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Bourlon C, Roddie C, Menne T, Norman J, O'Reilly M, Gibb A, Besley C, Chaganti S, Arias CG, Jones C, Dikair A, Allen S, Seymour F, Osborne W, Mathew A, Townsend W, Patten PE, Thoulouli E, Abdulgawad A, Lugthart S, Sanderson R, Kirkwood AA, Kuhnl A. Outcomes after chimeric antigen receptor T-cell therapy across large B-cell lymphoma subtypes. Haematologica 2024. [PMID: 38572567 DOI: 10.3324/haematol.2024.285010] [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] [Received: 01/08/2024] [Indexed: 04/05/2024] Open
Abstract
Not available.
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Affiliation(s)
| | - Claire Roddie
- Department of Haematology, University College London Hospitals, London, UK; UCL Cancer Institute, University College London, London
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle University, Newcastle
| | - Jane Norman
- Department of Haematology, Manchester Royal Infirmary, Manchester
| | - Maeve O'Reilly
- Department of Haematology, University College London Hospitals, London
| | - Adam Gibb
- Department of Medical Oncology, The Christie Hospital, Manchester
| | - Caroline Besley
- Department of Haematology, University Hospitals Bristol and Weston, Bristol
| | | | | | - Ceri Jones
- Department of Haematology. University Hospital of Wales, Cardiff
| | - Abdalla Dikair
- Department of Haematology, Queen Elizabeth Hospital, Glasgow
| | - Sharon Allen
- Department of Haematology, Cambridge University Hospitals, Cambridge
| | | | - Wendy Osborne
- Department of Haematology, Freeman Hospital, Newcastle University, Newcastle
| | - Amrith Mathew
- Department of Haematology, Queen Elizabeth Hospital, Birmingham
| | - William Townsend
- Department of Haematology, University College London Hospitals, London
| | - Piers Em Patten
- Department of Haematology, King's College Hospital, London, UK; Comprehensive Cancer Centre, King's College London, London
| | - Eleni Thoulouli
- Department of Haematology, Manchester Royal Infirmary, Manchester
| | | | - Sanne Lugthart
- Department of Haematology, University Hospitals Bristol and Weston, Bristol
| | | | - Amy A Kirkwood
- CR UK and UCL Cancer Trials Centre, UCL Cancer Institute, UCL, London
| | - Andrea Kuhnl
- Department of Haematology, King's College Hospital, London.
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Guilbert A, Bara TG, Bouchara T, Gaffard M, Bourlon C. Feasibility and relevance of an immersive virtual reality cancellation task assessing far space in unilateral spatial neglect. J Neuropsychol 2023. [PMID: 37942647 DOI: 10.1111/jnp.12353] [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: 07/17/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
Unilateral spatial neglect (USN) is a highly prevalent neuropsychological syndrome. However, its assessment in clinical practice, mainly based on paper-and-pencil tests, encounters limits as only near space, called peripersonal, is assessed. However, USN is a multicomponent syndrome that can also affect far space, called extrapersonal. This space is not assessed in current clinical assessment although it can be more impacted than peripersonal space. Immersive virtual reality (VR) allows developing tasks in far space to assess this heterogeneity. This study aimed to test the feasibility and the relevance of an immersive VR task to assess far space. A cancellation task, the Bells test, was used in its original paper-and-pencil version and was also adapted into a far immersive VR version. Ten patients with left USN and sixteen age-matched healthy participants were included. A single-case method was performed to investigate the performance of each patient. Although five patients showed very similar results between both versions, the five others exhibited a dissociation with a more severe impairment in the VR version. Three of these five patients significantly differed from the healthy participants only on the VR version. As USN in far space is not brought to light by paper-and-pencil tests, immersive VR appears as a promising tool to detect USN affecting this space.
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Affiliation(s)
- A Guilbert
- Laboratoire Vision Action Cognition (VAC), Université Paris Cité, Boulogne-Billancourt, France
| | - T-G Bara
- Centre d'Etudes et De Recherche en Informatique et Communications (CEDRIC), Conservatoire National des Arts et Métiers (CNAM), Paris, France
| | - T Bouchara
- Laboratoire Interdisciplinaire des Sciences du Numérique (LISN), Université Paris-Saclay, Orsay, France
| | - M Gaffard
- Laboratoire Vision Action Cognition (VAC), Université Paris Cité, Boulogne-Billancourt, France
- Hôpitaux de Saint-Maurice, Soins de Suite et Réadaptation Neurologique, Saint Maurice, France
| | - C Bourlon
- Hôpitaux de Saint-Maurice, Soins de Suite et Réadaptation Neurologique, Saint Maurice, France
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Avenoso D, Mehra V, Slonim LB, de Farias M, Alshehri H, Bouziana S, Krishnamurthy P, Kulasekararaj A, Dazzi F, Wood H, Kenyon M, Leung YT, Anteh S, Shah MN, Hannah G, Serpenti F, Gameil A, Bourlon C, Dragoi OD, Pagliuca A, Potter V. Myeloablative Dose of Busulfan and Fludarabine Combined with In Vivo T Cell Depletion Is Safe and Effective Conditioning for Acute Myeloid Leukemia and Myelodysplastic Syndrome Patients. Transplant Cell Ther 2023; 29:698.e1-698.e6. [PMID: 37579918 DOI: 10.1016/j.jtct.2023.08.012] [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: 04/10/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative strategy for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). The prediction of transplantation-related mortality (TRM) using the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) score and an arbitrary upper age limit of 55 years for administering myeloablative conditioning (MAC) are common strategies to ensure a safe procedure. The use of reduced-toxicity conditioning regimens is an additional approach to providing safe and effective myeloablation. Herein we report the outcome of AML and MDS patients conditioned with fludarabine and a myeloablative dose of busulfan (FB4) stratified by age and HCT-CI score. The primary objective was overall survival (OS) for patients age ≥55 years. Secondary objectives were total OS, TRM, graft-versus-host disease (GVHD), and GVHD, relapse-free survival (GRFS). The 2 year OS was 72% in patients age <55 and 51% in patients age ≥55. In patients age ≥55 with an HCT-CI <2, the estimated 2 year OS was 64%, with median OS not reached. In those with HCT-CI ≥2, the 2-year OS was 43%, with a median OS of 14 months. The total cumulative incidence of relapse was 30% regardless of age or HCT-CI score. FB4 conditioning regimen offers a high rate of prolonged remission with a relapse rate similar to that reported in previous studies. These positive outcomes suggest that this conditioning platform can be offered to patients age ≥55 years in the absence of comorbidities, and that age should not be the sole determinant of conditioning intensity.
