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Faisant MC, Legros L, Préaubert L, Forey PL, Blaise S, Equy V, Riethmuller D. [Management of pregnant woman with Klippel-Trenaunay syndrome: A rare and complex situation, about a case report]. Gynecol Obstet Fertil Senol 2022; 50:563-565. [PMID: 35472443 DOI: 10.1016/j.gofs.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/27/2022] [Accepted: 04/02/2022] [Indexed: 06/14/2023]
Affiliation(s)
- M-C Faisant
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France
| | - L Legros
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France
| | - L Préaubert
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France
| | - P-L Forey
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France
| | - S Blaise
- Médecine vasculaire, CHU Grenoble-Alpes, Grenoble, France
| | - V Equy
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France
| | - D Riethmuller
- Département de gynécologie-obstétrique et médecine de la reproduction, CHU Grenoble-Alpes, Grenoble, France.
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Faisant M, Legros L, Equy V, Riethmuller D. 313 Management of pregnant woman with klippel trenaunay syndrome and severe pelvic capillary angioma: A case report. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Huguet A, Bardou-Jacquet E, Houssel-Debry P, Latournerie M, Jezequel C, Legros L, Guyader D, Thibault R. La perte de masse musculaire mesurée par le diamètre du psoas est un facteur prédictif de mortalité des patients ayant une cirrhose inscrite sur liste de transplantation hépatique. NUTR CLIN METAB 2017. [DOI: 10.1016/j.nupar.2017.06.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Levraut M, Queyrel V, Drappier C, Fuzibet J, Raynaud S, Legros L, Martis N. Intérêt de la recherche de la recherche de la mutation V617F JAK2 chez les patients présentant une thrombose. Étude descriptive. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sebert M, Bally C, Peterlin P, Beyne-Rauzy O, Legros L, Gourin M, Sanhes L, Wattel E, Gyan E, Park S, Stamatoullas A, Laribi K, Banos A, Jueliger S, Chevret S, Ades L, Fenaux P. Results of a Phase II Study of Guadecitabine in Higher Risk MDS Patients Refractory to or Relapsing after Azacitidine Treatment. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30198-4] [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: 11/29/2022]
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Duchmann M, Braun T, Micol J, Platzbecker U, Park S, Pilorge S, Beyne-Rauzy O, Vey N, Sébert M, Gruson B, Dumas P, Guieze R, Chretien M, Laribi K, Chait Y, Legros L, Hirsch P, Solary E, Fenaux P, Itzykson R. A Retrospective Validation of International Consortium for MDS/MPN Response Criteria in CMML Treated with Hypomethylating Agents. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30157-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Huguet A, Bardou Jacquet E, Houssel Debry P, Latournerie M, Jezequel C, Legros L, Guyader D, Thibault R. OR01: A Low Transversal Psoas Muscle Thickness Assessed by Computed Tomography (CT) Scan is a Prognostic Factor in Cirrhotic Patients on Waiting-List for Liver Transplantation. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30240-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Legros L, Girodon F, Lanotto JC, Rey J, Ugo V. Les mutations de la calréticuline, une nouvelle aide pour le diagnostic des syndromes myéloprolifératifs. Rev Med Interne 2015; 36:791-3. [DOI: 10.1016/j.revmed.2015.06.012] [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] [Received: 06/05/2015] [Accepted: 06/06/2015] [Indexed: 10/23/2022]
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Toma A, Kosmider O, Chevret S, Delaunay J, Stamatoullas A, Rose C, Beyne-Rauzy O, Banos A, Guerci-Bresler A, Wickenhauser S, Caillot D, Laribi K, De Renzis B, Bordessoule D, Gardin C, Slama B, Sanhes L, Gruson B, Cony-Makhoul P, Chouffi B, Salanoubat C, Benramdane R, Legros L, Wattel E, Tertian G, Bouabdallah K, Guilhot F, Taksin AL, Cheze S, Maloum K, Nimuboma S, Soussain C, Isnard F, Gyan E, Petit R, Lejeune J, Sardnal V, Renneville A, Preudhomme C, Fontenay M, Fenaux P, Dreyfus F. Lenalidomide with or without erythropoietin in transfusion-dependent erythropoiesis-stimulating agent-refractory lower-risk MDS without 5q deletion. Leukemia 2015; 30:897-905. [PMID: 26500139 DOI: 10.1038/leu.2015.296] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/28/2015] [Accepted: 08/04/2015] [Indexed: 01/01/2023]
Abstract
After failure of erythropoiesis-stimulating agents (ESAs), lenalidomide (LEN) yields red blood cell (RBC) transfusion independence (TI) in 20-30% of lower-risk non-del5q myelodysplastic syndrome (MDS). Several observations suggest an additive effect of ESA and LEN in this situation. We performed a randomized phase III study in 131 RBC transfusion-dependent (TD, median transfusion requirement six RBC units per 8 weeks) lower-risk ESA-refractory non-del5q MDS. Patients received LEN alone, 10 mg per day, 21 days per 4 weeks (L arm) or LEN (same schedule) + erythropoietin (EPO) beta, 60,000 U per week (LE arm). In an intent-to-treat (ITT) analysis, erythroid response (HI-E, IWG 2006 criteria) after four treatment cycles (primary end point) was 23.1% (95% CI 13.5-35.2) in the L arm and 39.4% (95% CI 27.6-52.2) in the LE arm (P=0.044), while RBC-TI was reached in 13.8 and 24.2% of the patients in the L and LE arms, respectively (P=0.13). Median response duration was 18.1 and 15.1 months in the L and LE arms, respectively (P=0.47). Side effects were moderate and similar in the two arms. Low baseline serum EPO level and a G polymorphism of CRBN gene predicted HI-E. Combining LEN and EPO significantly improves erythroid response over LEN alone in lower-risk non-del5q MDS patients with anemia resistant to ESA.
