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Desmots F, Rossille D, Roussel M, Pangault C, Louarn L, De Saint Jore M, Le Gouill S, Bouabdallah K, Delwail V, Gressin R, Cornillon J, Damaj G, Maisonneuve H, Damotte D, Kraeber-Bodéré F, Lamy T, Parrens MC, Milpied N, Fest T. The negative influence of baseline cell-free DNA on long-term survival in DLBCL depends on frontline treatment intensity. Clin Cancer Res 2023:725124. [PMID: 37014666 DOI: 10.1158/1078-0432.ccr-22-2964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/13/2022] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE In this study, we address the question of the effect of first-line treatment intensity in de novo DLBCL on the impact of baseline cfDNA on long-term survival. EXPERIMENTAL DESIGN The GOELAMS 075 randomized clinical trial compared R-CHOP with high-dose R-chemotherapy plus autologous stem cell transplantation (R-HDT) for patients aged ≤60. An interim PET assessment was used to refer patients for salvage therapy. With a median follow-up of more than 5.8 years, we analyzed the effects of the treatment arm, salvage therapy, and cfDNA level at diagnosis on overall survival (OS). RESULTS In a representative group of 123 patients, a high cfDNA concentration (>55ng/ml) at diagnosis was associated with poor clinical prognostic factors and constituted a prognostic marker, independently of the age-adjusted International Prognostic Index. A cfDNA level above a threshold value of 55 ng/ml at diagnosis was associated with significantly worse OS. In an intention-to-treat analysis, high-cfDNA R-CHOP patients (but not high-cfDNA R-HDT patients) had worse OS (hazard ratio [95% confidence interval]: 3.99 [1.98-10.74], P=0.006). In patients with high cfDNA levels, salvage therapy and transplantation were associated with a significantly higher OS rate. Among 50 patients with complete response 6 months after the end of treatment, for 11 out of 24 R-CHOP patients, the cfDNA did not fall back to normal values. CONCLUSIONS In this randomized clinical trial, intensive regimens mitigated the negative influence of high cfDNA levels in de novo DLBCL, relative to R-CHOP.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Vincent Delwail
- Service d'Hématologie et Thérapie Cellulaire and CIC Inserm 1402, Poitiers, France
| | | | | | | | | | | | - Françoise Kraeber-Bodéré
- ICO Cancer Center, University Hospital, CRCINA, University of Nantes, INSERM UMR1232, CNRS-ERL6001, France
| | | | | | - Noël Milpied
- university hospital of Bordeaux, Bordeaux, France
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2
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Galtier J, Brice P, Bouabdallah K, Gros FX, Dilhuydy MS, Milpied N. eBEACOPP or A-AVD in advanced Hodgkin lymphoma: (re)thinking the toxicities in the PET-driven strategies era. Lancet Haematol 2021; 8:e620. [PMID: 34450096 DOI: 10.1016/s2352-3026(21)00239-8] [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: 07/27/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Jean Galtier
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Bordeaux, 33600 Bordeaux, France.
| | - Pauline Brice
- Service d'hématologie-oncologie, hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, 75010 Paris, France
| | - Krimo Bouabdallah
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Bordeaux, 33600 Bordeaux, France
| | - Françoix-Xavier Gros
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Bordeaux, 33600 Bordeaux, France
| | - Marie-Sarah Dilhuydy
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Bordeaux, 33600 Bordeaux, France
| | - Noël Milpied
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Bordeaux, 33600 Bordeaux, France
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3
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Galtier J, Parrens M, Milpied N. [Peripheral T cell lymphomas: diagnosis and treatment]. Rev Med Interne 2020; 41:829-837. [PMID: 32674892 DOI: 10.1016/j.revmed.2020.05.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 10/23/2022]
Abstract
Peripheral T cell lymphomas are rare malignancies with aggressive course, with several different subtype described in the 2016 WHO classification. Their distribution across the world is heterogenous, with marked difference between Western and Asian country. Their clinical presentation often comprise extra-nodal involvement, B symptoms and immune system disorder which can lead to wrong diagnosis orientation. Make a right diagnosis need a experienced pathologist in close collaboration with clinical datas. Peripheral T cell lymphomas are in general associated with poor prognosis when treated with anthracyclines-based regimen, and several studies and trials focused on the use of intensified regimen or novel targeted agents, whose proper indication still remain to be clarified.
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Affiliation(s)
- J Galtier
- CHU Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut-Leveque, F-33000 Bordeaux, France.
| | - M Parrens
- CHU Bordeaux, Unité de pathologie, Hôpital Haut-Leveque, F-33000 Bordeaux, France
| | - N Milpied
- CHU Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Haut-Leveque, F-33000 Bordeaux, France
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Timsit JF, Leverger G, Milpied N, Gachot B. Treatment of invasive fungal infections in intensive care units with micafungin: The MYRIADE study. Mycoses 2020; 63:443-451. [PMID: 32048344 DOI: 10.1111/myc.13060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/08/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Invasive fungal infections (IFIs) contribute significantly to nosocomial illness in intensive care units (ICUs). Current practice guidelines recommend echinocandins, such as micafungin, for the treatment of invasive candidiasis. However, limited information on their use in real-world practice is available. OBJECTIVE To describe the conditions of the use of micafungin in daily clinical practice and to evaluate its effectiveness and tolerability under real-world conditions. PATIENTS/METHODS This observational, prospective, multicentre study was performed in 34 ICUs in France. The study population consisted of 275 patients ≥16 years old who received treatment with micafungin during the inclusion period. Dose and duration of treatment were at the discretion of the physician. RESULTS Proven invasive candidiasis was documented before treatment in 106 patients (38.6%); 263 patients (95.6%) received the recommended dose (100 mg/day); 78 patients (28.8%) were treated for the recommended duration. A successful outcome was observed for 217 patients (79.2%). This proportion was significantly higher (83.3%; P < .0001) in patients treated for ≥14 days. Three patients discontinued treatment due to an adverse event considered related to micafungin. No clear impact of micafungin on hepatic function was observed. CONCLUSION Micafungin was effective in >75% of patients treated for IFIs in ICUs in France; outcomes may be improved with closer adherence to the recommended treatment duration.
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Affiliation(s)
- Jean-François Timsit
- Assistance Publique des Hôpitaux de Paris, Medical and Infectious Diseases Intensive Care Unit, Bichat Hospital, Paris, France
| | - Guy Leverger
- Assistance Publique des Hôpitaux de Paris, Pediatric Hematology Oncology Unit, Armand Trousseau Hospital, Paris, France
| | - Noël Milpied
- Hematology Department, Haut-Leveque Hospital, Bordeaux, France
| | - Bertrand Gachot
- Department of Acute Care, Gustave-Roussy Institute - Cancer Campus Grand Paris, Villejuif, France
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5
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Mesguich C, Bouabdallah K, Bordenave L, Milpied N, Hindié E. Interim PET Assessment of Advanced Hodgkin Lymphoma: Is It Sufficient? J Nucl Med 2020; 61:1694-1695. [DOI: 10.2967/jnumed.120.242594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Perino J, Mottal N, Bohbot Y, Servant V, Berroneau A, Poustis P, Fenaux P, Laribi K, Charbonnier A, Bilion E, Calmettes C, Bégaud B, Pigneux A, Milpied N, Miremont-Salamé G, Théophile H, Dimicoli-Salazar S. Cardiac failure in patients treated with azacitidine, a pyrimidine analogue: Case reports and disproportionality analyses in Vigibase. Br J Clin Pharmacol 2020; 86:991-998. [PMID: 31912911 DOI: 10.1111/bcp.14211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/25/2019] [Accepted: 12/09/2019] [Indexed: 01/09/2023] Open
Abstract
AIMS Azacitidine (AZA), a pyrimidine analogue, is validated for high-risk myelodysplastic syndrome or low-blast acute myeloid leukaemia in unfit patients for more intensive treatment. This study assessed the putative link between cardiac failure (CF) and AZA exposure. METHODS Cases of CF in patients treated with AZA were retrospectively collected and described from several centres of the Groupe Francophone des Myélodysplasies. A description analysis and a disproportionality analysis using Vigibase, the WHO Global Individual Case Safety Reports (ICSRs) database, were conducted on ICSRs by the Standardized MedDRA Queries (SMQ broad) cardiac failure and by preferred terms cardiac failure and cardiac failure acute. The reported odds ratio (ROR) and its 95% 2-sided confidence interval was computed by comparing the proportion of CF reports with the suspected drug (AZA) and the proportion of reports of the same adverse drug reaction with all other suspected drugs in the database during the same period. RESULTS In the 4 case reports, all patients presented a cardiovascular history. In 1 patient, CF recurred after AZA re-challenge. The pharmacovigilance analysis in Vigibase retrieved 307 ICSRs of CF (SMQ) with AZA. Significant disproportionality signals associated with AZA were identified by using the SMQ cardiac failure (ROR 1.3) and the preferred terms cardiac failure (ROR 5.1) and cardiac failure acute (ROR 23.2). CONCLUSION This study points to the potential role of AZA in the occurrence of CF. Cardiac evaluation before AZA initiation and regular monitoring of cardiac function during AZA treatment should be performed in patients with a history of cardiovascular disease.
