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Farge D, Pugnet G, Allez M, Castilla-Llorente C, Chatelus E, Cintas P, Faucher-Barbey C, Labauge P, Labeyrie C, Lioure B, Maria A, Michonneau D, Puyade M, Talouarn M, Terriou L, Treton X, Wojtasik G, Zephir H, Marjanovic Z. French protocol for the diagnosis and management of hematopoietic stem cell transplantation in autoimmune diseases. Rev Med Interne 2024; 45:79-99. [PMID: 38220493 DOI: 10.1016/j.revmed.2023.12.008] [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: 12/06/2023] [Accepted: 12/29/2023] [Indexed: 01/16/2024]
Abstract
Hematopoietic stem cell transplantation (HSCT) for severe ADs was developed over the past 25years and is now validated by national and international medical societies for severe early systemic sclerosis (SSc) and relapsing-remitting multiple sclerosis (MS) and available as part of routine care in accredited center. HSCT is also recommended, with varying levels of evidence, as an alternative treatment for several ADs, when refractory to conventional therapy, including specific cases of connective tissue diseases or vasculitis, inflammatory neurological diseases, and more rarely severe refractory Crohn's disease. The aim of this document was to provide guidelines for the current indications, procedures and follow-up of HSCT in ADs. Patient safety considerations are central to guidance on patient selection and conditioning, always validated at the national MATHEC multidisciplinary team meeting (MDTM) based on recent (less than 3months) thorough patient evaluation. HSCT procedural aspects and follow-up are then carried out within appropriately experienced and Joint Accreditation Committee of International Society for Cellular Therapy and SFGM-TC accredited centres in close collaboration with the ADs specialist. These French recommendations were performed according to HAS/FAI2R standard operating procedures and coordinated by the Île-de-France MATHEC Reference Centre for Rare Systemic Autoimmune Diseases (CRMR MATHEC) within the Filière FAI2R and in association with the Filière MaRIH. The task force consisted of 3 patients and 64 clinical experts from various specialties and French centres. These data-derived and consensus-derived recommendations will help clinicians to propose HSCT for their severe ADs patients in an evidence-based way. These recommendations also give directions for future clinical research in this area. These recommendations will be updated according to newly emerging data. Of note, other cell therapies that have not yet been approved for clinical practice or are the subject of ongoing clinical research will not be addressed in this document.
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Affiliation(s)
- D Farge
- AP-HP, hôpital St-Louis, centre de référence des maladies auto-immunes systémiques rares d'Île-de-France MATHEC (FAI2R), unité de Médecine Interne (UF 04) : CRMR MATHEC, maladies auto-immunes et thérapie cellulaire (UF 04), 1, avenue Claude-Vellefaux, 75010 Paris, France; Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, URP-3518, 75010 Paris, France; Department of Medicine, McGill University, H3A 1A1, Montreal, Canada.
| | - G Pugnet
- Service de médecine interne et immunologie clinique, pôle hospitalo-universitaire des maladies digestives, CHU Rangueil, 1, avenue du Pr-Jean-Poulhès, 31059 Toulouse cedex 9, France
| | - M Allez
- AP-HP, hôpital Saint-Louis, service d'hépato-gastro-entérologie, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Castilla-Llorente
- Gustave-Roussy cancer center, département d'hématologie, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - E Chatelus
- Département de rhumatologie, hôpitaux universitaires de Strasbourg, Strasbourg, France; Centre de référence des maladies auto-immunes systémiques rares de l'Est et du Sud-Ouest, Strasbourg, France
| | - P Cintas
- CHU Toulouse Purpan, service de neurologie, place du Dr-Baylac, 31059 Toulouse cedex 9, France
| | - C Faucher-Barbey
- Direction prélèvements et greffes de CSH, Direction médicale et scientifique, Agence de la biomédecine, 93212 St-Denis/La Plaine, France
| | - P Labauge
- CRC SEP, service de neurologie, CHU de Montpellier, 34295 Montpellier cedex 5, France
| | - C Labeyrie
- AP-HP, CHU de Bicêtre, service de neurologie, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - B Lioure
- Département d'onco-hématologie, université de Strasbourg, ICANS, Strasbourg, France
| | - A Maria
- Médecine interne & immuno-oncologie (MedI2O), Institute for Regenerative Medicine & Biotherapy (IRMB), hôpital Saint-Éloi, CHU de Montpellier, 80, avenue Augustin-Fliche, Montpellier, France; IRMB, Inserm U1183, hôpital Saint-Éloi, CHU de Montpellier, 34295 Montpellier, France
| | - D Michonneau
- Université de Paris, IRSL, Recherche clinique appliquée à l'hématologie, URP-3518, 75010 Paris, France; Service d'hématologie-greffe, AP-HP, hôpital Saint-Louis, institut de recherche Saint-Louis, Paris, France
| | - M Puyade
- CHU de Poitiers, service de médecine interne, 2, rue de La-Miletrie, 86021 Poitiers, France
| | - M Talouarn
- AP-HP, hôpital Saint-Antoine, service d'hématologie clinique et thérapie cellulaire, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - L Terriou
- CHU de Lille, département de médecine interne et immunologie clinique, 59000 Lille, France; Centre de référence des maladies auto-immunes et auto-inflammatoires rares (CERAINO), 59000 Lille, France
| | - X Treton
- Université de Paris, hôpital Beaujon, service de gastro-entérologie, MICI et assistance nutritive, DMU DIGEST, 100, boulevard Leclerc, 92110 Clichy, France
| | - G Wojtasik
- Université de Lille, Inserm, CHU de Lille, service de médecine interne et immunologie clinique, Centre de référence des maladies auto-immunes systémiques rares du Nord et Nord-Ouest de France (CeRAINO), U1286 - INFINITE - Institut de recherche translationnelle sur l'inflammation, Lille, France
| | - H Zephir
- CHU de Lille, université de Lille, pôle des neurosciences et de l'appareil locomoteur, Lille Inflammation Research International Center (LIRIC), UMR 995, rue Émile-Laine, 59000 Lille, France
| | - Z Marjanovic
- AP-HP, hôpital Saint-Antoine, service d'hématologie clinique et thérapie cellulaire, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
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Guillet S, Crickx E, Azzaoui I, Chappert P, Boutin E, Viallard JF, Rivière E, Gobert D, Galicier L, Malphettes M, Cheze S, Lefrere F, Audia S, Bonnotte B, Lambotte O, Noel N, Fain O, Moulis G, Hamidou M, Gerfaud-Valentin M, Marolleau JP, Terriou L, Martis N, Morin AS, Perlat A, Le Gallou T, Roy-Peaud F, Robbins A, Lega JC, Puyade M, Comont T, Limal N, Languille L, Zarrour A, Luka M, Menager M, Belmondo T, Hue S, Canoui-Poitrine F, Michel M, Godeau B, Mahévas M. Prolonged response after TPO-RA discontinuation in primary ITP: results of a prospective multicenter study. Blood 2023; 141:2867-2877. [PMID: 36893453 DOI: 10.1182/blood.2022018665] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/30/2023] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
Sustained response off treatment (SROT) after thrombopoietin receptor agonist (TPO-RA) discontinuation has been reported in immune thrombocytopenia (ITP). This prospective multicenter interventional study enrolled adults with persistent or chronic primary ITP and complete response (CR) on TPO-RAs. The primary end point was the proportion of patients achieving SROT (platelet count >30 × 109/L and no bleeding) at week 24 (W24) with no other ITP-specific medications. Secondary end points included the proportion of sustained CR off-treatment (SCROT, platelet count >100 × 109/L and no bleeding) and SROT at W52, bleeding events, and pattern of response to a new course of TPO-RAs. We included 48 patients with a median age of 58.5 years; 30 of 48 had chronic ITP at TPO-RA initiation. In the intention-to-treat analysis, 27 of 48 achieved SROT, 15 of 48 achieved SCROT at W24; 25 of 48 achieved SROT, and 14 of 48 achieved SCROT at W52. No severe bleeding episode occurred in patients who relapsed. Among patients rechallenged with TPO-RA, 11 of 12 achieved CR. We found no significant clinical predictors of SROT at W24. Single-cell RNA sequencing revealed enrichment of a tumor necrosis factor α signaling via NF-κB signature in CD8+ T cells of patients with no sustained response after TPO-RA discontinuation, which was further confirmed by a significant overexpression of CD69 on CD8+ T cells at baseline in these patients as compared with those achieving SCROT/SROT. Our results strongly support a strategy based on progressive tapering and discontinuation of TPO-RAs for patients with chronic ITP who achieved a stable CR on treatment. This trial was registered at www.clinicaltrials.gov as #NCT03119974.
