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Jourdes A, Cellerin E, Touzeau C, Harel S, Denis B, Escure G, Faure E, Jamard S, Danion F, Sonntag C, Ader F, Karlin L, Soueges S, Cazelles C, de La Porte des Vaux C, Frenzel L, Lanternier F, Brousse X, Cazaubiel T, Berger P, Collignon A, Blot M, Pieragostini A, Charles M, Chaleteix C, Redor A, Roland V, Cartau T, Macro M, Chalopin T, Vallet N, Perrot A, Martin-Blondel G. Characteristics and incidence of infections in patients with multiple myeloma treated by bispecific antibodies: a national retrospective study on the behalf of G2I and Intergroupe Francophone du Myélome. Clin Microbiol Infect 2024:S1198-743X(24)00098-3. [PMID: 38432433 DOI: 10.1016/j.cmi.2024.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/10/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVES Bispecific antibodies (BsAbs) are an effective treatment used in relapsed or refractory multiple myeloma. Despite a well-tolerated safety profile, infectious events appear to be frequent in clinical trials. Real-world data on epidemiology, characteristics, risk factors, and outcomes of infections in patients treated with BsAb are still needed. METHODS A retrospective, multicentre study in BsAb-treated patients with multiple myeloma was performed in 14 French centres from December 2020 to February 2023. The primary objective was to describe the incidence of infections that required hospitalization, specific treatment, or adaptation in BsAb administration. RESULTS Among 229 patients with multiple myeloma treated with BsAb, 153 (67%) received teclistamab, 47 (20%) received elranatamab, and 29 (13%) talquetamab. We reported a total of 234 infections, including 123 (53%) of grade of ≥3. Predominant infections affected the respiratory tract (n = 116, 50%) followed by bacteraemias (n = 36, 15%). The hospitalization rate was 56% (n = 131), and 20 (9%) infections resulted in death. Global cumulative incidence of the first infection was 70% in all patients, 73% in patients treated with B-cell maturation antigen-targeting, and 51% with GPRC5D-targeting BsAb. In univariate analyses, corticosteroids for cytokine release syndrome (CRS)/immune effector cell-associated neurotoxicity syndrome (ICANS) were associated with a higher risk of first infection (HR = 2.13; 95% CI, 1.38-3.28), whereas GPRC5D-targeting BsAb and anti-bacterial prophylaxis were associated with a lower risk (HR = 0.53; 95% CI, 0.3-0.94 and HR = 0.65; 95% CI, 0.46-0.9). Fine and Gray multivariate model found that only corticosteroids for CRS/ICANS were correlated with a higher risk of first infection (HR = 2.01; 95% CI, 1.27-3.19). DISCUSSIONS The implementation of preventive measures that aim to mitigate the risk of infection under BsAb is pivotal, notably in patients who received corticosteroids for CRS/ICANS.
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Affiliation(s)
- Aurélie Jourdes
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Toulouse, France
| | - Elise Cellerin
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France
| | - Cyrille Touzeau
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) Hôtel Dieu, Nantes, France
| | - Stéphanie Harel
- Service d'immuno-hématologie, Hôpital St-Louis, AP-HP, Paris, France
| | - Blandine Denis
- Service de Maladies Infectieuses et Tropicales, Hôpital St-Louis, AP-HP, Paris, France
| | - Guillaume Escure
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Lille, France
| | - Emmanuel Faure
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Lille, France; U1019-UMR 9017-Centre d'Infection et d'Immunité de Lille, INSERM, Centre National de la Recherche Scientifique, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Simon Jamard
- Service de Médecine Infectieuse et Tropicale, Centre Hospitalo-Universitaire (CHU) de Tours, France
| | - Francois Danion
- Service de Maladies Infectieuses et Tropicales, Les Hôpitaux Universitaires de Strasbourg, Strasbourg, Grand Est, France; Laboratoire d'Immuno-rhumatologie Moléculaire UMR_S 1109, INSERM, Strasbourg, Grand Est, France
| | - Cécile Sonntag
- Service d'hématologie, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Florence Ader
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM 1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Lionel Karlin
- Service d'hématologie, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Sarah Soueges
- Département des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon, France
| | - Clarisse Cazelles
- Service d'hématologie, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; Institut Cochin, Université de Paris, CNRS UMR8104, INSERM U1016, Paris, France
| | | | - Laurent Frenzel
- Service d'hématologie, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; CEREMAST, Institut Imagine, INSERM U1163, AP-HP, Hôpital Necker-Enfants Malades, Université Paris Centre, Paris, France
| | - Fanny Lanternier
- Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, Centre National de Référence Mycoses Invasives et Antifongiques, Groupe de Recherche Translationnelle en Mycologie, Département de Mycologie, Paris, Île-de-France, France
| | - Xavier Brousse
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Bordeaux, France
| | - Titouan Cazaubiel
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Bordeaux, France; Equipe Génomique et Immunologie du Myélome Multiple, Centre de Recherche en Cancérologie de Toulouse INSERM U1037, Université Paul Sabatier, Toulouse, France
| | - Pierre Berger
- Infectiologie Transversale, Institut Paoli-Calmettes, Marseille, France
| | - Aude Collignon
- Service d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Mathieu Blot
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Dijon-Bourgogne, France; INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France; Equipe Lipness, INSERM LNC-UMR1231 et LabEx LipSTIC, Université de Burgundy, Dijon, France
| | - Andrea Pieragostini
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Dijon-Bourgogne, France
| | - Morgane Charles
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) d'Estaing, Clermont-Ferrand, France
| | - Carine Chaleteix
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) d'Estaing, Clermont-Ferrand, France
| | - Alexis Redor
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier de Perpignan, France
| | - Virginie Roland
- Service d'hématologie, Centre Hospitalier de Perpignan, France
| | - Tom Cartau
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) Côte de Nacre, Caen, France
| | - Margaret Macro
- Service d'hématologie, Institut bas Normand d'Hématologie, CHU Caen Normandie, Caen, France
| | - Thomas Chalopin
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France
| | - Nicolas Vallet
- Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Tours, France; Equipe INSERM U1069 N2COx, Groupe LNOx, Université de Tours, France
| | - Aurore Perrot
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Bordeaux, France; Service d'hématologie, Centre Hospitalo-universitaire (CHU) de Toulouse, Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-O), Toulouse, France
| | - Guillaume Martin-Blondel
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalo-universitaire (CHU) de Toulouse, France; Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity) INSERM, Université Toulouse III, Toulouse, France.
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2
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Vallet N, Salmona M, Malet-Villemagne J, Bredel M, Bondeelle L, Tournier S, Mercier-Delarue S, Cassonnet S, Ingram B, Peffault de Latour R, Bergeron A, Socié G, Le Goff J, Lepage P, Michonneau D. Circulating T cell profiles associate with enterotype signatures underlying hematological malignancy relapses. Cell Host Microbe 2023; 31:1386-1403.e6. [PMID: 37463582 DOI: 10.1016/j.chom.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 05/23/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023]
Abstract
Early administration of azithromycin after allogeneic hematopoietic stem cell transplantation was shown to increase the relapse of hematological malignancies. To determine the impact of azithromycin on the post-transplant gut ecosystem and its influence on relapse, we characterized overtime gut bacteriome, virome, and metabolome of 55 patients treated with azithromycin or a placebo. We describe four enterotypes and the network of associated bacteriophage species and metabolic pathways. One enterotype associates with sustained remission. One taxon from Bacteroides specifically associates with relapse, while two from Bacteroides and Prevotella correlate with complete remission. These taxa are associated with lipid, pentose, and branched-chain amino acid metabolic pathways and several bacteriophage species. Enterotypes and taxa associate with exhausted T cells and the functional status of circulating immune cells. These results illustrate how an antibiotic influences a complex network of gut bacteria, viruses, and metabolites and may promote cancer relapse through modifications of immune cells.