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Affiliation(s)
- Justine Perino
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France
| | - Nathan Mottal
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Yohann Bohbot
- CHU d'Amiens, Pôle Cœur-Thorax-Vaisseaux, Département de Cardiologie, Amiens Cedex, France
| | - Vincent Servant
- Pharmacie à Usage Intérieur, CHU de Bordeaux, Pessac, France
| | - Aude Berroneau
- Pharmacie à Usage Intérieur, CHU de Bordeaux, Pessac, France
| | - Pierre Poustis
- Service des soins intensifs cardiologiques Haut-Lévêque (intensive care unit), Pessac, France
| | - Pierre Fenaux
- Service d'Hematologie Seniors, Hôpital Saint Louis, Ass Pub Hôp Paris and Paris 7 Université Paris, France
| | - Kamel Laribi
- Service d'Hematologie, Centre Hospitalier du Mans, Le Mans, France
| | - Aude Charbonnier
- Service d'Hematologie, Institut Paoli Calmettes, Marseille, France
| | - Emilien Bilion
- Service d'Hematologie, Institut Paoli Calmettes, Marseille, France
| | - Claire Calmettes
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Bernard Bégaud
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, team Pharmacoepidemiology, Bordeaux, France
| | - Arnaud Pigneux
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Noël Milpied
- CHU de Bordeaux, Service d'Hématologie Clinique et Thérapie Cellulaire Bordeaux, France
| | - Ghada Miremont-Salamé
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France.,Univ. Bordeaux, Inserm, Bordeaux Population Health Research Centre, team Pharmacoepidemiology, Bordeaux, France
| | - Hélène Théophile
- CHU de Bordeaux, Pôle de Santé Publique, Service de pharmacologie médicale, Centre Régional de pharmacovigilance de Bordeaux, Bordeaux, France
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7
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Milpied N. [Treatment of malignant blood diseases in hospital and in the home in the 21st century]. Soins 2019; 64:22-25. [PMID: 31864507 DOI: 10.1016/j.soin.2019.10.002] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Modern day treatment of blood cancers is characterised by the introduction of targeted therapies. Alone or in combination with more traditional treatments, administered in a hospital or an outpatient setting, these new medicines possess specific mechanisms of action and particular side effects in addition to or instead of those of traditional treatments. To understand the changes to the care management of patients taking these new treatments, it is necessary to describe their mechanism of action and their side effects.
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Affiliation(s)
- Noël Milpied
- Service d'hématologie clinique et thérapie cellulaire, hôpital Haut-Lévêque, 33604 Pessac cedex, France.
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8
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Mesguich C, Roch A, Hindié E, Milpied N, Bordenave L, Tlili G, Bouabdallah K. Prognostic utility of pre-transplantation [ 18 F] fluorodeoxyglucose positron emission tomography/computed tomography in patients with diffuse large B-cell lymphoma who underwent rituximab, dexamethasone, high-dose cytarabine, carboplatin salvage chemotherapy. Br J Haematol 2019; 188:268-271. [PMID: 31388998 DOI: 10.1111/bjh.16144] [Citation(s) in RCA: 2] [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: 04/15/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022]
Abstract
We analysed the outcomes of 62 patients with refractory/relapsed diffuse large B-cell lymphoma (rrDLBCL) who had pre-transplantation fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) after R-DHAC (rituximab, dexamethasone, high-dose cytarabine, carboplatin) salvage chemotherapy, and were evaluated using Deauville criteria and total lesion glycolysis (TLG). A positive pre-transplantation PET/CT with Deauville score of 5 was associated with shorter progression-free survival (PFS) (P = 0·01), while a Deauville score of 4 was not predictive of outcome. Only pre-transplant TLG was significantly associated with both PFS (P = 0·005) and overall survival (P = 0·03). TLG deserves to be further investigated in prospective studies.
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Affiliation(s)
| | | | - Elif Hindié
- Médecine Nucléaire, CHU Bordeaux, Bordeaux, France
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9
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Camou F, Didier M, Leguay T, Milpied N, Daste A, Ravaud A, Mourissoux G, Guisset O, Issa N. Long-term prognosis of septic shock in cancer patients. Support Care Cancer 2019; 28:1325-1333. [PMID: 31243586 DOI: 10.1007/s00520-019-04937-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 11/23/2018] [Accepted: 06/11/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES In the last decades, the number of cancer patients admitted in intensive care units (ICUs) for septic shock has dramatically increased. However, prognosis data remain scarce. METHODS To assess the 180-day mortality rate in cancer patients admitted to the ICU for septic shock, a 5-year prospective study was performed. All adult patients admitted for septic shock were included and categorized into the following two groups and four subgroups: cancer patients (solid tumor or hematological malignancy) and non-cancer patients (immunocompromised or not). Data were collected and compared between the groups. Upon early ICU admission, the decision to forgo life-sustaining therapy (DFLST) or not was made by consultation among hematologists, oncologists, and the patients or their relatives. RESULTS During the study period, 496 patients were admitted for septic shock: 252 cancer patients (119 hematological malignancies and 133 solid tumors) and 244 non-cancer patients. A DFLST was made for 39% of the non-cancer patients and 52% of the cancer patients. The 180-day mortality rate among the cancer patients was 51% and 68% for those with hematological malignancies and solid cancers, respectively. The mortality rate among the non-cancer patients was 44%. In a multivariate analysis, the performance status, Charlson comorbidity index, simplified acute physiology score 2, sequential organ failure assessment score, and DFLST were independent predictors of 180-day mortality. CONCLUSIONS Despite early admission to the ICU, the 180-day mortality rate due to septic shock was higher in cancer patients compared with non-cancer patients, due to excess mortality in the patients with solid tumors. The long-term prognosis of cancer patients with septic shock is modulated by their general state, severity of organ failure, and DFLST.
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Affiliation(s)
- Fabrice Camou
- Intensive Care and Infectious Disease Unit, CHU Bordeaux, 33000, Bordeaux, France
| | - Marion Didier
- Intensive Care and Infectious Disease Unit, CHU Bordeaux, 33000, Bordeaux, France
| | | | - Noël Milpied
- Hematology, CHU Bordeaux, 33000, Bordeaux, France
| | | | | | - Gaëlle Mourissoux
- Intensive Care and Infectious Disease Unit, CHU Bordeaux, 33000, Bordeaux, France
| | - Olivier Guisset
- Intensive Care and Infectious Disease Unit, CHU Bordeaux, 33000, Bordeaux, France
| | - Nahéma Issa
- Intensive Care and Infectious Disease Unit, CHU Bordeaux, 33000, Bordeaux, France. .,Hôpital Saint-André, 1 rue Jean Burguet, 33075, Bordeaux, France.
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10
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Favre S, Botella-Garcia C, Bijou F, Deau-Fisher B, Banos A, Rispal P, Saint-Lézer A, Fitoussi O, Lifermann F, Labouré G, Dagada C, Milpied N, Bouabdallah K. OUTCOME OF PATIENTS WITH C-MYC REARRANGED DIFFUSE LARGE B CELL LYMPHOMA ASSOCIATED OR NOT WITH BCL2 AND/OR BCL6 REARRANGEMENT: A MULTICENTRIC AND RETROSPECTIVE STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.17_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Favre
- Hematology; University Hospital of Bordeaux; Pessac France
| | | | - F. Bijou
- Hematology; Bergonié Institute; Bordeaux France
| | | | - A. Banos
- Hematology; Centre Hospitalier de la Côte Basque; Bayonne France
| | - P. Rispal
- Medecine; Centre Hospitalier Agen-Nérac; Agen France
| | - A. Saint-Lézer
- Medecine; Centre Hospitalier de Mont-de-Marsan; Mont-de-Marsan France
| | - O. Fitoussi
- Hematology; Polyclinique Bordeaux Nord Aquitaine; Bordeaux France
| | | | - G. Labouré
- Hematology; Centre Hospitalier de Libourne; Libourne France
| | - C. Dagada
- Medecine; Centre hospitalier de Pau; Pau France
| | - N. Milpied
- Hematology; University Hospital of Bordeaux; Pessac France
| | - K. Bouabdallah
- Hematology; University Hospital of Bordeaux; Pessac France
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11
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Dumas PY, Naudin C, Martin-Lannerée S, Izac B, Casetti L, Mansier O, Rousseau B, Artus A, Dufossée M, Giese A, Dubus P, Pigneux A, Praloran V, Bidet A, Villacreces A, Guitart A, Milpied N, Kosmider O, Vigon I, Desplat V, Dusanter-Fourt I, Pasquet JM. Hematopoietic niche drives FLT3-ITD acute myeloid leukemia resistance to quizartinib via STAT5-and hypoxia-dependent upregulation of AXL. Haematologica 2019; 104:2017-2027. [PMID: 30923103 PMCID: PMC6886433 DOI: 10.3324/haematol.2018.205385] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 03/21/2019] [Indexed: 12/28/2022] Open
Abstract
Internal tandem duplication in Fms-like tyrosine kinase 3 (FLT3-ITD) is the most frequent mutation observed in acute myeloid leukemia (AML) and correlates with poor prognosis. FLT3 tyrosine kinase inhibitors are promising for targeted therapy. Here, we investigated mechanisms dampening the response to the FLT3 inhibitor quizartinib, which is specific to the hematopoietic niche. Using AML primary samples and cell lines, we demonstrate that convergent signals from the hematopoietic microenvironment drive FLT3-ITD cell resistance to quizartinib through the expression and activation of the tyrosine kinase receptor AXL. Indeed, cytokines sustained phosphorylation of the transcription factor STAT5 in quizartinib-treated cells, which enhanced AXL expression by direct binding of a conserved motif in its genomic sequence. Likewise, hypoxia, another well-known hematopoietic niche hallmark, also enhanced AXL expression. Finally, in a xenograft mouse model, inhibition of AXL significantly increased the response of FLT3-ITD cells to quizartinib exclusively within a bone marrow environment. These data highlight a new bypass mechanism specific to the hematopoietic niche that hampers the response to quizartinib through combined upregulation of AXL activity. Targeting this signaling offers the prospect of a new therapy to eradicate resistant FLT3-ITD leukemic cells hidden within their specific microenvironment, thereby preventing relapses from FLT3-ITD clones.