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Affiliation(s)
- Stéphanie Guillet
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Etienne Crickx
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U1151/CNRS UMS 8253, Institut Necker Enfants Malades, ATIP-Avenir Team AI2B, Université de Paris Cité, Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM UMR U1163,Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, Université de Paris Cité, Paris, France
| | - Imane Azzaoui
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U1151/CNRS UMS 8253, Institut Necker Enfants Malades, ATIP-Avenir Team AI2B, Université de Paris Cité, Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U955, Équipe 2, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Pascal Chappert
- INSERM U1151/CNRS UMS 8253, Institut Necker Enfants Malades, ATIP-Avenir Team AI2B, Université de Paris Cité, Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U955, Équipe 2, Université Paris-Est Créteil (UPEC), Créteil, France
| | - Emmanuelle Boutin
- Unité de Recherche Clinique (Mondor), AP-HP, Henri Mondor Hôpitaux Universitaires, Créteil, France
- INSERM, Institut Mondor de Recherche Biomédicale, Équipe Clinical Epidemiology and Ageing, UPEC, Créteil, France
| | - Jean-François Viallard
- Service de Médecine Interne, Haut-Lévêque Hôpital, Université de Bordeaux, Bordeaux, France
| | - Etienne Rivière
- Service de Médecine Interne, Haut-Lévêque Hôpital, Université de Bordeaux, Bordeaux, France
| | - Delphine Gobert
- Service de Médecine Interne, Saint Antoine Hôpital, AP-HP, Sorbonne Université, Paris, France
| | - Lionel Galicier
- Service d'Immunologie Clinique, Saint Louis Hôpital, AP-HP, Université de Paris Cité, Paris, France
| | - Marion Malphettes
- Service d'Immunologie Clinique, Saint Louis Hôpital, AP-HP, Université de Paris Cité, Paris, France
| | - Stéphane Cheze
- Institut d'Hématologie de Basse-Normandie, Centre Hospitalier de Caen Normandie, Caen, France
| | | | - Sylvain Audia
- Service de Médecine Interne et d'Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-Immunes, Hôpital François Mitterrand, Centre Hospitalier Universitaire (CHU) Dijon-Bourgogne, Dijon, France
| | - Bernard Bonnotte
- Service de Médecine Interne et d'Immunologie Clinique, Centre de Référence Constitutif des Cytopénies Auto-Immunes, Hôpital François Mitterrand, Centre Hospitalier Universitaire (CHU) Dijon-Bourgogne, Dijon, France
| | - Olivier Lambotte
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Nicolas Noel
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, AP-HP, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Olivier Fain
- Service de Médecine Interne, Saint Antoine Hôpital, AP-HP, Sorbonne Université, Paris, France
| | - Guillaume Moulis
- Service de Médecine Interne, CHU de Toulouse, Toulouse, France
- CIC 1436, Équipe PEPSS, CHU de Toulouse, Toulouse, France
| | | | | | - Jean-Pierre Marolleau
- Service d'Hématologie Clinique et Thérapie Cellulaire, CHU Amiens-Picardie, Amiens, France
| | - Louis Terriou
- Service de Médecine Interne et d'Immunologie Clinique, CHU de Lille, Lille, France
| | - Nihal Martis
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital de Nice, Nice, France
| | - Anne-Sophie Morin
- Service de Médecine Interne, Jean Verdier Hôpital, AP-HP, Bondy, France
| | - Antoinette Perlat
- Service de Médecine Interne et Immunologie Clinique, CHU de Rennes, Rennes, France
| | - Thomas Le Gallou
- Service de Médecine Interne et Immunologie Clinique, CHU de Rennes, Rennes, France
| | - Frédérique Roy-Peaud
- Service de Médecine Interne-Maladies Infectieuses et Tropicales, CHU de Poitiers, Poitiers, France
| | - Ailsa Robbins
- Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Robert Debré Hospital, Reims University Hospitals, Reims, France
| | - Jean-Christophe Lega
- Service de Médecine Interne, Hospices Civils de Lyon, Lyon Sud Hôpital, Pierre-Bénite, France
| | - Matthieu Puyade
- Service de Médecine Interne, CHU de Poitiers, Poitiers, France
| | - Thibault Comont
- Service de Médecine Interne, CHU de Toulouse (IUCT-Oncopole), Toulouse, France
| | - Nicolas Limal
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Laetitia Languille
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Anissa Zarrour
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Marine Luka
- Université Paris Cité, Institut Imagine, Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Atip-Avenir Team, INSERM UMR 1163, F-75015 Paris, France
| | - Mickael Menager
- Université Paris Cité, Institut Imagine, Laboratory of Inflammatory Responses and Transcriptomic Networks in Diseases, Atip-Avenir Team, INSERM UMR 1163, F-75015 Paris, France
| | - Thibault Belmondo
- Département Immunologie-Hématologie, Henri Mondor Hôpital, AP-HP, UPEC, Créteil, France
- UPEC, Faculté de Médecine, Créteil, France
- Service de Santé Publique, AP-HP, Henri Mondor Hôpitaux Universitaires, Créteil, France
| | - Sophie Hue
- Département Immunologie-Hématologie, Henri Mondor Hôpital, AP-HP, UPEC, Créteil, France
- UPEC, Faculté de Médecine, Créteil, France
- INSERM U955, Équipe 16, Institut Mondor de Recherche Biomédicale, UPEC, Créteil, France
| | - Florence Canoui-Poitrine
- Unité de Recherche Clinique (Mondor), AP-HP, Henri Mondor Hôpitaux Universitaires, Créteil, France
- Service de Santé Publique, AP-HP, Henri Mondor Hôpitaux Universitaires, Créteil, France
| | - Marc Michel
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Bertrand Godeau
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
| | - Matthieu Mahévas
- Service de Médecine Interne, Centre National de Référence des Cytopénies Auto-Immunes de l'Adulte, Henri Mondor Hôpital, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U1151/CNRS UMS 8253, Institut Necker Enfants Malades, ATIP-Avenir Team AI2B, Université de Paris Cité, Université Paris-Est Créteil (UPEC), Créteil, France
- INSERM U955, Équipe 2, Université Paris-Est Créteil (UPEC), Créteil, France
