1
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Cavalieri D, Thiam M. [New drug approval: Zanubrutinib in monotherapy for chronic lymphocytic leukemia]. Bull Cancer 2023; 110:744-745. [PMID: 37085342 DOI: 10.1016/j.bulcan.2023.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/23/2023]
Affiliation(s)
| | - Marietou Thiam
- CHU de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France.
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2
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Croizier C, Guièze R. [Richter Syndrome: Diagnostic and Therapeutic Management]. Bull Cancer 2021; 108:521-527. [PMID: 33896586 DOI: 10.1016/j.bulcan.2021.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 10/21/2022]
Abstract
Richter syndrome (RS) is defined as the occurrence of an aggressive lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL) and rarely Hodgkin lymphoma (HL), in a patient with prior or concomitant chronic lymphocytic leukemia (CLL). RS is estimated to occur in 0.5-1 % per year and is associated with adverse outcome. In the vast majority of patients (80 %), RS is clonally related to the prior CLL. Those with unrelated RS appear to have better outcome. The therapeutic approach is based on those of de novo DLBCL or HL. However, even with modern immunochemotherapy regimens, response rate remains low. In eligible patients with related RS, a consolidation by autologous or allogeneic stem-cell transplantation must be proposed. Combinations including therapies targeting BCR or BCL2 and effective in CLL are currently being evaluated in RS. Novels immunotherapies could be promising approaches based on preliminary results.
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Affiliation(s)
- Carolyne Croizier
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, 1, place Lucie et Raymond Aubrac, 63000 Clermont-Ferrand, France.
| | - Romain Guièze
- Service d'Hématologie Clinique et de Thérapie Cellulaire, CHU Estaing, 1, place Lucie et Raymond Aubrac, 63000 Clermont-Ferrand, France; EA 7453, CHELTER, Université Clermont Auvergne, CHU Estaing, Hématologie Biologique, 1, place Lucie et Raymond Aubrac, 63003 Clermont-Ferrand, France
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3
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Abstract
Secondary forms of immune thrombocytopenia (ITP) represent approximately 20% of all ITP cases in adulthood and this rate increases with age. Since some causes may influence both the prognosis and outcome but also the management of ITP, a minimal workup must be performed at ITP diagnosis to look for an associated or underlying cause. Among adults, B-cell lymphomas and mainly chronic lymphocytic leukemia, systemic auto-immune diseases such as systemic lupus or primary immunodeficiencies mainly represented by common variable immunodeficiency are the most frequent causes of secondary ITP. Whereas first-line therapy used for secondary ITP is usually similar to the one commonly used in primary ITP and relies mostly on corticosteroids±intravenous immunoglobulin according to the severity of bleeding, second and third-line treatments must take into account the type and degree of activity of the underlying disease.
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Affiliation(s)
- M Michel
- Service de médecine interne, centre de référence pour les cytopénies auto-immunes de l'adulte, CHU Henri-Mondor, université Paris Est Créteil, Assistance publique-Hôpitaux de Paris, Créteil, France.
| | - J-C Lega
- Service de médecine interne et vasculaire, centre de compétences cytopénies auto-immunes, hôpital Lyon Sud, Lyon, France
| | - L Terriou
- Département de médecine interne et immunologie clinique, CHU de Lille, Lille, France
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4
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Rateau Y, Harbouche M, Damaj G, Troussard X. [Evaluation of management disparity in patients with chronic lymphocytic leukemia in France]. Bull Cancer 2018; 105:1147-1156. [PMID: 30396506 DOI: 10.1016/j.bulcan.2018.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 06/02/2018] [Revised: 07/15/2018] [Accepted: 08/27/2018] [Indexed: 11/20/2022]
Abstract
Environmental factors have an impact on the effectiveness of treatments for chronic lymphocytic leukemia: vulnerability, organization of the supply of care and proximity of the patient to health professionals. The disparity of care was assessed; vulnerability by the European index of deprivation, the provision of care by values of localized potential accessibility to general practitioners, nurses and pharmacists and hospital supply by the density of hematologists and time access to the center. The data, extracted from the public databases for each grouped island for statistical information, were cross-referenced to apply a principal component analysis and group them into 4 clusters. Cluster 1 has an average EDI, easy access to city professionals, remote access to the referral center, and a good density of hematologists. Cluster 2 has low EDI, satisfactory access to professionals, satisfactory proximity to the referral center and average density of hematologists. Cluster 3 has good EDI, access to professionals is difficult, access to the reference center is long, and the density of hematologists remains average. Cluster 4 has a good EDI, with access to professionals easier than in Cluster 3 but still difficult. The access time to the reference center is better than that of cluster 3 but remains elongated, the density of hematologists remaining average. Mapping is a tool for hospitals and institutions to evaluate care and compare it to other territories.