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Affiliation(s)
- Pierre-Yves Dumas
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux.,CHU Bordeaux, Service d'Hématologie Clinique et Thérapie cellulaire, F-33000, Bordeaux
| | - Cécile Naudin
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Séverine Martin-Lannerée
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Brigitte Izac
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Luana Casetti
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Olivier Mansier
- Service de Biologie des Tumeurs and Laboratoire d'Hématologie Biologique, Centre Hospitalo-Universitaire CHU Bordeaux, F-33000, Bordeaux
| | - Benoît Rousseau
- Service Commun des Animaleries, Animalerie A2, Université de Bordeaux, Bordeaux
| | - Alexandre Artus
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Mélody Dufossée
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
| | - Alban Giese
- Institut National de la Santé et de la Recherche Médicale INSERM U1218, and UMS005 TBM Core, Plateforme d'Histopathologie Expérimentale, Université de Bordeaux, F33000 Bordeaux
| | - Pierre Dubus
- Institut National de la Santé et de la Recherche Médicale INSERM U1218, and UMS005 TBM Core, Plateforme d'Histopathologie Expérimentale, Université de Bordeaux, F33000 Bordeaux.,Institut National de la Santé et de la Recherche Médicale, INSERM U1053, F33000 Bordeaux
| | - Arnaud Pigneux
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux.,CHU Bordeaux, Service d'Hématologie Clinique et Thérapie cellulaire, F-33000, Bordeaux
| | - Vincent Praloran
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux.,CHU Bordeaux, Service d'Hématologie Clinique et Thérapie cellulaire, F-33000, Bordeaux
| | - Audrey Bidet
- Service de Biologie des Tumeurs and Laboratoire d'Hématologie Biologique, Centre Hospitalo-Universitaire CHU Bordeaux, F-33000, Bordeaux
| | - Arnaud Villacreces
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
| | - Amélie Guitart
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
| | - Noël Milpied
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux.,CHU Bordeaux, Service d'Hématologie Clinique et Thérapie cellulaire, F-33000, Bordeaux
| | - Olivier Kosmider
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris.,Service d'Hématologie Biologique, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre, Paris, France
| | - Isabelle Vigon
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
| | - Vanessa Desplat
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
| | - Isabelle Dusanter-Fourt
- Université de Paris, Institut Cochin, Institut National de la Santé et de la Recherche Médicale INSERM U1016, Centre National de la Recherche Scientifique CNRS UMR8104, F-75014 Paris
| | - Jean-Max Pasquet
- Université de Bordeaux, Institut National de la Santé et de la Recherche Médicale INSERM U1035, F-33000 Bordeaux
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Mesguich C, Bouabdallah K, Milpied N, Hindié E. Additional Evidence That End-of-Treatment Fluorodeoxyglucose-Positron Emission Tomography Evaluation Is Necessary in Advanced Hodgkin Lymphoma. J Clin Oncol 2018; 36:2124-2125. [PMID: 29791291 DOI: 10.1200/jco.2018.78.6780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Charles Mesguich
- Charles Mesguich, Krimo Bouabdallah, Noël Milpied, and Elif Hindié, Bordeaux University Hospital, Bordeaux, France
| | - Krimo Bouabdallah
- Charles Mesguich, Krimo Bouabdallah, Noël Milpied, and Elif Hindié, Bordeaux University Hospital, Bordeaux, France
| | - Noël Milpied
- Charles Mesguich, Krimo Bouabdallah, Noël Milpied, and Elif Hindié, Bordeaux University Hospital, Bordeaux, France
| | - Elif Hindié
- Charles Mesguich, Krimo Bouabdallah, Noël Milpied, and Elif Hindié, Bordeaux University Hospital, Bordeaux, France
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13
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Craddock C, Versluis J, Labopin M, Socie G, Huynh A, Deconinck E, Volin L, Milpied N, Bourhis JH, Rambaldi A, Chevallier P, Blaise D, Manz M, Vellenga E, Vekemans MC, Maertens J, Passweg J, Vyas P, Schmid C, Löwenberg B, Ossenkoppele G, Mohty M, Cornelissen JJ, Nagler A. Distinct factors determine the kinetics of disease relapse in adults transplanted for acute myeloid leukaemia. J Intern Med 2018; 283:371-379. [PMID: 29214689 DOI: 10.1111/joim.12720] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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] [Indexed: 01/16/2023]
Abstract
BACKGROUND Disease recurrence remains the major cause of death in adults with acute myeloid leukaemia (AML) treated using either intensive chemotherapy (IC) or allogenic stem cell transplantation (allo-SCT). AIMS The timely delivery of maintenance drug or cellular therapies represent emerging strategies with the potential to reduce relapse after both treatment modalities, but whilst the determinants of overall relapse risk have been extensively characterized the factors determining the timing of disease recurrence have not been characterized. MATERIALS AND METHODS We have therefore examined, using a series of sequential landmark analyses, relapse kinetics in a cohort of 2028 patients who received an allo-SCT for AML in CR1 and separately 570 patients treated with IC alone. RESULTS In the first 3 months after allo-SCT, the factors associated with an increased risk of relapse included the presence of the FLT3-ITD (P < 0.001), patient age (P = 0.012), time interval from CR1 to transplant (P < 0.001) and donor type (P = 0.03). Relapse from 3 to 6 months was associated with a higher white cell count at diagnosis (P = 0.001), adverse-risk cytogenetics (P < 0.001), presence of FLT3-ITD mutation (P < 0.001) and time interval to achieve first complete remission (P = 0.013). Later relapse was associated with adverse cytogenetics, mutated NPM1, absence of chronic graft-versus-host disease (GVHD) and the use of in vivo T-cell depletion. In patients treated with IC alone, the factors associated with relapse in the first 3 months were adverse-risk cytogenetics (P < 0.001) and FLT3-ITD status (P = 0.001). The factors predicting later relapse were the time interval from diagnosis to CR1 (P = 0.22) and time interval from CR1 to IC (P = 0.012). DISCUSSION AND CONCLUSION Taken together, these data provide novel insights into the biology of disease recurrence after both allo-SCT and IC and have the potential to inform the design of novel maintenance strategies in both clinical settings.
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Affiliation(s)
- C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital, Birmingham, UK
| | - J Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - M Labopin
- Department of Haematology, Hospital Saint Antoine, Paris, France
| | - G Socie
- Department of Hematology, Hospital Saint-Louis, Sorbonne University, Paris, France
| | - A Huynh
- Department of Haematology, CHU, Toulouse, France
| | - E Deconinck
- Department of Hematology, CHU, Besancon, France
| | - L Volin
- Stem Cell Transplantation Unit, HUCH Comprehensive Cancer Center, Helsinki, Finland
| | - N Milpied
- Department of Hamatology, CHU, Nantes, France
| | - J H Bourhis
- Department of Medical Oncology, Institute of Cancer, Villejuif, France
| | - A Rambaldi
- Department of Hematology, University of Milan, Milan, Italy
| | | | - D Blaise
- Department of Hematology, Centre of Cancer Research, Marseille, France
| | - M Manz
- Center for Hemato-Oncology, University Hospital Zurich, Zurich, Switzerland
| | - E Vellenga
- Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands
| | - M-C Vekemans
- Department of Hematology, Saint-Luc University, Brussels, Belgium
| | - J Maertens
- Department of Haematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - J Passweg
- Department of Haematology, University of Basel, Basel, Switzerland
| | - P Vyas
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - C Schmid
- Stem Cell Transplantation Unit, Department of Medicine, University of Munich, Munich, Germany
| | - B Löwenberg
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - G Ossenkoppele
- Department of Haematology, University Medical Center, Amsterdam, The Netherlands
| | - M Mohty
- Hospital Saint-Antoine, University UPMC, Paris, France
| | - J J Cornelissen
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - A Nagler
- Chaim Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel.,ALWP office of the EBMT Hospital Saint Antoine, Paris, France
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14
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Hindié E, Mesguich C, Bouabdallah K, Milpied N. Response to the letter by Adams and Kwee, entitled: “Unproven value of end-of-treatment FDG-PET in Hodgkin lymphoma”. Eur J Nucl Med Mol Imaging 2017; 44:1937-1939. [DOI: 10.1007/s00259-017-3773-6] [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: 11/27/2022]
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15
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Thevenot F, Ramasamy Iferkhass K, Cabantous T, Lafarge X, Jeanne M, Marit G, Milpied N. Comparaison d’efficacité de collecte en CD34 de deux séparateurs d’aphérèse en cas de faible leucocytose. Transfus Clin Biol 2017. [DOI: 10.1016/j.tracli.2017.06.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Lamoureux A, Vergier B, Fidelin-Ferrati G, Hans P, Milpied N, Beylot-Barry M. « Malignant » Rosacea as a sign of systemic marginal zone lymphoma. J Eur Acad Dermatol Venereol 2017; 32:e71-e72. [PMID: 28776782 DOI: 10.1111/jdv.14502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Lamoureux
- Dermatology Department, CHU Bordeaux, Bordeaux, France
| | - B Vergier
- INSERM U1053, Bordeaux Research in Translational Oncology, Team 3 Oncogenesis of Cutaneous Lymphomas, University of Bordeaux, Bordeaux, France.,Pathology Department, CHU Bordeaux, Pessac, France
| | | | - P Hans
- Dermatology Practice, Mont de Marsan, France
| | - N Milpied
- Hematology Department, CHU Bordeaux, Pessac, France
| | - M Beylot-Barry
- Dermatology Department, CHU Bordeaux, Bordeaux, France.,INSERM U1053, Bordeaux Research in Translational Oncology, Team 3 Oncogenesis of Cutaneous Lymphomas, University of Bordeaux, Bordeaux, France
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17
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Brissot E, Labopin M, Stelljes M, Ehninger G, Schwerdtfeger R, Finke J, Kolb HJ, Ganser A, Schäfer-Eckart K, Zander AR, Bunjes D, Mielke S, Bethge WA, Milpied N, Kalhs P, Blau IW, Kröger N, Vitek A, Gramatzki M, Holler E, Schmid C, Esteve J, Mohty M, Nagler A. Comparison of matched sibling donors versus unrelated donors in allogeneic stem cell transplantation for primary refractory acute myeloid leukemia: a study on behalf of the Acute Leukemia Working Party of the EBMT. J Hematol Oncol 2017; 10:130. [PMID: 28646908 PMCID: PMC5483262 DOI: 10.1186/s13045-017-0498-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 06/16/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Primary refractory acute myeloid leukemia (PRF-AML) is associated with a dismal prognosis. Allogeneic stem cell transplantation (HSCT) in active disease is an alternative therapeutic strategy. The increased availability of unrelated donors together with the significant reduction in transplant-related mortality in recent years have opened the possibility for transplantation to a larger number of patients with PRF-AML. Moreover, transplant from unrelated donors may be associated with stronger graft-mediated anti-leukemic effect in comparison to transplantations from HLA-matched sibling donor, which may be of importance in the setting of PRF-AML. METHODS The current study aimed to address the issue of HSCT for PRF-AML and to compare the outcomes of HSCT from matched sibling donors (n = 660) versus unrelated donors (n = 381), for patients with PRF-AML between 2000 and 2013. The Kaplan-Meier estimator, the cumulative incidence function, and Cox proportional hazards regression models were used where appropriate. RESULTS HSCT provide patients with PRF-AML a 2-year leukemia-free survival and overall survival of about 25 and 30%, respectively. In multivariate analysis, two predictive factors, cytogenetics and time from diagnosis to transplant, were associated with lower leukemia-free survival, whereas Karnofsky performance status at transplant ≥90% was associated with better leukemia-free survival (LFS). Concerning relapse incidence, cytogenetics and time from diagnosis to transplant were associated with increased relapse. Reduced intensity conditioning regimen was the only factor associated with lower non-relapse mortality. CONCLUSIONS HSCT was able to rescue about one quarter of the patients with PRF-AML. The donor type did not have any impact on PRF patients' outcomes. In contrast, time to transplant was a major prognostic factor for LFS. For patients with PRF-AML who do not have a matched sibling donor, HSCT from an unrelated donor is a suitable option, and therefore, initiation of an early search for allocating a suitable donor is indicated.