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Croquette M, Puyade M, Montani D, Jutant EM, De Géa M, Lanéelle D, Thollot C, Trihan JE. Diagnostic Performance of Pulsed Doppler Ultrasound of the Common Femoral Vein to Detect Elevated Right Atrial Pressure in Pulmonary Hypertension. J Cardiovasc Transl Res 2023; 16:141-151. [PMID: 35604591 DOI: 10.1007/s12265-022-10276-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
Abstract
Right atrial pressure (RAP) is an important prognostic criterion in pulmonary hypertension (PH). The main goals were to evaluate the following: (i) the accuracy of Doppler assessment of common femoral vein flow waveform to detect elevated RAP and (ii) the diagnostic accuracy of RAP assessed by echocardiography (eRAP). Fifty-seven patients, addressed for right heart catheterization, were included in a retrospective cross-sectional study during a 6-month period. Forty-five patients (78.9%) had PH confirmed by RHC. Elevated RAP was defined by RAP ≥ 10 mmHg. Femoral venous stasis index (FVSI) was highly correlated to RAP on both univariate (p < 0.001) and multivariate analysis (p = 0.003), and showed good diagnostic performances to detect elevated RAP (specificity: 92.3% [80.0-99.3], diagnosis accuracy: 90.4 [77.4-97.3], positive likelihood ratio: 12.5 [3.01-51.97]). Diagnosis accuracy of eRAP was only 51.2% (36.2-66.1). FVSI is independently correlated to RAP and a useful tool to predict elevated RAP in PH patients.
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Affiliation(s)
- Magali Croquette
- Vascular Medicine Unit, Cardio-Vascular Center, University Hospital of Poitiers, Poitiers, France
| | - Matthieu Puyade
- Department of Internal Medicine, University Hospital of Poitiers, Poitiers, France
| | - David Montani
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999 Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Etienne-Marie Jutant
- Pneumologie, CHU de Poitiers, Poitiers, France.,INSERM CIC 1402, ALIVE Research Group, University of Poitiers, Poitiers, France
| | - Marion De Géa
- Department of Cardiology, CHU de Poitiers, Poitiers, France
| | - Damien Lanéelle
- Vascular Medicine Unit, Centre Hospitalier Universitaire de Caen Normandie, Caen, France.,COMETE Laboratory, INSERM 1075, Université de Caen, 14000, Caen, France
| | - Cécile Thollot
- Vascular Medicine Unit, Cardio-Vascular Center, University Hospital of Poitiers, Poitiers, France
| | - Jean-Eudes Trihan
- Vascular Medicine Unit, Cardio-Vascular Center, University Hospital of Poitiers, Poitiers, France.
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Suleiman M, Costedoat-Chalumeau N, Le Guern V, Morel N, Amoura Z, Espitia O, Martis N, Jeandel P, Audia S, Cormarmond C, Sève P, Sene D, Gerfaud-Valentin M, Goutte J, Lavigne C, Thomas G, Bourgarit A, Roblot P, Puyade M, Martin M. Syndrome des antiphospholipides et atteinte surrénalienne : étude cas-témoin nationale multicentrique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.060] [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: 12/12/2022]
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5
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Martin M, Nguyen H, Beuvon C, Benne J, Palassin P, Atzenhoffer M, Rouby F, Sassier M, Perault-Pochat M, Roblot P, Allouchery M, Puyade M. Cytopénies auto-immunes induites par les inhibiteurs de points de contrôle immunitaire : à propos de 68 cas issus de la base nationale de pharmacovigilance. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.040] [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: 12/12/2022]
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Hemmer M, Terriou L, Malphettes M, Ginoux M, Puyade M, Sève P, Hot A, Godeau B, Lobbes H. Érythroblastopénies auto-immunes associées aux tumeurs thymiques, cohorte nationale rétrospective française. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.048] [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: 12/12/2022]
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Fonlupt C, Rault C, Puyade M, Diaz V, Roblot P, Martin M. Évaluation objective de l’atteinte musculaire respiratoire dans la sclérodermie systémique. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.264] [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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Roeser A, Moulis G, Ebbo M, Terriou L, Poullot E, Lioger B, Chilles M, Labussière-Wallet H, Mausservey C, Pha M, Puyade M, Cheze S, Limal N, Michel M, Godeau B, Mahevas M. Une série rétrospective multicentrique évaluant les caractéristiques, la prise en charge et l’évolution des thrombopénies amégacaryocytaires acquises. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.307] [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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Roeser A, Puyade M. Actualités en immuno-hématologie. Rev Med Interne 2021; 42:10S9-10S11. [PMID: 34598749 DOI: 10.1016/s0248-8663(21)00657-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- A Roeser
- Service de médecine interne, Assistance publique - hôpitaux de Paris, 3, avenue Victoria, 75004 Paris, France
| | - M Puyade
- Service de médecine interne et de maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
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Roeser A, Puyade M. Actualités dans la COVID-19. Rev Med Interne 2021; 42:10S12-10S13. [PMID: 34598743 PMCID: PMC8479323 DOI: 10.1016/s0248-8663(21)00658-5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Roeser
- Service de médecine interne, Assistance publique - hôpitaux de Paris, 3, avenue Victoria, 75004 Paris, France
| | - M Puyade
- Service de médecine interne et de maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
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11
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Nguekap O, Martin M, Salaun K, Fontanelle J, Landron C, Roy-Péaud F, Souchaud-Debouverie O, Luca L, Ramassamy A, Gellen-Dautremer J, Roblot P, Puyade M, Prat L. [Thrombocytosis in a 56 year-old woman]. Rev Med Interne 2021; 42:746-749. [PMID: 34462152 DOI: 10.1016/j.revmed.2021.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/08/2021] [Indexed: 02/07/2023]
Affiliation(s)
- O Nguekap
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - M Martin
