1
|
Cottereau A, Vercellino L, Casasnovas O, Tilly H, Feugier P, Fruchart C, Roulin L, Oberic L, Pica G, Ribrag V, Abraham J, Simon M, Gonzalez H, Bouabdallah R, Fitoussi O, Sebban C, Lopez A, Macro M, Sahnes L, Morschhauser F, Trotman J, Corront B, Choufi B, Snauwaert S, Godmer P, Copie-Bergman C, Briere J, Salles G, Gaulard P, Meignan M, Thieblemont C. HIGH TOTAL METABOLIC TUMOR VOLUME AT BASELINE ALLOWS TO DISCRIMINATE FOR SURVIVAL PATIENTS IN RESPONSE AFTER R-CHOP: AN ANCILLARY ANALYSIS OF THE REMARC STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.19_2629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - L. Vercellino
- Medecine Nucleaire; APHP, Saint-Louis Hospital; Paris France
| | | | - H. Tilly
- Hematology; Centre H. Becquerel; Rouen France
| | - P. Feugier
- Hematology; CHU Brabois - Nancy; Nancy France
| | | | - L. Roulin
- Hematology; APHP, Henri Mondor Hospital; Créteil France
| | - L. Oberic
- Hematology; CHU Toulouse; Toulouse France
| | - G. Pica
- Hematology; CHU Annecy; Annecy France
| | | | | | - M. Simon
- Hematology; CH Valenciennes; Valenciennes France
| | | | | | - O. Fitoussi
- Hematology; Hopital Bordeaux Nord; Bordeaux France
| | - C. Sebban
- Hematology; Centre L. Berard; Lyon France
| | - A. Lopez
- Hematology; IOB; Barcelona Spain
| | - M. Macro
- Hematology; CHU Caen; Caen France
| | - L. Sahnes
- Hematology; CH Perpignan; Perpignan France
| | | | - J. Trotman
- Hematology; Concord Hospital; Sydney Australia
| | | | - B. Choufi
- Hematology; CH Boulogne; Boulogne France
| | | | - P. Godmer
- Hematology; CH Vannes; Vannes France
| | | | - J. Briere
- Pathology; APHP, Saint-Louis Hospital; Paris France
| | - G. Salles
- Hematology; CHU Lyon; Pierre-Benite France
| | - P. Gaulard
- Pathology; APHP, Henri Mondor Hospital; Créteil France
| | - M. Meignan
- Medecine Nucleaire; APHP, Henri Mondor Hospital; Créteil France
| | | |
Collapse
|
2
|
Marcant P, Terrom M, Alsuliman T, Choufi B, Le Moing A, Bécourt C, Delforge AF, Darras S. Pyoderma gangrenosum induit par l’azacitidine dans un contexte de syndrome myélodysplasique. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.334] [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: 11/25/2022]
|
3
|
Hunault-Berger M, Maillard N, Himberlin C, Recher C, Schmidt-Tanguy A, Choufi B, Bonmati C, Carré M, Couturier MA, Daguindau E, Marolleau JP, Orsini-Piocelle F, Delaunay J, Tavernier E, Lissandre S, Ojeda-Uribe M, Sanhes L, Sutton L, Banos A, Fornecker LM, Bernard M, Bouscary D, Saad A, Puyade M, Rouillé V, Luquet I, Béné MC, Hamel JF, Dreyfus F, Ifrah N, Pigneux A. Maintenance therapy with alternating azacitidine and lenalidomide in elderly fit patients with poor prognosis acute myeloid leukemia: a phase II multicentre FILO trial. Blood Cancer J 2017; 7:e568. [PMID: 28574488 PMCID: PMC5520397 DOI: 10.1038/bcj.2017.50] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- M Hunault-Berger
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - N Maillard
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - C Himberlin
- Service d'Hématologie, CHU Reims, Reims, France
| | - C Recher
- Hématologie Clinique, CHU, Institut Universitaire du Cancer Toulouse-Oncopole, CRCT UMR1037, Université de Toulouse III, Toulouse, France
| | - A Schmidt-Tanguy
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - B Choufi
- Service d'Hématologie, CH Boulogne, Boulogne, France
| | - C Bonmati
- Service d'Hématologie, CHU Nancy, Nancy, France
| | - M Carré
- Service d'Hématologie, UMR 5525, CHU Grenoble Alpes, La Tronche, France
| | - M-A Couturier
- Institut d'Hématologie et de Cancérologie, Hôpital Augustin Morvan, Brest, France
