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De Greef J, Averbuch D, Tondeur L, Duréault A, Zuckerman T, Roussel X, Robin C, Xhaard A, Pagliuca S, Beguin Y, Botella-Garcia C, Khanna N, Le Bourgeois A, Van Praet J, Ho A, Kröger N, Ducastelle Leprêtre S, Roos-Weil D, Aljurf M, Blijlevens N, Blau IW, Carlson K, Collin M, Ganser A, Villate A, Lakner J, Martin S, Nagler A, Ram R, Torrent A, Stamouli M, Mikulska M, Gil L, Wendel L, Tridello G, Knelange N, de la Camara R, Lortholary O, Fontanet A, Styczynski J, Maertens J, Coussement J, Lebeaux D. Risk factors for Nocardia infection among allogeneic hematopoietic cell transplant recipients: A case-control study of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. J Infect 2024; 88:106162. [PMID: 38663756 DOI: 10.1016/j.jinf.2024.106162] [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: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Nocardiosis is a rare but life-threatening infection after hematopoietic cell transplantation (HCT). We aimed at identifying risk factors for nocardiosis after allogeneic HCT and clarifying the effect of trimethoprim-sulfamethoxazole prophylaxis on its occurrence. METHODS We performed a retrospective multicenter case-control study of patients diagnosed with nocardiosis after allogeneic HCT between January 2000 and December 2018. For each case, two controls were matched by center, transplant date, and age group. Multivariable analysis was conducted using conditional logistic regression to identify potential risk factors for nocardiosis. Kaplan-Meier survival curves of cases and controls were compared using log-rank tests. RESULTS Sixty-four cases and 128 controls were included. Nocardiosis occurred at a median of 9 months after allogeneic HCT (interquartile range: 5-18). After adjustment for potential confounders in a multivariable model, Nocardia infection was associated with tacrolimus use (adjusted odds ratio [aOR] 9.9, 95 % confidence interval [95 % CI]: 1.6-62.7), lymphocyte count < 500/µL (aOR 8.9, 95 % CI: 2.3-34.7), male sex (aOR 8.1, 95 % CI: 2.1-31.5), recent use of systemic corticosteroids (aOR 7.9, 95 % CI: 2.2-28.2), and recent CMV infection (aOR 4.3, 95 % CI: 1.2-15.9). Conversely, use of trimethoprim-sulfamethoxazole prophylaxis was associated with a significantly decreased risk of nocardiosis (aOR 0.2, 95 % CI: 0.1-0.8). HCT recipients who developed nocardiosis had a significantly decreased survival, as compared with controls (12-month survival: 58 % and 90 %, respectively; p < 0.0001). CONCLUSIONS We identified six factors independently associated with the occurrence of nocardiosis among allogeneic HCT recipients. In particular, trimethoprim-sulfamethoxazole prophylaxis was found to protect against nocardiosis.
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Affiliation(s)
- Julien De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Dina Averbuch
- Pediatric Infectious Diseases, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel
| | - Laura Tondeur
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France
| | - Amélie Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Tsila Zuckerman
- Rambam Health Care Campus, Haifa, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Xavier Roussel
- Department of Hematology, University of Franche-Comte, INSERM UMR1098, Besançon University Hospital, Besançon, France
| | - Christine Robin
- Department of Hematology, Henri Mondor University Hospital, Creteil, France
| | - Alienor Xhaard
- Hematology-Transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - Simona Pagliuca
- Hematology Department, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - Yves Beguin
- Centre Hospitalier Universitaire of Liège and University of Liège, Liège, Belgium
| | | | - Nina Khanna
- Division of Infectious Diseases and Hospital Epidemiology, University and University Hospital of Basel, Basel, Switzerland
| | | | - Jens Van Praet
- Department of Nephrology and Infectious Diseases, Algemeen Ziekenhuis Sint-Jan Brugge-Oostende, Brugge, Belgium
| | | | - Nicolaus Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | | | | | - Mahmoud Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Matthew Collin
- Nordern Centre for Bone Marrow Transplantation Freeman Hospital - Adult HSCT Unit, Newcastle, United Kingdom
| | - Arnold Ganser
- Department of Hematology Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Alban Villate
- Service d'hématologie et thérapie cellulaire, Centre Hospitalier Universitaire de Tours, Université de Tours, Tours, France
| | - Johannes Lakner
- Medical Clinic III, University Medical Center, Rostock, Germany
| | | | - Arnon Nagler
- Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ron Ram
- Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Torrent
- ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Badalona, Spain
| | | | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lidia Gil
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Lotus Wendel
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Nina Knelange
- European Society for Blood and Marrow Transplantation (EBMT), Leiden Study Unit, Leiden, the Netherlands
| | - Rafael de la Camara
- Hospital de la Princesa, Madrid, Spain; Infectious Diseases Working Party, EBMT, Spain
| | - Olivier Lortholary
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris, Université Paris Descartes, Paris, France
| | - Arnaud Fontanet
- Emerging Diseases Epidemiology Unit, Institut Pasteur, Université Paris Cité, 75015 Paris, France; Unité PACRI, Conservatoire National des Arts et Métiers, 75003 Paris, France
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Johan Maertens
- Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Julien Coussement
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Victoria, Australia; Service de Maladies Infectieuses et Tropicales, Centre Hospitalier universitaire de Guadeloupe, Les Abymes, Guadeloupe, France.
| | - David Lebeaux
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, 75015 Paris, France; Département de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Saint-Louis, Lariboisière, F-75010 Paris, France
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2
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Aerts R, Mehra V, Groll AH, Martino R, Lagrou K, Robin C, Perruccio K, Blijlevens N, Nucci M, Slavin M, Bretagne S, Cordonnier C. Guidelines for the management of Toxoplasma gondii infection and disease in patients with haematological malignancies and after haematopoietic stem-cell transplantation: guidelines from the 9th European Conference on Infections in Leukaemia, 2022. Lancet Infect Dis 2024; 24:e291-e306. [PMID: 38134949 DOI: 10.1016/s1473-3099(23)00495-4] [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: 12/30/2022] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 12/24/2023]
Abstract
Patients with haematological malignancies might develop life-threatening toxoplasmosis, especially after allogeneic haematopoietic stem-cell transplantation (HSCT). Reactivation of latent cysts is the primary mechanism of toxoplasmosis following HSCT; hence, patients at high risk are those who were seropositive before transplantation. The lack of trimethoprim-sulfamethoxazole prophylaxis and various immune status parameters of the patient are other associated risk factors. The mortality of toxoplasma disease-eg, with organ involvement-can be particularly high in this setting. We have developed guidelines for managing toxoplasmosis in haematology patients, through a literature review and consultation with experts. In allogeneic HSCT recipients seropositive for Toxoplasma gondii before transplant, because T gondii infection mostly precedes toxoplasma disease, we propose weekly blood screening by use of quantitative PCR (qPCR) to identify infection early as a pre-emptive strategy. As trimethoprim-sulfamethoxazole prophylaxis might fail, prophylaxis and qPCR screening should be combined. However, PCR in blood can be negative even in toxoplasma disease. The duration of prophylaxis should be a least 6 months and extended during treatment-induced immunosuppression or severe CD4 lymphopenia. If a positive qPCR test occurs, treatment with trimethoprim-sulfamethoxazole, pyrimethamine-sulfadiazine, or pyrimethamine-clindamycin should be started, and a new sample taken. If the second qPCR test is negative, clinical judgement is recommended to either continue or stop therapy and restart prophylaxis. Therapy must be continued until a minimum of two negative PCRs for infection, or for at least 6 weeks for disease. The pre-emptive approach is not indicated in seronegative HSCT recipients, after autologous transplantation, or in non-transplant haematology patients, but PCR should be performed with a high level of clinical suspicion.
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Affiliation(s)
- Robina Aerts
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium; Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Varun Mehra
- Department of Haematological Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Rodrigo Martino
- Servei d'Hematologia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Katrien Lagrou
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Christine Robin
- Department of Haematology, Assistance Publique des Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France
| | - Katia Perruccio
- Pediatric Oncology Hematology, Mother and Child Health Department, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Nicole Blijlevens
- Department of Haematology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Marcio Nucci
- Department of Internal Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Monica Slavin
- Department of Infectious Diseases and Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Stéphane Bretagne
- Université Paris Cité, and Parasitology and Mycology laboratory, Assistance Publique des Hôpitaux de Paris, Saint Louis Hospital, Paris, France
| | - Catherine Cordonnier
- Department of Haematology, Assistance Publique des Hôpitaux de Paris, Henri Mondor Hospital, Créteil, France; University Paris-Est-Créteil, Créteil, France.
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Robin C, Poiroux L, Delaunay J, Seuwou P, Martin L, Démoulins E. Tele-expertise assessment of chronic wounds by advanced practice dermatology nurses. Ann Dermatol Venereol 2024; 151:103273. [PMID: 38678771 DOI: 10.1016/j.annder.2024.103273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/04/2023] [Accepted: 03/07/2024] [Indexed: 05/01/2024]
Affiliation(s)
- C Robin
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France.
| | - L Poiroux
- Direction de la recherche clinique et de l'innovation, CHU d'Angers, 49933 Angers, France
| | - J Delaunay
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
| | - P Seuwou
- University of Northampton, Northampton, United Kingdom
| | - L Martin
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
| | - E Démoulins
- Service de Dermatologie, CHU d'Angers, 49933 Angers, France
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4
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Averbuch D, Tridello G, Wendel L, Itälä-Remes M, Oren I, Karas M, Blijlevens N, Beguin Y, Broers A, Calore E, Cattaneo C, Isaksson C, Robin C, Gadisseur A, Maertens J, De Becker A, Lueck C, Metafuni E, Pichler H, Popova M, Ram R, Yeshurun M, Mikulska M, Camara RDL, Styczynski J. Listeria monocytogenes Infections in Hematopoietic Cell Transplantation Recipients: Clinical Manifestations and Risk Factors. A Multinational Retrospective Case-Control Study from the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. Transplant Cell Ther 2024:S2666-6367(24)00346-4. [PMID: 38621480 DOI: 10.1016/j.jtct.2024.04.008] [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: 12/02/2023] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
Listeriosis is rare after hematopoietic stem cell transplantation (HCT). Little is known about listeriosis in this population. In this retrospective international case-control study, we evaluated 41 listeriosis episodes occurring between 2000 and 2021 in HCT recipients (111 transplant centers in 30 countries) and assessed risk factors for listeriosis by comparisons with matched controls. The 41 listeriosis episodes (all due to Listeria monocytogenes [LM]) occurred in 30 allogeneic (allo)-HCT recipients and 11 autologous (auto)-HCT recipients at a median of 6.2 months (interquartile range [IQR], 1.6 to 19.3 months) post-HCT. The estimated incidence was 49.8/100,000 allo-HCT recipients and 13.7/100,000 auto-HCT recipients. The most common manifestations in our cohort were fever (n = 39; 95%), headache (n = 9; 22%), diarrhea, and impaired consciousness (n = 8 each; 20%). Four patients (10%) presented with septic shock, and 19 of 38 (50%) were severely lymphocytopenic. Thirty-seven patients (90%) had LM bacteremia. Eleven patients (27%) had neurolisteriosis, of whom 4 presented with nonspecific signs and 5 had normal brain imaging findings. Cerebrospinal fluid analysis revealed high protein and pleocytosis (mainly neutrophilic). Three-month mortality was 17% overall (n = 7), including 27% (n = 3 of 11) in patients with neurolisteriosis and 13% (n = 4 of 30) in those without neurolisteriosis. In the multivariate analysis comparing cases with 74 controls, non-first HCT (odds ratio [OR], 5.84; 95% confidence interval [CI], 1.10 to 30.82; P = .038); and lymphocytopenia <500 cells/mm3 (OR, 7.54; 95% CI, 1.50 to 37.83; P = .014) were significantly associated with listeriosis. There were no statistically significant differences in background characteristics, immunosuppression, and cotrimoxazole prophylaxis between cases and controls. HCT recipients are at increased risk for listeriosis compared to the general population. Listeriosis cause severe disease with septic shock and mortality. Neurolisteriosis can present with nonspecific signs and normal imaging. Lymphocytopenia and non-first HCT are associated with an increased risk of listeriosis, and cotrimoxazole was not protective.
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Affiliation(s)
- Dina Averbuch
- Pediatric Infectious Diseases, Faculty of Medicine, Hebrew University of Jerusalem, Hadassah Medical Center, Jerusalem, Israel.
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation, Leiden Study Unit, Leiden, The Netherlands
| | - Lotus Wendel
- European Society for Blood and Marrow Transplantation, Leiden Study Unit, Leiden, The Netherlands
| | - Maija Itälä-Remes
- Department of Clinical Haematology and Stem Cell Transplant Unit, Turku University Hospital, Turku, Finland
| | - Ilana Oren
- Department of Clinical Haematology and Stem Cell Transplant Unit, Turku University Hospital, Turku, Finland; Infectious Diseases Unit, Rambam Medical Center, Haifa, Israel
| | - Michal Karas
- Allogeneic Stem Cell Transplant Unit, Hematology and Oncology Department, Charles University Hospital, Pilsen, Czech Republic
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Yves Beguin
- Department of Hematology, CHU of Liège and University of Liège, Liège, Belgium
| | - Annoek Broers
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Elisabetta Calore
- Pediatric Hematology-Oncology and Stem Cell Transplant Division, University Hospital of Padova, Italy
| | | | | | - Christine Robin
- Department of Hematology, APHP Henri Mondor Teaching Hospital, Créteil, France
| | - Alain Gadisseur
- Department of Hematology, Stem Cell Transplantation & Coagulation Disorders, Antwerp University Hospital, Edegem, Belgium
| | - Johan Maertens
- Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium
| | - Ann De Becker
- Department of Hematology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Catherina Lueck
- Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Elisabetta Metafuni
- Department of Diagnostic Imaging, Radiation Oncology, and Hematology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Rome, Italy
| | - Herbert Pichler
- Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Marina Popova
- Bone Marrow Transplantation, RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Ron Ram
- Bone Marrow Transplantation Unit, Hematology Department, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Moshe Yeshurun
- Institution of Hematology, Rabin Medical Center, Beilinson Hospital, Petach-Tikva, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genova (DISSAL) and Ospedale Policlinico San Martino, Genova, Italy
| | | | - Jan Styczynski
- Department of Paediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Caillot L, Leclerc M, Sleiman EJR, Sloma I, Wagner-Ballon O, Claudel A, Beckerich F, Redjoul R, Robin C, Parinet V, Pautas C, Menouche D, Bouledroua S, Cabanne L, Nait-Sidenas Y, Gautier E, Rouard H, Lafon I, Chalandon Y, Boissel N, Caillot D, Maury S. Long-term outcome after autologous BCR::ABL1-negative peripheral blood stem cell transplantation in adults with Philadelphia-positive acute lymphoblastic leukemia: a comparative study. Haematologica 2024; 109:1264-1268. [PMID: 38031800 PMCID: PMC10985448 DOI: 10.3324/haematol.2023.283742] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Abstract
Not available.
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Affiliation(s)
- Leo Caillot
- Hematology Department, CHU Francois Mitterrand, Dijon
| | - Mathieu Leclerc
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | | | - Ivan Sloma
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Orianne Wagner-Ballon
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Alexis Claudel
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Florence Beckerich
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Rabah Redjoul
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Christine Robin
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Vincent Parinet
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Cecile Pautas
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Dehbia Menouche
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Selwa Bouledroua
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Ludovic Cabanne
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Yakout Nait-Sidenas
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010
| | - Eric Gautier
- Etablissement Francais du Sang, Ile de France, UPEC University, Creteil, F-94010
| | - Helene Rouard
- Etablissement Francais du Sang, Ile de France, UPEC University, Creteil, F-94010
| | - Ingrid Lafon
- Hematology Department, CHU Francois Mitterrand, Dijon
| | - Yves Chalandon
- Division of Hematology, Department of Medical Specialties, University Hospital and University of Geneva, Geneva, Switzerland
| | - Nicolas Boissel
- AP-HP, Paris Cite University, Unite d'Hematologie Adolescents et Jeunes Adultes, Hopital Saint Louis, Paris
| | - Denis Caillot
- Hematology Department, CHU Francois Mitterrand, Dijon
| | - Sebastien Maury
- AP-HP, UPEC University, Henri Mondor Hospital, Hematology Department, Creteil, F-94010.