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Faculté de médecine et pharmacie, Université de Poitiers, 6, rue de la Milétrie, 86000 Poitiers, France
| | - K Salaun
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - J Fontanelle
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - C Landron
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - F Roy-Péaud
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - O Souchaud-Debouverie
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - L Luca
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - A Ramassamy
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - J Gellen-Dautremer
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - P Roblot
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Faculté de médecine et pharmacie, Université de Poitiers, 6, rue de la Milétrie, 86000 Poitiers, France
| | - M Puyade
- Service de médecine interne, Maladies infectieuses, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - L Prat
- Service de médecine interne, hôpital privé Jacques-Cartier, 6, avenue du Noyer Lambert, 91300 Massy, France
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12
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Luca L, Beuvon C, Puyade M, Roblot P, Martin M. [Selective IgA deficiency]. Rev Med Interne 2021; 42:764-771. [PMID: 34364731 DOI: 10.1016/j.revmed.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/14/2021] [Accepted: 07/17/2021] [Indexed: 10/20/2022]
Abstract
Selective IgA deficiency (SIgAD) is defined by the European Society for Immunodeficiencies (ESID) as a serum IgA of less than 0.07g/L in patients greater than 4 years old with normal levels of IgG and IgM, normal vaccine responses, and with the exclusion of secondary causes of hypogammaglobulinemia. When serum IgA level is higher than 0.07g/L but two standard deviations below normal for age, the condition may be referred to as partial IgA deficiency, which is quite common. SIgAD is the most common primary immunodeficiency in Europe (1/600 in France) and most patients with SIgAD are asymptomatic (75-90%). The clinical complications associated with SIgAD include recurrent respiratory infections (in particular involving Haemophilus influenza and Streptococcus pneumoniae) and gastrointestinal (mainly due to Giardialamblia), autoimmune and allergic manifestations (anaphylaxis if blood products with IgA are administrated), inflammatory gastrointestinal disease. There is no specific treatment for SIgAD and each patient must be managed individually. While asymptomatic subjects do not need any treatment, it is still necessary for them to be up-to-date with vaccinations. If the patient experiences recurrent infections, prophylactic antibiotics may be beneficial. Immunoglobulin replacement therapy should be considered in patients with SIgAD and concomitant IgG subclass deficiency. Treatment for autoimmune and allergic manifestations is based on current standards of care for specific disease entities. To improve quality of life and reduce morbidity, an interdisciplinary team approach is essential.
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Affiliation(s)
- L Luca
- Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France.
| | - C Beuvon
- Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France
| | - M Puyade
- Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - P Roblot
- Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France
| | - M Martin
- Service de médecine interne, maladies infectieuses et tropicales, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers cedex, France; Université de Poitiers, 6, rue de la Milétrie, TSA 51115, 86073 Poitiers cedex 9, France
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13
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Coustal C, Quantin X, Lesage C, Michot J, Laparra A, Ederhy S, Assenat E, Faure M, Issa N, Lambotte O, Puyade M, Dereure O, Rullier P, Serre I, Klouche K, Vernhet H, Faillie J, Roubille F, Guilpain P, Maria A. Facteurs pronostiques des myocardites induites par les inhibiteurs du checkpoint immunologique. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.243] [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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14
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Motillon G, Landron C, Frouin E, Boutin D, Puyade M, Roblot P, Martin M. Dermatose neutrophilique urticarienne associée à un syndrome de Gougerot-Sjögren : description d’une nouvelle association. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.212] [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: 10/21/2022]
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15
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Urbain F, Labeyrie C, Castilla-Llorente C, Cintas P, Puma A, Maubeuge N, Puyade M, Farge D. [Autologous hematopoietic stem cell transplantation for chronic inflammatory demyelinating polyneuropathy]. Rev Med Interne 2021; 42:639-649. [PMID: 33773849 DOI: 10.1016/j.revmed.2021.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/02/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a dysimmune neuropathy with sensory and/or motor symptoms due to destruction of the myelin sheat secondary to an auto-immune attack. A quarter to a third of patients do not respond to immunomodulatory first line recommended therapies. No second line treatment has shown its effectiveness with a sufficient level of evidence. Autologous hematopoietic stem cell transplantation (AHSCT) is a promising therapy for autoimmune disease, especially for CIDP in recent works. We present in this article an update on the diagnosis of CIDP, its conventional treatments as well as the results of AHSCT in this indication, which was the subject of French recommendations under the aegis of the SFGMTC and neuromuscular disease french faculty (FILNEMUS) as a third line therapy after failure of two first-line and one second-line treatments.
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Affiliation(s)
- F Urbain
- Assistance Publique-Hôpitaux de Paris, Université Paris-Saclay, service de medecine interne, groupe hospitalier universitaire Paris Sud, hôpital Bicêtre, 94275 Le Kremlin-Bicêtre cedex, France.