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Affiliation(s)
- Daniele Avenoso
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom.
| | - Varun Mehra
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Liron Barnea Slonim
- King's College Hospital NHS Foundation Trust, Department of Histopathology, Denmark Hill, London, United Kingdom
| | - Madson de Farias
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Hassan Alshehri
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Styliani Bouziana
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Pramila Krishnamurthy
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Austin Kulasekararaj
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Francesco Dazzi
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Henry Wood
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Michelle Kenyon
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Ye Ting Leung
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Sandra Anteh
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Mili Naresh Shah
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Guy Hannah
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Fabio Serpenti
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Amna Gameil
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Christianne Bourlon
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Oana Diana Dragoi
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Antonio Pagliuca
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
| | - Victoria Potter
- King's College Hospital NHS Foundation Trust, Department of Haematological Medicine, Denmark Hill, London, United Kingdom
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Arias-Espinosa L, Acosta-Medina AA, Vargas-España A, Fuentes-Martin V, Colunga-Pedraza PR, Hawing-Zarate JA, Leon AGD, Soto-Mota A, Pacheco-Gutierrez G, Vargas-Serafín C, Barrera-Lumbreras G, Bourlon C. Acute Leukemia Relapse after Hematopoietic Stem Cell Transplantation: The Good, the Bad, and the Ugly of Isolated Extramedullary Relapse in a Latin American Population. Transplant Cell Ther 2023; 29:510.e1-510.e9. [PMID: 37169289 DOI: 10.1016/j.jtct.2023.05.006] [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: 02/07/2023] [Revised: 04/14/2023] [Accepted: 05/04/2023] [Indexed: 05/13/2023]
Abstract
Hematopoietic stem cell transplantation (HSCT) is an effective therapy for acute leukemia (AL). Relapse represents the main cause of mortality. Isolated extramedullary relapse (iEMR) is atypical and has been related to better outcomes. Here we describe the clinical characteristics and outcomes of AL relapse after HSCT in our study population and analyze the impacts of different types of relapse on survival outcomes. This retrospective, multicenter study included 124 patients age ≥15 years with AL who underwent HSCT between 2004 and 2019. At diagnosis, 66.1% of the patients had lymphocytic AL, 19.7% presented with high-risk features, and 18.5% had extramedullary disease (EMD). At HSCT, 83.1% of the patients were in complete remission (CR), and 44.8% had negative measurable residual disease (MRD). The vast majority of donors were related (96%), including 48.4% HLA-matched and 47.6% haploidentical. Myeloablative conditioning was provided to 80.6% of patients. The median overall survival (OS) was 15 months (95% confidence interval [CI] 9.9 to 20.1 months). Factors associated with improved OS were adolescent and young adult (AYA) patient (P = .035), first or second CR (P = .026), and chronic graft-versus-host disease (GVHD) (P < .001). Acute GVHD grade III-IV (P = .009) was associated with increased mortality. The median relapse-free survival was 13 months (95% CI, 7.17 to 18.8 months); early disease status (P = .017) and chronic GVHD (P < .001) had protective roles. Sixty-eight patients (55%) relapsed after HSCT, with a median time to relapse of 6 months (95% CI, 3.6 to 8.4 months). iEMR was reported in 16 patients (23.5%). The most commonly involved extramedullary sites were the central nervous system and skin. Compared to patients with bone marrow relapse, all patients with iEMR had a diagnosis of acute lymphoid leukemia (P = .008), and 93.8% belonged to the AYA group; regarding pre-HSCT characteristics, iEMR patients had higher rates of negative MRD (P = .06) and a history of EMD (P = .009). Seventy-seven percent of relapsed patients received additional treatment with curative intent. The median OS after relapse (OSr) was 4 months (95% CI, 2.6 to 5.4 months). Factors related to increased OSr included lymphoid phenotype (P = .03), iEMR (P = .0042), late relapse (≥6 months) (P = .014), receipt of systemic therapy including second HSCT (P < .001), and response to therapy (P < .001). Rates of relapse and iEMR were higher than those previously reported in other studies. Advanced disease, reduced-intensity conditioning, and a diminished graft-versus-leukemia effect were factors influencing these findings. At relapse, presenting with iEMR after 6 months and receiving intensive therapy with adequate response were associated with better outcomes. Our results strongly suggest that a personalized approach to treating patients with HSCT is needed to counterbalance specific adverse factors and can positively impact clinical outcomes.
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Affiliation(s)
- Luis Arias-Espinosa
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Andres Vargas-España
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Valerie Fuentes-Martin
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Perla R Colunga-Pedraza
- Department of Hematology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico
| | - Jose Angel Hawing-Zarate
- Department of Hematology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico
| | - Andres Gómez-De Leon
- Department of Hematology, Universidad Autonoma de Nuevo Leon, Facultad de Medicina y Hospital Universitario Dr Jose Eleuterio Gonzalez, Monterrey, Mexico
| | - Adrian Soto-Mota
- Metabolic Diseases Research Unit, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico; School of Medical Sciences, Monterrey Institute of Technology and Higher Education, Mexico City, Mexico
| | - Guillermo Pacheco-Gutierrez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Cesar Vargas-Serafín
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Georgina Barrera-Lumbreras
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
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León AGD, Gil-Flores L, Colunga-Pedraza P, Bourlon C, Vargas-Serafín C, del Campo-Martínez MDLÁ, Olaya-Vargas A, Pérez-García M, González-Leal XJ, Herrera Rojas MA, Lozano-Rodríguez S, Solano-Genesta M, Rodríguez-Zúñiga AC, Sánchez-Arteaga A, Ruiz-Argüelles GJ, Gómez-Almaguer D. Hematopoietic stem cell transplantation activity in Mexico during the COVID19 pandemic: on the way to recovery. Hematology 2022; 27:1294-1300. [DOI: 10.1080/16078454.2022.2156737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Andrés Gómez-De León
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Lourdes Gil-Flores
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Perla Colunga-Pedraza
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - César Vargas-Serafín
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | | | - Xitlaly J. González-Leal
- Instituto Tecnológico de Estudios Superiores de Monterrey. Monterrey Nuevo León.S, Monterrey, Mexico
- Clínica Gómez-Almaguer, Monterrey
| | | | - Sergio Lozano-Rodríguez
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | - Anna Cecilia Rodríguez-Zúñiga
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | - Alexia Sánchez-Arteaga
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
| | | | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo León, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico
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Bourlon MT, Jiménez Franco B, Castro-Alonso FJ, Bourlon C, Matar CF, Gunn E, Ginsburg O, Lopes G, Segelov E. Global Oncology Authorship and Readership Patterns. JCO Glob Oncol 2022; 8:e2100299. [PMID: 35258989 PMCID: PMC8920442 DOI: 10.1200/go.21.00299] [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] [Indexed: 12/09/2022] Open
Abstract
PURPOSE Global Oncology is the movement to improve equitable access to cancer control and care, recognizing challenges because of economic and social factors between high-, middle-, and low-income countries (HIC, MIC, and LIC, respectively). The JCO Global Oncology (JCO GO) is a major platform dedicated to publishing peer-reviewed research relevant to populations with limited resources. To assess the success of its goals of encouraging global interaction and increasing MIC and LIC engagement, we analyzed authorship and readership patterns. METHODS Metadata of logged views between January 1, 2018, and June 30, 2019, of articles published in 2018 by JCO GO were identified using Google Analytics. The country of origin of each author and those who accessed the journal were categorized according to the 2019 income group World Bank Classification (WBC). RESULTS One hundred thirty-two articles were published in JCO GO in 2018. Corresponding authors came from 34 nations: 35% HIC, 47% MIC, and 18% LIC. The top publishing countries were the United States, India, Brazil, Mexico, and Nigeria. Article authors were solely from within one WBC group in 41% (23% HIC, 16% MIC, and 2% LIC). In those with mixed-WBC authorship origins, collaborations were 42% HIC + MIC, 11% HIC + LIC, and 6% HIC + MIC + LIC, but none with MIC + LIC. Regarding viewing, 87,860 views originated from 180 countries (82% of the WBC list): 35% HIC, 51% MIC, and 14% LIC. The most common accessing nations were the United States, India, the United Kingdom, Brazil, and Ethiopia. CONCLUSION More than half of JCO GO's authorship comes from mixed WBC groups, with viewership extending to most of the world's nations. Areas to address are low level of LIC corresponding authors, few papers from authors across all WBC groups, no publications from MIC + LIC collaborations, and a low percentage of readership by LIC. These data provide focus to target interventions aimed at reducing the academic segregation of LIC and improving interactions across all WBC countries.
