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Dourthe ME, Yakouben K, David A, Thouvenin S, Chaillou D, Caillat-Zucman S, Cuffel A, Tardy C, Lainey E, Caye-Eude A, Arfeuille C, Delaugerre C, Chaix-Baudier ML, Naudin J, Auvin S, Bergaoui K, Merlat-Guitard AI, De Jorna R, Mebarki M, Dalle JH, Baruchel A. Success of donor-derived CAR-T cells after failure of autologous CD19 CAR-T cells (tisagenlecleucel) in B-cell acute lymphoblastic leukaemia. Br J Haematol 2024. [PMID: 38735758 DOI: 10.1111/bjh.19524] [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: 03/20/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Marie Emilie Dourthe
- Department of Pediatric Hematology and Immunology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, AP-HP and Université Paris Cité, Institut Necker-Enfants Malades (INEM), INSERM U1151, Paris, France
| | - Karima Yakouben
- Department of Pediatric Hematology and Immunology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Audrey David
- Department of Pediatric Hematology and Oncology, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Sandrine Thouvenin
- Department of Pediatric Hematology and Oncology, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - Delphine Chaillou
- Department of Pediatric Hematology and Immunology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Sophie Caillat-Zucman
- Laboratory of Immunology, Hôpital Universitaire Saint Louis, AP-HP and INSERM UMR1149, Université Paris Cité, Paris, France
| | - Alexis Cuffel
- Laboratory of Immunology, Hôpital Universitaire Saint Louis, AP-HP and INSERM UMR1149, Université Paris Cité, Paris, France
| | - Cléa Tardy
- Pharmacy Department, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Elodie Lainey
- Laboratory of Hematology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Aurélie Caye-Eude
- Department of Genetics, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
- INSERM U1131, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
| | - Chloé Arfeuille
- Department of Genetics, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
- INSERM U1131, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
| | - Constance Delaugerre
- Laboratory of Virology, Hôpital Saint Louis, AP-HP and Université Paris Cité, Paris, France
| | | | - Jérôme Naudin
- Pediatric Intensive Care Unit, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Stéphane Auvin
- Neurology Department, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - Karim Bergaoui
- Radiology Department, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | | | - Romain De Jorna
- Pharmacy Department, Hôpital Saint Louis, AP-HP and Université Paris Cité, Paris, France
| | - Miryam Mebarki
- Unité de Thérapie Cellulaire et Centre MEARY de Thérapie Cellulaire et Génique, AP-HP and Université Paris Cité, Hôpital Saint- Louis, U976 et CICBT, INSERM, Paris, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology and Immunology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, Hôpital Universitaire Robert Debré, AP-HP and Université Paris Cité, Paris, France
- EA3518, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
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Balducci E, Simonin M, Duployez N, Steimlé T, Dourthe ME, Villarese P, Ducassou S, Arnoux I, Cayuela JM, Balsat M, Courtois L, Andrieu GP, Touzart A, Huguet F, Petit A, Ifrah N, Dombret H, Baruchel A, Macintyre EA, Preudhomme C, Boissel N, Asnafi V. Genomic imbalances analysis provides new insight into prognostic factors in adult and pediatric T-ALL. Blood 2024:blood.2023022154. [PMID: 38518104 DOI: 10.1182/blood.2023022154] [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: 08/28/2023] [Revised: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 03/24/2024] Open
Abstract
Given the poor outcome of refractory and relapsing T-ALL, identifying prognostic markers is still challenging. Using SNP-array analysis, we provide a comprehensive analysis of genomic imbalances in a cohort of 317 newly-diagnosed T-ALL patients including 135 children and 182 adults with respect to clinical and biological features and outcomes. SNP-array results identified at least one somatic genomic imbalance in virtually all T-ALL patients (~96%). Del(9)(p21) (~70%) and UPD(9)p21)/CDKN2A/B (~28%) were the most frequent genomic imbalances. Unexpectedly del(13q14)/RB1/DLEU1 (~14%) was the second more frequent CNV followed by del(6)(q15)/CASP8AP2 (~11%), del(1)(p33)/SIL-TAL1 (~11%), del(12)(p13)ETV6/CDKN1B (~9%), del(18)(p11)/PTPN2 (~9%), del(1)(p36)/RPL22 (~9%), and del(17)(q11)/NF1/SUZ12 (~8%). SNP-array also revealed distinct profiles of genomic imbalances according to age, immunophenotype, and oncogenetic subgroups. In particular, adult T-ALL patients demonstrated a significantly higher incidence of del(1)(p36)/RPL22, and del(13)(q14)/RB1/DLEU1, and lower incidence of del(9)(p21) and UPD(9p21)/CDKN2A/B. We determined a threshold of 15 genomic imbalances to stratify patients into high- and low-risk groups of relapse. Survival analysis also revealed the poor outcome, despite the low number of affected cases, conferred by the presence of chromothripsis (n=6, ~2%), del(16)(p13)/CREBBP (n=15, ~5%) as well as the newly identified recurrent gain at 6q27 involving MLLT4 (n=10, ~3%). Genomic complexity, del(16)(p13)/CREBBP and gain at 6q27 involving MLLT4 maintained their significance in multivariate analysis for survival outcome. Our study thus demonstrated that whole genome analysis of imbalances provides new insights to refine risk stratification in T-ALL.
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Affiliation(s)
| | - Mathieu Simonin
- Institut Necker Enfants-Malades, INSERM U1151, Paris, France
| | | | - Thomas Steimlé
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Paris, France
| | | | - Patrick Villarese
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Paris, France, Paris, France
| | | | | | - Jean-Michel Cayuela
- University Hospital Saint-Louis, APHP and Université Paris Cité, Paris, France
| | | | - Lucien Courtois
- Institut Necker Enfants-Malades, INSERM U1151, Paris, France
| | | | | | | | - Arnaud Petit
- Hopital Armand Trousseau, APHP.Sorbonne Université, Paris, France
| | - Norbert Ifrah
- Centre Hospitalier Universitaire Angers, Angers, France
| | - Herve Dombret
- Université Paris Cité, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris (AP-HP), Paris, France
| | - André Baruchel
- Hôpital Robert Debré (AP-HP) and Université de Paris, Paris, France
| | | | | | | | - Vahid Asnafi
- Laboratory of Onco-Hematology, Assistance Publique-Hopitaux De Paris (AP-HP), Hopital Necker Enfants-Malades, Paris, France
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Strullu M, Caye-Eude A, Fenneteau O, Arfeuille C, Cuccuini W, Cavé H, Baruchel A, Lainey E. A PAX5 P80R pediatric B acute lymphoblastic leukemia with monocytic lineage switch at diagnosis: Deciphering classification ambiguity. Pediatr Blood Cancer 2024; 71:e30842. [PMID: 38189777 DOI: 10.1002/pbc.30842] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Marion Strullu
- Pediatric Hematology and Immunology Department, Robert-Debré Hospital, APHP, Paris, France
- University of Paris Cité, Paris, France
- Inserm U1131, IUH, Paris, France
| | - Aurélie Caye-Eude
- Inserm U1131, IUH, Paris, France
- Genetic Department, Robert-Debré Hospital, APHP, Paris, France
| | - Odile Fenneteau
- Hematology Laboratory, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Chloé Arfeuille
- University of Paris Cité, Paris, France
- Inserm U1131, IUH, Paris, France
- Genetic Department, Robert-Debré Hospital, APHP, Paris, France
| | - Wendy Cuccuini
- Hematology Laboratory, Saint-Louis Hospital, APHP, Paris, France
| | - Hélène Cavé
- University of Paris Cité, Paris, France
- Inserm U1131, IUH, Paris, France
- Genetic Department, Robert-Debré Hospital, APHP, Paris, France
| | - André Baruchel
- Pediatric Hematology and Immunology Department, Robert-Debré Hospital, APHP, Paris, France
- University of Paris Cité, Paris, France
- URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
| | - Elodie Lainey
- University of Paris Cité, Paris, France
- Inserm U1131, IUH, Paris, France
- Hematology Laboratory, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
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Meyran D, Arfeuille C, Chevret S, Neven Q, Caye-Eude A, Lainey E, Petit A, Rialland F, Michel G, Plantaz D, Jubert C, Theron A, Gandemer V, Ouachée-Chardin M, Paillard C, Bruno B, Buchbinder N, Pochon C, Calvo C, Fahd M, Baruchel A, Cavé H, Dalle JH, Strullu M. A predictive classifier of poor prognosis in transplanted patients with juvenile myelomonocytic leukemia: a study on behalf of the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire. Haematologica 2024. [PMID: 38385260 DOI: 10.3324/haematol.2023.284103] [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: 08/17/2023] [Indexed: 02/23/2024] Open
Abstract
Juvenile myelomonocytic leukemia (JMML) is an aggressive pediatric myeloproliferative neoplasm requiring hematopoietic stem cell transplantation (HSCT) in most cases. We retrospectively analyzed 119 JMML patients who underwent first allogeneic HSCT between 2002 and 2021. The majority (97%) carried a RAS-pathway mutation, and 62% exhibited karyotypic alterations or additional mutations in SETBP1, ASXL1, JAK3 and/or the RAS pathway. Relapse was the primary cause of death, with a 5-year cumulative incidence of 24.6% (95%CI: 17.1-32.9). Toxic deaths occurred in 12 patients, resulting in treatmentrelated mortality (TRM) of 9.0% (95%CI: 4.6-15.3). The 5-year overall (OS) and event-free survival were 73.6% (95%CI: 65.7-82.4) and 66.4% (95%CI: 58.2-75.8), respectively. Four independent adverse prognostic factors for OS were identified: age at diagnosis >2 years, time from diagnosis to HSCT >6 months, monocyte count at diagnosis >7.2x109/L, and the presence of additional genetic alterations. Based on these factors, we proposed a predictive classifier. Patients with three or more predictors (21% of the cohort) had a 5-year OS of 34.2%, whereas those with none (7%) had a 5-year OS of 100%. Our study demonstrates improved transplant outcomes compared to prior published data, which can be attributed to the synergistic impacts of a low TRM and a reduced yet still substantial relapse incidence. By integrating genetic information with clinical and hematological features, we have devised a predictive classifier. This classifier effectively identifies a subgroup of patients who are at a heightened risk of unfavorable post-transplant outcomes who would benefit novel therapeutic agents and post-transplant strategies.
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Affiliation(s)
- Déborah Meyran
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; Children's Cancer Centre, Royal Children's Hospital, Parkville, Victoria, Australia; Sir Peter MacCallum Dept of Oncology, University of Melbourne, Melbourne, 3010 Australia
| | - Chloé Arfeuille
- Service de de Génétique Moléculaire, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; INSERM UMR_S1131, Institut Universitaire d'Hématologie, Université Paris Cité, Paris-Cité, Paris
| | - Sylvie Chevret
- Service de biostatistique et information médicale, Hôpital Saint Louis, GHU AP-HP Nord - Université Paris Cité, Paris
| | - Quentin Neven
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris
| | - Aurélie Caye-Eude
- Service de de Génétique Moléculaire, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris
| | - Elodie Lainey
- INSERM UMR_S1131, Institut Universitaire d'Hématologie, Université Paris Cité, Paris-Cité, Paris, France; Service d'Hématologie Biologique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris
| | - Arnaud Petit
- Service d'Hémato-Immunologie pédiatrique, Hôpital Armand Trousseau, Université Paris Sorbonne, Paris
| | - Fanny Rialland
- Service d'Onco-Hématologie pédiatrique, CHU de Nantes, Nantes
| | - Gérard Michel
- Service d'Hématologie pédiatrique, Assistance Publique des Hôpitaux de Marseille AP-HM, Marseille
| | | | - Charlotte Jubert
- CHU Bordeaux, Service d'hématologie oncologie pédiatrique, F-33000 Bordeaux
| | - Alexandre Theron
- Department of Pediatric Oncology and Hematology, CHU Montpellier, France; IRMB, University of Montpellier, INSERM, Montpellier
| | | | | | | | | | | | - Cécile Pochon
- Service d'Onco-Hématologie pédiatrique, Hôpital d'Enfants de Brabois, Vandoeuvre lès Nancy
| | - Charlotte Calvo
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris
| | - Mony Fahd
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris
| | - André Baruchel
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; Unité Inserm U976, Université Paris Cité, Paris-Cité, Paris
| | - Hélène Cavé
- Service de de Génétique Moléculaire, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; INSERM UMR_S1131, Institut Universitaire d'Hématologie, Université Paris Cité, Paris-Cité, Paris
| | - Jean-Hugues Dalle
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; Unité Inserm U976, Université Paris Cité, Paris-Cité, Paris
| | - Marion Strullu
- Service d'Hémato-Immunologie pédiatrique, Hôpital Robert Debré, GHU AP-HP Nord - Université Paris Cité, Paris, France; INSERM UMR_S1131, Institut Universitaire d'Hématologie, Université Paris Cité, Paris-Cité, Paris.
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Faust C, Auquier P, Gandemer V, Bertrand Y, Tabone M, Ansoborlo S, Baruchel A, Bonneau J, Dalle J, Chastagner P, Kanold J, Poirée M, Theron A, Olivier L, Pellier I, Michel G, Berbis J. Educational outcomes in siblings of childhood leukemia survivors: Factors associated with school difficulties and comparison with general population. Cancer Med 2024; 13:e6821. [PMID: 38204153 PMCID: PMC10904966 DOI: 10.1002/cam4.6821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/15/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND To investigate the educational outcomes of siblings of childhood leukemia survivors, explore determinants of school difficulties, and compare the rates of repeating grades between siblings and the general population. METHODS A cross-sectional study of childhood leukemia survivors' siblings recruited through the Leucémies de l'Enfant et de l'Adolescent cohort, a French long-term follow-up program, was conducted, and education-related data were obtained via self-report questionnaires. Adjusted logistic regression models were used to identify variables associated with school difficulties and time since diagnosis. Rates of repeating a grade in middle school were compared between siblings and the general population of the same generation. RESULTS A total of 564 siblings with a mean time from diagnosis of 14.1 ± 6.4 years were included, among whom 139 (24.6%) repeated a grade, at an average of 6.4 ± 4.5 years after diagnosis. In multivariate analysis, the risk factors for repeating a grade were older siblings (odds ratio [OR] 2.3, p = 0.006), family financial difficulties (OR 2.8, p = 0.008), and history of repetition in survivors (OR, 2.5, p = 0.001). Sibling hematopoietic stem cell donors were at greater risk of repeating a grade long-term after diagnosis (p = 0.018). Overall, siblings did not have a higher risk of educational delays at the end of middle school than the general population. CONCLUSION Although the results are reassuring, socioeconomic and cancer-related factors may have an impact on siblings' schooling long after diagnosis. Paying attention to siblings contributes to identifying the most vulnerable families, allowing more attention and appropriate resources to avoid long-term repercussions. Additionally, supportive and targeted interventions can be developed to improve the organization of education and the health care system.
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
| | - Pascal Auquier
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
| | - Virginie Gandemer
- Department of Pediatric Hematology‐OncologyUniversity Hospital of RennesRennesFrance
| | - Yves Bertrand
- Department of Pediatric Hematology‐OncologyUniversity Hospital of LyonLyonFrance
| | | | - Sophie Ansoborlo
- Department of Pediatric Hematology‐OncologyUniversity Hospital of BordeauxBordeauxFrance
| | - André Baruchel
- Department of Pediatric Hematology‐Oncology, Robert Debré HospitalGHU AP‐HP Nord Université Paris CitéParisFrance
| | - Jacinthe Bonneau
- Department of Pediatric Hematology‐OncologyUniversity Hospital of RennesRennesFrance
| | - Jean‐Hugues Dalle
- Department of Pediatric Hematology‐Oncology, Robert Debré HospitalGHU AP‐HP Nord Université Paris CitéParisFrance
| | - Pascal Chastagner
- Department of Pediatric Hematology‐OncologyChildren's Hospital of BraboisVandoeuvre Les NancyFrance
| | - Justyna Kanold
- Department of Pediatric Hematology‐OncologyCIC Inserm 501, University Hospital of Clermont‐FerrandClermont‐FerrandFrance
| | - Maryline Poirée
- Department of Pediatric Hematology‐OncologyUniversity Hospital L'ArchetNiceFrance
| | - Alexandre Theron
- Department of Pediatric Hematology‐OncologyUniversity Hospital of MontpellierMontpellierFrance
| | - Laura Olivier
- Department of Pediatric Hematology‐OncologyUniversity Hospital of ToulouseToulouseFrance
| | - Isabelle Pellier
- Department of Pediatric Hematology‐OncologyUniversity Hospital of AngersAngersFrance
| | - Gérard Michel
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
- Department of Pediatric Hematology‐OncologyTimone Children's Hospital and Aix‐Marseille UniversityMarseilleFrance
| | - Julie Berbis
- UR 3279, CERESS – Health Service Research and Quality of Life CenterAix‐Marseille UniversityMarseilleFrance
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Rossig C, Pearson AD, Vassal G, Scobie N, Bird N, Blanc P, Vormoor HJ, Calkoen FG, Locatelli F, Bufalo FD, Rives S, Jacoby E, Balduzzi A, Bourquin JP, Baruchel A. Chimeric Antigen Receptor (CAR) T-Cell Products for Pediatric Cancers: Why Alternative Development Paths Are Needed. J Clin Oncol 2024; 42:253-257. [PMID: 38011605 DOI: 10.1200/jco.23.01314] [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: 06/19/2023] [Revised: 09/14/2023] [Accepted: 10/02/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Gilles Vassal
- ACCELERATE, Brussels, Belgium
- Department of Paediatric and Adolescent Oncology, Institut Gustave Roussy and Paris-Saclay University, Villejuif, France
| | | | - Nick Bird
- Solving Kids' Cancer UK, London, United Kingdom
| | | | - H Josef Vormoor
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Friso G Calkoen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Franco Locatelli
- Department of Pediatric Haematology/Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Francesca Del Bufalo
- Department of Pediatric Haematology/Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
- AND Catholic University of the Sacred Heart, Rome, Italy
| | - Susana Rives
- CAR T-cell Unit, Leukemia and Lymphoma Department, Pediatric Cancer Center Barcelona /Hospital Sant Joan de Déu, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Elad Jacoby
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adriana Balduzzi
- Pediatrics, Hematopoietic Stem Cell Transplantation Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Jean-Pierre Bourquin
- Department of Pediatric Hematology and Oncology, Immunology and Stem Cell Transplantation, University Children's Hospital, Zurich, Switzerland
| | - André Baruchel
- Department of Pediatric Hemato-Immunology, Hôpital Universitaire Robert Debré (APHP and Université Paris Cité), Paris, France
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Jeha S, Goto H, Baruchel A, Boëlle-Le Corfec E, Geffriaud-Ricouard C, Pieters R, Shin HY. Patient-Level Meta-analysis of Clofarabine in Acute Lymphoblastic Leukemia. Adv Ther 2023; 40:5447-5463. [PMID: 37819554 PMCID: PMC10611855 DOI: 10.1007/s12325-023-02696-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Clofarabine monotherapy at a dose of 52 mg/m2 per day was approved in the USA in 2004 for the treatment of relapsed or refractory acute lymphoblastic leukemia (R/R ALL) in patients aged 1-21 years after at least two prior regimens. To address a post-marketing requirement for additional evidence of the clinical benefit of clofarabine in its approved indication, a meta-analysis of patient-level data was conducted. METHODS A systematic literature review was conducted, using the Dr.Evidence software platform, DOC Search, and Embase, to identify clinical trials with patients with R/R ALL who received clofarabine monotherapy at 52 mg/m2. The primary endpoint was complete remission (CR). Secondary endpoints were overall remission (OR, defined by CR or CR with either incomplete platelet recovery or incomplete neutrophil and platelet recovery), duration of response, overall survival (OS), and safety. RESULTS A total of 754 patients in 12 clinical studies were analyzed including 682 patients with R/R ALL treated with clofarabine monotherapy at 52 mg/m2; of them, 374 were aged < 22 years (pediatric population). Rates of CR and OR were 16% (95% confidence interval [CI] 7, 26) and 28% (95% CI 20, 37), respectively, in the pediatric population and 12% (95% CI 5, 21) and 21% (95% CI 13, 31) in the overall population. Median OS (evaluable in three studies in pediatric patients) was 3.7 months (95% CI 0.1, 31.4), reaching 10.1 months (95% CI 0.3, 68.9) for those achieving OR. Sensitivity analyses supported these findings. The most frequent grade 3-4 adverse events were liver abnormalities, anemia, diarrhea, and febrile neutropenia. CONCLUSION In this meta-analysis, CR duration and median OS in pediatric patients with R/R ALL appeared to be slightly longer than in the phase II study. No new safety signals were identified. Results support the use of clofarabine monotherapy in its approved indication.