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Robin C, Cordonnier C, Tridello G, Knelange N, Xhaard A, Chantepie S, Tanguy-Schmidt A, Schouten HC, Yeshurun M, Rocha V, Srour M, Kröger N, Ledoux MP, Dalgaard J, Thiebaut A, Giardino S, Calore E, Zuckerman T, Groll AH, Raida L, Avcin S, Vicent MG, Kaare A, Drozd-Sokolowska J, Turlure P, Bretagne S, Mikulska M, Camara RDL, Cesaro S, Styczynski J. Pneumocystis Pneumonia After Allogeneic Hematopoietic Cell Transplantation: A Case-Control Study on Epidemiology and Risk Factors on Behalf of the Infectious Diseases Working Party of the European Society for Blood and Marrow Transplantation. Transplant Cell Ther 2024; 30:235.e1-235.e10. [PMID: 38007092 DOI: 10.1016/j.jtct.2023.11.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/07/2023] [Accepted: 11/16/2023] [Indexed: 11/27/2023]
Abstract
Pneumocystis pneumonia (PCP) is a life-threatening complication after allogeneic hematopoietic cell transplantation (allo-HCT). However, allo-HCT procedures have evolved toward older patients, unrelated donors, and reduced-intensity conditioning, possibly modifying the risks. Polymerase chain reaction (PCR), widely used nowadays, is more sensitive than microscopy diagnostic methods. This study aimed to assess the factors associated with PCP in allo-HCT recipients within 2 years of HCT and managed according to current procedures. This multicenter, nested case-control study included PCP cases diagnosed by PCR, cytology, or immunofluorescence on bronchoalveolar lavage fluid between 2016 and 2018. Two controls per case were selected from the ProMISe registry and matched for the center, transplant date, and underlying disease. Fifty-two cases and 104 controls were included among the 5452 patients who underwent allo-HCT in the participating centers. PCP occurred at a median of 11.5 months after transplantation. The mortality rate was 24% on day 30 after the PCP diagnosis and 37% on day 90. The clinical presentation and mortality rates of the 24 patients diagnosed using only PCR were not different from those diagnosed with microscopy methods. Our study demonstrates a substantial incidence of, and mortality from, PCP, after allogeneic HCT despite well-established prophylactic approaches. In our experience, PCP nowadays occurs later after transplant than previously reported, justifying the prolongation of prophylaxis after six months in many cases. Allo-HCT recipients diagnosed with PCR as the only PCP marker should benefit from specific treatment as for other patients.
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Affiliation(s)
- Christine Robin
- Department of Haematology, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Créteil, France.
| | - Catherine Cordonnier
- Department of Haematology, Henri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Créteil, France
| | - Gloria Tridello
- Department of Mother and Child, Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | | | - Alienor Xhaard
- Haematology Transplant Unit, APHP, Saint-Louis Hospital, Paris, France
| | - Sylvain Chantepie
- Basse-Normandie Haematology Institute, Caen University Hospital, Caen, France
| | - Aline Tanguy-Schmidt
- Blood Diseases Department, France Federation University Hospital "Grand Ouest against Leukemia", Angers France; CRCI2NA, Angers, France
| | | | - Moshe Yeshurun
- Institute of Hematology, Rabin Medical Center, Petach Tikva, Israel
| | - Vanderson Rocha
- Hematology Bone Marrow Transplant Unit, Hospital Sirio-Libanes, Sao Paulo, Brazil
| | - Micha Srour
- Department of Haematology, Lille University Hospital, Lille, France
| | - Nicolaus Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - Marie-Pierre Ledoux
- Department of Haematology, Cancer Institute of Strasburg, Strasbourg, France
| | - Jakob Dalgaard
- Department of Haematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Anne Thiebaut
- Department of Haematology, Grenoble Alpes University Hospital, Grenoble, France
| | - Stefano Giardino
- Haematopoietic Stem Cell Transplantation Unit IRCCS Istituto Giannina Gaslini, Pediatric Haematology and Oncology, Genova, Italy
| | - Elisabetta Calore
- Clinica di Oncoematologia Pediatrica, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Tsila Zuckerman
- Department of Haematology and Bone Marrow Transplantation, Rambam Medical Center, Haifa, Israel
| | - Andreas H Groll
- Center for Bone Marrow Transplantation and Department of Pediatric Haematology/Oncology, University Children's Hospital, Infectious Disease Research Program, Munster, Germany
| | - Ludek Raida
- Department of Haemato-Oncology, Olomouc University Hospital, Olomouc, Czech Republic
| | | | | | - Ain Kaare
- Clinic of Haematology and Oncology, Tartu University Hospital, Tartu, Estonia
| | - Joanna Drozd-Sokolowska
- Department of Haematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Pascal Turlure
- Department of Haematology, Limoges University Hospital, Limoges, France
| | | | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genova (DISSAL), Genova, Italy; IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Rafael de la Camara
- Department of Haematology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Simone Cesaro
- Department of Mother and Child, Pediatric Haematology Oncology, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Jan Styczynski
- Pediatric Haematology and Oncology, University Hospital, Collegium Medicum UMK, Bydgoszcz, Poland
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Leroyer EH, Petitpain N, Morisset S, Neven B, Castelle M, Winter S, Souchet L, Morel V, Le Cann M, Fahd M, Yacouben K, Mechinaud F, Ouachée-Chardin M, Renard C, Wallet HL, Angoso M, Jubert C, Chevallier P, Léger A, Rialland F, Dhedin N, Robin C, Maury S, Beckerich F, Beauvais D, Cluzeau T, Loschi M, Fernster A, Bittencourt MDC, Cravat M, Bilger K, Clément L, Decot V, Gauthier M, Legendre A, Larghero J, Ouedrani A, Martin-Blondel G, Pochon C, Reppel L, Rouard H, Nguyen-Quoc S, Dalle JH, D'Aveni M, Bensoussan D. On behalf of the SFGM-TC: Real-life use of third-party virus-specific T-cell transfer in immunocompromised transplanted patients. Hemasphere 2024; 8:e40. [PMID: 38434523 PMCID: PMC10878191 DOI: 10.1002/hem3.40] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/14/2023] [Indexed: 03/05/2024] Open
Affiliation(s)
| | - Nadine Petitpain
- Regional Centre of Pharmacovigilance Nancy University Hospital Vandoeuvre-les-Nancy France
| | | | - Bénédicte Neven
- Assistance Publique des Hôpitaux de Paris, Department of Pediatric Immuno-hematology Necker Children Hospital Paris France
| | - Martin Castelle
- Assistance Publique des Hôpitaux de Paris, Department of Pediatric Immuno-hematology Necker Children Hospital Paris France
| | - Sarah Winter
- Assistance Publique des Hôpitaux de Paris, Department of Pediatric Immuno-hematology Necker Children Hospital Paris France
| | - Laetitia Souchet
- Assistance Publique des Hôpitaux de Paris, Department of Hematology La Pitié-Salpêtrière Hospital Paris France
| | - Véronique Morel
- Assistance Publique des Hôpitaux de Paris, Department of Hematology La Pitié-Salpêtrière Hospital Paris France
| | - Marie Le Cann
- Assistance Publique des Hôpitaux de Paris, Department of Hematology La Pitié-Salpêtrière Hospital Paris France
| | - Mony Fahd
- Department of Pediatric Hematology and Immunology, Robert Debré Academic Hospital GHU APHP Nord Université Paris Cité Paris France
| | - Karima Yacouben
- Department of Pediatric Hematology and Immunology, Robert Debré Academic Hospital GHU APHP Nord Université Paris Cité Paris France
| | - Françoise Mechinaud
- Department of Pediatric Hematology and Immunology, Robert Debré Academic Hospital GHU APHP Nord Université Paris Cité Paris France
| | - Marie Ouachée-Chardin
- Institute of Pediatric Hematology and Oncology (IHOPe) Hospices Civils de Lyon and Claude Bernard University Lyon France
| | - Cécile Renard
- Institute of Pediatric Hematology and Oncology (IHOPe) Hospices Civils de Lyon and Claude Bernard University Lyon France
| | - Hélène Labussière Wallet
- Institute of Pediatric Hematology and Oncology (IHOPe) Hospices Civils de Lyon and Claude Bernard University Lyon France
| | - Marie Angoso
- Department of Pediatric Hematology Oncology University Hospital of Bordeaux Bordeaux France
| | - Charlotte Jubert
- Department of Pediatric Hematology Oncology University Hospital of Bordeaux Bordeaux France
| | | | - Alexandra Léger
- Department of Pediatric Hematology, Hôpital Mère-Enfant Nantes University Hospital Nantes France
| | - Fanny Rialland
- Department of Pediatric Hematology, Hôpital Mère-Enfant Nantes University Hospital Nantes France
| | - Nathalie Dhedin
- Assistance Publique des Hôpitaux de Paris, Department of Hematology Saint-Louis Hospital Paris France
| | - Christine Robin
- Assistance Publique des Hôpitaux de Paris, Department of Hematology Henri Mondor Hospital and Université Créteil France
| | - Sébastien Maury
- Assistance Publique des Hôpitaux de Paris, Department of Hematology Henri Mondor Hospital and Université Créteil France
| | - Florence Beckerich
- Assistance Publique des Hôpitaux de Paris, Department of Hematology Henri Mondor Hospital and Université Créteil France
| | - David Beauvais
- Department of Hematology, Allogeneic Stem Cell Transplantation Unit Lille University Hospital Lille France
| | - Thomas Cluzeau
- Department of Hematology, Université Cote d'Azur Nice University Hospital Nice France
| | - Michaël Loschi
- Department of Hematology, Université Cote d'Azur Nice University Hospital Nice France
| | - Alina Fernster
- Hôpital Universitaire des Enfants de la Reine Fabiola, Department of Pediatric Hematology Brussels University Hospital Brussels Belgium
| | | | - Maxime Cravat
- Cytometry Platform Nancy University Hospital Vandoeuvre-les-Nancy France
| | - Karin Bilger
- INCANS Department of Hematology Strasbourg France
| | - Laurence Clément
- Department of Hematology Bordeaux University Hospital Bordeaux France
| | - Véronique Decot
- Cell Therapy Unit Nancy University Hospital Vandoeuvre-les-Nancy France
| | - Mélanie Gauthier
- Cell Therapy Unit Nancy University Hospital Vandoeuvre-les-Nancy France
| | | | - Jérôme Larghero
- Assistance Publique des Hôpitaux de Paris, Cell Therapy Unit, INSERM CICBT 501 Saint-Louis Hospital Paris France
| | - Amani Ouedrani
- Assistance Publique des Hôpitaux de Paris, Department of Immunology and Histocompatibily Saint-Louis Hospital Paris France
| | - Guillaume Martin-Blondel
- Department of Infectious and Tropical Diseases, and Toulouse Institute for Infectious and Inflammatory Diseases, INSERM UMR1291-CNRS UMR5051-Université Toulouse III Toulouse University Hospital Toulouse France
| | - Cécile Pochon
- Department of Pediatric Hematology Nancy University Hospital Vandoeuvre-les-Nancy France
- CNRS Unit UMR 7365 IMoPA Lorraine University Vandoeuvre-les-Nancy France
| | - Loïc Reppel
- Cell Therapy Unit Nancy University Hospital Vandoeuvre-les-Nancy France
- CNRS Unit UMR 7365 IMoPA Lorraine University Vandoeuvre-les-Nancy France
| | | | - Stéphanie Nguyen-Quoc
- Assistance Publique des Hôpitaux de Paris, Department of Hematology La Pitié-Salpêtrière Hospital Paris France
| | - Jean-Hugues Dalle
- Department of Pediatric Hematology and Immunology, Robert Debré Academic Hospital GHU APHP Nord Université Paris Cité Paris France
| | - Maud D'Aveni
- Department of Hematology Nancy University Hospital Vandoeuvre-les-Nancy France
- CNRS Unit UMR 7365 IMoPA Lorraine University Vandoeuvre-les-Nancy France
| | - Danièle Bensoussan
- Cell Therapy Unit Nancy University Hospital Vandoeuvre-les-Nancy France
- CNRS Unit UMR 7365 IMoPA Lorraine University Vandoeuvre-les-Nancy France
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Coste A, Conrad A, Porcher R, Poirée S, Peterlin P, Defrance C, Letscher-Bru V, Morio F, Gastinne T, Bougnoux ME, Suarez F, Nevez G, Dupont D, Ader F, Halfon-Domenech C, Ducastelle-Leprêtre S, Botterel F, Millon L, Guillerm G, Ansart S, Boutoille D, Ledoux MP, Herbrecht JE, Robin C, Melica G, Danion F, Blanchard E, Paccoud O, Garcia-Hermoso D, Lortholary O, Herbrecht R, Lanternier F. Improving Diagnosis of Pulmonary Mucormycosis: Leads From a Contemporary National Study of 114 Cases. Chest 2023; 164:1097-1107. [PMID: 37419276 DOI: 10.1016/j.chest.2023.06.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/24/2023] [Revised: 06/04/2023] [Accepted: 06/29/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Pulmonary mucormycosis (PM) is a life-threatening invasive mold infection. Diagnosis of mucormycosis is challenging and often delayed, resulting in higher mortality. RESEARCH QUESTION Are the disease presentation of PM and contribution of diagnosis tools influenced by the patient's underlying condition? STUDY DESIGN AND METHODS All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed. Cases were defined according to updated European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria with the addition of diabetes and trauma as host factors and positive serum or tissue PCR as mycologic evidence. Thoracic CT scans were reviewed centrally. RESULTS A total of 114 cases of PM were recorded, including 40% with disseminated forms. Main underlying conditions were hematologic malignancy (49%), allogeneic hematopoietic stem cell transplantation (21%), and solid organ transplantation (17%). When disseminated, main dissemination sites were the liver (48%), spleen (48%), brain (44%), and kidneys (37%). Radiologic presentation included consolidation (58%), pleural effusion (52%), reversed halo sign (26%), halo sign (24%), vascular abnormalities (26%), and cavity (23%). Serum quantitative polymerase chain reaction (qPCR) was positive in 42 (79%) of 53 patients and BAL in 46 (50%) of 96 patients. Results of transthoracic lung biopsy were diagnostic in 8 (73%) of 11 patients with noncontributive BAL. Overall 90-day mortality was 59%. Patients with neutropenia more frequently displayed an angioinvasive presentation, including reversed halo sign and disseminated disease (P < .05). Serum qPCR was more contributive in patients with neutropenia (91% vs 62%; P = .02), and BAL was more contributive in patients without neutropenia (69% vs 41%; P = .02). Serum qPCR was more frequently positive in patients with a > 3 cm main lesion (91% vs 62%; P = .02). Overall, positive qPCR was associated with an early diagnosis (P = .03) and treatment onset (P = .01). INTERPRETATION Neutropenia and radiologic findings influence disease presentation and contribution of diagnostic tools during PM. Serum qPCR is more contributive in patients with neutropenia and BAL examination in patients without neutropenia. Results of lung biopsies are highly contributive in cases of noncontributive BAL.
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Affiliation(s)
- Anne Coste
- Infectious Diseases Department, La Cavale Blanche Hospital, Brest University Hospital, Brest, France; UMR 1101, Laboratoire de Traitement de l'Information Médicale, Université de Bretagne Occidentale, Brest, France
| | - Anne Conrad
- Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon 1, CNRS, UMR 5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | - Raphaël Porcher
- Centre d'Epidémiologie Clinique, Hôtel-Dieu Hospital, AP-HP, Paris, France
| | - Sylvain Poirée
- Radiology Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Pierre Peterlin
- Clinical Hematology Department, Nantes University Hospital, Nantes, France
| | - Claire Defrance
- Radiology Department, Nantes University Hospital, Nantes, France
| | - Valérie Letscher-Bru
- Parasitology and Medical Mycology Laboratory, Strasbourg University Hospital, Strasbourg, France; Institut de Parasitologie et Pathologie Tropicale, UR 7292, Strasbourg University, Strasbourg, France
| | - Florent Morio
- Parasitology and Mycology Laboratory, Nantes University Hospital, Nantes, France; UR 1155 IICiMed, Nantes University, Nantes, France
| | - Thomas Gastinne
- Clinical Hematology Department, Nantes University Hospital, Nantes, France
| | - Marie-Elisabeth Bougnoux
- Mycology and Parasitology Laboratory, Necker-Enfants Malades Hospital, AP-HP, Paris, France; Unité Biologie et Pathogénicité Fongiques, Institut Pasteur, Paris, France
| | - Felipe Suarez
- Hematology Department, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Gilles Nevez
- Mycology and Parasitology Department, La Cavale Blanche University Hospital, Brest, France
| | - Damien Dupont
- Medical Mycology and Parasitology Department, Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Florence Ader
- Infectious Diseases Department, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, Université Claude Bernard Lyon 1, CNRS, UMR 5308, Ecole Normale Supérieure de Lyon, Univ Lyon, Lyon, France
| | | | | | - Françoise Botterel
- Mycology and Parasitology Unit, Henri Mondor University Hospital, AP-HP, Créteil, France; EA DYNAMYC 1380, Université Paris-Est Créteil, Créteil, France
| | - Laurence Millon
- Mycology and Parasitology Laboratory, Besançon University Hospital, Besançon, France; UMR 6249, CNRS Chrono-Environnement, Université de Bourgonne Franche-Comté, Besançon, France
| | - Gaelle Guillerm
- Hematology Department, Morvan Hospital, Brest University Hospital, Brest, France
| | - Séverine Ansart
- Infectious Diseases Department, La Cavale Blanche Hospital, Brest University Hospital, Brest, France; UMR 1101, Laboratoire de Traitement de l'Information Médicale, Université de Bretagne Occidentale, Brest, France
| | - David Boutoille
- Infectious Diseases Department, Nantes University Hospital, Nantes, France; Centre d'Investigation Clinique, INSERM 1413, Nantes University Hospital, Nantes, France
| | - Marie-Pierre Ledoux
- Hematology Department, European Strasbourg Cancer Institute, Strasbourg, France
| | | | - Christine Robin
- Hematology Department, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Giovanna Melica
- Infectious Diseases Department, Henri Mondor Hospital, AP-HP, Créteil, France
| | - François Danion
- Infectious Diseases Department, Strasbourg University Hospital, Strasbourg, France; UMR_S 1109, INSERM, ImmunoRhumatologie Moléculaire, Strasbourg University, Strasbourg, France
| | - Elodie Blanchard
- Pneumology Department, Bordeaux University Hospital, Bordeaux, France
| | - Olivier Paccoud
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
| | - Olivier Lortholary
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
| | - Raoul Herbrecht
- Hematology Department, European Strasbourg Cancer Institute, Strasbourg, France
| | - Fanny Lanternier
- Infectious Diseases Department, Necker-Enfants Malades Hospital, Paris-Cité University, AP-HP, Paris, France; Institut Pasteur, Université Paris Cité, National Reference Center for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France.