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Affiliation(s)
- Nicolas Vallet
- Université de Paris Cité, INSERM U976, 75010 Paris, France
| | - Maud Salmona
- Université de Paris Cité, INSERM U976, 75010 Paris, France; Virology Department, AP-HP, Saint-Louis Hospital, 75010 Paris, France
| | - Jeanne Malet-Villemagne
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Domaine de Vilvert, 78350 Jouy-en-Josas, France
| | - Maxime Bredel
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Domaine de Vilvert, 78350 Jouy-en-Josas, France
| | - Louise Bondeelle
- Pneumology Unit, AP-HP, Saint-Louis Hospital, 75010 Paris, France
| | - Simon Tournier
- Core Facilities, Saint-Louis Research Institute, Université de Paris Cité, UAR 2030/US 53, 75010 Paris, France
| | | | - Stéphane Cassonnet
- Service de Biostatistique et Information Médicale, AP-HP, Saint-Louis Hospital, 75010 Paris, France
| | | | - Régis Peffault de Latour
- Hematology Transplantation, AP-HP, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France; Cryostem Consortium, 13382 Marseille, France
| | - Anne Bergeron
- Pneumology Department, Geneva University Hospitals, 1205 Geneva, Switzerland
| | - Gérard Socié
- Université de Paris Cité, INSERM U976, 75010 Paris, France; Hematology Transplantation, AP-HP, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France
| | - Jérome Le Goff
- Université de Paris Cité, INSERM U976, 75010 Paris, France; Virology Department, AP-HP, Saint-Louis Hospital, 75010 Paris, France
| | - Patricia Lepage
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Domaine de Vilvert, 78350 Jouy-en-Josas, France
| | - David Michonneau
- Université de Paris Cité, INSERM U976, 75010 Paris, France; Hematology Transplantation, AP-HP, Saint-Louis Hospital, 1 avenue Claude Vellefaux, 75010 Paris, France.
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3
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Haméon C, Machet A, Drieu La Rochelle L, Vallet N, Lejeune J, Ravalet N, Cottier J, Hérault O, Gyan E. Cerebral localization of chronic myelomonocytic leukemia and improvement with high-dose cytarabine: A case report. EJHaem 2023; 4:844-847. [PMID: 37601847 PMCID: PMC10435672 DOI: 10.1002/jha2.740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023]
Abstract
Chronic myelomonocytic leukemia (CMML) is a myelodysplastic/myeloproliferative neoplasm characterized by the infiltration of blood and bone marrow by immature monocytes, in which extra-hematopoietic localization is uncommon. We report the case of a 69-year-old-man with highly likely ectopic brain CMML involvement by MRI. Without the possibility of cerebral biopsy and with a negative infectious disease assessment, high-dose cytarabine-based chemotherapy was successfully administered. The favorable evolution in this case highlights the potential benefit of such treatment, even without a cerebral biopsy to confirm the disease. This case can aid clinical decision-making in the future.
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Affiliation(s)
- Clémence Haméon
- Hematology and Cell Therapy DepartmentTours University HospitalToursFrance
| | - Antoine Machet
- Hematology and Cell Therapy DepartmentTours University HospitalToursFrance
| | | | - Nicolas Vallet
- Hematology and Cell Therapy DepartmentTours University HospitalToursFrance
- Equipe CNRS LNOx ERL7001University of ToursToursFrance
| | - Julien Lejeune
- Hematology and Cell Therapy DepartmentTours University HospitalToursFrance
- Equipe CNRS LNOx ERL7001University of ToursToursFrance
| | - Noémie Ravalet
- Department of Biological HematologyTours University HospitalToursFrance
- Equipe CNRS LNOx ERL7001University of ToursToursFrance
| | | | - Olivier Hérault
- Department of Biological HematologyTours University HospitalToursFrance
- Equipe CNRS LNOx ERL7001University of ToursToursFrance
- Grand Ouest Against Leukemia University Hospital Federation (GOAL)AngersFrance
| | - Emmanuel Gyan
- Hematology and Cell Therapy DepartmentTours University HospitalToursFrance
- Equipe CNRS LNOx ERL7001University of ToursToursFrance
- Grand Ouest Against Leukemia University Hospital Federation (GOAL)AngersFrance
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4
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Vallet N, Michonneau D, Tournier S. Toward practical transparent verifiable and long-term reproducible research using Guix. Sci Data 2022; 9:597. [PMID: 36195618 PMCID: PMC9532446 DOI: 10.1038/s41597-022-01720-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 09/26/2022] [Indexed: 11/09/2022] Open
Abstract
Reproducibility crisis urge scientists to promote transparency which allows peers to draw same conclusions after performing identical steps from hypothesis to results. Growing resources are developed to open the access to methods, data and source codes. Still, the computational environment, an interface between data and source code running analyses, is not addressed. Environments are usually described with software and library names associated with version labels or provided as an opaque container image. This is not enough to describe the complexity of the dependencies on which they rely to operate on. We describe this issue and illustrate how open tools like Guix can be used by any scientist to share their environment and allow peers to reproduce it. Some steps of research might not be fully reproducible, but at least, transparency for computation is technically addressable. These tools should be considered by scientists willing to promote transparency and open science.
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Affiliation(s)
- Nicolas Vallet
- Université de Paris, INSERM U976, F-75010, Paris, France.
| | - David Michonneau
- Université de Paris, INSERM U976, F-75010, Paris, France.,Hematology Transplantation, Saint Louis hospital, 1 avenue Claude Vellefaux, 75010, Paris, France
| | - Simon Tournier
- Université de Paris, INSERM US53, CNRS UAR 2030, Saint Louis Research Institute, 1 avenue Claude Vellefaux, 75010, Paris, France
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5
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Gyan E, Pigneux A, Hunault M, Peterlin P, Carré M, Bay JO, Bonmati C, Gallego-Hernanz MP, Lioure B, Bertrand P, Vallet N, Ternant D, Darrouzain F, Picou F, Béné MC, Récher C, Hérault O. Adjunction of a fish oil emulsion to cytarabine and daunorubicin induction chemotherapy in high-risk AML. Sci Rep 2022; 12:9748. [PMID: 35697729 PMCID: PMC9192636 DOI: 10.1038/s41598-022-13626-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
The treatment of acute myeloid leukemia (AML) with unfavorable cytogenetics treatment remains a challenge. We previously established that ex vivo exposure of AML blasts to eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), or fish oil emulsion (FO) induces Nrf2 pathway activation, metabolic switch, and cell death. The FILO group launched a pilot clinical study to evaluate the feasibility, safety, and efficacy of the adjunction of a commercial FO emulsion to 3 + 7 in untreated AML with unfavorable cytogenetics. The primary objective was complete response (CR). Thirty patients were included. FO administration raised the plasma levels of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids (p < 0.001). The pharmacokinetics of cytarabine and daunorubicin were unaffected. A historical comparison to the LAM2001 trial (Lioure et al. Blood 2012) found a higher frequency of grade 3 serious adverse events, with no drug-related unexpected toxicity. The CR rate was 77%, and the partial response (PR) 10%, not significantly superior to that of the previous study (CR 72%, PR 1%). RT-qPCR analysis of Nrf2 target genes and antioxidant enzymes did not show a significant in vivo response. Overall, FO emulsion adjunction to 3 + 7 is feasible. An improvement in CR was not shown in this cohort of high-risk patients. The present data does not support the use of FO in adjunction with 3 + 7 in high-risk AML patients. ClinicalTrials.gov identifier: NCT01999413.