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Affiliation(s)
- Maria T Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Brenda Jiménez Franco
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Charbel F Matar
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Emilie Gunn
- American Society of Clinical Oncology, Alexandria, VA
| | - Ophira Ginsburg
- Perlmutter Cancer Center, NYU Grossman School of Medicine, New York City, NY
| | - Gilberto Lopes
- University of Miami Miller School of Medicine, Miami, FL
| | - Eva Segelov
- Monash University and Monash Health, Subang Jaya, Malaysia
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Inclan-Alarcon SI, Riviello-Goya S, Teran-De-la-Sancha K, Fierro-Angulo OM, Acosta-Medina AA, Demichelis-Gomez R, Bourlon C. Induction-related mortality in adolescents and young adults with acute lymphoblastic leukemia in a resource-limited setting: do treatment-related complications create more impact than disease biology? Blood Res 2022; 57:29-33. [PMID: 35197368 PMCID: PMC8958371 DOI: 10.5045/br.2021.2021058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
Background Acute lymphoblastic leukemia (ALL) is a malignant clonal bone marrow disorder with a high mortality rate during the initial therapy. This retrospective study aimed to describe and analyze the risk factors and causes of induction-related mortality (IRM) in an adolescent and adult ALL population treated in a low- and middle-income country. Methods From 2009 to 2016, a total of 167 patients were included, of which 50.9% were male with a median age of 28 years. B-immunophenotype represented 97.6%, and high-risk cytogenetics were present in 23.3%. During induction therapy, 91% had at least 1 complication, most of which were infectious, with an IRM of 12%. Results Factors associated with increased mortality rate were central nervous system (CNS) status [CNS-3: hazard ratio (HR) 3.029; 95% confidence interval (CI), 0.79-11.49; P=0.103 and CNS-2: HR, 9.98; 95% CI, 2.65-37.65; P=0.001] and dialysis requirement (HR, 9.15; 95% CI, 2.44-34.34; P=0.001). Conclusion Our study confirms that ALL patients treated in resource-constrained settings have high rates of IRM, mainly attributed to advanced disease and high tumor burden at diagnosis.
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Affiliation(s)
- Sergio I Inclan-Alarcon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Santiago Riviello-Goya
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Kevin Teran-De-la-Sancha
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Oscar M Fierro-Angulo
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roberta Demichelis-Gomez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Rajme-Lopez S, Crabtree-Ramírez B, Acosta-Medina AA, Olivas-Martínez A, Bourlon C. HIV-positive patients presenting with peripheral blood cytopenias: is bone marrow assessment a priority? Hematol Transfus Cell Ther 2021; 44:542-548. [PMID: 34312113 PMCID: PMC9605914 DOI: 10.1016/j.htct.2021.02.008] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/21/2021] [Accepted: 02/18/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction Hematologic abnormalities are frequent among persons living with HIV (PLWH). The bone marrow aspirate (BMA) and biopsy (BMB) are commonly performed in the diagnostic approach of patients with unexplained cytopenias. Changes in antiretrovirals, supportive therapy and increased life expectancy have modified the distribution and etiology of cytopenias, questioning their use. Our aim was to analyze the diagnostic yield of BMA, BMB and marrow cultures for the evaluation of cytopenias in PLWH. Methods This was a retrospective cohort of ≥ 18-year-old PLWH undergoing bone marrow assessment (MA) for the evaluation of cytopenias between January 2002 and December 2015. Results A total of 236 cytopenic events were analyzed, 47.9% being PLWH who had a longstanding diagnosis (≥ 1 year). Adherence to antiretrovirals was 63.5%. Anemia was seen in 91.9% and pancytopenia in 39%. Common presentations included fever (52.1%), weight loss (42.8%) and adenopathies (28.8%). Median days from detection to MA was 5 (0 – 63 days). Most common etiologies were non-HIV infectious diseases (31.4%) and benign/malignant hematologic diseases (26.3%). The diagnostic yield was 16.1% for BMA, 20.3% for BMB, 30.5% for both and 35.6% when cultures were added. Patients most likely to have conclusive MA were those with moderate/severe thrombocytopenia (p = 0.007). Fever, splenomegaly, and low CD4+ counts were associated with infectious etiologies, while hematologic diagnoses were related to the presence of adenopathies. Conclusion As a minimally invasive intervention, the MA has a high yield for identifying the etiology of cytopenic events in PLWH, being conclusive in one in three patients. Early performance could lead to prompt diagnosis and timely therapy initiation.
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Affiliation(s)
- Sandra Rajme-Lopez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Aldo A Acosta-Medina
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Bourlon C, Acosta-Medina AA, Arias-Espinosa L, Marentes-Ortiz M, Barrera-Lumbreras G. Cost Assessment and Comparison of Mobilization Strategies for Autologous Stem Cell Transplantation in a Resource-Limited Setting: Cheap Can be Expensive. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vargas-Serafin C, Acosta-Medina AA, Ordonez-Gonzalez I, Martínez-Baños D, Bourlon C. Impact of Socioeconomic Characteristics and Comorbidities on Therapy Initiation and Outcomes of Newly Diagnosed Multiple Myeloma: Real-World Data From a Resource-Constrained Setting. Clin Lymphoma Myeloma Leuk 2021; 21:182-187. [PMID: 33414064 DOI: 10.1016/j.clml.2020.11.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Outcomes of newly diagnosed multiple myeloma (NDMM) in developing regions have not paralleled those in developed settings. Economic disadvantage, comorbidities, and aggressive disease behavior play competing roles on defining outcomes. Our aim was to analyze the impact of socioeconomic characteristics and comorbidities on therapy initiation, drug selection, and survival outcomes of NDMM in a resource-constrained setting. PATIENTS AND METHODS This retrospective single-center cohort included ≥ 18-year-old NDMM patients from January 2006 to December 2018. RESULTS A total of 245 patients were included with a median age of 62 years, Eastern Cooperative Oncology Group performance status ≤ 2 in 70.2%, International Staging System score ≥ 2 in 89.4%, and high-risk disease in 31.6%. Comorbidities were reported in 69.4%, and Charlson comorbidity index (CCI) was ≥ 2 in 64.1%. A total of 87.4% (n = 214) received thalidomide-, alkylating-, and bortezomib-based induction in 67.8%, 18.2%, and 13.1%. Patient-related factors including performance status, comorbidities, and CCI, but not myeloma-related factors, were associated with a decreased likelihood of initiating induction therapy. On multivariate analysis, CCI ≥ 2 remained statistically significant (odds ratio, 5.81; P = .005). Overall survival was 44 months. Although both patient- and myeloma-related factors were associated with a decreased overall survival, only International Staging System score > 2 (hazard ratio, 3.53; P = .004) and induction without bortezomib-based regimens (hazard ratio, 4.45; P < .001) were statistically significant on multivariate analysis. CONCLUSION Myeloma- and treatment-related factors are the main determinants of survival in NDMM induction-eligible patients. Patient-related factors play a pivotal role determining access to therapy and survival outcomes. Comorbidity index and performance status were determinant on defining therapy initiation in this real-world population, which emphasizes the need to improve health baseline conditions in resource-constrained settings.
