response, cyclosporine therapy was given there was rapid and complete hematological recovery, highly suggestive of an immune-mediated mechanism, in this case.
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Affiliation(s)
- D Bouscary
- Service d'Hématologie, Hôpital Cochin, Paris, France
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