| | - E Daguindau
- Service d'Hématologie, CHU Besançon, Besançon, France
| | | | | | - J Delaunay
- Service d'Hématologie, CHU Nantes, Nantes, France
| | - E Tavernier
- Service d'Hématologie, Institut de Cancérologie de la Loire, Saint Etienne, France
| | - S Lissandre
- Service d'Hématologie et thérapie cellulaire, CHU, Tours, France
| | - M Ojeda-Uribe
- Service d'Hématologie, CH Mulhouse, Mulhouse, France
| | - L Sanhes
- Service d'Hématologie, CH Perpignan, Perpignan, France
| | - L Sutton
- Service d'Hématologie, CH Argenteuil, Argenteuil, France
| | - A Banos
- Service d'Hématologie, CH Côte Basque, Bayonne, France
| | - L M Fornecker
- Département d'Hématologie et d'Oncologie, CHU Hautepierre, Strasbourg, France
| | - M Bernard
- Hématologie Clinique, Hôpital Pontchaillou, Rennes, France
| | - D Bouscary
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - A Saad
- Hématologie, CH Béziers, Béziers, France
| | - M Puyade
- Service d'Hématologie, CHU Poitiers, Poitiers, France
| | - V Rouillé
- Service Hématologie, Hôpital Lapeyronie, Montpellier, France
| | - I Luquet
- Hématologie Biologique, CHU, IUC Toulouse-Oncopole, Toulouse, France
| | - M C Béné
- Hématologie Biologique, CHU de Nantes, Nantes, France
| | - J-F Hamel
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - F Dreyfus
- Hématologie Clinique, Hôpital Cochin, APHP, Paris, France
| | - N Ifrah
- Maladies du Sang, CHU Angers, CRCINA, INSERM, Université de Nantes, Université d'Angers, Angers, France
| | - A Pigneux
- Hématologie Clinique, CHU Bordeaux, Inserm 1035, Bordeaux, France
| |
Collapse
|
4
|
Hermet E, Cabrespine A, Guièze R, Garnier A, Tempescul A, Lenain P, Bouabdallah R, Vilque JP, Frayfer J, Bordessoule D, Sibon D, Janvier M, Caillot D, Biron P, Legros L, Choufi B, Drenou B, Gorin NC, Bilger K, Tamburini J, Soussain C, Brechignac S, Bay JO. Autologous hematopoietic stem cell transplantation in elderly patients (≥ 70 years) with non-Hodgkin's lymphoma: A French Society of Bone Marrow Transplantation and Cellular Therapy retrospective study. J Geriatr Oncol 2015; 6:346-52. [PMID: 26116168 DOI: 10.1016/j.jgo.2015.04.005] [Citation(s) in RCA: 27] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 12/16/2014] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Limited data is available on the feasibility of high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (AHSCT) in elderly patients over 70 years of age with non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS In the setting of the Société Française de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC) group, we retrospectively analyzed 81 consecutive patients with NHL over 70 years of age who received AHSCT. RESULTS The median age at AHSCT was 72.3 years [70-80]. Patients' were diagnosed with diffuse large B-cell lymphoma (n=40), follicular lymphoma (n=16), mantle cell lymphoma (n=15), T-cell lymphoma (n=5), and other (n=5). Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) was 0 in 73% of patients. Main conditionings were BEAM (Carmustine-Etoposide-Cytarabine-Melphalan, n=61) and melphalan alone (n=14). Median delays to reach 0.5×10⁹/L neutrophils and 20 × 10(9)/L platelets were of 12 [9-76] days and 12 [0-143] days, respectively. One hundred day and one year cumulative incidence of NRM was 5.4% and 8.5%, respectively. The main cause of death remains relapse. CONCLUSION In conclusion, this study revealed that AHSCT seemed to be acceptable in patients over 70 years of age with NHL. Patient age is not a limiting factor if clinical condition is adequate.
Collapse
Affiliation(s)
- E Hermet
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France.