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Affiliation(s)
- Yann Rateau
- YUNI, 20, rue des Volontaires, 75015 Paris, France
| | | | - Gandhi Damaj
- CHU de Caen, service hématologie clinique, IHBN, 14000 Caen, France
| | - Xavier Troussard
- CHU de Caen, laboratoire d'hématologie, avenue de la Côte-de-Nacre, 14000 Caen, France.
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5
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Gauthier M, Comont T, Vergez F, Ysebaert L. [Minimal residual disease in chronic lymphocytic leukemia: A still current issue in 2018]. Bull Cancer 2018; 105:1042-1051. [PMID: 30243477 DOI: 10.1016/j.bulcan.2018.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/16/2018] [Revised: 06/19/2018] [Accepted: 07/01/2018] [Indexed: 12/21/2022]
Abstract
Minimal residual disease (MRD) is widely used in oncohematology. In chronic lymphocytic leukemia (CLL), it can be measured by flow cytometry or polymerase chain reaction and is getting a greater place, owing to the dramatic therapeutic advances in the management this disease. As MRD decrease after chemoimmunotherapy is associated with improved progression free and overall survivals, its measure is now recommended as a surrogate marker for cytotoxic drugs licensures. This association is independent from treatment received and raises a few questions, such as sequential MRD measures to stop treatment in case of an early deep response and on the opposite, treatment continuation until reaching undetectable MRD (with the possible use of maintenance therapy). Furthermore, following MRD after a cytotoxic treatment could lead clinical trials investigators to propose pre-emptive treatments in case of MRD re-growth, to avoid overt relaspe. MRD re-growth kinetics and CD4 count after treatment completion can improve MRD-based survival predictions. On the other hand, BCR inhibitors do not lead to undetectable MRD, but their association with chemoimmunotherapy increases the proportion of patients reaching that goal. Moreover, BCL2 inhibitors do lead to deep response including in the relapse/refractory setting, giving to MRD a central place in currently investigated treatments evaluation.
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Affiliation(s)
- Martin Gauthier
- IUCT-Oncopôle, service d'hématologie clinique, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
| | - Thibault Comont
- IUCT-Oncopôle, service de médecine interne, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - François Vergez
- IUCT-Oncopôle, laboratoire d'hématologie-immunophenotypage et hematologie cellulaire, 1 avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - Loïc Ysebaert
- IUCT-Oncopôle, service d'hématologie clinique, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; IUCT-Oncopôle, laboratoire d'hématologie-immunophenotypage et hematologie cellulaire, 1 avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; CRCT, Inserm UMR 1037, 2, avenue Hubert-Curien, 31037 Toulouse cedex 1, France
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6
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Vial R, Daniel L, Devos M, Bouchacourt B, Cazajous G, Sichez H, Mazodier K, Lankester M, Gobert P, Seguier J, Swiader L, Sallée M, Jourde-Chiche N, Harlé JR. [Chronic lymphoid leukemia and renal complication: Report on 10 cases from Marseille over 16 years]. Rev Med Interne 2018; 39:612-7. [PMID: 29891261 DOI: 10.1016/j.revmed.2018.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/02/2018] [Accepted: 05/17/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Chronic lymphoid leukemia (CLL) is a hematological malignant disease, associated with a clonal B cell proliferation. The incidence is 4400 new cases per year in France. The prevalence increases with age with a median age at diagnostic of 65 years. Renal involvement is rare and estimated at 1.2% of patients with CLL. Renal pathological diagnoses associated with CLL are variable and are not always related to the hematological disease. We report here on cases of patients with CLL who underwent a renal biopsy over the past 16 years in Marseille. METHODS All cases of renal biopsies performed in patients with CLL between2000 and 2016 in Marseille were included. Pathological analysis was performed by the same experimented pathologist. Data were collected at the time of biopsy and after treatment. RESULTS Ten patients were included in this study. The reason for renal biopsy was acute kidney injury or the onset of nephrotic syndrome. We report on 4 cases of membranous nephropathy, 1 minimal change disease, 1 cryglobulinemia-related membrano-proliferative glomerulonephritis, 1 light chain amyloidosis, 1 fibrillary glomerulonephritis, 1 interstitial monoclonal infiltration and one case of non-specific tubular lesions. Only one patient was treated before the biopsy, 7 patients received a specific hematological treatment of CLL because of its renal involvement. Renal and hematological responses were variable. CONCLUSION Renal involvement of CLL is rare and is not mentioned in the Binet classification. Yet, it can be severe, with acute kidney injury or nephrotic syndrome, and can lead to the initiation of a specific treatment. The most frequent presentation this series was secondary MN, which differs from previous series.