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Affiliation(s)
- Emmanuel Gyan
- Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Bâtiment Kaplan, 2, boulevard Tonnellé, 37044, Tours Cedex 09, France. .,ERL CNRS 7001, Leukemic Niche and Redox Metabolism (LNOx), Faculté de Médecine, Université de Tours, Tours, France. .,Centre d'Investigation Clinique, INSERM U1415, Centre Hospitalier Universitaire, Tours, France.
| | - Arnaud Pigneux
- Clinique d'Hématologie, Université de Bordeaux, Hôpital Haut-Levêque, Pessac, France
| | - Mathilde Hunault
- Service des Maladies du Sang, FHU GOAL, CRCINA, INSERM Angers, Centre Hospitalier Universitaire, Tours, France
| | - Pierre Peterlin
- Service d'Hématologie, Centre Hospitalier Universitaire, Nantes, France
| | - Martin Carré
- Service d'Hématologie, Centre Hospitalier Universitaire, Grenoble, France
| | - Jacques-Olivier Bay
- Service d'Hématologie, Centre Hospitalier Universitaire, Clermont-Ferrand, France
| | - Caroline Bonmati
- Service d'Hématologie, Centre Hospitalier Universitaire, Nancy, France
| | | | - Bruno Lioure
- Service d'Hématologie, Centre Hospitalier Universitaire, Strasbourg, France
| | - Philippe Bertrand
- Laboratoire de Biostatistiques, Faculté de Médecine, Université de Tours, Tours, France
| | - Nicolas Vallet
- Service d'Hématologie et Thérapie Cellulaire, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Bâtiment Kaplan, 2, boulevard Tonnellé, 37044, Tours Cedex 09, France.,ERL CNRS 7001, Leukemic Niche and Redox Metabolism (LNOx), Faculté de Médecine, Université de Tours, Tours, France
| | - David Ternant
- Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Universitaire, Tours, France
| | | | - Frédéric Picou
- ERL CNRS 7001, Leukemic Niche and Redox Metabolism (LNOx), Faculté de Médecine, Université de Tours, Tours, France
| | | | - Christian Récher
- Service d'Hématologie, Institut Universitaire de Cancérologie de Toulouse, Toulouse, France
| | - Olivier Hérault
- ERL CNRS 7001, Leukemic Niche and Redox Metabolism (LNOx), Faculté de Médecine, Université de Tours, Tours, France. .,Service d'Hématologie Biologique, FHU GOAL, Centre Hospitalier Universitaire de Tours, Hôpital Bretonneau, Bâtiment B2A, 2, boulevard Tonnellé, 37044, Tours Cedex 09, France.
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6
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Delaye JB, Alarcan H, Vallet N, Veyrat-Durebex C, Bernard L, Hérault O, Ropert M, Marlet J, Gyan E, Andres C, Blasco H, Piver E. Specific changes of erythroid regulators and hepcidin in patients infected by SARS-COV-2. J Investig Med 2022; 70:934-938. [PMID: 35292508 PMCID: PMC8931795 DOI: 10.1136/jim-2021-002270] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/22/2022]
Abstract
Iron metabolism is tightly linked to infectious and inflammatory signals through hepcidin synthesis. To date, iron homeostasis during SARS-CoV-2 infection has not yet been described. The aim of this study is to characterize the hepcidin and erythroid regulators (growth differentiation factor 15 (GDF-15) and erythroferrone (ERFE)) by measuring concentrations in plasma in context of COVID-19 disease.We performed a single-center observational study of patients with COVID-19 to evaluate concentrations of main regulatory proteins involved in iron homeostasis, namely: hepcidin, ERFE and GDF-15. SARS-CoV-2 infection (COVID-19+) was defined by a positive RT-PCR. Sixteen patients with COVID-19+ were gender-matched and age-matched to 16 patients with a sepsis unrelated to SARS-CoV-2 (COVID-19-) and were compared with non-parametric statistic test.Clinical and hematological parameters, plasma iron, transferrin, transferrin saturation, ferritin, soluble transferrin receptor and C reactive protein were not statistically different between both groups. Median plasma hepcidin concentrations were higher in the COVID-19+ group (44.1 (IQR 16.55-70.48) vs 14.2 (IQR 5.95-18.98) nmol/L, p=0.003), while median ERFE and GDF-15 concentrations were lower in the COVID-19+ group (0.16 (IQR 0.01-0.73) vs 0.89 (IQR 0.19-3.82) ng/mL, p=0.035; 2003 (IQR 1355-2447) vs 4713 (IQR 2082-7774) pg/mL, p=0015), respectively) compared with the COVID-19- group.This is the first study reporting lower ERFE and GDF-15 median concentrations in patients with COVID-19+ compared with patients with COVID-19-, associated with an increased median concentration of hepcidin in the COVID-19+ group compared with COVID19- group.