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Affiliation(s)
- Eolia Brissot
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
| | - Myriam Labopin
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
| | - Matthias Stelljes
- Department of Medicine A/Hematology and Oncology, University of Muenster, Muenster, Germany
| | - Gerhard Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum, Dresden, Germany
| | | | - Jürgen Finke
- Faculty of Medicine and Medical Center, Hematology, Oncology and Stem Cell Transplantation, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Arnold Ganser
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | | | - Axel R. Zander
- Bone Marrow Transplantation Center, University Hospital Eppendorf, Hamburg, Germany
| | - Donald Bunjes
- Klinik fuer Innere Medizin III, Universtätklinikum, Ulm, Germany
| | - Stephan Mielke
- Department of Internal Medicine II, Würzburg University Medical Center, Würzburg, Germany
| | - Wolfgang A. Bethge
- Medical Department, Hematology and Oncology, University of Tuebingen, Tübingen, Germany
| | | | - Peter Kalhs
- Department of Internal Medicine I, Bone Marrow Transplantation Unit, Medical University of Vienna, Vienna, Austria
| | - Igor-Woflgang Blau
- Charite-Campus Benjamin Franklin Universitaetsmedizin Berlin Klinik III- Hematologie u Onkologie, Hindenburgdamm, Berlin, Germany
| | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antonin Vitek
- Department of Clinical Hematology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Martin Gramatzki
- Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel, Germany
| | - Ernst Holler
- Department of Haematology/Oncology, University Hospital Regensburg, Regensburg, Germany
| | | | - Jordi Esteve
- Hospital Clinic Institut d’investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Mohamad Mohty
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, APHP, 184 rue du faubourg Saint-Antoine, 75571 Paris, Cedex 12 France
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
| | - Arnon Nagler
- Acute Leukemia Working Party Office, Hôpital Saint Antoine, APHP, Paris, France
- Chaim Sheba Medical Center, Tel Hashomer, Israel
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18
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Chabannon C, Bijou F, Grouin JM, Drillat P, Milpied N, Mohty M. The choice of in-hospital or home administration for plerixafor injection to poor mobilizers has no adverse consequence on subsequent hematopoietic stem cell harvest. Bone Marrow Transplant 2017; 52:1212-1214. [PMID: 28581475 DOI: 10.1038/bmt.2017.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- C Chabannon
- Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer, Université d'Aix-Marseille, Inserm CBT 1409, Centre d'Investigations Cliniques en Biothérapie, Marseille, France
| | - F Bijou
- Institut Bergonié, Bordeaux, France
| | - J-M Grouin
- Inserm U1219 'Population Health' and Université de Rouen, Rouen, France
| | - P Drillat
- Etablissement Français du Sang, Direction Médicale et Scientifique, La Plaine St Denis, France
| | - N Milpied
- Centre Hospitalier et Universitaire de Bordeaux, Bordeaux, France
| | - M Mohty
- Hôpital Saint Antoine, Assistance Publique des Hôpitaux de Paris (AP-HP), Université Pierre et Marie Curie (UPMC), INSERM, UMRs 938, Centre de Recherches Saint-Antoine, Paris, France
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19
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Gros FX, Cazaubiel T, Forcade E, Lechevalier N, Leguay T, Servant V, Tabrizi R, Clement L, Dumas PY, Bidet A, Pigneux A, Vigouroux S, Milpied N. Severe acute GvHD following administration of ipilimumab for early relapse of AML after haploidentical stem cell transplantation. Bone Marrow Transplant 2017; 52:1047-1048. [DOI: 10.1038/bmt.2017.78] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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20
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Mohty M, Drillat P, Grouin JM, Bijou F, Milpied N, Chabannon C. Addition of plerixafor to G-CSF is useful to achieve efficient collection even in very poor mobilizers: hope for patients with diminished hematopoietic function. Bone Marrow Transplant 2017; 52:1049-1050. [DOI: 10.1038/bmt.2017.80] [Citation(s) in RCA: 4] [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] [Indexed: 11/10/2022]
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21
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Debus L, Vigouroux S, Gargallo G, Adiko F, Milpied N. No adverse effect of granulocyte colony-stimulating factor during the peri-implantation period of an unrecognized pregnancy in a donor of peripheral blood stem cells. Leuk Lymphoma 2017; 58:2979-2980. [DOI: 10.1080/10428194.2017.1312389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lucile Debus
- Hématology and Cellular Therapy Unit, University Hospital of Bordeaux, Bordeaux, France
| | - Stéphane Vigouroux
- Hématology and Cellular Therapy Unit, University Hospital of Bordeaux, Bordeaux, France
| | - Guillaume Gargallo
- Hématology and Cellular Therapy Unit, University Hospital of Bordeaux, Bordeaux, France
| | - Fabienne Adiko
- Hématology and Cellular Therapy Unit, University Hospital of Bordeaux, Bordeaux, France
| | - Noël Milpied
- Hématology and Cellular Therapy Unit, University Hospital of Bordeaux, Bordeaux, France
- Bordeaux Segalen University, Bordeaux, Nouvelle Aquitaine, France
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22
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Lamoureux A, Vergier B, Fidelin-Ferrati G, Hans P, Milpied N, Beylot-Barry M. Des rosacées « malignes » : une présentation parfois révélatrice de lymphoprolifération B à petites cellules. Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.540] [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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Mesguich C, Cazeau AL, Bouabdallah K, Soubeyran P, Guyot M, Milpied N, Bordenave L, Hindié E. Hodgkin lymphoma: a negative interim-PET cannot circumvent the need for end-of-treatment-PET evaluation. Br J Haematol 2016; 175:652-660. [PMID: 27539369 DOI: 10.1111/bjh.14292] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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: 03/31/2016] [Accepted: 06/22/2016] [Indexed: 02/02/2023]
Abstract
We examined the outcome of a cohort of patients with Hodgkin lymphoma (HL) in order to assess if fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) at the end of treatment (end-PET) can be omitted when the interim PET (int-PET) is negative. Seventy-six ABVD(adriamycin, bleomycin, vinblastine, dacarbazine)-treated patients were retrospectively included. No change in treatment was made on the basis of int-PET results. Suspicious foci on end-PET received biopsy confirmation whenever possible. Median follow-up was 58·9 months. Uptake on int-PET higher than liver (scores 4-5) was rated positive according to the Lugano classification, while a positive end-PET corresponded to scores 3, 4 and 5. Fifteen patients had treatment failure. Sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy of int-PET were 46·7%, 85·2%, 43·8%, 86·7% and 77·6%, respectively. For end-PET the figures were: 80%, 93·4%, 75%, 95% and 90·8%. Eight patients with negative int-PET had treatment failure; six of them were identified as non-responders with end-PET. The 5-year progression-free survival (PFS) was 87% for patients with negative int-PET versus 56% with positive int-PET. The 5-year PFS was 96% with negative end-PET versus 23% with positive end-PET. The prognostic information from int-PET as regards PFS (log-rank test P = 0·0048) was lower than that provided by end-PET (P < 0·0001). Int-PET predicted only half of the failures. When used in clinical routine, a negative int-PET study cannot obviate the need for end-PET examination.
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Affiliation(s)
- Charles Mesguich
- Department of Nuclear Medicine, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Anne-Laure Cazeau
- Department of Nuclear Medicine, Institut Bergonié Cancer Centre, Bordeaux, France
| | - Krimo Bouabdallah
- Department of Haematology, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Pierre Soubeyran
- Department of Haematology, Institut Bergonié Cancer Centre, Bordeaux, France
| | - Martine Guyot
- Department of Nuclear Medicine, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Noël Milpied
- Department of Haematology, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Laurence Bordenave
- Department of Nuclear Medicine, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
| | - Elif Hindié
- Department of Nuclear Medicine, Hôpital Haut-Lévêque, University Hospital of Bordeaux, Pessac, France
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24
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Van Den Neste E, Schmitz N, Mounier N, Gill D, Linch D, Trneny M, Milpied N, Radford J, Ketterer N, Shpilberg O, Dührsen U, Ma D, Brière J, Thieblemont C, Salles G, Moskowitz CH, Glass B, Gisselbrecht C. Outcome of patients with relapsed diffuse large B-cell lymphoma who fail second-line salvage regimens in the International CORAL study. Bone Marrow Transplant 2016; 51:51-7. [PMID: 26367239 DOI: 10.1038/bmt.2015.213] [Citation(s) in RCA: 187] [Impact Index Per Article: 23.4] [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: 07/07/2015] [Accepted: 07/31/2015] [Indexed: 01/21/2023]
Abstract
Salvage chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard second-line treatment for relapsed and refractory diffuse large B-cell lymphoma (DLBCL). However, the strategy is less clear in patients who require third-line treatment. Updated outcomes of 203 patients who could not proceed to scheduled ASCT in the Collaborative Trial in Relapsed Aggressive Lymphoma (CORAL) are herein reviewed. In the intent-to-treat analysis, overall response rate to third-line chemotherapy was 39%, with 27% CR or CR unconfirmed, and 12% PR. Among the 203 patients, 64 (31.5%) were eventually transplanted (ASCT 56, allogeneic SCT 8). Median overall survival (OS) of the entire population was 4.4 months. OS was significantly improved in patients with lower tertiary International Prognostic Index (IPI), patients responding to third-line treatment and patients transplanted with a 1-year OS of 41.6% compared with 16.3% for the not transplanted (P<0.0001). In multivariate analysis, IPI at relapse (hazard ratio (HR) 2.409) and transplantation (HR 0.375) independently predicted OS. Third-line salvage chemotherapy can lead to response followed by transplantation and long-term survival in DLBCL patients. However, improvement of salvage efficacy is an urgent need with new drugs.