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7
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Boudin L, Patient M, Roméo E, Bladé JS, Gisserot O, de Jauréguiberry JP. [Acquired, non-amyloid related factor X deficiency: A first case associated with atypical chronic lymphocytic leukemia and literature review]. Rev Med Interne 2017; 38:478-481. [PMID: 28110969 DOI: 10.1016/j.revmed.2016.12.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/26/2016] [Accepted: 12/15/2016] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Acquired factor X deficiency is in most cases associated with AL amyloidosis. Acquired non-amyloid related factor X deficiency (DNAA-FX) has been exceptionally reported in the literature. CASE REPORT We report the first case of acquired, non-amyloid related factor X deficiency associated with atypical chronic lymphoid leukemia in a 66-year-old patient with spontaneous hematomas. After therapeutic failure with polyclonal intravenous immunoglobulins, specific lymphoid malignancy treatment allowed symptoms and coagulation disorder resolution. CONCLUSION DNAA-FX should be considered in case of bleeding events or coagulation disorders during low-grade hematological malignancies. Its occurrence can be considered as a treatment indication to prevent potentially fatal bleeding complications.
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Affiliation(s)
- L Boudin
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France; École du Val-de-Grâce, boulevard Port-Royal, 75005 Paris, France
| | - M Patient
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France; École du Val-de-Grâce, boulevard Port-Royal, 75005 Paris, France
| | - E Roméo
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - J-S Bladé
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - O Gisserot
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France
| | - J-P de Jauréguiberry
- Service de médecine interne- oncologie, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, 83000 Toulon, France; École du Val-de-Grâce, boulevard Port-Royal, 75005 Paris, France.
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8
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Lafon-Desmurs B, Monsel G, Leblond V, Papo M, Caumes E, Fekkar A, Jaureguiberry S. Sequential disseminated aspergillosis and pulmonary tuberculosis in a patient treated by idelalisib for chronic lymphocytic leukemia. Med Mal Infect 2016; 47:293-296. [PMID: 27818019 DOI: 10.1016/j.medmal.2016.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 07/27/2016] [Accepted: 10/04/2016] [Indexed: 11/25/2022]
Affiliation(s)
- B Lafon-Desmurs
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - G Monsel
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - V Leblond
- Service d'hématologie clinique, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Papo
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - E Caumes
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Fekkar
- Laboratoire de parasitologie-mycologie, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm U1135, CNRS ERL 8255, centre d'immunologie et des maladies infectieuses (CIMI-Paris), 75013 Paris, France
| | - S Jaureguiberry
- Service des maladies infectieuses et tropicales, hôpital Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm U1135, CNRS ERL 8255, centre d'immunologie et des maladies infectieuses (CIMI-Paris), 75013 Paris, France
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9
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Leblond V. [Not Available]. Rev Prat 2016; 66:1015. [PMID: 30512373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Véronique Leblond
- Service d'hématologie clinique, groupe hospitalier Pitié-Salpêtrière, Paris, France
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10
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Lequeu H, Michallet AS. [Not Available]. Rev Prat 2016; 66:1016-1019. [PMID: 30512374] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Definition, classification and prognostic factors in chronic lymphocytic leukemia. Chronic lymphoid leukaemia is characterized by the monoclonal proliferation of mature lymphocytes with or without tumoral syndrome. It is the malignant blood disease most frequent in Occident characterized by a monoclonal lymphocytary proliferation > 5 000/mm3 over one duration higher than 3 months. The prognostic classification of this pathology is at the same time clinical resting on the stage of Binet but also biological. It is very heterogeneous character in term of clinical and biological presentation, but especially of evolution in fact an enthralling and complex pathology with a major current challenge: that to define prognostic factors allowing to establish an evolutionary risk.