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Findlater L, Robin C, Hopgood K, Waite T. Help-seeking following a flooding event: a cross-sectional analysis of adults affected by flooding in England in winter 2013/14. Eur J Public Health 2023; 33:834-840. [PMID: 37328436 PMCID: PMC10567239 DOI: 10.1093/eurpub/ckad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Flooding can cause long-term, significant impacts on mental health in affected populations. We explored help-seeking behaviour of households affected by flooding. METHODS A cross-sectional analysis was conducted on National Study of Flooding and Health data on households flooded in England in winter 2013/14. Participants (Year 1: n = 2006; Year 2: n = 988; Year 3: n = 819) were asked if they sought help from health services and other sources. Logistic regression was conducted to calculate odds ratios (ORs) of help-seeking in flooded and disrupted participants compared to unaffected, adjusted for a priori confounders. RESULTS The odds of seeking help from any source 1 year after flooding were greater for flooded participants [adjusted OR (aOR): 1.71, 95% confidence interval (CI): 1.19-1.45] and those disrupted by flooding (aOR: 1.92, 95% CI: 1.37-2.68) compared to unaffected participants. This continued in the second year (flooded: aOR 6.24, 95% CI: 3.18-13.34; disrupted: aOR: 2.22, 95% CI: 1.14-4.68), and help-seeking remained greater in flooded than unaffected participants in the third year. Flooded and disrupted participants were particularly likely to seek help from informal sources. Help-seeking was more prevalent amongst participants with mental health outcomes, but a notable proportion of individuals with any mental health outcome did not seek help (Year 1: 15.0%; Year 2: 33.3%; Year 3: 40.3%). CONCLUSIONS Flooding is associated with increased demand for formal and informal support, persisting for at least 3 years, and an unmet need for help amongst affected individuals. Our findings should be considered in flood response planning to reduce the long-term adverse health impacts of flooding.
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Affiliation(s)
- L Findlater
- UK Health Security Agency, Bristol, UK
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) on Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
| | - C Robin
- UK Health Security Agency, Bristol, UK
- National Institute of Health Research (NIHR) Health Protection Research Unit (HPRU) on Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
| | - K Hopgood
- UK Health Security Agency, Bristol, UK
| | - T Waite
- Department of Health and Social Care, UK
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Malard F, Loschi M, Huynh A, Cluzeau T, Guenounou S, Legrand F, Magro L, Orvain C, Charbonnier A, Panz-Klapuch M, Desmier D, Mear JB, Cornillon J, Robin C, Daguindau E, Bilger K, Vehreschild MJ, Chevallier P, Labussière-Wallet H, Mediavilla C, Couturier MA, Bulabois CE, Camus V, Chantepie S, Ceballos P, Gaugler B, Holler E, Doré J, Prestat E, Gasc C, Plantamura E, Mohty M. Pooled allogeneic faecal microbiota MaaT013 for steroid-resistant gastrointestinal acute graft-versus-host disease: a single-arm, multicentre phase 2 trial. EClinicalMedicine 2023; 62:102111. [PMID: 37654670 PMCID: PMC10466244 DOI: 10.1016/j.eclinm.2023.102111] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 09/02/2023] Open
Abstract
Background Failure of gastrointestinal acute graft-versus-host disease (GI-aGvHD) to respond to steroid therapy is associated with limited further therapeutic options. We aimed to assess the safety and efficacy of the first-in-human use of the pooled allogeneic faecal microbiota, MaaT013, for the treatment of steroid-refractory GI-aGvHD. Methods This prospective, international, single-arm, phase 2a study reports clinical outcomes from a 24-patient cohort with grade III-IV, steroid refractory GI-aGvHD treated with the pooled allogeneic faecal microbiota MaaT013. MaaT013 involved pooling faecal matter from 3 to 8 screened donors then transplanting the pooled batches into patients to treat GI-aGVHD. The 24 patients were treated in the HERACLES study (Aug 2018 to Nov 2020) at 26 sites in Europe and an additional 52 patients were treated in a compassionate use/expanded access program (EAP) in France (July 2018 to April 2021). The primary endpoint was GI response at day 28, defined as the proportion of patients with GI-aGvHD who had a complete response (CR) or very good partial response (VGPR). GvHD grading and staging were assessed according to the revised Glucksberg criteria. Adverse events and severe adverse events were monitored for 6 months and 12 months, respectively. The HERACLES study was registered with ClinicalTrials.gov (NCT03359980). Findings Compared with single donors, MaaT013 is characterised by higher microbial richness and reduced variability across batches. At day 28 (D28), the GI-overall response rate (ORR) was 38% in the prospective population, including 5 complete responses (CR), 2 very good partial responses (VGPR) and 2 partial responses (PR). In the EAP, the GI-ORR was 58% (17 CR, 9 VGPR and 4 PR). The 12-month overall survival (OS) was 25% in the prospective study and 38% in the EAP. Regarding safety, five infectious complications, including 3 sepsis, could not be excluded from being related to the study procedure in HERACLES. Shotgun sequencing analyses of the identified strains suggest that none were found in MaaT013. In the EAP, 18 pharmacovigilance cases were reported among 52 treated patients, including 11 bacteraemia/sepsis. In HERACLES, we observed in stools from responding patients at D28 a higher microbiota richness and increased levels of beneficial bacteria, in particular butyrate producers, along with increased levels of short-chain fatty acid and bile acids. In contrast, stools from non-responding (NR) patients displayed increased levels of pathogenic pro-inflammatory bacteria along with increased systemic inflammatory parameters. Interpretation Overall, MaaT013 was safe in this population of highly immunocompromised patients and was associated with responses in some patients with GI-aGvHD and deserves further investigation. Funding MaaT Pharma.
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Affiliation(s)
- Florent Malard
- Sorbonne Université, AP-HP, Centre de Recherche Saint-Antoine INSERM UMRs938, Service D'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Michael Loschi
- Haematology Department, CHU of Nice, Cote D'Azur University, France
| | - Anne Huynh
- Service Hématologie, CHU/IUCT-Oncopole, Toulouse Cédex 31059, France
| | - Thomas Cluzeau
- Haematology Department, CHU of Nice, Cote D'Azur University, France
| | - Sarah Guenounou
- Service Hématologie, CHU/IUCT-Oncopole, Toulouse Cédex 31059, France
| | - Faezeh Legrand
- Haematology Department, Institut Paoli Calmettes, Marseille, France
| | - Leonardo Magro
- Unité d'Allogreffe, Maladies du sang, CHRU, Lille 59000, France
| | | | | | - Marta Panz-Klapuch
- Department of Haematology and Bone Marrow Transplantation, School of Medicine in Katowice, Medical University of Silesia, Dąbrowski Street, 25, Katowice 40-032, Poland
| | - Deborah Desmier
- CHU de Poitiers, Service d’Hématologie et de Thérapie Cellulaire, Poitiers, France
| | | | - Jérôme Cornillon
- Département d’Hématologie Clinique et de Thérapie Cellulaire, CHU de St-Etienne, Saint-Etienne, France
| | - Christine Robin
- Hôpital Henri Mondor, Service d’Hématologie Clinique et de Thérapie Cellulaire, Créteil, France
| | | | - Karin Bilger
- Hôpital de Hautepierre, Pôle Oncologie-Hématologie, Strasbourg, France
| | | | | | | | | | | | | | - Vincent Camus
- Department of Haematology and INSERM U1245, Centre Henri Becquerel, Rouen, France
| | - Sylvain Chantepie
- Institut d’Hématologie de Basse Normandie, CHU Caen Normandie, Caen, France
| | | | - Béatrice Gaugler
- Sorbonne Université, AP-HP, Centre de Recherche Saint-Antoine INSERM UMRs938, Service D'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France
| | - Ernst Holler
- Department of Internal Medicine III, University Medical Centre, Regensburg, Germany
| | - Joël Doré
- INRAE, MGP, Université Paris-Saclay, Jouy-en-Josas 78350, France
| | | | | | | | - Mohamad Mohty
- Sorbonne Université, AP-HP, Centre de Recherche Saint-Antoine INSERM UMRs938, Service D'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France
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Lucas D, Robin C, Vongmany N, Dewitte JD, Loddé B, Pougnet R, Larabi L. Main Causal Agents of Occupational Asthma in France, Reported to the National Network for Occupational Disease Vigilance and Prevention (RNV3P) 2001-2018. Ann Work Expo Health 2023; 67:297-302. [PMID: 36477519 DOI: 10.1093/annweh/wxac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 10/21/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The definition of work-related Asthma (WRA) has changed in recent years and new etiologies and agents have been identified. The aim of this study is to describe the main causal agents of WRA in France in the period 2001-2018 in the main work sectors. METHODS Data were collected from the French national network of occupational health surveillance and prevention [Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)], Data between 2001 and 2018 with at least a probable or certain association with one occupational agent, were included. RESULTS Work sectors with more cases OF WRA included personal service activities (10.6%), food industry (10.2%) and healthcare activities (7.6%). WRA cases were most frequently related to flour (10%), quaternary ammoniums compounds (5.3%), isocyanates (5.1%) and cleaning products (4.8%). CONCLUSION Occupational exposure to specific agents capable of causing WRA is still present, and four agents represent more than 25% of the cases. Actions to prevent respiratory exposure are still relevant.
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Affiliation(s)
- D Lucas
- Occupational Diseases Centre, CHRU Morvan, 2 Avenue Foch, 29609 Brest Cedex 2, France.,ORPHY Laboratory, 6 Av V Le Gorgeu 29238 Brest Cedex, Occidental Brittany University Brest, France
| | - C Robin
- Occupational Diseases Centre, CHRU Morvan, 2 Avenue Foch, 29609 Brest Cedex 2, France
| | - N Vongmany
- Direction des alertes et des vigilances sanitaires, National Agency for Security of Food, Environment and Work Agence Nationale de sécurité de l'alimentation, de l'environnement et du travail (ANSES), 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France
| | - J D Dewitte
- Occupational Diseases Centre, CHRU Morvan, 2 Avenue Foch, 29609 Brest Cedex 2, France.,Laboratory of Research on Sociology (EA 3149), Université de Bretagne Occidentale Brest, 22 Avenue Camille Desmoulins, 29238 Brest Cedex 3, France
| | - B Loddé
- Occupational Diseases Centre, CHRU Morvan, 2 Avenue Foch, 29609 Brest Cedex 2, France.,ORPHY Laboratory, 6 Av V Le Gorgeu 29238 Brest Cedex, Occidental Brittany University Brest, France
| | - R Pougnet
- Occupational Diseases Centre, CHRU Morvan, 2 Avenue Foch, 29609 Brest Cedex 2, France.,Laboratory of Research on Sociology (EA 3149), Université de Bretagne Occidentale Brest, 22 Avenue Camille Desmoulins, 29238 Brest Cedex 3, France
| | - L Larabi
- Direction des alertes et des vigilances sanitaires, National Agency for Security of Food, Environment and Work Agence Nationale de sécurité de l'alimentation, de l'environnement et du travail (ANSES), 14 rue Pierre et Marie Curie, 94700 Maisons-Alfort, France
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Maertens J, Lodewyck T, Donnelly JP, Chantepie S, Robin C, Blijlevens N, Turlure P, Selleslag D, Baron F, Aoun M, Heinz WJ, Bertz H, Ráčil Z, Vandercam B, Drgona L, Coiteux V, Llorente CC, Schaefer-Prokop C, Paesmans M, Ameye L, Meert L, Cheung KJ, Hepler DA, Loeffler J, Barnes R, Marchetti O, Verweij P, Lamoth F, Bochud PY, Schwarzinger M, Cordonnier C. Empiric vs Preemptive Antifungal Strategy in High-Risk Neutropenic Patients on Fluconazole Prophylaxis: A Randomized Trial of the European Organization for Research and Treatment of Cancer. Clin Infect Dis 2023; 76:674-682. [PMID: 35906831 PMCID: PMC9938744 DOI: 10.1093/cid/ciac623] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Empiric antifungal therapy is considered the standard of care for high-risk neutropenic patients with persistent fever. The impact of a preemptive, diagnostic-driven approach based on galactomannan screening and chest computed tomography scan on demand on survival and on the risk of invasive fungal disease (IFD) during the first weeks of high-risk neutropenia is unknown. METHODS Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) and allogeneic hematopoietic cell transplant recipients were randomly assigned to receive caspofungin empirically (arm A) or preemptively (arm B), while receiving fluconazole 400 mg daily prophylactically. The primary end point of this noninferiority study was overall survival (OS) 42 days after randomization. RESULTS Of 556 patients recruited, 549 were eligible: 275 in arm A and 274 in arm B. Eighty percent of the patients had AML or MDS requiring high-dose chemotherapy, and 93% of them were in the first induction phase. At day 42, the OS was not inferior in arm B (96.7%; 95% confidence interval [CI], 93.8%-98.3%) when compared with arm A (93.1%; 95% CI, 89.3%-95.5%). The rates of IFDs at day 84 were not significantly different, 7.7% (95% CI, 4.5%-10.8%) in arm B vs 6.6% (95% CI, 3.6%-9.5%) in arm A. The rate of patients who received caspofungin was significantly lower in arm B (27%) than in arm A (63%; P < .001). CONCLUSIONS The preemptive antifungal strategy was safe for high-risk neutropenic patients given fluconazole as prophylaxis, halving the number of patients receiving antifungals without excess mortality or IFDs. Clinical Trials Registration. NCT01288378; EudraCT 2010-020814-27.