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Affiliation(s)
| | - N Schmitz
- AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany
| | | | - D Gill
- Princess Alexandra Hospital, Woodville, SA, Australia
| | - D Linch
- University College London, Cancer Institute, London, UK
| | - M Trneny
- Charles Univ. General Hosp., Praha, Czech Republic
| | - N Milpied
- Hématologie Clinique et thérapie cellulaire, Hôpital Haut-Lévêque, Pessac, France
| | - J Radford
- University of Manchester, c/o Department of Medical Oncology, Christie Hospital NHS, Manchester, UK
| | - N Ketterer
- Clinique Bois-Cerf, Lausanne, Switzerland
| | | | - U Dührsen
- Universitätsklinikum Essen, KlinikfürHämatologie, Essen, Germany
| | - D Ma
- St Vincent's Hospital Sydney, Darlinghurst, NW, Australia
| | - J Brière
- Hemato-Oncologie Hôpital Hôpital Saint-Louis, Paris, France
| | - C Thieblemont
- Hemato-Oncologie Hôpital Hôpital Saint-Louis, Paris, France
| | - G Salles
- Hospices Civils de Lyon, Service d'Hématologie, Université de Lyon, Lyon, France
| | - C H Moskowitz
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - B Glass
- AsklepiosKlinik St Georg, AbteilungHämatologie und Stammzelltransplantation, Hamburg, Germany
| | - C Gisselbrecht
- Hemato-Oncologie Hôpital Hôpital Saint-Louis, Paris, France
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25
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Brissot E, Rialland F, Cahu X, Strullu M, Corradini N, Thomas C, Blin N, Rialland X, Thebaud E, Chevallier P, Moreau P, Milpied N, Harousseau JL, Mechinaud F, Mohty M. Improvement of overall survival after allogeneic hematopoietic stem cell transplantation for children and adolescents: a three-decade experience of a single institution. Bone Marrow Transplant 2015; 51:267-72. [PMID: 26642337 DOI: 10.1038/bmt.2015.250] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 08/04/2015] [Accepted: 08/24/2015] [Indexed: 01/14/2023]
Abstract
Allogeneic stem cell transplantation (allo-SCT) has become an essential component of the treatment for a variety of diseases in pediatric patients. During the past decades, advances in the transplant technology, availability of hematopoietic stem cells and supportive care not only have resulted in improved outcomes, but also have expanded the transplant options. However, these features have been studied mainly in adult populations. This investigation analyzed changes in patient profile, transplantation, graft characteristics and outcome among 250 children and adolescent patients who received allo-SCT in a single center between 1983 and 2010. In the 2000-2010, compared with the 1983-1999 period, a significantly higher 5-year overall survival (64% versus 52%, P=0.03) was observed together with a significant decrease of non-relapse mortality (27% versus 9%, P=0.0002). The progression-free survival was comparable between the two periods (49% versus 57%; P=0.17). The 5-year cumulative incidence of relapse was 24% between 1983 and 1999, and 34% between 2000 and 2010 (P=0.08). Major advances in supportive care practice have been made over the past decade, resulting in a significant survival benefit for the pediatric population undergoing allo-SCT. However, post-transplant relapse remains the leading cause of failure of this therapeutic approach, and preventing relapse represents a major challenge today.
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Affiliation(s)
- E Brissot
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
| | - F Rialland
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - X Cahu
- Service d'Hématologie Clinique, CHU de Rennes, Rennes, France
| | - M Strullu
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - N Corradini
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - C Thomas
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
| | - N Blin
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France.,Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - X Rialland
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - E Thebaud
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - P Chevallier
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
| | - P Moreau
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France.,Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France
| | - N Milpied
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
| | - J L Harousseau
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France.,Centre d'Investigation Clinique en Cancérologie (CI2C), Nantes, France
| | - F Mechinaud
- Service d'Onco-Hématologie Pédiatrique, CHU de Nantes, Nantes, France
| | - M Mohty
- Service d'Hématologie Clinique, CHU de Nantes, Nantes, France
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26
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Poiré X, Labopin M, Cornelissen JJ, Volin L, Richard Espiga C, Veelken JH, Milpied N, Cahn JY, Yacoub-Agha I, van Imhoff GW, Michallet M, Michaux L, Nagler A, Mohty M. Outcome of conditioning intensity in acute myeloid leukemia with monosomal karyotype in patients over 45 year-old: A study from the acute leukemia working party (ALWP) of the European group of blood and marrow transplantation (EBMT). Am J Hematol 2015; 90:719-24. [PMID: 26010466 DOI: 10.1002/ajh.24069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 05/08/2015] [Accepted: 05/15/2015] [Indexed: 11/10/2022]
Abstract
Acute myeloid leukemia with monosomal karyotype (MK AML) carries a very poor prognosis, even after allogeneic stem cell transplantation (SCT). However, SCT remains the only curative option in this high-risk population. Because myeloablative conditioning regimen (MAC) is associated with less relapse, we hypothesized that more intensive conditioning regimen might be beneficial for MK AML patients. We reviewed 303 patients over age 45 diagnosed with either de novo or secondary MK AML. One hundred and five patients received a MAC and 198 a reduced-intensity conditioning (RIC). The median age at SCT was 57-year-old, significantly lower in the MAC (53-year-old) than in the RIC group (59-year-old). The median follow-up was 42 months (range, 3 - 156 months). The 3-year overall survival (OS), leukemia-free survival (LFS), and relapse rate (RR) were not significantly different between both groups with overall values of 34%, 29%, and 51%, respectively. On the contrary, the 3-year nonrelapse mortality (NRM) was significantly higher in MAC recipients (28%) compared with RIC patients (16%, P = 0.004). The incidence of Grades II to IV acute graft-versus-host disease (GvHD) was significantly higher after a MAC (30.5%) than after a RIC (19.3%, P = 0.02). That of chronic GvHD was comparable between both groups (35%) and did not impact on LFS. Interestingly, within our MK AML cohort, hypodiploidy was significantly associated with worse outcomes. Due to reduced toxicity and comparable OS, LFS, and RR, RIC appears as a good transplant option in the very high-risk population, including older patients, diagnosed with MK AML.
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Affiliation(s)
- Xavier Poiré
- Section of Hematology, Cliniques Universitaires Saint-Luc; Brussels Belgium
| | | | - Jan J. Cornelissen
- Section of Hematology, Erasmus MC-Daniel Den Hoed Cancer Centre; Rotterdam The Netherlands
| | - Liisa Volin
- Section of Hematology, Helsinki University Central Hospital; Helsinki Sweden
| | | | - J. Hendrik Veelken
- Section of Hematology, Leiden University Hospital; Leiden The Netherlands
| | - Noël Milpied
- Section of Hematology, CHU Bordeaux; Pessac France
| | - Jean-Yves Cahn
- Section of Hematology, Hôpital a Michallon; Grenoble France
| | | | - Gustaaf W. van Imhoff
- Section of Hematology, University Medical Center Groningen; Groningen The Netherlands
| | | | - Lucienne Michaux
- Section of Hematology, Cliniques Universitaires Saint-Luc; Brussels Belgium
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center; Tel Hashomer Israel
| | - Mohamad Mohty
- Section of Hematology, Hôpital Saint-Antoine; Paris France
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27
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Pérard B, Rougeron A, Favre S, Accoceberry I, Vigouroux S, Mohr C, Milpied N. Trichosporon faecale invasive infection in a patient with severe aplastic anemia: Efficacy of voriconazole and liposomal amphotericin B before neutrophil recovery. Med Mycol Case Rep 2015. [PMID: 26199866 PMCID: PMC4506992 DOI: 10.1016/j.mmcr.2015.06.003] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report a case of a 51-year old man with a severe aplastic anemia who developed an invasive trichosporonosis to Trichosporon faecale with fungemia and skin lesions during severe neutropenia. The treatment was successful before neutrophil recovery with a combination of voriconazole and liposomal amphotericin B.