| | - A Cabrespine
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - R Guièze
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | - A Garnier
- Hôpital Pitié-Salpétrière, Paris, France
| | | | - P Lenain
- Centre Henri Becquerel, Rouen, France
| | | | | | - J Frayfer
- Centre Hospitalier de Meaux, Meaux, France
| | | | - D Sibon
- Hôpital Saint-Louis, Paris, France
| | - M Janvier
- Centre René Huguelin, St Cloud, France
| | | | - P Biron
- Centre Leon Berard, Lyon, France
| | | | - B Choufi
- Hôpital Duchenne, Boulogne/mer, France
| | - B Drenou
- Hôpital Emile Muller, Mulhouse, France
| | | | - K Bilger
- Hôpital Hautepierre, Strasbourg, France
| | | | | | | | - J O Bay
- Service de thérapie cellulaire et d'hématologie clinique adulte, Université d'Auvergne EA3846, CIC-501, CHU Clermont-Ferrand Hôpital Estaing, Clermont-Ferrand, France
| | | |
Collapse
|
5
|
Choufi B, Thiant S, Trauet J, Cliquennois M, Cherrel M, Boulanger F, Coiteux V, Magro L, Labalette M, Yakoub-Agha I. Impact de la composition du greffon sur le devenir des patients après une allogreffe de cellules souches hématopoïétiques : corrélation entre proportion des lymphocytes T CD4+ du greffon exprimant le CCR7 et la survenue d’une GVH aiguë. ACTA ACUST UNITED AC 2014; 62:123-8. [DOI: 10.1016/j.patbio.2014.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 02/19/2014] [Indexed: 01/27/2023]
|
6
|
Gardin C, Thepot S, Beyne-Rauzy O, Benabdelali R, Prebet T, Park S, Stamatoulas A, Guerci-Bresler A, Cheze S, Tertian G, Choufi B, Legros L, Bastie J, Delaunay J, Chaury M, Wattel E, Dreyfus F, Preudhomme C, Vey N, Fenaux P. O-010 Prognostic factors of response to azacitidine (AZA) in low-risk MDS resistant to erythroid stimulating agents (ESA). The GFM Azaepo 08 study. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70032-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
7
|
Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. Erratum to: High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013. [DOI: 10.1007/s00277-013-1713-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
Kelaidi C, Beyne-Rauzy O, Braun T, Sapena R, Cougoul P, Adès L, Pillard F, Lamberto C, Lambert C, Charniot JC, Guerci A, Choufi B, Stamatoullas A, Slama B, De Renzis B, Ame S, Damaj G, Boyer F, Chaury MP, Legros L, Cheze S, Testu A, Gyan E, Béné MC, Rose C, Dreyfus F, Fenaux P. High response rate and improved exercise capacity and quality of life with a new regimen of darbepoetin alfa with or without filgrastim in lower-risk myelodysplastic syndromes: a phase II study by the GFM. Ann Hematol 2013; 92:621-31. [PMID: 23358617 DOI: 10.1007/s00277-013-1686-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/17/2013] [Indexed: 11/24/2022]
Abstract
Darbepoetin (DAR), with or without granulocyte colony-stimulating factor (G-CSF), has proved effective in treating anemia in patients with lower-risk myelodysplastic syndrome (MDS), but its effects on quality of life (QoL) and exercise functioning are less well established. In this phase II study (no. NCT00443339), lower-risk MDS patients with anemia and endogenous erythropoietin (EPO) level <500 IU/L received DAR 500 μg once every 2 weeks for 12 weeks, with G-CSF added at week 12 in non-responders. Physical performance was assessed with the 6-min walking test and, for fit patients, maximal oxygen consumption (VO2max). QoL was evaluated using SF-36 and FACT-An tests. In 99 patients, erythroid response rate according to IWG 2006 criteria was 48 and 56 % at 12 and 24 weeks, respectively. Addition of G-CSF rescued 22 % of non-responders. In 48 % of the responders, interval between darbepoetin injections could be increased for maintenance treatment. Serum EPO level was the only independent predictive factor of response at 12 weeks, and its most discriminant cutoff value was 100 IU/L. QoL and VO2max showed improvement over time in responders, compared with non-responders. With a median follow-up of 52 months, median response duration was not reached, and 3-year cumulative incidence of acute myeloid leukemia and overall survival (OS) was 14.5 and 70 %, respectively. Baseline transfusion dependence, International Prognostic Score System (IPSS), and Revised IPSS accurately predicted OS from treatment onset. Tolerance of darbepoetin was good. In conclusion, this regimen of darbepoetin every 2 weeks yielded high response rates and prolonged response duration. Objective improvement in exercise testing and in patient-reported QoL confirms the clinical relevance of anemia correction with erythropoiesis-stimulating agents.