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Affiliation(s)
- Cesar Vargas-Serafin
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Deborah Martínez-Baños
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Vargas-Serafin C, Acosta-Medina AA, Teran-De-la-Sancha K, Delgado-de-la-Mora J, Bourlon MT, Bourlon C. Access to Palliative Care Services and Clinical Outcomes of Patients With Solid Malignancy-Associated Myelophthisis in a Resource-Limited Setting. Am J Hosp Palliat Care 2020; 38:932-937. [PMID: 33161730 DOI: 10.1177/1049909120969963] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Myelophthisis (MPT) has been associated with a dreadful prognosis. Patients' access to palliative care (PC) and factors influencing its clinical outcomes are poorly described. Our aim was to analyze the impact of patient- and disease-specific characteristics on survival of patients with MPT and describe their use of PC in a resource-limited setting. METHODS Retrospective study including patients with solid tumor MPT, diagnosed between 1996 and 2018. RESULTS Seventy patients (median 58 years) were included. 58% were synchronously diagnosed with MPT at time of primary tumor diagnosis. Most common oncologic diagnoses were prostate (25.7%), gastrointestinal (20%), and breast (18.6%) neoplasms. Median overall survival (OS) was 1.9 months. Primaries other than prostate, breast, and lung (HR 1.37, 95% CI 1.15 - 1.8; p = 0.02) and transfusion requirements (HR 2.8, 95% CI 1.01 - 7.9; p = 0.04) were independently associated with decreased OS. Administration of multiple systemic therapeutic interventions (HR 0.15, 95% CI 0.06 - 0.39; p = 0.01) was the sole factor improving OS. Assessment by PC was pursued in 51.4% of patients. The median number of consults per patient was two, with no difference in assessment rate or consult number across different primaries (P = 0.96). Four cases of palliative sedation were reported, all performed by the primary care team. CONCLUSION MPT is highly heterogeneous and risk stratification to optimize the use of therapeutic interventions in unison with palliative interventions is needed to maximize efforts toward improving patient quality of life. There is an alarming need of PC services in the multidisciplinary management of patients within developing regions.
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Affiliation(s)
- Cesar Vargas-Serafin
- Department of Hematology and Oncology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Kevin Teran-De-la-Sancha
- Department of Hematology and Oncology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jesus Delgado-de-la-Mora
- Department of Pathology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - María T Bourlon
- Department of Hematology and Oncology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Santiesteban SG, Verduzco-Aguirre H, Bourlon C, Bourlon MT. Abstract PO-019: Impact of a hospital conversion to COVID-19 center on cancer care of patients in a urologic oncology clinic in Mexico. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.covid-19-po-019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: COVID-19 has been a challenge for health systems worldwide. Many hospitals were converted into COVID-19 centers, including our center. Diagnostic studies, ambulatory procedures, and elective surgeries were canceled, and emergency care and inpatient services were closed for patients without COVID-19. Lack of access to hospital services represents a problem in the care of cancer, especially in low- and middle-income countries (LMICs). Our aim was to analyze the impact of hospital conversion to a COVID-19 center on the follow-up and management of patients in our urologic oncology clinic.
Methods: We analyzed data of all patients in our urologic oncology clinic with appointments scheduled from March 16th to May 31st. A fellow reviewed all cases to evaluate if appointments were eligible for regular visit, telemedicine, or postponement and patients were contacted. Demographic, disease, and treatment characteristics were obtained. Population was analyzed according to type of visit (standard of care vs. clinical trial). We examined univariate associations between groups. A p-value ≤0.05 indicated statistical significance.
Results: A total of 336 patients were included; the median age was 65 (18-94) years, and 306 (91.1%) were men. The main neoplasms were prostate (49.4%), kidney (20.2%), germ cell tumors (21.4%), urothelial (8.6%), and penile (0.3%) cancer. 46.7% of patients were in active treatment, and 11.9% were enrolled in a clinical trial. Remote communication was established with 184/224 (82.1%) patients. We planned to reschedule the visits of 224/336 (66.7%) patients. Medical appointments were rescheduled to a median of 91 days (IQR 65-105 days). All patients enrolled in clinical trials visited the clinic as scheduled. Among patients eligible for telemedicine, 105 (46.9%) were on surveillance, 68 (30.4%) on hormone therapy, 45 (20.1%) on no active treatment, and 6 (2.7%) on other therapy. The majority of the 111 patients who had an in-person appointment were receiving chemotherapy (24.3%), followed by immunotherapy (15.3%), targeted therapy (15.3%), and hormone therapy (13.5%). 13.5% had no active treatment and 9.0% were on surveillance. Comparing non-protocol versus protocol patients, we found a significant difference in loss of follow-up (12.2% vs 0% p = 0.012). During the study period, two (0.6%) confirmed cases and one (0.3%) death due to COVID-19 were recorded.
Conclusions: In our initial experience, rescheduling of visits and remote follow-up was possible in most patients during hospital conversion to a COVID-19 center. Despite the constrained resources and communication barriers of LMICs, the rate of patients lost to follow-up was not increased during the pandemic in our center. Telemedicine was possible, particularly for those on surveillance and hormone therapy. Comparing standard clinical care versus clinical trial patients, we found a significant difference in terms of loss to follow-up.
Citation Format: Salvador G. Santiesteban, Haydee Verduzco-Aguirre, Christianne Bourlon, Maria T. Bourlon. Impact of a hospital conversion to COVID-19 center on cancer care of patients in a urologic oncology clinic in Mexico [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-019.
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Affiliation(s)
| | | | - Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maria T. Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Carril-Ajuria L, Remolina-Bonilla YA, Carretero-Gonzalez A, Martin-Soberon M, Castellano D, Bourlon C, de Velasco G, Bourlon MT. Challenges of Treating a Patient With Advanced Prostate Cancer During the COVID-19 Pandemic. Oncology (Williston Park) 2020; 34:317-319. [PMID: 32785928 DOI: 10.46883/onc.2020.3408.0317] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 78-year-old man had a medical history of hypertension, atrial fibrillation, chronic kidney disease, and metastatic castration-resistant prostate cancer (CRPC). He had progressed to first-line therapy for CRPC with abiraterone plus androgen-deprivation therapy (ADT) and as second-line therapy he was being treated with docetaxel, with biochemical progression in his last prostate specific antigen measurement. He was admitted to the hospital on April 2020, in the middle of the coronavirus disease 2019 (COVID-19) pandemic, because of painful bone lesions and deterioration of renal function.