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11
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Troussard X. [Not Available]. Rev Prat 2016; 66:1020-1024. [PMID: 30512375] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Therapeutic indications in chronic lymphocytic leukemia. Chronic lymphocytic leukemia (CLL) is the most common leukemia in Western countries, while it is rare in Asia. It is defined by the presence of more than 5 G/L of B cell clonal. If its evolution is very heterogeneous, the treatment required in the active forms of the disease, progressive stages A and B and stage C of the classification of Binet, benefited in recent years of considerable progress. We consider in this paper the treatment of CLL front line and in patients with relapsed or refractory (R/R), with or without inactivation of TP53: deletion or del(17p) and/or mutations of the TP53 gene. We will discuss the place of immunochemotherapy, including the choice of anti-CD20 monoclonal antibodies: rituximab, ofatumumab or obinutuzumab. For BCR inhibitors, we will limit to the most mature drugs that have obtained marketing authorization: inhibitors of Bruton tyrosine kinase (BTK) ibrutinib and phosphatidyinositol 3-kinase (PI3K) delta, idelalisib. Given its impact, research inactivation of TP53 should be performed before each line of therapy, his presence modifying therapeutic strategies. The treatments, if properly codified, must consider the often little known side effects, whose management is complex.
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Affiliation(s)
- Xavier Troussard
- Laboratoire d'hématologie, hôpital de la Côte de Nacre, CHU de Caen, Caen, France
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12
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Leblond V, Bellanger A. [Not Available]. Rev Prat 2016; 66:1031-1033. [PMID: 30512377] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Ambulatory care management of patient with chronic lymphocytic leukemia; a new concept. In recent years, considerable progress has been made in the treatment and management of hematalogic malignancies. In particular, a new medical practice paradigm is emerging for chronic lymphocytic leukemia (CLL) with more and more targeted oral therapies, often for older and elderly patients with multimorbidity (or multiple chronic diseases) and polypharmacy requiring a new concept of multidisciplinary care so as to avoid discontinuities in treatment and optimize management of adverse reactions and drug-drug interactions. There is a shift away from 'hospital-centered' management to patient-centered home care guided by the hospital. Decisions have to be made with health establishments, hospital and primary healthcare professionals, patient-centered networks and patient associations, organized around several objectives: the proper use of medication, coordination of hospital and home care, patient information and the training of healthcare professionals.
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Affiliation(s)
| | - Agnès Bellanger
- Pharmacie à usage intérieur, groupe hospitalier Pitié Salpêtrière- Charles Foix, université Pierre-et-Marie-Curie, UPMC Paris-6 Paris, France
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13
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Leblond V, Bellanger A. [Not Available]. Rev Prat 2016; 66:1026-1030. [PMID: 30512376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
| | - Agnès Bellanger
- Pharmacie à usage intérieur, groupe hospitalier Pitié Salpêtrière-Charles Foix, université Pierre-et-Marie-Curie, UPMC Paris-6 Paris, France
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14
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Bobot M, Benzaquen M, Rouby F, Lebowitz D, Serratrice J, Durand JM. [Rituximab-induced acute thrombocytopenia in a patient with chronic lymphocytic leukemia]. Rev Med Interne 2016; 38:344-346. [PMID: 27639907 DOI: 10.1016/j.revmed.2016.08.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/12/2016] [Accepted: 08/05/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Rituximab is a chimeric anti-CD20 monoclonal antibody generally well tolerated. However, a severe but rare rituximab-related immune-toxic syndrome, associating fever, chills and thrombocytopenia can occur shortly after the infusion. CASE REPORT We report a case of severe acute rituximab-induced thrombocytopenia with favorable outcome in a patient with chronic lymphocytic leukemia and discuss the possible underlying mechanisms. CONCLUSION Despite the potential initial severity of rituximab-induced thrombocytopenia in CLL, chemotherapy should not be discontinued; tolerance might increase as the hematologic disorder is controlled.