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Affiliation(s)
- Sima Jeha
- St Jude Children's Hospital Research, 262 Danny Thomas Place, Memphis, TN, 38105-3678, USA.
| | - Hiroaki Goto
- Division of Hematology/Oncology, Kanagawa Children's Medical Center, Minami-ku, Yokohama, Kanagawa, Japan
| | - André Baruchel
- Department of Pediatric Hemato-Immunology, Hôpital Universitaire Robert Debré (APHP and Université Paris Cité), Paris, France
| | | | | | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Hee Young Shin
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea
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8
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Dourthe ME, Andrieu GP, Potier A, Balducci E, Guerder J, Simonin M, Courtois L, Petit A, Macintyre E, Boissel N, Baruchel A, Asnafi V. The oncogenetic landscape and clinical impact of BCL11B alterations in adult and pediatric T-cell acute lymphoblastic leukemia. Haematologica 2023; 108:3165-3169. [PMID: 36891734 PMCID: PMC10620567 DOI: 10.3324/haematol.2022.282605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/28/2023] [Indexed: 03/10/2023] Open
Affiliation(s)
- Marie Emilie Dourthe
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France; Université de Paris Cité, Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Paris
| | - Guillaume P Andrieu
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris
| | - Amandine Potier
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France; Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Paris, France and Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CDR Saint-Antoine, GRC n°07, GRC MyPAC, Paris
| | - Estelle Balducci
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris
| | - Julie Guerder
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris
| | - Mathieu Simonin
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France; Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Paris, France and Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CDR Saint-Antoine, GRC n°07, GRC MyPAC, Paris
| | - Lucien Courtois
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Paris, France and Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CDR Saint-Antoine, GRC n°07, GRC MyPAC, Paris
| | - Elizabeth Macintyre
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris
| | - Nicolas Boissel
- AP-HP, Hôpital Saint Louis, Unité d'Hématologie Adolescents et Jeunes Adultes, Paris, France; Université de Paris, Institut de Recherche Saint-Louis, EA-3518, Paris
| | - André Baruchel
- Université de Paris Cité, Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Paris, France; Université de Paris, Institut de Recherche Saint-Louis, EA-3518, Paris
| | - Vahid Asnafi
- Université de Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris.
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Lamble AJ, Moskop A, Pulsipher MA, Maude SL, Summers C, Annesley C, Baruchel A, Gore L, Amrolia P, Shah N. INSPIRED Symposium Part 2: Prevention and Management of Relapse Following Chimeric Antigen Receptor T Cell Therapy for B Cell Acute Lymphoblastic Leukemia. Transplant Cell Ther 2023; 29:674-684. [PMID: 37689393 DOI: 10.1016/j.jtct.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/30/2023] [Indexed: 09/11/2023]
Abstract
Although CD19-directed chimeric antigen receptor (CAR) T cell therapy (CAR-T) for relapsed/refractory B cell acute lymphoblastic leukemia (B-ALL) has been transformative in inducing and sustaining remission, relapse rates remain unacceptably high, with approximately 50% of children and young adults experiencing relapse within the first year postinfusion. Emerging strategies to extend the durability of remission involve the use of prognostic biomarkers to identify those at high risk of relapse or incorporate strategies aimed to enhancing functional CAR T cell persistence. Nonetheless, with antigen loss/down-regulation or evolution to lineage switch as major mechanisms of relapse, optimizing single antigen targeting alone is insufficient. Here, with a focus on relapse prevention strategies, including postinfusion surveillance and treatment approaches being explored to optimize post-CAR-T management (eg, combinatorial antigen targeting strategies, preemptive hematopoietic cell transplantation), we review the current state of the art in the prevention and management of post CAR-T relapse. We highlight the advancements in the field and identify gaps in the literature to guide future research in optimizing the prevention and management of post-CAR-T relapse in children and young adults with B-ALL.
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Affiliation(s)
- Adam J Lamble
- Division of Hematology/Oncology, University of Washington, Seattle Children's Hospital, Seattle, Washington.
| | - Amy Moskop
- Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, Wisconsin
| | - Michael A Pulsipher
- Division of Hematology and Oncology, Intermountain Primary Children's Hospital, Huntsman Cancer Institute, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, Utah
| | - Shannon L Maude
- Division of Oncology, Cell Therapy and Transplant Section, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Corinne Summers
- Division of Hematology/Oncology, University of Washington, Seattle Children's Hospital, Seattle, Washington; Fred Hutchinson Cancer Center, Seattle, Washington
| | - Colleen Annesley
- Division of Hematology/Oncology, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - André Baruchel
- Pediatric Hematology Department, Robert Debré University Hospital, AP-HP and Université Paris Cité, Paris, France
| | - Lia Gore
- Pediatric Hematology/Oncology/BMT-CT, University of Colorado, Children's Hospital Colorado, Aurora, Colorado
| | - Persis Amrolia
- Great Ormond Street Hospital for Children, London, United Kingdom
| | - Nirali Shah
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
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10
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Baruchel A, Bourquin JP, Crispino J, Cuartero S, Hasle H, Hitzler J, Klusmann JH, Izraeli S, Lane AA, Malinge S, Rabin KR, Roberts I, Ryeom S, Tasian SK, Wagenblast E. Down syndrome and leukemia: from basic mechanisms to clinical advances. Haematologica 2023; 108:2570-2581. [PMID: 37439336 PMCID: PMC10542835 DOI: 10.3324/haematol.2023.283225] [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: 05/02/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
Children with Down syndrome (DS, trisomy 21) are at a significantly higher risk of developing acute leukemia compared to the overall population. Many studies investigating the link between trisomy 21 and leukemia initiation and progression have been conducted over the last two decades. Despite improved treatment regimens and significant progress in iden - tifying genes on chromosome 21 and the mechanisms by which they drive leukemogenesis, there is still much that is unknown. A focused group of scientists and clinicians with expertise in leukemia and DS met in October 2022 at the Jérôme Lejeune Foundation in Paris, France for the 1st International Symposium on Down Syndrome and Leukemia. This meeting was held to discuss the most recent advances in treatment regimens and the biology underlying the initiation, progression, and relapse of acute lymphoblastic leukemia and acute myeloid leukemia in children with DS. This review provides a summary of what is known in the field, challenges in the management of DS patients with leukemia, and key questions in the field.
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Affiliation(s)
- André Baruchel
- Hôpital Universitaire Robert Debré (APHP and Université Paris Cité), Paris, France
| | | | - John Crispino
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Sergi Cuartero
- Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Johann Hitzler
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Shai Izraeli
- Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Department of Human Molecular Genetics and Biochemistry, Sackler School of Medicine, Aviv University, Aviv, Israel
| | | | - Sébastien Malinge
- Telethon Kids Institute - Cancer Centre, Perth, Western Australia, Australia
| | - Karen R. Rabin
- Baylor College of Medicine, Texas Children's Cancer Center, Houston, TX, USA
| | | | - Sandra Ryeom
- Department of Surgery, Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Sarah K. Tasian
- Children’s Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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11
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Balducci E, Steimlé T, Smith C, Villarese P, Feroul M, Payet-Bornet D, Kaltenbach S, Couronné L, Lhermitte L, Touzart A, Dourthe ME, Simonin M, Baruchel A, Dombret H, Ifrah N, Boissel N, Nadel B, Macintyre E, Cieslak A, Asnafi V. TREC mediated oncogenesis in human immature T lymphoid malignancies preferentially involves ZFP36L2. Mol Cancer 2023; 22:108. [PMID: 37430263 DOI: 10.1186/s12943-023-01794-y] [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: 03/17/2023] [Accepted: 05/25/2023] [Indexed: 07/12/2023] Open
Abstract
The reintegration of excised signal joints resulting from human V(D)J recombination was described as a potent source of genomic instability in human lymphoid cancers. However, such molecular events have not been recurrently reported in clinical patient lymphoma/leukemia samples. Using a specifically designed NGS-capture pipeline, we here demonstrated the reintegration of T-cell receptor excision circles (TRECs) in 20/1533 (1.3%) patients with T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL). Remarkably, the reintegration of TREC recurrently targeted the tumor suppressor gene, ZFP36L2, in 17/20 samples. Thus, our data identified a new and hardly detectable mechanism of gene deregulation in lymphoid cancers providing new insights in human oncogenesis.
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Affiliation(s)
- Estelle Balducci
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Thomas Steimlé
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
- TAGC, UMR 1090, Aix-Marseille University, INSERM, Marseille, France
| | - Charlotte Smith
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Patrick Villarese
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Mélanie Feroul
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | | | - Sophie Kaltenbach
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Lucile Couronné
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Ludovic Lhermitte
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Aurore Touzart
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Marie-Emilie Dourthe
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Mathieu Simonin
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, University Hospital Robert Debré, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
- Institut Universitaire d'Hématologie, EA-3518, University Hospital Saint-Louis, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
| | - Hervé Dombret
- Université Paris Diderot, Institut Universitaire d'Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, 75010, Paris, France
| | - Norbert Ifrah
- PRES LUNAM, CHU Angers Service Des Maladies du Sang, INSERM U 892, 49933, Angers, France
| | - Nicolas Boissel
- Université Paris Diderot, Institut Universitaire d'Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, 75010, Paris, France
| | - Bertrand Nadel
- Aix Marseille Université, CNRS, INSERM, CIML, Marseille, France
| | - Elizabeth Macintyre
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France
| | - Agata Cieslak
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France.
| | - Vahid Asnafi
- Laboratory of Onco-Hematology, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
- Université Paris Cité, CNRS, INSERM U1151, Institut Necker Enfants Malades (INEM), Paris, France.
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12
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Lambert J, Di Blasi R, Rabian F, Dourthe ME, Baruchel A, Thiéblemont C, Boissel N, Levy V, Picat MQ, Chevret S. Real-world Experience of Approved Chimeric Antigen Receptor T-cell Therapies Compared to Clinical Trials Data. Hemasphere 2023; 7:e873. [PMID: 37260917 PMCID: PMC10228472 DOI: 10.1097/hs9.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/08/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Jérôme Lambert
- Biostatistic Department, Saint Louis Hospital (APHP), Paris, France
- ECSTRRA Team, UMR1153, Inserm, Université Paris Cité, Paris, France
- Paris Cité University, Paris, France
| | - Roberta Di Blasi
- Hemato-oncology Department, Saint Louis Hospital (APHP), Paris, France
| | - Florence Rabian
- Paris Cité University, Paris, France
- Unité d’Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France
- URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
| | - Marie-Emilie Dourthe
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - André Baruchel
- Paris Cité University, Paris, France
- URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Catherine Thiéblemont
- Paris Cité University, Paris, France
- Hemato-oncology Department, Saint Louis Hospital (APHP), Paris, France
- Université Paris Cité, NF-kappaB, Différenciation et Cancer, Paris, France
| | - Nicolas Boissel
- Paris Cité University, Paris, France
- Unité d’Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France
- URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, Paris, France
| | - Vincent Levy
- ECSTRRA Team, UMR1153, Inserm, Université Paris Cité, Paris, France
- Centre d’investigations cliniques, Hôpital Avicenne, Bobigny, France
| | | | - Sylvie Chevret
- Biostatistic Department, Saint Louis Hospital (APHP), Paris, France
- ECSTRRA Team, UMR1153, Inserm, Université Paris Cité, Paris, France
- Paris Cité University, Paris, France
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13
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Faust C, Auquier P, Bertrand Y, Tabone MD, Ansoborlo S, Baruchel A, Gandemer V, Dalle JH, Chastagner P, Kanold J, Poirée M, Theron A, Plat G, Pellier I, Michel G, Berbis J. Impact of childhood leukemia on siblings: their long-term perception of family functioning and its relationship with their psychosocial characteristics using structural equation modeling. J Cancer Surviv 2023:10.1007/s11764-023-01385-2. [PMID: 37162684 DOI: 10.1007/s11764-023-01385-2] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE In the context of pediatric cancer, siblings' adaptation and needs have been previously investigated; however, research on the long-term consequences on siblings, especially on their family environment, is scarce. We aimed to (1) assess the family functioning (FF) perceived by siblings of childhood leukemia survivors long after diagnosis and (2) explore characteristics likely associated and investigate associations with psycho-behavioral and social factors. METHODS Childhood leukemia survivors' siblings older than 11 years were recruited through the LEA cohort, a French long-term follow-up program, and completed the family assessment device (FAD). Logistic regression analysis was used to determine factors likely associated with unhealthy functioning in families as perceived by siblings. Structural equation modeling (SEM) was used to examine relationships that predict siblings' perception of FF. RESULTS We included 605 siblings (mean follow-up time from diagnosis 14.1 ± 6.8 years), of whom 175 (28.9%) perceived unhealthy functioning. SEM showed that older siblings were more likely to perceive problematic functioning (β = 0.095, p = 0.014). Sex and leukemia burden had indirect effects on FF through mediators. Family financial situation at diagnosis was not associated with the risk of reporting unhealthy functioning. CONCLUSIONS Our study contributed to identifying siblings at risk of facing family issues and reinforced the need to provide more consideration and suitable resources to avoid late consequences. Often considered as the "forgotten children", future research should focus on developing targeted interventions to facilitate family communication and improve siblings' social support. IMPLICATIONS FOR CANCER SURVIVORS Overall, results regarding FF perceived by siblings are reassuring and provide new enlightening elements that allow for better support to all families.
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France.
| | - Pascal Auquier
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology-Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology-Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - André Baruchel
- Department of Pediatric Hematology-Oncology, Saint Louis Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology-Oncology, University Hospital of Rennes, Rennes, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, University Hospital of Clermont-Ferrand, CIC Inserm 501, Clermont-Ferrand, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, University Hospital of Nice, Nice, France
| | - Alexandre Theron
- Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Gérard Michel
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
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14
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Grain A, Rialland-Battisti F, Chevallier P, Blin N, Dalle JH, Michel G, Dhédin N, Peffault de Latour R, Pochon C, Yakoub-Agha I, Bertrand Y, Sirvent A, Jubert C, Forcade E, Berceanu A, Gandemer V, Schneider P, Bay JO, Rohrlich PS, Brissot E, Paillard C, Plantaz D, Nguyen Quoc S, Gonzales F, Maillard N, Planche L, Baruchel A. Hematopoietic stem cell transplantation for acute lymphoblastic leukemia: why do adolescents and young adults outcomes differ from those of children? A retrospective study on behalf of the Francophone Society of Stem Cell Transplantation and Cellular Therapy (SFGM-TC). J Cancer Res Clin Oncol 2023; 149:1473-1483. [PMID: 35507103 DOI: 10.1007/s00432-022-04021-1] [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: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE In the acute lymphoblastic leukemia (ALL) landscape, adolescents and young adults (AYA) often present high-risk diseases and increased chemotherapy-related toxicity. Studies analyzing the outcomes of AYA after hematopoietic stem cell transplantation (HSCT) are scarce. Our study aimed to compare the outcomes of children and AYA with ALL after HSCT and to determine the factors influencing potential differences. METHOD 891 patients, from the SFGM-TC registry, aged between 1 and 25 years who received HSCT between 2005 and 2012 were included. The outcomes of AYA were compared to the ones of their younger counterparts. RESULTS Five-year OS and GRFS were lower in AYA: 53.1% versus 64% and 36% versus 47% (p = 0.0012 and p = 0.007, respectively). WhileCIR was similar in both groups, 5 year-treatment related mortality was higher in AYA: 19% versus 13% (p = 0.04). The lower GRFS in AYA was mainly explained by a higher chronic graft versus host disease (cGvHD) incidence: 32% versus 19% (p < 0.001). Use of peripheral blood stem cells and use of anti-thymoglobulin appeared to be the main factors impacting cGvHD occurrence in AYA. CONCLUSION AYA have worse outcomes than children after HSCT for ALL because of a greater risk of TRM due to cGvHD. HSCT practices should be questioned in this population.
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Affiliation(s)
- Audrey Grain
- Pediatric Hematology-Oncology Department, CHU Hopital Mère-Enfant, Nantes, France.
| | | | | | - Nicolas Blin
- Hematology Department, CHU Hotel Dieu, Nantes, France
| | - Jean-Hugues Dalle
- Robert Debré University Hospital (APHP), Université de Paris, Paris, France
| | - Gérard Michel
- Department of Paediatric Haematology and Oncology and EA3279, Timone Children Hospital and Aix-Marseille University, Marseille, France
| | - Nathalie Dhédin
- AYA Unit, Clinical Hematology Departments, Saint-Louis Hospital, Paris, France
| | | | - Cécile Pochon
- Allogeneic Hematopoietic Stem Cell Transplantation Unit, Department of Pediatric Oncohematology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | | | - Yves Bertrand
- Institut of Hematology and Pediatric Oncology, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Anne Sirvent
- Department of Clinical Haematology, CHU Montpellier, Montpellier, France
| | - Charlotte Jubert
- Department of Pediatric Hematology, Bordeaux Hospital, Bordeaux, France
| | - Edouard Forcade
- Department of Hematology and Cellular Therapy, CHU Bordeaux, Bordeaux, France
| | - Ana Berceanu
- Department of Hematology, CHU Besançon, Besançon, France
| | - Virginie Gandemer
- Department of Pediatric Oncology and Haematology, University Hospital of Rennes, Rennes, France
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - Jacques-Olivier Bay
- Department of Hematology and Cellular Therapy CHU Estaing, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Eolia Brissot
- Department of Haematology, Hôpital Saint-Antoine, Paris, France
| | - Catherine Paillard
- Pediatric Oncohematology and Bone Marrow Transplantation Unit, Hôpital de Hautepierre, CHRU, Strasbourg, France
| | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital Grenoble, Grenoble, France
| | | | - Fanny Gonzales
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277, CANTHER, Cancer Heterogeneity Plasticity and Resistance to Therapies, 59000, Lille, France
| | | | - Lucie Planche
- Clinical Research Unit, CHD Vendée, La Roche sur Yon, France
| | - André Baruchel
- Robert Debré University Hospital (APHP), Université de Paris, Paris, France
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15
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Dourthe ME, Courtois L, Andrieu GP, Simonin M, Touzart A, Lhermitte L, Petit A, Boissel N, Baruchel A, Asnafi V, Macintyre E. Impact of T-cell Receptor Status on Mutational Landscape and Outcome in T-ALL. Hemasphere 2023; 7:e871. [PMID: 36950021 PMCID: PMC10027033 DOI: 10.1097/hs9.0000000000000871] [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: 10/26/2022] [Accepted: 02/09/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
- Marie Emilie Dourthe
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
- Department of Pediatric Hematology and Immunology, Université Paris Cité, Robert Debré University Hospital (AP-HP), Paris, France
| | - Lucien Courtois
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Guillaume P. Andrieu
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Mathieu Simonin
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Aurore Touzart
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Ludovic Lhermitte
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Nicolas Boissel
- AP-HP, Hôpital Saint Louis, Unité d’Hématologie Adolescents et Jeunes Adultes, Paris, France
- Université de Paris, Institut de Recherche Saint-Louis, Paris, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, Université Paris Cité, Robert Debré University Hospital (AP-HP), Paris, France
- Université de Paris, Institut de Recherche Saint-Louis, Paris, France
| | - Vahid Asnafi
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Elizabeth Macintyre
- Université Paris Cité, Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
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16
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Laetsch TW, Maude SL, Rives S, Hiramatsu H, Bittencourt H, Bader P, Baruchel A, Boyer M, De Moerloose B, Qayed M, Buechner J, Pulsipher MA, Myers GD, Stefanski HE, Martin PL, Nemecek E, Peters C, Yanik G, Khaw SL, Davis KL, Krueger J, Balduzzi A, Boissel N, Tiwari R, O'Donovan D, Grupp SA. Three-Year Update of Tisagenlecleucel in Pediatric and Young Adult Patients With Relapsed/Refractory Acute Lymphoblastic Leukemia in the ELIANA Trial. J Clin Oncol 2023; 41:1664-1669. [PMID: 36399695 PMCID: PMC10022844 DOI: 10.1200/jco.22.00642] [Citation(s) in RCA: 67] [Impact Index Per Article: 67.0] [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: 03/16/2022] [Revised: 08/24/2022] [Accepted: 09/26/2022] [Indexed: 11/19/2022] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.In the primary analysis of the global phase II ELIANA trial (ClinicalTrials.gov identifier: NCT02435849), tisagenlecleucel provided an overall remission rate of 81% in pediatric and young adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL), with 59% of responders remaining relapse-free at 12 months. Here, we report an update on efficacy, safety, and patient-reported quality of life in 79 pediatric and young adult patients with R/R B-ALL following a median follow-up of 38.8 months. The overall remission rate was 82%. The median event-free survival was 24 months, and the median overall survival was not reached. Event-free survival was 44% (95% CI, 31 to 57) and overall survival was 63% (95% CI, 51 to 73) at 3 years overall (most events occur within the first 2 years). The estimated 3-year relapse-free survival with and without censoring for subsequent therapy was 52% (95% CI, 37 to 66) and 48% (95% CI, 34 to 60), respectively. No new or unexpected long-term adverse events were reported. Grade 3/4 adverse events were reported in 29% of patients > 1 year after infusion; grade 3/4 infection rate did not increase > 1 year after infusion. Patients reported improvements in quality of life up to 36 months after infusion. These findings demonstrate favorable long-term safety and suggest tisagenlecleucel as a curative treatment option for heavily pretreated pediatric and young adult patients with R/R B-ALL.