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Affiliation(s)
| | - Hugo Alarcan
- Service de Biochimie et Biologie Moléculaire, CHRU Tours, Tours, France
| | - Nicolas Vallet
- Service d'Hématologie et thérapie cellulaire, CHRU Tours, Tours, France
| | - Charlotte Veyrat-Durebex
- Service de Biochimie et Biologie Moléculaire, CHRU Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Tours, France
| | - Louis Bernard
- Service de Médecine Interne et Maladies Infectieuses, CHRU Tours, Tours, France
| | - Olivier Hérault
- Service d'Hématologie biologique, CHRU Tours, Tours, France
- CNRS ERL7001 LNOX, EA 3549, Université de Tours, Tours, France
| | | | - Julien Marlet
- INSERM U1259, MAVIVH, Université de Tours, Tours, France
- Service de bactériologie-virologie-hygiène, CHRU Tours, Tours, France
| | - Emmanuel Gyan
- Service d'Hématologie et thérapie cellulaire, CHRU Tours, Tours, France
- CNRS ERL7001 LNOX, EA 3549, Université de Tours, Tours, France
| | - Christian Andres
- Service de Biochimie et Biologie Moléculaire, CHRU Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Tours, France
| | - Hélène Blasco
- Service de Biochimie et Biologie Moléculaire, CHRU Tours, Tours, France
- UMR 1253, iBrain, Université de Tours, Tours, France
| | - Eric Piver
- Service de Biochimie et Biologie Moléculaire, CHRU Tours, Tours, France
- INSERM U1259, MAVIVH, Université de Tours, Tours, France
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7
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Dubouchet L, Todorov H, Seurinck R, Vallet N, Van Gassen S, Corneau A, Blanc C, Zouali H, Boland A, Deleuze JF, Ingram B, de Latour RP, Saeys Y, Socié G, Michonneau D. Operational tolerance after hematopoietic stem cell transplantation is characterized by distinct transcriptional, phenotypic, and metabolic signatures. Sci Transl Med 2022; 14:eabg3083. [PMID: 35196024 DOI: 10.1126/scitranslmed.abg3083] [Citation(s) in RCA: 3] [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] [Indexed: 11/02/2022]
Abstract
The mechanisms underlying operational tolerance after hematopoietic stem cell transplantation in humans are poorly understood. We studied two independent cohorts of patients who underwent allogeneic hematopoietic stem cell transplantation from human leukocyte antigen-identical siblings. Primary tolerance was associated with long-lasting reshaping of the recipients' immune system compared to their healthy donors with an increased proportion of regulatory T cell subsets and decreased T cell activation, proliferation, and migration. Transcriptomics profiles also identified a role for nicotinamide adenine dinucleotide biosynthesis in the regulation of immune cell functions. We then compared individuals with operational tolerance and nontolerant recipients at the phenotypic, transcriptomic, and metabolomic level. We observed alterations centered on CD38+-activated T and B cells in nontolerant patients. In tolerant patients, cell subsets with regulatory functions were prominent. RNA sequencing analyses highlighted modifications in the tolerant patients' transcriptomic profiles, particularly with overexpression of the ectoenzyme NT5E (encoding CD73), which could counterbalance CD38 enzymatic functions by producing adenosine. Further, metabolomic analyses suggested a central role of androgens in establishing operational tolerance. These data were confirmed using an integrative approach to evaluating the immune landscape associated with operational tolerance. Thus, balance between a CD38-activated immune state and CD73-related production of adenosine may be a key regulator of operational tolerance.
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Affiliation(s)
| | - Helena Todorov
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, 9052 Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, 9052 Ghent, Belgium
| | - Ruth Seurinck
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, 9052 Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, 9052 Ghent, Belgium
| | | | - Sofie Van Gassen
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, 9052 Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, 9052 Ghent, Belgium
| | - Aurélien Corneau
- Plateforme de Cytométrie de la Pitié-Salpétrière (CyPS), UMS037-PASS, Sorbonne Université-Faculté de Médecine, F-75013 Paris, France
| | - Catherine Blanc
- Plateforme de Cytométrie de la Pitié-Salpétrière (CyPS), UMS037-PASS, Sorbonne Université-Faculté de Médecine, F-75013 Paris, France
| | - Habib Zouali
- Centre d'étude du polymorphisme humain, 75010 Paris, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057 Evry, France
| | - Jean-François Deleuze
- Centre d'étude du polymorphisme humain, 75010 Paris, France.,Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, 91057 Evry, France
| | | | - Regis Peffault de Latour
- Hematology Transplantation, Saint Louis Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - Yvan Saeys
- Data Mining and Modeling for Biomedicine, VIB Center for Inflammation Research, 9052 Ghent, Belgium.,Department of Applied Mathematics, Computer Science and Statistics, Ghent University, 9052 Ghent, Belgium
| | - Gérard Socié
- Université de Paris, INSERM U976, F-75010 Paris, France.,Hematology Transplantation, Saint Louis Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France
| | - David Michonneau
- Université de Paris, INSERM U976, F-75010 Paris, France.,Hematology Transplantation, Saint Louis Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France
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8
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Vallet N, Delaye JB, Ropert M, Foucault A, Ravalet N, Deriaz S, Chalopin T, Blasco H, Maillot F, Hérault O, Gyan E. Megaloblastic anemia-related iron overload and erythroid regulators: a case report. J Med Case Rep 2021; 15:463. [PMID: 34538261 PMCID: PMC8451118 DOI: 10.1186/s13256-021-03065-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/16/2021] [Indexed: 01/28/2023] Open
Abstract
Background In ineffective erythropoiesis, hepcidin synthesis is suppressed by erythroid regulators, namely erythroferrone and growth differentiation factor-15. For the first time, the hypothesis that iron overload in megaloblastic anemia may be related to ineffective erythropoiesis is explored by describing the kinetics of hepcidin, erythroferrone, and growth differentiation factor-15 levels in a patient diagnosed with megaloblastic anemia associated with iron overload. Case presentation An 81-year-old Caucasian male was admitted for fatigue. He had type-2 diabetes previously treated with metformin, ischemic cardiac insufficiency, and stage-3 chronic kidney disease. Vitiligo was observed on both hands. Biological tests revealed normocytic non-regenerative anemia associated with hemolysis, thrombocytopenia, and elevated sideremia, ferritin, and transferrin saturation levels. Megaloblastic anemia was confirmed with undetectable blood vitamin B12 and typical cytological findings like hyper-segmented neutrophils in blood and megaloblasts in bone marrow. The patient received vitamin B12 supplementation. At 3 months, biological parameters reached normal values. Hepcidin kinetics from diagnosis to 3 months inversely correlated with those of erythroferrone and growth differentiation factor-15. Conclusions This case suggests that iron-overload mechanisms of dyserythropoietic anemias may apply to megaloblastic anemias.
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Affiliation(s)
- Nicolas Vallet
- Department of Hematology and Cell Therapy, Tours University Hospital, 2 Boulevard Tonnellé, 37044, Tours Cedex, France
| | - Jean-Baptiste Delaye
- Department of Biochemistry and Molecular Biology, Tours University Hospital, Tours, France
| | | | - Amélie Foucault
- Department of Biological Hematology, Tours University Hospital, Tours, France.,CNRS ERL7001 LNOX, EA 3549, Tours University, Tours, France
| | - Noémie Ravalet
- Department of Biological Hematology, Tours University Hospital, Tours, France.,CNRS ERL7001 LNOX, EA 3549, Tours University, Tours, France
| | - Sophie Deriaz
- Department of Internal Medicine, Tours University Hospital, Tours, France
| | - Thomas Chalopin
- Department of Hematology and Cell Therapy, Tours University Hospital, 2 Boulevard Tonnellé, 37044, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, Tours University Hospital, Tours, France
| | - François Maillot
- Department of Internal Medicine, Tours University Hospital, Tours, France
| | - Olivier Hérault
- Department of Biological Hematology, Tours University Hospital, Tours, France.,CNRS ERL7001 LNOX, EA 3549, Tours University, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, Tours University Hospital, 2 Boulevard Tonnellé, 37044, Tours Cedex, France. .,CNRS ERL7001 LNOX, EA 3549, Tours University, Tours, France.