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Affiliation(s)
- Baptiste Pérard
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France
| | - Amandine Rougeron
- Laboratoire de Parasitologie Mycologie, CHU Pellegrin, Bordeaux, France
| | - Simon Favre
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France
| | | | - Stéphane Vigouroux
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France
| | - Catherine Mohr
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France ; Université Bordeaux Segalen, Bordeaux, France
| | - Noël Milpied
- Service d'Hématologie et de Thérapie Cellulaire, CHU Haut-Lévêque, Bordeaux, France ; Université Bordeaux Segalen, Bordeaux, France
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28
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Pigneux A, Labopin M, Maertens J, Cordonnier C, Volin L, Socié G, Blaise D, Craddock C, Milpied N, Bacher U, Malard F, Esteve J, Nagler A, Mohty M. Outcome of allogeneic hematopoietic stem-cell transplantation for adult patients with AML and 11q23/MLL rearrangement (MLL-r AML). Leukemia 2015; 29:2375-81. [PMID: 26082270 DOI: 10.1038/leu.2015.143] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/19/2015] [Accepted: 05/21/2015] [Indexed: 12/20/2022]
Abstract
Acute myeloid leukemia (AML) with 11q23/MLL rearrangement (MLL-r AML) is allocated to the intermediate- or high-risk cytogenetic prognostic category depending on the MLL fusion partner. A more favorable outcome has been reported in patients receiving an allogeneic hematopoietic stem-cell transplantation (alloHSCT), but this has not been confirmed in large series. We analyzed the outcome of alloHSCT among adult patients reported to the Acute Leukemia Working Party between 2000 and 2010. We identified 159 patients with 11q23/MLL rearranged AML allografted in first complete remission (CR1, n=138) or CR2, mostly corresponding to t(9;11), t(11;19), t(6;11) and t(10;11) translocations. Two-year overall survival (OS), leukemia-free survival (LFS), relapse incidence and non-relapse mortality were 56±4%, 51±4%, 31±3% and 17±4%, respectively. The outcome differed according to 11q23/MLL rearrangement, being more favorable in patients with t(9;11) and t(11;19) compared with t(10;11) and t(6;11) (2-year OS: 64±6% and 73±10% vs 40±13% and 24±11%, respectively; P<0.0001). Multivariate analysis for OS identified t(6;11), t(10;11), age>40 years and CR2 as unfavorable features, whereas t(6;11), t(10;11), CR2 and the use of reduced-intensity conditioning regimen affected poorly the LFS. This study confirms the potential role of alloHSCT for adult patients with 11q23/MLL rearranged AML in CR1.
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Affiliation(s)
- A Pigneux
- Department of Hematology, CHU de Bordeaux, Bordeaux, France.,Hématopoïèses Leucémique et Cible Thérapeutique, INSERM U 1035, Université Bordeaux Segalen, Bordeaux, France
| | - M Labopin
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
| | - J Maertens
- Department of Hematology, Acute Leukemia and Stem Cell Transplantation Unit, University Hospitals Leuven Leuven, Belgium
| | - C Cordonnier
- Service d'Hématologie and Faculté de Médecine, Hôpital Henri Mondor, Paris, France
| | - L Volin
- Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
| | - G Socié
- Bone Marrow Transplantation, Saint-Louis Hospital, Paris, France
| | - D Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - C Craddock
- Centre for Clinical Haematology, Queen Elizabeth Hospital and School of Cancer Studies, University of Birmingham, Birmingham, UK
| | - N Milpied
- Department of Hematology, CHU de Bordeaux, Bordeaux, France
| | - U Bacher
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - F Malard
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
| | - J Esteve
- Department of Hematology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - A Nagler
- ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - M Mohty
- Clinical Hematology and Cellular Therapy Department, Hospital Saint Antoine, APHP, Paris, France.,ALWP EBMT, Hôpital Saint Antoine, Paris, France.,Universite Pierre et Marie Curie, Paris, France.,INSERM UMRs 938, Paris, France
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29
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Calmettes C, Vigouroux S, Labopin M, Tabrizi R, Turlure P, Lafarge X, Marit G, Pigneux A, Leguay T, Bouabdallah K, Dilhuydy MS, Duclos C, Mohr C, Lascaux A, Dumas PY, Dimicoli-Salazar S, Saint-Lézer A, Milpied N. Risk Factors for Steroid-Refractory Acute Graft-versus-Host Disease after Allogeneic Stem Cell Transplantation from Matched Related or Unrelated Donors. Biol Blood Marrow Transplant 2015; 21:860-5. [DOI: 10.1016/j.bbmt.2015.01.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/14/2015] [Indexed: 11/24/2022]
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30
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Médiavilla C, Vigouroux S, Tabrizi R, Pigneux A, Duclos C, Mohr C, Robles M, Milpied N. Transient Grades 3 to 4 Acute Hepatitis Is a Common Complication of Rabbit Antithymocyte Globulin (Thymoglobulin) Administered before Allogeneic Stem Cell Transplantation. Biol Blood Marrow Transplant 2015; 21:661-5. [DOI: 10.1016/j.bbmt.2014.12.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 12/15/2014] [Indexed: 11/26/2022]
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31
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Bouabdallah K, Furst S, Asselineau J, Chevalier P, Tournilhac O, Ceballos P, Vigouroux S, Tabrizi R, Doussau A, Bouabdallah R, Mohty M, Le Gouill S, Blaise D, Milpied N. 90Y-ibritumomab tiuxetan, fludarabine, busulfan and antithymocyte globulin reduced-intensity allogeneic transplant conditioning for patients with advanced and high-risk B-cell lymphomas. Ann Oncol 2015; 26:193-198. [PMID: 25361987 DOI: 10.1093/annonc/mdu503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [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] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with advanced B-cell non-Hodgkin's lymphoma (NHL) refractory to initial chemotherapy or relapsing after autologous stem-cell transplantation have a poor prognosis. Allogeneic stem-cell transplantation after reduced-intensity conditioning (RIC) regimen can be a therapeutic option. However, the high incidence of relapse remains a challenging issue. We speculated that the incorporation of (90)Y-Ibritumomab tiuxetan into a fludarabine-based RIC regimen would improve the lymphoma control without overwhelming toxicity. Our aim was to evaluate the safety of (90)Y-Ibritumomab tiuxetan in association with such a regimen in a prospective multicenter phase II trial. PATIENTS AND METHODS Thirty-one patients with advanced lymphoma from five distinct institutions were included between February 2008 and October 2010. Thirty patients in complete or partial response after failure of a median of 3 (range, 2-4) previous chemotherapy regimens including autologous transplant in 29 were evaluable for nonrelapse mortality (NRM) at day 100 post-transplant that was the primary end point. RESULTS With a median follow-up of 32 months (range, 29-60 months), the 2-year event-free and overall survivals of the whole study group were both 80% [95 confidence interval (CI) 60.8% to 90.5%). The 100-day and 2-year post-transplant cumulative incidences of NRM were 3.3% (95% CI 0.2% to 14.9%) and 13.3% (95% CI 5.4% to 33.2%), respectively. The 2-year cumulative incidence of relapse was 6.7% (95% CI 1.7% to 25.4%). The cumulative incidences of grade II-IV and extensive chronic graft-versus-host disease were 27% and 14%, respectively. CONCLUSIONS For chemosensitive advanced high-risk B-cell lymphoma, the addition of (90)Y-Ibritumomab tiuxetan to a RIC regimen based on fludarabine, busulfan and antithymocyte globulin followed by allogeneic transplant is safe and highly effective. clinicaltrials.gov: NCT00607854.
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Affiliation(s)
- K Bouabdallah
- Department of Hematology and Cellular Therapy, Haut-Leveque University Hospital, Bordeaux.
| | - S Furst
- Department of Hematology, Institut Paoli Calmettes, Marseille
| | - J Asselineau
- Methodological Support Unit in Clinical and Epidemiological Research (USMR), University Hospital, Bordeaux; Department of National Health Institute and Medical Research (INSERM U897, CIC-EC7), Bordeaux
| | - P Chevalier
- Department of Hematology, University Hospital, Nantes
| | - O Tournilhac
- Department of Hematology, University Hospital, Clermont-Ferrand
| | - P Ceballos
- Department of Hematology, University Hospital, Montpellier
| | - S Vigouroux
- Department of Hematology and Cellular Therapy, Haut-Leveque University Hospital, Bordeaux
| | - R Tabrizi
- Department of Hematology and Cellular Therapy, Haut-Leveque University Hospital, Bordeaux
| | - A Doussau
- Methodological Support Unit in Clinical and Epidemiological Research (USMR), University Hospital, Bordeaux; Department of National Health Institute and Medical Research (INSERM U897, CIC-EC7), Bordeaux; Medical School Department, Bordeaux Segalen University, Bordeaux
| | - R Bouabdallah
- Department of Hematology, Institut Paoli Calmettes, Marseille
| | - M Mohty
- Department of Hematology, Saint-Antoine University Hospital, Paris
| | - S Le Gouill
- Department of Hematology, University Hospital, Nantes; Department of National Health Institute and Medical Research (INSERM, UMR 892), Team 10, Nantes, France
| | - D Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille
| | - N Milpied
- Department of Hematology and Cellular Therapy, Haut-Leveque University Hospital, Bordeaux; Medical School Department, Bordeaux Segalen University, Bordeaux
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32
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Guillotin V, Saint-Lézer A, Prevel R, Sahali D, Bouabdallah K, Dilhuydy M, Milpied N. Syndrome néphrotique paranéoplasique et maladie de Hodgkin : à propos de c-mip. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.345] [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: 10/24/2022]
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33
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Blaise D, Devillier R, Lecoroller-Sorriano AG, Boher JM, Boyer-Chammard A, Tabrizi R, Chevallier P, Fegueux N, Sirvent A, Michallet M, Bay JO, Fürst S, El-Cheikh J, Vincent L, Guillaume T, Regny C, Milpied N, Castagna L, Mohty M. Low non-relapse mortality and long-term preserved quality of life in older patients undergoing matched related donor allogeneic stem cell transplantation: a prospective multicenter phase II trial. Haematologica 2014; 100:269-74. [PMID: 25425691 DOI: 10.3324/haematol.2014.113571] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Allogeneic transplantation is a challenge in patients of advanced age because of a high risk of non-relapse mortality and potential long-lasting impairment of health-related quality of life. The development of reduced-intensity conditioning regimens has allowed the use of allogeneic transplantation in this population, but the optimal regimen remains undefined. We conducted a multicenter phase II trial evaluating the safety and efficacy of a reduced-intensity conditioning regimen combining fludarabine, intravenous busulfan, and rabbit antithymocyte globulins in patients older than 55 years of age transplanted from matched-related donor. In addition, health-related quality of life was prospectively measured. Seventy-five patients with a median age of 60 years (range 55-70) were analyzed. Grade III-IV acute and extensive chronic graft-versus-host diseases were found in 3% and 27% of patients, respectively. The day 100 and 1-year non-relapse mortality incidences were 1% and 9%, respectively. The cumulative incidences of relapse, progression-free survival and overall survival at two years were 36%, 51% and 67%, respectively, with a median follow up of 49 months. Global health-related quality of life, physical functioning, emotional functioning, and social functioning were not impaired compared to baseline for more than 75% of the patients (75%, 81.4%, 82.3%, and 75%, respectively). Thirty-four of the 46 (74%) progression-free patients at one year were living without persistent extensive chronic graft-versus-host disease. We conclude that the reduced-intensity conditioning regimen combining fludarabine, intravenous busulfan, and rabbit antithymocyte globulins is well tolerated in patients older than 55 years with low non-relapse mortality and long-term preserved quality of life.