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Affiliation(s)
- Theodore W. Laetsch
- Division of Oncology, Center for Childhood Cancer Research and Cancer Immunotherapy Program, Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shannon L. Maude
- Division of Oncology, Center for Childhood Cancer Research and Cancer Immunotherapy Program, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Susana Rives
- Department of Pediatric Hematology—Oncology and Institut de Recerca, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Hidefumi Hiramatsu
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Henrique Bittencourt
- Department of Pediatrics, Faculty of Medicine, University of Montreal, Montreal, Canada
- The Hematology Oncology Division and Charles-Bruneau Cancer Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Peter Bader
- Division of Stem Cell Transplantation and Immunology, Hospital for Children and Adolescents, University Hospital Frankfurt, Frankfurt, Germany
| | - André Baruchel
- University Hospital Robert Debré (APHP) and Université de Paris, Paris, France
| | - Michael Boyer
- Department of Pediatrics and Internal Medicine, University of Utah, Salt Lake City, UT
| | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Muna Qayed
- Aflac Cancer and Blood Disorders Center, Emory University, Atlanta, GA
| | - Jochen Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - Michael A. Pulsipher
- Division of Hematology, Oncology, Blood and Marrow Transplant, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA
- At the time of present work, now affiliated with Division of Pediatric Hematology and Oncology, Intermountain Primary Children's Hospital, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | | | - Heather E. Stefanski
- National Bone Marrow Donor Program, Be the Match, Division of Pediatric Blood and Marrow Transplant, University of Minnesota, Minneapolis, MN
| | - Paul L. Martin
- Pediatric Transplant and Cellular Therapy, Duke University Medical Center, Durham, NC
| | | | - Christina Peters
- Stem Cell Transplantation Unit, St Anna Children's Hospital, Vienna, Austria
| | - Gregory Yanik
- Department of Pediatrics, University of Michigan Medical Center, Ann Arbor, MI
| | - Seong Lin Khaw
- Children's Cancer Centre, Royal Children's Hospital and Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Kara L. Davis
- Division of Hematology, Oncology, Stem Cell Transplant and Regenerative Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Joerg Krueger
- Division of Haematology/Oncology/Bone Marrow Transplantation, Hospital for Sick Children, Toronto, Canada
| | - Adriana Balduzzi
- Clinica Pediatrica Università degli Studi di Milano Bicocca, Monza, Italy
| | - Nicolas Boissel
- Saint-Louis Hospital (APHP) and Université de Paris Diderot, Paris, France
| | | | | | - Stephan A. Grupp
- Division of Oncology, Center for Childhood Cancer Research and Cancer Immunotherapy Program, Children's Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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17
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Simonin M, Andrieu GP, Birsen R, Balsat M, Hypolite G, Courtois L, Graux C, Grardel N, Cayuela JM, Huguet F, Chalandon Y, Le Bris Y, Macintyre E, Gandemer V, Petit A, Rousselot P, Baruchel A, Bouscary D, Hermine O, Boissel N, Asnafi V. Prognostic value and oncogenic landscape of TP53 alterations in adult and pediatric T-ALL. Blood 2023; 141:1353-1358. [PMID: 36599110 DOI: 10.1182/blood.2022017755] [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: 07/13/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Mathieu Simonin
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, Paris, France
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris, Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Guillaume P Andrieu
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Rudy Birsen
- Department of Hematology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Paris, France
| | - Marie Balsat
- Hospices Civils de Lyon, Service d'Hématologie Clinique, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
| | - Guillaume Hypolite
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Lucien Courtois
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Carlos Graux
- CHU UCLouvain Namur-Godinne, service d'Hématologie, Yvoir, Belgium
| | - Nathalie Grardel
- Laboratory of Hematology, CHRU Lille, Lille, France
- INSERM U1172, Lille, France
| | - Jean-Michel Cayuela
- Laboratory of Hematology and EA3518, Saint-Louis University Hospital, Université de Paris Cité, Paris, France
| | - Françoise Huguet
- Department of Hematology, CHRU-Institut Universitaire de Cancer Toulouse-Oncopole, Toulouse, France
| | - Yves Chalandon
- Division of Hematology, Department of Oncology, University Hospital of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Swiss Group for Clinical Cancer Research, Bern, Switzerland
| | - Yannick Le Bris
- Hematology Biology, Nantes University Hospital and Nantes-Angers Cancer and Immunology Research Center, Nantes, France
| | - Elizabeth Macintyre
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris, Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris, Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Philippe Rousselot
- Department of Hematology, Centre Hospitalier de Versailles, Le Chesnay, France
- Université Paris-Saclay, Communauté Paris-Saclay, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Université de Paris Cité, Paris, France
| | - Didier Bouscary
- Department of Hematology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris Cité, Paris, France
- Institut Cochin, INSERM U1016, Paris, France
| | - Olivier Hermine
- Department of Hematology, INSERM U1163, IMAGINE Institute, Paris University, Necker Hospital, Paris, France
| | - Nicolas Boissel
- Université Paris Cité, Institut de Recherche Saint-Louis, URP-3518, Publique-Hôpitaux de Paris, Saint-Louis University Hospital, Paris, France
| | - Vahid Asnafi
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Université de Paris Cité, Paris, France
- Institut Necker-Enfants Malades, INSERM U1151, Paris, France
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18
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Attarbaschi A, Möricke A, Harrison CJ, Mann G, Baruchel A, De Moerloose B, Conter V, Devidas M, Elitzur S, Escherich G, Hunger SP, Horibe K, Manabe A, Loh ML, Pieters R, Schmiegelow K, Silverman LB, Stary J, Vora A, Pui CH, Schrappe M, Zimmermann M. Outcomes of Childhood Noninfant Acute Lymphoblastic Leukemia With 11q23/ KMT2A Rearrangements in a Modern Therapy Era: A Retrospective International Study. J Clin Oncol 2023; 41:1404-1422. [PMID: 36256911 PMCID: PMC9995095 DOI: 10.1200/jco.22.01297] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 06/05/2022] [Revised: 08/01/2022] [Accepted: 09/07/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We aimed to study prognostic factors and efficacy of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) in first remission of patients with noninfant childhood acute lymphoblastic leukemia (ALL) with 11q23/KMT2A rearrangements treated with chemotherapy regimens between 1995 and 2010. PATIENTS AND METHODS Data were retrospectively retrieved from 629 patients with 11q23/KMT2A-rearranged ALL from 17 members of the Ponte-di-Legno Childhood ALL Working Group. Clinical and biologic characteristics, early response assessed by minimal residual disease at the end of induction (EOI) therapy, and allo-HSCT were analyzed for their impact on outcomes. RESULTS A specific 11q23/KMT2A translocation partner gene was identified in 84.3% of patients, with the most frequent translocations being t(4;11)(q21;q23) (n = 273; 51.5%), t(11;19)(q23;p13.3) (n = 106; 20.0%), t(9;11)(p21_22;q23) (n = 76; 14.3%), t(6;11)(q27;q23) (n = 20; 3.8%), and t(10;11)(p12;q23) (n = 14; 2.6%); 41 patients (7.7%) had less frequently identified translocation partner genes. Patient characteristics and early response varied among subgroups, indicating large biologic heterogeneity and diversity in therapy sensitivity among 11q23/KMT2A-rearranged ALL. The EOI remission rate was 93.2%, and the 5-year event-free survival (EFS) for the entire cohort was 69.1% ± 1.9%, with a range from 41.7% ± 17.3% for patients with t(9;11)-positive T-ALL (n = 9) and 64.8% ± 3.0% for patients with t(4;11)-positive B-ALL (n = 266) to 91.2% ± 4.9% for patients with t(11;19)-positive T-ALL (n = 34). Low EOI minimal residual disease was associated with favorable EFS, and induction failure was particularly predictive of nonresponse to further therapy and relapse and poor EFS. In addition, EFS was not improved by allo-HSCT compared with chemotherapy only in patients with both t(4;11)-positive B-ALL (n = 64 v 51; P = .10) and 11q23/KMT2A-rearranged T-ALL (n = 16 v 10; P = .69). CONCLUSION Compared with historical data, prognosis of patients with noninfant 11q23/KMT2A-rearranged ALL has improved, but allo-HSCT failed to affect outcome. Targeted therapies are needed to reduce relapse and treatment-related mortality rates.
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Affiliation(s)
- Andishe Attarbaschi
- St Anna Children's Hospital and St Anna Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - Anja Möricke
- Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Christine J. Harrison
- Leukaemia Research Cytogenetics Group, Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Newcastle upon Tyne, United Kingdom
| | - Georg Mann
- St Anna Children's Hospital and St Anna Children's Cancer Research Institute, Medical University of Vienna, Vienna, Austria
| | - André Baruchel
- Robert Debré University Hospital (APHP), Université Paris Cité, Paris, France
| | | | - Valentino Conter
- University of Milano-Bicocca, MBBM Foundation/ASST Monza, Monza, Italy
| | - Meenakshi Devidas
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Sarah Elitzur
- Schneider Children's Medical Center, Tel Aviv, Israel
- Tel Aviv University, Tel Aviv, Israel
| | - Gabriele Escherich
- Clinic of Paediatric Haematology and Oncology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Keizo Horibe
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Atsushi Manabe
- Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Mignon L. Loh
- Ben Towne Center for Childhood Cancer Research, Seattle Children's Research Institute, Seattle, WA
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA
| | - Rob Pieters
- Princess Máxima Centre for Pediatric Oncology, Utrecht, the Netherlands
| | - Kjeld Schmiegelow
- Rigshospitalet and University Hospital Copenhagen, Copenhagen, Denmark
- Faculty of Medicine, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Jan Stary
- University Hospital Motol and Charles University, Prague, Czech Republic
| | - Ajay Vora
- Great Ormond Street Hospital, London, United Kingdom
| | - Ching-Hon Pui
- St Jude Children's Research Hospital, Memphis, TN
- University of Tennessee, Memphis, TN
| | - Martin Schrappe
- Christian-Albrechts-University Kiel and University Medical Center Schleswig-Holstein, Kiel, Germany
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19
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Faust C, Auquier P, Hamidou Z, Bertrand Y, Tabone MD, Ansoborlo S, Baruchel A, Gandemer V, Dalle JH, Chastagner P, Kanold J, Poirée M, Sirvent N, Plat G, Pellier I, Michel G, Berbis J. Brothers and sisters of childhood acute leukemia survivors: Their long-term quality of life and its determinants. Cancer Med 2023; 12:6200-6212. [PMID: 36266927 PMCID: PMC10028038 DOI: 10.1002/cam4.5355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Childhood cancer confront the whole family with a traumatic event. Because brothers and sisters may encounter emotional problems that can remain for a long time and that only few studies have assessed their long-term outcome, our present objectives were to describe the long-term quality of life (QoL) of childhood leukemia survivors' siblings and to explore its determinant. METHODS Brothers and sisters (from 8-year-old) of survivors included in the French LEA Cohort completed a QoL questionnaire (according to their age). Scores were compared with those reported by age- and gender-matched French general population and by survivors. Using a clustering method, siblings were categorized into 3 groups depending on their level of QoL's scores and factors likely to be linked with these clusters were explored with multivariate analyses. RESULTS We included 689 brothers and sisters (313 minors, 376 adults) and the mean time from diagnosis was 13.2 ± 6.6 years. Minor siblings reported higher QoL scores than general population (p < 0.001), but a lower score for relationship with family than survivors (p < 0.001). In adult siblings, Mental Component Summary score was lower than general population (p < 0.001). Level of siblings' QoL was linked with female gender, but no association was found with cancer-related factors. CONCLUSION Brothers and sisters expressed a divergent perception of their long-term QoL depending on their age. To minimize the impact from childhood to adulthood, long-term attention should also be paid to siblings, often referred as "forgotten children".
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Affiliation(s)
- Cindy Faust
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Zeinab Hamidou
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology-Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, A. Trousseau Hospital, AP-HP, Paris, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology-Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - André Baruchel
- Department of Pediatric Hematology-Oncology, Saint Louis Hospital, AP-HP, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology-Oncology, University Hospital of Rennes, Rennes, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, AP-HP, Paris, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Maryline Poirée
- Department of Pediatric Hematology-Oncology, University Hospital L'Archet, Nice, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology-Oncology, University Hospital of Montpellier, Montpellier, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, University Hospital of Toulouse, Toulouse, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Gérard Michel
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
- Department of Pediatric Hematology-Oncology, Timone Children's Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- UR 3279, CERESS - Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
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20
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Chabut M, Schneider P, Courbiere B, Saultier P, Bertrand Y, Tabone MD, Pochon C, Ducassou S, Paillard C, Gandemer V, Kanold J, Dalle JH, Poiree M, Plat G, Thouvenin S, Plantaz D, Sirvent N, Weinhard S, Berbis J, Baruchel A, Leverger G, Hamidou Z, Auquier P, Michel G. Ovarian Function and Spontaneous Pregnancy After Hematopoietic Stem Cell Transplantation for Leukemia Before Puberty: An L.E.A. Cohort Study. Transplant Cell Ther 2023:S2666-6367(23)01130-2. [PMID: 36849077 DOI: 10.1016/j.jtct.2023.02.019] [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: 11/05/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
Ovarian function impairment and infertility are among the most frequent late effects after hematopoietic stem cell transplantation (HSCT). The aim of this study was to evaluate ovarian function, occurrence of premature ovarian insufficiency (POI), and spontaneous pregnancy in a large cohort of adult survivor women who had undergone HSCT for leukemia before puberty. We conducted a retrospective observational study in women from the national cohort L.E.A., the long-term French follow-up program after childhood leukemia. The median follow-up duration was 18 years (14.2-23.3) after HSCT. Among 178 women, 106 (60%) needed pubertal induction with hormone substitution treatment, whereas 72 (40%) had spontaneous menarche. After spontaneous menarche, 33 (46%) developed POI, mostly within 5 years of HSCT. Older age at time of HSCT and cryopreservation of ovarian tissue appeared as significant risk factors for POI. More than 65% of patients who underwent HSCT before the age of 4.8 years had spontaneous menarche, and almost 50% didn't have POI at last evaluation, whereas more than 85% with HSCT after the age of 10.9 years didn't have spontaneous menarche and needed induction of puberty with hormone replacement therapy. Twenty-two women (12%) had at least one spontaneous pregnancy, with 17 live-births, 14 miscarriages, 4 legal abortions, and 2 therapeutic abortions. These results add supplementary data to better counsel patients and their families on the chances of ovarian residual function and pregnancy after HSCT, as well as on the potential interest of fertility preservation.
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Affiliation(s)
- Mathilde Chabut
- Department of Pediatrics, University Hospital of Rouen, Rouen, France.
| | - Pascale Schneider
- Department of Pediatric Hematology and Oncology, University Hospital of Rouen, Rouen, France
| | - Blandine Courbiere
- Department of Gynecology-Obstetric and Reproductive Medicine, AP-HM, Hôpital La Conception/Aix-Marseille Université, IMBE, CNRS, IRD, Avignon Université, Marseille, France
| | - Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, Marseille, France; Aix Marseille Univ, INSERM, INRAe, C2VN, Marseille, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, AP-HP, Sorbonne University, Paris, France
| | - Cécile Pochon
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Brabois,France
| | - Stéphane Ducassou
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Hugues Dalle
- Department of Pediatric Onco-Hematology, University Hospital of Saint Louis, Paris, France; Department of Hematology and immunology, Hôpital Robert-Debré, GHU APHP-Nord Université de Paris-Cité, Paris, France
| | - Maryline Poiree
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Sandrine Thouvenin
- Department of Pediatric Onco-hematology, CHU de Saint-Etienne, Saint-Etienne, France
| | - Dominique Plantaz
- Department of Pediatric Hematology and Oncology, University Hospital of Grenoble, Grenoble, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital of Montpellier, Montpellier, France
| | - Sara Weinhard
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Brabois,France
| | - Julie Berbis
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - André Baruchel
- Department of Hematology and immunology, Hôpital Robert-Debré, GHU APHP-Nord Université de Paris-Cité, Paris, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, AP-HP, Sorbonne University, Paris, France
| | - Zeinab Hamidou
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Pascal Auquier
- CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
| | - Gérard Michel
- Department of Pediatric Hematology, Immunology and Oncology, APHM, La Timone Children's Hospital, Marseille, France; CEReS Research Unit EA 3279 and Department of Public Health, Hôpital de la Timone, Marseille, France
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Huault A, Michel G, Charon V, Chouklati K, Domenech C, Chastagner P, Dalle JH, Paillard C, Ducassou S, Poirée M, Plat G, Tabone MD, Kanold J, Baruchel A, Berger C, Pellier I, Plantaz D, Theron A, Mustafa A, Auquier P, Gandemer V. Symptomatic osteonecrosis in French survivors of childhood and adolescent leukemia: a clinical and MRI study of LEA cohort. Pediatr Hematol Oncol 2023:1-17. [PMID: 36820621 DOI: 10.1080/08880018.2023.2168810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Osteonecrosis (ON) is a known complication of acute leukemia (AL) management, affecting 1%-10% of young patients and resulting in long-term morbidity. Widespread access to MRI over the past decade has allowed earlier detection and more accurate assessment. This study investigated clinical and MRI features of the 129 (2.5%) patients with symptomatic ON retrospectively recruited from the French LEA (Leucémies de l'Enfant et de l'Adolescent, or child and adolescent leukemias) cohort (n = 4,973). We analyzed data concerning ON risk factors, multifocal involvement, severe lesions detected by MRI, and patient quality of life (QoL). ON patients tended to be >10 years old at the time of AL diagnosis (odds ratio [OR]: 22.46; p < 10-6), female (OR: 1.8; p = 0.002), or treated for relapse (OR: 1.81; p = 0.041). They more frequently suffered from other sequelae (p < 10-6). Most necroses involved weight-bearing joints, and they were multifocal in 69% of cases. Double-blinded review of MRIs for 39 patients identified severe lesions in 14, usually in the hips. QoL of adolescents and adults was poor and permanently impacted after onset of ON. In conclusion, age >10 at time of AL diagnosis, female sex, and relapse occurrence were risk factors for multifocal ON; MRI revealed severe ON in a third of the patients considered; and ON was associated with persistently poor QoL affecting multiple domains. Future studies should include prospective data addressing ON management and seek to identify genetic markers for targeted screening enabling early ON detection and treatment.