| | - C Labeyrie
- Assistance Publique-Hôpitaux de Paris, centre de reference maladies rares neuropathies amyloïdes familiales et autres neuropathies peripheriques rares, service de neurologie, groupe hospitalier universitaire Paris Sud, hôpital Bicêtre, 94275 Le Kremlin-Bicêtre cedex, France
| | - C Castilla-Llorente
- Institut Gustave-Roussy, service d'hématologie, 114, rue Édouard-Vaillant, 94800 Villejuif, France
| | - P Cintas
- Explorations neurophysiologiques, centre SLA, centre de référence de pathologie neuromusculaire, CHU Toulouse, hôpital Pierre-Paul-Riquet, 31059 Toulouse Cedex, France
| | - A Puma
- Maladies du systeme nerveux peripherique et du muscle, Centre SLA, hôpital Pasteur 2-Zone C, CS 51069, 06001 Nice cedex 1, France
| | - N Maubeuge
- CHU de Poitiers, service de neurologie, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - M Puyade
- CHU de Poitiers, service de médecine interne et maladies infectieuses, 2, rue de la Milétrie, 86021 Poitiers cedex, France; CHU de Poitiers, CIC-1402, 2, rue de la Milétrie, 86021 Poitiers cedex, France
| | - D Farge
- Unité de médecine interne, maladies auto-immunes et pathologie vasculaire UF04, Centre de référence des maladies auto-immunes systémiques rares d'Île-de-France MATHEC Hôpital Saint-Louis, UF04, Filière 'FAI2R', 1, avenue Claude-Vellefaux, 75475 Paris, France; Université de Paris, EA 3518, Paris, France; Département de Médecine, Université McGill, Montreal, QC, Canada
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16
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Puyade M, Patel A, Yeong L, Blank N, Badoglio M, Gualandi F, Ma D, Maximova N, Grecco R, Alexander T, Snowden J. Autogreffe de cellules souches dans la maladie de Behçet: analyse rétrospective du registre de l’European Society for Blood and Bone Marrow Transplantation. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.118] [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: 11/27/2022]
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17
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Beuvon C, Rammaert B, Torregrossa J, Gallego Hernanz M, Roblot F, Roblot P, Puyade M. Impact du seuil de fièvre dans l’initiation de l’antibiothérapie empirique chez les patients atteints de neutropénie fébrile : étude FLAM. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.249] [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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18
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Lauda-Maillen M, Lemaignen A, Puyade M, Catroux M, Le Moal G, Beraud G, El Hajj H, Michaud A, Destrieux C, Bernard L, Rammaert B, Cazenave-Roblot F. Feasibility of early switch to oral antibiotic in brain abscesses and empyema: a multicentre retrospective study. Eur J Clin Microbiol Infect Dis 2020; 40:209-213. [PMID: 32671654 DOI: 10.1007/s10096-020-03904-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 04/07/2020] [Indexed: 11/26/2022]
Affiliation(s)
- M Lauda-Maillen
- Université de Poitiers, Poitiers, France.
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France.
| | - A Lemaignen
- Université de Tours, Tours, France
- Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, Hôpital Bretonneau, Tours, France
| | - M Puyade
- Service de Médecine Interne, CHU de Poitiers, Poitiers, France
| | - M Catroux
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - G Le Moal
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - G Beraud
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
| | - H El Hajj
- Service de Neurochirurgie, CHU de Poitiers, Poitiers, France
| | - A Michaud
- Service de Microbiologie, CHU de Poitiers, Poitiers, France
| | - C Destrieux
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
- Service de Neurochirurgie, CHRU de Tours, Tours, France
| | - L Bernard
- Université de Tours, Tours, France
- Service de Médecine Interne et Maladies Infectieuses, CHRU de Tours, Hôpital Bretonneau, Tours, France
| | - B Rammaert
- Université de Poitiers, Poitiers, France
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
- INSERM U1070, Poitiers, France
| | - F Cazenave-Roblot
- Université de Poitiers, Poitiers, France
- Service de Maladies Infectieuses et Tropicales, CHU de Poitiers, 2 rue de la Milétrie CS 90577, 86021, Poitiers cedex, France
- INSERM U1070, Poitiers, France
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19
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Systchenko T, Defossez G, Guidez S, Laurent C, Puyade M, Debiais-Delpech C, Dreyfus B, Machet A, Leleu X, Delwail V, Ingrand P. R-CHOP appears to be the best first-line treatment for second primary diffuse large B cell lymphoma: a cancer registry study. Ann Hematol 2020; 99:1605-1613. [PMID: 32451709 DOI: 10.1007/s00277-020-04100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Abstract
Second primary diffuse large B cell lymphoma (spDLBCL) is defined as a metachronous tumor occurring after a first primary cancer. To date, while R-CHOP is the standard first-line treatment for de novo DLBCL, no available data show that R-CHOP is the optimal treatment for spDLBCL. This exploratory study aimed to investigate treatment of spDLBCL. From 2008 to 2015, the Poitou-Charentes general cancer registry recorded 68 cases of spDLBCL ≤ 80 years old, having received a first-line treatment with either R-CHOP (78%) or other regimens (22%). Patients without R-CHOP have worse overall survival in univariate (HR 2.89 [1.33-6.24], P = 0.007) and multivariate (HR 2.98 [1.34-6.67], P = 0.008) analyses. Patients without R-CHOP more frequently had PS > 1 (67% vs. 28%, P = 0.007) and prior chemotherapy (60% vs. 26%, P = 0.02), which suggests that both of these factors influence a clinician's decision to not use R-CHOP. Prior chemotherapy had no prognostic impact in univariate and multivariate analyses; this result could call into question the risk-benefit balance of not using R-CHOP to prevent toxicity. In our study, one DLBCL out of ten occurred after a first primary cancer, and as regards de novo DLBCL, R-CHOP appeared to be the best first-line treatment. Larger series are needed to confirm these results.
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Affiliation(s)
- T Systchenko
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France. .,INSERM CIC 1402, CHU de Poitiers, Poitiers, France. .,Haematology Department, CHU de Poitiers, Poitiers, France.
| | - G Defossez
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
| | - S Guidez
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - C Laurent
- Anatomy-pathology Department, CHU de Toulouse, Réseau Lymphopath, Toulouse, France
| | - M Puyade
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
| | | | - B Dreyfus
- Haematology Department, CHU de Poitiers, Poitiers, France
| | - A Machet
- Haematology Department, CHU de Poitiers, Poitiers, France
| | - X Leleu
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - V Delwail
- INSERM CIC 1402, CHU de Poitiers, Poitiers, France.,Haematology Department, CHU de Poitiers, Poitiers, France
| | - P Ingrand
- Poitou-Charentes General Cancer Registry, Université de Poitiers, 6 rue de la Milétrie, 86073, Poitiers Cedex 9, France.,INSERM CIC 1402, CHU de Poitiers, Poitiers, France
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20
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Martellosio JP, Barra A, Roy-Peaud F, Souchaud-Debouverie O, Martin M, Lateur C, Gombert JM, Roblot P, Puyade M. Performance diagnostique des rapports κ/λ des chaines légères libres sériques (test Freelite®) et IgGκ/IgGλ (test Hevylite®) comme marqueurs pronostiques de chronicisation du purpura thrombopénique immunologique de l’adulte. Rev Med Interne 2020; 41:3-7. [DOI: 10.1016/j.revmed.2019.10.333] [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: 06/23/2019] [Revised: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
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21
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Monier A, Puyade M, Hernanz MPG, Bouchaert P, Leleu X, Tourani JM, Roblot F, Rammaert B. Observational study of vaccination in cancer patients: How can vaccine coverage be improved? Med Mal Infect 2019; 50:263-268. [PMID: 31848105 DOI: 10.1016/j.medmal.2019.11.006] [Citation(s) in RCA: 5] [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: 09/15/2018] [Revised: 03/04/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Chemotherapy increases the risk of infections, often severe, and some of them are vaccine-preventable infections. We aimed to assess vaccination coverage and associated factors in oncology and hematology patients. METHODS Consecutive adult patients followed in a French university hospital for hematological malignancy or solid cancer voluntarily completed an anonymous questionnaire in September and October 2016. It included questions on underlying disease, chemotherapy, flu, and pneumococcal vaccination uptakes, and attitudes toward vaccination. Factors associated with vaccination uptake were assessed by multivariate logistic regression. RESULTS The response rate was 41.9% (N=671) among 1,600 questionnaires distributed; 232 patients had underlying hematological malignancy and 439 had solid cancer. Half of the patients were aged over 65 years. Chemotherapy was ongoing or discontinued for less than one year in 74.7% of patients. In patients aged <65 years undergoing chemotherapy, flu vaccination rate was 19.9% whereas patients aged >65 years had coverage of 47%. Pneumococcal vaccine uptake was 7.3%. However, 64.7% of patients were favorable to vaccination. Vaccine uptake was associated with age >65 years (OR 4.5 [2.9-7.0]), information about vaccination delivered by the family physician (OR 12.9 [5.5-30.1]), follow-up in hematology unit (OR 2.0 [1.3-3.1]), and positive opinion about vaccination (OR 2.0 [1.3-3.1]). CONCLUSION Despite specific recommendations regarding immunocompromised patients, anti-pneumococcal and flu vaccinations were rarely conducted, even in elderly patients. Targeted information campaigns to family physicians, oncologists, and patients should be implemented to improve vaccine coverage in patients with underlying malignancies.