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Affiliation(s)
- Lucil Carril-Ajuria
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Yuly A Remolina-Bonilla
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - Daniel Castellano
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Guillermo de Velasco
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Carril-Ajuria L, Remolina-Bonilla Y, Carrertero-Gonzalez A, Martin-Soberon M, Castellano D, Bourlon C, de Velasco G, Bourlon M. Challenges of Treating a Patient With Advanced Prostate Cancer During the COVID-19 Pandemic. Oncology 2020. [DOI: 10.46883/onc.3408.317] [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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Bourlon C, Riviello-Goya S, Acosta-Medina AA, Caballero-Landinez RE, Manrique-Rubio A, Teran-De-la-Sancha K, Gulias-Herrero A, Bourlon MT. Outcomes and Challenges of Reproductive Health in Hematopoietic Stem Cell Transplantation Survivors. Biol Blood Marrow Transplant 2020; 26:2127-2131. [PMID: 32659435 DOI: 10.1016/j.bbmt.2020.07.007] [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: 05/25/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/19/2022]
Abstract
Long-term therapy-related reproductive health side effects impact the quality of life of hematopoietic stem cell transplantation (HSCT) survivors. In this study, we evaluated the prevalence of gonadal dysfunction (GD) pre- and post-HSCT, analyzed factors associated with GD, and explored rates of fertility assessment (FA) and fertility preservation (FP) in a resource-limited setting. FA and outcomes of patients age ≤45 years undergoing HSCT between June 2000 and May 2018 were collected retrospectively. We included 213 patients with a median age of 26 years. Pre-HSCT FA was performed in 71.8%, with a GD rate of 17%. The rate of GD was not different between the sexes (females, 19.5% versus males, 16.1%; P = .616) and was only associated with increasing age. The rate of cryopreservation in the cohort was 3.3%. Almost one-half (47.7%) of post-HSCT patients completed FA and evidenced an increase in GD rate to 48.9%. Comparing pre-HSCT and post-HSCT GD rates, women had a significant increase (19.5% versus 81.4%; P < .001), whereas men did not (16.1% versus 20.4%; P = .76). These results were confirmed by a multiple imputation analysis accounting for missing data. Female sex, pre-HSCT cytotoxic therapy, myeloablative conditioning, and germ cell tumor (GCT) diagnosis were associated with post-HSCT GD. Reproductive health preservation can be positively impacted when FA and FP are prioritized at the initial diagnosis in HSCT candidates, particularly in women of older age and men with a diagnosis of GCT. The low FP success observed urges implementation of strategies that favor accessibility and improve quality of life of HSCT survivors in low- and middle-income countries.
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Affiliation(s)
- Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Santiago Riviello-Goya
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rosa E Caballero-Landinez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | | - Alfonso Gulias-Herrero
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maria T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Bourlon C, Camacho-Hernández R, Fierro-Angulo OM, Acosta-Medina AA, Bourlon MT, Niembro-Ortega MD, Gonzalez-Lara MF, Sifuentes-Osornio J, Ponce-de-León A. Latent Tuberculosis in Hematopoietic Stem Cell Transplantation: Diagnostic and Therapeutic Strategies to Prevent Disease Activation in an Endemic Population. Biol Blood Marrow Transplant 2020; 26:1350-1354. [PMID: 32200119 DOI: 10.1016/j.bbmt.2020.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/26/2020] [Accepted: 03/10/2020] [Indexed: 02/04/2023]
Abstract
Latent tuberculosis infection (LTBI) affects one-fourth of the world´s population. Hematopoietic stem cell transplantation (HSCT) recipients are at an elevated risk of developing active tuberculosis infection (ATBI). In this retrospective study of donors and HSCT recipients who underwent transplantation between February 2000 and June 2018, our aim was to determine the prevalence of LTBI and ATBI and to describe diagnostic and therapeutic strategies in an HSCT population in an endemic region. The cohort of 409 participants included 125 allogeneic HSCT (allo-HSCT) recipients, 165 autologous HSCT (auto-HSCT) recipients, and 119 HSCT donors. Patients were evaluated pre-HSCT with tuberculin skin test and thoracic imaging. LTBI was diagnosed in 26.2% of the cohort. Cases represented 20% of the auto-HSCT population, 20% of the allo-HSCT population, and 41.2% of the donor population. Pre-HSCT evaluation to rule out ATBI was performed in 62.6% of the cohort; all results were negative. Isoniazid was administered to 73.3% of those with LTBI. Within subgroups, 91.7% of HSCT recipients and 51% of donors received treatment. The median duration of therapy pre-HSCT was 70 days in recipients and 48 days in donors. The incidence of post-HSCT ATBI was 0 at 1-year follow-up. The incidence of LTBI in our population was higher than expected and still might have been underestimated owing to diagnostic test limitations. The absence of incident ATBI suggests that recipients, as opposed to donors, must receive LTBI treatment. Prevention of infectious complications in the HSCT population should be prioritized to improve clinical outcomes. Prospective data from collaborative working groups is needed to determine the best diagnostic and therapeutic approaches in this vulnerable patient population.
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Affiliation(s)
- Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Rocío Camacho-Hernández
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Oscar M Fierro-Angulo
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maria T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - María Dolores Niembro-Ortega
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - María F Gonzalez-Lara
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Sifuentes-Osornio
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alfredo Ponce-de-León
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Bourlon C, Acosta-Medina AA, Caballero-Landinez RE, Manrique-Rubio A, Terán-De la Sancha K, Bourlon MT. Challenges and Unmet Oncofertility Needs in Hematopoietic Stem Transplant Recipients in a Middle-Income Nation. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Acosta-Medina AA, Arias-Espinosa L, Villaseñor-Echavarri R, Chouciño P, Martínez-Quesada JI, Armillas-Canseco FM, Barrera-Lumbreras G, Bourlon MT, Bourlon C. Mobilization Success and Bariers for Autologous Hematopoietic Stem Cell Transplantation in a Constrained-Resource Nation. Biol Blood Marrow Transplant 2020. [DOI: 10.1016/j.bbmt.2019.12.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Riviello-Goya S, Acosta-Medina AA, Inclan-Alarcon SI, Garcia-Miranda S, Bourlon C. Isolated Extramedullary Relapse in Acute Lymphoblastic Leukemia: What Can We Do Before and After Transplant? Oncology (Williston Park) 2020; 34:39-43. [PMID: 32645192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
• Isolated EMR is defined as the presence of clonal blasts in any tissue other than the medullary compartment with a bone marrow evaluation with less than 5% clonal blasts and a full donor chimerism. • Patients with iEMR have shown better survival outcomes when compared to BMR and EMR and in most cases it heralds a systemic relapse. • Risk factors for iEMR include: younger age, history of EMD, poor risk cytogenetics, advanced disease at HSCT, development of GVHD, and non-TBI based conditioning regimens. • Combination therapy, local and systemic, can achieve better remission rates in this subgroup of patients.
