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Al Saati A, Vande Perre P, Plenecassagnes J, Gilhodes J, Monselet N, Cabarrou B, Lignon N, Filleron T, Telly D, Perello-Lestrade E, Feillel V, Staub A, Martinez M, Chipoulet E, Collet G, Thomas F, Gladieff L, Toulas C. Multigene Panel Sequencing Identifies a Novel Germline Mutation Profile in Male Breast Cancer Patients. Int J Mol Sci 2023; 24:14348. [PMID: 37762649 PMCID: PMC10531866 DOI: 10.3390/ijms241814348] [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: 08/16/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Even though male breast cancer (MBC) risk encompasses both genetic and environmental aetiologies, the primary risk factor is a germline pathogenic variant (PV) or likely pathogenic variant (LPV) in BRCA2, BRCA1 and/or PALB2 genes. To identify new potential MBC-specific predisposition genes, we sequenced a panel of 585 carcinogenesis genes in an MBC cohort without BRCA1/BRCA2/PALB2 PV/LPV. We identified 14 genes carrying rare PVs/LPVs in the MBC population versus noncancer non-Finnish European men, predominantly coding for DNA repair and maintenance of genomic stability proteins. We identified for the first time PVs/LPVs in PRCC (pre-mRNA processing), HOXA9 (transcription regulation), RECQL4 and WRN (maintenance of genomic stability) as well as in genes involved in other cellular processes. To study the specificity of this MBC PV/LPV profile, we examined whether variants in the same genes could be detected in a female breast cancer (FBC) cohort without BRCA1/BRCA2/PALB2 PV/LPV. Only 5/109 women (4.6%) carried a PV/LPV versus 18/85 men (21.2%) on these genes. FBC did not carry any PV/LPV on 11 of these genes. Although 5.9% of the MBC cohort carried PVs/LPVs in PALLD and ERCC2, neither of these genes were altered in our FBC cohort. Our data suggest that in addition to BRCA1/BRCA2/PALB2, other genes involved in DNA repair/maintenance or genomic stability as well as cell adhesion may form a specific MBC PV/LPV signature.
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Affiliation(s)
- Ayman Al Saati
- Oncogenetics Laboratory, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (A.A.S.); (D.T.); (E.P.-L.)
- DIAD, Inserm, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France;
- Université de Toulouse, Université Toulouse III-Paul Sabatier, Toulouse, France
| | - Pierre Vande Perre
- Oncogenetics Laboratory, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (A.A.S.); (D.T.); (E.P.-L.)
- DIAD, Inserm, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France;
| | - Julien Plenecassagnes
- Bioinformatics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France;
| | - Julia Gilhodes
- Biostatistics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (J.G.); (N.M.); (B.C.); (T.F.)
| | - Nils Monselet
- Biostatistics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (J.G.); (N.M.); (B.C.); (T.F.)
| | - Bastien Cabarrou
- Biostatistics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (J.G.); (N.M.); (B.C.); (T.F.)
| | - Norbert Lignon
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | - Thomas Filleron
- Biostatistics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (J.G.); (N.M.); (B.C.); (T.F.)
| | - Dominique Telly
- Oncogenetics Laboratory, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (A.A.S.); (D.T.); (E.P.-L.)
| | - Emilie Perello-Lestrade
- Oncogenetics Laboratory, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (A.A.S.); (D.T.); (E.P.-L.)
| | - Viviane Feillel
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | - Anne Staub
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | | | - Edith Chipoulet
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | - Gaëlle Collet
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | - Fabienne Thomas
- DIAD, Inserm, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France;
- Université de Toulouse, Université Toulouse III-Paul Sabatier, Toulouse, France
- Pharmacology Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Laurence Gladieff
- Oncogenetics Department, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (N.L.); (V.F.); (A.S.); (E.C.); (G.C.); (L.G.)
| | - Christine Toulas
- Oncogenetics Laboratory, Oncopole Claudius Regaud, IUCT-Oncopole, Toulouse, France; (A.A.S.); (D.T.); (E.P.-L.)