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Affiliation(s)
- A Monier
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France
| | - M Puyade
- Service de médecine interne, CHU de Poitiers, Poitiers, France
| | - M P Gallego Hernanz
- Service d'hématologie et thérapie cellulaire, CHU de Poitiers, Poitiers, France
| | - P Bouchaert
- Service d'oncologie médicale, CHU de Poitiers, Poitiers, France
| | - X Leleu
- Service d'hématologie et thérapie cellulaire, CHU de Poitiers, Poitiers, France; Inserm CIC 1402, Poitiers, France
| | - J M Tourani
- Service d'oncologie médicale, CHU de Poitiers, Poitiers, France
| | - F Roblot
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France; Inserm U1070, Poitiers, France
| | - B Rammaert
- Faculté de médecine et pharmacie, University of Poitiers, Poitiers, France; Service de maladies infectieuses et tropicales, CHU de Poitiers, Poitiers, France; Inserm U1070, Poitiers, France.
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22
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Rolland M, Fontanelle J, Puyade M, Landron C, Roblot P, Martin M. Tularémie. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.304] [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: 11/17/2022]
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23
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Martellosio J, Puyade M, Elsendoorn A, Souchaud-Debouverie O, Roblot P, Martin M. Rendement diagnostique de la biopsie ostéo-médullaire en médecine interne : étude rétrospective monocentrique de 506 cas. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.033] [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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24
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Giraud V, Landron C, Cohen-Aubart F, Lhote R, Nguekap Tchoumba O, Bourgarit A, Puyade M. L’obésité est-elle prise en compte dans la prescription d’une anticoagulation préventive ? Étude post-hoc de la base SiFMI 2017. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.034] [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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25
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Joncour A, Puyade M, Michaud A, Tourani JM, Cazenave-Roblot F, Rammaert B. Is current initial empirical antibiotherapy appropriate to treat bloodstream infections in short-duration chemo-induced febrile neutropenia? Support Care Cancer 2019; 28:3103-3111. [DOI: 10.1007/s00520-019-05113-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 10/06/2019] [Indexed: 11/28/2022]
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26
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Glavier M, Puyade M, Roblot F, Rammaert B. Vaccination of cancer patients treated with chemotherapy: A survey among general practitioners. Med Mal Infect 2019; 49:586-592. [PMID: 31551165 DOI: 10.1016/j.medmal.2019.09.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/13/2018] [Accepted: 09/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Despite specific recommendations issued by the French Public Health Council (Haut Conseil de Santé Publique), the vaccination coverage of patients with cancer or malignant blood disease remains insufficient. The aim of this study was to assess the vaccination of chemotherapy patients by their general practitioner (GP). METHODS A survey was conducted between March and July 2017 in 4 French departments to describe the immunization practices of GPs for their chemotherapy patients and provide solutions to help to increase the vaccination rate. RESULTS Of the 1610 GPs who received the questionnaire, 287 (17.8%) returned a usable form; 92.6% were globally pro-vaccine. One third of GPs (37.3%) declared that they vaccinated all their chemotherapy patients. The GPs (n=180) who never or only sometimes vaccinated their chemotherapy patients mainly voiced concerns about not being properly trained (45.6%) and the lack of easily available information on vaccination (35.0%). Three-quarters (n=212; 74%) of the GPs wanted to improve their level of medical knowledge via continuing education (52.4%) or by reading guidelines available on-line (39.6%). GPs suggested that a specific vaccination schedule be included in the letter they receive from the cancer specialist (72.8%) and that patient awareness be increased (50.5%). CONCLUSIONS GPs are in favor of the vaccination of cancer patients. The main obstacles stated are the lack of education and the lack of easily available information. Vaccination coverage could be increased by improving the doctor-to-doctor relation between GPs and cancer specialists.
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Affiliation(s)
- M Glavier
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; Service de maladies infectieuses et tropicales et médecine interne, CHU de Poitiers, 86000 Poitiers, France
| | - M Puyade
- Service de maladies infectieuses et tropicales et médecine interne, CHU de Poitiers, 86000 Poitiers, France
| | - F Roblot
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; INSERM U1070, 86000 Poitiers, France
| | - B Rammaert
- Faculté de médecine, université de Poitiers, 86000 Poitiers, France; INSERM U1070, 86000 Poitiers, France.