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Affiliation(s)
- Santiago Riviello-Goya
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Aldo A Acosta-Medina
- Department of Hematology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Sofia Garcia-Miranda
- Department of Hematology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Velázquez HE, Castro-Alonso FJ, Bourlon C, Gabutti A, Gallegos C, Bourlon MT. Diffuse Hepatic Infiltration by Metastatic Melanoma. Oncology (Williston Park) 2019; 33:629386. [PMID: 31365754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Lee-Tsai YL, Luna-Santiago R, Demichelis-Gómez R, Ponce-de-León A, Ochoa-Hein E, Tamez-Torres KM, Bourlon MT, Bourlon C. Determining the risk factors associated with the development of Clostridium difficile infection in patients with hematological diseases. Blood Res 2019; 54:120-124. [PMID: 31309090 PMCID: PMC6614093 DOI: 10.5045/br.2019.54.2.120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 12/14/2018] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 02/07/2023] Open
Abstract
Background Clostridium difficile infection (CDI) is a nosocomial condition prevalent in patients with hematological disorders. We aimed to identify the risk factors associated with the development of CDI and assess the mortality rate at 15 and 30 days among hematologic patients admitted to a tertiary care center. Methods We conducted a retrospective case-control study from January 2010 to December 2015. Forty-two patients with hematologic malignancy and CDI, and 84 with hematologic disease and without history of CDI were included in the case and control groups, respectively. Results Univariate analysis revealed that episodes of febrile eutropenia [odds ratio (OR), 5.5; 95% confidence interval (CI), 2.3-12.9; P<0.001], admission to intensive care unit (OR, 3.8; 95% CI, 1.4-10.2; P=0.009), gastrointestinal surgery (OR, 1.2; 95% CI, 1.1-1.4; P<0.001), use of therapeutic (OR, 6.4; 95% CI, 2.5-15.9; P<0.001) and prophylactic antibiotics (OR, 4.2; 95% CI, 1.6-10.7; P=0.003) in the last 3 months, and >1 hospitalization (OR, 5.6; 95% CI, 2.5-12.6; P<0.001) were significant risk factors. Multivariate analysis showed that use of therapeutic antibiotics in the last 3 months (OR, 6.3; 95% CI, 2.1-18.8; P=0.001) and >1 hospitalization (OR, 4.3; 95% CI, 1.7-11.0; P=0.002) were independent risk factors. Three (7.1%) and 6 (14.2%) case patients died at 15 and 30 days, respectively. Conclusion The risk factors for developing CDI were exposure to therapeutic antibiotics and previous hospitalization. Hematological patients who developed CDI had higher early mortality rates, suggesting that new approaches for prevention and treatment are needed.
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Affiliation(s)
- Yu Ling Lee-Tsai
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rodrigo Luna-Santiago
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roberta Demichelis-Gómez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alfredo Ponce-de-León
- Department of Infectology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Eric Ochoa-Hein
- Departament of Hospital Epidemiology and Quality Control of Medical Care, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Karla María Tamez-Torres
- Department of Infectology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - María T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Morales-Chacón K, Bourlon C, Acosta-Medina AA, Bourlon MT, Aguayo A, Tuna-Aguilar E. Impact of Additional Cytogenetic Abnormalities on the Clinical Behavior of Patients With Chronic Myeloid Leukemia: Report on a Latin American Population. Clinical Lymphoma Myeloma and Leukemia 2019; 19:e299-e306. [DOI: 10.1016/j.clml.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/11/2019] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
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Cooke A, Montante-Montes D, Zúñiga-Tamayo D, Rivera M, Bourlon C, Aguayo Á, Demichelis-Gómez R. Bone marrow fibrosis as prognostic marker in adult patients with acute lymphoblastic leukemia. J Hematop 2019. [DOI: 10.1007/s12308-019-00353-z] [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: 11/25/2022] Open
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Morales-Chacón K, Bourlon MT, Martínez-Baños D, Delgado-de-la-Mora J, Bourlon C. Multiple Myeloma With Extramedullary Disease: A Challenging Clinical Dilemma. Oncology (Williston Park) 2019; 33:149-155. [PMID: 30990568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the current recommendations for the use of bispecific antibodies (bsAb) in hematologic malignancies and explore the future in this field. RECENT FINDINGS Bispecific antibodies are molecules able to target two different antigen-binding sites: one towards a tumor antigen and another to activate a cytotoxic cell. Phase II/III trials on blinatumomab for acute lymphoblastic leukemia (ALL) have demonstrated its efficacy for treating minimal residual disease (MRD+) and relapsed refractory (r/r) Philadelphia positive (Ph+) and negative (Ph-) ALL in adults and children. Currently, the only bispecific antibody (bsAb) approved for its use in hematologic malignancies is blinatumomab. However, multiple trials are under development not only to explore blinatumomab's clinical activity in other neoplasia, such as lymphoma or multiple myeloma, but also to develop new molecules against different antigens.
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Affiliation(s)
- Roberta Demichelis-Gómez
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Belisario Dominguez Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
| | - Daniela Pérez-Sámano
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Belisario Dominguez Sección XVI, Tlalpan, 14080, Mexico City, Mexico
| | - Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Avenida Vasco de Quiroga No. 15, Belisario Dominguez Sección XVI, Tlalpan, 14080, Mexico City, Mexico
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De La Mora H, López C, Jimenez B, Sánchez P, Bourlon C, Castillo JD, Bourlon MT. Fear of recurrence as a triage strategy to identify testicular cancer survivors in need of psychological interventions. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e22110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hector De La Mora
- Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
| | - Claudia López
- National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico
| | - Brenda Jimenez
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Delegacion Tlalpan, MX
| | | | - Christianne Bourlon
- Instituto Nacional Nutricion Y Ciencias Medicas Salvador Zubiran, Mexico, Mexico
| | | | - Maria Teresa Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Bourlon C, Morales-Chacon K, Medina-Acosta AA, Aguayo A, Anguiano-Alvarez VM, Bourlon MT, Olivas-Martinez A, Tuna-Aguilar E. Impact of additional cytogenetic abnormalities on clinical outcomes in chronic myeloid leukemia: First report in a Latin American population. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e19023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Christianne Bourlon
- Instituto Nacional Nutricion Y Ciencias Medicas Salvador Zubiran, Mexico, Mexico
| | | | | | | | | | - Maria Teresa Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Elena Tuna-Aguilar
- Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico
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Bourlon MT, Velázquez HE, Luna-Santiago R, Vázquez-Manjarrez S, Bourlon C. Is This Patient With Metastatic Bladder Cancer a Candidate for Second-Line Immunotherapy Treatment? Oncology (Williston Park) 2018; 32:64-68. [PMID: 29492946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Bourlon C, Lipton JH, Deotare U, Gupta V, Kim DD, Kuruvilla J, Viswabandya A, Thyagu S, Messner HA, Michelis FV. Extramedullary disease at diagnosis of AML does not influence outcome of patients undergoing allogeneic hematopoietic cell transplant in CR1. Eur J Haematol 2017; 99:234-239. [PMID: 28556258 DOI: 10.1111/ejh.12909] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Extramedullary disease (EMD) at diagnosis of acute myeloid leukemia (AML) has been associated with increased risk of relapse and worse outcomes post-chemotherapy. This study sought to investigate the association of EMD with outcomes following allogeneic hematopoietic cell transplantation (allo-HCT). METHODS This single-center retrospective study investigated the impact of EMD at diagnosis on the outcome of patients transplanted for AML in first complete remission (CR1). The study included 303 consecutive patients with AML transplanted in CR1, median age 51 years (range 18-71). RESULTS EMD at diagnosis was documented in 39 patients (13%), either histologically (26 patients) or clinically/radiologically (13 patients). Among the 39 EMD patients, 16 had CNS disease, seven had gingival infiltration, and five had leukemia cutis. On univariate analysis, EMD had no significant impact on survival, with a 3-year OS of 55% (95% CI 38-69) compared to 48% for the non-EMD group (95% CI 42%-55%) (P=.84). Likewise, 3-year CIR was 18% vs 19% (P=.86) and 3-year NRM was 26% vs 33% (P=.83) for EMD vs non-EMD groups, respectively. Multivariate analysis confirmed these results. CONCLUSIONS We conclude that EMD at diagnosis of AML does not seem to influence outcomes following allo-HCT performed in CR1.