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9
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Chalopin T, Vallet N, Theisen O, Ochmann M, Tiab M, Godmer P, Barin C, Hérault O, Gyan E, Le Gouill S, Avet-Loiseau H, Benboubker L, Moreau P, Touzeau C. No survival improvement in patients with high-risk multiple myeloma harbouring del(17p) and/or t(4;14) over the two past decades. Br J Haematol 2021; 194:635-638. [PMID: 33928635 DOI: 10.1111/bjh.17488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Thomas Chalopin
- Department of Hematology and Cell Therapy, Tours University Hospital, Tours, France
| | - Nicolas Vallet
- Department of Hematology and Cell Therapy, Tours University Hospital, Tours, France
| | - Olivier Theisen
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Marlène Ochmann
- Department of Hematology, Orleans Regional Hospital, Orleans, France
| | - Mourad Tiab
- Department of Hematology, La Roche-Sur-Yon Hospital, La Roche-Sur-Yon, France
| | - Pascal Godmer
- Department of Hematology, Vannes Hospital, Vannes, France
| | - Carole Barin
- Department of Cytogenetics, University Hospital of Tours, France
| | - Olivier Hérault
- Department of Biological Hematology, University Hospital of Tours, France.,CNRS ERL 7001 LNOx, University of Tours, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, Tours University Hospital, Tours, France.,CNRS ERL 7001 LNOx, University of Tours, Tours, France
| | - Steven Le Gouill
- Department of Hematology, University Hospital, Nantes, France.,CRCNA, INSERM, CNRS, University of Nantes, Nantes, France.,Site de Recherche Intégrée sur le Cancer (SIRIC) «ILIAD», Nantes, France
| | | | - Lotfi Benboubker
- Department of Hematology and Cell Therapy, Tours University Hospital, Tours, France
| | - Philippe Moreau
- Department of Hematology, University Hospital, Nantes, France.,CRCNA, INSERM, CNRS, University of Nantes, Nantes, France.,Site de Recherche Intégrée sur le Cancer (SIRIC) «ILIAD», Nantes, France
| | - Cyrille Touzeau
- Department of Hematology, University Hospital, Nantes, France.,CRCNA, INSERM, CNRS, University of Nantes, Nantes, France.,Site de Recherche Intégrée sur le Cancer (SIRIC) «ILIAD», Nantes, France
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10
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Chalopin T, Vallet N, Morel M, Maguet R, d'Alteroche L, de Pinieux G, Hérault O, Gyan E, Sutton L, Villate A. Eosinophilic fasciitis (Shulman syndrome), a rare entity and diagnostic challenge, as a manifestation of severe chronic graft-versus-host disease: a case report. J Med Case Rep 2021; 15:135. [PMID: 33722291 PMCID: PMC7958384 DOI: 10.1186/s13256-021-02735-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 02/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Shulman’s disease, or eosinophilic fasciitis (EF), is a rare autoimmune disease, characterized by sclerodermic skin lesions with progressive induration and thickening of the soft tissues. Chronic graft-versus-host-disease (GVHD) presenting as EF is a very rare manifestation of cutaneous GVHD. Case presentation We report an unusual case of EF in a 46-year-old Caucasian male patient who had received an allogenic hematopoietic stem cell transplantation in the context of relapsed/refractory multiple myeloma. The diagnosis was challenging, with the patient presenting hepatic dysfunction, normal eosinophils count, and incomplete clinical signs. Magnetic resonance imaging (MRI) and skin biopsy confirmed the diagnosis of EF. Early initiation of specific treatment with corticosteroids and prednisolone achieved complete response. Conclusion In practice, incomplete signs in this rare complication should lead to MRI as it is a major tool to guide decision-making based on the skin biopsy, allowing a rapid diagnosis and the initiation of treatment without delay.
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Affiliation(s)
- Thomas Chalopin
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Nicolas Vallet
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Marion Morel
- Department of Medical Imaging, University Hospital of Tours, Tours, France
| | - Raphael Maguet
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Louis d'Alteroche
- Department of Hepatology, University Hospital of Tours, Tours, France
| | | | - Olivier Hérault
- Department of Biological Hematology, University Hospital of Tours, Tours, France.,Groupe Innovation et Ciblage Cellulaire EA 7501, ERL 7001 LNOx, CNRS-University of Tours, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France.,Groupe Innovation et Ciblage Cellulaire EA 7501, ERL 7001 LNOx, CNRS-University of Tours, Tours, France.,Clinical Investigation Center, University Hospital of Tours-INSERM U1415, Tours, France
| | - Laurent Sutton
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Alban Villate
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France.
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11
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Vallet N, Boissel N, Elefant E, Chevillon F, Pasquer H, Calvo C, Dhedin N, Poirot C. Can Some Anticancer Treatments Preserve the Ovarian Reserve? Oncologist 2021; 26:492-503. [PMID: 33458904 DOI: 10.1002/onco.13675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Preventing premature ovarian failure (POF) is a major challenge in oncology. With conventional regimens, cytotoxicity-associated POF involves primordial follicles (PF) pool depletion by apoptosis or overactivation mechanisms, notably mediated by the ABL/TAp63 and PI3K/Akt/mTOR pathways. New anticancer treatments have been designed to target pathways implicated in tumor growth. Although concerns regarding fertility arise with these targeted therapies, we hypothesized that targeted therapies may exert off-tumor effects on PF that might delay POF. We provide an overview of evidence concerning these off-tumor effects on PF. Limitations and future potential implications of these findings are discussed. DESIGN PubMed was searched by combining Boolean operators with the following keywords: fertility, ovarian, follicle, anti-tumoral, cancer, targeted, cytotoxic, and chemotherapy. RESULTS Cisplatin-related PF apoptosis via the ABL/TAp63 pathway was targeted with a tyrosine kinase inhibitor, imatinib, in mice, but effects were recently challenged by findings on human ovarian xenografts in mice. In cyclophosphamide-treated mice, PI3K/Akt/mTOR pathway inhibition with mTOR inhibitors and AS101 preserved the PF pool. Proteasome and GSK3 inhibitors were evaluated for direct and indirect follicle DNA damage prevention. Surprisingly, evidence for cytotoxic drug association with PF pool preservation was found. We also describe selected non-anticancer molecules that may minimize gonadotoxicity. CONCLUSION Not all anticancer treatments are associated with POF, particularly since the advent of targeted therapies. The feasibility of associating a protective drug targeting PF exhaustion mechanisms with cytotoxic treatments should be evaluated, as a way of decreasing the need for conventional fertility preservation techniques. Further evaluations are required for transfer into clinical practice. IMPLICATIONS FOR PRACTICE Anticancer therapies are associated with infertility in 10%-70% of patients, which is the result of primordial follicles pool depletion. Alone or associated with gonadotoxic treatments, some targeted therapies may exert favorable off-targets effects on the primordial follicle pool by slowing down their exhaustion. Current evidence of these effects relies on murine models or human in vitro models. Evaluation of these protective strategies in humans is challenging; however, if these results are confirmed with clinical and biological data, it not only could be a new approach to female fertility preservation but also would change standard fertility strategies.