- DIAD, Inserm, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France;
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Dumas E, Laot L, Coussy F, Grandal Rejo B, Daoud E, Laas E, Kassara A, Majdling A, Kabirian R, Jochum F, Gougis P, Michel S, Houzard S, Le Bihan-Benjamin C, Bousquet PJ, Hotton J, Azencott CA, Reyal F, Hamy AS. The French Early Breast Cancer Cohort (FRESH): A Resource for Breast Cancer Research and Evaluations of Oncology Practices Based on the French National Healthcare System Database (SNDS). Cancers (Basel) 2022; 14:cancers14112671. [PMID: 35681651 PMCID: PMC9179405 DOI: 10.3390/cancers14112671] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/27/2022] [Revised: 05/10/2022] [Accepted: 05/22/2022] [Indexed: 12/10/2022] Open
Abstract
Simple Summary Because of an important disparity of care pathways and quality of care among women diagnosed with an early-stage breast cancer, we aimed to create a unique cohort of patients including all French women aged 18 years or over, treated by surgery and registered in the general health insurance coverage plan. After aggregating and annotating medico-administrative data on 235,368 early breast cancer patients, we open up perspectives for research on adverse effects, morbidity, mortality, the monitoring of care consumption, or medical-economic studies. We describe data sources, inclusion, and exclusion criteria, basic descriptive analyses, and longitudinal trends over time. Abstract Background: Breast cancer (BC) is the most frequent cancer and the leading cause of cancer-related death in women. The French National Cancer Institute has created a national cancer cohort to promote cancer research and improve our understanding of cancer using the National Health Data System (SNDS) and amalgamating all cancer sites. So far, no detailed separate data are available for early BC. Objectives: To describe the creation of the French Early Breast Cancer Cohort (FRESH). Methods: All French women aged 18 years or over, with early-stage BC newly diagnosed between 1 January 2011 and 31 December 2017, treated by surgery, and registered in the general health insurance coverage plan were included in the cohort. Patients with suspected locoregional or distant metastases at diagnosis were excluded. BC treatments (surgery, chemotherapy, targeted therapy, radiotherapy, and endocrine therapy), and diagnostic procedures (biopsy, cytology, and imaging) were extracted from hospital discharge reports, outpatient care notes, or pharmacy drug delivery data. The BC subtype was inferred from the treatments received. Results: We included 235,368 patients with early BC in the cohort (median age: 60 years). The BC subtype distribution was as follows: luminal (80.2%), triple-negative (TNBC, 9.5%); HER2+ (10.3%), or unidentifiable (n = 44,388, 18.9% of the cohort). Most patients underwent radiotherapy (n = 200,685, 85.3%) and endocrine therapy (n = 165,655, 70.4%), and 38.3% (n = 90,252) received chemotherapy. Treatments and care pathways are described. Conclusions: The FRESH Cohort is an unprecedented population-based resource facilitating future large-scale real-life studies aiming to improve care pathways and quality of care for BC patients.
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Affiliation(s)
- Elise Dumas
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
- INSERM, U900, 75005 Paris, France;
- MINES ParisTech, CBIO-Centre for Computational Biology, PSL Research University, 75006 Paris, France
| | - Lucie Laot
- Department of Surgical Oncology, Institut Curie, University of Paris, 75005 Paris, France; (L.L.); (E.L.); (S.M.)
| | - Florence Coussy
- Department of Medical Oncology, Institut Curie, University of Paris, 75005 Paris, France;
| | - Beatriz Grandal Rejo
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
| | - Eric Daoud
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
- INRIA, DI/ENS, PSL Research University, 75006 Paris, France
| | - Enora Laas
- Department of Surgical Oncology, Institut Curie, University of Paris, 75005 Paris, France; (L.L.); (E.L.); (S.M.)
| | - Amyn Kassara
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
| | - Alena Majdling
- Centre René Hughenin, Medical Oncology Department, 92210 Saint Cloud, France; (A.M.); (R.K.)
| | - Rayan Kabirian
- Centre René Hughenin, Medical Oncology Department, 92210 Saint Cloud, France; (A.M.); (R.K.)
| | - Floriane Jochum
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
- Department of Gynecology, Strasbourg University Hospital, 67091 Strasbourg, France
| | - Paul Gougis
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
| | - Sophie Michel
- Department of Surgical Oncology, Institut Curie, University of Paris, 75005 Paris, France; (L.L.); (E.L.); (S.M.)
| | - Sophie Houzard
- Survey Data Science and Assessment Division, French National Cancer Institute (Institut National du Cancer INCa), 92100 Boulogne-Billancourt, France; (S.H.); (C.L.B.-B.); (P.-J.B.)
| | - Christine Le Bihan-Benjamin
- Survey Data Science and Assessment Division, French National Cancer Institute (Institut National du Cancer INCa), 92100 Boulogne-Billancourt, France; (S.H.); (C.L.B.-B.); (P.-J.B.)
| | - Philippe-Jean Bousquet
- Survey Data Science and Assessment Division, French National Cancer Institute (Institut National du Cancer INCa), 92100 Boulogne-Billancourt, France; (S.H.); (C.L.B.-B.); (P.-J.B.)