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Affiliation(s)
- A Toma
- Department of Hematology, Hopital Universitaire Henri Mondor, Assistance Publique-Hôpitaux de Paris (APHP) and Paris 12 University, Creteil, France
| | - O Kosmider
- Assistance Publique-Hopitaux de Paris, Hopital Cochin, Laboratory of Hematology and Paris Descartes University, Paris, France
| | - S Chevret
- Biostatistics Team (ECSTRA), UMR1153, Inserm, Hopital Saint Louis, APHP and Paris 7 University, Paris, France
| | - J Delaunay
- Department of Hematology, Centre Hospitalier Universitaire, Nantes, France
| | - A Stamatoullas
- Department of Hematology, Centre Henri Becquerel, Rouen, France
| | - C Rose
- Department of Hematology, Hopital Saint Vincent de Paul, Lomme, France
| | - O Beyne-Rauzy
- Department of Hematology, Centre Hospitalier Universitaire, Purpan, France
| | - A Banos
- Department of Hematology, Centre Hospitalier Universitaire, Strasbourg, France
| | - A Guerci-Bresler
- Department of Hematology, Centre Hospitalier Universitaire, Nancy, France
| | - S Wickenhauser
- Department of Hematology, Centre Hospitalier Universitaire, Nimes, France
| | - D Caillot
- Department of Hematology, Centre Hospitalier Universitaire, Dijon, France
| | - K Laribi
- Department of Hematology, Centre Hospitalier, Le Mans, France
| | - B De Renzis
- Department of Hematology, Centre Hospitalier Universitaire, Clermont Ferrand, France
| | - D Bordessoule
- Department of Hematology, Centre Hospitalier Universitaire, Limoges, France
| | - C Gardin
- Department of Hematology, Hopital Avicenne, APHP, and Paris 13 University Bobigny, Bobigny, France
| | - B Slama
- Department of Hematology, Centre Hospitalier, Avignon, France
| | - L Sanhes
- Department of Hematology, Centre Hospitalier, Perpignan, France
| | - B Gruson
- Department of Hematology, Hopital Universitaire Amiens, Amiens, France
| | - P Cony-Makhoul
- Department of Hematology, Centre Hospitalier Annecy-Genevois, Prigny, France
| | - B Chouffi
- Department of Hematology, Centre Hospitalier, Boulogne sur Mer, France
| | - C Salanoubat
- Department of Hematology, Centre Hospitalier, Corbeil, France
| | - R Benramdane
- Department of Hematology, Centre Hospitalier, Pontoise, France
| | - L Legros
- Department of Hematology, Centre Hospitalier Universitaire, Nice, France
| | - E Wattel
- Department of Hematology, Centre Hospitalier Edouard Herriot, Lyon, France
| | - G Tertian
- Department of Hematology, Hopital Kremlin Bicetre, APHP, Kremlin Bicetre, France
| | - K Bouabdallah
- Department of Hematology, Centre Hospitalier Universitaire, Bordeaux, France
| | - F Guilhot
- Department of Hematology, Centre Hospitalier Jean Bernard, Poitiers, France
| | - A L Taksin
- Department of Hematology, Centre Hospitalier, Versailles, France
| | - S Cheze
- Department of Hematology, Centre Hospitalier Universitaire, Caen, France
| | - K Maloum
- Department of Hematology, Hopital Pitie Salpetriere, APHP and Paris 6 University Paris, Paris, France
| | - S Nimuboma
- Department of Hematology, Centre Hospitalier Universitaire, Rennes, France
| | - C Soussain
- Department of Oncology, Centre Rene Huguenin, Saint Cloud, France
| | - F Isnard
- Department of Hematology, Hopital Saint Antoine, APHP, and Paris 6 University Paris, Paris, France
| | - E Gyan
- Department of Hematology, Centre Hospitalier Universitaire, Tours, France
| | - R Petit
- Departement de Recherche Clinique, Hopital Saint Louis, APHP, Paris, France
| | - J Lejeune
- Biostatistics Team (ECSTRA), UMR1153, Inserm, Hopital Saint Louis, APHP and Paris 7 University, Paris, France
| | - V Sardnal
- Assistance Publique-Hopitaux de Paris, Hopital Cochin, Laboratory of Hematology and Paris Descartes University, Paris, France
| | - A Renneville
- Department of Biology, Centre Hospitalier Universitaire, Lille, France
| | - C Preudhomme
- Department of Biology, Centre Hospitalier Universitaire, Lille, France
| | - M Fontenay
- Assistance Publique-Hopitaux de Paris, Hopital Cochin, Laboratory of Hematology and Paris Descartes University, Paris, France
| | - P Fenaux
- Department of Hematology, Service Hematologie Seniors, Hopital Saint Louis, APHP, and Paris 7 University Paris, Paris, France
| | - F Dreyfus
