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Lelard A, Le Calvez B, Bouzy S, Couec ML, Eveillard M. Neonatal diagnosis of congenital dyserythropoietic anemia type II. Int J Lab Hematol 2024. [PMID: 38477083 DOI: 10.1111/ijlh.14265] [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] [Received: 12/08/2023] [Accepted: 02/17/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Apolline Lelard
- Nantes Université, Hematology Biology, CHU Nantes, Nantes, France
| | - Baptiste Le Calvez
- Pediatric Oncology, Nantes University Hospital, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, CRCI2NA, Nantes, France
| | - Simon Bouzy
- Nantes Université, Hematology Biology, CHU Nantes, Nantes, France
| | | | - Marion Eveillard
- Nantes Université, Hematology Biology, CHU Nantes, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, CRCI2NA, Nantes, France
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2
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Jullien M, Guillaume T, Le Bourgeois A, Peterlin P, Garnier A, Eveillard M, Le Bris Y, Bouzy S, Tessoulin B, Gastinne T, Dubruille V, Touzeau C, Mahé B, Blin N, Lok A, Vantyghem S, Sortais C, Antier C, Moreau P, Scotet E, Béné MC, Chevallier P. Phase I study of zoledronic acid combined with escalated doses of interleukine-2 for early in vivo generation of Vγ9Vδ2 T-cells after haploidentical stem cell transplant with posttransplant cyclophosphamide. Am J Hematol 2024; 99:350-359. [PMID: 38165016 DOI: 10.1002/ajh.27191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024]
Abstract
The presence of donor Vγ9Vδ2 T-cells after haploidentical hematopoietic stem cell transplant (h-HSCT) has been associated with improved disease-free survival. These cells kill tumor cells in a non-MHC restricted manner, do not induce graft-versus-host disease (GVHD), and can be generated by stimulation with zoledronic acid (ZA) in combination with interleukin-2 (IL-2). This monocentric phase I, open-label, dose-escalating study (ClinicalTrials.gov: NCT03862833) aimed at evaluating the safety and possibility to generate Vγ9Vδ2 T-cells early after h-HSCT. It applied a standard 3 + 3 protocol to determine the maximum tolerated dose (MTD) of increasing low-doses of IL-2 (5 days [d] per week, 4 weeks) in combination with a single dose of ZA, starting both the first Monday after d + 15 posttransplant. Vγ9Vδ2 T-cell monitoring was performed by multiparameter flow cytometry on blood samples and compared with a control cohort of h-HSCT recipients. Twenty-six patients were included between April 2019 and September 2022, 16 of whom being ultimately treated and seven being controls who received h-HSCT only. At the three dose levels tested, 1, 0, and 1 dose-limiting toxicities were observed. MTD was not reached. A significantly higher number of Vγ9Vδ2 T-cells was observed during IL-2 treatment compared with controls. In conclusion, early in vivo generation of Vγ9Vδ2 T-cells is feasible after h-HSCT by using a combination of ZA and repeated IL-2 infusions. This study paves the way to a future phase 2 study, with the hope to document lesser posttransplant relapse with this particular adaptive immunotherapy.
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Affiliation(s)
- Maxime Jullien
- Hematology Department, Nantes University Hospital, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
| | - Thierry Guillaume
- Hematology Department, Nantes University Hospital, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
| | | | - Pierre Peterlin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Alice Garnier
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Marion Eveillard
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Yannick Le Bris
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Simon Bouzy
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Benoît Tessoulin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Thomas Gastinne
- Hematology Department, Nantes University Hospital, Nantes, France
| | | | - Cyrille Touzeau
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Béatrice Mahé
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Nicolas Blin
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Anne Lok
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Sophie Vantyghem
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Clara Sortais
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Chloé Antier
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Philippe Moreau
- Hematology Department, Nantes University Hospital, Nantes, France
| | - Emmanuel Scotet
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
| | - Marie C Béné
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Patrice Chevallier
- Hematology Department, Nantes University Hospital, Nantes, France
- Nantes Université, Inserm UMR 1307, CNRS UMR 6075, Université d'Angers, CRCI2NA, Nantes, France
- LabEx IGO "Immunotherapy, Graft, Oncology", Nantes, France
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3
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Desmares A, Bouzy S, Thonier F, Goustille J, Llamas-Gutierrez F, Genevieve F, Cottin L, Baseggio L, Lemaire P, Lafon CL, Cornillet-Lefebvre P, Galoisy AC, Brouzes C, Rault E, Dindinaud E, Fleury C, Blanc-Jouvan F, Wuilleme S, Bardet V, Fest T, Lamy T, Roussel M, Pannetier M, Pastoret C. Hepatosplenic T-cell lymphoma displays an original oyster-shell cytological pattern and a distinct genomic profile from that of gamma-delta T-cell large granular lymphocytic leukemia. Haematologica 2024. [PMID: 38268478 DOI: 10.3324/haematol.2023.283856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Indexed: 01/26/2024] Open
Abstract
Not available.