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Affiliation(s)
- Nicolas Vallet
- Department of Hematology and Cellular Therapy, Tours University Hospital, Tours, France
| | - Nicolas Boissel
- Department of Hematology, Adolescent and Young Adults Unit, Fertility Preservation, Saint Louis Hospital, AP-, HP, Paris, France.,Paris University, Paris, France
| | - Elisabeth Elefant
- Centre de Référence sur les Agents Tératogènes (CRAT), Armand Trousseau Hospital, AP-, HP, Paris, France.,Faculty of Medicine, Sorbonne University, Paris, France
| | - Florian Chevillon
- Department of Hematology, Adolescent and Young Adults Unit, Fertility Preservation, Saint Louis Hospital, AP-, HP, Paris, France
| | - Hélène Pasquer
- Department of Hematology, Adolescent and Young Adults Unit, Fertility Preservation, Saint Louis Hospital, AP-, HP, Paris, France
| | - Charlotte Calvo
- Pediatric Hematology Department, Robert Debré Hospital, AP-, HP, Paris, France
| | - Nathalie Dhedin
- Department of Hematology, Adolescent and Young Adults Unit, Fertility Preservation, Saint Louis Hospital, AP-, HP, Paris, France
| | - Catherine Poirot
- Department of Hematology, Adolescent and Young Adults Unit, Fertility Preservation, Saint Louis Hospital, AP-, HP, Paris, France.,Faculty of Medicine, Sorbonne University, Paris, France
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12
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Chalopin T, Vallet N, Benboubker L, Ochmann M, Gyan E, Chaumier F. Retrospective review of end-of-life care in the last month of life in older patients with multiple myeloma: what collaboration between haematologists and palliative care teams? BMJ Support Palliat Care 2020:bmjspcare-2020-002293. [PMID: 32887726 DOI: 10.1136/bmjspcare-2020-002293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Patients with haematological malignancies (HM) receive more aggressive treatments near the end-of-life (EOL) than patients with solid tumours. Palliative care (PC) needs are less widely acknowledged in patients with multiple myeloma (MM) than in other HM. The main objective of our study was to describe EOL care and PC referral in a population of older patients with MM. METHODS We retrospectively included deceased inpatients and outpatients with an MM previously diagnosed at the age of 70 and over in two tertiary centres in France. We reported EOL characteristics regarding treatments considered to be aggressive-antimyeloma therapies, hospitalisations, blood product transfusions, intensive care units (ICUs) or emergency admissions-and PC referral. RESULTS We included 119 patients. In their last month of life, 75 (63%) were hospitalised for fever, pain, asthenia, anaemia or bleeding, 49 (41%) were admitted in the emergency department and 12 (10%) in ICU, 76 (64%) still received antimyeloma therapy and 45 (38%) had at least two transfusions. Only 24 (20%) received PC intervention for pain, global care, family support, anxiety, social care or confusion. Median follow-up until death was 20 days. CONCLUSIONS Our study found a high rate of hospitalisations and antimyeloma therapies in the last month of life. The PC referral rate was low, often once specific treatments were stopped. Our results suggest the need for more effective collaboration between PC teams and haematologists in order to respond to the specific needs of these patients and to improve their quality of care at EOL.
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Affiliation(s)
- Thomas Chalopin
- Department of Haematology and Cell Therapy, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, France
| | - Nicolas Vallet
- Department of Haematology and Cell Therapy, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, France
| | - Lotfi Benboubker
- Department of Haematology and Cell Therapy, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, France
| | - Marlène Ochmann
- Department of Haematology, Regional Hospital Centre Orleans, Orleans, Centre-Val de Loire, France
| | - Emmanuel Gyan
- Department of Haematology and Cell Therapy, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, France
- CNRS ERL 7001 LNOx (Leukemic Niche & redOx metabolism), Université de Tours, Tours, Centre-Val de Loire, France
| | - François Chaumier
- Palliative Care Team, Regional University Hospital Centre Tours, Tours, Centre-Val de Loire, France
- UMR INSERM U1246 SPHERE (methodS in Patients-centered outcomes and HEalth ResEarch), Université de Tours, Tours, Centre-Val de Loire, France
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13
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Vallet N, Foucault A, Picou F, Gyan E, Herault O. Meta-analysis of case-control studies to examine the relationship between occupational pesticide exposure and risk of acute myeloid leukemia. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.7540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7540 Background: Occupational pesticide exposure (OPE) is associated with the risk of developing lymphoid malignancies, but less information is available on large cohorts about the risk of occurrence of acute myeloid leukemia (AML). To answer this question, we performed a meta-analysis including relevant adult case-control studies which reported OPE. Methods: Following PRISMA and MOOSE guidelines, two investigators performed a systematic search in PubMed and Cochrane databases for case-control studies evaluating the association between OPE and AML between 1946 and August 28, 2018. In order to identify the maximum number of studies, keywords related to demographical, pesticides and chemicals data exposures were used. Studies reporting AML diagnosis based only on death certificates, controls from cancer databases and pediatric cases (<15 years-old) were not included. Statistical analyses were performed with R software and the ‘mefafor’ package. Results: Fifteen studies which included 4,068 AML patients and 250,975 control subjects were included. Using a random effects model, the overall analysis showed a significant adverse association between OPE and AML with OR=1.49 (95%CI: 1.10-2.01), and a significant heterogeneity between studies ( I² =0.73, p<0.001). The robustness was checked after sequential exclusion of one study at a time which did not influence the overall OR estimate. A publication bias underestimating the OR was suggested by an asymmetrical funnel plot. Using trim-and-fill method, hypothetical missing studies were added studies in order to adjust the OR (OR=1.76 [95%CI: 1.30-2.38]. A stratified analysis showed that the association was significant in Asian populations (OR=1.74; 95%CI: 1.32-2.30) and upon exposure to insecticides (OR=1.45; 95%CI: 1.16-1.81), yet partly influenced by other factors, since most of the studies reported unadjusted results (n=8, 53%). Data on biological characteristics were unavailable to stratify patients according to AML molecular or cytogenetic characteristics. Conclusions: From this new extensive review and analysis, it clearly appears that AML should be considered as occupational illness in patients with demonstrated OPE. Further studies will have to focus on the biological effects of individual and pesticides cocktails in order to determine the pathogenesis mechanisms involved in leukemogenesis, and to improve individual protection.