- Department of Hematology, Hopital Cochin, APHP, and Paris 5 University Paris, Paris, France
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Legros L, Revencu N, Nassogne MC, Wese FX, Feyaerts A. [Multiple bladder diverticula caused by occipital horn syndrome]. Arch Pediatr 2015; 22:1147-50. [PMID: 26386812 DOI: 10.1016/j.arcped.2015.07.017] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Revised: 11/18/2014] [Accepted: 07/30/2015] [Indexed: 12/17/2022]
Abstract
We report on the case of a child who presented with recurrent, multiple, and voluminous bladder diverticula. Bladder diverticula are defined as a herniation of the mucosa through the bladder muscle or the detrusor. Causes are numerous and diverticula can be classified into primary congenital diverticula (para-ureteral - or Hutch diverticula - and posterolateral diverticula); secondary diverticula (resulting from chronic mechanical obstruction or from neurological disease; and diverticula secondary to connective tissue or muscle fragility. The latter is seen in disease entities such as prune belly syndrome, Ehlers-Danlos syndrome, cutis laxa syndrome, OHS (occipital horn syndrome), Menkes disease, and Williams-Beuren syndrome. In this patient, the cause of these diverticula was OHS, a genetic, recessive X-chromosome-linked syndrome, responsible for abnormal tissue caused by a disorder in copper metabolism. This case reminds us of the importance of pushing the diagnostic workup when presented with multiple and/or large bladder diverticula, and in particular to search for rare malformation syndromes after exclusion of an obstacle.
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Affiliation(s)
- L Legros
- Service d'urologie, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - N Revencu
- Centre de génétique humaine, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - M-C Nassogne
- Service de neurologie pédiatrique, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - F-X Wese
- Service d'urologie, cliniques universitaires Saint-Luc, Bruxelles, Belgique
| | - A Feyaerts
- Service d'urologie, cliniques universitaires Saint-Luc, Bruxelles, Belgique.
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Hermet E, Cabrespine A, Guièze R, Garnier A, Tempescul A, Lenain P, Bouabdallah R, Vilque JP, Frayfer J, Bordessoule D, Sibon D, Janvier M, Caillot D, Biron P, Legros L, Choufi B, Drenou B, Gorin NC, Bilger K, Tamburini J, Soussain C, Brechignac S, Bay JO. Autologous hematopoietic stem cell transplantation in elderly patients (≥ 70 years) with non-Hodgkin's lymphoma: A French Society of Bone Marrow Transplantation and Cellular Therapy retrospective study. J Geriatr Oncol 2015; 6:346-52. [PMID: 26116168 DOI: 10.1016/j.jgo.2015.04.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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: 08/07/2014] [Revised: 12/16/2014] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Limited data is available on the feasibility of high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) in elderly patients over 70 years of age with non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS In the setting of the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) group, we retrospectively analyzed 81 consecutive patients with NHL over 70 years of age who received AHSCT. RESULTS The median age at AHSCT was 72.3 years [70-80]. Patients' were diagnosed with diffuse large B-cell lymphoma (n=40), follicular lymphoma (n=16), mantle cell lymphoma (n=15), T-cell lymphoma (n=5), and other (n=5). Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) was 0 in 73% of patients. Main conditionings were BEAM (Carmustine-Etoposide-Cytarabine-Melphalan, n=61) and melphalan alone (n=14). Median delays to reach 0.5×10⁹/L neutrophils and 20 × 10(9)/L platelets were of 12 [9-76] days and 12 [0-143] days, respectively. One hundred day and one year cumulative incidence of NRM was 5.4% and 8.5%, respectively. The main cause of death remains relapse. CONCLUSION In conclusion, this study revealed that AHSCT seemed to be acceptable in patients over 70 years of age with NHL. Patient age is not a limiting factor if clinical condition is adequate.
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Affiliation(s)
- E Hermet
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France.