- Inserm, IRD, SESSTIM, Equipe Labellisée Ligue Contre le Cancer, Aix-Marseille Université, 13005 Marseille, France
| | - Judicaël Hotton
- Department of Surgery, Institut Jean Godinot, 51100 Reims, France;
| | - Chloé-Agathe Azencott
- INSERM, U900, 75005 Paris, France;
- MINES ParisTech, CBIO-Centre for Computational Biology, PSL Research University, 75006 Paris, France
- Institut Curie, PSL Research University, 75005 Paris, France
| | - Fabien Reyal
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
- Department of Surgical Oncology, Institut Curie, University of Paris, 75005 Paris, France; (L.L.); (E.L.); (S.M.)
- Department of Surgery, Institut Jean Godinot, 51100 Reims, France;
| | - Anne-Sophie Hamy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, 75005 Paris, France; (E.D.); (B.G.R.); (E.D.); (A.K.); (F.J.); (P.G.); (F.R.)
- Centre René Hughenin, Medical Oncology Department, 92210 Saint Cloud, France; (A.M.); (R.K.)
- Correspondence:
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Simonet D. French Idiosyncratic Health-Care Reforms, Performance Management and Its Political Repercussions. Risk Manag Healthc Policy 2021; 14:2971-2981. [PMID: 34285611 PMCID: PMC8286423 DOI: 10.2147/rmhp.s306381] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/23/2021] [Indexed: 11/23/2022] Open
Abstract
Context France has undergone major changes in social policy that made an impact on the health-care sector. The paper reminds readers of the application and shortcomings of the concept of New Public Management (NPM) in the French health system. Problem The paper investigates NPM health reforms in France. Reforms aimed at containing costs. What administrative restructuring was implemented? What were reform idiosyncrasies? What were their limitations? Which critical public health emergencies remain? Methods We examine the political and economic context of health-care reforms, the rise of the regulatory state, and its core element: the diagnostic-related group (DRG) scale. We critically examine the recentralization of health policy decisions and its impact on care providers and provide an international perspective on reforms. Results Reforms put priority on the use of yardsticks and also emphasized regulation and competition but rejected public–private partnerships on the Anglo-Saxon model. Central health authorities regain their authority over health policy decisions, and decentralization was weakened. Conclusion Restrictions in public service delivery triggered a general discontent among the population. The political repercussions of reforms eventually crystallized into the Yellow Vest movement.
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Affiliation(s)
- Daniel Simonet
- Management Department, School of Business and Management, American University of Sharjah, Sharjah, United Arab Emirates
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Taha MK, Weil-Olivier C, Bouée S, Emery C, Nachbaur G, Pribil C, Loncle-Provot V. Risk factors for invasive meningococcal disease: a retrospective analysis of the French national public health insurance database. Hum Vaccin Immunother 2021; 17:1858-1866. [PMID: 33449835 PMCID: PMC8115611 DOI: 10.1080/21645515.2020.1849518] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Indexed: 12/12/2022] Open
Abstract
Vaccination of at-risk populations against Neisseria meningitidis is an important strategy to prevent invasive meningococcal disease (IMD). The objective of this study was to characterize preexisting risk factors in patients with IMD and to compare their relative importance. This case-control analysis was performed in the French national public health insurance database (SNDS). Cases consisted of all people hospitalized for IMD in France over a six-year period (2012–2017). Controls were matched by age, gender, and district of residence. Medical risk factors were identified from ICD-10 codes in the SNDS. Socioeconomic risk factors studied were low household income and social deprivation of the municipality of residence. Associations of these risk factors with hospitalization for IMD were quantified as odds ratios (ORs) between cases and controls with their 95% confidence intervals (95%CI). The medical risk factors showing the most robust associations were congenital immunodeficiency (OR: 39.1 [95%CI: 5.1–299], acquired immunodeficiency (10.3 [4.5–24.0]) and asplenia/hyposplenia (6.7 [3.7–14.7]). In addition, certain chronic medical conditions, such as autoimmune disorders (5.4 [2.5–11.8]), hemophilia (4.7 [1.8–12.2]) and severe chronic respiratory disorders (4.3 [3.1–6.2]) were also strongly associated, as was low household income (1.68 [1.49–1.80]). In conclusion, this study has documented potential risk factors associated with hospitalization for IMD in a large and comprehensive sample of individuals with IMD in France. Several of the risk factors identified may help identify groups who could benefit from targeted prevention measures (such as vaccination) in order to reduce the burden of IMD.