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Affiliation(s)
- Anne Desmares
- Centre Hospitalier Universitaire de Rennes, Laboratoire d'Hématologie, Rennes, France; Groupe Francophone d'Hématologie Cellulaire, Bron
| | - Simon Bouzy
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Nantes, Laboratoire d'Hématologie, Nantes
| | | | - Julien Goustille
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier de Saint-Malo, Laboratoire de Biologie, Saint-Malo
| | | | - Franck Genevieve
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire d'Angers, Laboratoire d'Hématologie, Angers
| | - Laurane Cottin
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire d'Angers, Laboratoire d'Hématologie, Angers
| | - Lucile Baseggio
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Hospices Civils de Lyon - HCL, Laboratoire d'Hématologie, Bron
| | - Pierre Lemaire
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Hôpital Saint-Louis AP-HP, Laboratoire d'hématologie, Paris
| | - Carinne Lecoq Lafon
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Reims, Laboratoire d'hématologie, Reims France
| | | | - Anne-Cécile Galoisy
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Strasbourg, Laboratoire d'Hématologie, Strasbourg
| | - Chantal Brouzes
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Hôpital Necker AP-HP, Laboratoire d'hématologie, Paris
| | - Emmanuelle Rault
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Tours, Laboratoire d'Hématologie, Tours
| | - Elodie Dindinaud
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Poitiers, Laboratoire d'hématologie, Poitiers
| | - Carole Fleury
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Hôpital Avicenne AP-HP, Laboratoire d'hématologie, Bobigny
| | - Florence Blanc-Jouvan
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Annecy Genevois, Laboratoire de biologie, Epagny Metz-Tessy
| | - Soraya Wuilleme
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire de Nantes, Laboratoire d'Hématologie, Nantes
| | - Valérie Bardet
- Groupe Francophone d'Hématologie Cellulaire, Bron, France; Centre Hospitalier Universitaire Ambroise Paré AP-HP, Service d'Hématologie-Immunologie-Transfusion, Paris
| | - Thierry Fest
- Centre Hospitalier Universitaire de Rennes, Laboratoire d'Hématologie, Rennes, France; Université de Rennes 1, INSERM UMR 1236, Rennes
| | - Thierry Lamy
- Université de Rennes 1, INSERM UMR 1236, Rennes, France; Centre Hospitalier Universitaire de Rennes, Hématologie clinique, Rennes
| | - Mikael Roussel
- Centre Hospitalier Universitaire de Rennes, Laboratoire d'Hématologie, Rennes, France; Université de Rennes 1, INSERM UMR 1236, Rennes
| | - Mélanie Pannetier
- Centre Hospitalier Universitaire de Rennes, Laboratoire d'Hématologie, Rennes, France; Groupe Francophone d'Hématologie Cellulaire, Bron
| | - Cédric Pastoret
- Centre Hospitalier Universitaire de Rennes, Laboratoire d'Hématologie, Rennes, France; Université de Rennes 1, INSERM UMR 1236, Rennes.