| | - A Cabrespine
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - R Guièze
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - A Garnier
- Hôpital Pitié-Salpétrière, Paris, France
| | | | - P Lenain
- Centre Henri Becquerel, Rouen, France
| | | | | | - J Frayfer
- Centre Hospitalier de Meaux, Meaux, France
| | | | - D Sibon
- Hôpital Saint-Louis, Paris, France
| | - M Janvier
- Centre René Huguelin, St Cloud, France
| | | | - P Biron
- Centre Leon Berard, Lyon, France
| | | | - B Choufi
- Hôpital Duchenne, Boulogne/mer, France
| | - B Drenou
- Hôpital Emile Muller, Mulhouse, France
| | | | - K Bilger
- Hôpital Hautepierre, Strasbourg, France
| | | | | | | | - J O Bay
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
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Bernardin S, Millot F, Baruchel A, Chastagner P, Stephan J, Plat G, Nicolini F, Rea D, Gardembas M, Etienne G, Cony-Makhoul P, Giraudier S, Guerci-Bresler A, Guilhot-Gaudeffroy J, Huguet-Rigal F, Rohrlich P, Legros L. SFCE P-19 - La Leucémie Myéloïde Chronique chez les Adolescents et Jeunes Adultes (AJA). Arch Pediatr 2014. [DOI: 10.1016/s0929-693x(14)71635-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Gardin C, Thepot S, Beyne-Rauzy O, Benabdelali R, Prebet T, Park S, Stamatoulas A, Guerci-Bresler A, Cheze S, Tertian G, Choufi B, Legros L, Bastie J, Delaunay J, Chaury M, Wattel E, Dreyfus F, Preudhomme C, Vey N, Fenaux P. O-010 Prognostic factors of response to azacitidine (AZA) in low-risk MDS resistant to erythroid stimulating agents (ESA). The GFM Azaepo 08 study. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70032-8] [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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Gronier S, Delmont E, Legros L, Launay M, Desnuelle C. Efficacité de l’autogreffe de cellules souches hématopoïétiques périphériques sur la polyneuropathie du syndrome POEMS : évaluation clinique et électrophysiologique. Rev Neurol (Paris) 2013. [DOI: 10.1016/j.neurol.2013.01.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. Erratum to: High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013. [DOI: 10.1007/s00277-013-1713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Lambert C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013; 92:621-31. [PMID: 23358617 DOI: 10.1007/s00277-013-1686-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/17/2013] [Indexed: 11/24/2022]
Abstract
Darbepoetin (DAR), with or without granulocyte colony-stimulating factor (G-CSF), has proved effective in treating anemia in patients with lower-risk myelodysplastic syndrome (MDS), but its effects on quality of life (QoL) and exercise functioning are less well established. In this phase II study (no. NCT00443339), lower-risk MDS patients with anemia and endogenous erythropoietin (EPO) level <500 IU/L received DAR 500 μg once every 2 weeks for 12 weeks, with G-CSF added at week 12 in non-responders. Physical performance was assessed with the 6-min walking test and, for fit patients, maximal oxygen consumption (VO2max). QoL was evaluated using SF-36 and FACT-An tests. In 99 patients, erythroid response rate according to IWG 2006 criteria was 48 and 56 % at 12 and 24 weeks, respectively. Addition of G-CSF rescued 22 % of non-responders. In 48 % of the responders, interval between darbepoetin injections could be increased for maintenance treatment. Serum EPO level was the only independent predictive factor of response at 12 weeks, and its most discriminant cutoff value was 100 IU/L. QoL and VO2max showed improvement over time in responders, compared with non-responders. With a median follow-up of 52 months, median response duration was not reached, and 3-year cumulative incidence of acute myeloid leukemia and overall survival (OS) was 14.5 and 70 %, respectively. Baseline transfusion dependence, International Prognostic Score System (IPSS), and Revised IPSS accurately predicted OS from treatment onset. Tolerance of darbepoetin was good. In conclusion, this regimen of darbepoetin every 2 weeks yielded high response rates and prolonged response duration. Objective improvement in exercise testing and in patient-reported QoL confirms the clinical relevance of anemia correction with erythropoiesis-stimulating agents.
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Affiliation(s)
- C Kelaidi
- GFM Service d'Hématogie Clinique, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, Université Paris 13, 125 rue de Stalingrad, Bobigny, France
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Legros L. Inhibiteur de tyrosine-kinase de 1re génération: résultats à long terme. ONCOLOGIE 2012. [DOI: 10.1007/s10269-012-2213-2] [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: 10/27/2022]
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Itzykson R, Thépot S, Beyne-Rauzy O, Ame S, Isnard F, Dreyfus F, Salanoubat C, Taksin AL, Chelgoum Y, Berthon C, Malfuson JV, Legros L, Vey N, Turlure P, Gardin C, Boehrer S, Ades L, Fenaux P. Does addition of erythropoiesis stimulating agents improve the outcome of higher-risk myelodysplastic syndromes treated with azacitidine? Leuk Res 2011; 36:397-400. [PMID: 22177456 DOI: 10.1016/j.leukres.2011.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 11/10/2011] [Accepted: 11/24/2011] [Indexed: 11/25/2022]
Abstract
We studied a retrospective cohort of 282 higher-risk MDS treated with azacitidine, including 32 patients who concomitantly received an ESA for a median of 5.8 months after azacitidine onset. Forty-four percent of ESA and 29% of no-ESA patients reached HI-E (p=0.07); 48% and 20% achieved transfusion independence (p=0.01). Median OS was 19.6 months in the ESA and 11.9 months in the no-ESA groups (p=0.04). Addition of an ESA significantly improved OS (p=0.03) independently of azacitidine schedule and duration, and of our proposed azacitidine risk score (Blood 2011;117:403-11). Adding an ESA to azacitidine in higher-risk MDS should be studied prospectively.