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Affiliation(s)
- Didier Blaise
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille Centre de Recherche sur le Cancer de Marseille (CRCM), Inserm U 1068, Marseille Aix-Marseille University, Marseille
| | - Raynier Devillier
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille Centre de Recherche sur le Cancer de Marseille (CRCM), Inserm U 1068, Marseille Aix-Marseille University, Marseille
| | - Anne-Gaëlle Lecoroller-Sorriano
- Mixed Research Unit 912, Institute of Research and Development, National Institute of Health and Medical Research, Paoli Calmettes Institute, Aix-Marseille University, Marseille
| | - Jean-Marie Boher
- Clinical Trial Office and Biostatistics Unit, Paoli Calmettes Institute, Marseille
| | - Agnès Boyer-Chammard
- Clinical Trial Office and Biostatistics Unit, Paoli Calmettes Institute, Marseille
| | - Reza Tabrizi
- Hematology Department, Haut-Leveque Hospital and Bordeaux University Hospital Center, Pessac
| | | | | | - Anne Sirvent
- Hematology Department, University Hospital Center, Montpellier
| | | | | | - Sabine Fürst
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille
| | - Jean El-Cheikh
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille
| | - Laure Vincent
- Hematology Department, University Hospital Center, Montpellier
| | | | - Caroline Regny
- Hematology Department, University Hospital Center, Grenoble
| | - Noël Milpied
- Hematology Department, Haut-Leveque Hospital and Bordeaux University Hospital Center, Pessac
| | - Luca Castagna
- Hematology Department, Transplantation Unit, Paoli Calmettes Institute, Marseille
| | - Mohamad Mohty
- Hematology Department, University Hospital Center, Nantes CRNCA, UMR 892 INSERM - 6299 CNRS, and Université de Nantes, Faculté de Médecine, Nantes, France Hematology and Cellular Therapy Unit, AP-HP, Université Paris 6, Hôpital Saint Antoine, Paris, France
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34
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Detrait MY, Morisset S, Peffault de Latour R, Yakoub-Agha I, Crocchiolo R, Tabrizi R, Bay JO, Chevalier P, Barraco F, Raus N, Vigouroux S, Magro L, Mohty M, Milpied N, Blaise D, Socié G, Michallet M. Pre-transplantation risk factors to develop sclerotic chronic GvHD after allogeneic HSCT: A multicenter retrospective study from the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC). Bone Marrow Transplant 2014; 50:253-8. [DOI: 10.1038/bmt.2014.244] [Citation(s) in RCA: 6] [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: 04/22/2014] [Revised: 08/02/2014] [Accepted: 09/17/2014] [Indexed: 12/11/2022]
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35
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Taris M, de Mascarel A, Riols M, Delwail V, Milpied N, Dubus P, Parrens M. Lymphoprolifération germinotrope HHV8+/EBV+ : une entité rare, à propos d’un cas et revue de la littérature. Ann Pathol 2014; 34:373-7. [DOI: 10.1016/j.annpat.2014.06.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 04/15/2014] [Accepted: 06/22/2014] [Indexed: 11/30/2022]
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36
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Calmels B, Boulanger F, Baudoux E, Decot V, Fawaz A, Giraud C, Hivert B, Garderet L, Milpied N, Yakoub-Agha I. [Conservation and destruction of autologous and allogeneic cryopreserved cellular products: recommendations from the SFGM-TC]. ACTA ACUST UNITED AC 2014; 62:221-5. [PMID: 24996844 DOI: 10.1016/j.patbio.2014.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Accepted: 05/14/2014] [Indexed: 11/16/2022]
Abstract
Thousands of autologous and at less extent allogeneic hematopoietic stem cells (HSC) bags are cryopreserved in France. The majority of autologous HSC grafts are used within a year after collection. However, many bags are still unused and cryopreserved for many years. In France and on a European scale, the ever-growing number of cryopreserved bags represents a real economic health concern. Indeed, the cost of storage is about 100€ per bag and per year. In addition, quality and therapeutic value of these long-term cryopreserved grafts needs to be evaluated. In the attempt to harmonize clinical practices between different French transplantation centers, the French Society of Bone Marrow Transplantation and Cell Therapies (SFGM-TC) set up its fourth annual series of workshops which brought together practitioners from its member centers across France. These workshops took place in September 2013 in Lille. In this article, we addressed the issue of the destruction of long-term cryopreserved grafts be them autologous or allogeneic and provide recommendations regarding their destruction.
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Affiliation(s)
- B Calmels
- Centre de thérapie cellulaire et génique, institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, BP 156, 13273 Marseille cedex 09, France; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - F Boulanger
- EFS Nord de France, laboratoire de thérapie cellulaire, 96, rue de Jemmapes, CS 22018, 59013 Lille cedex, France; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - E Baudoux
- Laboratoire de thérapie cellulaire et génique, CHU de Liège, Tour 2 niveau -4(E), 4000 Liège, Belgique; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - V Decot
- Unité de thérapie cellulaire et banque de tissus, CHU Nancy-Brabois, rue du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - A Fawaz
- Service hématologie clinique, hôpital Victor-Provo, boulevard Lacordaire, 59100 Roubaix, France; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - C Giraud
- CHU de Poitiers, 2, rue de La-Milétrie, BP 577, 86021 Poitiers cedex, France; EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France
| | - B Hivert
- EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France; Maladies du sang, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France
| | - L Garderet
- EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France; Inserm, UMR_S 938, proliferation and differentiation of stem cells, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Département d'hématologie et de thérapie cellulaire, université Pierre et Marie-Curie Paris 6, 75012 Paris, France
| | - N Milpied
- EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France; Service des maladies du sang, G.H. du Haut Levêque, avenue de Magellan, 33604 Pessac, France
| | - I Yakoub-Agha
- EFS centre atlantique, site de Poitiers, 350, avenue Jacques-Cœur, BP 482, 86012 Poitiers cedex, France; Maladies du sang, CHRU de Lille, rue Michel-Polonovski, 59037 Lille cedex, France.
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Versluis J, Labopin M, Niederwieser D, Socie G, Schlenk RF, Milpied N, Nagler A, Blaise D, Rocha V, Cornelissen JJ, Mohty M. Prediction of non-relapse mortality in recipients of reduced intensity conditioning allogeneic stem cell transplantation with AML in first complete remission. Leukemia 2014; 29:51-7. [PMID: 24913728 DOI: 10.1038/leu.2014.164] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 04/13/2014] [Accepted: 04/28/2014] [Indexed: 01/21/2023]
Abstract
Non-relapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation (alloHSCT) can be predicted by the hematopoietic cell transplantation comorbidity index (HCT-CI) and the European Group for Blood and Marrow Transplantation (EBMT) score, which are composed of different parameters. We set out to integrate the parameters of both scores in patients with acute myeloid leukemia (AML) in first complete remission (CR1) receiving reduced intensity conditioning (RIC) alloHSCT. All parameters from the HCT-CI and the EBMT-score with the addition of patient and donor cytomegalovirus serology were evaluated in 812 patients by multivariable analysis with end-point NRM at 2 years. Subsequently, 16 parameters were selected based on hazard ratio >1.2, and were incorporated into a novel score, which was further internally validated by bootstrapping. Both the HCT-CI and the EBMT-score showed relatively weak predictive value, whereas the integrated score allowed to identify three clearly distinct risk groups with 2-year NRM estimates of 8±2% (low-risk), 17±2% (intermediate-risk) and 38±4% (high-risk), which also translated in prediction of overall survival. Collectively, integration of the most dominant parameters from the HCT-CI and the EBMT-score allowed to develop a simple and robust, integrated score with improved prediction of NRM for AML patients proceeding to RIC alloHSCT in CR1.