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Affiliation(s)
- Alice Huault
- Department of Pediatric Hematology-Oncology, Nantes University Hospital, Nantes, France
| | - Gérard Michel
- Department of Pediatric Oncology, Aix-Marseille University and La Timone Children's Hospital, Marseille, France
| | - Valérie Charon
- Department of Radiology, Rennes University Hospital, Rennes, France
| | - Kamal Chouklati
- Department of Radiology, Rennes University Hospital, Rennes, France
| | - Carine Domenech
- Department of Pediatric Hematology-Oncology, Pediatric Hematology and Oncology Institute (IHOPE), Hospices Civils de Lyon, University Lyon 1, Lyon, France
| | - Pascal Chastagner
- Department of Pediatric Hematology-Oncology, Hôpital d'Enfants de Brabois, Vandoeuvre-lès-Nancy, France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, Strasbourg University Hospital, Strasbourg, France
| | - Stéphane Ducassou
- Department of Pediatric Hematology-Oncology, Bordeaux University Hospital, Bordeaux, France
| | - Marilyne Poirée
- Department of Pediatric Hematology-Oncology, Nice University Hospital (L'Archet), Nice, France
| | - Geneviève Plat
- Department of Pediatric Hematology-Oncology, Toulouse University Hospital (Purpan), Toulouse, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology-Oncology, Armand Trousseau Hospital, APHP. Sorbonne Université, Paris, France
| | - Justyna Kanold
- Department of Pediatric Hematology-Oncology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - André Baruchel
- Department of Pediatric Hematology, Robert Debré Hospital, Paris, France
| | - Claire Berger
- Department of Pediatric Hematology, Saint-Étienne University Hospital, Saint-Etienne, France
| | | | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, Grenoble Alpes University Hospital, Grenoble, France
| | - Alexandre Theron
- Department of Pediatric Hematology-Oncology, Montpellier University Hospital, Montpellier, France
| | - Alaa Mustafa
- Department of Public Health, EA 3279 Research Unit, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Pascal Auquier
- Department of Public Health, EA 3279 Research Unit, Marseille University Hospital, Aix-Marseille University, Marseille, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology department, University Hospital, Rennes, France
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22
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Sebert M, Gachet S, Leblanc T, Rousseau A, Bluteau O, Kim R, Ben Abdelali R, Sicre de Fontbrune F, Maillard L, Fedronie C, Murigneux V, Bellenger L, Naouar N, Quentin S, Hernandez L, Vasquez N, Da Costa M, Prata PH, Larcher L, de Tersant M, Duchmann M, Raimbault A, Trimoreau F, Fenneteau O, Cuccuini W, Gachard N, Auger N, Tueur G, Blanluet M, Gazin C, Souyri M, Langa Vives F, Mendez-Bermudez A, Lapillonne H, Lengline E, Raffoux E, Fenaux P, Adès L, Forcade E, Jubert C, Domenech C, Strullu M, Bruno B, Buchbinder N, Thomas C, Petit A, Leverger G, Michel G, Cavazzana M, Gluckman E, Bertrand Y, Boissel N, Baruchel A, Dalle JH, Clappier E, Gilson E, Deriano L, Chevret S, Sigaux F, Socié G, Stoppa-Lyonnet D, de Thé H, Antoniewski C, Bluteau D, Peffault de Latour R, Soulier J. Clonal hematopoiesis driven by chromosome 1q/MDM4 trisomy defines a canonical route toward leukemia in Fanconi anemia. Cell Stem Cell 2023; 30:153-170.e9. [PMID: 36736290 DOI: 10.1016/j.stem.2023.01.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [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: 04/22/2022] [Revised: 12/02/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023]
Abstract
Fanconi anemia (FA) patients experience chromosome instability, yielding hematopoietic stem/progenitor cell (HSPC) exhaustion and predisposition to poor-prognosis myeloid leukemia. Based on a longitudinal cohort of 335 patients, we performed clinical, genomic, and functional studies in 62 patients with clonal evolution. We found a unique pattern of somatic structural variants and mutations that shares features of BRCA-related cancers, the FA-hallmark being unbalanced, microhomology-mediated translocations driving copy-number alterations. Half the patients developed chromosome 1q gain, driving clonal hematopoiesis through MDM4 trisomy downmodulating p53 signaling later followed by secondary acute myeloid lukemia genomic alterations. Functionally, MDM4 triplication conferred greater fitness to murine and human primary FA HSPCs, rescued inflammation-mediated bone marrow failure, and drove clonal dominance in FA mouse models, while targeting MDM4 impaired leukemia cells in vitro and in vivo. Our results identify a linear route toward secondary leukemogenesis whereby early MDM4-driven downregulation of basal p53 activation plays a pivotal role, opening monitoring and therapeutic prospects.
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Affiliation(s)
- Marie Sebert
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Stéphanie Gachet
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Thierry Leblanc
- Robert Debré Hospital, Department of Pediatric Hematology, Paris, France; EA 3518, IRSL, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Alix Rousseau
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France
| | - Olivier Bluteau
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Rathana Kim
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Raouf Ben Abdelali
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Flore Sicre de Fontbrune
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; EA 3518, IRSL, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Loïc Maillard
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Carèle Fedronie
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Valentine Murigneux
- Genome Integrity, Immunity and Cancer Unit, INSERM U1223, Equipe Labellisée Ligue Contre Le Cancer, Institut Pasteur, Paris, France
| | - Léa Bellenger
- Sorbonne Université, CNRS FR3631, INSERM US037, Institut de Biologie Paris Seine (IBPS), ARTbio Bioinformatics Analysis Facility, Institut Français de Bioinformatique (IFB), Paris, France
| | - Naira Naouar
- Sorbonne Université, CNRS FR3631, INSERM US037, Institut de Biologie Paris Seine (IBPS), ARTbio Bioinformatics Analysis Facility, Institut Français de Bioinformatique (IFB), Paris, France
| | - Samuel Quentin
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Lucie Hernandez
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Nadia Vasquez
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Mélanie Da Costa
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Pedro H Prata
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Lise Larcher
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Marie de Tersant
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Matthieu Duchmann
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Anna Raimbault
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Franck Trimoreau
- Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Hematology Laboratory, CHU Limoges, Limoges, France
| | | | - Wendy Cuccuini
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Nathalie Gachard
- Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Hematology Laboratory, CHU Limoges, Limoges, France
| | - Nathalie Auger
- Département de Biologie et Pathologie Médicales, Institut de Cancérologie Gustave Roussy, Villejuif, France
| | - Giulia Tueur
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Maud Blanluet
- Department of Genetics, Institut Curie, Université de Paris, INSERM U830, Paris, France
| | - Claude Gazin
- INSERM U944/CNRS UMR7212, Paris, France; Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Evry, France
| | - Michèle Souyri
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM UMR S1131, Hôpital Saint Louis, Paris, France
| | | | - Aaron Mendez-Bermudez
- Université Côte d'Azur, CNRS, Inserm, Institute for Research on Cancer and Aging, Nice (IRCAN), France; Department of Medical Genetics, CHU, Nice, France
| | | | - Etienne Lengline
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Emmanuel Raffoux
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Pierre Fenaux
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Lionel Adès
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; INSERM U944/CNRS UMR7212, Paris, France
| | - Edouard Forcade
- CHU Bordeaux, Service d'Hématologie et Thérapie Cellulaire et Unité d'Hématologie Oncologie Pédiatrique, 33000 Bordeaux, France
| | - Charlotte Jubert
- CHU Bordeaux, Service d'Hématologie et Thérapie Cellulaire et Unité d'Hématologie Oncologie Pédiatrique, 33000 Bordeaux, France
| | - Carine Domenech
- Institut of Hematology and Pediatric Oncology (IHOP), Hospices Civils de Lyon, France; Centre de Recherche en Cancérologie de Lyon, INSERM U1052, CNRS 5286, Centre Léon Bérard, Université Lyon 1, Lyon, France
| | - Marion Strullu
- Robert Debré Hospital, Department of Pediatric Hematology, Paris, France; EA 3518, IRSL, Paris, France
| | | | - Nimrod Buchbinder
- Centre Pédiatrique de Transplantation de Cellules Souches Hématopoïétiques, CHU de Rouen, Rouen, France
| | - Caroline Thomas
- Service d'Oncologie-Hématologie et Immunologie Pédiatrique, CHU de Nantes, Nantes, France
| | - Arnaud Petit
- Pediatric Hematology-Oncology, Trousseau Hospital and HUEP, Paris, France
| | - Guy Leverger
- Pediatric Hematology-Oncology, Trousseau Hospital and HUEP, Paris, France
| | - Gérard Michel
- Timone Enfants Hospital, Department of Pediatric Hematology and Oncology, Aix-Marseille University, EA 3279, Marseille, France
| | - Marina Cavazzana
- Biotherapy Department, Necker Children's Hospital, APHP Centre, Biotherapy Clinical Investigation Center, Inserm U1416, University of Paris, Imagine Institute, Paris, France
| | - Eliane Gluckman
- Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; Eurocord, Department of Hematology, Saint-Louis Hospital, Paris, France
| | - Yves Bertrand
- Institut of Hematology and Pediatric Oncology (IHOP), Hospices Civils de Lyon, France; Centre de Recherche en Cancérologie de Lyon, INSERM U1052, CNRS 5286, Centre Léon Bérard, Université Lyon 1, Lyon, France
| | - Nicolas Boissel
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; EA 3518, IRSL, Paris, France
| | - André Baruchel
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Robert Debré Hospital, Department of Pediatric Hematology, Paris, France; EA 3518, IRSL, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Jean-Hugues Dalle
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Robert Debré Hospital, Department of Pediatric Hematology, Paris, France; EA 3518, IRSL, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Emmanuelle Clappier
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Eric Gilson
- Université Côte d'Azur, CNRS, Inserm, Institute for Research on Cancer and Aging, Nice (IRCAN), France; Department of Medical Genetics, CHU, Nice, France
| | - Ludovic Deriano
- Genome Integrity, Immunity and Cancer Unit, INSERM U1223, Equipe Labellisée Ligue Contre Le Cancer, Institut Pasteur, Paris, France
| | - Sylvie Chevret
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Division of Biostatistics, Saint-Louis Hospital, APHP, Paris, France
| | - François Sigaux
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France
| | - Gérard Socié
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; INSERM UMR-976, Saint-Louis Hospital, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | | | - Hugues de Thé
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Collège de France, Paris, France
| | - Christophe Antoniewski
- Sorbonne Université, CNRS FR3631, INSERM US037, Institut de Biologie Paris Seine (IBPS), ARTbio Bioinformatics Analysis Facility, Institut Français de Bioinformatique (IFB), Paris, France
| | - Dominique Bluteau
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; EPHE, PSL University, Paris, France.
| | - Régis Peffault de Latour
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; Clinical Hematology Departments, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; EA 3518, IRSL, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France
| | - Jean Soulier
- Institut de Recherche Saint-Louis (IRSL), Université Paris Cité, 75010 Paris, France; INSERM U944/CNRS UMR7212, Paris, France; Saint-Louis Hospital, Hematology Laboratory, APHP, Paris, France; Centre de Référence Maladies Rares "Aplasie Médullaire", Saint-Louis and Robert Debré Hospitals, Paris, France.
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23
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Beauvais D, Castilla-Llorente C, Diral E, Sirvent A, Vandewiele A, Baruchel A, Yakoub-Agha I, Yakouben K. [Role of allogeneic hematopoietic cell transplantation after anti-CD19 CAR T-cell treatment: Guidelines from the SFGM-TC]. Bull Cancer 2023; 110:S108-S115. [PMID: 35791974 DOI: 10.1016/j.bulcan.2022.04.017] [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: 01/16/2022] [Revised: 04/14/2022] [Accepted: 04/20/2022] [Indexed: 10/17/2022]
Abstract
The role of allogeneic hematopoietic cell transplantation (allo-HCT) after CAR T- treatment cells in hematologic malignancies is currently controversial. Prolonged remissions after several years of follow-up suggest that there is a curative effect of CAR T-cells therapy, whereas allo-HCT was previously considered the only curative treatment in relapse situation. The aim of this harmonization workshop is to detail the existing data in the literature on the feasibility of allo-HCT after CAR T-cells and to propose to consider allograft in selected patients with B-acute lymphoblastic leukemia (B-ALL) and diffuse large B-cell lymphoma (DLBCL). In B-ALL, various intrinsic factors (inherent to the patient, to the disease, to the type of CAR T-cells) and especially various post CAR T-cells criteria (early expansion kinetics, residual disease at D28, early loss of B-cell aplasia) should lead to consider performing allo-HCT before the occurrence of a relapse. In DLBCL, although there are risk factors for relapse at diagnosis and prior to CAR T-cells therapy, response assessed by PET-CT at three months is critical and allo-HCT cannot currently be recommended in cases of complete or partial remission. In any case, if the age is appropriate for allogeneic transplantation, HLA typing should be performed before CAR T-cells treatment in order not to delay the allo-HCT project if needed.
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Affiliation(s)
- David Beauvais
- Université de Lille, CHU de Lille, service des maladies du sang, Inserm, Infinite, U1286, Lille, France.
| | | | - Elisa Diral
- Service d'onco-hématologie et greffe de moëlle, IRCCS San Raffaele, Milano, Italie
| | - Anne Sirvent
- Hôpital Arnaud-de-Villeneuve, service d'onco-hématologie pédiatrique, Montpellier, France
| | - Audrey Vandewiele
- Institut de cancérologie Lucien-Neuwirth, département d'hématologie clinique, Saint-Priest-en-Jarez, France
| | - André Baruchel
- Hôpital universitaire Robert-Debré (AP-HP) and université de Paris, department of pediatric hematology, Paris, France
| | - Ibrahim Yakoub-Agha
- Université de Lille, CHU de Lille, service des maladies du sang, Inserm, Infinite, U1286, Lille, France
| | - Karima Yakouben
- Hôpital universitaire Robert-Debré (AP-HP) and université de Paris, department of pediatric hematology, Paris, France
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24
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Smith C, Touzart A, Simonin M, Tran-Quang C, Hypolite G, Latiri M, Andrieu GP, Balducci E, Dourthe MÉ, Goyal A, Huguet F, Petit A, Ifrah N, Baruchel A, Dombret H, Macintyre E, Plass C, Ghysdael J, Boissel N, Asnafi V. Harnessing the MYB-dependent TAL1 5'super-enhancer for targeted therapy in T-ALL. Mol Cancer 2023; 22:12. [PMID: 36650499 PMCID: PMC9847025 DOI: 10.1186/s12943-022-01701-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/16/2022] [Indexed: 01/19/2023] Open
Abstract
The acquisition of genetic abnormalities engendering oncogene dysregulation underpins cancer development. Certain proto-oncogenes possess several dysregulation mechanisms, yet how each mechanism impacts clinical outcome is unclear. Using T-cell acute lymphoblastic leukemia (T-ALL) as an example, we show that patients harboring 5'super-enhancer (5'SE) mutations of the TAL1 oncogene identifies a specific patient subgroup with poor prognosis irrespective of the level of oncogene dysregulation. Remarkably, the MYB dependent oncogenic 5'SE can be targeted using Mebendazole to induce MYB protein degradation and T-ALL cell death. Of note Mebendazole treatment demonstrated efficacy in vivo in T-ALL preclinical models. Our work provides proof of concept that within a specific oncogene driven cancer, the mechanism of oncogene dysregulation rather than the oncogene itself can identify clinically distinct patient subgroups and pave the way for future super-enhancer targeting therapy.
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Affiliation(s)
- Charlotte Smith
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Aurore Touzart
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Mathieu Simonin
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Christine Tran-Quang
- grid.418596.70000 0004 0639 6384Institut Curie, Orsay, France ,grid.493838.dCNRS UMR3348, Institut Curie, Orsay, France ,grid.5842.b0000 0001 2171 2558INSERM U1278, Centre Universitaire, Orsay, France ,grid.440907.e0000 0004 1784 3645PSL Research University, Paris, France ,grid.460789.40000 0004 4910 6535University Paris-Saclay, 91400 Orsay, France
| | - Guillaume Hypolite
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Mehdi Latiri
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Guillaume P. Andrieu
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Estelle Balducci
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Marie-Émilie Dourthe
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France ,grid.413235.20000 0004 1937 0589Department of Pediatric Hematology and Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, Université de Paris Cité, Paris, France
| | - Ashish Goyal
- grid.7497.d0000 0004 0492 0584Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Françoise Huguet
- grid.411175.70000 0001 1457 2980Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Laboratoire d’Hématologie, Toulouse, France
| | - Arnaud Petit
- grid.462844.80000 0001 2308 1657Service d’Hématologie Et d’Oncologie Pédiatrique, AP-HP, Hôpital Armand Trousseau, Sorbonne Université, Paris, France
| | - Norbert Ifrah
- grid.7252.20000 0001 2248 3363UFR Santé, Université Angers, PRES LUNAM, Centre Hospitalier-Universitaire (CHU) d’Angers, Service Des Maladies du Sang Et INSERM U892, 49933 Angers, France
| | - André Baruchel
- grid.413235.20000 0004 1937 0589Department of Pediatric Hematology and Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, Université de Paris Cité, Paris, France
| | - Hervé Dombret
- Université de Paris Cité, Institut Universitaire d’Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, Paris, France
| | - Elizabeth Macintyre
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
| | - Christoph Plass
- grid.7497.d0000 0004 0492 0584Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany ,German Cancer Research Consortium (DKTK), 69120 Heidelberg, Germany
| | - Jacques Ghysdael
- grid.418596.70000 0004 0639 6384Institut Curie, Orsay, France ,grid.493838.dCNRS UMR3348, Institut Curie, Orsay, France ,grid.5842.b0000 0001 2171 2558INSERM U1278, Centre Universitaire, Orsay, France ,grid.440907.e0000 0004 1784 3645PSL Research University, Paris, France ,grid.460789.40000 0004 4910 6535University Paris-Saclay, 91400 Orsay, France
| | - Nicolas Boissel
- Université de Paris Cité, Institut Universitaire d’Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, Paris, France
| | - Vahid Asnafi
- grid.7429.80000000121866389Université de Paris Cité, Institut Necker Enfants-Malades INEM, Institut National de La Santé Et de La Recherche Médicale (Inserm), U1151 Paris, France ,grid.50550.350000 0001 2175 4109Laboratory of Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades 75743, Paris, France
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25
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Berrou J, Dupont M, Djamai H, Adicéam E, Parietti V, Kaci A, Clappier E, Cayuela JM, Baruchel A, Paublant F, Prudent R, Ghysdael J, Gardin C, Dombret H, Braun T. Preclinical Evaluation of a Novel Small Molecule Inhibitor of LIM Kinases (LIMK) CEL_Amide in Philadelphia-Chromosome Positive ( BCR::ABL+) Acute Lymphoblastic Leukemia (ALL). J Clin Med 2022; 11:jcm11226761. [PMID: 36431240 PMCID: PMC9692768 DOI: 10.3390/jcm11226761] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/17/2022] Open
Abstract
Ph+ (BCR::ABL+) B-ALL was considered to be high risk, but recent advances in BCR::ABL-targeting TKIs has shown improved outcomes in combination with backbone chemotherapy. Nevertheless, new treatment strategies are needed, including approaches without chemotherapy for elderly patients. LIMK1/2 acts downstream from various signaling pathways, which modifies cytoskeleton dynamics via phosphorylation of cofilin. Upstream of LIMK1/2, ROCK is constitutively activated by BCR::ABL, and upon activation, ROCK leads to the phosphorylation of LIMK1/2, resulting in the inactivation of cofilin by its phosphorylation and subsequently abrogating its apoptosis-promoting activity. Here, we demonstrate the anti-leukemic effects of a novel LIMK1/2 inhibitor (LIMKi) CEL_Amide in vitro and in vivo for BCR::ABL-driven B-ALL. The IC50 value of CEL_Amide was ≤1000 nM in BCR::ABL+ TOM-1 and BV-173 cells and induced dose-dependent apoptosis and cell cycle arrest in these cell lines. LIMK1/2 were expressed in BCR::ABL+ cell lines and patient cells and LIMKi treatment decreased LIMK1 protein expression, whereas LIMK2 expression was unaffected. As expected, CEL_Amide exposure caused specific activating downstream dephosphorylation of cofilin in cell lines and primary cells. Combination experiments with CEL_Amide and BCR::ABL TKIs imatinib, dasatinib, nilotinib, and ponatinib were synergistic for the treatment of both TOM-1 and BV-173 cells. CDKN2Ako/BCR::ABL1+ B-ALL cells were transplanted in mice, which were treated with combinations of CEL_Amide and nilotinib or ponatinib, which significantly prolonged their survival. Altogether, the LIMKi CEL_Amide yields activity in Ph+ ALL models when combined with BCR::ABL-targeting TKIs, showing promising synergy that warrants further investigation.