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Affiliation(s)
- Johan Maertens
- Correspondence: J. Maertens, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium ()
| | - Tom Lodewyck
- Department of Hematology, Algemeen Ziekenhuis St Jan, Brugge, Belgium
| | - J Peter Donnelly
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Christine Robin
- Department of Hematology, Centre Hospitalier Universitaire Henri Mondor, Créteil, France
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Pascal Turlure
- Department of Hematology, Centre Hospitalier Universitaire Limoges, Limoges, France
| | - Dominik Selleslag
- Department of Hematology, Algemeen Ziekenhuis St Jan, Brugge, Belgium
| | - Frédéric Baron
- Department of Hematology, University of Liège and University Hospital of Liège, Liège, Belgium
| | - Mickael Aoun
- Department of Internal Medicine, Institut Jules Bordet, Brussels, Belgium
| | - Werner J Heinz
- Department of Hematology/Oncology, Caritas Hospital, Bad Mergentheim, Germany
| | - Hartmut Bertz
- Department of Hematology/Oncology, Faculty of Medicine and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Zdeněk Ráčil
- Department of Hematology, Masaryk University Brno and Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Bernard Vandercam
- Department of Internal Medicine/Infectious Diseases, Cliniques Universitaires St. Luc, Brussels, Belgium
| | - Lubos Drgona
- Department of Oncohematology, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Valerie Coiteux
- Service des maladies du sang, Centre Hospitalier Régional Universitaire Lille, Lille, France
| | | | | | - Marianne Paesmans
- Department of Internal Medicine, Institut Jules Bordet, Brussels, Belgium
| | - Lieveke Ameye
- Department of Internal Medicine, Institut Jules Bordet, Brussels, Belgium
| | - Liv Meert
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | - Kin Jip Cheung
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | | | - Jürgen Loeffler
- Department of Internal Medicine II, Universitaetsklinikum, Würzburg, Germany
| | - Rosemary Barnes
- Department of Infection, Immunity and Biochemistry, Cardiff University, Cardiff, United Kingdom
| | - Oscar Marchetti
- Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
- Department of Infectious Diseases, Ensemble Hospitalier de la Côte, Morges, Switzerland
| | - Paul Verweij
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Frederic Lamoth
- Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Pierre-Yves Bochud
- Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Michael Schwarzinger
- Translational Health Economics Network, Bordeaux University Hospital, Bordeaux, France
| | - Catherine Cordonnier
- Department of Hematology, Centre Hospitalier Universitaire Henri Mondor, Créteil, France
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Garot P, Brunel P, Dibie A, Morelle JF, Abdellaoui M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Copt S, Sadozai S, Olroyd K, Morice MC, Lipiecki J. 2 years outcomes in patients with or without ARC-HBR criteria undergoing PCI with polymer-free biolimus coated stents: The Biofreedom France Study. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.005] [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: 12/31/2022]
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14
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Ljungman P, Tridello G, Piñana JL, Ciceri F, Sengeloev H, Kulagin A, Mielke S, Yegin ZA, Collin M, Einardottir S, Lepretre SD, Maertens J, Campos A, Metafuni E, Pichler H, Folber F, Solano C, Nicholson E, Yüksel MK, Carlson K, Aguado B, Besley C, Byrne J, Heras I, Dignan F, Kröger N, Robin C, Khan A, Lenhoff S, Grassi A, Dobsinska V, Miranda N, Jimenez MJ, Yonal-Hindilerden I, Wilson K, Averbuch D, Cesaro S, Xhaard A, Knelange N, Styczynski J, Mikulska M, de la Camara R. Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry. Front Immunol 2023; 14:1125824. [PMID: 36960069 PMCID: PMC10028143 DOI: 10.3389/fimmu.2023.1125824] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 12/16/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction COVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. Methods This study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic. Results The median age was 50.3 years (min - max; 1.0 - 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min - max; 0.0 - 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 - 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 - 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022. Discussion Although the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.
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Affiliation(s)
- Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Per Ljungman,
| | - Gloria Tridello
- European Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, Netherlands
| | - Jose Luis Piñana
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
- Fundación Investigación del Hospital Clínico de la Comunidad Valenciana (INCLIVA), Instituto de Investigación Sanitaria Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Fabio Ciceri
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, University Vita-Salute San Raffaele, Milan, Italy
| | - Henrik Sengeloev
- Department of Hematology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Alexander Kulagin
- Raisa Memorial (RM) Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russia
| | - Stephan Mielke
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zeynep Arzu Yegin
- Department of Hematology, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Matthew Collin
- Translational and Clinical Research Institute and The National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre, Newcastle, United Kingdom
| | - Sigrun Einardottir
- Department of Hematology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Johan Maertens
- Department of Hematology University Hospital Gasthuisberg, Leuven, Belgium
| | - Antonio Campos
- Marrow Transplant Department Inst. Português de Oncologia do Porto, Porto, Portugal
| | - Elisabetta Metafuni
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica e Ematologia, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Herbert Pichler
- St. Anna Children’s Hospital, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Frantisek Folber
- Department of Internal Medicine, Hematology and Oncology University Hospital Brno, Brno, Czechia
- Department of Internal Medicine, Hematology and Oncology Masaryk University, Brno, Czechia
| | - Carlos Solano
- European Society for Blood and Marrow Transplantation (EBMT) Data Office, Department of Medical Statistics & Bioinformatics, Leiden, Netherlands
| | - Emma Nicholson
- Haematology-oncology Unit Royal Marsden Hospital, London, United Kingdom
| | - Meltem Kurt Yüksel
- Department of Hematology, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Kristina Carlson
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Beatriz Aguado
- Department of Hematology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Caroline Besley
- University Hospitals Bristol and Weston National Health Service (NHS) Foundation Trust, Bristol, United Kingdom
| | - Jenny Byrne
- Department of Haematology Nottingham University Hospital, Nottingham, United Kingdom
| | - Immaculada Heras
- Department of Hematology, Hospital Universitario Morales Meseguer, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, Universidad de Murcia, Murcia, Spain
| | - Fiona Dignan
- Clinical Haematology Department Manchester Royal Infirmary, Manchester, United Kingdom
| | - Nicolaus Kröger
- Department of Stem cell Transplantation, University Hospital Eppendorf, Hamburg, Germany
| | - Christine Robin
- Assistance Publique-Hôpitaux de Paris (APHP), Henri Mondor Hospital, Department of Hematology, Créteil, France
| | - Anjum Khan
- Department of Haematology Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Stig Lenhoff
- Department of Hematology Skåne’s University Hospital, Lund, Sweden
| | - Anna Grassi
- Bone Marrow Transplantation Unit, Azienda Sociosanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
| | - Veronika Dobsinska
- Department of Pediatric Hematology and Oncology, National Institute of Children’s Diseases, Comenius University, Bratislava, Slovakia
| | - Nuno Miranda
- Department of Haematology Inst. Portugues Oncologia, Lisbon, Portugal
| | - Maria-Jose Jimenez
- Department of Clinical Haematology Institut Catala d'Oncologia (ICO)-Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Ipek Yonal-Hindilerden
- Istanbul Medical Faculty, Adult Hematopoietic Stem Cell Transplant Center, Istanbul University, Istanbul, Türkiye
| | - Keith Wilson
- Blood and Bone Marrow Transplantation Department University of Cardiff, Cardiff, United Kingdom
| | - Dina Averbuch
- Pediatric Infectious Diseases Unit, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Simone Cesaro
- Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Alienor Xhaard
- Hematology-Transplantation Unit, Department of Hematology: Hôpital St. Louis, Paris, France
| | - Nina Knelange
- European Society for Blood and Marrow Transplantation (EBMT) Leiden Study Unit, European Society for Blood and Marrow Transplantation (EBMT) Data Office, Leiden, Netherlands
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - Rafael de la Camara
- Department of Hematology, Hospital Universitario de la Princesa, Madrid, Spain
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Bergeron A, Mikulska M, De Greef J, Bondeelle L, Franquet T, Herrmann JL, Lange C, Spriet I, Akova M, Donnelly JP, Maertens J, Maschmeyer G, Rovira M, Goletti D, de la Camara R, Maertens J, De Greef J, Slavin M, Spriet I, Hubacek P, Bergeron A, Cordonnier C, Kanerva J, Herbrecht R, Herrmann JL, Lanternier F, Bondeelle L, Robin C, Einsele H, Lehrnbecher T, Groll A, Maschmeyer G, Lange C, von Lilienfeld-Toal M, Pana D, Roilides E, Kassa C, Averbuch D, Engelhard D, Cesaro S, Mikulska M, Pagano L, Castagnola E, Compagno F, Goletti D, Mesini A, Donnelly PJ, Styczynski J, Botelho de Sousa A, Aljurf M, de la Camara R, Navarro D, Rovira M, Franquet T, Garcia-Vidal C, Ljungman P, Paukssen K, Ammann R, Lamoth F, Hirsch H, Ritz N, Akova M, Ceesay M, Warris A, Chemaly R. Mycobacterial infections in adults with haematological malignancies and haematopoietic stem cell transplants: guidelines from the 8th European Conference on Infections in Leukaemia. Lancet Infect Dis 2022; 22:e359-e369. [PMID: 35636446 DOI: 10.1016/s1473-3099(22)00227-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
Mycobacterial infections, both tuberculosis and nontuberculous, are more common in patients with haematological malignancies and haematopoietic stem cell transplant recipients than in the general population-although these infections remain rare. Mycobacterial infections pose both diagnostic and therapeutic challenges. The management of mycobacterial infections is particularly complicated for patients in haematology because of the many drug-drug interactions between antimycobacterial drugs and haematological and immunosuppressive treatments. The management of mycobacterial infections must also consider the effect of delaying haematological management. We surveyed the management practices for latent tuberculosis infection (LTBI) in haematology centres in Europe. We then conducted a meticulous review of the literature on the epidemiology, diagnosis, and management of LTBI, tuberculosis, and nontuberculous mycobacterial infections among patients in haematology, and we formulated clinical guidelines according to standardised European Conference on Infections in Leukaemia (ECIL) methods. In this Review, we summarise the available literature and the recommendations of ECIL 8 for managing mycobacterial infections in patients with haematological malignancies.
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Affiliation(s)
- Anne Bergeron
- Division of Pulmonology, Geneva University Hospitals, Geneva, Switzerland; University of Paris, ECSTRRA Team, Inserm, Paris, France.
| | - Malgorzata Mikulska
- Division of Infectious Diseases, Department of Health Sciences, University of Genoa, Genoa, Italy; San Martino Polyclinic Hospital, Genoa, Italy
| | - Julien De Greef
- Division of Internal Medicine and Infectious Diseases, Saint-Luc University Clinics, Catholic University of Louvain, Brussels, Belgium
| | - Louise Bondeelle
- Division of Pulmonology, Saint Louis Hospital, APHP, University of Paris, Paris, France
| | - Tomas Franquet
- Department of Radiology, Sant Pau Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Jean-Louis Herrmann
- Microbiology Department, Raymond Poincaré Hospital, GHU Paris-Saclay, Paris, France; Division of Infection and Inflammation, Paris-Saclay University, UVSQ, Inserm, Paris, France
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), TTU Tuberculosis, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany; Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Isabel Spriet
- Department of Pharmaceutical and Pharmacological Sciences, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Murat Akova
- Department of Medicine, Section of Infectious Diseases, Hacettepe University Medical School, Ankara, Turkey
| | | | - Johan Maertens
- Department of Haematology, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Georg Maschmeyer
- Department of Haematology, Oncology, and Palliative Care, Ernst von Bergmann Clinic, Potsdam, Germany
| | - Montserrat Rovira
- BMT Unit, Haematology Department, Hospital Clinic, IDIBAPS and Josep Carreras Foundation, Barcelona, Spain
| | - Delia Goletti
- Translational Research Unit, Department of Epidemiology and Preclinical Research, Lazzaro Spallanzani National Institute for Infectious Diseases, Rome, Italy
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Coste A, Conrad A, Porcher R, Poirée S, Peterlin P, Defrance C, Letscher-Bru V, Morio F, Gastinne T, Bougnoux ME, Suarez F, Nevez G, Dupont D, Ader F, Halfon-Domenech C, Ducastelle-Duprêtre S, Botterel F, Millon L, Guillerm G, Ansart S, Boutoille D, Ledoux MP, Robin C, Herbrecht JE, Melica G, Danion F, Paccoud O, Lortholary O, Herbrecht R, Lanternier F. P397 Influence of underlying conditions on disease presentation and diagnostic strategy during pulmonary mucormycosis: Anational study of 114 cases. Med Mycol 2022. [PMCID: PMC9509859 DOI: 10.1093/mmy/myac072.p397] [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] [Indexed: 11/13/2022] Open
Abstract
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Pulmonary mucormycosis (PM) is a life-threatening invasive fungal infection mostly affecting immunocompromised patients. We aimed to study the influence of underlying conditions on disease presentation and diagnostic strategy during PM. Methods All PM cases from six French teaching hospitals between 2008 and 2019 were retrospectively reviewed. Cases were defined according to EORTC/MSG 2019 criteria with the addition of diabetes and traumatism as host factors and positive serum or tissue PCR as mycological evidence. Thoracic CT scans were reviewed centrally. Results Among 114 cases of PM, 52 (46%) were proven and 62 (54%) were probable, including 12 cases with a positive serum qPCR as the sole mycological criterion. Hematological malignancy was the most common risk factor (49%), followed by allogeneic hematopoietic stem-cell transplantation (21%), and solid organ transplantation (SOT, 17%). Fever was the first symptom for 66% patients and was more frequent in patients with neutropenia than in those without (97% vs 52%, P <.01). A total of 46 (40%) patients had a disseminated infection, which was more frequently reported in neutropenic patients (50% vs 25%, P <.01). Main dissemination sites were the liver (48%), spleen (48%), brain (44%), and kidneys (37%). Sinusitis was present in 13% of cases. Chest radiological presentation included consolidation (58%), pleural effusion (52%), reversed halo sign (26%), halo sign (24%), vascular abnormalities (26%), and excavation (23%). The excavation was more frequently reported in SOT patients (64%, P <.01) compared with other groups. Vascular involvement was associated with reversed halo sign and Rhizomucor infection. Neutropenic patients presented more frequently than non-neutropenic patients with ground-glass opacities (75 vs 49%, P = .01), halo sign (32% vs 10%, P = .02), and reversed halo sign (35 vs 10%, P <.01). A total of 83 (73%) patients had a positive fungal culture from any type of respiratory sample. Serum qPCR was positive for 42/53 patients (79%) and respiratory fluid qPCR for 16/21 (76%) patients. In neutropenic patients, BAL culture was less often positive (30% vs 66%, P <.01), and serum qPCR was more frequently positive (91% vs 62%, P = .02). A transthoracic lung biopsy was contributive in 8/11 (73%) patients with negative bronchoalveolar lavage (BAL). Serum qPCR was more frequently positive in patients with the main lesion of >3 cm in diameter (91% vs 62%, P = .02). Rhizomucor spp. Was identified in 31 patients (32%), Rhizopus spp. In 29 patients (30%), Lichtheimia spp. In 24 patients (25%), Mucor spp. In 10 patients (10%) and Cunninghamella spp. In 4 patients (4%). Neutropenic patients were more frequently infected with Rhizomucor (43% vs 13%, P <.01) and less frequently with Rhizopus (17% vs 50%, P <.01). Histopathological specimens were available for 48 patients (42%) and revealed Mucorales hyphae in 85% of cases. Patients with a disseminated infection and neutropenia presented more often with angioinvasion than patients with localized disease (50% vs 9%, P <.01 and 38% vs 13%, P = .10). Overall, 90-day mortality was 59%. Conclusion Underlying conditions significantly influenced clinical and radiological presentation and diagnostic tools’ contribution. Neutropenic patients present more frequently with dissemination, fever, reversed halo sign, pathological angioinvasion, the negativity of BAL culture, the positivity of serum qPCR, and Rhizomucor infection.