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Affiliation(s)
- R Itzykson
- Service d'Hématogie Clinique Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, and Paris 13 University, France
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Wolfromm A, Dreyfus F, Vey N, Delaunay J, Stamatoullas A, Banos A, Marfaing-Koka A, De Botton S, Bordessoule D, Legros L, Rauzy OB, Gyan E, Makhoul PC, Thepot S, Itzykson R, Fenaux P, Ades L. 106 Treatment of advanced CMML by azacitidine (AZA) in a compassionate program. The GFM experience in 38 patients (pts). Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70108-4] [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: 10/18/2022]
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20
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Gyan E, Andrieu V, Caille A, Park S, Stamatoullas A, Sélosse V, Bordessoule D, Gelsi-Boyer V, Ades L, Vey N, Cheze S, Beyne-Rauzy O, Sapena R, Zerazhi H, Legros L, Guerci-Bresler A, Fenaux P, Dreyfus F. 59 Myelodysplastic syndromes with isolated neutropenia or thrombocytopenia: Are they refractory cytopenias with unilineage dysplasia? A GFM registry study. Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70061-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Mahon FX F, Rea D, Guilhot F, Legros L, Guilhot J, Aton E, Dulucq S, Reiffers J, Rousselot P. Persistence of complete molecular remission in chronic myeloid leukemia after imatinib discontinuation: Interim analysis of the STIM trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.7084] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7084 Background: Imatinib (IM) has greatly improved survival in chronic myeloid leukemia (CML). However, IM must be continued for an indefinite period of time. A multicenter trial “Stop Imatinib” (STIM) was initiated in July 2007, in order to evaluate the persistence of complete molecular remission (CMR) after stopping IM and determine factors associated with CMR persistence. Methods: Inclusion criteria were IM treatment duration ≥3 years and sustained CMR, defined as BCR-ABL transcripts below a detection threshold of a 5-log reduction (undetectable by RQ-PCR) for ≥2 years. Molecular relapse was defined as RQ-PCR positivity confirmed on 2 successive occasions. In case of relapse, pts were rechallenged with IM at 400 mg daily. Molecular monitoring was performed according to international recommendations. Results: Sixty-nine pts were recruited among which 60 with a follow-up >1 month, including 22 males and 38 females. Median age was 62 (29–80), 31 pts had been treated with IFN prior to IM and 29 with IM frontline (de novo). Median follow-up was 5 months (1–16). Relapse occurred in 37 pts within 6 months of IM discontinuation. Only 1 pt relapsed after 6 months (M7). All patients in molecular relapse were sensitive to IM reintroduction. At last follow-up in December 2008, CMR was sustained in 8 pts at M14 and 3 pts at M16. No differences in terms of demography, duration of IM treatment and CMR duration were found between pts who relapsed and those who did not. At M9, the probability of persistent CMR was 46% (95% CI: 32–59%), 53% (95% CI: 33–69%) for previously IFN-treated pts and 39% (95% CI: 20–58%) for de novo pts (p = 0.54). A trend for a lower probability of relapse in low Sokal score pts was observed. Conclusions: Our data confirm that CMR can be long-lasting after discontinuation of IM. Using stringent criteria, it is possible to stop IM in patients with sustained CMR, even in those treated with IM as a single agent. Updated follow-up will be presented. No significant financial relationships to disclose.
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Affiliation(s)
- F. Mahon FX
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - D. Rea
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - F. Guilhot
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - L. Legros
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - J. Guilhot
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - E. Aton
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - S. Dulucq
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - J. Reiffers
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
| | - P. Rousselot
- Université Victor Segalen CHU de Bordeaux, Bordeaux, France; Hopital Saint Louis, Paris, France; Hopital Jean Bernard, Poitiers, France; Centre Hospitalier Universitaire, Nice, France; Centre Hospitalier, Versailles, France
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Park S, Kelaidi C, Sapena R, Vassilieff D, Beyne-Rauzy O, Coiteux V, Vey N, Ravoet C, Cheze S, Legros L, Stamatoullas A, Escoffre-Barbe M, Fenaux P, Dreyfus F. P107 Treatment of MDS with moderate anemia, not requiring RBC transfusions, by erythropoiesis stimulating agents (ESAs). Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Kelaidi C, Park S, Tamburini J, Sapena R, Raffoux E, Beyne-Rauzy O, Coiteux V, Aljassem L, Prebet T, Legros L, Stamatoullas A, Sanhes L, Delarue R, Dreyfus F, Fenaux P. P111 Long-term outcome of MDS with del 5q before the lenalidomide era. The GFM experience. Leuk Res 2009. [DOI: 10.1016/s0145-2126(09)70192-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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24
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Itzykson R, Ayari S, Vassilief D, Berger E, Slama B, Vey N, Suarez F, Beyne-Rauzy O, Guerci A, Cheze S, Thomas X, Stamatoullas A, Gardembas M, Bauduer F, Kolb A, Chaury MC, Legros L, Damaj G, Chermat F, Dreyfus F, Fenaux P, Ades L. Is there a role for all-trans retinoic acid in combination with recombinant erythropoetin in myelodysplastic syndromes? A report on 59 cases. Leukemia 2009; 23:673-8. [PMID: 19151787 DOI: 10.1038/leu.2008.362] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Erythropoiesis-stimulating agents (ESAs) remain the first-line treatment of anemia in lower risk myelodysplastic syndromes (MDS) without 5q deletion. A preliminary report suggested that adding all-trans retinoic acid (ATRA) to ESAs may improve their erythroid response, particularly in patients with high endogenous erythropoietin (EPO) level, and may improve other cytopenias. We conducted a prospective multicenter study of EPO-beta and ATRA in anemic MDS patients with marrow blasts <10% and either previous ESA failure or relapse, endogenous EPO >500 U/l or other cytopenia(s) (absolute neutrophilic count <1.0 G/l or platelets <50 G/l). A total of 59 patients were evaluable after 12 weeks of treatment. The erythroid response rates according to IWG 2000 and 2006 criteria, respectively, were as follows: overall: 49 and 36%; patients with previous ESA failure (n=28): 43 and 32%; patients with endogenous EPO >500 U/l (n=18): 11 and 19%; patients transfused >2 red blood cells units/month (n=28) 43 and 39%. Only one neutrophil, but no platelet response, and no major side effect were observed. EPO-beta-ATRA combination appears a possible therapeutic option in anemia of MDS having failed an ESA alone, but not in patients with high endogenous EPO level, and does not improve neutropenia and thrombocytopenia.