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Affiliation(s)
- Jeannig Berrou
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Mélanie Dupont
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Hanane Djamai
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Emilie Adicéam
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Véronique Parietti
- INSERM/CNRS, US53/UAR2030, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Anna Kaci
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
| | - Emmanuelle Clappier
- Laboratory of Hematology, Hôpital Saint-Louis (Assistance Publique–Hôpitaux de Paris and Université Paris Cité), 75010 Paris, France
| | - Jean-Michel Cayuela
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
- Laboratory of Hematology, Hôpital Saint-Louis (Assistance Publique–Hôpitaux de Paris and Université Paris Cité), 75010 Paris, France
| | - André Baruchel
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
- Department of Pediatric Hemato-Immunology, Hôpital Universitaire Robert Debré (Assistance Publique–Hôpitaux de Paris and Université Paris Cité), 75010 Paris, France
| | | | | | - Jacques Ghysdael
- CNRS UMR3348, INSERM U1278, Institut Curie, Centre Universitaire Bat 110, 91405 Orsay, France
| | - Claude Gardin
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
- Hematology Department, Hôpital Avicenne (Assistance Publique–Hôpitaux de Paris and Université Paris XIII), 93000 Bobigny, France
| | - Hervé Dombret
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
- Leukemia Unit, Hematology Department, Hôpital Saint-Louis (Assistance Publique–Hôpitaux de Paris and Université Paris Cité), 75010 Paris, France
| | - Thorsten Braun
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint-Louis, Université Paris Cité, 75010 Paris, France
- Hematology Department, Hôpital Avicenne (Assistance Publique–Hôpitaux de Paris and Université Paris XIII), 93000 Bobigny, France
- Correspondence: ; Tel.: +33-(0)-1-4895-7051
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26
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Elitzur S, Vora A, Burkhardt B, Inaba H, Attarbaschi A, Baruchel A, Escherich G, Gibson B, Liu H, Loh M, Moorman A, Moricke A, Pieters R, Uyttebroeck A, Baird S, Bartram J, Ben-Harosh M, Bertrand Y, Buitenkamp T, Caldwell K, Drut R, Geerlinks A, Grainger J, Haouy S, Heaney N, Huang M, Ingham D, Krenova Z, Kuhlen M, Lehrnbecher T, Manabe A, Niggli F, Paris C, Revel-Vilk S, Rohrlich P, Sandeep B, Sinno M, Szczepanski T, Tamesberger M, Warrier R, Wolfl M, Nirel R, Izraeli S, Borkhardt A, Schmiegelow K. EBV-DRIVEN LYMPHOID NEOPLASMS ASSOCIATED WITH ALL MAINTENANCE THERAPY: AN INTERNATIONAL OBSERVATINAL STUDY. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00201-6] [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: 11/06/2022]
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27
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Ghorashian S, Jacoby E, De Moerloose B, Rives S, Bonney D, Shenton G, Bader P, Bodmer N, Quintana AM, Herrero B, Algeri M, Locatelli F, Vettenranta K, Gonzalez B, Attarbaschi A, Harris S, Bourquin JP, Baruchel A. Tisagenlecleucel therapy for relapsed or refractory B-cell acute lymphoblastic leukaemia in infants and children younger than 3 years of age at screening: an international, multicentre, retrospective cohort study. Lancet Haematol 2022; 9:e766-e775. [PMID: 36084658 DOI: 10.1016/s2352-3026(22)00225-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 04/23/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Children aged younger than 3 years were excluded from the ELIANA phase 2 trial of tisagenlecleucel in children with acute lymphoblastic leukaemia. The feasibility, safety, and activity of tisagenlecleucel have not been defined in this group, the majority of whom have high-risk (KMT2A-rearranged) infant acute lymphoblastic leukaemia and historically poor outcomes despite intensification of chemotherapy, and for whom novel therapies are urgently needed. We aimed to provide real-world outcome analysis of the feasibility, activity, and safety of tisagenlecleucel in younger children and infants with acute lymphoblastic leukaemia. METHODS We did an international, multicentre, retrospective cohort study at 15 hospitals across ten countries in Europe. Eligible patients were children aged younger than 3 years at screening between Sept 1, 2018, and Sept 1, 2021, who were screened for tisagenlecleucel therapy for relapsed or refractory B-cell precursor acute lymphoblastic leukaemia according to licensed indications. Patients received a single intravenous infusion of tisagenlecleucel. We tracked chimeric antigen receptor T-cell therapy outcomes using a standardised data reporting form. Overall survival, event-free survival, stringent event-free survival, B-cell aplasia, and toxicity were assessed in all patients who received a tisagenlecleucel infusion. FINDINGS 38 eligible patients were screened, of whom 35 (92%) received a tisagenlecleucel infusion. 29 (76%) of 38 patients had KMT2A-rearranged acute lymphoblastic leukaemia, and 25 (66%) had relapsed after previous allogeneic haematopoietic stem-cell transplantation (HSCT). Patients had previously received a median of 2 lines (IQR 2-3) of (non-HSCT) therapy. Seven (18%) of 38 patients had received inotuzumab and 14 (37%) had received blinatumomab. After a median of 14 months (IQR 9-21) of follow-up, overall survival at 12 months after tisagenlecleucel infusion was 84% (64-93; five patients had died), event-free survival was 69% (47-83; nine events), and stringent event-free survival was 41% (23-58; 18 events). The probability of ongoing B-cell aplasia was 70% (95% CI 46-84; seven events) at 12 months. Adverse events included cytokine release syndrome, which occurred at any grade in 21 (60%) of 35 patients and at grade 3 or worse in five (14%), and neurotoxicity at any grade in nine (26%), none of which were severe. Measurable residual disease-negative complete response with or without haematological recovery occurred in 24 (86%) of 28 patients who had measurable disease. INTERPRETATION These data suggest that tisagenlecleucel has antitumour activity and has an acceptable safety profile for young children and infants with B-cell precursor acute lymphoblastic leukaemia. FUNDING None.
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Affiliation(s)
- Sara Ghorashian
- Department of Developmental Biology and Cancer, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Haematology, Great Ormond Street Hospital for Children, London, UK
| | - Elad Jacoby
- The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology and Stem Cell Transplantation, Ghent University Hospital, Ghent, Belgium
| | - Susana Rives
- Department of Haematology and Department of Oncology, Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Denise Bonney
- Department of Haematology and Department of Bone Marrow Transplantation, Royal Manchester Children's Hospital, Manchester, UK
| | - Geoff Shenton
- Department of Haematology and Department of Bone Marrow Transplantation, Great North Children's Hospital, Newcastle Upon Tyne, UK
| | - Peter Bader
- Division of Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Nicole Bodmer
- Department of Oncology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Agueda Molinos Quintana
- Department of Hematology, Pediatric Hematology Section, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CISC), Seville, Spain
| | - Blanca Herrero
- Department of Haematology-Oncology and Stem Cell Transplantation, Pediatric University Hospital Niño Jesús, Madrid, Spain
| | - Mattia Algeri
- Department of Pediatric Haematology/Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza University of Rome, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Haematology/Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza University of Rome, Rome, Italy
| | - Kim Vettenranta
- Department of Pediatrics, New Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Berta Gonzalez
- Department of Haematology-Oncology and Stem Cell transplantation, Pediatric University Hospital La Paz, Madrid, Spain
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Stephen Harris
- UCL Institute of Health Informatics, University College London, London, UK
| | - Jean Pierre Bourquin
- Department of Oncology, University Children's Hospital Zürich, Zürich, Switzerland
| | - André Baruchel
- Department of Pediatric Hemato-Immunology, Hôpital Universitaire Robert Debré (APHP and Université Paris Cité), Paris, France.
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28
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Bontoux C, Simonin M, Garnier N, Lhermitte L, Touzart A, Andrieu G, Bruneau J, Lengliné E, Plesa A, Boissel N, Baruchel A, Bertrand Y, Molina TJ, Macintyre E, Asnafi V. Oncogenetic landscape of T-cell lymphoblastic lymphomas compared to T-cell acute lymphoblastic leukemia. Mod Pathol 2022; 35:1227-1235. [PMID: 35562412 DOI: 10.1038/s41379-022-01085-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/09/2022]
Abstract
In the latest 2016 World Health Organization classification of hematological malignancies, T-cell lymphoblastic lymphoma (T-LBL) and lymphoblastic leukemia (T-ALL) are grouped together into one entity called T-cell lymphoblastic leukemia/lymphoma (T-LBLL). However, the question of whether these entities represent one or two diseases remains. Multiple studies on driver alterations in T-ALL have led to a better understanding of the disease while, so far, little data on genetic profiles in T-LBL is available. We sought to define recurrent genetic alterations in T-LBL and provide a comprehensive comparison with T-ALL. Targeted whole-exome next-generation sequencing of 105 genes, multiplex ligation-dependent probe amplification, and quantitative PCR allowed comprehensive genotype assessment in 818, consecutive, unselected, newly diagnosed patients (342 T-LBL vs. 476 T-ALL). The median age at diagnosis was similar in T-LBL and T-ALL (17 vs. 15 years old, respectively; p = 0.2). Although we found commonly altered signaling pathways and co-occurring mutations, we identified recurrent dissimilarities in actionable gene alterations in T-LBL as compared to T-ALL. HOX abnormalities (TLX1 and TLX3 overexpression) were more frequent in T-ALL (5% of T-LBL vs 13% of T-ALL had TLX1 overexpression; p = 0.04 and 6% of T-LBL vs 17% of T-ALL had TLX3 overexpression; p = 0.006). The PI3K signaling pathway was significantly more frequently altered in T-LBL as compared to T-ALL (33% vs 19%; p < 0.001), especially through PIK3CA alterations (9% vs 2%; p < 0.001) with PIK3CAH1047 as the most common hotspot. Similarly, T-LBL genotypes were significantly enriched in alterations in genes coding for the EZH2 epigenetic regulator and in TP53 mutations (respectively, 13% vs 8%; p = 0.016 and 7% vs 2%; p < 0.001). This genetic landscape of T-LBLL identifies differential involvement of recurrent alterations in T-LBL as compared to T-ALL, thus contributing to better understanding and management of this rare disease.
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Affiliation(s)
- Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, 06000, Nice, France.,Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France
| | - Mathieu Simonin
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.,Department of Pediatric Hematology and Oncology, Armand Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Nathalie Garnier
- Institute of Pediatric Hematology and Oncology, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France
| | - Ludovic Lhermitte
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France
| | - Aurore Touzart
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France
| | - Guillaume Andrieu
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France
| | - Julie Bruneau
- Department of Pathology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Etienne Lengliné
- Hematology Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Adriana Plesa
- Laboratory of Hematology and Flow Cytometry, CHU Lyon-Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Boissel
- Adolescent and Young Adult Hematology Unit, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Louis Hospital, Paris, France
| | - André Baruchel
- Pediatric Hematology and Immunology Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Yves Bertrand
- Institute of Pediatric Haematology and Oncology, Hospices Civils de Lyon, Lyon, France
| | - Thierry Jo Molina
- Department of Pathology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Paris, France
| | - Elizabeth Macintyre
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France
| | - Vahid Asnafi
- Laboratory of Onco-Hematology, Hôpital Necker Enfants-Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris, Institut Necker-Enfants Malades (INEM), Institut National de recherche Médicale (INSERM) U1151, Paris, France.
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van der Sluis IM, Bertrand Y, Baruchel A, Pieters R. Is asparaginase encapsulated in erythrocytes effective as second-line treatment in acute lymphoblastic leukaemia? Br J Haematol 2022; 198:e82-e83. [PMID: 35857756 PMCID: PMC9544388 DOI: 10.1111/bjh.18372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Yves Bertrand
- Insitute d'Hématology et d'Oncologie Pediatric (IHOPE), Pediatric Hematology and Immunology, Lyon, France
| | - André Baruchel
- Hôpital Universitaire Robert Debré (APHP), Hemato-Immunology/Pediatric Hemato-immunology, Paris, France
| | - Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Delafoy M, Goutines J, Fourmont AM, Birgy A, Chomton M, Levy M, Naudin J, Zafrani L, Le Mouel L, Yakouben K, Cointe A, Caseris M, Lafaurie M, Bonacorsi S, Mechinaud F, Pereyre S, Boissel N, Baruchel A. Case Report: Hyperammonemic Encephalopathy Linked to Ureaplasma spp. and/or Mycoplasma hominis Systemic Infection in Patients Treated for Leukemia, an Emergency Not to Be Missed. Front Oncol 2022; 12:912695. [PMID: 35875088 PMCID: PMC9304698 DOI: 10.3389/fonc.2022.912695] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background Hyperammonemic encephalopathy caused by Ureaplasma spp. and Mycoplasma hominis infection has been reported in immunocompromised patients undergoing lung transplant, but data are scarce in patients with hematological malignancies. Case Presentation We describe the cases of 3 female patients aged 11–16 years old, developing initially mild neurologic symptoms, rapidly evolving to coma and associated with very high ammonia levels, while undergoing intensive treatment for acute leukemia (chemotherapy: 2 and hematopoietic stem cell transplant: 1). Brain imaging displayed cerebral edema and/or microbleeding. Electroencephalograms showed diffuse slowing patterns. One patient had moderate renal failure. Extensive liver and metabolic functions were all normal. Ureaplasma spp. and M. hominis were detected by PCR and specific culture in two patients, resulting in prompt initiation of combined antibiotics therapy by fluoroquinolones and macrolides. For these 2 patients, the improvement of the neurological status and ammonia levels were observed within 96 h, without any long-term sequelae. M. hominis was detected post-mortem in vagina, using 16S rRNA PCR for the third patient who died of cerebral edema. Conclusion Hyperammonemic encephalopathy linked to Ureaplasma spp. and M. hominis is a rare complication encountered in immunocompromised patients treated for acute leukemia, which can lead to death if unrecognized. Combining our experience with the few published cases (n=4), we observed a strong trend among female patients and very high levels of ammonia, consistently uncontrolled by classical measures (ammonia-scavenging agents and/or continuous kidney replacement therapy). The reversibility of the encephalopathy without sequelae is possible with prompt diagnosis and adequate combined specific antibiotherapy. Any neurological symptoms in an immunocompromised host should lead to the measurement of ammonia levels. If increased, and in the absence of an obvious cause, it should prompt to perform a search for Ureaplasma spp. and M. hominis by PCR as well as an immediate empirical initiation of combined specific antibiotherapy.
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Affiliation(s)
- Manon Delafoy
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- *Correspondence: Manon Delafoy,
| | - Juliette Goutines
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Aude-Marie Fourmont
- Department of Hematology, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - André Birgy
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Maryline Chomton
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Michaël Levy
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Jérôme Naudin
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Lara Zafrani
- Medical Intensive Care Unit, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Unité Mixte de Recherche 976, Institut National de la Santé Et de la Recherche Médicale, Paris, France
| | - Lou Le Mouel
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Karima Yakouben
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Aurélie Cointe
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Marion Caseris
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Matthieu Lafaurie
- Department of Infectious Diseases, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Stéphane Bonacorsi
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Françoise Mechinaud
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Sabine Pereyre
- Department of Bacteriology, National Reference Center for Bacterial Sexually Transmitted Infections, Bordeaux University Hospital, Bordeaux, France
- Unité Mixte de Recherche 5234, Fundamental Microbiology and Pathogenicity, Université de Bordeaux, Centre National de la Recherche Scientifique, Bordeaux, France
| | - Nicolas Boissel
- Department of Hematology, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Research Unit EA-3518, Université Paris Cité, Paris, France
| | - André Baruchel
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Research Unit EA-3518, Université Paris Cité, Paris, France
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Calvo C, Lainey E, Caye A, Cuccuini W, Fenneteau O, Yakouben K, Bellanné-Chantelot C, Baruchel A, Dalle JH, Leblanc T. Leukaemic transformation in a 10-year-old girl with SRP54 congenital neutropenia. Br J Haematol 2022; 198:1069-1072. [PMID: 35732340 DOI: 10.1111/bjh.18334] [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: 05/11/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Charlotte Calvo
- Pediatric Hematology and Immunology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Elodie Lainey
- Hematology Laboratory, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Aurélie Caye
- Genetic Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Wendy Cuccuini
- Hematology Laboratory, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Odile Fenneteau
- Hematopathology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Karima Yakouben
- Pediatric Hematology and Immunology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Christine Bellanné-Chantelot
- Department of Medical Genetics, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - André Baruchel
- Pediatric Hematology and Immunology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Jean-Hugues Dalle
- Pediatric Hematology and Immunology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
| | - Thierry Leblanc
- Pediatric Hematology and Immunology Department, Robert-Debré University Hospital (APHP and Université de Paris), Paris, France
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Brivio E, Baruchel A, Beishuizen A, Bourquin JP, Brown PA, Cooper T, Gore L, Kolb EA, Locatelli F, Maude SL, Mussai FJ, Vormoor-Bürger B, Vormoor J, von Stackelberg A, Zwaan CM. Targeted inhibitors and antibody immunotherapies: Novel therapies for paediatric leukaemia and lymphoma. Eur J Cancer 2022; 164:1-17. [PMID: 35121370 DOI: 10.1016/j.ejca.2021.12.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [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: 09/28/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 12/19/2022]
Abstract
Despite improved outcomes achieved in the last decades for children with newly diagnosed leukaemia and lymphoma, treatment of patients with refractory/relapsed disease remains a challenge. The cure rate is still unsatisfactory and often achieved at the cost of significant morbidity. Exploring treatment with novel agents should offer less toxic therapeutic options, without compromising efficacy. Bispecific and antibody-drug conjugates targeting CD19 and CD22 (blinatumomab and inotuzumab ozogamicin) play an important role in the treatment of relapsed and refractory B-cell precursor acute lymphoblastic leukaemia (BCP-ALL); antibodies targeting CD123 and CD38 are also under investigation for acute myeloid leukaemia (AML) and T-ALL, respectively. Targeted therapy with small molecules is of primary importance for specific genetic subtypes, such as BCR-ABL-positive ALL, FLT3-ITD AML and anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma. KMT2A-directed targeted therapy with menin inhibitors holds promise to be of relevance in KMT2A-rearranged leukaemias, known to have dismal prognosis. Target inhibition in cellular pathways such as BCL-2, RAS, MEK, Bruton's tyrosine kinase, JAK-STAT or CDK4/CDK6 inhibition may be suitable for different diseases with common mutated pathways. Nevertheless, development and approval of new agents for paediatric cancers lags behind adult therapeutic options. New regulations were implemented to accelerate drug development for children. Considering the number of oncology medicinal products available for adults and the rarity of paediatric cancers, prioritisation based on scientific evidence and medical need, as well as international collaboration, is critical. Herein, we review the current status of drug development for children with leukaemia and lymphoma, excluding cellular therapy despite its well-known significance.