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Affiliation(s)
- Anne Coste
- Brest University Hospital , Brest , France
| | | | | | | | | | | | | | - Florent Morio
- Strasbourg University Hospital , Strasbourg , France
| | | | | | - Felipe Suarez
- Assistante Public - Hôpitaux de Paris , Paris , France
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Fourati S, Robin C, Rodriguez C, Leclerc M, Beckerich F, Pawlotsky J, Redjoul R, Maury S. Breakthrough Covid‐19 infections in vaccinated recipients of allogeneic stem cell transplantation. eJHaem 2022; 3:980-982. [PMID: 35941883 PMCID: PMC9349499 DOI: 10.1002/jha2.512] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Slim Fourati
- Virology Department Assistance Publique‐Hôpitaux de Paris (AP‐HP) Henri Mondor Hospital Créteil France
- INSERM U955 Paris Est Créteil University UPEC Créteil France
| | - Christine Robin
- Hematology Department AP‐HP Fédération Hospitalo‐Universitaire TRUE InnovaTive theRapy for immUne disordErs Henri Mondor Hospital Créteil France
| | - Christophe Rodriguez
- Virology Department Assistance Publique‐Hôpitaux de Paris (AP‐HP) Henri Mondor Hospital Créteil France
- INSERM U955 Paris Est Créteil University UPEC Créteil France
| | - Mathieu Leclerc
- INSERM U955 Paris Est Créteil University UPEC Créteil France
- Hematology Department AP‐HP Fédération Hospitalo‐Universitaire TRUE InnovaTive theRapy for immUne disordErs Henri Mondor Hospital Créteil France
| | - Florence Beckerich
- Hematology Department AP‐HP Fédération Hospitalo‐Universitaire TRUE InnovaTive theRapy for immUne disordErs Henri Mondor Hospital Créteil France
| | - Jean‐Michel Pawlotsky
- Virology Department Assistance Publique‐Hôpitaux de Paris (AP‐HP) Henri Mondor Hospital Créteil France
- INSERM U955 Paris Est Créteil University UPEC Créteil France
| | - Rabah Redjoul
- Hematology Department AP‐HP Fédération Hospitalo‐Universitaire TRUE InnovaTive theRapy for immUne disordErs Henri Mondor Hospital Créteil France
| | - Sébastien Maury
- INSERM U955 Paris Est Créteil University UPEC Créteil France
- Hematology Department AP‐HP Fédération Hospitalo‐Universitaire TRUE InnovaTive theRapy for immUne disordErs Henri Mondor Hospital Créteil France
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Robin C, Redjoul R, Terrade A, Deghmane AE, Cabanne L, Cordonnier C, Taha MK. Immunogenicity and safety of the meningococcal B recombinant (4CMenB) vaccine in allogeneic hematopoietic cell transplantation recipients. Clin Microbiol Infect 2022; 28:1609-1614. [PMID: 35803542 DOI: 10.1016/j.cmi.2022.06.024] [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: 03/21/2022] [Revised: 06/16/2022] [Accepted: 06/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Despite a high risk of invasive meningococcal (Men) disease, there is no published data on any MenB vaccine after hematopoietic cell transplantation (HCT). We investigated the immunogenicity and safety of the 4CMenB recombinant vaccine (Bexsero®) in adult HCT recipients. METHODS Patients were eligible from 6 months post-HCT to receive 2 4CMenB doses at 2 months interval. Sera were collected at baseline, 1 month after the second dose, and 12 months after enrollment. The serum bactericidal activity (SBA) using human complement (hSBA) was assessed against fHbp, NadA, PorAP1.4 and NHBA antigens. The vaccine response was defined by one criteria for one vaccine antigen: (1) In patients with a hSBA titer < 4 at baseline: a titer > 4; (2) In patients with a hSBA titer > 4 at baseline: at least a x4 increase. RESULTS 40 patients were included at a median of 2.14 (0.57-13.03) years post-transplant. At baseline, most patients (32/40 80%) had hSBA titers < 4 for all vaccine antigens. After 2 vaccine doses, the proportion of patients with a titer > 4 was significantly increased for fHbp (23/40 57.5%), NadA (25/40 62.5%), and PorA (31/40 77.5%) but not for NHBA for which only 6/40 (15%) patients responded. 36/40 (90%) patients were responders to > 1 antigen. However, 9 months later, only 23/37 (62.2%) patients were still seroprotected. No severe adverse event was observed. CONCLUSION The response rate of 90% for >1 vaccine antigen and our safety data supports the 4CMenB vaccination of HCT recipients from 6 months after transplant with 2 doses. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov, NCT03509051.
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Affiliation(s)
- Christine Robin
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France; University Paris-Est-Créteil, Créteil, France.
| | - Rabah Redjoul
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Aude Terrade
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
| | - Ala-Eddine Deghmane
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
| | - Ludovic Cabanne
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Catherine Cordonnier
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France; University Paris-Est-Créteil, Créteil, France.
| | - Muhamed-Kheir Taha
- Institut Pasteur, Invasive bacterial infections Unit and National reference center for meningococci and Haemophilus influenzae, 28, rue du Dr Roux, Paris, France
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Robin C, Broner J, Holubar J, Bergeret B, Roger P, Arnaud E, Goulabchand R. Efficacité du Belimumab sur une atteinte cutanée sévère de connectivite mixte. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.038] [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]
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Robin C, Vongmany N, Dewitte JD, Lodde B, Larabi L, Lucas D. Asthmes en relation avec le travail chez la femme : comparaison aux données masculines. Étude rétrospective des données issues du Réseau national de vigilance et de prévention des pathologies professionnelles (RNV3P). ARCH MAL PROF ENVIRO 2022. [DOI: 10.1016/j.admp.2022.01.013] [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: 11/26/2022]
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Bienvenu AL, Pavese P, Leboucher G, Berger P, Roux S, Charmillon A, Foroni L, Menotti J, Lebeaux D, Mayan R, Mondain V, Robin C, Lesprit P, Alfandari S, Kernéis S. Practical checklist for implementation of antifungal stewardship programmes. J Med Microbiol 2022; 71. [PMID: 35771615 DOI: 10.1099/jmm.0.001560] [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] [Indexed: 11/18/2022] Open
Abstract
Introduction. Antifungal stewardship programmes are needed in healthcare facilities to limit the overuse or misuse of antifungals, which are responsible for an increase in antifungal resistance.Hypothesis/Gap Statement. Core recommendations for antifungal stewardship were published by the Mycoses Study Group Education and Research Consortium, while the Centers for Disease Control and Prevention (CDC) provided a Core Elements of Hospital Antibiotic Stewardship Programs checklist. The recommendations offer global core elements for best practices in antifungal stewardship, but do not provide a framework for the implementation of antifungal stewardship programmes in healthcare facilities.Aim. In line with the recommendations, it is of the utmost importance to establish a practical checklist that may be used to implement antifungal stewardship programmes.Methodology. The practical checklist was established by a national consensus panel of experts involved in antifungal stewardship activities. A preliminary checklist was sent to all experts. The final document was approved by the panel after discussion and the resolution of any disagreements by consensus.Results. The final checklist includes the following items: leadership support; actions to support optimal antifungal use; actions to monitor antifungal prescribing, use and resistance; and an education programme.Conclusion. This antifungal stewardship checklist offers opportunities for antifungal resistance containment, given that antifungal stewardship activities promote the optimal use of antifungals.
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Affiliation(s)
- Anne-Lise Bienvenu
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France.,Univ Lyon, Malaria Research Unit, SMITh, ICBMS UMR 5246, Lyon, France
| | - Patricia Pavese
- Service des Maladies Infectieuses, CHU de Grenoble, Grenoble, France
| | - Gilles Leboucher
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Pierre Berger
- Infectiologie, Institut Paoli Calmettes, Marseille, France
| | - Sandrine Roux
- Service des Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Lyon
| | | | - Luc Foroni
- Omédit, ARS Auvergne-Rhône-Alpes, Lyon, France
| | - Jean Menotti
- Service de Mycologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - David Lebeaux
- Maladies Infectieuses et Tropicales, Hôpital Européen Georges-Pompidou, Paris, France
| | - Rémi Mayan
- Infectiologie, Ramsay Sante, Clinique Belharra, Bayonne, France
| | | | - Christine Robin
- Service d'hématologie clinique et de thérapie cellulaire, APHP, Hôpital Henri Mondor, Créteil, France
| | - Philippe Lesprit
- Service des Maladies Infectieuses, CHU de Grenoble, Grenoble, France
| | - Serge Alfandari
- Service de Réanimation et Maladies Infectieuses, CH Dron, Tourcoing, France
| | - Solen Kernéis
- Equipe de Prévention du Risque Infectieux, Hôpital Bichat, Paris, France
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Leclerc M, Redjoul R, Le Bouter A, Beckerich F, Robin C, Parinet V, Pautas C, Menouche D, Bouledroua S, Roy L, Cabanne L, Nait-Sidenas Y, Harfouch E, Gautier E, Fourati S, Maury S. Impact of donor vaccination on recipient response to early SARS-CoV-2 mRNA vaccination after allogeneic HSCT. The Lancet Haematology 2022; 9:e318-e321. [PMID: 35378072 PMCID: PMC8975260 DOI: 10.1016/s2352-3026(22)00097-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Mathieu Leclerc
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France; INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Rabah Redjoul
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Anne Le Bouter
- Virology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Florence Beckerich
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Christine Robin
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Vincent Parinet
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Cécile Pautas
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France; INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Dehbia Menouche
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Selwa Bouledroua
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Lydia Roy
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France; INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Ludovic Cabanne
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Yakout Nait-Sidenas
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France
| | - Elham Harfouch
- Etablissement Français du Sang, Ile de France, Créteil, France
| | - Eric Gautier
- Etablissement Français du Sang, Ile de France, Créteil, France
| | - Slim Fourati
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France; Virology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Sébastien Maury
- Haematology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Fédération Hospitalo-Universitaire TRUE innovative therapy for immune disorders, Henri Mondor Hospital, Creteil 94000, France; INSERM U955, Paris Est Créteil University UPEC, Créteil, France.
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23
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Leclerc M, Redjoul R, Le Bouter A, Beckerich F, Robin C, Parinet V, Pautas C, Menouche D, Bouledroua S, Roy L, Cabanne L, Nait-Sidenas Y, Fourati S, Maury S. Determinants of SARS-CoV-2 waning immunity in allogeneic hematopoietic stem cell transplant recipients. J Hematol Oncol 2022; 15:27. [PMID: 35303906 PMCID: PMC8931584 DOI: 10.1186/s13045-022-01250-2] [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: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 01/12/2023] Open
Abstract
Hematopoietic stem cell transplant (HSCT) recipients are at high-risk for severe COVID-19 and have altered immune responses to vaccination. We sought to evaluate the dynamics of immune response to BNT162b2 mRNA vaccine in HSCT recipients. We systematically proposed vaccination with BNT162b2 to HSCT recipients and gave a third vaccine dose to those showing titers of IgG(S-RBD) below 4160 AU/mL 1 month following the second dose. We then quantified anti-SARS-CoV-2 antibodies dynamics in 133 of these HSCT recipients (88 after two and 45 after three vaccine doses) 6 months after the first vaccine dose. Mean IgG(S-RBD) titer at 6 months was significantly lower than the peak value measured 1 month after a second (p < 0.001) or third (p < 0.01) vaccine dose. IgG(S-RBD) titers at 6 months were strongly correlated to peak values (p < 0.001) and a peak titer above 10,370 AU/mL predicted persistent protection at 6 months. Seventy-two percent (96/133) of patients retained protective antibody levels at 6 months. Immunosuppressive drugs and low lymphocyte counts in peripheral blood correlated with lower IgG(S-RBD) titers at 6 months. Four patients (3%) developed PCR-documented SARS-CoV-2 infection and one died.
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Affiliation(s)
- Mathieu Leclerc
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Rabah Redjoul
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Anne Le Bouter
- Virology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Florence Beckerich
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Christine Robin
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Vincent Parinet
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Cécile Pautas
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Dehbia Menouche
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Selwa Bouledroua
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Lydia Roy
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France
| | - Ludovic Cabanne
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Yakout Nait-Sidenas
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Slim Fourati
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France
- Virology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Sébastien Maury
- Hematology Department, Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErsHenri Mondor Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), 51 avenue du Mal de Lattre de Tassigny, 94010, Créteil Cedex, France.
- INSERM U955, Paris Est Créteil University UPEC, Créteil, France.
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Beauvais D, Robin C, Thiebaut A, Alain S, Coiteux V, Ducastelle-Lepretre S, Marçais A, Ceballos P, Xhaard A, Redjoul R, Nguyen S, Brissot E, Joris M, Turlure P, Rubio MT, Chevallier P, Bénard N, Liautard C, Yakoub-Agha I. Effective Letermovir Prophylaxis of CMV infection post allogeneic hematopoietic cell transplantation: Results from the French temporary authorization of use compassionate program. J Clin Virol 2022; 148:105106. [PMID: 35182958 DOI: 10.1016/j.jcv.2022.105106] [Citation(s) in RCA: 6] [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: 12/05/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
We report the results of the French Temporary Authorization of Use (ATU) compassionate program of letermovir for primary prophylaxis conducted in 21 transplant centers. Patients were CMV seropositive allogeneic hematopoietic cell transplantation recipients and at high risk for CMV infection. Primary prophylaxis was defined as initiation of letermovir between day 0 and day +28 post-transplant. Between November 2017 and January 2019, 96 patients with a median age of 56 years received letermovir and follow-up data were available for 78 patients. The median time from transplant to letermovir initiation was 4 days, and the median duration of exposure to letermovir was 78 days, with 57 patients still on treatment at the cutoff date. Letermovir was temporarily discontinued in 4 patients (5.1%) and stopped in 39 patients (50.0%), in most cases due to planned end of treatment (n = 16, 20.5%). Fifteen patients (19.2%) each presented one positive CMV PCR, in median 13 days after letermovir initiation. Clinically significant CMV infection was reported in 5 patients (6.4%). No CMV disease was reported. At least one adverse drug reaction was reported for 12 patients (15.4%). In this early access program, letermovir was effective with comparable results of the phase 3 study with a low rate of clinically significant CMV infection, including in patients who were at high-risk for CMV infection.
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Affiliation(s)
- David Beauvais
- Univ Lille, CHU Lille, Hematology Department, Inserm, Infinite U1286, Lille, France.
| | - Christine Robin
- University Paris-Est-Créteil, Hematology Department, Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Anne Thiebaut
- Hematology Department, CHU Grenoble, Grenoble, France
| | - Sophie Alain
- INSERM, CHU Limoges, RESINFIT, U1092, National Reference Center for Herpesviruses, Limoges University, Limoges, France
| | - Valérie Coiteux
- Univ Lille, CHU Lille, Hematology Department, Inserm, Infinite U1286, Lille, France
| | | | - Ambroise Marçais
- Department of adult hematology, Assistance Publique-Hôpitaux de Paris, university hospital Necker, Paris, France
| | - Patrice Ceballos
- Hematology Department, Saint-Eloi University Hospital, Montpellier, France
| | - Alienor Xhaard
- Hematology and transplantation unit, Saint Louis Hospital, APHP, Paris, France
| | - Rabah Redjoul
- University Paris-Est-Créteil, Hematology Department, Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Créteil, France
| | - Stéphanie Nguyen
- Department of Hematology, AP-HP, Hôpital Pitié-Salpétrière, Sorbonne Université, Paris, France
| | - Eolia Brissot
- Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, Sorbonne Université, INSERM UMRs 938, Paris, France
| | - Magalie Joris
- Department of Haematology, Amiens University Medical Center, Amiens, France
| | - Pascal Turlure
- CHU Limoges, Univ. Limoges, Department of Hematology, Limoges, France
| | | | | | | | | | - Ibrahim Yakoub-Agha
- Univ Lille, CHU Lille, Hematology Department, Inserm, Infinite U1286, Lille, France
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Lipiecki J, Brunel P, Dibie A, Morelle J, Abdellauoi M, Levy R, Carrié D, Karsenty B, Robin C, Berland J, Maillard L, Pankert M, Depoli F, Delarche N, Boiffard E, Champagne S, Piot C, Morel O, Chapon P, Garot P. Biofreedom France registry: A prospective evaluation of clinical outcomes in real-world patients treated by coronary angioplasty with Biolimus A9 polymer-free Biofreedom stents. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.012] [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: 11/26/2022]
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Averbuch D, De Greef J, Duréault A, Wendel L, Tridello G, Lebeaux D, Mikulska M, Gil L, Knelange N, Zuckerman T, Roussel X, Robin C, Xhaard A, Aljurf M, Beguin Y, Le Bourgeois A, Botella-Garcia C, Khanna N, Van Praet J, Kröger N, Blijlevens N, Ducastelle Leprêtre S, Ho A, Roos-Weil D, Yeshurun M, Lortholary O, Fontanet A, de la Camara R, Coussement J, Maertens J, Styczynski J. Nocardia infections in hematopoietic cell transplant recipients: a multicenter international retrospective study of the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT). Clin Infect Dis 2021; 75:88-97. [PMID: 34596213 DOI: 10.1093/cid/ciab866] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/21/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nocardiosis is rare after hematopoietic cell transplantation (HCT). Little is known regarding its presentation, management, and outcome in this population. METHODS In this retrospective international study, we reviewed nocardiosis episodes in HCT recipients (01.01.2000-31.12.2018; 135 transplant centers; 33 countries) and described their clinical, microbiological, radiological, and outcome characteristics. RESULTS We identified 81 nocardiosis episodes in 74 allo- and 7 auto-HCT recipients. Nocardiosis occurred at a median of 8 (IQR 4-18) months post-HCT. The most frequently involved organs were lungs (70/81; 86%) and brain (30/81; 37%); 29 (36%) patients were afebrile; 46/81 (57%) had disseminated infections. The most common lung imaging findings were consolidations (33/68; 49%) or nodules (32/68; 47%); and brain imaging findings were multiple brain abscesses (19/30; 63%). 10/30 (33%) patients with brain involvement lacked neurological symptoms. 14/48 (29%) patients were bacteremic. N. farcinica was the most common among molecularly identified species (27%, 12/44). Highest susceptibility rates were reported to linezolid 45/45 (100%), amikacin 56/57 (98%), trimethoprim-sulfamethoxazole 57/63 (90%), and imipenem 49/57 (86%).One-year and last follow-up (IQR: 4-42.5 months) all-cause mortality were 40% (32/81) and 52% (42/81), respectively. In the multivariable analysis, underlying disease not in complete remission (HR 2.81, 95%CI 1.32-5.95), and prior bacterial infection (HR 3.42, 95%CI 1.62-7.22) were associated with higher one-year all-cause mortality. CONCLUSIONS Nocardiosis is a late post-HCT infection usually manifesting as a pulmonary disease with frequent dissemination, brain infection and bacteremia. Brain imaging should be performed in HCT recipients with nocardiosis regardless of neurological symptoms. Overall mortality is high.