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Affiliation(s)
- Nicolas Vallet
- Tours University Hospital and ERL7001 LNOX, EA 3549, Tours, France
| | - Amélie Foucault
- Tours University Hospital and CNRS ERL7001 LNOX, EA 3549, Tours, France
| | - Frederic Picou
- Tours University Hospital and CNRS ERL7001 LNOX, EA 3549, Tours, France
| | - Emmanuel Gyan
- Tours University Hospital and CNRS ERL7001 LNOX, EA7501, Tours, France
| | - Olivier Herault
- Tours University Hospital and CNRS ERL7001 LNOX, EA7501, Tours, France
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14
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Vallet N, Ertault M, Delaye JB, Chalopin T, Villate A, Drieu La Rochelle L, Lejeune J, Foucault A, Eloit M, Barin-Le Guellec C, Hérault O, Colombat P, Gyan E. Hypercalcemia is associated with a poor prognosis in lymphoma a retrospective monocentric matched-control study and extensive review of published reported cases. Ann Hematol 2020; 99:229-239. [PMID: 31907572 DOI: 10.1007/s00277-019-03890-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 12/06/2019] [Indexed: 12/14/2022]
Abstract
The prognostic significance of hypercalcemia in lymphoma has only been studied on small series to date. We conducted a retrospective, monocentric, matched-control study that aimed to compare the outcome of patients diagnosed with any histological subtype of lymphoma associated with hypercalcemia, at diagnosis or relapse, with a group of controls matched for histological and prognostic factors. Sixty-two and 118 comparable patients treated between 2000 and 2016 were included in hypercalcemia and control cohorts, respectively. Hypercalcemia was found mainly at diagnosis (71%) in higher-risk patients (prognosis scores ≥ 3, 76%) and those with diffuse large B cell lymphoma (67.7%), stage III/IV disease (91.9%), and elevated LDH (90.3%). Two-year progression-free survival (PFS) was shorter in the hypercalcemia than control cohort [30.1% (95% confidence interval (95% CI) 18.3-41.9) vs 63.9% (95% CI 5.1-72.7), p < 0.001]. Two-year overall survival (OS) was 40.6% (95% CI 28.1-53.1) and 77.7% (95% CI 70.1-85.3) in the hypercalcemia and control cohorts, respectively (p < 0.001). Hypercalcemia was independently associated with poor PFS [HR = 2.5 (95% CI 1.4-3.5)] and OS [HR = 4.7 (95% CI 2.8-7.8)] in multivariate analysis. Among the 40 patients who received autologous stem cell transplantation (ASCT), hypercalcemia was still associated with shorter OS [2-year OS: 65% (95% CI 40.1-89.9) vs 88.0 (95% CI 75.3-100), p = 0.04]. Hypercalcemia may be associated with chemo-resistance, given its impact on PFS and OS. Hence, these data suggest that alternate strategies for lymphoma patients with hypercalcemia should be developed.
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Affiliation(s)
- Nicolas Vallet
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Marjan Ertault
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Jean-Baptiste Delaye
- Department of Biochemistry and Molecular Biology, University Hospital, Tours, France
| | - Thomas Chalopin
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Alban Villate
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | | | - Julien Lejeune
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Amélie Foucault
- Department of Biological Hematology, University Hospital, Tours, France
| | - Martin Eloit
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | | | - Olivier Hérault
- Department of Biological Hematology, University Hospital, Tours, France.,CNRS ERL7001 LNOx "Leukemic Niche & Redox Metabolism", EA7501 GICC, Tours University, Tours, France
| | - Philippe Colombat
- Department of Hematology and Cell Therapy, University Hospital, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, University Hospital, Tours, France. .,CNRS ERL7001 LNOx "Leukemic Niche & Redox Metabolism", EA7501 GICC, Tours University, Tours, France. .,Department of Hematology and Cell Therapy, 2 Boulevard Tonnellé, 37044, Tours Cedex, France.
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15
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Brachet-Botineau M, Deynoux M, Vallet N, Polomski M, Juen L, Hérault O, Mazurier F, Viaud-Massuard MC, Prié G, Gouilleux F. A Novel Inhibitor of STAT5 Signaling Overcomes Chemotherapy Resistance in Myeloid Leukemia Cells. Cancers (Basel) 2019; 11:cancers11122043. [PMID: 31861239 PMCID: PMC6966442 DOI: 10.3390/cancers11122043] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/11/2019] [Accepted: 12/14/2019] [Indexed: 01/08/2023] Open
Abstract
Signal transducers and activators of transcription 5A and 5B (STAT5A and STAT5B) are crucial downstream effectors of tyrosine kinase oncogenes (TKO) such as BCR-ABL in chronic myeloid leukemia (CML) and FLT3-ITD in acute myeloid leukemia (AML). Both proteins have been shown to promote the resistance of CML cells to tyrosine kinase inhibitors (TKI) such as imatinib mesylate (IM). We recently synthesized and discovered a new inhibitor (17f) with promising antileukemic activity. 17f selectively inhibits STAT5 signaling in CML and AML cells by interfering with the phosphorylation and transcriptional activity of these proteins. In this study, the effects of 17f were evaluated on CML and AML cell lines that respectively acquired resistance to IM and cytarabine (Ara-C), a conventional therapeutic agent used in AML treatment. We showed that 17f strongly inhibits the growth and survival of resistant CML and AML cells when associated with IM or Ara-C. We also obtained evidence that 17f inhibits STAT5B but not STAT5A protein expression in resistant CML and AML cells. Furthermore, we demonstrated that 17f also targets oncogenic STAT5B N642H mutant in transformed hematopoietic cells.
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Affiliation(s)
- Marie Brachet-Botineau
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
| | - Margaux Deynoux
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
| | - Nicolas Vallet
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
- Service d’Hématologie et Thérapie Cellulaire, CHRU de Tours, 37000 Tours, France
| | - Marion Polomski
- IMT, GICC, EA 7501, University of Tours, 37000 Tours, France; (M.P.); (L.J.); (M.-C.V.-M.); (G.P.)
| | - Ludovic Juen
- IMT, GICC, EA 7501, University of Tours, 37000 Tours, France; (M.P.); (L.J.); (M.-C.V.-M.); (G.P.)
| | - Olivier Hérault
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
- Service d’Hematologie Biologique, CHRU de Tours, 37000 Tours, France
| | - Frédéric Mazurier
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
| | | | - Gildas Prié
- IMT, GICC, EA 7501, University of Tours, 37000 Tours, France; (M.P.); (L.J.); (M.-C.V.-M.); (G.P.)
| | - Fabrice Gouilleux
- LNOx, GICC, CNRS ERL 7001, University of Tours, 37000 Tours, France; (M.B.-B.); (M.D.); (N.V.); (O.H.); (F.M.)
- Correspondence: ; Tel.: +33-(2)-47-36-62-91
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16
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Chalopin T, Vallet N, Arbion F, Barin C, Rault E, Villate A, Eloit M, La Rochelle LD, Foucault A, Ertault M, Dartigeas C, Benboubker L, Estienne MH, Domenech J, Hérault O, Gyan E. Characteristics, combinations, treatments, and survival of second primary hematological neoplasm: a retrospective single-center cohort of 49 patients (Hemo 2study). Ann Hematol 2019; 98:2367-2377. [PMID: 31455988 DOI: 10.1007/s00277-019-03778-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
Abstract
The coexistence of dual hematological neoplasms is very rare. Sequential or synchronous neoplasms in hematology are an uncommon and complex clinical situation. The aim of the Hemo2 study was to describe the clinical characteristics and analyze the outcome of these patients. We performed a retrospective review of all patients diagnosed with sequential or synchronous hematological malignancies in the university hospital of Tours, between 2007 and 2018. We identified 49 patients in our study, with a prevalence of 0.89%. Sequential and synchronous combinations were found in 36 (73%) and 13 (27%) patients, respectively. One patient presented three sequential neoplasms. The median cumulative incidence was 6 years (95% CI 3-7). Among all neoplasms diagnosed (n = 99), we found 79 lymphoid neoplasms (LNs) (80%) and 20 myeloid neoplasms (MNs) (20%). Sex ratio was 1.88 with 65% of males and 35% of females. The most common LNs were Hodgkin lymphoma (n = 16; 16%) and multiple myeloma (n = 11; 11%). The most frequent MN was essential thrombocythemia (n = 5; 5%). The most common combination was Hodgkin lymphoma and follicular lymphoma in five (10%) patients. The overall survival from the first diagnosis (OS1) at 5 years was 82.4% (95% CI 72.1-94.3). The median overall survival from the second diagnosis (OS2) was 98 months (95% CI 44-NR) and 5-year OS2 was 58.7% (95% CI 45.5-75.7). Median progression-free survival from the second diagnosis (PFS) was 47 months (95% CI 27-NR) with 5-year PFS of 49% (95% CI 35.9-67). OS and PFS did not statistically differ between synchronous and sequential dual neoplasms. In this cohort, that the death relative risk (RR) was significantly lower if the second neoplasm appeared after more than 4 years following the first diagnosis (OR 0.37 (95% CI 0.16-0.90)). The Hemo2study confirmed the rarity of dual hematological neoplasms. In this cohort, HL and FL were the most frequent combinations. Our results may support that synchronous and sequential dual neoplasms bear the same prognosis. Further studies are needed to better characterize these uncommon clinical situations.