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Affiliation(s)
- M Bobot
- Service de néphrologie, hôpital La-Conception, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France.
| | - M Benzaquen
- Service de dermatologie, hôpital Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, chemin des Bourrely, 13015 Marseille, France
| | - F Rouby
- Service de pharmacologie clinique et pharmacovigilance, centre régional de pharmacovigilance Marseille Provence Corse, hôpital Sainte-Marguerite, AP-HM, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France
| | - D Lebowitz
- Département de médecine interne, service de médecine interne générale, HUG, 4, rue Gabrielle-Perret-Gentil, 1211 Genève 14, Suisse
| | - J Serratrice
- Département de médecine interne, service de médecine interne générale, HUG, 4, rue Gabrielle-Perret-Gentil, 1211 Genève 14, Suisse
| | - J-M Durand
- Service de médecine interne, hôpital La Timone, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, 264, rue Saint-Pierre, 13005 Marseille, France
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15
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Mazeron R, Bosq J, Rivin del Campo E, Arfi-Rouche J, Boros A, Ghez D. An uncommon cause of dysuria solved by "boom-boom" radiotherapy. Cancer Radiother 2016; 20:115-8. [PMID: 26971221 DOI: 10.1016/j.canrad.2015.12.001] [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: 10/26/2015] [Revised: 12/19/2015] [Accepted: 12/24/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic lymphocytic leukaemia is a common disease affecting the hematopoietic organs. The disease remains classically indolent for years preceding a blast crisis. However, the disease can affect all parts of the body. We report here an unusual localization. CASE PRESENTATION A 72-year-old man was followed for 2 years for an indolent chronic lymphocytic leukaemia while he presented a rapidly progressive dysuria. Prostate biopsies were performed concluding to a prostate involvement by the chronic lymphocytic leukaemia. In the absence of progression according to RAI staging system and Binet's classification, he was treated with local low-dose radiotherapy, twice 2 Gy, allowing for a rapid resolution of the symptoms. No systemic treatment was introduced, and 1 year after the completion of his treatment, he is still under watchful waiting strategy for his chronic lymphocytic leukaemia. CONCLUSION Low-dose radiotherapy is an underused effective strategy in indolent lymphoma. In this case, urinary symptoms from a prostate involvement were relieved non-invasively at low cost.
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Affiliation(s)
- R Mazeron
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France.
| | - J Bosq
- Department of biopathology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - E Rivin del Campo
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - J Arfi-Rouche
- Department of radiology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - A Boros
- Department of radiation oncology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
| | - D Ghez
- Department of hematology, Gustave-Roussy cancer campus Grand Paris, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France
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16
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Dougé A, Ravinet A, Bay JO, Tournilhac O, Guièze R, Lemal R. [Ibrutinib prescription in B-cell lymphoid neoplasms]. Bull Cancer 2016; 103:127-37. [PMID: 26822906 DOI: 10.1016/j.bulcan.2015.12.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 10/26/2015] [Accepted: 12/21/2015] [Indexed: 11/29/2022]
Abstract
Ibrutinib is a new-targeted therapy that irreversibly and specifically inhibits the Bruton's Tyrosine Kinase (BTK), a key component of the signaling pathways of B cells. The results are very encouraging as monotherapy in the treatment of chronic lymphocytic leukemia, mantle cell lymphoma, and Waldenström's macroglobulinemia. Following the results of recent studies, ibrutinib is now available in France for these three diseases.