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Affiliation(s)
- D Averbuch
- Pediatric Infectious Diseases Faculty of Medicine, Hebrew University of Jerusalem; Hadassah Medical Center, Jerusalem, Israel
| | - J De Greef
- Department of Internal Medicine and Infectious Diseases, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Duréault
- Centre d'Infectiologie Necker Pasteur, Hôpital Necker-Enfants Malades, APHP, Université Paris Descartes, Paris, France
| | - L Wendel
- EBMT Data Office, Leiden, Netherlands
| | - G Tridello
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - D Lebeaux
- Université de Paris, F-75006 Paris, France.,Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, Paris, France
| | - M Mikulska
- Division of Infectious Diseases, University of Genoa and Ospedale Policlinico San Martino, Genova, Italy
| | - L Gil
- University of Medical Sciences, Poznan, Poland
| | | | | | - X Roussel
- University hospital of Besançon, hematology department, Besançon, France
| | - C Robin
- Henri Mondor University Hospital, Creteil, France
| | - A Xhaard
- Hematology-transplantation, Hospital St-Louis, Paris Diderot University, Paris, France
| | - M Aljurf
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Y Beguin
- CHU of Liège and University of Liège, Liège, Belgium
| | | | | | - N Khanna
- Division of Infectious Diseases and Hospital Epidemiology. University and University Hospital of Basel, Basel, Switzerland
| | - J Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - N Kröger
- Department of Stem Cell Transplantation, University Medical Center, Hamburg, Germany
| | - N Blijlevens
- Radboud university medical center, Nijmegen, The Netherlands
| | | | - A Ho
- Singapore General Hospital, Singapore, Singapore
| | - D Roos-Weil
- Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - M Yeshurun
- Institution of Hematology, Rabin medical Center, Petah Tikva, Israel and Sacker School of Medicine, Tel Aviv University, Israel
| | - O Lortholary
- Paris University, Necker Pasteur Center for Infectious Diseases and Tropical Medicine, IHU Imagine, Necker Enfants malades University Hospital, Paris, France.,National Reference Center for Invasive Mycoses and Antifungals, Molecular Mycology Unit, CNRS UMR 2000, Institut Pasteur, Paris, France
| | - A Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Global Health Department, Paris, France.,PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
| | | | - J Coussement
- Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Australia.,National Centre for Infection in Cancer, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - J Maertens
- Department of Haematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
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Houist AL, Bondeelle L, Salmona M, LeGoff J, de Latour RP, Rivière F, Soler C, Houdouin V, Dalle JH, Robin C, Fourati S, Griscelli F, Coman T, Chevret S, Bergeron A. Evaluation of prognostic scores for respiratory syncytial virus infection in a French multicentre cohort of allogeneic haematopoietic stem cell transplantation recipients. Bone Marrow Transplant 2021; 56:3032-3041. [PMID: 34548625 PMCID: PMC8454013 DOI: 10.1038/s41409-021-01462-z] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/19/2021] [Accepted: 09/01/2021] [Indexed: 11/09/2022]
Abstract
Haematopoietic stem cell transplantation (HSCT) recipients are at risk for severe respiratory syncytial virus (RSV) infection. Two prognostic scores have been proposed to predict the risk of progression from upper respiratory tract infection (URTI) to lower respiratory tract infection (LRTI) and death. This was a multicentre study of allogeneic HSCT recipients diagnosed with an RSV infection between 2010 and 2019 who were retrospectively stratified by the immunodeficiency scoring index (ISI) and the severe immunodeficiency (SID) score. Endpoints were overall survival, RSV-attributable mortality and progression to LRTI after URTI. Prognostic analyses were performed using Cox regression models. We included 147 consecutive patients, including 94 (63.9%) initially diagnosed with URTI and 53 (36.1%) with LRTI. At 90 days, 14 patients had died (survival rate, 90.5%; 95% CI: 85.9-95.3), and nine deaths were attributable to RSV (attributable mortality rate, 5.4%; 95% CI: 2.5-10.0). The cumulative 90-day incidence of LRTI after URTI was 13.8% (95% CI: 7.8-21.6). Neither score showed prognostic value for mortality, while the ISI allowed the prediction of progression to LRTI (p = 0.0008). Our results do not fully replicate the results previously reported in cohorts of HSCT recipients. This may reflect the recent epidemiology of RSV infections in this HSCT cohort.
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Affiliation(s)
| | - Louise Bondeelle
- Université de Paris, Service de Pneumologie, Hôpital Saint-Louis, AP-HP -, Paris, France
| | - Maud Salmona
- Université de Paris, Service de Virologie, Hôpital Saint-Louis, AP-HP -, Paris, France
| | - Jérôme LeGoff
- Université de Paris, Service de Virologie, Hôpital Saint-Louis, AP-HP -, Paris, France
| | | | - Frédéric Rivière
- Service de Pneumologie, Hôpital d'instruction des armées Percy -, Clamart, France
| | - Charles Soler
- Service de Microbiologie, Hôpital d'instruction des armées Percy -, Clamart, France
| | - Véronique Houdouin
- Université de Paris, Service de Pneumologie-Pédiatrie, Hôpital Robert Debré, AP-HP -, Paris, France
| | - Jean-Hugues Dalle
- Université de Paris, Service d'Hématologie pédiatrique, Hôpital Robert Debré, AP-HP -, Paris, France
| | - Christine Robin
- Service d'Hématologie, Hôpital Henri Mondor, Université Paris-Est, AP-HP -, Créteil, France
| | - Slim Fourati
- Département de Bactériologie-Virologie, Hôpital Henri Mondor, Université Paris-Est, AP-HP -, Créteil, France
| | - Franck Griscelli
- Département de Biologie et de Pathologies médicales, Institut Gustave-Roussy -, Villejuif, France
| | - Tereza Coman
- Service d'Hématologie, Institut Gustave-Roussy -, Villejuif, France
| | - Sylvie Chevret
- Université de Paris, Département de Biostatistique et Informatique Médicale, Hôpital Saint Louis, AP-HP -, Paris, France.,Université de Paris, ECSTRRA Team, Inserm, UMR 1153 CRESS, F-75010, Paris, France
| | - Anne Bergeron
- Université de Paris, Service de Pneumologie, Hôpital Saint-Louis, AP-HP -, Paris, France. .,Université de Paris, ECSTRRA Team, Inserm, UMR 1153 CRESS, F-75010, Paris, France.
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28
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Decanter C, Delepine J, Behal H, Manier S, Bruno B, Barbatti M, Robin C, Labreuche J, Morschhauser F, Pigny P. Longitudinal study of AMH variations in 122 Adolescents and Young Adults (AYA) and non-AYA lymphoma patients to evaluate the chemo-induced ovarian toxicity to further personalise fertility preservation counselling. Hum Reprod 2021; 36:2743-2752. [PMID: 34417822 DOI: 10.1093/humrep/deab189] [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: 03/05/2021] [Revised: 07/02/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION What is the influence of age and chemotherapy regimen on the longitudinal blood anti-Müllerian hormone (AMH) variations in a large series of adolescents and young adult (AYA) (15-24 years old) and non-AYA (25-35 years old) lymphoma patients? SUMMARY ANSWER In case of alkylating regimen treatment, there was a deep and sustained follicular depletion in AYA as well as non-AYA patients; however in both groups, the ovarian toxicity was extremely low in cases of non-alkylating treatments. WHAT IS KNOWN ALREADY AMH is now well-recognised to be a real-time indicator of ovarian follicular depletion and recovery in women treated by chemotherapy. Its longitudinal variations may discriminate between highly and minimally toxic protocols regarding ovarian function. It has been shown, in different cancer types, that age, type of chemotherapy regimen and pre-treatment AMH levels are the main predictors of ovarian recovery. Large studies on longitudinal AMH variations under chemotherapy in lymphoma patients are few but can provide the opportunity to assess the degree of follicle loss at a young age. STUDY DESIGN, SIZE, DURATION This prospective cohort study was conducted in the Fertility Observatory of the Lille University Hospital. Data were collected between 2007 and 2016. Non-Hodgkin or Hodgkin lymphoma patients (n = 122) between 15 and 35 years old were prospectively recruited before commencing chemotherapy. Patients were treated either by a non-alkylating protocol (ABVD group; n = 67) or by an alkylating regimen (alkylating group; n = 55). PARTICIPANTS/MATERIALS, SETTING, METHODS Serial AMH measurements were performed at baseline (AMH0), 15 days after the start of chemotherapy (AMH1), 15 days before the last chemotherapy cycle (AMH2), and at time 3, 6, 9, 12, 18 and 24 months from the end of chemotherapy. The whole study population was divided into two groups according to age: AYA (15-24; n = 65) and non-AYA (25-35; n = 57). All patients received a once monthly GnRH agonist injection during the whole treatment period. A linear mixed model was used to account for the repeated measures of single patients. MAIN RESULTS AND THE ROLE OF CHANCE At baseline, non-AYA patients had higher BMI and lower AMH levels than AYA patients. All AYA and non-AYA patients having received ABVD protocols had regular cycles at 12 months of follow-up. In case of alkylating regimens, amenorrhoea was more frequent in non-AYA patients than in AYA patients at 12 months (37% vs 4%, P = 0.011) and at 24 months (24% vs 4%, P = 0.045). We distinguished a similar depletion phase from AMH0 to AMH2 between ABVD and alkylating groups but significantly different recovery phases from AMH2 to AMH + 24 months. AMH recovery was fast and complete in case of ABVD protocols whatever the age: AMH reached pre-treatment values as soon as the 6th month of follow-up in the AYA group (mean (95% CI) in log AMH M0 vs M6: 3.07 (2.86 to 3.27) vs 3.05 (2.78 to 3.31), P = 1.00) and in the non-AYA group (mean (95% CI) in log AMH M0 vs M6: 2.73 (2.40 to 3.05) vs 2.47 (2.21 to 2.74), P = 1.00). In contrast, no patients from the alkylating group returned to pre-treatment AMH values whatever the age of patients (AYA or non-AYA). Moreover, none of the AMH values post-chemotherapy in the non-AYA group were significantly different from AMH2. Conversely in the AYA group, AMH levels from 6 months (mean (95% CI) in log AMH: 1.79 (1.47 to 2.11), P < 0.001) to 24 months (mean (95% CI) in log AMH: 2.16 (1.80 to 2.52), P ≤ 0.001) were significantly higher than AMH2 (mean (95% CI) in log AMH: 1.13 (0.89 to 1.38)). Considering the whole study population (AYA and non-AYA), pre-treatment AMH levels influenced the pattern of the AMH variation both in alkylating and ABVD protocols (interaction P-value = 0.005 and 0.043, respectively). Likewise, age was significantly associated with the pattern of the recovery phase but only in the alkylating group (interaction P-value =0.001). BMI had no influence on the AMH recovery phase whatever the protocol (interaction P-value = 0.98 in alkylating group, 0.72 in ABVD group). LIMITATIONS, REASONS FOR CAUTION There was a large disparity in subtypes of protocols in the alkylating group. The average duration of chemotherapy for patients treated with alkylating protocols was longer than that for patients treated with ABVD. WIDER IMPLICATIONS OF THE FINDINGS These results make it possible to develop strategies for fertility preservation according to age and type of protocol in a large series of young lymphoma patients. In addition, it was confirmed that young age does not protect against ovarian damage caused by alkylating agents. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by Agence Régionale de Santé Hauts de France and Agence Onco Hauts-de-France who provided finances for AMH dosages (n° DOS/SDES/AR/FIR/2019/282). There are no competing interests. TRIAL REGISTRATION NUMBER DC-2008-642 and CNIL DEC2015-112.
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Affiliation(s)
- C Decanter
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.,EA 4308 Gamétogénèse et qualité du gamète, Lille University Hospital, Lille, France
| | - J Delepine
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France.,EA 4308 Gamétogénèse et qualité du gamète, Lille University Hospital, Lille, France
| | - H Behal
- Department of Biostatistics of the Lille University Hospital, ULR 2694-METRICS: Health Technologies Evaluation and Medical Practices, Lille, France
| | - S Manier
- Department of Hematology, Lille University Hospital, Lille, France
| | - B Bruno
- Department of Pediatric Hematology-Oncology Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - M Barbatti
- Department of Pediatric Hematology-Oncology Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - C Robin
- Academic ART and Fertility Preservation Centre, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France
| | - J Labreuche
- Department of Biostatistics of the Lille University Hospital, ULR 2694-METRICS: Health Technologies Evaluation and Medical Practices, Lille, France
| | - F Morschhauser
- Department of Hematology, Lille University Hospital, Lille, France
| | - P Pigny
- Department of Biochemistry and Hormonology, Metabolism, Nutrition and Oncology, Lille University Hospital, Lille, France
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Zhang T, Robin C, Cai S, Sawyer C, Rice W, Smith LE, Amlôt R, Rubin GJ, Reynolds R, Yardley L, Hickman M, Oliver I, Lambert H. Public health information on COVID-19 for international travellers: lessons learned from a mixed-method evaluation. Public Health 2021; 193:116-123. [PMID: 33780897 PMCID: PMC7874910 DOI: 10.1016/j.puhe.2021.01.028] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES In the containment phase of the response to the COVID-19 outbreak, Public Health England (PHE) delivered advice to travellers arriving at major UK ports. We aimed to rapidly evaluate the impact and effectiveness of these communication materials for passengers in the early stages of the pandemic. STUDY DESIGN The study design used is the mixed-methods evaluation. METHODS A questionnaire survey and follow-up interviews with passengers arriving at London Heathrow Airport on scheduled flights from China and Singapore. The survey assessed passengers' knowledge of symptoms, actions to take, and attitudes towards PHE COVID-19 public health information; interviews explored their views of official public health information and self-isolation. RESULTS One hundred and twenty-one passengers participated in the survey and 15 in follow-up interviews. Eighty three percentage of surveyed passengers correctly identified all three COVID-19 associated symptoms listed in PHE information at that time. Most could identify the recommended actions and found the advice understandable and trustworthy. Interviews revealed that passengers shared concerns about the lack of wider official action, and that passengers' knowledge had been acquired elsewhere as much from PHE. Respondents also noted their own agency in choosing to self-isolate, partially as a self-protective measure. CONCLUSION PHE COVID-19 public health information was perceived as clear and acceptable, but we found that passengers acquired knowledge from various sources and they saw the provision of information alone on arrival as an insufficient official response. Our study provides fresh insights into the importance of taking greater account of diverse information sources and of the need for public assurance in creating public health information materials to address global health threats.
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Affiliation(s)
- T Zhang
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - C Robin
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK; NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - S Cai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - C Sawyer
- UK Field Epidemiology Training Programme, Global Public Health Division, Public Health England, London, UK; Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - W Rice
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK
| | - L E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - R Amlôt
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK; Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, UK
| | - G J Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - R Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - L Yardley
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Sciences, University of Bristol, Bristol, UK; Department of Psychology, University of Southampton, Southampton, UK
| | - M Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - I Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - H Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK.
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30
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Debonnet C, Robin G, Prasivoravong J, Vuotto F, Catteau-Jonard S, Faure K, Dessein R, Robin C. [Update of Chlamydia trachomatis infection]. ACTA ACUST UNITED AC 2021; 49:608-616. [PMID: 33434747 DOI: 10.1016/j.gofs.2021.01.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Indexed: 12/25/2022]
Abstract
Chlamydia trachomatis (CT) is the most common sexually transmitted bacterial infection worldwide. It is asymptomatic in most cases and mainly affects young women, with potential long term sequelae (pelvic inflammatory disease, tubal infertility, obstetric complications). The impact on male fertility is controversial. Screening methods as well as antibiotics use have recently been reassessed due to resistance phenomena and the negative effect on the urogenital microbiota. Positive CT serology may be indicative of tuboperitoneal pathology, which may not be noticed on hysterosalpingography. New research on single-nucleotide polymorphisms (SNPs) aims to establish a patient profile at higher risk of infectious tubal damage due to CT. CT seropositivity is also associated with decreased spontaneous pregnancy rates and is a predictive factor for obstetrical complications.