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Motillon G, Landron C, Roblot P, Puyade M, Suhrab S, Léger A, Peyrou J. Syndrome de Tako-Tsubo secondaire à un choc anaphylactique traité par adrénaline. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.270] [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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Martellosio JP, Leleu X, Roblot P, Martin M, Puyade M. Dosage des chaînes légères libres : indications et méthodes. Rev Med Interne 2019; 40:297-305. [DOI: 10.1016/j.revmed.2019.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/04/2019] [Accepted: 01/20/2019] [Indexed: 12/18/2022]
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Glavier M, Puyade M, Roblot F, Rammaert B. Vaccination des patients atteints de cancer sous chimiothérapie : enquête de pratique auprès de médecins généralistes. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.350] [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: 10/14/2022]
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Boutin D, Frouin E, Puyade M, Hainaut E, Godet J, Solassol J. Implication de TRAP1 dans le mélanome cutané primitif. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.525] [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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Hunault-Berger M, Maillard N, Himberlin C, Recher C, Schmidt-Tanguy A, Choufi B, Bonmati C, Carré M, Couturier MA, Daguindau E, Marolleau JP, Orsini-Piocelle F, Delaunay J, Tavernier E, Lissandre S, Ojeda-Uribe M, Sanhes L, Sutton L, Banos A, Fornecker LM, Bernard M, Bouscary D, Saad A, Puyade M, Rouillé V, Luquet I, Béné MC, Hamel JF, Dreyfus F, Ifrah N, Pigneux A. Maintenance therapy with alternating azacitidine and lenalidomide in elderly fit patients with poor prognosis acute myeloid leukemia: a phase II multicentre FILO trial. Blood Cancer J 2017; 7:e568. [PMID: 28574488 PMCID: PMC5520397 DOI: 10.1038/bcj.2017.50] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- M Hunault-Berger
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - N Maillard
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - C Himberlin
- Service d'Hématologie, CHU Reims, Reims, France
| | - C Recher
- Hématologie Clinique, CHU, Institut Universitaire du Cancer Toulouse-Oncopole, CRCT UMR1037, Université de Toulouse III, Toulouse, France
| | - A Schmidt-Tanguy
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - B Choufi
- Service d'Hématologie, CH Boulogne, Boulogne, France
| | - C Bonmati
- Service d'Hématologie, CHU Nancy, Nancy, France
| | - M Carré
- Service d'Hématologie, UMR 5525, CHU Grenoble Alpes, La Tronche, France
| | - M-A Couturier
- Institut d'Hématologie et de Cancérologie, Hôpital Augustin Morvan, Brest, France
| | - E Daguindau
- Service d'Hématologie, CHU Besançon, Besançon, France
| | | | | | - J Delaunay
- Service d'Hématologie, CHU Nantes, Nantes, France
| | - E Tavernier
- Service d'Hématologie, Institut de Cancérologie de la Loire, Saint Etienne, France
| | - S Lissandre
- Service d'Hématologie et thérapie cellulaire, CHU, Tours, France
| | - M Ojeda-Uribe
- Service d'Hématologie, CH Mulhouse, Mulhouse, France
| | - L Sanhes
- Service d'Hématologie, CH Perpignan, Perpignan, France
| | - L Sutton
- Service d'Hématologie, CH Argenteuil, Argenteuil, France
| | - A Banos
- Service d'Hématologie, CH Côte Basque, Bayonne, France
| | - L M Fornecker
- Département d'Hématologie et d'Oncologie, CHU Hautepierre, Strasbourg, France
| | - M Bernard
- Hématologie Clinique, Hôpital Pontchaillou, Rennes, France
| | - D Bouscary
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - A Saad
- Hématologie, CH Béziers, Béziers, France
| | - M Puyade
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - V Rouillé
- Service Hématologie, Hôpital Lapeyronie, Montpellier, France
| | - I Luquet
- Hématologie Biologique, CHU, IUC Toulouse-Oncopole, Toulouse, France
| | - M C Béné
- Hématologie Biologique, CHU de Nantes, Nantes, France
| | - J-F Hamel
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - F Dreyfus
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - N Ifrah
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - A Pigneux
- Hématologie Clinique, CHU Bordeaux, Inserm 1035, Bordeaux, France
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Monier A, Puyade M, Bouchaert P, Tourani J, Leleu X, Roblot F, Rammaert B. Enquête sur la vaccination des patients d’onco-hématologie dans un pôle régional de cancérologie. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.284] [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: 10/19/2022]
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Delaval L, De Boysson H, Liozon E, Daumas A, Lazaro E, Blockmans D, Puyade M, Benhamou Y, Sacré K, Berezne A, Samson M, Terrier B. Caractéristiques des vascularites des vaisseaux de gros calibre diagnostiquées entre 50 et 60 ans : étude rétrospective portant sur 181 cas. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.03.094] [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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Meriglier E, Puyade M, Carretier M, Roblot F, Roblot P. [Long-term infectious risks after splenectomy: A retrospective cohort study with up to 10 years follow-up]. Rev Med Interne 2017; 38:436-443. [PMID: 28190612 DOI: 10.1016/j.revmed.2016.12.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/16/2016] [Accepted: 12/30/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period. METHODS A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015. RESULTS One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days-12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR=6.2; 95%CI: 1.4-27.1; after 65 years old) and underlying reason for splenectomy (P=0.02). There is no difference with or without prophylactic antibiotics. CONCLUSION After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy.
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Affiliation(s)
- E Meriglier
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - M Puyade
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - M Carretier
- Service de chirurgie viscérale, centre hospitalier universitaire de Poitiers, Poitiers, France
| | - F Roblot
- Service de maladies infectieuses et tropicales, centre hospitalier universitaire Poitiers, Poitiers, France
| | - P Roblot
- Service de médecine interne, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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Meriglier E, Puyade M, Roblot P. PADS 1-08 - Complications infectieuses au delà de 10 ans chez les patients splénectomisés. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30479-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Meriglier E, Puyade M, Cazenave-Roblot F, Roblot P. Complications infectieuses à long terme des patients splénectomisés : cohorte rétrospective avec un suivi de plus de 10ans. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.276] [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: 10/21/2022]
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37
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Colin O, Julian A, Puyade M, Bouyer S, Meurin E, Blondeau S, Houeto JL, Neau JP. [Relapse of acute promyelocytic leukemia in the central nervous system revealed by isolated dementia]. Rev Med Interne 2016; 37:844-848. [PMID: 27020402 DOI: 10.1016/j.revmed.2016.02.015] [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: 07/21/2015] [Revised: 12/16/2015] [Accepted: 02/26/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Approximately 1.5% of dementia is due to curable aetiology. We report an isolated dementia syndrome due to a meningeal relapse of acute promyelocytic leukaemia with favourable outcome after appropriate treatment. CASE REPORT A 72-year-old woman, in remission of an acute promyelocytic leukaemia, presented a loss of autonomy for several months due to corticosubcortical dementia. Lumbar puncture showed blast cells indicating meningeal relapse of leukaemia. Intrathecal chemotherapy and arsenic trioxide obtained biological and molecular remission as well as restoration of normal cognitive functions. CONCLUSION In patients with hematologic past history such as acute promyelocytic leukaemia, an isolated cognitive impairment should alert physicians to search for an isolated neuromeningeal relapse.