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Affiliation(s)
- J Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - M Labopin
- 1] Sorbonne Universités, Paris, France [2] Institut National de la Sante et de la Recherche Medicale (INSERM), Paris, France [3] AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
| | - D Niederwieser
- Department of Hematology and Oncology, University Leipzig, Leipzig, Germany
| | - G Socie
- 1] Institut National de la Sante et de la Recherche Medicale (INSERM), Paris, France [2] Department of Hematology/Transplantation, Hopital Saint-Louis, Sorbonne University, Paris, France
| | - R F Schlenk
- Department of Internal Medicine III, University Hospital of Ulm, Ulm, Germany
| | - N Milpied
- Department of Hematology, CHU de Bordeaux, Bordeaux, France
| | - A Nagler
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - D Blaise
- Department of Hematology and Transplant Program, Institut Paoli Calmettes, Marseille, France
| | - V Rocha
- Eurocord International Registry, Hopital Saint Louis, Sorbonne University, Paris, France
| | - J J Cornelissen
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - M Mohty
- 1] Sorbonne Universités, Paris, France [2] Institut National de la Sante et de la Recherche Medicale (INSERM), Paris, France [3] AP-HP, Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Paris, France
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Rossille D, Gressier M, Damotte D, Maucort-Boulch D, Pangault C, Semana G, Le Gouill S, Haioun C, Tarte K, Lamy T, Milpied N, Fest T. High level of soluble programmed cell death ligand 1 in blood impacts overall survival in aggressive diffuse large B-Cell lymphoma: results from a French multicenter clinical trial. Leukemia 2014; 28:2367-75. [DOI: 10.1038/leu.2014.137] [Citation(s) in RCA: 245] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 03/24/2014] [Accepted: 04/03/2014] [Indexed: 01/21/2023]
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Wallet HL, Sobh M, Robin M, Fegueux N, Fürst S, Mohty M, Yakoub-Agha I, Marry E, Rocha V, Blaise D, Milpied N, Nicolini FE, Michallet M. First application of the EBMT risk score in double umbilical cord blood transplantation for hematologic malignancies: Significant impact on different outcomes. Exp Hematol 2014; 42:161-2. [DOI: 10.1016/j.exphem.2013.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 10/25/2013] [Accepted: 11/11/2013] [Indexed: 10/26/2022]
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Cunha R, Loiseau P, Ruggeri A, Sanz G, Michel G, PaolaIori A, Socié G, Arcese W, Picardi A, Dias de Heredia C, Rio B, Locatelli F, O'Brien TA, Yakoub-Agha I, Angel Diaz M, Milpied N, Bittencourt H, Pedro Souza M, Aljurf M, Charron D, Boudjedir K, Labopin M, Gluckman E, Rocha V. Impact of HLA mismatch direction on outcomes after umbilical cord blood transplantation for hematological malignant disorders: a retrospective Eurocord-EBMT analysis. Bone Marrow Transplant 2013; 49:24-9. [DOI: 10.1038/bmt.2013.120] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 05/14/2013] [Accepted: 06/17/2013] [Indexed: 11/09/2022]
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Duléry R, Giraud C, Beaumont JL, Bilger K, Borel C, Dhedin N, Thiebaut A, Willems E, Alain S, Alfandari S, Dewilde A, Jouet JP, Milpied N, Yakoub-Agha I. Conduite à tenir devant une anomalie biologique découverte lors du bilan pré-don cellules souches hématopoïétiques : sérologie IgM positive pour le cytomégalovirus, le virus d’Epstein-Barr, la toxoplasmose, ou la syphilis. ACTA ACUST UNITED AC 2013; 61:155-7. [DOI: 10.1016/j.patbio.2013.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 07/19/2013] [Indexed: 11/24/2022]
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42
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Wallet HL, Sobh M, Morisset S, Robin M, Fegueux N, Fürst S, Mohty M, Deconinck E, Fouillard L, Bordigoni P, Rio B, Sirvent A, Renaud M, Dhedin N, Tabrizi R, Maury S, Buzyn A, Michel G, Maillard N, Cahn JY, Bay JO, Yakoub-Agha I, Huynh A, Schmidt-Tanguy A, Lamy T, Lioure B, Raus N, Marry E, Garnier F, Balère ML, Gluckman E, Rocha V, Socié G, Blaise D, Milpied N, Michallet M. Double umbilical cord blood transplantation for hematological malignancies: a long-term analysis from the SFGM-TC registry. Exp Hematol 2013; 41:924-33. [PMID: 23831606 DOI: 10.1016/j.exphem.2013.05.297] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 05/23/2013] [Accepted: 05/25/2013] [Indexed: 01/10/2023]
Abstract
Allogeneic hematopoietic stem cell (HSC) transplantation is a curative treatment for many hematologic malignancies for which umbilical cord blood (UCB) represents an alternative source of HSCs. To overcome the low cellularity of one UCB unit, double UCB transplantation (dUCBT) has been developed in adults. We have analyzed the outcome of 136 patients who underwent dUCBT reported to the SFGM-TC registry between 2005 and 2007. Forty-six patients received myeloablative regimens, and 90 patients received reduced-intensity conditioning regimens. There were 84 cases of leukemia, 17 cases of non-Hodgkin lymphoma, 11 cases of myeloma, and 24 other hematologic malignancies. At transplantation, 40 (29%) patients were in complete remission. At day 60 after transplantation, the cumulative incidence of neutrophil recovery was 91%. We observed one UCB unit domination in 88% of cases. The cumulative incidence of day 100 acute graft-versus-host disease, chronic graft-versus-host disease, transplant-related mortality, and relapse at 2 years were 36%, 23%, 27%, and 28% respectively. After a median follow-up of 49.5 months, the 3-year probabilities of overall and progression-free survival were 41% and 35%, respectively, with a significant overall survival advantage when male cord engrafted male recipients. We obtained a long-term plateau among patients in complete remission, which makes dUCBT a promising treatment strategy for these patients.
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Robinson SP, Canals C, Luang JJ, Tilly H, Crawley C, Cahn JY, Pohlreich D, Le Gouill S, Gilleece M, Milpied N, Attal M, Biron P, Maury S, Rambaldi A, Maertens J, Capria S, Colombat P, Montoto S, Sureda A. The outcome of reduced intensity allogeneic stem cell transplantation and autologous stem cell transplantation when performed as a first transplant strategy in relapsed follicular lymphoma: an analysis from the Lymphoma Working Party of the EBMT. Bone Marrow Transplant 2013; 48:1409-14. [PMID: 23771004 DOI: 10.1038/bmt.2013.83] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 04/26/2013] [Accepted: 05/01/2013] [Indexed: 01/04/2023]
Abstract
Both auto-SCT and reduced intensity allo-SCT (RIST) are employed in the treatment of relapsed follicular lymphoma (FL). We have analysed the outcome of these two transplant procedures when used as a first transplant in this setting. We conducted a retrospective comparison of 726 patients who underwent an auto-SCT and 149 who underwent a RIST as a first transplant procedure for relapsed FL as reported to the Lymphoma Working Party of the European Bone Marrow Transplant. The non-relapse mortality (NRM) was significantly worse for patients undergoing a RIST (relative risk (RR) 4.0, P<0.001). The 1-year NRM was 15% for those undergoing a RIST compared with 3% for those undergoing an auto-SCT. Disease relapse or progression were significantly worse for those receiving an auto-SCT (RR 3.1, P<0.001). Patients undergoing a RIST had a 5-year relapse rate of 20% compared with 47% for those undergoing an auto-SCT. The PFS at 5 years was 57% for patients receiving a RIST compared with 48% for those receiving an auto-SCT. There was no significant difference in OS between the two groups. RIST is associated with a higher NRM and lower relapse rate in patients with relapsed FL.
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Affiliation(s)
- S P Robinson
- BMT Unit, Bristol Children's Hospital, Bristol, UK
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Milpied N. Expansion des cellules souches hématopoïétiques. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.04.077] [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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45
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Bouzgarrou R, Dazey B, Lafarge X, Vigouroux S, Tabrizi R, Milpied N, Assal A. Effets bénéfiques du prélèvement des CSP allogéniques au cinquième jour de mobilisation de G-CSF. Transfus Clin Biol 2013. [DOI: 10.1016/j.tracli.2013.03.194] [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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Martínez C, Canals C, Sarina B, Alessandrino EP, Karakasis D, Pulsoni A, Sica S, Trneny M, Snowden JA, Kanfer E, Milpied N, Bosi A, Guidi S, de Souza CA, Willemze R, Arranz R, Jebavy L, Hellmann A, Sibon D, Oneto R, Luan JJ, Dreger P, Castagna L, Sureda A. Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation. Ann Oncol 2013. [PMID: 23712545 DOI: 10.1093/annonc/mdt206.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT. METHODS Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed. RESULTS Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure. CONCLUSION(S) Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.
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Affiliation(s)
- C Martínez
- Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
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47
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Auner HW, Szydlo R, van Biezen A, Iacobelli S, Gahrton G, Milpied N, Volin L, Janssen J, Nguyen Quoc S, Michallet M, Schoemans H, El Cheikh J, Petersen E, Guilhot F, Schönland S, Ahlberg L, Morris C, Garderet L, de Witte T, Kröger N. Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2013; 48:1395-400. [PMID: 23708704 DOI: 10.1038/bmt.2013.73] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/24/2013] [Accepted: 04/16/2013] [Indexed: 11/12/2022]
Abstract
Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.
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Affiliation(s)
- H W Auner
- Department of Medicine, Centre for Haematology, Hammersmith Hospital Campus, Imperial College London, London, UK
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48
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Martínez C, Canals C, Sarina B, Alessandrino EP, Karakasis D, Pulsoni A, Sica S, Trneny M, Snowden JA, Kanfer E, Milpied N, Bosi A, Guidi S, de Souza CA, Willemze R, Arranz R, Jebavy L, Hellmann A, Sibon D, Oneto R, Luan JJ, Dreger P, Castagna L, Sureda A. Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation. Ann Oncol 2013; 24:2430-4. [PMID: 23712545 DOI: 10.1093/annonc/mdt206] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT. METHODS Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed. RESULTS Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure. CONCLUSION(S) Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.
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Affiliation(s)
- C Martínez
- Hematology Department, Institute of Hematology and Oncology, Hospital Clinic, Barcelona, Spain.
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49
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Damaj G, Duhame A, Robin M, Milpied N, Michallet M, Chevallier P, Beguin Y, Nguyen S, Lioure B, Blaise D, Maillard N, Rubio M, Fegueux N, Cornillon J, Francois S, Mohty M, Huyn A, Bulabois C, Fenaux P, Yakoub-Agha I. O-014 Azacitidine versus best supportive care before non-myeloablative allogeneic stem cell transplantation for MDS: A study by the SFGM-TC. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70036-5] [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: 10/26/2022]
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Labouré G, Dulucq S, Labopin M, Tabrizi R, Guérin E, Pigneux A, Lafarge X, Leguay T, Bouabdallah K, Dilhuydy MS, Duclos C, Lascaux A, Marit G, Mahon FX, Boiron JM, Milpied N, Vigouroux S. Potent Graft-versus-Leukemia Effect after Reduced-Intensity Allogeneic SCT for Intermediate-Risk AML with FLT3-ITD or Wild-Type NPM1 and CEBPA without FLT3-ITD. Biol Blood Marrow Transplant 2012; 18:1845-50. [DOI: 10.1016/j.bbmt.2012.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 06/18/2012] [Indexed: 11/30/2022]
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