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Affiliation(s)
- Erica Brivio
- Princess Ma´xima Center for Pediatric Oncology, Utrecht, the Netherlands; Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - André Baruchel
- Hématologie-Immunologie Pédiatrique, Hoˆ pital Universitaire Robert Debré (APHP) and Université de Paris, Paris, France
| | - Auke Beishuizen
- Princess Ma´xima Center for Pediatric Oncology, Utrecht, the Netherlands; Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Jean-Pierre Bourquin
- Department of Oncology and Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Patrick A Brown
- Departments of Oncology and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Todd Cooper
- Aflac Cancer and Blood Disorders Center/Children's Healthcare of Atlanta/Emory University, Atlanta, GA, USA
| | - Lia Gore
- University of Colorado School of Medicine and Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, USA
| | - E Anders Kolb
- Nemours Center for Cancer and Blood Disorders, Nemours/Alfred I DuPont Hospital for Children, Wilmington, DE, USA
| | - Franco Locatelli
- Department of Pediatric Hematology/Oncology and Cell and Gene Therapy, IRCCS Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome, Italy
| | - Shannon L Maude
- Division of Oncology, Department of Pediatrics, Center for Childhood Cancer Research, Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Francis J Mussai
- Institute for Immunology and Immunotherapy, Cancer Research UK Birmingham Centre, The University of Birmingham, Birmingham, United Kingdom
| | | | - Josef Vormoor
- Princess Ma´xima Center for Pediatric Oncology, Utrecht, the Netherlands; University Medical Center, Utrecht, the Netherlands; Newcastle University, Newcastle, UK
| | | | - C Michel Zwaan
- Princess Ma´xima Center for Pediatric Oncology, Utrecht, the Netherlands; Pediatric Oncology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands; The Innovative Therapies for Children with Cancer Consortium, Paris, France.
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33
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Steimlé T, Dourthe ME, Alcantara M, Touzart A, Simonin M, Mondesir J, Lhermitte L, Bond J, Graux C, Grardel N, Cayuela JM, Arnoux I, Gandemer V, Balsat M, Vey N, Macintyre E, Ifrah N, Dombret H, Petit A, Baruchel A, Ruminy P, Boissel N, Asnafi V. Clinico-biological features of T-cell acute lymphoblastic leukemia with fusion proteins. Blood Cancer J 2022; 12:14. [PMID: 35082269 PMCID: PMC8791998 DOI: 10.1038/s41408-022-00613-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 09/02/2021] [Revised: 01/01/2022] [Accepted: 01/06/2022] [Indexed: 12/23/2022] Open
Abstract
T-cell acute lymphoblastic leukemias (T-ALL) represent 15% of pediatric and 25% of adult ALL. Since they have a particularly poor outcome in relapsed/refractory cases, identifying prognosis factors at diagnosis is crucial to adapting treatment for high-risk patients. Unlike acute myeloid leukemia and BCP ALL, chromosomal rearrangements leading to chimeric fusion-proteins with strong prognosis impact are sparsely reported in T-ALL. To address this issue an RT-MPLA assay was applied to a consecutive series of 522 adult and pediatric T-ALLs and identified a fusion transcript in 20% of cases. PICALM-MLLT10 (4%, n = 23), NUP214-ABL1 (3%, n = 19) and SET-NUP214 (3%, n = 18) were the most frequent. The clinico-biological characteristics linked to fusion transcripts in a subset of 235 patients (138 adults in the GRAALL2003/05 trials and 97 children from the FRALLE2000 trial) were analyzed to identify their prognosis impact. Patients with HOXA trans-deregulated T-ALLs with MLLT10, KMT2A and SET fusion transcripts (17%, 39/235) had a worse prognosis with a 5-year EFS of 35.7% vs 63.7% (HR = 1.63; p = 0.04) and a trend for a higher cumulative incidence of relapse (5-year CIR = 45.7% vs 25.2%, HR = 1.6; p = 0.11). Fusion transcripts status in T-ALL can be robustly identified by RT-MLPA, facilitating risk adapted treatment strategies for high-risk patients.
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Affiliation(s)
- Thomas Steimlé
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Marie-Emilie Dourthe
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
- Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Université de Paris, Paris, France
| | - Marion Alcantara
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
- Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Université de Paris, Paris, France
- Center for Cancer Immunotherapy, INSERM U932, Institut Curie, PSL Research University, Paris, France
| | - Aurore Touzart
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Mathieu Simonin
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
- Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Université de Paris, Paris, France
- Center for Cancer Immunotherapy, INSERM U932, Institut Curie, PSL Research University, Paris, France
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CDR Saint-Antoine, GRC n°07, GRC MyPAC, Paris, France
| | - Johanna Mondesir
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Ludovic Lhermitte
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Jonathan Bond
- Systems Biology Ireland, School of Medicine, University College Dublin, Dublin, Ireland
| | - Carlos Graux
- Department of Hematology, Université catholique de Louvain, CHU UCL Namur - site Godinne, Yvoir, Belgium
| | - Nathalie Grardel
- Laboratory of Hematology, CHRU Lille, Lille, France and U1172, INSERM, Lille, France
| | - Jean-Michel Cayuela
- Laboratory of Hematology and EA 3518 University Hospital Saint-Louis, AP-HP and Université de Paris, Paris, France
| | - Isabelle Arnoux
- Hematology Laboratory, Marseille University Hospital Timone, Marseille, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Marie Balsat
- Service d'hématologie clinique, Hôpital Lyon Sud, Marseille, France
| | - Norbert Vey
- Aix-Marseille Univ, Inserm, CNRS, Institut Paoli-Calmettes, CRCM, Marseille, France
| | - Elizabeth Macintyre
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France
| | - Norbert Ifrah
- PRES LUNAM, CHU Angers service des Maladies du Sang et CRCINA INSERM, Angers, France
| | - Hervé Dombret
- Institut de Recherche Saint-Louis, Université de Paris, EA-3518, Paris, France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), GH HUEP, Armand Trousseau Hospital, Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMRS 938, CDR Saint-Antoine, GRC n°07, GRC MyPAC, Paris, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, Robert Debré University Hospital (AP-HP), Université de Paris, Paris, France
- Institut de Recherche Saint-Louis, Université de Paris, EA-3518, Paris, France
| | - Philippe Ruminy
- Inserm U1245, Centre Henri Becquerel, Université de Rouen, IRIB, Rouen, France
| | - Nicolas Boissel
- Institut de Recherche Saint-Louis, Université de Paris, EA-3518, Paris, France
- Inserm U1245, Centre Henri Becquerel, Université de Rouen, IRIB, Rouen, France
- AP-HP, Hôpital Saint Louis, Unité d'Hématologie Adolescents et Jeunes Adultes, Paris, France
| | - Vahid Asnafi
- Université de Paris (Descartes), Institut Necker-Enfants Malades (INEM), Institut national de la santé et de la recherche médicale (Inserm) U1151, and Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France.
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Buechner J, Caruana I, Künkele A, Rives S, Vettenranta K, Bader P, Peters C, Baruchel A, Calkoen FG. Chimeric Antigen Receptor T-Cell Therapy in Paediatric B-Cell Precursor Acute Lymphoblastic Leukaemia: Curative Treatment Option or Bridge to Transplant? Front Pediatr 2022; 9:784024. [PMID: 35145941 PMCID: PMC8823293 DOI: 10.3389/fped.2021.784024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/02/2021] [Indexed: 01/02/2023] Open
Abstract
Chimeric antigen receptor T-cell therapy (CAR-T) targeting CD19 has been associated with remarkable responses in paediatric patients and adolescents and young adults (AYA) with relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukaemia (BCP-ALL). Tisagenlecleucel, the first approved CD19 CAR-T, has become a viable treatment option for paediatric patients and AYAs with BCP-ALL relapsing repeatedly or after haematopoietic stem cell transplantation (HSCT). Based on the chimeric antigen receptor molecular design and the presence of a 4-1BB costimulatory domain, tisagenlecleucel can persist for a long time and thereby provide sustained leukaemia control. "Real-world" experience with tisagenlecleucel confirms the safety and efficacy profile observed in the pivotal registration trial. Recent guidelines for the recognition, management and prevention of the two most common adverse events related to CAR-T - cytokine release syndrome and immune-cell-associated neurotoxicity syndrome - have helped to further decrease treatment toxicity. Consequently, the questions of how and for whom CD19 CAR-T could substitute HSCT in BCP-ALL are inevitable. Currently, 40-50% of R/R BCP-ALL patients relapse post CD19 CAR-T with either CD19- or CD19+ disease, and consolidative HSCT has been proposed to avoid disease recurrence. Contrarily, CD19 CAR-T is currently being investigated in the upfront treatment of high-risk BCP-ALL with an aim to avoid allogeneic HSCT and associated treatment-related morbidity, mortality and late effects. To improve survival and decrease long-term side effects in children with BCP-ALL, it is important to define parameters predicting the success or failure of CAR-T, allowing the careful selection of candidates in need of HSCT consolidation. In this review, we describe the current clinical evidence on CAR-T in BCP-ALL and discuss factors associated with response to or failure of this therapy: product specifications, patient- and disease-related factors and the impact of additional therapies given before (e.g., blinatumomab and inotuzumab ozogamicin) or after infusion (e.g., CAR-T re-infusion and/or checkpoint inhibition). We discuss where to position CAR-T in the treatment of BCP-ALL and present considerations for the design of supportive trials for the different phases of disease. Finally, we elaborate on clinical settings in which CAR-T might indeed replace HSCT.
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Affiliation(s)
- Jochen Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - Ignazio Caruana
- Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, University Hospital Würzburg, Würzburg, Germany
| | - Annette Künkele
- Department of Pediatric Oncology and Hematology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Susana Rives
- Department of Pediatric Hematology and Oncology, Hospital Sant Joan de Déu de Barcelona, Institut per la Recerca Sant Joan de Déu, Barcelona, Spain
| | - Kim Vettenranta
- University of Helsinki and Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Peter Bader
- Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Department for Children and Adolescents, University Hospital, Goethe University, Frankfurt, Germany
| | - Christina Peters
- St. Anna Children's Hospital, Medical University Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - André Baruchel
- Université de Paris et Institut de Recherche Saint-Louis (EA 35-18) and Hôpital Universitaire Robert Debré (APHP), Paris, France
| | - Friso G. Calkoen
- Department of Stem Cell Transplantation and Cellular Therapy, Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
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Le Louet S, Icart V, Strullu M, Petit A, Freycon C, Blouin P, Serre J, Rama N, Reguerre Y, Piguet C, Pasquet M, David A, Simon P, Poiree M, Carausu L, Rialland F, Abouchahla W, Saultier P, Ducassou S, Valduga J, Baruchel A, Bertrand Y, Domenech C. Novel Insights into Pediatric Acute Lymphoblastic Leukemia Ophthalmic Relapses from a Nationwide Cohort Study. J Cancer 2022; 13:1272-1281. [PMID: 35281861 PMCID: PMC8899370 DOI: 10.7150/jca.64996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/30/2021] [Indexed: 11/23/2022] Open
Abstract
Ten to fifteen percent of children with acute lymphoblastic leukemia (ALL) relapse following treatment. Of these, less than 2% display ophthalmic relapses, which owing to their scarcity, are largely undocumented, leaving clinicians with few diagnostic and therapeutic recommendations, despite serious functional sequelae. We conducted a French multicenter retrospective study to collect all clinical, radiological, biological, and therapeutic data, and outcomes for children with ALL ophthalmic relapses. From 2000 to 2020, 20 ophthalmic relapses occurring after first-line therapy performed before January 1st, 2017 were included in our study: 14 B-ALL and 6 T-ALL. Fifteen patients (75%) had concomitant involvement of the central nervous system, and 11 (55%) a combined bone marrow relapse. Only 1 had an isolated ophthalmic relapse. Eight children (40%) died, 7 from a refractory disease and 1 from toxic death, and 4 patients relapsed. With a median follow-up of 63.1 months, 8 patients are currently alive in continuous complete remission with only 2 displaying severe ophthalmic sequelae. Although rare, ophthalmic relapse could have a significant impact on the functional prognosis of survivors. Their management must be multidisciplinary, with a central role given to ophthalmologists.
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Taj MM, Moorman AV, Hamadeh L, Petit A, Asnafi V, Alby-Laurent F, Vora A, Mansour MR, Gale R, Chevret S, Moppett J, Baruchel A, Macintyre E. Prognostic value of Oncogenetic mutations in pediatric T Acute Lymphoblastic Leukemia: a comparison of UKALL2003 and FRALLE2000T protocols. Leukemia 2022; 36:263-266. [PMID: 34183766 DOI: 10.1038/s41375-021-01334-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/10/2021] [Accepted: 06/16/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Mary M Taj
- Royal Marsden Hospital, NHS Foundation Trust, London, UK
| | - Anthony V Moorman
- Leukaemia Research Cytogenetics Group, Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lina Hamadeh
- Leukaemia Research Cytogenetics Group, Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, AP-HP Hôpital Armand Trousseau, Sorbonne Université, UMRS_938, CDR Saint-Antoine, Paris, France
| | - Vahid Asnafi
- Laboratory of Onco-Hematology, AP-HP Hôpital Necker-Enfants Malades, Université de Paris and Institut Necker-Enfants Malades, Paris, France
| | - Fanny Alby-Laurent
- Department of Pediatric Hematology and Oncology, AP-HP Hôpital Armand Trousseau, Sorbonne Université, UMRS_938, CDR Saint-Antoine, Paris, France
| | - Ajay Vora
- Great Ormond Street Hospital, London, UK
| | | | - Rosemary Gale
- University College London Cancer Institute, London, UK
| | | | - John Moppett
- University Hospitals Bristol and Weston, Bristol, UK
| | - André Baruchel
- Department of Pediatric Hematology, AP-HP, Hôpital Universitaire Robert Debré, EA 3518, Université de Paris, Paris, France
| | - Elizabeth Macintyre
- Laboratory of Onco-Hematology, AP-HP Hôpital Necker-Enfants Malades, Université de Paris and Institut Necker-Enfants Malades, Paris, France.
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Djamai H, Berrou J, Dupont M, Coudé MM, Delord M, Clappier E, Marceau-Renaut A, Kaci A, Raffoux E, Itzykson R, Berthier C, Wu HC, Hleihel R, Bazarbachi A, de Thé H, Baruchel A, Gardin C, Dombret H, Braun T. Biological Effects of BET Inhibition by OTX015 (MK-8628) and JQ1 in NPM1-Mutated (NPM1c) Acute Myeloid Leukemia (AML). Biomedicines 2021; 9:biomedicines9111704. [PMID: 34829934 PMCID: PMC8615962 DOI: 10.3390/biomedicines9111704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
BET inhibitors (BETi) including OTX015 (MK-8628) and JQ1 demonstrated antileukemic activity including NPM1c AML cells. Nevertheless, the biological consequences of BETi in NPM1c AML were not fully investigated. Even if of better prognosis AML patients with NPM1c may relapse and treatment remains difficult. Differentiation-based therapy by all trans retinoic acid (ATRA) combined with arsenic trioxide (ATO) demonstrated activity in NPM1c AML. We found that BETi, similar to ATO + ATRA, induced differentiation and apoptosis which was TP53 independent in the NPM1c cell line OCI-AML3 and primary cells. Furthermore, BETi induced proteasome-dependent degradation of NPM1c. BETi degraded NPM1c in the cytosol while BRD4 is degraded in the nucleus which suggests that restoration of the NPM1/BRD4 equilibrium in the nucleus of NPM1c cells is essential for the efficacy of BETi. While ATO + ATRA had significant biological activity in NPM1c IMS-M2 cell line, those cells were resistant to BETi. Gene profiling revealed that IMS-M2 cells probably resist to BETi by upregulation of LSC pathways independently of the downregulation of a core BET-responsive transcriptional program. ATO + ATRA downregulated a NPM1c specific HOX gene signature while anti-leukemic effects of BETi appear HOX gene independent. Our preclinical results encourage clinical testing of BETi in NPM1c AML patients.
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Affiliation(s)
- Hanane Djamai
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
| | - Jeannig Berrou
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
| | - Mélanie Dupont
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
| | - Marie-Magdelaine Coudé
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Laboratory of Hematology, Hôpital Saint-Louis, AP-HP, Université de Paris, 75010 Paris, France;
| | - Marc Delord
- Bioinformatics, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France;
| | - Emmanuelle Clappier
- Laboratory of Hematology, Hôpital Saint-Louis, AP-HP, Université de Paris, 75010 Paris, France;
| | | | - Anna Kaci
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
| | - Emmanuel Raffoux
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Leukemia Unit, Hematology Department, Hôpital Saint-Louis, AP-HP, Université de Paris, 75010 Paris, France;
| | - Raphaël Itzykson
- Leukemia Unit, Hematology Department, Hôpital Saint-Louis, AP-HP, Université de Paris, 75010 Paris, France;
- INSERM U944—CNRS UMR7212, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (C.B.); (H.-C.W.); (H.d.T.)
| | - Caroline Berthier
- INSERM U944—CNRS UMR7212, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (C.B.); (H.-C.W.); (H.d.T.)
| | - Hsin-Chieh Wu
- INSERM U944—CNRS UMR7212, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (C.B.); (H.-C.W.); (H.d.T.)
| | - Rita Hleihel
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut P.O. Box 113-6044, Lebanon; (R.H.); (A.B.)
| | - Ali Bazarbachi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut P.O. Box 113-6044, Lebanon; (R.H.); (A.B.)
| | - Hugues de Thé
- INSERM U944—CNRS UMR7212, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (C.B.); (H.-C.W.); (H.d.T.)
| | - André Baruchel
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Department of Pediatric Hemato-Immunology, Hôpital Robert Debré, AP-HP, Université de Paris, 75010 Paris, France
| | - Claude Gardin
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Hematology Department, Hôpital Avicenne, AP-HP, Université de Paris, 93000 Bobigny, France
| | - Hervé Dombret
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Leukemia Unit, Hematology Department, Hôpital Saint-Louis, AP-HP, Université de Paris, 75010 Paris, France;
| | - Thorsten Braun
- Laboratoire de Transfert des Leucémies, URP-3518, Institut de Recherche Saint Louis, Université de Paris, 75010 Paris, France; (H.D.); (J.B.); (M.D.); (M.-M.C.); (A.K.); (E.R.); (A.B.); (C.G.); (H.D.)