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Affiliation(s)
- C Debonnet
- Service de médecine de la reproduction, université de Lille, CHU Lille, 59000 Lille, France.
| | - G Robin
- Service de médecine de la reproduction, université de Lille, CHU Lille, 59000 Lille, France; Service d'andrologie, université de Lille, CHU Lille, 59000 Lille, France
| | - J Prasivoravong
- Service d'andrologie, université de Lille, CHU Lille, 59000 Lille, France
| | - F Vuotto
- Service de maladies infectieuses, université de Lille, CHU Lille, 59000 Lille, France
| | - S Catteau-Jonard
- Service de médecine de la reproduction, université de Lille, CHU Lille, 59000 Lille, France
| | - K Faure
- Service de maladies infectieuses, université de Lille, CHU Lille, 59000 Lille, France
| | - R Dessein
- Institut de microbiologie et service de bactériologie, université de Lille, CHU Lille, 59000 Lille, France
| | - C Robin
- Service de médecine de la reproduction, université de Lille, CHU Lille, 59000 Lille, France
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Smith LE, Amlȏt R, Lambert H, Oliver I, Robin C, Yardley L, Rubin GJ. Factors associated with adherence to self-isolation and lockdown measures in the UK: a cross-sectional survey. Public Health 2020; 187:41-52. [PMID: 32898760 PMCID: PMC7474581 DOI: 10.1016/j.puhe.2020.07.024] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [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: 06/05/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To investigate factors associated with adherence to self-isolation and lockdown measures due to COVID-19 in the UK. STUDY DESIGN Online cross-sectional survey. METHODS Data were collected between 6th and 7th May 2020. A total of 2240 participants living in the UK aged 18 years or older were recruited from YouGov's online research panel. RESULTS A total of 217 people (9.7%) reported that they or someone in their household had symptoms of COVID-19 (cough or high temperature/fever) in the last 7 days. Of these people, 75.1% had left the home in the last 24 h (defined as non-adherent). Men were more likely to be non-adherent, as were people who were less worried about COVID-19, and who perceived a smaller risk of catching COVID-19. Adherence was associated with having received help from someone outside your household. Results should be taken with caution as there was no evidence for associations when controlling for multiple analyses. Of people reporting no symptoms in the household, 24.5% had gone out shopping for non-essentials in the last week (defined as non-adherent). Factors associated with non-adherence and with a higher total number of outings in the last week included decreased perceived effectiveness of government 'lockdown' measures, decreased perceived severity of COVID-19 and decreased estimates of how many other people were following lockdown rules. Having received help was associated with better adherence. CONCLUSIONS Adherence to self-isolation is poor. As we move into a new phase of contact tracing and self-isolation, it is essential that adherence is improved. Communications should aim to increase knowledge about actions to take when symptomatic or if you have been in contact with a possible COVID-19 case. They should also emphasise the risk of catching and spreading COVID-19 when out and about and the effectiveness of preventative measures. Using volunteer networks effectively to support people in isolation may promote adherence.
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Affiliation(s)
- L E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.
| | - R Amlȏt
- Public Health England, Behavioural Science Team, Emergency Response Department Science and Technology, UK
| | - H Lambert
- University of Bristol, Department of Population Health Sciences, Bristol Medical School, UK
| | - I Oliver
- Public Health England, Field Epidemiology, Field Service, National Infection Service, Bristol, UK
| | - C Robin
- Public Health England, Field Epidemiology, Field Service, National Infection Service, Liverpool, UK
| | - L Yardley
- University of Bristol, School of Psychological Sciences, UK
| | - G J Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
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Robin C, Thiebaut A, Alain S, Sicre de Fontbrune F, Berceanu A, D'Aveni M, Ceballos P, Redjoul R, Nguyen-Quoc S, Bénard N, Pahlavan-Grumel G, Cordonnier C. Letermovir for Secondary Prophylaxis of Cytomegalovirus Infection and Disease after Allogeneic Hematopoietic Cell Transplantation: Results from the French Compassionate Program. Biol Blood Marrow Transplant 2020; 26:978-984. [DOI: 10.1016/j.bbmt.2020.01.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 12/22/2022]
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Robin C, Mariaggi AA, Redjoul R, Leclerc M, Beckerich F, Cabanne L, Pautas C, Maury S, Rozenberg F, Cordonnier C. Long-Term Immunity to Measles after Allogeneic Hematopoietic Cell Transplantation: Factors Associated with Seroprotection before Revaccination. Biol Blood Marrow Transplant 2020; 26:985-991. [DOI: 10.1016/j.bbmt.2020.02.001] [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: 11/05/2019] [Revised: 01/26/2020] [Accepted: 02/03/2020] [Indexed: 10/25/2022]
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Robin C, Bahuaud M, Redjoul R, Jeljeli M, Leclerc M, Cabanne L, Beckerich F, Pautas C, Maury S, Cordonnier C. Antipneumococcal Seroprotection Years After Vaccination in Allogeneic Hematopoietic Cell Transplant Recipients. Clin Infect Dis 2019; 71:e301-e307. [DOI: 10.1093/cid/ciz1168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/28/2019] [Indexed: 12/11/2022] Open
Abstract
Abstract
Background
International guidelines recommend vaccinating allogeneic hematopoietic cell transplant (HCT) recipients at 3 months after transplant, giving 3 doses of pneumococcal conjugate vaccine (PCV) followed by either a dose of 23-valent pneumococcal polysaccharide vaccine (PSV23) or a fourth PCV dose in the case of graft-versus-host disease (GvHD). However, the long-term immunity after this regimen is unknown, and there is no recommendation from 24 months after transplant regarding boosts. Our objective was to assess the antipneumococcal antibody titers and seroprotection rates of allogeneic HCT recipients years after different schedules of vaccination.
Methods
We assessed 100 adult HCT recipients a median of 9.3 years (range: 1.7–40) after transplant. All patients had received at least one dose of PCV and were assessed for antipneumococcal immunoglobulin G (IgG) antibody titers against the 7 serotypes shared by PCV7, PCV13, and PSV23. Sixty-six percent of the patients had been vaccinated according to the current guidelines.
Results
Considering an IgG titer ≥ 0.35 µg/mL as protective for each serotype, the seroprotection rate was 50% for 7/7 serotypes and 70% for 5/7 serotypes, with no differences between the different vaccination schedules. The lack of seroprotection was associated with a transplant performed not in complete remission or from a cord-blood unit, a relapse after transplant, or chronic GvHD at assessment.
Conclusion
Because only half of the vaccinated patients had long-term protection, pending prospective studies defining the best boost program after the initial one, we recommend the assessment of specific IgG titers starting from 24 months to decide for further doses.
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Affiliation(s)
- Christine Robin
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
- University Paris-Est-Créteil, Créteil, France
| | - Mathilde Bahuaud
- APHP Cochin Hospital and University Paris-Descartes, Plateforme d’Immunomonitoring Vaccinal, Laboratoire d’Immunologie, Paris, France
| | - Rabah Redjoul
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Mohamed Jeljeli
- APHP, Cochin Hospital and University Paris-Descartes, Laboratoire d’Immunologie, Institut Cochin, Paris, France
| | - Mathieu Leclerc
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
- University Paris-Est-Créteil, Créteil, France
| | - Ludovic Cabanne
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Florence Beckerich
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Cécile Pautas
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
| | - Sébastien Maury
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
- University Paris-Est-Créteil, Créteil, France
| | - Catherine Cordonnier
- Assistance Publique-Hopitaux de Paris (AP-HP), Henri Mondor Hospital, Hematology Department, Creteil, France
- University Paris-Est-Créteil, Créteil, France
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Robin C, Leclerc M, Angebault C, Redjoul R, Beckerich F, Cabanne L, Foulet F, Pautas C, Toma A, Maury S, Botterel F, Cordonnier C. Toxoplasmosis as an Early Complication of Allogeneic Hematopoietic Cell Transplantation. Biol Blood Marrow Transplant 2019; 25:2510-2513. [DOI: 10.1016/j.bbmt.2019.07.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
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Schmidt-Hieber M, Engelhard D, Ullmann A, Ljungman P, Maertens J, Martino R, Rovira M, Shaw PJ, Robin C, Faraci M, Byrne J, Schäfer-Eckart K, Einsele H, Faber E, Rigacci L, Saccardi R, Balaguer-Rosello A, Isaksson C, Christopeit M, Tridello G, Wang J, Knelange N, Mikulska M, Cesaro S, Styczynski J. Central nervous system disorders after hematopoietic stem cell transplantation: a prospective study of the Infectious Diseases Working Party of EBMT. J Neurol 2019; 267:430-439. [PMID: 31664549 DOI: 10.1007/s00415-019-09578-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 09/28/2019] [Accepted: 10/10/2019] [Indexed: 12/18/2022]
Abstract
We performed a prospective study to evaluate the types and characteristics of central nervous system (CNS) disorders in patients after hematopoietic stem cell transplantation. The study included 163 episodes of CNS disorders of which 58 (36%) were infections. Proven or probable infections were documented in 34 patients and included fungi (n = 10, 29%), viruses (n = 12, 35%), Toxoplasma spp. (n = 9, 27%) and bacteria (n = 3, 9%). Non-infectious neurological disorders (n = 105, 64%) frequently encompassed metabolic/drug-induced abnormalities (n = 28, 27%) or cerebral vascular events (n = 22, 21%). Median onset times were later for infectious (day + 101) vs non-infectious neurological disorders (day + 50, p = 0.009). An unremarkable cranial CT scan was found in 33% of infection episodes. Absence of cerebrospinal fluid pleocytosis despite a normal or increased peripheral blood white blood cell count occurred in 26% of infections. Day-30 mortality rates were significantly higher for fungal (87%) vs non-fungal infections (40%, p < 0.001). Significantly higher mortality rates were also documented for cerebral vascular events than for other non-infectious disorders (86% vs 34%, p < 0.001). Our prospective study shows that diagnostic findings in CNS infections might differ between hematopoietic stem cell transplant recipients and immunocompetent hosts. Special awareness and timely initiation of adequate diagnostics are crucial to improve the prognosis of these patients.
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Affiliation(s)
- Martin Schmidt-Hieber
- Clinic for Hematology and Oncology, Carl-Thiem-Klinikum, Thiemstr. 111, 03048, Cottbus, Germany.
| | - Dan Engelhard
- Department of Pediatrics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Andrew Ullmann
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Per Ljungman
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium
| | - Rodrigo Martino
- Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Department of Hematology, Institute of Hematology and Oncology, IDIBAPS, Hospital Clinic, University of Barcelona, Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Peter J Shaw
- The Children's Hospital at Westmead, Sydney, Australia
| | - Christine Robin
- Assistance Publique-Hopitaux de Paris, Henri Mondor University Hospital, Hematology Department and UPEC, Créteil France Hôspital Henri Mondor, Créteil, France
| | - Maura Faraci
- Hematopoietic Stem Cell Unit Transplantation, IRCCS Instituto G. Gaslini, Genova, Italy
| | - Jenny Byrne
- Nottingham University Hospital, Nottingham, UK
| | - Kerstin Schäfer-Eckart
- Clinic for Hematology and Oncology, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Edgar Faber
- Department of Hemato-Oncology, Faculty Hospital Olomouc, Faculty of Medicine and Dentistry Palacky University, Olomouc, Czech Republic
| | | | | | | | | | - Maximilian Christopeit
- Department of Stem Cell Transplantation, University Medical Center Eppendorf, Hamburg, Germany
| | - Gloria Tridello
- Pediatric Hematology Oncology, Mother and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.,EBMT Data Office, Leiden, The Netherlands
| | | | | | - Malgorzata Mikulska
- Division of Infectious Diseases, University of Genova, DISSAL, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Simone Cesaro
- Pediatric Hematology Oncology, Mother and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum UMK, Bydgoszcz, Poland
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Ward KN, Hill JA, Hubacek P, de la Camara R, Crocchiolo R, Einsele H, Navarro D, Robin C, Cordonnier C, Ljungman P. Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation. Haematologica 2019; 104:2155-2163. [PMID: 31467131 PMCID: PMC6821622 DOI: 10.3324/haematol.2019.223073] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 08/27/2019] [Indexed: 01/15/2023] Open
Abstract
Of the two human herpesvirus 6 (HHV-6) species, human herpesvirus 6B (HHV-6B) encephalitis is an important cause of morbidity and mortality after allogeneic hematopoietic stem cell transplant. Guidelines for the management of HHV-6 infections in patients with hematologic malignancies or post-transplant were prepared a decade ago but there have been no other guidelines since then despite significant advances in the understanding of HHV-6 encephalitis, its therapy, and other aspects of HHV-6 disease in this patient population. Revised guidelines prepared at the 2017 European Conference on Infections in Leukaemia covering diagnosis, preventative strategies and management of HHV-6 disease are now presented.
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Affiliation(s)
- Katherine N Ward
- Division of Infection and Immunity, University College London, London, UK
| | - Joshua A Hill
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Petr Hubacek
- Department of Medical Microbiology and Department of Paediatric Haematology and Oncology 2 Medical Faculty of Charles University and Motol University Hospital, Prague, Czech Republic
| | | | | | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, Julius Maximilians Universität, Würzburg, Germany
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Instituto de Investigación INCLIVA and Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Christine Robin
- Department of Haematology, Henri Mondor Hospital, Assistance Publique-Hopitaux de Paris, Université Paris-Est Créteil, Créteil, France
| | - Catherine Cordonnier
- Department of Haematology, Henri Mondor Hospital, Assistance Publique-Hopitaux de Paris, Université Paris-Est Créteil, Créteil, France
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Ljungman P, de la Camara R, Robin C, Crocchiolo R, Einsele H, Hill JA, Hubacek P, Navarro D, Cordonnier C, Ward KN. Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis 2019; 19:e260-e272. [PMID: 31153807 DOI: 10.1016/s1473-3099(19)30107-0] [Citation(s) in RCA: 244] [Impact Index Per Article: 48.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 01/05/2019] [Accepted: 03/05/2019] [Indexed: 12/11/2022]
Abstract
Cytomegalovirus is one of the most important infections to occur after allogeneic haematopoietic stem cell transplantation (HSCT), and an increasing number of reports indicate that cytomegalovirus is also a potentially important pathogen in patients treated with recently introduced drugs for hematological malignancies. Expert recommendations have been produced by the 2017 European Conference on Infections in Leukaemia (ECIL 7) after a review of the literature on the diagnosis and management of cytomegalovirus in patients after HSCT and in patients receiving other types of therapy for haematological malignancies. These recommendations cover diagnosis, preventive strategies such as prophylaxis and pre-emptive therapy, and management of cytomegalovirus disease. Antiviral drugs including maribavir and letermovir are in development and prospective clinical trials have recently been completed. However, management of patients with resistant or refractory cytomegalovirus infection or cytomegalovirus disease is a challenge. In this Review we summarise the reviewed literature and the recommendations of the ECIL 7 for management of cytomegalovirus in patients with haematological malignancies.
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Affiliation(s)
- Per Ljungman
- Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, and Division of Hematology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
| | | | - Christine Robin
- Assistance Publique-Hopitaux de Paris, Department of Hematology, Henri Mondor Hospital and Université Paris-Est Créteil, Créteil, France
| | - Roberto Crocchiolo
- Servizio Immunoematologia e Medicina Trasfusionale, Azienda Socio Sanitaria Territoriale di Bergamo Ovest, Treviglio, Italy
| | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, Julius Maximilians Universitaet, Würzburg, Germany
| | - Joshua A Hill
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Petr Hubacek
- Department of Medical Microbiology and Department of Paediatric Haematology and Oncology, Second Faculty of Medicine of Motol University Hospital and Charles University, Prague, Czech Republic
| | - David Navarro
- Microbiology Service, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain
| | - Catherine Cordonnier
- Assistance Publique-Hopitaux de Paris, Department of Hematology, Henri Mondor Hospital and Université Paris-Est Créteil, Créteil, France
| | - Katherine N Ward
- Division of Infection and Immunity, University College London, London, UK
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Artignan B, Martignac B, Robin C, Marty-Enguehard C, du Couedic L, Trehony A, L’Heveder C, Lestang E, Maugin E, Guerzider P. Pleurésie amyloïde révélatrice d’une amylose généralisée. Rev Mal Respir 2019. [DOI: 10.1016/j.rmr.2019.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Song SV, Anderson C, Good RT, Leslie S, Wu Y, Oakeshott JG, Robin C. Population differentiation between Australian and Chinese Helicoverpa armigera occurs in distinct blocks on the Z-chromosome. Bull Entomol Res 2018; 108:817-830. [PMID: 29397798 DOI: 10.1017/s0007485318000081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Over the last 40 years, many types of population genetic markers have been used to assess the population structure of the pest moth species Helicoverpa armigera. While this species is highly vagile, there is evidence of inter-continental population structure. Here, we examine Z-chromosome molecular markers within and between Chinese and Australian populations. Using 1352 polymorphic sites from 40 Z-linked loci, we compared two Chinese populations of moths separated by 700 km and found virtually no population structure (n = 41 and n = 54, with <1% of variation discriminating between populations). The levels of nucleotide diversity within these populations were consistent with previous estimates from introns in Z-linked genes of Australian samples (π = 0.028 vs. 0.03). Furthermore, all loci surveyed in these Chinese populations showed a skew toward rare variants, with ten loci having a significant Tajima's D statistic, suggesting that this species could have undergone a population expansion. Eight of the 40 loci had been examined in a previous study of Australian moths, of which six revealed very little inter-continental population structure. However, the two markers associated with the Cyp303a1 locus that has previously been proposed to be a target of a selective sweep, exhibited allele structuring between countries. Using a separate dataset of 19 Australian and four Chinese moths, we scanned the molecular variation distributed across the entire Z-chromosome and found distinct blocks of differentiation that include the region containing Cyp303a1. We recommend some of these loci join those associated with insecticide resistance to form a set of genes best suited to analyzing population structure in this global pest.