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Affiliation(s)
| | | | | | | | | | - Céline Pribil
- Vaccine Medical Department, GSK, Rueil-Malmaison, France
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Lamure S, Duléry R, Di Blasi R, Chauchet A, Laureana C, Deau-Fischer B, Drenou B, Soussain C, Rossi C, Noël N, Choquet S, Bologna S, Joly B, Kohn M, Malak S, Fouquet G, Daguindau E, Bernard S, Thiéblemont C, Cartron G, Lacombe K, Besson C. Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study. EClinicalMedicine 2020; 27:100549. [PMID: 33073216 PMCID: PMC7550257 DOI: 10.1016/j.eclinm.2020.100549] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/29/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with lymphoma are immunocompromised because of the disease per se and its treatments. We aimed to describe the characteristics of patients with lymphoma hospitalized for Coronavirus Disease 2019 (Covid-19) and to analyze pre-Covid-19 determinants of mortality. METHODS This retrospective multicentric cohort study used the Programme de Médicalisation des Systèmes d'Information database to identify all adult patients with lymphoma, hospitalized for Covid-19 in March and April 2020, in 12 hospitals of three French regions with pandemic outbreaks. The characteristics of lymphoma and Covid-19 were collected from medical charts. FINDINGS Eighty-nine patients were included. The median age was 67 years (range, 19-92), 66% were male and 72% had a comorbidity. Most patients had B-cell non-Hodgkin lymphoma (86%) and had received a lymphoma treatment within one year (70%). With a median follow-up of 33 days from admission, 30-day overall survival was 71%, (95% confidence interval, 62-81%). In multivariable analysis, having an age ≥ 70 years (hazard ratio 2·87, 1·20-6·85, p = 0·02) and relapsed/refractory lymphoma (hazard ratio 2·54, 1·14-5·66, p = 0·02) were associated with mortality. Recent bendamustine treatment (n = 9) was also pejorative (hazard ratio 3·20, 1·33-7·72, p = 0·01), but was strongly associated with relapsed/refractory lymphoma. Remarkably, 30-day overall survival for patients < 70 years of age without relapsed/refractory lymphoma was 88% (78% - 99%). INTERPRETATION Thirty-day mortality was associated with being older and relapsed/refractory lymphoma. Survival of patients younger than 70 years without relapsed/refractory lymphoma was comparable to that of the general population. FUNDING There have been no specific funds to run this study.
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Affiliation(s)
- Sylvain Lamure
- Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France
| | - Rémy Duléry
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Inserm UMRs 938, Sorbonne Université, Paris, France
| | - Roberta Di Blasi
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | | | - Cécile Laureana
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
| | - Bénédicte Deau-Fischer
- Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Bernard Drenou
- Département d'Hématologie Groupe Hospitalier de Mulhouse Sud Alsace, Mulhouse, France
| | - Carole Soussain
- Département d'Oncologie médicale – Hématologie, Institut Curie, Saint Cloud, France
| | - Cédric Rossi
- Service d'Hématologie Clinique, CHU de Dijon Bourgogne, Dijon, France
| | - Nicolas Noël
- Service de Médecine Interne – Immunologie, Hôpital Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | - Sylvain Choquet
- Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Serge Bologna
- Service d'Hématologie, Centre d'Oncologie de Gentilly, Nancy, France
| | - Bertrand Joly
- Service d'Hématologie, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | - Milena Kohn
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
| | - Sandra Malak
- Département d'Oncologie médicale – Hématologie, Institut Curie, Saint Cloud, France
| | - Guillemette Fouquet
- Service d'Hématologie Clinique, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Paris, France
| | | | - Sophie Bernard
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | - Catherine Thiéblemont
- Service d'Hématologie-Oncologie, Hôpital St Louis, Assistance Publique - Hôpitaux de Paris ; Université de Paris – Diderot, Paris, France
| | - Guillaume Cartron
- Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France
| | - Karine Lacombe
- Sorbonne Université, Inserm IPLESP, Service des Maladies Infectieuses et Tropicales, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Caroline Besson
- Service d'Hématologie Oncologie, Centre Hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay Cedex, France
- Université Paris-Saclay, UVSQ, Montigny le Bretonneux; Inserm U1018, CESP, Villejuif, France
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