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Affiliation(s)
- R Itzykson
- Service d'Hématologie Clinique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Avicenne-Paris 13 University, Bobigny, France
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25
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Attia RR, Gardner LA, Mahrous E, Taxman DJ, Legros L, Rowe S, Ting JPY, Geller A, Kotb M. Selective targeting of leukemic cell growth in vivo and in vitro using a gene silencing approach to diminish S-adenosylmethionine synthesis. J Biol Chem 2008; 283:30788-95. [PMID: 18753136 PMCID: PMC2576526 DOI: 10.1074/jbc.m804159200] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 08/21/2008] [Indexed: 11/06/2022] Open
Abstract
We exploited the fact that leukemic cells utilize significantly higher levels of S-adenosylmethionine (SAMe) than normal lymphocytes and developed tools that selectively diminished their survival under physiologic conditions. Using RNA interference gene silencing technology, we modulated the kinetics of methionine adenosyltransferase-II (MAT-II), which catalyzes SAMe synthesis from ATP and l-Met. Specifically, we silenced the expression of the regulatory MAT-IIbeta subunit in Jurkat cells and accordingly shifted the K(m L-Met) of the enzyme 10-15-fold above the physiologic levels of l-Met, thereby reducing enzyme activity and SAMe pools, inducing excessive apoptosis and diminishing leukemic cell growth in vitro and in vivo. These effects were reversed at unphysiologically high l-Met (>50 microm), indicating that diminished leukemic cell growth at physiologic l-Met levels was a direct result of the increase in MAT-II K(m L-Met) due to MAT-IIbeta ablation and the consequent reduction in SAMe synthesis. In our NOD/Scid IL-2Rgamma(null) humanized mouse model of leukemia, control shRNA-transduced Jurkat cells exhibited heightened engraftment, whereas cells lacking MAT-IIbeta failed to engraft for up to 5 weeks post-transplant. These stark differences in malignant cell survival, effected by MAT-IIbeta ablation, suggest that it may be possible to use this approach to disadvantage leukemic cell survival in vivo with little to no harm to normal cells.
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Affiliation(s)
- Ramy R Attia
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
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26
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Mahon F, Bouchet S, Etienne G, Legros L, Réa D, Guilhot F, Huguet F, Titier K, Moore N, Reiffers J, Molimard M. Management of chronic myelogenous leukemia using therapeutic drug monitoring of imatinib: the French experience of a centralized laboratory. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.7087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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27
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Etienne G, Mathoulin-Pélissier S, Fort M, Guerci-Bresler A, Guilhot F, Rousselot PH, Nicolini FE, Legros L, Cholet C, Reiffers J, Mahon F. A phase II open trial evaluating imatinib mesylate and zoledronic acid in patients with chronic myeloid leukemia with molecular residual disease. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.18006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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28
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Legros L, Hayette S, Nicolini FE, Raynaud S, Chabane K, Magaud JP, Cassuto JP, Michallet M. BCR-ABLT315I transcript disappearance in an imatinib-resistant CML patient treated with homoharringtonine: a new therapeutic challenge? Leukemia 2007; 21:2204-6. [PMID: 17541396 DOI: 10.1038/sj.leu.2404772] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Antineoplastic Agents/therapeutic use
- Benzamides
- Bone Marrow/metabolism
- Drug Resistance, Neoplasm/genetics
- Fusion Proteins, bcr-abl/biosynthesis
- Fusion Proteins, bcr-abl/genetics
- Gene Expression Regulation, Leukemic
- Harringtonines/therapeutic use
- Homoharringtonine
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Male
- Middle Aged
- Mutation
- Piperazines/pharmacology
- Pyrimidines/pharmacology
- Time Factors
- Treatment Outcome
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29
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Fabre C, Sebert M, Hernandez E, Chermat F, Bordessoule D, Chaury M, Dartigeas C, de Botton S, Dreyfus F, Legros L, Mannone L, Marfaing-Koka A, Noel M, Park S, Prebet T, Stamatoullas A, Vey N, Fenaux P. P149 Treatment of high risk MDS and AML post-MDS with azacytidine (AZA): current results of the French ATU program. Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Mannone L, Gardin C, Quarre MC, Bernard JF, Vassilieff D, Ades L, Park S, Vaultier S, Hamza F, Beyne-rauzy MO, Cheze S, Giraudier S, Agape P, Legros L, Voillat L, Dreyfus F, Fenaux P. High-dose darbepoetin alpha in the treatment of anaemia of lower risk myelodysplastic syndrome results of a phase II study. Br J Haematol 2006; 133:513-9. [PMID: 16681638 DOI: 10.1111/j.1365-2141.2006.06070.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
An open-label, phase II non-randomised trial was conducted with darbepoetin (DAR), an erythropoiesis-stimulating factor with prolonged half-life, at a weekly dose of 300 mug subcutaneously in 62 anaemic patients with myelodysplastic syndrome (MDS) with an endogenous erythropoietin (EPO) level <500 mU/ml. Most of the patients were classified as low or intermediate 1 according to the International Prognostic Scoring System. After 12 weeks, 44 (71%) patients had an erythroid response (34 major and 10 minor), including eight of 13 patients who were previous non-responders to conventional EPO. Two additional responses (one minor and one major) occurred, in 10 non-responders, after the addition of granulocyte colony-stimulating factor (G-CSF). Thirty-six of the 46 total responders (31/35 major and 5/11 minor) continued to respond on maintenance DAR after a median of 40 weeks (range 4-84). Median dose of DAR required to maintain response was 300 microg every 14 d. The only prognostic factors of favourable response were low endogenous EPO level and low or absent red blood cell transfusion requirement. Those results suggest that high-dose DAR alone yields high erythroid response rates in anaemia of lower risk MDS, possibly equivalent to those obtained with conventional EPO + G-CSF, although this will need to be confirmed in larger and randomised trials.