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Affiliation(s)
- Christianne Bourlon
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Jeffrey H Lipton
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Uday Deotare
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Vikas Gupta
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Dennis D Kim
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - John Kuruvilla
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Auro Viswabandya
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Santhosh Thyagu
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Hans A Messner
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Fotios V Michelis
- Allogeneic Blood and Marrow Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Bourlon C, Vargas-Serafín C, López-Karpovitch X. Mycobacterium genavenseinvading the bone marrow in a HIV-positive patient. Clin Case Rep 2017; 5:1043-1045. [PMID: 28588869 PMCID: PMC5458027 DOI: 10.1002/ccr3.961] [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: 03/03/2016] [Revised: 12/26/2016] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
Nontuberculous mycobacteria infrequently cause disseminated infections in immunocompetent hosts. However, they are increasingly being recognized in immunocompromised patients. We present the case of a 40‐year‐old HIV‐positive male presenting with lymphadenopathies and pancytopenia in whom disseminated infection, with bone marrow involvement by Mycobacterium genavense (M. genavense) was diagnosed.
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Affiliation(s)
- Christianne Bourlon
- Department of Hematology and Oncology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Mexico City Mexico
| | - Cesar Vargas-Serafín
- Department of Internal Medicine; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Mexico City Mexico
| | - Xavier López-Karpovitch
- Department of Hematology and Oncology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Mexico City Mexico
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Bourlon C, Alamoudi S, Kumar D, Viswabandya A, Thyagu S, Michelis FV, Kim DDH, Lipton JH, Messner HA, Deotare U. A short tale of blood, kidney and brain: BK virus encephalitis in an allogeneic stem cell transplant recipient. Bone Marrow Transplant 2017; 52:907-909. [PMID: 28218753 DOI: 10.1038/bmt.2017.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C Bourlon
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - S Alamoudi
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - D Kumar
- Transplant Infectious Diseases, University Health Network, Toronto, Canada
| | - A Viswabandya
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - S Thyagu
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - F V Michelis
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - D D-H Kim
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - J H Lipton
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - H A Messner
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - U Deotare
- Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
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Bourlon C, Hernandez-Mata C, Vargas-Serafín C, Bourlon MT, Tuna-Aguilar E, Aguayo A. Fluorescent In Situ Hybridization Monitoring and Effect of Detected Early Responses in the Outcome of Patients With Chronic Phase Chronic Myeloid Leukemia: A Report From a Latin American Country. Clin Lymphoma Myeloma Leuk 2016; 16:453-9. [PMID: 27259590 DOI: 10.1016/j.clml.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/15/2016] [Accepted: 04/26/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The cytogenetic hallmark of chronic myeloid leukemia (CML) is the Philadelphia chromosome. Monitoring the response in patients receiving therapy is a standard of care. The present study was conducted to assess the monitoring adherence and reliableness of fluorescent in situ hybridization (FISH) as a monitoring tool and the effect of a complete cytogenetic response (CCyR) assessed by FISH on the prognosis of patients in a chronic phase (CP)-CML cohort. MATERIALS AND METHODS We retrospectively analyzed the data from 63 newly diagnosed CP-CML patients treated with imatinib mesylate at a dose of 400 mg/day as frontline therapy. The clinical data and cytogenetic test results at diagnosis and during monitoring were collected. The cytogenetic monitoring adherence assessment rates were measured. A correlation between chromosome banding analysis (CBA) and FISH was performed. The CCyR assessed by FISH was defined as < 1% BCR-ABL1(+) nuclei. The Kaplan-Meier method was used for overall survival analysis and time-to-event estimates. RESULTS The cytogenetic monitoring assessment adherence was 50.8% at 3 months, 93.5% at 6 months, 96.7% at 12 months, and 88.6% at 18 months. The Pearson correlation coefficient showed a significantly positive association (r = 0.84; P < .001) between CBA and FISH. The median follow-up duration after imatinib mesylate initiation was 60 months. A CCyR was achieved in 90.4% of patients within the first 18 months of therapy. At 3 months, 31 patients underwent a FISH evaluation, and 13 (41.9%) had achieved a CCyR. The patients who did not achieve a CCyR at 3 months had a significantly inferior probability of 5-year failure-free survival (38% vs. 94%; P = .001) and progression-free survival (80% vs. 100%; P = .043) compared with those with a CCyR. CONCLUSION We found improved monitoring adherence compared with the previous reports of Latin American populations. In countries with a high incidence of failure for CBA and a lack of real-time polymerase chain reaction standardization, FISH is a sensitive monitoring tool. In our cohort, patients not achieving an early CCyR, as tested by FISH, were a poor prognosis subgroup with worse rates of failure-free survival and progression-free survival.
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Affiliation(s)
- Christianne Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Carlos Hernandez-Mata
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Cesar Vargas-Serafín
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - María T Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Elena Tuna-Aguilar
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Alvaro Aguayo
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México.