Collapse
Affiliation(s)
- C Kelaidi
- GFM Service d'Hématogie Clinique, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris, Université Paris 13, 125 rue de Stalingrad, Bobigny, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Kelaidi C, Park S, Sapena R, Beyne-Rauzy O, Coiteux V, Vey N, Stamatoullas A, Choufi B, Delaunay J, Gourin MP, Cheze S, Ravoet C, Ferrant A, Escoffre-Barbe M, Aljassem L, Raffoux E, Itzykson R, Adès L, Dreyfus F, Fenaux P. Long-term outcome of anemic lower-risk myelodysplastic syndromes without 5q deletion refractory to or relapsing after erythropoiesis-stimulating agents. Leukemia 2013; 27:1283-90. [DOI: 10.1038/leu.2013.16] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
10
|
Gressin R, Damaj GL, Bouabdallah K, Cartron G, Choufi B, Gyan E, Jaccard A, Park S, Schiano De Colella JM, Voillat L, Joly B, Le Gouill S, Saad A, Sanhes L, Moles-Moreau MP, Bubenheim M, Bene MC, Martin A, Marolleau JP, Lamy T. Multicenter, phase II study of bendamustine in refractory or relapsed T-cell lymphoma: The BENTLY trial. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.8026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8026 Background: T-cell lymphomas have a poor prognosis with few options of effective treatment. This study determined the efficacy and safety of bendamustine as a single agent in the treatment of refractory or relapsed T-cell lymphomas. Methods: Patients with histologically confirmed peripheral T-cell lymphoma (PTCL) or cutaneous T-cell lymphoma (CTCL), who had previously received at least one line of chemotherapy were selected. Bendamustine was administered IV at the dosage of 120 mg/m2 on days 1 and 2 every 3 weeks, for 6 cycles. Treatment response was assessed using the IWC for non-Hodgkin's lymphoma. The primary end point was overall response rate (ORR). Secondary end points were duration of response (DoR), progression-free survival (PFS), and overall survival (OS), NCT00959686. Results: Twenty two female and 38 male were included. The median age was 66 years with more 1/4 of them > 75. Histology was predominantly angio-immunoblastic lymphadenopathy (n=32) and PTCL-nos (n=23). The median previous line of chemotherapy was 1 (1-3). Nearly one half (45%) of the patients was refractory to the last previous chemotherapy and the median duration of the best previous response was 6.6 (1.5-67) months. The disease was disseminated in the majority of case (87%) and the international prognostic index (IPI) was high (3–5) in 68% of the patients. Twenty patients (33%) received less than 3 cycles of bendamustine. The major reason for early discontinuation was disease progression. In the Intent-To-Treat (ITT) population, the best ORR was 50%, including complete response (CR) in 28% and partial response (PR) in 22 %. Bendamustine showed a consistency in the efficacy as a function of major disease characteristics. The median values for DoR, PFS and OS were 3.5, 4 and 6 months respectively. The most frequent grade 3/4 AEs were neutropenia (30%), thrombocytopenia (24%) and infections (20%). Conclusions: Bendamustine is active in high risk refractory and relapsed T-cell lymphoma with manageable toxicity.
Collapse
Affiliation(s)
| | | | - Kamal Bouabdallah
- Department of Hemagology, Hôpital du Haut Lévêque, Centre François Magendie, Pessac, France
| | | | - B Choufi
- Hématologie, CH Boulogne, Boulogne, France
| | | | - Arnaud Jaccard
- Hématologie Clinique et Thérapie Cellulaire, Limoges, France
| | | | | | - Laurent Voillat
- Hematology, Hopital de Chalons sur Saone, Chalons sur Saone, France
| | - Bertrand Joly
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | | | - Alain Saad
- Hematology/Oncology, Hopital de Beziers, Beziers, France
| | | | | | - Michael Bubenheim
- Biostatistics Department, Rouen University Hospital-Charles Nicolle, Rouen, France
| | - Marie C. Bene
- Immunology Laboratory, CHU de Brabois and Nancy University, Vandoeuvre les Nancy, France
| | - Antoine Martin
- Pathology, University hospital Avicenne, Bobigny, France
| | | | | |
Collapse
|
11
|
Gardin C, Thépot S, Beyne-Rauzy O, Prébet T, Park S, Stamatoulas A, Guerci-Bresler A, Cheze S, Tertian G, Choufi B, Legros L, Bastie JN, Delaunay J, Wattel E, Dreyfus F, Vey N, Boehrer S, Fenaux P. Results of a phase II trial of azacitidine (AZA) with or without epoetin beta (EPO) in lower-risk MDS. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.6523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6523 Background: Although anemia of IPSS low and int-1 (LR) MDS initially responds to erythroid stimulating agents (ESA) in 40-50% of patients (pts), response is generally transient. Anemia recurrence with RBC cell transfusion dependency (RBC-TD) is an indicator of poor prognosis, even in absence of progression to higher risk MDS. AZA leads to RBC transfusion independence (RBC-TI) in 30–40% of LR-MDS (Lyons, JCO, 2009), but it has not been prospectively tested in LR-MDS patients resistant to ESA. It also remains unknown if the addition of ESA to AZA would be useful in such pts. Methods: In this randomized phase-II trial (GFMAzaEpo-2008-1 trial, NCT01015352), the Groupe Francophone des Myélodysplasies (GFM) compared AZA 75mg/m2/d for 5 days every 28 days for 6 cycles (AZA arm) to the same treatment plus EPO 60000U/week (AZA+EPO arm). Inclusion criteria were LR-MDS resistant to at least 12 weeks of ESA, with RBC-TD ≥ 4 RBC units in the previous 8 weeks. Responders in both arms were eligible for maintenance up to 12 monthly cycles, unless progression or loss of erythroid response occurred. The primary endpoint was RBC-TI (HI-E major using IWG 2000 criteria) after 6 courses. Results: Between 2009 and 2010, the 98 planned pts were included: M/F 65/28; median age 71y (41-84); 5 pts were excluded (one consent withdrawal, 2 early unrelated events and 2 with exclusion criteria). In the remaining 93 pts, IPSS risk was low in 69 and int-1 in 23 pts, with no imbalance between arms. Five pts received < 4 cycles and 16 received only 4 or 5 cycles, mainly due to toxicity or progression. RBC-TI after 6 courses was observed in 16.7% (8/48) in the AZA arm and 18 % (8/45) in the AZA+EPO arm (P=1), and in 19.5% (8/41) and 26 % (8/31) respectively, in the 72 pts who received ≥ 6 cycles (P=.57). Overall best response rate (at least HI-E minor using IWG 2000 criteria) was 35 and 33% in the AZA and AZA+EPO arms, respectively (P=0.99). Of note, only 9 pts in the AZA+EPO arm required at least one hospitalization for a SAE, compared to 22 pts in the AZA arm (P=0.015). Conclusions: Erythroid response to AZA, in LR MDS with demonstrated ESA resistance, appears lower than expected, with no improved outcome when combined with an ESA. The latter may however improve tolerance of AZA in LR MDS.