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Affiliation(s)
- L Mannone
- Department of Haematology, Nice University Hospital, Nice, France
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31
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Jacquel A, Herrant M, Defamie V, Belhacene N, Colosetti P, Marchetti S, Legros L, Deckert M, Mari B, Cassuto JP, Hofman P, Auberger P. A survey of the signaling pathways involved in megakaryocytic differentiation of the human K562 leukemia cell line by molecular and c-DNA array analysis. Oncogene 2006; 25:781-94. [PMID: 16186797 DOI: 10.1038/sj.onc.1209119] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The K562 cell line serves as a model to study the molecular mechanisms associated with leukemia differentiation. We show here that cotreatment of K562 cells with PMA and low doses of SB202190 (SB), an inhibitor of the p38 MAPK pathway, induced a majority of cells to differentiate towards the megakaryocytic lineage. Electronic microscopy analysis showed that K562 cells treated with PMA+SB exhibited characteristic features of physiological megakaryocytic differentiation including the presence of vacuoles and demarcation membranes. Differentiation was also accompanied by a net increase in megakaryocytic markers and a reduction of erythroid markers, especially when both effectors were present. PMA effect was selectively mediated by new PKC isoforms. Differentiation of K562 cells by the combination of PMA and SB required Erk1/2 activation, a threshold of JNK activation and p38 MAPK inhibition. Interestingly, higher concentrations of SB, which drastically activated JNK, blocked megakaryocytic differentiation, and considerably increased cell death in the presence of PMA. c-DNA microarray membranes and PCR analysis allow us to identify a set of genes modulated during PMA-induced K562 cell differentiation. Several gene families identified in our screening, including ephrins receptors and some angiogenic factors, had never been reported so far to be regulated during megakaryocytic differentiation.
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Affiliation(s)
- A Jacquel
- INSERM U526, Physiopathologie de la Survie et de la Mort Cellulaires, Equipe Labellisée par la Ligue Nationale contre le Cancer, Université de Nice Sophia-Antipolis, IFR50, Faculté de Médecine, Avenue de Valombrose, 06107 Nice Cedex 2, France
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Rea D, Legros L, Raffoux E, Thomas X, Turlure P, Maury S, Dupriez B, Pigneux A, Choufi B, Reman O, Stéphane D, Royer B, Vigier M, Ojeda-Uribe M, Recher C, Dombret H, Huguet F, Rousselot P. High-dose imatinib mesylate combined with vincristine and dexamethasone (DIV regimen) as induction therapy in patients with resistant Philadelphia-positive acute lymphoblastic leukemia and lymphoid blast crisis of chronic myeloid leukemia. Leukemia 2006; 20:400-3. [PMID: 16437142 DOI: 10.1038/sj.leu.2404115] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Imatinib combined with high-dose chemotherapy is now becoming the gold standard for treatment of Philadelphia chromosome-positive acute leukemias. However, in all studies imatinib dosage was tapered to 400-600 mg per day. We decided to initiate a clinical trial to evaluate an opposite strategy based on high-dose imatinib (800 mg per day) combined with a less intensive chemotherapeutic regimen (vincristine and dexamethasone), which we called the DIV induction regimen. Thirty-one patients (18 relapsing or refractory Ph+ acute lymphoblastic leukemias and 13 lymphoid blast crisis chronic myelogenous leukemias) were enrolled. Complete remission (CR) was obtained in 28 out of 30 assessable patients. The median bcr-abl/abl ratio after the induction course was 0.1%. Median time to neutrophil recovery was 21 days. Fungus infections were observed in six patients out of 31 and possibly related to dexamethasone. Neuropathy due to vincristine was noted in 14 cases. Nine out of 19 patients under 55 years received allogenic stem cell transplantation after a median time of 78 days post-CR. Patients older than 55 years experienced a 90% CR rate without additional toxicities, suggesting the DIV regimen may also be proposed as a front line therapy in older patients.
