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Petit C, Saillard C, Mohty B, Hicheri Y, Villetard F, Maisano V, Charbonnier A, Rey J, D'Incan E, Rouzaud C, Gelsi-Boyer V, Murati A, Lhoumeau AC, Ittel A, Mozziconacci MJ, Alary AS, Hospital MA, Vey N, Garciaz S. Azacitidine-venetoclax versus azacitidine salvage treatment for primary induction failure or first relapsed acute myeloid leukaemia patients. Eur J Haematol 2024; 112:530-537. [PMID: 38031389 DOI: 10.1111/ejh.14140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVES To compare the efficacy of venetoclax-azacitidine (VEN-AZA) with AZA in the real-life for patients with first relapsed or refractory acute myeloid leukaemia (R/R AML). METHODS We retrospectively analysed R/R AML patients treated with VEN-AZA at the Institut Paoli Calmettes between September 2020 and February 2022. We compared them to a historical cohort of patients treated with AZA between 2010 and 2021. RESULTS Thirty-five patients treated with VEN-AZA were compared with 140 patients treated with AZA. There were more favourable cytogenetics (25.7% vs. 8.6%; p = 0.01) and less FLT3-ITD mutated AML (8.8% vs. 25.5%; p = .049) in the VEN-AZA group. The overall 30-day mortality rate was 7.4% and the overall 90-day mortality was 20%, with no difference between the groups. The complete remission rate was 48.6% in the VEN-AZA group versus 15% (p < .0001). The composite complete response rate was 65.7% in the VEN-AZA group versus 23.6% (p < .0001). OS was 12.8 months in the VEN-AZA group versus 7.3 months (p = 0.059). Patients with primary refractory AML, poor-risk cytogenetics, prior hematopoietic stem-cell transplantation (HSCT) and FLT3-ITD mutated AML had lower response and survival rates. CONCLUSION VEN-AZA was associated with a better response rate and a longer survival than AZA monotherapy in AML patients who relapsed after or were refractory to intensive chemotherapy.
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Affiliation(s)
- C Petit
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - C Saillard
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - B Mohty
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - Y Hicheri
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - F Villetard
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - V Maisano
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - A Charbonnier
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - J Rey
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - E D'Incan
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - C Rouzaud
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - V Gelsi-Boyer
- Département de Biologie des Tumeurs CRCM, Inserm, CNRS, Institut Paoli-Calmettes, Aix-Marseille Univ, Marseille, France
| | - A Murati
- Département de Biologie des Tumeurs, Institut Paoli-Calmettes, Marseille, France
| | - A C Lhoumeau
- Département de Biologie des Tumeurs, Institut Paoli-Calmettes, Marseille, France
| | - A Ittel
- Département de Biologie des Tumeurs, Institut Paoli-Calmettes, Marseille, France
| | - M J Mozziconacci
- Département de Biologie des Tumeurs, Institut Paoli-Calmettes, Marseille, France
| | - A S Alary
- Département de Biologie des Tumeurs, Institut Paoli-Calmettes, Marseille, France
| | - M-A Hospital
- Département d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - N Vey
- Département d'hématologie, CRCM, Inserm, CNRS, Institut Paoli-Calmettes, Aix-Marseille Univ, Marseille, France
| | - S Garciaz
- Département d'hématologie, CRCM, Inserm, CNRS, Institut Paoli-Calmettes, Aix-Marseille Univ, Marseille, France
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Collignon A, Hospital MA, Montersino C, Courtier F, Charbonnier A, Saillard C, D'Incan E, Mohty B, Guille A, Adelaïde J, Carbuccia N, Garnier S, Mozziconacci MJ, Zemmour C, Pakradouni J, Restouin A, Castellano R, Chaffanet M, Birnbaum D, Collette Y, Vey N. A chemogenomic approach to identify personalized therapy for patients with relapse or refractory acute myeloid leukemia: results of a prospective feasibility study. Blood Cancer J 2020; 10:64. [PMID: 32488055 PMCID: PMC7266815 DOI: 10.1038/s41408-020-0330-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/06/2020] [Accepted: 04/23/2020] [Indexed: 02/05/2023] Open
Abstract
Targeted next-generation sequencing (tNGS) and ex vivo drug sensitivity/resistance profiling (DSRP) have laid foundations defining the functional genomic landscape of acute myeloid leukemia (AML) and premises of personalized medicine to guide treatment options for patients with aggressive and/or chemorefractory hematological malignancies. Here, we have assessed the feasibility of a tailored treatment strategy (TTS) guided by systematic parallel ex vivo DSRP and tNGS for patients with relapsed/refractory AML (number NCT02619071). A TTS issued by an institutional personalized committee could be achieved for 47/55 included patients (85%), 5 based on tNGS only, 6 on DSRP only, while 36 could be proposed on the basis of both, yielding more options and a better rationale. The TSS was available in <21 days for 28 patients (58.3%). On average, 3 to 4 potentially active drugs were selected per patient with only five patient samples being resistant to the entire drug panel. Seventeen patients received a TTS-guided treatment, resulting in four complete remissions, one partial remission, and five decreased peripheral blast counts. Our results show that chemogenomic combining tNGS with DSRP to determine a TTS is a promising approach to propose patient-specific treatment options within 21 days.