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Affiliation(s)
- Thomas Chalopin
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Nicolas Vallet
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Flavie Arbion
- Department of Pathology, University Hospital of Tours, Tours, France
| | - Carole Barin
- Department of Cytogenetics, University Hospital of Tours, Tours, France
| | - Emmanuelle Rault
- Department of Biological Hematology, University Hospital of Tours, Tours, France
| | - Alban Villate
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Martin Eloit
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Laurianne Drieu La Rochelle
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Amélie Foucault
- Department of Biological Hematology, University Hospital of Tours, Tours, France
| | - Marjan Ertault
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Caroline Dartigeas
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | - Lotfi Benboubker
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France
| | | | - Jorge Domenech
- Department of Biological Hematology, University Hospital of Tours, Tours, France.,University of Tours, CNRS ERL 7001 LNOx and EA 7501, Tours, France
| | - Olivier Hérault
- Department of Biological Hematology, University Hospital of Tours, Tours, France.,University of Tours, CNRS ERL 7001 LNOx and EA 7501, Tours, France
| | - Emmanuel Gyan
- Department of Hematology and Cell Therapy, University Hospital of Tours, 2 Boulevard Tonnellé, 37044, Tours Cedex 9, France. .,University of Tours, CNRS ERL 7001 LNOx and EA 7501, Tours, France. .,Clinical Investigation Center, University Hospital of Tours, INSERM U1415, Tours, France.
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17
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Picou F, Debeissat C, Bourgeais J, Gallay N, Ferrié E, Foucault A, Ravalet N, Maciejewski A, Vallet N, Ducrocq E, Haddaoui L, Domenech J, Hérault O, Gyan E. n-3 Polyunsaturated fatty acids induce acute myeloid leukemia cell death associated with mitochondrial glycolytic switch and Nrf2 pathway activation. Pharmacol Res 2018; 136:45-55. [DOI: 10.1016/j.phrs.2018.08.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/03/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
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18
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Khanna RK, Vallet N, Fromont-Hankard G, Pisella PJ, Le Lez ML. Pseudo-panuveitis masquerade syndrome associated with an orbital and systemic MALT-type B-cell lymphoma. J Fr Ophtalmol 2018; 41:e125-e128. [PMID: 29567022 DOI: 10.1016/j.jfo.2017.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/12/2017] [Accepted: 10/16/2017] [Indexed: 10/17/2022]
Affiliation(s)
- R K Khanna
- Service d'ophtalmologie, CHRU Bretonneau, université François-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours, France.
| | - N Vallet
- Service d'hématologie et thérapie cellulaire, CHRU Bretonneau, 37044 Tours, France
| | - G Fromont-Hankard
- Service d'anatomopathologie, CHRU Bretonneau, université François-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - P-J Pisella
- Service d'ophtalmologie, CHRU Bretonneau, université François-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours, France
| | - M-L Le Lez
- Service d'ophtalmologie, CHRU Bretonneau, université François-Rabelais de Tours, 2, boulevard Tonnellé, 37044 Tours, France
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Vallet N, de Fontbrune FS, Loschi M, Desmier D, Villate A, Barraco F, Chevallier P, Terriou L, Yakoub-Agha I, Ruggeri A, Mohty M, Maillard N, Rohrlich PS, Ceballos P, Nguyen S, Poiré X, Guillerm G, Tabrizi R, Farhi J, Devillier R, Rubio MT, Socié G, de Latour RP. Hematopoietic stem cell transplantation for patients with paroxysmal nocturnal hemoglobinuria previously treated with eculizumab: a retrospective study of 21 patients from SFGM-TC centers. Haematologica 2017; 103:e103-e105. [PMID: 29269526 DOI: 10.3324/haematol.2017.182360] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Mohamad Mohty
- Hematology Department, Saint Antoine Hospital, Paris, France
| | | | | | | | - Stéphanie Nguyen
- Hematology Department, Pitié Salpêtrière Hospital, Paris, France
| | | | | | | | | | | | | | - Gérard Socié
- Hematology Department, Saint Louis Hospital, Paris, France
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20
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Bugeaud J, Colombat P, Vallet N, Hardouin C, Thibault N. [Infections of implantable ports in haematology patients]. Rev Infirm 2017; 66:41-43. [PMID: 28865699 DOI: 10.1016/j.revinf.2017.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
From 2010 to 2015, a study analysed the infections of implantable ports in haematology patients. Communication, collaboration and diligence were some of the main issues raised.
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Affiliation(s)
- Julie Bugeaud
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France.
| | - Philippe Colombat
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Nicolas Vallet
- Service d'hématologie et thérapie cellulaire, Unité stérile de soins intensifs, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Christelle Hardouin
- Service de néphrologie, CHRU Bretonneau, 2 boulevard Tonnellé, 37000 Tours, France
| | - Nathalie Thibault
- Service de soins palliatifs, Centre hospitalier de Luynes, 28 avenue du clos Mignot, 37230 Luynes, France
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21
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Chaumier F, Gyan E, Vallet N, Hérault B, Mallet D. Acute Myeloblastic Leukemia in the Elderly: How Could Palliative Care Teams and Hematologists Better Work Together? J Palliat Med 2016; 19:906-7. [DOI: 10.1089/jpm.2016.0157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- François Chaumier
- Palliative Care Team, CHRU de Tours, Tours, France
- Medicine Faculty, Université François Rabelais de Tours, Tours, France
| | - Emmanuel Gyan
- Department of Hematology, CHRU de Tours, Tours, France
- UMR CNRS 7292, Université François Rabelais de Tours, Tours, France
| | | | - Béatrice Hérault
- Etablissement Français du Sang Centre Atlantique, CHRU de Tours, Tours, France
| | - Donatien Mallet
- Palliative Care Unit, Centre Hospitalier Jean Pagès, Luynes, France
- Equipe “Education, Ethique, Santé”, Université François Rabelais de Tours, Tours, France
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22
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Rubio B, Vallet N, Rigal N. Food behaviours in children aged 5–8 years-old: factors determining neophobia and preferences. Appetite 2006. [DOI: 10.1016/j.appet.2006.07.059] [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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