Collapse
Affiliation(s)
- Claude Gardin
- Hematology, Hopital Avicenne APHP, University of Paris 13, Bobigny, France
| | - Sylvain Thépot
- Hematology, Hopital Avicenne APHP, University of Paris 13, Bobigny, France
| | | | | | | | | | | | | | | | - B Choufi
- Hématologie, CH Boulogne, Boulogne, France
| | | | | | | | | | - Francois Dreyfus
- Hematology, Hopital Cochin APHP, University of Paris 5, Paris, France
| | | | - Simone Boehrer
- Hematology, Hopital Avicenne APHP, University of Paris 13, Bobigny, France
| | | |
Collapse
|
12
|
Kelaidi C, Park S, Sapena R, Beyne-Rauzy O, Coiteux V, Vey N, Stamatoullas A, Choufi B, Delaunay J, Gourin MP, Cheze S, Ravoet C, Ferrant A, Escoffre-Barbe M, Aljassem L, Raffoux E, Itzykson R, Ades L, Dreyfus F, Fenaux P. 219 Long-term outcome of anemic non del 5q lower-risk MDS refractory to or relapsing after erythropoiesis stimulating agents (ESAs). Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70221-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
13
|
Michy T, Choufi B, Le Bouëdec G, Dauplat J. [Polycythemia and fibromyoma. Case report]. Gynecol Obstet Fertil 2006; 34:622-4. [PMID: 16854610 DOI: 10.1016/j.gyobfe.2006.06.007] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Accepted: 06/08/2006] [Indexed: 05/10/2023]
Abstract
Leiomyoma of the uterus is a frequent benign tumor of non menopausal women. Among possible complications, polycythemia is rare and often unrecognised. We report a very demonstrative case, that of a 52-year-old woman, who presented initially an episode of metrorrhagia. The difficulty of diagnosis and the treatment are detailed. The different physiopathological hypotheses are discussed in order to ameliorate our knowledge about this association between fibromyoma and polycythemia, and to optimise therapeutic management.
Collapse
Affiliation(s)
- T Michy
- Service de chirurgie oncologique, centre Jean-Perrin, rue Montalembert, place Henri-Dunant, 63000 Clermont-Ferrand, France.
| | | | | | | |
Collapse
|
14
|
Rea D, Legros L, Raffoux E, Thomas X, Turlure P, Maury S, Dupriez B, Pigneux A, Choufi B, Reman O, Stéphane D, Royer B, Vigier M, Ojeda-Uribe M, Recher C, Dombret H, Huguet F, Rousselot P. High-dose imatinib mesylate combined with vincristine and dexamethasone (DIV regimen) as induction therapy in patients with resistant Philadelphia-positive acute lymphoblastic leukemia and lymphoid blast crisis of chronic myeloid leukemia. Leukemia 2006; 20:400-3. [PMID: 16437142 DOI: 10.1038/sj.leu.2404115] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [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: 11/09/2022]
Abstract
Imatinib combined with high-dose chemotherapy is now becoming the gold standard for treatment of Philadelphia chromosome-positive acute leukemias. However, in all studies imatinib dosage was tapered to 400-600 mg per day. We decided to initiate a clinical trial to evaluate an opposite strategy based on high-dose imatinib (800 mg per day) combined with a less intensive chemotherapeutic regimen (vincristine and dexamethasone), which we called the DIV induction regimen. Thirty-one patients (18 relapsing or refractory Ph+ acute lymphoblastic leukemias and 13 lymphoid blast crisis chronic myelogenous leukemias) were enrolled. Complete remission (CR) was obtained in 28 out of 30 assessable patients. The median bcr-abl/abl ratio after the induction course was 0.1%. Median time to neutrophil recovery was 21 days. Fungus infections were observed in six patients out of 31 and possibly related to dexamethasone. Neuropathy due to vincristine was noted in 14 cases. Nine out of 19 patients under 55 years received allogenic stem cell transplantation after a median time of 78 days post-CR. Patients older than 55 years experienced a 90% CR rate without additional toxicities, suggesting the DIV regimen may also be proposed as a front line therapy in older patients.