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Affiliation(s)
- A Collignon
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - M A Hospital
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - C Montersino
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - F Courtier
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - A Charbonnier
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - C Saillard
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - E D'Incan
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - B Mohty
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France
| | - A Guille
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - J Adelaïde
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - N Carbuccia
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - S Garnier
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - M J Mozziconacci
- Department of Biopathology, Institut Paoli-Calmettes, Marseille, France
| | - C Zemmour
- Department of Clinical Research & Innovation, Institut Paoli-Calmettes, Biostatistics & Methodology Unit, Aix Marseille Université, INSERM, IRD, SESSTIM, Marseille, France
| | - J Pakradouni
- Department of Clinical Research & Innovation, Sponsor Unit, Institut Paoli-Calmettes, Marseille, France
| | - A Restouin
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - R Castellano
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France
| | - M Chaffanet
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France
| | - D Birnbaum
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Predictive Oncology, Aix-Marseille Université, Marseille, France.
| | - Y Collette
- Inserm, CNRS, Institut Paoli-Calmettes, CRCM, TrGET Preclinical Platform, Aix-Marseille Université, Marseille, France.
| | - N Vey
- Haematology Department, Institut Paoli-Calmettes, Aix-Marseille Université, Marseille, France.
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Crocchiolo R, Castagna L, Furst S, Devillier R, Sarina B, Bramanti S, El-Cheikh J, Granata A, Harbi S, Morabito L, Faucher C, Rimondo A, Girardi D, Mohty B, Calmels B, Carlo-Stella C, Chabannon C, Bouabdallah R, Santoro A, Vey N, Weiller PJ, Blaise D. The patient’s CMV serological status affects clinical outcome after T-cell replete haplo-HSCT and post-transplant cyclophosphamide. Bone Marrow Transplant 2016; 51:1134-6. [DOI: 10.1038/bmt.2016.69] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Castagna L, Bramanti S, Furst S, Giordano L, Sarina B, Crocchiolo R, El-Cheikh J, Cheikh JE, Granata A, Morabito L, Mauro E, Faucher C, Mohty B, Harbi S, Devillier R, Chabannon C, Carlo-Stella C, Santoro A, Blaise D. Tacrolimus compared with cyclosporine A after haploidentical T-cell replete transplantation with post-infusion cyclophosphamide. Bone Marrow Transplant 2015; 51:462-5. [PMID: 26595078 DOI: 10.1038/bmt.2015.289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L Castagna
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - S Bramanti
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - S Furst
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - L Giordano
- Statistic Unit, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - B Sarina
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - R Crocchiolo
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | | | - J El Cheikh
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - A Granata
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - L Morabito
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - E Mauro
- Department of Hematology, Ospedale Ferrarotto, Catania, Italy
| | - C Faucher
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - B Mohty
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - S Harbi
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - R Devillier
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France
| | - C Chabannon
- Cell Therapy Unit Institut Paoli Calmettes, Marseille, France.,Aix-Marseille Université, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France
| | - C Carlo-Stella
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - A Santoro
- Department of Hematology, Humanitas Cancer Center, Istituto Clinico Humanitas, Rozzano, Italy