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Bourlon C, Urbanski M. From unconscious to conscious vision: Rehabilitation of a case of cortical blindness. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.079] [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: 11/25/2022]
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Lunven M, Correia S, Migliaccio R, Duret C, Blanchard M, Laurent G, Bartolomeo P, Bourlon C. Recuperation of daily activities and quality of life after stroke: The EAVQ-QdV scale. Ann Phys Rehabil Med 2015. [DOI: 10.1016/j.rehab.2015.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bourlon C, Vargas-Serafín C, Bourlon MT, de la Peña-Lopez R, Crawford ED. Biphenotypic extramedullary blast crisis of chronic myeloid leukemia with variant Philadelphia chromosome translocation. Oncology (Williston Park) 2015; 29:571-572. [PMID: 26281843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Bourlon C, Vargas-Serafin C, Bourlon M, De La Pena-Lopez R. Biphenotypic Extramedullary Blast Crisis of Chronic Myeloid Leukemia With Variant Philadelphia Chromosome Translocation. Oncology 2015. [DOI: 10.46883/onc.2015.2908.0575] [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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Bourlon C, Vargas-Serafín C, Bourlon MT, de la Peña-Lopez R. Biphenotypic extramedullary blast crisis of chronic myeloid leukemia with variant Philadelphia chromosome translocation. Oncology (Williston Park) 2015; 29:575-577. [PMID: 26355182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
MESH Headings
- Blast Crisis/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Phenotype
- Philadelphia Chromosome
- Translocation, Genetic
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Bourlon C, Hernandez-Mata CF, Bourlon MT, Tuna-Aguilar E, Aguayo A. Impact of early responses in the outcome of patients with newly diagnosed CML-CP, evaluated by FISH in countries where standard cytogenetics are not available or reliable. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e18027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Christianne Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Maria Teresa Bourlon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Elena Tuna-Aguilar
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Alvaro Aguayo
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, Mexico City, Mexico
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Bourlon C, Lehenaff L, Batifoulier C, Bordier A, Chatenet A, Desailly E, Fouchard C, Marsal M, Martinez M, Rastelli F, Thierry A, Bartolomeo P, Duret C. Interaction entre performances posturales et cognitives chez des patients cérébrolésés droits : une étude en double tâche. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lunven M, Thiebaut de Schotten M, Duret C, Bourlon C, Migliaccio R, Rode G, Bartolomeo P. Chronic neglect and disconnection of white matter pathways: A longitudinal study. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bourlon C, Lehenaff L, Batifoulier C, Bordier A, Chatenet A, Desailly E, Fouchard C, Marsal M, Martinez M, Rastelli F, Thierry A, Bartolomeo P, Duret C. Interaction between postural and cognitive performances in right brain damaged patients: A dual task study. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bourlon MT, Bourlon C, Atisha-Fregoso Y, Chable-Montero F, Teliz MA, Angeles-Angeles A, Carrillo-Maravilla E, Llorente L, Uscanga LF. Clinical and Immunopathologic Profile of Mexican Patients with IgG4 Autoimmune Pancreatitis. ISRN Rheumatol 2012; 2012:164914. [PMID: 22666608 PMCID: PMC3361187 DOI: 10.5402/2012/164914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 03/06/2012] [Indexed: 12/24/2022]
Abstract
Autoimmune pancreatitis is part of the spectrum of IgG4-associated diseases. Its diagnostic criteria and histological subtypes have been formally proposed recently and although based on current data it has been suggested that there are differences in clinical presentation among populations, more research is needed to properly establish if this heterogeneity exists. In this paper, we describe 15 cases of autoimmune pancreatitis diagnosed at a Mexican centre of reference, all of them associated to the lymphoplasmocytic sclerosing pancreatitis variant. The mean age at the onset of symptoms was 47.5 ± 14.4 years, and 53% of patients were male. The main manifestations were weight loss (87%), obstructive jaundice (53%), and acute (27%) and chronic (27%) pancreatitis. Only 20% of patients had high IgG4 serum levels at the time of diagnosis. All patients receiving prednisone responded favourably, both in their pancreatic and extrapancreatic manifestations. Clinical manifestations of Mexican patients showed certain differences with respect to those usually reported.
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Affiliation(s)
- María T Bourlon
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 14, 14000 México, DF, Mexico
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Bourlon C, Chokron S, Bachoud-Lévi AC, Coubard O, Bergeras I, Moulignier A, Viret AC, Bartolomeo P. [Presentation of an assessment battery for visual mental imagery and visual perception]. Rev Neurol (Paris) 2010; 165:1045-54. [PMID: 19487005 DOI: 10.1016/j.neurol.2009.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Revised: 03/17/2009] [Accepted: 04/24/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The relationship between visual perception and visual mental imagery are at the center of a lively theoretical debate between those postulating common neurocognitive processes between perception and imagery and those who emphasize the differences between these two entities. Neuropsychology can make an important contribution to this debate, by assessing associations and dissociations between perceptual and imaginal deficits in patients with brain damage. However, currently there is no standardized test battery available for such assessments. MATERIAL AND METHODS Here we present a battery of paper-and-pencil tests assessing different domains of visual mental imagery and visual perception abilities: object form and color, animals, orthographic material, numbers, faces, and space. We also explored the effects of age, educational level and gender on performance on a group of 103 participants free of neurological damage. RESULTS The battery includes two parts: one composed of 14 tests assessing mental imagery and the second part composed of eight tests assessing the abilities of visual perception. We calculated the correlations between the tests, and found that, with the exception of orthographic material, there were generally poor correlations between imagery and perceptual tests. CONCLUSION This result seems inconsistent with hypotheses postulating a strict correspondence between perceptual and imagery abilities.
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Affiliation(s)
- C Bourlon
- Inserm UMRS 975, pavillon Claude-Bernard, hôpital Pitié-Salpêtrière (AP-HP), 47, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, Paris, France; Service de neurologie, clinique Les Trois Soleils, Boissise-le-Roi, France
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Urbanski M, Angeli V, Bourlon C, Cristinzio C, Ponticorvo M, Rastelli F, Thiebaut de Schotten M, Bartolomeo P. Négligence spatiale unilatérale : une conséquence dramatique mais souvent négligée des lésions de l’hémisphère droit. Rev Neurol (Paris) 2007; 163:305-22. [PMID: 17404518 DOI: 10.1016/s0035-3787(07)90403-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Unilateral Spatial Neglect (USN) is a common consequence of right brain damage. In the most severe cases, behavioral signs of USN can last several years and compromise patients' autonomy and social rehabilitation. These clinical facts stress the need for reliable procedures of diagnosis and rehabilitation. STATE OF THE ART The last 3 decades have witnessed an explosion of studies on USN, which raises issues related to complex cognitive activities such as mental representation, spatial attention and consciousness. USN is probably a heterogeneous syndrome, but some of its underlying mechanisms might be understood as an association of disorders of spatial attention. A bias of automatic orienting towards right-sided objects seems typical of left USN. Afterwards, patients find it difficult to disengage their attention in order to explore the rest of the visual scene. Neglected objects are sometimes processed in an "implicit" way. PERSPECTIVES The development of behavioural paradigms and of neuroimaging techniques and their application to the study of USN has advanced our understanding of the functional mechanisms of attention and spatial awareness, as well as of their neural bases. A number of new procedures for rehabilitation have recently been proposed. CONCLUSION The present review describes the clinical presentation of USN, its anatomical basis and some of possible accounts of different aspects of neglect behavior. Results of computer simulations and of rehabilitation techniques are also presented with implications for the functioning of normal neurocognitive systems.
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Affiliation(s)
- M Urbanski
- INSERM U610, Pavillon Claude Bernard, Hôpital de la Salpêtrière, Paris, France.
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