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Belicard F, Belhomme N, Bouzy S, Saillard C, Nedelec F, Mear JB, Ardois S, Pastoret C, Reizine F, Camus C, Painvin B. Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome in the intensive care unit: a case report. J Med Case Rep 2023; 17:314. [PMID: 37480098 PMCID: PMC10362754 DOI: 10.1186/s13256-023-04034-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 06/11/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome is a newly discovered inflammatory disease affecting male subjects, for which few data exist in the literature. Here, we describe the case of a patient with known Sweet's syndrome admitted to the intensive care unit and for whom a vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome was diagnosed, allowing for appropriate treatment and the patient's discharge and recovery. CASE PRESENTATION A 70-year-old male White patient was hospitalized in the intensive care unit following an intrahospital cardiac arrest. History started a year before with repeated deep vein thrombosis and episodes of skin eruption compatible with Sweet's syndrome. After a course of oral steroids, fever and inflammatory syndrome relapsed with onset of polychondritis, episcleritis along with neurological symptoms and pulmonary infiltrates. Intrahospital hypoxic cardiac arrest happened during patient's new investigations, and he was admitted in a critical state. During the intensive care unit stay, he presented with livedoid skin lesions on both feet. Vasculitis was not proven; however, cryoglobulinemia screening came back positive. Onset of pancytopenia was explored with a myelogram aspirate. It showed signs of dysmyelopoiesis and vacuoles in erythroid and myeloid precursors. Of note, new deep vein thrombosis developed, despite being treated with heparin leading to the diagnosis of heparin-induced thrombocytopenia. The course of symptoms were overlapping multiple entities, and so a multidisciplinary team discussion was implemented. Screening for UBA1-mutation in the blood came back positive, confirming the vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome. Corticosteroids and anti-IL1 infusion were started with satisfactory results supporting patient's discharge from intensive care unit to the internal medicine ward. CONCLUSIONS Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome should be suspected in male patients presenting with inflammatory symptoms, such as fever, skin eruption, chondritis, venous thromboembolism, and vacuoles in bone marrow precursors. Patients with undiagnosed vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic syndrome may present with organ failure requiring hospitalization in intensive care unit, where screening for UBA1 mutation should be performed when medical history is evocative. Multidisciplinary team involvement is highly recommended for patient management, notably to start appropriate immunosuppressive treatments.
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Affiliation(s)
- Félicie Belicard
- Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Nicolas Belhomme
- Internal Medicine Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Simon Bouzy
- Hematology Laboratory Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Clémence Saillard
- Dermatology Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Fabienne Nedelec
- Hemostasis Laboratory Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Jean-Baptiste Mear
- Hematology Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Samuel Ardois
- Internal Medicine Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Cedric Pastoret
- Hematology Laboratory Department, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Florian Reizine
- Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Christophe Camus
- Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France
| | - Benoit Painvin
- Service de Réanimation Médicale et des Maladies Infectieuses, Centre Hospitalier Universitaire de Rennes, Hôpital Pontchaillou, 2 rue Henri le Guilloux, 35033, Rennes Cedex 9, France.