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Affiliation(s)
- Aurore Dougé
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France
| | - Aurélie Ravinet
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France
| | - Jacques-Olivier Bay
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France
| | - Olivier Tournilhac
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France
| | - Romain Guièze
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France
| | - Richard Lemal
- CHU de Clermont-Ferrand, service d'hématologie clinique adulte et de thérapie cellulaire, 63003 Clermont-Ferrand, France; Clermont université, université d'Auvergne, EA7283, CIC501, BP 10448, 63000 Clermont-Ferrand, France.
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17
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Moumine M, Moudden MK, El Baaj M, Choumi F, Nassih M, Hadri L. [Soft palate chronic lymphocytic leukemia]. ACTA ACUST UNITED AC 2014; 116:103-5. [PMID: 25458595 DOI: 10.1016/j.revsto.2014.10.003] [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: 04/15/2014] [Revised: 09/17/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Forty percent of non-Hodgkin lymphoma (NHL) are located in extranodal sites. The palatal location of chronic lymphocytic leukemia (CLL) is usually observed at a late stage of the disease. CASE We report the case of a 62-year-old male patient managed for 8 years for CLL, having presented with a soft palatal tumor in the last 2 years. The diagnosis of CLL was made by immunohistochemistry. The patient was given 6 courses of chemotherapy combining fludarabine, cyclophosphamide, and rituximab. DISCUSSION The diagnosis of CLL requires immunohistochemistry. Chemotherapy is the first line treatment. The complication may be an aggressive lymphoma (Richter).
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Affiliation(s)
- M Moumine
- Service de chirurgie maxillo-faciale et stomatologie, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc.
| | - M-K Moudden
- Service de médecine interne, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc
| | - M El Baaj
- Service de médecine interne, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc
| | - F Choumi
- Service de chirurgie maxillo-faciale et stomatologie, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc
| | - M Nassih
- Service de chirurgie maxillo-faciale et stomatologie, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc
| | - L Hadri
- Service de médecine interne, hôpital militaire Moulay-Ismail, 12000 Meknès, Maroc
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18
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Serris A, Michot JM, Fourn E, Le Bras P, Dollat M, Hirsch G, Pallier C, Carbonnel F, Tertian G, Lambotte O. [Disseminated varicella-zoster virus infection with hemorrhagic gastritis during the course of chronic lymphocytic leukemia: case report and literature review]. Rev Med Interne 2013; 35:337-40. [PMID: 23773904 DOI: 10.1016/j.revmed.2013.05.004] [Citation(s) in RCA: 8] [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] [Received: 12/28/2012] [Revised: 03/24/2013] [Accepted: 05/03/2013] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The reactivation of varicella-zoster virus occurs in immunocompromised patients, especially in cases of hematological malignancy. Disseminated reactivation could involve digestive tract with life-threatening condition. CASE REPORT A 76-year-old woman, with a history of chronic lymphocytic leukemia, presented with left hypochondrium pain, and a vesicular rash with hemorrhagic shock that revealed an hemorrhagic gastritis due to varicella-zoster virus. The literature review identified 28 additional cases of gastrointestinal mucosal damage during reactivation of varicella-zoster virus. Mortality is 40%. We report here the first case in the course of low-grade lymphoid malignancy. CONCLUSION Acute gastrointestinal symptoms in immunocompromised patients should evoke a varicella-zoster virus reactivation with gastrointestinal involvement. This clinical manifestation, although rare, should not be ignored because of its severity.
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MESH Headings
- Aged
- Female
- Gastritis/complications
- Gastritis/diagnosis
- Gastritis/virology
- Gastrointestinal Hemorrhage/complications
- Gastrointestinal Hemorrhage/diagnosis
- Gastrointestinal Hemorrhage/virology
- Herpes Zoster/complications
- Herpes Zoster/diagnosis
- Herpesvirus 3, Human/physiology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/complications
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/virology
- Virus Activation
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Affiliation(s)
- A Serris
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - J-M Michot
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France.
| | - E Fourn
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - P Le Bras
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - M Dollat
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - G Hirsch
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - C Pallier
- Service de microbiologie et virologie, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - F Carbonnel
- Service de gastro-entérologie, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - G Tertian
- Service d'hématologie biologique, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
| | - O Lambotte
- Service de médecine interne, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Université Paris Sud XI, 94275 Le Kremlin-Bicêtre cedex, France
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