Collapse
Affiliation(s)
- D Rea
- Service d'Hématologie Clinique, Hôpital Saint-Louis, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Mohty M, Jacot W, Faucher C, Bay JO, Zandotti C, Collet L, Choufi B, Bilger K, Tournilhac O, Vey N, Stoppa AM, Coso D, Gastaut JA, Viens P, Maraninchi D, Olive D, Blaise D. Infectious complications following allogeneic HLA-identical sibling transplantation with antithymocyte globulin-based reduced intensity preparative regimen. Leukemia 2003; 17:2168-77. [PMID: 12931226 DOI: 10.1038/sj.leu.2403105] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.2] [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: 11/09/2022]
Abstract
In the setting of reduced-intensity conditioning (RIC) regimens for allogeneic stem cell transplantation (allo-SCT), the epidemiology of transplant-related infections is still poorly defined. In 101 high-risk patients who received an HLA-identical sibling allo-SCT after RIC, including fludarabine, busulfan and antithymocyte globulin (ATG), we report during the first 6 months a cumulative incidence of positive CMV antigenemia of 42% (95% CI 32-52%), developing at a median of 37 (range 7-116) days without evidence of CMV disease (median follow-up, 434 days). The cumulative incidence of bacteremia was 25% (95% CI 17-33%), occurring at a median of 67 (range 7-172) days, while patients had recovered a full neutrophil count. In all, 65% of the bacteremia (95% CI 49-81%) were gram negative. The cumulative incidence of fungal infections was 8% (95% CI 3-13%), with a median onset of 89 (range 7-170) days. In multivariate analysis, stem cell source (bone marrow; P=0.0002) was significantly associated with the risk of positive CMV antigenemia, while higher doses of prednisone (>2 mg/kg) represented the major risk factor for bacteremia (P=0.0001). Infectious-related mortality was 5% (95% CI 1-9%), with aspergillosis being the principal cause. Collectively, these results suggest that prospective efforts are warranted to develop optimal antimicrobial preventive strategies after RIC allo-SCT.
Collapse
Affiliation(s)
- M Mohty
- Unité de Transplantation et de Thérapie Cellulaire, Institut Paoli-Calmettes, Marseille, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Bay JO, Fleury J, Choufi B, Tournilhac O, Vincent C, Bailly C, Dauplat J, Viens P, Faucher C, Blaise D. Allogeneic hematopoietic stem cell transplantation in ovarian carcinoma: results of five patients. Bone Marrow Transplant 2002; 30:95-102. [PMID: 12132048 DOI: 10.1038/sj.bmt.1703609] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2001] [Accepted: 03/14/2002] [Indexed: 01/15/2023]
Abstract
Allogeneic hematopoietic stem cell transplantation is often used to treat hematologic malignancies. The efficacy of this procedure is due to both myeloablative conditioning and graft-versus-leukemia (GVL). However, the disadvantages of allogeneic transplantation include graft-versus-host disease (GVHD), relapse from the original tumor, and patient susceptibility to opportunistic infections. Lately, allogeneic transplantation has been developed to treat solid tumors, with the expectation that graft-versus-tumor (GVT), like GVL, will have a significant anti-tumor effect. This effect has been demonstrated in renal carcinomas, and with less evidence in breast cancers. Five patients with malignant ovarian tumors resistant to chemotherapy underwent allogeneic transplantation, four from bone marrow, and one from peripheral blood stem cells. All donors were HLA-identical siblings. One patient received a myeloablative conditioning regimen, while the other four received a non-myeloablative regimen. Two patients received donor lymphocyte infusions (DLI). Four of the patients presented with acute or chronic GVHD associated with tumor regression of at least 50%. These tumor regressions were measured by CA-125 levels and CT scans. The fifth patient died of rapid progression just after transplantation. Of the four transplantation survivors, three received a non-myeloablative regimen which did not seem to reduce treatment effectiveness. While it did reduce toxicity, one of these patients died of GVHD after 127 days. DLI was administered to two patients. These infusions seemed to promote GVHD which was able to control disease progression for one patient and had no apparent effect on the other. Allograft of hematopoietic stem cells might be of interest in ovarian cancer. The results in one patient also suggest that DLI may be an effective immunotherapy, although doses and timing need to be determined. The number of cases presented is small, however, and clinical experience on a larger scale will be required to determine the real clinical efficacy of graft versus cancerous ovarian cells.