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Peterlin P, Le Bris Y, Turlure P, Chevallier P, Ménard A, Gourin MP, Dumas PY, Thepot S, Berceanu A, Park S, Hospital MA, Cluzeau T, Bouzy S, Torregrosa-Diaz JM, Drevon L, Sapena R, Chermat F, Ades L, Dimicoli-Salazar S, Chevret S, Béné MC, Fenaux P. CPX-351 in higher risk myelodysplastic syndrome and chronic myelomonocytic leukaemia: a multicentre, single-arm, phase 2 study. Lancet Haematol 2023; 10:e521-e529. [PMID: 37245522 DOI: 10.1016/s2352-3026(23)00090-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND CPX-351, an encapsulated form of cytarabine and daunorubicin, has shown greater efficacy than the classic 3 + 7 treatment administration in secondary acute myeloid leukaemia. Given that higher-risk myelodysplastic syndrome and chronic myelomonocytic leukaemia share similarities with secondary acute myeloid leukaemia, we aimed to investigate the safety and efficacy of CPX-351 in this context. METHODS This investigator-initiated two-cohort phase 2 trial was conducted by the Groupe Francophone des Myélodysplasies, with 12 participating centres in France. It comprised cohort A (reported here and completed), which included patients in first-line treatment, and cohort B, which was stopped for lack of inclusion (ie, not enough patients met the inclusion criteria), for patients with hypomethylating agent failure that is not reported here. Cohort A enrolled patients with newly diagnosed higher-risk myelodysplastic syndrome or chronic myelomonocytic leukaemia (aged 18-70 years old) with an Eastern Cooperative Oncology Group performance status of 0-1. Intravenous CPX-351 (100 mg/m2 cytarabine and 44 mg/m2 daunorubicin) was given on days 1, 3, and 5, with a second induction cycle given (same daily dose on days 1 and 3) if at least a partial response was not reached. Patients who responded could receive up to four monthly consolidation cycles (same daily dose on day 1) or allogeneic haematopoietic stem-cell transplantation (HSCT). Overall response rate after one or two induction courses according to European LeukemiaNet 2017 acute myeloid leukaemia was the primary endpoint after CPX-351 induction, whether patients received one or two induction cycles. Safety was assessed in all patients enrolled (in cohort A). This trial is registered with ClinicalTrials.gov, NCT04273802. FINDINGS Between April 29, 2020, and Feb 10, 2021, 21 (68%) male and ten (32%) female patients were enrolled. 27 (87%) of 31 patients responded (95% CI 70-96). 16 (52%) of the 31 patients received at least one consolidation cycle. 30 (97%) of the 31 patients included were initially considered eligible for allogeneic HSCT and 29 (94%) of the 31 patients had the procedure. Median follow-up was 16·1 months (IQR 8·3-18·1). The most common grade 3-4 adverse events were pulmonary (eight [26%] of 31 patients) and cardiovascular (six [19%] of 31 patients). There were 14 serious adverse events (mainly hospitalisation for infection [n=5] and only one was treatment-related) and no treatment-related death. INTERPRETATION CPX-351 appears to be active and safe in patients with higher-risk myelodysplastic syndrome and chronic myelomonocytic leukaemia, allowing bridging to allogenic HSCT in most patients. FUNDING Jazz Pharmaceuticals.
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Affiliation(s)
- Pierre Peterlin
- Clinical Hematology, Nantes University Hospital, Nantes, France.
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Pascal Turlure
- Clinical Hematology, Limoges University Hospital, Limoges, France
| | | | - Audrey Ménard
- Hematology Biology, Nantes University Hospital, Nantes, France
| | | | - Pierre-Yves Dumas
- Clinical Hematology, Bordeaux University Hospital Haut-Lévèque, Pessac, France
| | - Sylvain Thepot
- Clinical Hematology, Angers University Hospital, Angers, France
| | - Ana Berceanu
- Clinical Hematology, Besançon University Hospital, Besançon, France
| | - Sophie Park
- Clinical Hematology, Grenoble University Hospital, Grenoble, France
| | | | - Thomas Cluzeau
- Clinical Hematology, Nice University Hospital, Nice, France
| | - Simon Bouzy
- Hematology Biology, Nantes University Hospital, Nantes, France
| | | | - Louis Drevon
- Clinical Hematology, Hôpital Saint Louis, Paris, France
| | - Rosa Sapena
- Groupe Francophone des Myelodysplasies, Paris, France
| | | | - Lionel Ades
- Clinical Hematology, Hôpital Saint Louis, Paris, France
| | | | - Sylvie Chevret
- Biostatistics Department, Hôpital Saint Louis, Paris, France
| | | | - Pierre Fenaux
- Groupe Francophone des Myelodysplasies, Paris, France
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Le Calvez B, Rialland F, Bassi C, Richard C, Chucherko K, Bouzy S, Le Bris Y, Theisen O, Béné MC, Grain A, Eveillard M. Lineage switch and relapse in sanctuary site: Some lessons to learn about plasticity in KMT2Ar acute leukemia. Pediatr Blood Cancer 2022; 69:e29683. [PMID: 35441496 DOI: 10.1002/pbc.29683] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/08/2022]
Affiliation(s)
| | - Fanny Rialland
- Pediatric Oncology, Nantes University Hospital, Nantes, France
| | - Corentin Bassi
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Camille Richard
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Kevin Chucherko
- Pediatric Oncology, Nantes University Hospital, Nantes, France
| | - Simon Bouzy
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Olivier Theisen
- Hematology Biology, Nantes University Hospital, Nantes, France