- Hematology Department, Hôpital Avicenne, AP-HP, Université de Paris, 93000 Bobigny, France
- Correspondence: ; Tel.: +33-148957072
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Broussais F, Bay JO, Boissel N, Baruchel A, Arnulf B, Morschhauser F, Robin M, Guepin GR, Moreau P, Gandemer V, Manier S, Leguay T, Nguyen Quoc S, Schwartzmann A, Houot R, Le Gouill S. [DESCAR-T, a nationwide registry for patient treated by CAR-T Cells in France]. Bull Cancer 2021; 108:S143-S154. [PMID: 34920797 DOI: 10.1016/j.bulcan.2021.07.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022]
Abstract
CAR-T Cells have opened new doors for cellular immunotherapies and provides new therapeutic options for patients with refractory B-cell malignancies, B-cell acute lymphoblastic leukemia and diffuse large B-cel lymphoma. CAR-T Cells have benefited from an accelerated approval procedure in many countries. Indeed, The French health authorities have approved the specialties Tisacel ® and Axicel ®, but additional data including the use of CAR-T Cells in real life were also mandatory. In regard to the scientific interest of the project, LYSA-LYSARC committed itself to prospectively and retrospectively collect information on patients eligible for CAR-T Cells as required by French health authorities. Other academic cooperating groups (GRAALL, IFM, SFCE, FILO and the scientific society SFGM-TC) were associated to this initiative which aims to build a nationwide CAR-T Cells devoted registry, so-called DESCART (Dispositif d'Enregistrement et Suivi des patients traités par CAR-T cells). DESCAR-T is a real-life multicentric registry set up in French sites qualified for CAR-T Cells treatment. DESCAR-T objective is to describe the use of CAR-T Cells in real life. All paediatric and adult patients with hematological malignancy fulfilling CAR-T Cells approval criteria and for whom a CAR-T Cells therapy has been discussed are included from 1 July 2018. Clinical data are directly collected from medical records and patients are treated according to the centers' routine practices. One of the distinctive features of DESCAR-T is its link with HTA for CAR-T Cells s reimbursement by the French public health system. DESCAR-T is the first national registry promoted by an academic group allowing centralized data collection for both academic and HTA/health authorities' purposes.
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Affiliation(s)
- Florence Broussais
- LYSARC : Centre Hospitalier Lyon-Sud Batiment 2D, 69495 Pierre-Bénite Cedex, France.
| | - Jacques Olivier Bay
- CHU ESTAING Service d'hématologie clinique et de thérapie cellulaire adulte, 1, place Lucie Aubrac, 63003 Clermont-Ferrand Cedex, France.
| | - Nicolas Boissel
- Hôpital Saint-Louis, AP-HP, service d'hématologie adolescents et jeunes adultes, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - André Baruchel
- Hôpital Robert-Debré, service d'hémato-immunologie, 48, boulevard Sérurier, 79395 Paris cedex 19, France.
| | - Bertrand Arnulf
- Hôpital Saint-Louis, Service d'immunohématologie, UMR Inserm 1126, Paris, France.
| | - Franck Morschhauser
- CHU de Lille, Hôpital Huriez, service des maladies du sang, 1, rue Michel-Polonowski, 59037 Lille Cedex, France.
| | - Marie Robin
- Hôpital Saint-Louis, Inserm 1131, université Paris 7, Service d'hématologie-allogreffe, Paris, France.
| | - Gabrielle Roth Guepin
- Hôpitaux de Brabois, Service d'Hématologie du CHRU de Nancy, 8, rue Du Morvan, 54500 Vandoeuvre Les Nancy, France.
| | - Philippe Moreau
- Service d'hématologie clinique, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - Virginie Gandemer
- Service d'hémato-oncologie pédiatrique, Centre hospitalier universitaire de Rennes, 2 rue Henri Le Guilloux, 35033 Rennes cedex 9, France.
| | - Salomon Manier
- CHU de Lille, Hôpital Huriez, service des maladies du sang, 1, rue Michel-Polonowski, 59037 Lille Cedex, France.
| | - Thibaut Leguay
- Hopital Haut-Leveque -CHU, Service d'hématologie et de thérapie cellulaire, avenue de Magellan, 33600 Pessac, France.
| | - Stéphanie Nguyen Quoc
- Assistance publique-Hôpitaux de Paris, service d'hématologie clinique, groupe hospitalier Pitié-Salpêtrière, Paris, France.
| | - Alexia Schwartzmann
- LYSARC : Centre Hospitalier Lyon-Sud Batiment 2D, 69495 Pierre-Bénite Cedex, France.
| | - Roch Houot
- Service d'Hématologie, centre hospitalier universitaire de Rennes, 2 rue Henri Le Guilloux, 35033 Rennes cedex 9, France.
| | - Steven Le Gouill
- Service d'hématologie clinique, CHU Hôtel Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France.
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Dourthe ME, Baruchel A. CAR T-cells in acute lymphoblastic leukemia: Current results. Bull Cancer 2021; 108:S40-S54. [DOI: 10.1016/j.bulcan.2021.08.001] [Citation(s) in RCA: 1] [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: 06/28/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 12/27/2022]
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Bastard P, Galerne A, Lefevre-Utile A, Briand C, Baruchel A, Durand P, Landman-Parker J, Gouache E, Boddaert N, Moshous D, Gaudelus J, Cohen R, Deschenes G, Fischer A, Blanche S, de Pontual L, Neven B. Different Clinical Presentations and Outcomes of Disseminated Varicella in Children With Primary and Acquired Immunodeficiencies. Front Immunol 2021; 11:595478. [PMID: 33250898 PMCID: PMC7674974 DOI: 10.3389/fimmu.2020.595478] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/09/2020] [Indexed: 11/13/2022] Open
Abstract
Primary infection with varicella-zoster virus (VZV) causes chickenpox, a benign and self-limited disease in healthy children. In patients with primary or acquired immunodeficiencies, primary infection can be life-threatening, due to rapid dissemination of the virus to various organs [lung, gastrointestinal tract, liver, eye, central nervous system (CNS)]. We retrospectively described and compared the clinical presentations and outcomes of disseminated varicella infection (DV) in patients with acquired (AID) (n= 7) and primary (PID) (n= 12) immunodeficiencies. Patients with AID were on immunosuppression (mostly steroids) for nephrotic syndrome, solid organ transplantation or the treatment of hemopathies, whereas those with PID had combined immunodeficiency (CID) or severe CID (SCID). The course of the disease was severe and fulminant in patients with AID, with multiple organ failure, no rash or a delayed rash, whereas patients with CID and SICD presented typical signs of chickenpox, including a rash, with dissemination to other organs, including the lungs and CNS. In the PID group, antiviral treatment was prolonged until immune reconstitution after bone marrow transplantation, which was performed in 10/12 patients. Four patients died, and three experienced neurological sequelae. SCID patients had the worst outcome. Our findings highlight substantial differences in the clinical presentation and course of DV between children with AID and PID, suggesting differences in pathophysiology. Prevention, early diagnosis and treatment are required to improve outcome.
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Affiliation(s)
- Paul Bastard
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France
| | - Aurélien Galerne
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France
| | - Alain Lefevre-Utile
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,INSERM U976-Human Systems Immunology and Inflammatory Networks, Institut de Recherche de Saint Louis, Paris, France.,Université de Paris, Paris, France
| | - Coralie Briand
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France
| | - André Baruchel
- Université de Paris, Paris, France.,Département d'Hématologie Pédiatrique, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Philippe Durand
- Service de Réanimation Pédiatrique, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre, France.,Université Paris XI, AP-HP, Paris.,Université Paris Saclay, Saint-Aubin, France
| | - Judith Landman-Parker
- Sorbonne Université, Service de d'Hématologie Oncologie Pédiatrique, Hôpital Armand Trousseau, AP-HP, Paris, France
| | - Elodie Gouache
- Sorbonne Université, Service de d'Hématologie Oncologie Pédiatrique, Hôpital Armand Trousseau, AP-HP, Paris, France
| | - Nathalie Boddaert
- Université de Paris, Paris, France.,Service de Radiologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
| | - Despina Moshous
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
| | - Joel Gaudelus
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Sorbonne Paris Nord University, Bobigny, France
| | - Robert Cohen
- ACTIV Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Georges Deschenes
- Service de Néphrologie Pédiatrique, Hôpital Robert-Debré, AP-HP, Paris, France
| | - Alain Fischer
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France.,Experimental Medicine, Collège de France, Paris, France
| | - Stéphane Blanche
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France
| | - Loïc de Pontual
- Service de Pédiatrie, Hôpital Jean Verdier, Bondy, AP-HP (Assistance-Publique-Hôpitaux de Paris), France.,Sorbonne Paris Nord University, Bobigny, France
| | - Bénédicte Neven
- Service d'Immunologie et Hématologie Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Paris, France.,Université de Paris, Paris, France.,INSERM U1163, Institut IMAGINE, Paris, France
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Niswander LM, Loftus JP, Lainey É, Caye-Eude A, Pondrom M, Hottman DA, Iacobucci I, Mullighan CG, Jain N, Konopleva M, Cavé H, Baruchel A, Rohrlich PS, Tasian SK. Therapeutic potential of ruxolitinib and ponatinib in patients with EPOR-rearranged Philadelphia chromosome-like acute lymphoblastic leukemia. Haematologica 2021; 106:2763-2767. [PMID: 34196168 PMCID: PMC8485673 DOI: 10.3324/haematol.2021.278697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/03/2021] [Indexed: 11/09/2022] Open
Abstract
Not available.
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Affiliation(s)
- Lisa M Niswander
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia; Philadelphia, Pennsylvania USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine; Philadelphia, Pennsylvania USA
| | - Joseph P Loftus
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia; Philadelphia, Pennsylvania USA
| | - Élodie Lainey
- Service d'Hématologie Biologique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP); Paris, France; INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Aurélie Caye-Eude
- INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université de Paris, Paris, France; Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP); Paris, France
| | - Morgane Pondrom
- Pediatric Hematology Unit, L'Archet Hospital, CHU Nice; Nice, France
| | - David A Hottman
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia; Philadelphia, Pennsylvania USA
| | - Ilaria Iacobucci
- Department of Pathology, St Jude Children's Research Hospital; Memphis, Tennessee, USA
| | - Charles G Mullighan
- Department of Pathology, St Jude Children's Research Hospital; Memphis, Tennessee, USA
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center; Houston, Texas, USA
| | - Hélène Cavé
- INSERM, UMR_S1131, Institut de Recherche Saint-Louis, Université de Paris, Paris, France; Département de Génétique, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP); Paris, France
| | - André Baruchel
- Department of Pediatric Hematology/Immunology, Hôpital Robert Debré, Assistance Publique des Hôpitaux de Paris (AP-HP); Paris, France
| | - Pierre S Rohrlich
- Pediatric Hematology Unit, L'Archet Hospital, CHU Nice; Nice, France; Université de Cote d'Azur, INSERM, C3M; Nice, France
| | - Sarah K Tasian
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia; Philadelphia, Pennsylvania USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine; Philadelphia, Pennsylvania USA; Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine; Philadelphia, Pennsylvania USA.
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Janssen JM, Dorlo TPC, Niewerth D, Wilhelm AJ, Zwaan CM, Beijnen JH, Attarbaschi A, Baruchel A, Fagioli F, Klingebiel T, De Moerloose B, Palumbo G, von Stackelberg A, Kaspers GJL, Huitema ADR. A Semi-Mechanistic Population Pharmacokinetic/Pharmacodynamic Model of Bortezomib in Pediatric Patients with Relapsed/Refractory Acute Lymphoblastic Leukemia. Clin Pharmacokinet 2021; 59:207-216. [PMID: 31313068 DOI: 10.1007/s40262-019-00803-y] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The pharmacokinetics (PK) of the 20S proteasome inhibitor bortezomib are characterized by a large volume of distribution and a rapid decline in plasma concentrations within the first hour after administration. An increase in exposure was observed in the second week of treatment, which has previously been explained by extensive binding of bortezomib to proteasome in erythrocytes and peripheral tissues. We characterized the nonlinear population PK and pharmacodynamics (PD) of bortezomib in children with acute lymphoblastic leukemia. METHODS Overall, 323 samples from 28 patients were available from a pediatric clinical study investigating bortezomib at an intravenous dose of 1.3 mg/m2 twice weekly (Dutch Trial Registry number 1881/ITCC021). A semi-physiological PK model for bortezomib was first developed; the PK were linked to the decrease in 20S proteasome activity in the final PK/PD model. RESULTS The plasma PK data were adequately described using a two-compartment model with linear elimination. Increased concentrations were observed in week 2 compared with week 1, which was described using a Langmuir binding model. The decrease in 20S proteasome activity was best described by a direct effect model with a sigmoidal maximal inhibitory effect, representing the relationship between plasma concentrations and effect. The maximal inhibitory effect was 0.696 pmol AMC/s/mg protein (95% confidence interval 0.664-0.728) after administration. CONCLUSION The semi-physiological model adequately described the nonlinear PK and PD of bortezomib in plasma. This model can be used to further optimize dosing of bortezomib.
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Affiliation(s)
- Julie M Janssen
- Department of Pharmacy and Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - T P C Dorlo
- Department of Pharmacy and Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - D Niewerth
- Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands
| | - A J Wilhelm
- Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam, The Netherlands
| | - C M Zwaan
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology/Hematology, Erasmus-MC Sophia Children's Hospital, Rotterdam, The Netherlands
- ITCC Consortium, Paris, France
| | - J H Beijnen
- Department of Pharmacy and Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands
| | - A Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Vienna, Austria
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria
| | - A Baruchel
- Department of Pediatric Hematology, Hopital Saint Louis, Paris, France
- ITCC Consortium, Paris, France
| | - F Fagioli
- Università degli Studi di Torino, Turin, Italy
| | - T Klingebiel
- Department of Pediatrics, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - B De Moerloose
- Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - G Palumbo
- Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - A von Stackelberg
- Department of Pediatric Oncology/Hematology, Charité Universitätsmedizin, Berlin, Germany
| | - G J L Kaspers
- Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - A D R Huitema
- Department of Pharmacy and Pharmacology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Dourthe ME, Rabian F, Yakouben K, Chevillon F, Cabannes-Hamy A, Méchinaud F, Grain A, Chaillou D, Rahal I, Caillat-Zucman S, Lesprit E, Naudin J, Roupret-Serzec J, Parquet N, Brignier A, Guérin-El Khourouj V, Lainey E, Caye-Eude A, Cavé H, Clappier E, Mathis S, Azoulay E, Dalle JH, Dhédin N, Madelaine I, Larghero J, Boissel N, Baruchel A. Determinants of CD19-positive vs CD19-negative relapse after tisagenlecleucel for B-cell acute lymphoblastic leukemia. Leukemia 2021; 35:3383-3393. [PMID: 34002027 DOI: 10.1038/s41375-021-01281-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/20/2021] [Accepted: 04/30/2021] [Indexed: 01/01/2023]
Abstract
Tisagenlecleucel therapy has shown promising efficacy for relapsed/refractory (R/R) B-cell precursor acute lymphoblastic leukemia (BCP-ALL). However, relapses occur in 30-50% of patients. Determinants for CD19pos versus CD19neg relapses are poorly characterized. We report on 51 patients with R/R BCP-ALL (median age 17 years) infused with tisagenlecleucel after lymphodepletion. Complete remission rate at D28 was 96%. Prior blinatumomab increased the risk of early failure at D28. The 18-month cumulative incidence of relapse (CIR), event-free survival (EFS), and overall survival (OS) were 51%, 44%, and 74%, respectively, at a median follow-up of 15.5 months. Factors associated with a high tumor burden (occurrence of cytokine release syndrome) and prior blinatumomab were associated with an increased CIR, and a shorter EFS and OS. Pre-lymphodepletion high disease burden (MRD ≥ 10-2, SHR 10.4, p = 0.03) and detectable MRD at D28 (SHR 7.2, p = 0.006) correlated with an increased risk of CD19neg relapse. Low disease burden (SHR 5.3, p = 0.03) and loss of B-cell aplasia (BCA) (SHR 21.7, p = 0.004) predicted an increased risk of CD19pos relapses. These data highlight the impact of prior therapy on patient outcome. Finally, detectable MRD at D28 and loss of BCA both define patients at high risk of relapse for whom additional interventions are needed.
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Affiliation(s)
- Marie-Emilie Dourthe
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France.,Laboratory of Onco-Hematology, AP-HP, Hôpital Necker Enfants-Malades, Université de Paris, Institut Necker-Enfants Malades (INEM), INSERM U1151, Paris, France
| | - Florence Rabian
- Unité d'Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France
| | - Karima Yakouben
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Florian Chevillon
- Unité d'Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France
| | | | - Françoise Méchinaud
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Audrey Grain
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Delphine Chaillou
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Ilhem Rahal
- Hematology Unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France
| | - Sophie Caillat-Zucman
- Laboratory of Immunology, AP-HP, Hôpital Saint Louis, INSERM UMR1149, Université de Paris, Paris, France
| | - Emmanuelle Lesprit
- Etablissement Français du Sang, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Jérôme Naudin
- Pediatric Intensive Care Unit, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Julie Roupret-Serzec
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Nathalie Parquet
- Therapeutic Apheresis Unit, AP-HP, Hôpital Saint Louis, Paris, France
| | - Anne Brignier
- Therapeutic Apheresis Unit, AP-HP, Hôpital Saint Louis, Paris, France
| | | | - Elodie Lainey
- Laboratory of Hematology, AP-HP, Hôpital Universitaire Robert Debré, Université de Paris, Paris, France
| | - Aurélie Caye-Eude
- Department of Genetics, AP-HP, Hôpital Universitaire Robert Debré, Université de Paris, Paris, France
| | - Hélène Cavé
- Department of Genetics, AP-HP, Hôpital Universitaire Robert Debré, Université de Paris, Paris, France.,UMRS 1131, Institut de Recherche Saint-Louis, INSERM, Université de Paris, Paris, France
| | - Emmanuelle Clappier
- Hematology Laboratory, AP-HP, Hôpital Saint Louis, Paris, France.,INSERM U944/CNRS UMR7212, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - Stéphanie Mathis
- Hematology Laboratory, AP-HP, Hôpital Saint Louis, Paris, France
| | - Elie Azoulay
- Intensive Care Unit, AP-HP, Hôpital Saint Louis, Université de Paris, Paris, France
| | - Jean Hugues Dalle
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France
| | - Nathalie Dhédin
- Unité d'Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France
| | | | - Jérôme Larghero
- Unité de Thérapie Cellulaire et Centre MEARY de Thérapie Cellulaire et Génique, Université de Paris, AP-HP, Hôpital Saint-Louis, U976 et CICBT, INSERM, Paris, France
| | - Nicolas Boissel
- Unité d'Hématologie Adolescents et Jeunes Adultes, AP-HP, Hôpital Saint Louis, Paris, France.,EA3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, AP-HP, Hôpital Universitaire Robert Debré, Paris, France. .,EA3518, Institut de Recherche Saint-Louis, Université de Paris, Paris, France.
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Simonin M, Schmidt A, Bontoux C, Dourthe MÉ, Lengliné E, Andrieu GP, Lhermitte L, Graux C, Grardel N, Cayuela JM, Huguet F, Arnoux I, Ducassou S, Macintyre E, Gandemer V, Dombret H, Petit A, Ifrah N, Baruchel A, Boissel N, Asnafi V. Oncogenetic landscape and clinical impact of IDH1 and IDH2 mutations in T-ALL. J Hematol Oncol 2021; 14:74. [PMID: 33941203 PMCID: PMC8091755 DOI: 10.1186/s13045-021-01068-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/02/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
IDH1 and IDH2 mutations (IDH1/2Mut) are recognized as recurrent genetic alterations in acute myeloid leukemia (AML) and associated with both clinical impact and therapeutic opportunity due to the recent development of specific IDH1/2Mut inhibitors. In T-cell acute lymphoblastic leukemia (T-ALL), their incidence and prognostic implications remain poorly reported. Our targeted next-generation sequencing approach allowed comprehensive assessment of genotype across the entire IDH1 and IDH2 locus in 1085 consecutive unselected and newly diagnosed patients with T-ALL and identified 4% of, virtually exclusive (47 of 49 patients), IDH1/2Mut. Mutational patterns of IDH1/2Mut in T-ALL present some specific features compared to AML. Whereas IDH2R140Q mutation was frequent in T-ALL (25 of 51 mutations), the IDH2R172 AML hotspot was absent. IDH2 mutations were associated with older age, an immature phenotype, more frequent RAS gain-of-function mutations and epigenetic regulator loss-of-function alterations (DNMT3A and TET2). IDH2 mutations, contrary to IDH1 mutations, appeared to be an independent prognostic factor in multivariate analysis with the NOTCH1/FBXW7/RAS/PTEN classifier. IDH2Mut were significantly associated with a high cumulative incidence of relapse and very dismal outcome, suggesting that IDH2-mutated T-ALL cases should be identified at diagnosis in order to benefit from therapeutic intensification and/or specific IDH2 inhibitors.