Collapse
Affiliation(s)
- J-O Bay
- Unité de Transplantation Médullaire, Centre Jean Perrin, Centre de Lutte Contre le Cancer, 58 rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Bay JO, Choufi B, Tournilhac O, Faucher C, Blaise D. [Allogeneic hematopoietic cell transplantation in solid tumors]. Bull Cancer 2001; 88:900-7. [PMID: 11604364] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Allogeneic bone marrow transplantation is being used to treat hematologic malignancies after induction. The efficacy of this procedure is due to both myeloablative conditioning and graft versus leukemia (GvL). However, the disadvantages of allogenic transplantation include graft versus host disease (GvH), the susceptibility of patients to opportunistic infections, and relapse from the original tumor. Since 1995 is used conditioning regimen which are deeply immunosuppressive and non myeloablative. The therapeutic toxicity related to myeloablation and drug side effects should be reduced. Lately, allogeneic transplantation has been developed to treat solid tumors, with the expectation that graft versus tumor (GvT), like GvL, will have a significant anti-tumoral effect. According to the literature, the feasibility of this procedure seems demonstrated. The fist available results in renal carcinomas are encouraging. However, the efficacy of this procedure remains uncertain for other potential indications. After presenting the published results, we will discussed the actual difficulties and the future potential developments.
Collapse
Affiliation(s)
- J O Bay
- Unité de transplantation médullaire, Centre régional de lutte contre le cancer Jean-Perrin, BP 392, 63011 Clermont-Ferrand Cedex 01.
| | | | | | | | | |
Collapse
|
18
|
Bay JO, Choufi B, Pomel C, Dauplat J, Durando X, Tournilhac O, Travade P, Plagne R, Blaise D. Potential allogeneic graft-versus-tumor effect in a patient with ovarian cancer. Bone Marrow Transplant 2000; 25:681-2. [PMID: 10734306 DOI: 10.1038/sj.bmt.1702206] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [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: 11/09/2022]
Abstract
A 33-year-old woman developed progressive ovarian cancer resistant to classical chemotherapy agents. We performed a bone marrow allograft after a myeloablative regimen. During hematological recovery, she developed acute graft-versus-host disease (GVHD). From this time her tumor diminished progressively. One year post transplant she has limited chronic liver GVHD and is still free of disease. The complete remission of advanced ovarian cancer was probably related to the GVHD which might therefore provide a new treatment option for this disease.
Collapse
Affiliation(s)
- J O Bay
- Unité de Transplantation Médullaire, Marseille, France
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Fleury J, Béal D, Bay J, Choufi B, Suzanne F, Dauplat J, Condat P, Bons J, Curé H, Plagne R. High-dose chemotherapy and autologous hematopoietic stem cell transplantation for 62 patients with poor prognosis breast cancer. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81614-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
20
|
Tchirkov A, Giollant M, Tavernier F, Briançon G, Tournilhac O, Kwiatkowski F, Philippe P, Choufi B, Deméocq F, Travade P, Malet P. Interphase cytogenetics and competitive RT-PCR for residual disease monitoring in patients with chronic myeloid leukaemia during interferon-alpha therapy. Br J Haematol 1998; 101:552-7. [PMID: 9633901 DOI: 10.1046/j.1365-2141.1998.00717.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/20/2022]
Abstract
There is a need for fast and sensitive methods to evaluate the response of patients with chronic myeloid leukaemia (CML) to interferon-alpha (IFN-alpha) therapy to complement cytogenetic analysis of Philadelphia (Ph) chromosome-positive metaphases. We have used interphase FISH (fluorescence in situ hybridization) and competitive RT-PCR (reverse transcriptase-polymerase chain reaction) techniques for detection of BCR-ABL-positive cells to measure suppression of leukaemic clone in a series of 51 follow-up samples from 24 CML patients undergoing IFN-alpha treatment. Interphase FISH analysis of the malignant clone in bone marrow using BCR and ABL probes was found to be highly correlated to conventional G-banding metaphase examination (r = 0.98). RT-PCR quantification of BCR-ABL mRNA transcripts in blood also showed a high degree of concordance with the proportion of Ph-positive metaphases (r = 0.93). In addition, the degree of cytogenetic response did not influence the equivalence between karyotype analysis and molecular methods. We concluded that interphase FISH and competitive RT-PCR provide reliable information on residual tumour burden and response to IFN-alpha in CML patients. These molecular methods may significantly improve the efficiency of residual disease monitoring during IFN-alpha therapy of CML.