| | - D Blaise
- Department of Hematology, Transplantation Program Institut Paoli Calmettes, Marseille, France.,Aix-Marseille Université, Marseille, France.,Centre de Recherche en Cancérologie de Marseille (CRCM), Marseille, France
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Blaise D, Saillard C, Fürst S, Faucher C, Prebet T, El Cheikh J, Castagna L, Charbonnier A, Granata A, Rey J, Devillier R, Mohty B, Arnoulet C, Moziconnaci M, Chabannon C, Vey N. 128 SINGLE CENTER EXPERIENCE OF RIC BASED ALLOGENIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN 100 PATIENTS WITH MDS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30129-6] [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: 11/16/2022]
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Engelhard D, Mohty B, de la Camara R, Cordonnier C, Ljungman P. European guidelines for prevention and management of influenza in hematopoietic stem cell transplantation and leukemia patients: summary of ECIL-4 (2011), on behalf of ECIL, a joint venture of EBMT, EORTC, ICHS, and ELN. Transpl Infect Dis 2013; 15:219-32. [DOI: 10.1111/tid.12054] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 11/19/2012] [Accepted: 11/23/2012] [Indexed: 12/22/2022]
Affiliation(s)
| | - B. Mohty
- Department of Hematology; Geneva University Hospital; Geneva; Switzerland
| | - R. de la Camara
- Department of Hematology; University Hospital La Princesa; Madrid; Spain
| | - C. Cordonnier
- Department of Hematology; Henri Mondor Teaching Hospital; Assistance Publique-Hopitaux de Paris and Paris Est-Créteil University; Créteil; France
| | - P. Ljungman
- Department of Haematology; Karolinska University Hospital and Division of Haematology; Department of Medicine; Karolinska Institutet/Huddinge; Stockholm; Sweden
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Mohty B, Thomas Y, Vukicevic M, Nagy M, Levrat E, Bernimoulin M, Kaiser L, Roosnek E, Passweg J, Chalandon Y. Clinical features and outcome of 2009-influenza A (H1N1) after allogeneic hematopoietic SCT. Bone Marrow Transplant 2012; 47:236-42. [PMID: 21423124 PMCID: PMC7091841 DOI: 10.1038/bmt.2011.57] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/28/2011] [Accepted: 01/30/2011] [Indexed: 11/29/2022]
Abstract
The impact of the 2009 H1N1-Influenza A (H1N1) pandemic in allogeneic hematopoietic SCT recipients (allo-HSCT) is not yet well defined. Between May 2009 and May 2010, all allo-HSCTs who presented with respiratory symptoms were screened for the presence of the H1N1 virus. Oseltamivir resistance was assessed and chart reviews were performed for all cases. In all, 51 of 248 (20%) allo-HSCT recipients followed at our outpatient clinic were screened. We identified 10 patients with H1N1 infection. Close contact with children was the most commonly suspected mode of transmission. Upper and lower respiratory tract infections were present in eight and five patients, respectively. Lymphopenia (<1 G/L) was the most frequent biological abnormality. High immunosuppression was responsible for severe infection requiring mechanical ventilation associated with prolonged viral shedding in three patients who had significant comorbidities and GvHD. Two of them developed an oseltamivir-resistant strain and both patients died subsequently despite intensive therapy, resulting in a case fatality rate of 20%. In conclusion, although most allo-HSCTs had mild symptoms from H1N1 infection, severe immunosuppression and emergence of oseltamivir resistance were likely responsible for a substantial morbidity, further supporting the need for vaccination and monitoring of close contacts, especially children.
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Affiliation(s)
- B Mohty
- Division of Hematology, University Hospital, Geneva, Switzerland.
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Fontanet A, Chalandon Y, Roosnek E, Mohty B, Passweg JR. Cotrimoxazole myelotoxicity in hematopoietic SCT recipients: time for reappraisal. Bone Marrow Transplant 2010; 46:1272-3. [DOI: 10.1038/bmt.2010.285] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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