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Affiliation(s)
- Mathieu Simonin
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), Armand Trousseau Hospital, Sorbonne Université, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France
| | - Aline Schmidt
- PRES LUNAM, CHU Angers service des Maladies du Sang, INSERM U 892, Angers, France
| | - Christophe Bontoux
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France
| | - Marie-Émilie Dourthe
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France.,Department of Pediatric Hematology and Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, University Paris Diderot, Paris, France
| | - Etienne Lengliné
- Université Paris Diderot, Institut Universitaire d'Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, Paris, France
| | - Guillaume P Andrieu
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France
| | - Ludovic Lhermitte
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France
| | - Carlos Graux
- Department of Hematology, Université Catholique de Louvain, CHU UCL Namur - site Godinne, Yvoir, Belgium
| | - Nathalie Grardel
- Laboratory of Hematology, CHRU - Inserm U1172, Lille, France.,Inserm U1172, Lille Cedex, France
| | | | - Françoise Huguet
- Department of Hematology, CHRU - Institut Universitaire de Cancer Toulouse - Oncopole, Toulouse, France
| | - Isabelle Arnoux
- Laboratory of Hematology, Marseille University Hospital Timone, Marseille, France
| | - Stéphane Ducassou
- Pediatric Hematology-Oncology Department, Centre Hospitalier Universitaire (CHU), Bordeaux, France
| | - Elizabeth Macintyre
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France.,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Hervé Dombret
- Université Paris Diderot, Institut Universitaire d'Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, Paris, France
| | - Arnaud Petit
- Department of Pediatric Hematology and Oncology, Assistance Publique-Hôpitaux de Paris (AP-HP), Armand Trousseau Hospital, Sorbonne Université, Paris, France
| | - Norbert Ifrah
- PRES LUNAM, CHU Angers service des Maladies du Sang, INSERM U 892, Angers, France
| | - André Baruchel
- Department of Pediatric Hematology and Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, University Paris Diderot, Paris, France
| | - Nicolas Boissel
- Université Paris Diderot, Institut Universitaire d'Hématologie, EA-3518, Assistance Publique-Hôpitaux de Paris, University Hospital Saint-Louis, Paris, France
| | - Vahid Asnafi
- Laboratory of Onco-Hematology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker Enfants-Malades, Université de Paris, 149 rue de Sèvres, 75015, Paris, France. .,Institut Necker-Enfants Malades (INEM), Institut National de la Santé et de la Recherche Médicale (Inserm) U1151, Paris, France.
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Rouger-Gaudichon J, Bertrand Y, Boissel N, Brethon B, Ducassou S, Gandemer V, Halfon-Domenech C, Leblanc T, Leverger G, Michel G, Petit A, Ray-Lunven AF, Rohrlich PS, Schneider P, Sirvent N, Strullu M, Baruchel A. COVID19 and acute lymphoblastic leukemias of children and adolescents: Updated recommendations (Version 2) of the Leukemia Committee of the French Society for the fight against Cancers and leukemias in children and adolescents (SFCE). Bull Cancer 2021; 108:490-500. [PMID: 33781551 PMCID: PMC7951944 DOI: 10.1016/j.bulcan.2021.02.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 01/31/2021] [Accepted: 02/21/2021] [Indexed: 12/12/2022]
Abstract
Since the emergence of the SARS-CoV-2 infection, many recommendations have been made. However, the very specific nature of acute lymphoblastic leukemias and their treatment in children and adolescents led the Leukemia Committee of the French Society for the fight against Cancers and leukemias in children and adolescents (SFCE) to propose more specific recommendations. Here is the second version of these recommendations updated according to the evolution of knowledge on COVID19.
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Affiliation(s)
- Jérémie Rouger-Gaudichon
- Unité d'hémato-oncologie pédiatrique, CHU Caen, avenue de la Côte de Nacre, 14033 Caen cedex 9, France
| | - Yves Bertrand
- Institut d'hémato-oncologie pédiatrique, CHU Lyon, 3, quai des Célestins, 69002 Lyon, France
| | - Nicolas Boissel
- Université de Paris, unité adolescents et jeunes adultes, hôpital Saint-Louis (APHP), 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - Benoit Brethon
- Université de Paris, service d'hémato-immunologie pédiatrique, hôpital universitaire Robert-Debré (APHP), boulevard Sérurier, 75019 Paris, France
| | - Stéphane Ducassou
- Groupe hospitalier Pellegrin, unité d'hémato-oncologie pédiatrique, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - Virginie Gandemer
- Service d'hémato-oncologie pédiatrique, CHU Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France
| | - Carine Halfon-Domenech
- Institut d'hémato-oncologie pédiatrique, CHU Lyon, 3, quai des Célestins, 69002 Lyon, France
| | - Thierry Leblanc
- Université de Paris, service d'hémato-immunologie pédiatrique, hôpital universitaire Robert-Debré (APHP), boulevard Sérurier, 75019 Paris, France
| | - Guy Leverger
- Hôpital Armand-Trousseau (APHP) et Sorbonne Université, service d'hémato-oncologie pédiatrique, 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12, France
| | - Gérard Michel
- CHU la Timone, service d'hématologie pédiatrique, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - Arnaud Petit
- Hôpital Armand-Trousseau (APHP) et Sorbonne Université, service d'hémato-oncologie pédiatrique, 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12, France
| | - Anne-France Ray-Lunven
- Université de Paris, service d'hémato-immunologie pédiatrique, hôpital universitaire Robert-Debré (APHP), boulevard Sérurier, 75019 Paris, France
| | - Pierre-Simon Rohrlich
- CHU l'Archet, service d'hémato-oncologie pédiatrique, 151, route de Saint-Antoine, 06200 Nice, France
| | - Pascale Schneider
- CHU Charles-Nicolle, service d'hématologie pédiatrique, 37, boulevard Gambetta, 76038 Rouen, France
| | - Nicolas Sirvent
- CHU Arnaud-de-Villeneuve, service d'hématologie et oncologie pédiatrique, 191, avenue du Doyen-Giraud, 34295 Montpellier cedex 5, France
| | - Marion Strullu
- Université de Paris, service d'hémato-immunologie pédiatrique, hôpital universitaire Robert-Debré (APHP), boulevard Sérurier, 75019 Paris, France
| | - André Baruchel
- Université de Paris, service d'hémato-immunologie pédiatrique, hôpital universitaire Robert-Debré (APHP), boulevard Sérurier, 75019 Paris, France.
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46
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Feltesse C, Yakouben K, Fahd M, Ouachee M, le Mouel L, Le Goff J, Carcelain G, Guérin V, Baruchel A, Chevret S, Dalle JH. Impact of Two Different Types of Rabbit Anti-Thymocyte Globulin on Immune Reconstitution and Overall Results after Allogeneic Hematopoietic Stem Cell Transplantation for Acute Lymphoblastic Leukemia in Children. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00427-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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47
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Roussel A, Germanaud D, Bouchoucha Y, Ouldali N, Vedrenne‐Cloquet M, Castelle M, Baruchel A. Cranial polyneuropathy as the first manifestation of a severe COVID-19 in a child. Pediatr Blood Cancer 2021; 68:e28707. [PMID: 32970376 PMCID: PMC7536950 DOI: 10.1002/pbc.28707] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Aphaia Roussel
- Pediatric Hematology‐Immunology DepartmentUniversity Hospital Robert‐Debre (APHP)ParisFrance
| | - David Germanaud
- Pediatric Neurology DepartmentUniversity Hospital Robert‐Debre (APHP)ParisFrance
| | - Yassine Bouchoucha
- Pediatric Hematology‐Immunology DepartmentUniversity Hospital Robert‐Debre (APHP)ParisFrance
| | - Naïm Ouldali
- General Pediatric Department and Infectious DiseasesUniversity Hospital Robert‐Debre (APHP)ParisFrance
| | - Meryl Vedrenne‐Cloquet
- Pediatric Intensive Care UnitUniversity Hospital Necker‐Enfants‐Malades (APHP)ParisFrance
| | - Martin Castelle
- Hematology‐Immunology DepartmentUniversity Hospital Necker Enfants Malades (APHP)ParisFrance
| | - André Baruchel
- Pediatric Hematology‐Immunology DepartmentUniversity Hospital Robert‐Debre (APHP)ParisFrance,University of ParisUFR Paris‐NordParisFrance
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48
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Brethon B, Lainey E, Caye-Eude A, Grain A, Fenneteau O, Yakouben K, Roupret-Serzec J, Le Mouel L, Cavé H, Baruchel A. Case Report: Targeting 2 Antigens as a Promising Strategy in Mixed Phenotype Acute Leukemia: Combination of Blinatumomab With Gemtuzumab Ozogamicin in an Infant With a KMT2A-Rearranged Leukemia. Front Oncol 2021; 11:637951. [PMID: 33718232 PMCID: PMC7953899 DOI: 10.3389/fonc.2021.637951] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/20/2021] [Indexed: 12/14/2022] Open
Abstract
Mixed phenotype acute leukemia (MPAL) accounts for 2-5% of leukemia in children. MPAL are at higher risk of induction failure. Lineage switch (B to M or vice versa) or persistence of only the lymphoid or myeloid clone is frequently observed in biphenotypic/bilineal cases, highlighting their lineage plasticity. The prognosis of MPAL remains bleak, with an event-free survival (EFS) of less than 50% in children. A lymphoid-type therapeutic approach appears to be more effective but failures to achieve complete remission (CR) remain significant. KMT2A fusions account for 75-80% of leukemia in infants under one year of age and remains a major pejorative prognostic factor in the Interfant-06 protocol with a 6 years EFS of only 36%. The search for other therapeutic approaches, in particular immunotherapies that are able to eradicate all MPAL clones, is a major issue. We describe here the feasibility and tolerance of the combination of two targeted immunotherapies, blinatumomab and Gemtuzumab Ozogamicin, in a 4-year-old infant with a primary refractory KTM2A-rearranged MPAL. Our main concern was to determine how to associate these two immunotherapies and we describe how we decided to do it with the parents’ agreement. The good MRD response on the two clones made it possible to continue the curative intent with a hematopoietic stem cell transplant at 9 months of age. Despite a relapse at M11 post-transplant because of the recurrence of a pro-B clone retaining the initial lymphoid phenotype, the child is now 36 months old, in persistent negative MRD CR2 for 12 months after a salvage chemotherapy and an autologous CAR T cells infusion, with no known sequelae to date. This case study can thus lead to the idea of a sequential combination of two immunotherapies targeting two distinct leukemic subclones (or even a single biphenotypic clone), as a potential one to be tested prospectively in children MPAL and even possibly all KMT2A-rearranged infant ALL.
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Affiliation(s)
- Benoît Brethon
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Elodie Lainey
- Department of Biological Hematology, University Robert Debre Hospital, APHP, Paris, France.,INSERM UMR_S1131, Institut de Recherche Saint-Louis, University of Paris, Paris, France
| | - Aurélie Caye-Eude
- INSERM UMR_S1131, Institut de Recherche Saint-Louis, University of Paris, Paris, France.,Department of Genetics, University Robert Debre Hospital, APHP, Paris, France
| | - Audrey Grain
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Odile Fenneteau
- Department of Biological Hematology, University Robert Debre Hospital, APHP, Paris, France
| | - Karima Yakouben
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Julie Roupret-Serzec
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France.,Transversal Unit for Therapeutic Patient Education, University Robert Debre Hospital, APHP, Paris, France
| | - Lou Le Mouel
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France
| | - Hélène Cavé
- INSERM UMR_S1131, Institut de Recherche Saint-Louis, University of Paris, Paris, France.,Department of Genetics, University Robert Debre Hospital, APHP, Paris, France
| | - André Baruchel
- Department of Pediatric Hematology, University Robert Debre Hospital, Assistance Publique Hôpitaux de Paris (APHP), Paris, France.,University Institute of Hematology, University Saint-Louis Hospital, APHP, Paris, France
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49
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Lopez R, Plat G, Bertrand Y, Ducassou S, Saultier P, Berbis J, Pochon C, Hamidou Z, Poiree M, Tabone MD, Kanold J, Dalle JH, Gandemer V, Paillard C, Sirvent N, Plantaz D, Thouvenin S, Pellier I, Ansoborlo S, Leverger G, Baruchel A, Auquier P, Michel G. Testosterone deficiency in men surviving childhood acute leukemia after treatment with hematopoietic stem cell transplantation or testicular radiation: an L.E.A. study. Bone Marrow Transplant 2021; 56:1422-1425. [PMID: 33454725 DOI: 10.1038/s41409-020-01180-y] [Citation(s) in RCA: 4] [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: 04/23/2020] [Revised: 10/21/2020] [Accepted: 11/27/2020] [Indexed: 11/09/2022]
Abstract
We included 255 patients from the L.E.A. French long-term follow-up cohort. All had received hematopoietic stem cell transplantation (HSCT) and/or testicular radiation for childhood acute leukemia and were older than 18 years at last L.E.A. evaluation. Total testosterone deficiency was defined as a <12 nmol/l level or by substitutive therapy, partial deficiency as normal testosterone with elevated luteinizing hormone (>10 UI/l). After myeloablative total body irradiation (n = 178), 55.6% had total deficiency, 15.7% partial deficiency, and 28.7% were normal. A 4-6 Gy testicular boost and a younger age at HSCT increased significantly the risk. After a Busulfan-containing myeloablative conditioning regimen (n = 53), 28.3% had total deficiency, 15.1% partial deficiency, 56.6% were normal (62.5% vs. 0% in patients without or with additional testicular radiation). A 24-Gy testicular radiation without HSCT induced total or partial deficiency in 71.4% and 28.6%, respectively (n = 21). Total testosterone deficiency increased the risk of metabolic syndrome: 25% vs. 12.1% in men with partial testosterone deficiency and 8.8% when Leydig cell function was normal (p = 0.031).
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Affiliation(s)
- Romain Lopez
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Geneviève Plat
- Department of Pediatric Hematology and Oncology, University Hospital of Toulouse, Toulouse, France
| | - Yves Bertrand
- Department of Pediatric Hematology and Oncology, University Hospital of Lyon, Lyon, France
| | - Stéphane Ducassou
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Paul Saultier
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France
| | - Julie Berbis
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Cécile Pochon
- Department of Pediatric Hematology and Oncology, Children's Hospital of Brabois, Vandoeuvre Les Nancy, France
| | - Zeinab Hamidou
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Marilyne Poiree
- Department of Pediatric Hematology and Oncology, University Hospital L'Archet, Nice, France
| | - Marie-Dominique Tabone
- Department of Pediatric Hematology and Oncology, Trousseau University Hospital, APHP, Paris, France
| | - Justyna Kanold
- Department of Pediatric Hematology and Oncology, CIC Inserm 501, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Hugues Dalle
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | - Virginie Gandemer
- Department of Pediatric Hematology and Oncology, University Hospital of Rennes, Rennes, France
| | - Catherine Paillard
- Department of Pediatric Hematology-Oncology, University Hospital, Strasbourg, France
| | - Nicolas Sirvent
- Department of Pediatric Hematology and Oncology, University Hospital, Montpellier, France
| | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital of Grenoble, Grenoble, France
| | - Sandrine Thouvenin
- Department of Pediatric Hematology-Oncology, University Hospital St Etienne, St Etienne, France
| | - Isabelle Pellier
- Department of Pediatric Hematology-Oncology, University Hospital of Angers, Angers, France
| | - Sophie Ansoborlo
- Department of Pediatric Hematology and Oncology, University Hospital of Bordeaux, Bordeaux, France
| | - Guy Leverger
- Department of Pediatric Hematology and Oncology, Trousseau University Hospital, APHP, Paris, France
| | - André Baruchel
- Pediatric Hematology Department, Robert Debré Hospital, Paris, France
| | - Pascal Auquier
- Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France
| | - Gérard Michel
- Department of Pediatric Hematology and Oncology, Timone Enfants Hospital and Aix-Marseille University, Marseille, France. .,Research Unit EA 3279 and Department of Public Health, Aix-Marseille University and Timone Hospital Marseille, Marseille, France.
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50
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Djamai H, Berrou J, Dupont M, Kaci A, Ehlert JE, Weber H, Baruchel A, Paublant F, Prudent R, Gardin C, Dombret H, Braun T. Synergy of FLT3 inhibitors and the small molecule inhibitor of LIM kinase1/2 CEL_Amide in FLT3-ITD mutated Acute Myeloblastic Leukemia (AML) cells. Leuk Res 2020; 100:106490. [PMID: 33373830 DOI: 10.1016/j.leukres.2020.106490] [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: 06/02/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/30/2022]
Abstract
Patients with FLT3-ITD mutated (FLT3-ITD+) Acute Myeloid Leukemia (AML), have frequently relapsed or refractory disease and FLT3-ITD+ inhibitors have limited efficacy. Rho kinases (ROCK) are constitutively activated by FLT3-ITD+ in AML via PI3 kinase and Rho GTPase. Upon activation by ROCK, LIM kinases (LIMK) inactivate cofilin by phosphorylation which affects cytoskeleton dynamics, cell growth and apoptosis. LIMK inhibition leads to cofilin activation via dephosphorylation and activated cofilin localizes to mitochondria inducing apoptosis. Thus, we investigated the therapeutic potential of the LIMK1/2 inhibitor CEL_Amide (LIMKi) in FLT3-ITD+ AML. Expression of LIMK1/2 in FLT3-ITD+ cell lines MOLM-13 and MV-4-11 cells could be detected by RT-qPCR and at the protein level. IC50 after LIMKi monotherapy was 440 nM in MOLM-13 cells and 420 nM in MV4-11 cells. Treatment with LIMKi decreased LIMK1 protein levels and repression of inactivating phosphorylation of cofilin in FLT3-ITD+ cells. Combination experiments with LIMKi and FLT3 inhibitors including midostaurin, crenolanib and gilteritinib were synergistic for treatment of MOLM-13 cells while combinations with quizartinib were additive. Combinations of LIMKi and the hypomethylating agent azacitidine or the ROCK inhibitor fasudil were additive. In NOD-SCID mice engrafted with MOLM13-LUC cells, the FLT3 inhibitor midostaurin and LIMKi delayed MOLM13-LUC engraftment as detected by in vivo bioluminescence imaging and the LIMKi and midostaurin combination prolonged significantly survival of leukemic mice. LIMK1/2 inhibition by the small molecule CEL_Amide seems to have promising activity in combination with FLT3 inhibitors in vitro as well as in vivo and may constitute a novel treatment strategy for FLT3-ITD+ AML.
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Affiliation(s)
- Hanane Djamai
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France
| | - Jeannig Berrou
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France
| | - Mélanie Dupont
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France
| | - Anna Kaci
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France
| | | | | | - André Baruchel
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France; Department of Pediatric Hemato-Immunology, Hôpital Robert Debré (Assistance Publique - Hôpitaux de Paris and University of Paris), Paris, France
| | | | | | - Claude Gardin
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France; Hematology Department, Hôpital Avicenne (Assistance Publique-Hôpitaux de Paris and University Paris XIII), Bobigny, France
| | - Hervé Dombret
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France; Leukemia Unit, Hematology Department, Hôpital Saint-Louis (Assistance Publique-Hôpitaux de Paris and University of Paris), Paris, France
| | - Thorsten Braun
- Laboratoire de Transfert des Leucémies, EA3518, Institut de Recherche Saint Louis, University of Paris, Paris, France; Hematology Department, Hôpital Avicenne (Assistance Publique-Hôpitaux de Paris and University Paris XIII), Bobigny, France.
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