Collapse
MESH Headings
- Antineoplastic Agents/therapeutic use
- Female
- Fusion Proteins, bcr-abl
- Humans
- In Situ Hybridization, Fluorescence/methods
- Interferon-alpha/therapeutic use
- Interphase
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Accelerated Phase/pathology
- Leukemia, Myeloid, Accelerated Phase/therapy
- Leukemia, Myeloid, Chronic-Phase/pathology
- Leukemia, Myeloid, Chronic-Phase/therapy
- Male
- Middle Aged
- Neoplasm, Residual
- Polymerase Chain Reaction/methods
- Prospective Studies
- RNA, Messenger/analysis
- Sensitivity and Specificity
Collapse
Affiliation(s)
- A Tchirkov
- Laboratoire de Cytogénétique Médicale, Faculté de Médecine, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Legros M, Dauplat J, Fleury J, Cure H, Suzanne F, Chassagne J, Bay JO, Sol C, Canis M, Condat P, Choufi B, Tavernier F, Glenat C, Chollet P, Plagne R. High-dose chemotherapy with hematopoietic rescue in patients with stage III to IV ovarian cancer: long-term results. J Clin Oncol 1997; 15:1302-8. [PMID: 9193321 DOI: 10.1200/jco.1997.15.4.1302] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.9] [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: 02/04/2023] Open
Abstract
PURPOSE A series of 53 patients with poor-prognosis epithelial ovarian cancer treated with high-dose chemotherapy (HDC) followed by hematopoietic rescue was retrospectively studied from the day of diagnosis for toxicity and long-term survival analysis. PATIENTS AND METHODS Patients were treated with surgery followed by cisplatin combination chemotherapy. After second-look operation (SLO), HDC was administered: 23 patients received melphalan (140 mg/m2 on day 1) and 30 patients received a combination of carboplatin (400 mg/m2 on days 1 to 4) and cyclophosphamide (1.6 g/m2 on days 1 to 4). After HDC, autologous stem-cell transplantation was performed for hematologic support. RESULTS One patient died of cardiac failure after HDC, but the acute toxicity was acceptable for the other patients. With a median follow-up of 81.5 months, the 5-year overall survival rate for the 53 patients was 59.9% and the disease-free survival (DFS) rate at 5 years was 23.6%. Twenty-four patients (45.3%) were alive, 12 with no evidence of disease and 12 with recurrent disease. The best results were achieved in 19 patients with pathologic complete response at SLO (74.2% 5-year overall survival; 32.8% 5-year DFS). CONCLUSION HDC followed by autologous stem-cell support is a well-tolerated therapeutic approach for patients with poor-prognosis ovarian carcinoma. In this report, the 59.9% survival of 53 patients at 5 years must be compared to the 20% to 30% 5-year survival observed after conventional therapy. These results should be confirmed by an ongoing prospective randomized trial.
Collapse
Affiliation(s)
- M Legros
- Centre Jean Perrin, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Legros M, Fleury J, Bay JO, Choufi B, Basile M, Condat P, Glenat C, Communal Y, Tavernier F, Bons JM, Chollet P, Plagne R, Chassagne J. rhGM-CSF vs placebo following rhGM-CSF-mobilized PBPC transplantation: a phase III double-blind randomized trial. Bone Marrow Transplant 1997; 19:209-13. [PMID: 9028547 DOI: 10.1038/sj.bmt.1700640] [Citation(s) in RCA: 18] [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: 02/03/2023]
Abstract
In this placebo-controlled randomized trial we evaluated the hematological and clinical effects of r-Hu GM-CSF after high-dose chemotherapy (HDC) followed by GM-CSF-mobilized PBPC transplantation. Fifty patients with poor prognosis malignancies were randomized in a double-blind study to receive either GM-CSF or placebo after HDC followed by PBPC rescue. For all patients, PBPCs were recruited using a combination of VP-16 (300 mg/m2 on days 1 and 2), cytoxan (3 g/m2 on days 3 and 4) and GM-CSF (5 micrograms/kg from day 5). No differences were demonstrated between the two groups in median time to neutrophil or platelet recoveries. There was no significant difference between the GM-CSF group and the placebo group in the median duration of post-transplant hospitalization, in the number of days of antibiotic treatment, in the number of infections and in red blood cell or platelet transfusion requirements. There was a significant difference with an advantage for the placebo group in the mean duration of febrile days (P = 0.01). We conclude that the administration of GM-CSF in patients transplanted with GM-CSF-mobilized PBPC is not associated with a clinical benefit in term of tempo of engraftment, numbers of documented infections, transfusion requirements and mucositis grading.
Collapse
Affiliation(s)
- M Legros
- Centre Jean Perrin, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Cure H, Legros M, Fleury J, Dauplat J, Condat P, Choufi B, Chollet P, Plagne R. High-dose chemotherapy and autologous stem cell transplantation in advanced epithelial ovarian cancer. Bone Marrow Transplant 1996; 18 Suppl 1:S34-5. [PMID: 8899168] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- H Cure
- Centre Jean Perrin, Clermont-Ferrand, France
| | | | | | | | | | | | | | | |
Collapse
|