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Affiliation(s)
- O Colin
- Service de neurologie et neuropsychologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
| | - A Julian
- Service de neurologie et neuropsychologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France; Centre mémoire de ressources et de recherche Poitou-Charentes, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - M Puyade
- Service d'onco-hématologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - S Bouyer
- Laboratoire d'hématologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - E Meurin
- Centre mémoire de ressources et de recherche Poitou-Charentes, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - S Blondeau
- Centre mémoire de ressources et de recherche Poitou-Charentes, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - J L Houeto
- Service de neurologie et neuropsychologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France; Centre mémoire de ressources et de recherche Poitou-Charentes, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
| | - J P Neau
- Service de neurologie et neuropsychologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France; Centre mémoire de ressources et de recherche Poitou-Charentes, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France
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Puyade M, Defossez G, Guilhot F, Ingrand P. Multiple myeloma: the quality of care is linked to geographical and organisational determinants. A study in a French registry. Eur J Cancer Care (Engl) 2015; 25:855-63. [PMID: 26603508 DOI: 10.1111/ecc.12414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2015] [Indexed: 11/28/2022]
Abstract
Multiple myeloma is a haematological malignancy whose care is spread over several specialities and provided by centres that various sizes, which raises the issue of equal opportunities in care access. Incident cases of myeloma between 2008 and 2010 were exhaustively identified by the Poitou-Charentes Cancer Registry. To ascertain the quality of care, the diagnosis, staging, and treatment administered were compared to international recommendations. Three hundred and sixty-seven patients were included. The diagnostic procedure exhibited 98% compliance, the staging 58%, and treatment 89%. Concerning diagnostic and staging, non-compliance with recommendations was associated to the failure to perform collegiate case assessments in multidisciplinary team (MDT) meetings [OR 2.15 (1.15-4.04)], care provided at a secondary centre, and a distance between home and the centre of 5-25 km [2.16 (1.06-4.40)] and 25-50 km [2.86 (1.37-6.01)]. Regarding treatment, non-compliance with recommendations was associated with care provided at a secondary centre [5.28 (2.03-13.75)]. Finally, diagnosis, staging and treatment quality improved over time. This study underlines the need to improve the organisation of the healthcare offer, so that patients can receive the best possible care. MDT seems to be the main means to improve quality of care.
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Affiliation(s)
- M Puyade
- INSERM CIC 1402, Poitiers Cedex.,Registre des Cancers Poitou-Charentes, Faculté de Médecine et Pharmacie, Université Poitiers, Poitiers Cedex 9, France
| | - G Defossez
- Registre des Cancers Poitou-Charentes, Faculté de Médecine et Pharmacie, Université Poitiers, Poitiers Cedex 9, France
| | | | - P Ingrand
- INSERM CIC 1402, Poitiers Cedex.,Registre des Cancers Poitou-Charentes, Faculté de Médecine et Pharmacie, Université Poitiers, Poitiers Cedex 9, France
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Cassou-Mounat T, Delwail V, Cayssials E, Terroir M, Puyade M. Use of temozolomide instead of cyclophosphamide in diffuse large B-cell lymphoma. Leuk Lymphoma 2015; 57:724-5. [DOI: 10.3109/10428194.2015.1070152] [Citation(s) in RCA: 2] [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: 12/31/2022]
Affiliation(s)
- T. Cassou-Mounat
- Department of Nuclear Medicine, Hospital St Antoine APHP, UPMC Paris, 184 rue du Fg St Antoine, 75012 Paris, France
| | - V. Delwail
- Department of Haematology, CHU Poitiers, 2 rue de la Miletrie, 86000 Poitiers, France
| | - E. Cayssials
- Department of Haematology, CHU Poitiers, 2 rue de la Miletrie, 86000 Poitiers, France
| | - M. Terroir
- Department of Nuclear Medicine, Gustave Roussy, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - M. Puyade
- Department of Haematology, CHU Poitiers, 2 rue de la Miletrie, 86000 Poitiers, France
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Saunier A, Puyade M, Greib C, Chaigne Delalande S, Pellegrin JL, Viallard JF, Lazaro E, Néel A. Une histoire qui aurait pu se dérouler à la bourse de Londres. Rev Med Interne 2014; 35:274-7. [DOI: 10.1016/j.revmed.2013.07.010] [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: 07/21/2013] [Accepted: 07/24/2013] [Indexed: 11/29/2022]
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Puyade M, Badin J, Quéron B, Christiaens L, Varroud-Vial N, Pierre F, Pourrat O. Purpura thrombotique thrombocytopénique : ne pas méconnaître l’atteinte cardiaque. Rev Med Interne 2014; 35:264-7. [DOI: 10.1016/j.revmed.2013.02.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 02/11/2013] [Accepted: 02/13/2013] [Indexed: 01/30/2023]
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Puyade M, Guilhot F, Defossez G, Ingrand P. Inégalités d’accès aux soins chez les patients atteints de myélome multiple en Poitou-Charentes de 2008–2010. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.030] [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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Puyade M, Contis A, Saunier A, Narain Sookool U, Greib C, Pellegrin JL, Viallard JF, Seneschal J, Lazaro E. Une gammapathie payée rubis sur ongle. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.273] [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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Roux X, Puyade M, Aumaître O. [Training in internal medicine: the young internists' point of view]. Rev Med Interne 2011; 32:714-6. [PMID: 21852024 DOI: 10.1016/j.revmed.2011.07.006] [Citation(s) in RCA: 4] [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] [Received: 12/19/2010] [Revised: 06/17/2011] [Accepted: 07/16/2011] [Indexed: 11/26/2022]
Abstract
In France, internal medicine is a speciality obtained after 5 years of theoretical and practical training, often completed by additional years. The last version of the official training program was released in 2004 and was characterised by its polyvalence. After the reform of medical studies was announced, the French young internists group decided to carry out a survey in order to know the vision of the young internist about their initial theoretical and practical training. This survey was done online using a questionnaire from February 10th to April 8th, 2010. One hundred and twenty-three young internists under training completed the questionnaire. The results showed that a high number of trainees chose a subspeciality and took a complementary training afterwards. About 63% of them would rather have more theoretical training through lectures (72%) and oral presentations (58%). Eighty-eight per cent of young internists would rather have a national frame of reference with a common training program. According to 73% of the young internists who completed the survey, the practical training is adapted but 95% of them would like to be given the opportunity to have some consultation during their initial training. Seventy-nine per cent of the young internists seem to be interested in the clinical research but most of them (89%) think to be not well trained enough to do it.
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Affiliation(s)
- X Roux
- Service de médecine interne, hôpital d'instruction des armées de Metz, France.
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Puyade M, Albouy-Llaty M, Kurrimbukus R, Baudemont C, Bellarbre F, Roy-Péaud F, Landron C, Roblot P, Paccalin M. Étude d’intervention pour diminuer la prescription des numérations formule sanguine en médecine interne et en gériatrie. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.028] [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: 11/27/2022]
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Puyade M, Landron C, Paccalin M, Roblot P. Neuropathie périphérique d’un syndrome de Gougerot-Sjögren liée à des anticorps anti-Yo sans cancer retrouvé. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.158] [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: 11/15/2022]
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