| | - Marie C Béné
- Hematology Biology, Nantes University Hospital, Nantes, France.,Nantes Université, INSERM, CNRS, Université d'Angers, CRCI2NA, Nantes, France
| | - Audrey Grain
- Pediatric Oncology, Nantes University Hospital, Nantes, France.,Nantes Université, INSERM, CNRS, Université d'Angers, CRCI2NA, Nantes, France
| | - Marion Eveillard
- Hematology Biology, Nantes University Hospital, Nantes, France.,Nantes Université, INSERM, CNRS, Université d'Angers, CRCI2NA, Nantes, France
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7
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Kostopoulou F, Gabillaud C, Chapiro E, Grange B, Tran J, Bouzy S, Degaud M, Ghamlouch H, Le Garff-Tavernier M, Maloum K, Choquet S, Leblond V, Gabarre J, Lavaud A, Morel V, Roos-Weil D, Uzunov M, Guieze R, Bernard OA, Susin SA, Tournilhac O, Nguyen-Khac F. Gain of the short arm of chromosome 2 (2p gain) has a significant role in drug-resistant chronic lymphocytic leukemia. Cancer Med 2019; 8:3131-3141. [PMID: 31066214 PMCID: PMC6558483 DOI: 10.1002/cam4.2123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/07/2019] [Accepted: 03/12/2019] [Indexed: 12/27/2022] Open
Abstract
The different types of drug resistance encountered in chronic lymphocytic leukemia (CLL) cannot be fully accounted for by the 17p deletion (and/or TP53 mutation), a complex karyotype (CK), immunoglobulin heavy‐chain variable region genes (IGHV) status and gene mutations. Hence, we sought to assess the associations between recurrent genomic abnormalities in CLL and the disease's development and outcome. To this end, we analyzed 64 samples from patients with CLL and gain of the short arm of chromosome 2 (2p+), which is frequent in late‐stage and relapsed/refractory CLL. We found that fludarabine/cyclophosphamide/rituximab (a common first‐line treatment in CLL) is not effective in removing the 2p+ clone ‐ even in samples lacking a CK, the 17p deletion or unmutated IGHV. Our results suggest strongly that patients with CLL should be screened for 2p+ (using karyotyping and fluorescence in situ hybridization) before a treatment option is chosen. Longer follow‐up is now required to evaluate bendamustine‐rituximab, ibrutinib, and idelalisib‐rituximab treatments.
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Affiliation(s)
- Fotini Kostopoulou
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,Molecular Diagnostics Laboratory, KARYO Ltd, Thessaloniki, Greece
| | - Clementine Gabillaud
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Elise Chapiro
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,INSERM U1138, Centre de Recherche des Cordeliers, Sorbonne Université, Paris, France
| | - Beatrice Grange
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Julie Tran
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Simon Bouzy
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Michael Degaud
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Hussein Ghamlouch
- Gustave Roussy, INSERM U1170, Université Paris-Saclay, Villejuif, France
| | - Magali Le Garff-Tavernier
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,INSERM U1138, Centre de Recherche des Cordeliers, Sorbonne Université, Paris, France
| | - Karim Maloum
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Sylvain Choquet
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Veronique Leblond
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Jean Gabarre
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Anne Lavaud
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Veronique Morel
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Damien Roos-Weil
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Madalina Uzunov
- Service d'Hématologie Clinique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Romain Guieze
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Olivier A Bernard
- Gustave Roussy, INSERM U1170, Université Paris-Saclay, Villejuif, France
| | - Santos A Susin
- INSERM U1138, Centre de Recherche des Cordeliers, Sorbonne Université, Paris, France
| | - Olivier Tournilhac
- Service d'Hématologie Clinique et de Thérapie Cellulaire, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Florence Nguyen-Khac
- Service d'Hématologie Biologique, Sorbonne Université, Hôpital Pitié-Salpêtrière, APHP, Paris, France.,INSERM U1138, Centre de Recherche des Cordeliers, Sorbonne Université, Paris, France
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8