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Affiliation(s)
- D Rea
- Service d'Hématologie Clinique, Hôpital Saint-Louis, Paris, France
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Zoccola D, Legros L, Cassuto P, Fuzibet JG, Nucifora G, Raynaud SD. A discriminating screening is necessary to ascertain EVI1 expression by RT-PCR in malignant cells from the myeloid lineage without 3q26 rearrangement. Leukemia 2003; 17:643-5. [PMID: 12646959 DOI: 10.1038/sj.leu.2402859] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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35
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Sirvent-von Bueltzingsloewen A, Gratecos N, Legros L, Fuzibet JG, Cassuto JP. Antithymocyte-associated reticulonodular pneumonitis during a conditioning regimen of reduced intensity for genoidentical bone marrow transplantation. Bone Marrow Transplant 2001; 27:891-2. [PMID: 11477450 DOI: 10.1038/sj.bmt.1703016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Moreau P, Huynh A, Facon T, Bouilly I, Sotto JJ, Legros L, Milpied N, Attal M, Bataille R, Harousseau JL. Lack of efficacy of clarithromycin in advanced multiple myeloma. Intergroupe Français du Myélome (IFM). Leukemia 1999; 13:490-1. [PMID: 10086745 DOI: 10.1038/sj.leu.2401332] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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37
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Legros L, Benezery K, Lagrange JL. [Radiotherapy in primary cerebral lymphoma]. Cancer Radiother 1999; 3:149-53. [PMID: 10230374 DOI: 10.1016/s1278-3218(99)80045-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Primary cerebral lymphoma is a rare disease with an unfavorable prognosis. Whole brain radiotherapy has been the standard treatment, but neither the optimal radiation fields nor optimal dose level of the regimen are as yet firmly established. From this review of the literature, it seems that the whole brain must be treated, and a boost to the area of the primary site must be discussed. With regard to dose, the radiation dose-response relationship is not clearly proven. Yet, a minimum dose of 40 Gy is necessary, and the maximum dose is set at 50 Gy because of late neurological sequelae. Because of the poor prognosis of this disease and the risk of late sequelaes, other avenues have been explored. Chemotherapy has been studied, seem to have a survival advantage and combinations of radiotherapy and chemotherapy, especially with high-dose methotrexate. Because primary cerebral lymphoma is an uncommon disease, randomized clinical trials that compare radiotherapy alone to chemotherapy plus radiotherapy may not be feasible. Finally, even if chemotherapy seems to have a survival advantage, the regimen of chemotherapy is still a matter of debate.
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Affiliation(s)
- L Legros
- Département de radiothérapie, centre Antoine-Lacassagne, Nice, France
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38
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Moreau P, Le Tortorec S, Mahé B, Legros L, Milpied N, Harousseau JL. Administration of granulocyte colony-stimulating factor from day 7 after autologous bone marrow transplantation: effects on neutropenia and duration of hospitalization. Nouv Rev Fr Hematol (1978) 1994; 36:455-8. [PMID: 7538659] [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: 01/25/2023]
Abstract
G-CSF (5 mg/kg/day Filgrastim) was administered from day 7 after autologous bone marrow transplantation (ABMT) in a series of 17 patients treated for multiple myeloma or non-Hodgkin's lymphoma. In comparison with retrospective controls receiving ABMT without G-CSF and matched for age, underlying disease, disease status at ABMT, number of CFU-GM/kg reinfused, conditioning regimen and number and type of chemotherapy courses prior to ABMT, the duration of neutropenia, intravenous antibiotics and hospitalization was significantly reduced in the G-CSF group (p < 0.001). Delaying the administration of G-CSF after ABMT is an interesting possibility which merits further exploration in prospective randomized studies.
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Affiliation(s)
- P Moreau
- Department of Haematology, CHU Hôtel-Dieu, Nantes, France
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Bryan SE, Legros L, Brown J, Byrne C, Re RN. Copper-rich nucleoprotein generated by micrococcal nuclease. Biol Trace Elem Res 1985; 8:219-29. [PMID: 24257947 DOI: 10.1007/bf02917461] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/1985] [Accepted: 05/20/1985] [Indexed: 10/21/2022]
Abstract
Nuclei from calf thymus tissue digested with micrococcal nuclease under nonchelating conditions yielded soluble nucleoprotein enriched in copper. Following limited digestion, the ratio of μg Cu:mg DNA was inversely related either to percent solubility of chromatin or to levels of enzyme maintaining an enzyme:A 260 ratio of 0.059. The enzyme appeared to cleave preferentially regions of chromatin where copper is localized, releasing no additional metal upon further digestion. Moreover, the highest copper: DNA ratio was always associated with the least-digested sample.The distribution between copper and angiotensin II (AII) in chromatin fragments following slight nuclease digestion suggests a possible link between copper and nuclear AII binding. When nuclei are incubated with AII prior to digestion and dialysis, solubilized chromatin contained about three times more copper than buffer control. Metal profiles generated from gel (A-5 M) chromatography for these samples were distinctive: copper peaks appeared near or adjacent to linker DNA regions, and in the case of AII, coincided with fragments containing specific AII receptors; thus, there appears to be an enrichment of copper in these active nucleoprotein fragments.
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Affiliation(s)
- S E Bryan
- Department of Biological Sciences, University of New Orleans, 70148, New Orleans, Louisiana
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