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Chapiro E, Lesty C, Gabillaud C, Durot E, Bouzy S, Armand M, Le Garff-Tavernier M, Bougacha N, Struski S, Bidet A, Laharanne E, Barin C, Veronese L, Prié N, Eclache V, Gaillard B, Michaux L, Lefebvre C, Gaillard JB, Terré C, Penther D, Bastard C, Nadal N, Fert-Ferrer S, Auger N, Godon C, Sutton L, Tournilhac O, Susin SA, Nguyen-Khac F. "Double-hit" chronic lymphocytic leukemia: An aggressive subgroup with 17p deletion and 8q24 gain. Am J Hematol 2018; 93:375-382. [PMID: 29194741 DOI: 10.1002/ajh.24990] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 01/21/2023]
Abstract
Chronic lymphocytic leukemia (CLL) with 17p deletion (17p-) is associated with a lack of response to standard treatment and thus the worst possible clinical outcome. Various chromosomal abnormalities (including unbalanced translocations, deletions, ring chromosomes and isochromosomes) result in the loss of 17p and one copy of the TP53 gene. The objective of the present study was to determine whether the type of chromosomal abnormality leading to 17p- and the additional aberrations influenced the prognosis in a series of 195 patients with 17p-CLL. Loss of 17p resulted primarily from an unbalanced translocation (70%) with several chromosome partners (the most frequent being chromosome 18q), followed by deletion 17p (23%), monosomy 17 (8%), isochromosome 17q [i(17q)] (5%) and a ring chromosome 17 (2%). In a univariate analysis, monosomy 17, a highly complex karyotype (≥5 abnormalities), and 8q24 gain were associated with poor treatment-free survival, and i(17q) (P = .04), unbalanced translocations (P = .03) and 8q24 gain (P = .001) were significantly associated with poor overall survival. In a multivariate analysis, 8q24 gain remained a significant predictor of poor overall survival. We conclude that 17p deletion and 8q24 gain have a synergistic impact on outcome, and so patients with this "double-hit" CLL have a particularly poor prognosis. Systematic, targeting screening for 8q24 gain should therefore be considered in cases of 17p- CLL.
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Affiliation(s)
- Elise Chapiro
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Sorbonne Universités, UPMC Paris 6; Paris France
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Claude Lesty
- Sorbonne Universités, UPMC Paris 6; Paris France
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Clémentine Gabillaud
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Eric Durot
- Service d'Hématologie Clinique, CHU Reims; Reims France
| | - Simon Bouzy
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Marine Armand
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Sorbonne Universités, UPMC Paris 6; Paris France
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Magali Le Garff-Tavernier
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
| | - Nadia Bougacha
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Sorbonne Universités, UPMC Paris 6; Paris France
| | - Stéphanie Struski
- Laboratoire de Cytogénétique, Institut Universitaire du Cancer de Toulouse; Toulouse France
| | - Audrey Bidet
- CHU Bordeaux, Service d'Hématologie biologique, F-33000; Bordeaux France
| | - Elodie Laharanne
- CHU Bordeaux, Service d'Hématologie biologique, F-33000; Bordeaux France
| | - Carole Barin
- Unité de Génétique, CHU Bretonneau; Tours France
| | - Lauren Veronese
- Laboratoire de Cytogénétique, CHU Estaing; Clermont-Ferrand France
| | - Nolwen Prié
- Laboratoire de Cytogénétique, CHU Estaing; Clermont-Ferrand France
| | - Virginie Eclache
- Laboratoire d'Hématologie, Hôpital Avicenne, AP-HP; Bobigny France
| | | | | | - Christine Lefebvre
- Laboratoire de Cytogénétique Onco-hématologique, CHU Grenoble; Grenoble France
| | | | - Christine Terré
- Centre Hospitalier de Versailles; Laboratoire de Cytogénétique; Versailles France
| | - Dominique Penther
- Laboratoire de Génétique Oncologique, centre de lutte contre le cancer Henri Becquerel; Rouen France
| | - Christian Bastard
- Laboratoire de Génétique Oncologique, centre de lutte contre le cancer Henri Becquerel; Rouen France
| | - Nathalie Nadal
- Service de génétique chromosomique et moléculaire, CHU Dijon; Dijon France
| | - Sandra Fert-Ferrer
- Centre Hospitalier Métropole Savoie; Laboratoire de Génétique Chromosomique; France, Chambéry
| | - Nathalie Auger
- Laboratoire de Cytogénétique, Institut Gustave Roussy; Villejuif France
| | - Catherine Godon
- Laboratoire de Cytogénétique Hématologique, CHU Nantes; Nantes France
| | - Laurent Sutton
- Centre Hospitalier Métropole Savoie; Service d'Hématologie Clinique; Chambéry France
| | | | - Santos A. Susin
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Sorbonne Universités, UPMC Paris 6; Paris France
| | - Florence Nguyen-Khac
- INSERM UMR_S 1138, Centre de Recherche des Cordeliers; Paris France
- Sorbonne Universités, UPMC Paris 6; Paris France
- Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP; Paris France
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