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Affiliation(s)
- S V Song
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - C Anderson
- MRC Human Genetics Unit,MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital,Edinburgh,UK
| | - R T Good
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - S Leslie
- School of Biosciences, University of Melbourne,Victoria,Australia
| | - Y Wu
- College of Plant Protection, Nanjing Agricultural University,Nanjing,China
| | - J G Oakeshott
- Land and Water Flagship,Commonwealth Scientific and Industrial Research Organisation,Australian Capital Territory,Australia
| | - C Robin
- School of Biosciences, University of Melbourne,Victoria,Australia
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Deudon M, Martignac B, Robin C, Marty-Enguehard C, Du Couedic L, Trehony A, Graveleau J, L’Heveder C. Une microangiopathie révélatrice d’une néoplasie pulmonaire. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2018.05.006] [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: 10/14/2022]
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Robin C, Lê MP, Melica G, Massias L, Redjoul R, Khoudour N, Leclerc M, Beckerich F, Maury S, Hulin A, Cordonnier C. Plasma concentrations of atovaquone given to immunocompromised patients to prevent Pneumocystis jirovecii. J Antimicrob Chemother 2018. [PMID: 28651341 DOI: 10.1093/jac/dkx198] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objectives Atovaquone is one of the alternatives to trimethoprim/sulfamethoxazole for prophylaxis of Pneumocystis jirovecii pneumonia (PCP) in immunocompromised patients. In volunteers, there was wide inter-individual variability in atovaquone bioavailability. The aim of this study was to assess the plasma concentrations of atovaquone in immunocompromised patients under PCP prophylaxis. Methods Adult haematology or HIV-positive patients receiving atovaquone (750 mg oral suspension twice a day) for PCP prophylaxis were included. Plasma concentrations were assessed using UV-HPLC, around 12 h after the evening dose (Cmin) and 1-5 h after the morning dose (Cmax). Results A total of 82 measurements were performed in 33 patients. This included 19 HSCT recipients, 7 haematology non-transplant patients and 7 HIV-positive patients. The median Cmin (IQR) was 11.3 μg/mL (6.2-27.8) and the median Cmax was 13.4 μg/mL (6.0-28.3). The Cmin and Cmax of atovaquone were not different between HIV-negative and HIV-positive patients, or between HSCT and non-HSCT patients. Atovaquone concentrations were not influenced by the co-administration of valaciclovir (n = 20) or ciclosporin (n = 11), by gut graft-versus-host disease (n = 7) or by the intake of atovaquone with food. Nineteen of the 33 (58%) patients had Cmin <15 μg/mL, a threshold associated with a low rate of clinical response in PCP treatment. Conclusions Atovaquone is poorly absorbed in more than half of immunocompromised patients and its bioavailability varies between individuals. These unpredictable variations raise the question of therapeutic drug monitoring, in order to identify patients with low concentrations and those who could benefit from regimen adaptation or from alternatives.
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Affiliation(s)
- Christine Robin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Minh Patrick Lê
- APHP, Bichat-Claude Bernard Teaching Hospital, Pharmacology Laboratory, Paris, France.,IAME, Inserm UMR1137, Université Paris Diderot-Sorbonne Paris Cité, Paris, France
| | - Giovanna Melica
- AP-HP, Henri Mondor Teaching Hospital, Department of Clinical Immunology, Créteil, France
| | - Laurent Massias
- APHP, Bichat-Claude Bernard Teaching Hospital, Pharmacology Laboratory, Paris, France.,IAME, Inserm UMR1137, Université Paris Diderot-Sorbonne Paris Cité, Paris, France
| | - Rabah Redjoul
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France
| | - Nihel Khoudour
- AP-HP, Henri Mondor Teaching Hospital, Department of Pharmacology, Créteil, France
| | - Mathieu Leclerc
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Florence Beckerich
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Sébastien Maury
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
| | - Anne Hulin
- AP-HP, Henri Mondor Teaching Hospital, Department of Pharmacology, Créteil, France
| | - Catherine Cordonnier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Henri Mondor Teaching Hospital, Department of Haematology, Créteil, France.,University Paris-Est Créteil (UPEC), Créteil, France
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Garban F, Guyard A, Labussière H, Bulabois CE, Marchand T, Mounier C, Caillot D, Bay JO, Coiteux V, Schmidt-Tanguy A, Le Niger C, Robin C, Ladaique P, Lapusan S, Deconinck E, Rolland C, Foote AM, François A, Jacquot C, Tardivel R, Tiberghien P, Bosson JL. Comparison of the Hemostatic Efficacy of Pathogen-Reduced Platelets vs Untreated Platelets in Patients With Thrombocytopenia and Malignant Hematologic Diseases: A Randomized Clinical Trial. JAMA Oncol 2018; 4:468-475. [PMID: 29392283 PMCID: PMC5885167 DOI: 10.1001/jamaoncol.2017.5123] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [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: 09/08/2017] [Accepted: 11/09/2017] [Indexed: 01/10/2023]
Abstract
IMPORTANCE Pathogen reduction of platelet concentrates may reduce transfusion-transmitted infections but is associated with qualitative impairment, which could have clinical significance with regard to platelet hemostatic capacity. OBJECTIVE To compare the effectiveness of platelets in additive solution treated with amotosalen-UV-A vs untreated platelets in plasma or in additive solution in patients with thrombocytopenia and hematologic malignancies. DESIGN, SETTING, AND PARTICIPANTS The Evaluation of the Efficacy of Platelets Treated With Pathogen Reduction Process (EFFIPAP) study was a randomized, noninferiority, 3-arm clinical trial performed from May 16, 2013, through January 21, 2016, at 13 French tertiary university hospitals. Clinical signs of bleeding were assessed daily until the end of aplasia, transfer to another department, need for a specific platelet product, or 30 days after enrollment. Consecutive adult patients with bone marrow aplasia, expected hospital stay of more than 10 days, and expected need of platelet transfusions were included. INTERVENTIONS At least 1 transfusion of platelets in additive solution with amotosalen-UV-A treatment, in plasma, or in additive solution. MAIN OUTCOMES AND MEASURES The proportion of patients with grade 2 or higher bleeding as defined by World Health Organization criteria. RESULTS Among 790 evaluable patients (mean [SD] age, 55 [13.4] years; 458 men [58.0%]), the primary end point was observed in 126 receiving pathogen-reduced platelets in additive solution (47.9%; 95% CI, 41.9%-54.0%), 114 receiving platelets in plasma (43.5%; 95% CI, 37.5%-49.5%), and 120 receiving platelets in additive solution (45.3%; 95% CI, 39.3%-51.3%). With a per-protocol population with a prespecified margin of 12.5%, noninferiority was not achieved when pathogen-reduced platelets in additive solution were compared with platelets in plasma (4.4%; 95% CI, -4.1% to 12.9%) but was achieved when the pathogen-reduced platelets were compared with platelets in additive solution (2.6%; 95% CI, -5.9% to 11.1%). The proportion of patients with grade 3 or 4 bleeding was not different among treatment arms. CONCLUSIONS AND RELEVANCE Although the hemostatic efficacy of pathogen-reduced platelets in thrombopenic patients with hematologic malignancies was noninferior to platelets in additive solution, such noninferiority was not achieved when comparing pathogen-reduced platelets with platelets in plasma. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01789762.
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Affiliation(s)
- Frédéric Garban
- University Grenoble Alpes, Centre National de Recherche Scientifique, Techniques de l'Ingénierie Médicale et de la Complexité–Institut Mathématiques Appliquées de Grenoble 38000, Grenoble, France
- Service d’Hématologie, Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
- Etablissement Français du Sang, Grenoble, France
| | - Audrey Guyard
- Centre d’Investigation Clinique 1406–Innovation Technologique, Institut national de la santé et de la recherche médicale, Grenoble, France
- Service de Biostatistiques, Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - Helene Labussière
- Service d’Hématologie, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Claude-Eric Bulabois
- University Grenoble Alpes, Centre National de Recherche Scientifique, Techniques de l'Ingénierie Médicale et de la Complexité–Institut Mathématiques Appliquées de Grenoble 38000, Grenoble, France
- Service d’Hématologie, Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - Tony Marchand
- Service d’Hématologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Christiane Mounier
- Service d’Hématologie, Institut de Cancérologie Lucien Neuwirth, Saint-Priest-en-Jarez, France
| | - Denis Caillot
- Service d’Hématologie, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Jacques-Olivier Bay
- Service d’Hématologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valérie Coiteux
- Service d’Hématologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Aline Schmidt-Tanguy
- Service d’Hématologie, Centre Hospitalier Universitaire d’Angers, Angers, France
| | - Catherine Le Niger
- Service d’Hématologie, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Christine Robin
- Service d’Hématologie, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Créteil, France
| | - Patrick Ladaique
- Service d’Hématologie, Institut Paoli Calmettes, Marseille, France
| | - Simona Lapusan
- Service d’Hématologie, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Eric Deconinck
- Service d’Hématologie, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Carole Rolland
- University Grenoble Alpes, Centre National de Recherche Scientifique, Techniques de l'Ingénierie Médicale et de la Complexité–Institut Mathématiques Appliquées de Grenoble 38000, Grenoble, France
| | - Alison M. Foote
- Cellule Publication, Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
| | - Anne François
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Chantal Jacquot
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - René Tardivel
- Etablissement Français du Sang, La Plaine Saint-Denis, France
- Etablissement Français du Sang, Rennes, France
| | - Pierre Tiberghien
- Etablissement Français du Sang, La Plaine Saint-Denis, France
- Unité mixte de recherche 1098, Institut national de la santé et de la recherche médicale, Université de Franche-Comté, Etablissement Français du Sang, Besançon, France
| | - Jean-Luc Bosson
- University Grenoble Alpes, Centre National de Recherche Scientifique, Techniques de l'Ingénierie Médicale et de la Complexité–Institut Mathématiques Appliquées de Grenoble 38000, Grenoble, France
- Centre d’Investigation Clinique 1406–Innovation Technologique, Institut national de la santé et de la recherche médicale, Grenoble, France
- Service de Biostatistiques, Centre Hospitalier Universitaire de Grenoble Alpes, Grenoble, France
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Robin C, Hémery F, Dindorf C, Thillard J, Cabanne L, Redjoul R, Beckerich F, Rodriguez C, Pautas C, Toma A, Maury S, Durand-Zaleski I, Cordonnier C. Economic burden of preemptive treatment of CMV infection after allogeneic stem cell transplantation: a retrospective study of 208 consecutive patients. BMC Infect Dis 2017; 17:747. [PMID: 29207952 PMCID: PMC5717816 DOI: 10.1186/s12879-017-2854-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cytomegalovirus (CMV) infection and disease (CMV episodes) are global concerns after allogeneic hematopoietic stem cell transplantation (HSCT). They affect survival, both by direct and indirect effects. Due to safety issues of current anti-CMV antivirals, long-term CMV prophylaxis is poorly tolerated and the most common strategy to decrease the incidence of CMV disease is preemptive. New, less toxic, molecules are currently being assessed for CMV prophylaxis which should replace or considerably decrease the preemptive approach. The aim of this study was to assess the economic burden of CMV episodes after HSCT with a preemptive approach. METHODS We analyzed data from 208 consecutive adults transplanted in our institution, between 2008 and 2013. Hospital resource utilization was retrieved via the linked hospital admissions and Diagnostic Related Groups for the period of conditioning to 12 months after transplant. RESULTS CMV episodes occurred in 70 patients (34%) over the first 12 months following HSCT, after a mean of 75 days (median: 46 (7-334)). The mean total length of stay was significantly associated with the occurrence of a CMV episode (113.9 vs. 87.5 days, p = 0.0002) but was associated neither with the pre-transplant CMV serology of donors/recipients nor with survival. The mean cost of transplant was €104,016 (SD = €37,281) after 12 months. Bivariate and multivariate analyses indicated that the occurrence of >1 CMV episode increased the costs of allogeneic HSCT by 25-30% (p < 0.0001). CONCLUSION Our study, which is the largest, single-institution cost study of allogeneic HSCT in Europe, shows that two or more CMV episodes significantly increased the transplant cost. New prophylactic strategies to prevent CMV infection and disease should decrease transplant costs.
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Affiliation(s)
- Christine Robin
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France.,University Paris-Est Créteil (UPEC), 94000, Créteil, France
| | - François Hémery
- Department of Medical Information, APHP, Henri Mondor Teaching Hospital, Créteil, France
| | | | | | - Ludovic Cabanne
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France
| | - Rabah Redjoul
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France
| | - Florence Beckerich
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France.,University Paris-Est Créteil (UPEC), 94000, Créteil, France
| | - Christophe Rodriguez
- University Paris-Est Créteil (UPEC), 94000, Créteil, France.,Department of Virology, and INSERM U955 Team 18, APHP, Henri Mondor Teaching Hospital, 94000, Créteil, France
| | - Cécile Pautas
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France
| | - Andrea Toma
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France
| | - Sébastien Maury
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France.,University Paris-Est Créteil (UPEC), 94000, Créteil, France
| | - Isabelle Durand-Zaleski
- University Paris-Est Créteil (UPEC), 94000, Créteil, France.,Department of Public Health, APHP, Henri Mondor Teaching Hospital, 94000-, Créteil, France
| | - Catherine Cordonnier
- Department of Hematology, Assistance Publique-Hopitaux de Paris (APHP), Henri Mondor Teaching Hospital, 94010, Créteil, France. .,University Paris-Est Créteil (UPEC), 94000, Créteil, France.
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Sicre de Fontbrune F, Arnaud C, Cheminant M, Boulay A, Konopacki J, Lapusan S, Robin C, Bernaudin F, Suarez F, Simon F, Socié G, Colin de Verdière N, Consigny PH. Immunogenicity and Safety of Yellow Fever Vaccine in Allogeneic Hematopoietic Stem Cell Transplant Recipients After Withdrawal of Immunosuppressive Therapy. J Infect Dis 2017; 217:494-497. [DOI: 10.1093/infdis/jix564] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/25/2017] [Indexed: 11/14/2022] Open
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46
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Robin C, Héquette-Ruz R, Guery B, Boyle E, Herbaux C, Galperine T. Treating Clostridium difficile infection in patients presenting with hematological malignancies: Are current guidelines applicable? Med Mal Infect 2017; 47:532-539. [PMID: 28823390 DOI: 10.1016/j.medmal.2017.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 11/15/2016] [Accepted: 07/10/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Adults with hematological malignancies are at high-risk of Clostridium difficile infection (CDI), but no guidelines for CDI treatment are available in this population. Our primary objective was to evaluate the clinical outcomes in CDI patients with hematological malignancies. Our secondary objectives were to describe CDI severity using the main clinical guidelines and to evaluate the compliance of treatment choice with published guidelines. PATIENTS AND METHODS Single-center, retrospective, observational case series including every consecutive adult patient with a confirmed diagnosis of CDI admitted in the hematology unit of our teaching hospital. Each CDI episode was classified as moderate, severe, or complicated according to the main clinical guidelines (IDSA 2010, AJG 2013, ESCMID 2014). RESULTS Twenty-three episodes of CDI in 19 patients admitted to the hematology unit occurred between June 2012 and October 2013. Clinical cure was achieved for 20 episodes (87%). Ten weeks after diagnosis, global cure was reached for 14 episodes (61%) whereas recurrence occurred in two episodes (10%). The mortality rate reached 37% (7/19) but the attributable mortality rate was 5% (1/19). ESCMID criteria more frequently classified patients in the severe category compared with the two other classifications. Prescription compliance with clinical guidelines was observed in 61% of episodes with IDSA criteria, 43% with AJG, and 9% with ESCMID. CONCLUSIONS IDSA and AJG assessment may underestimate the potential risk of unfavorable clinical outcome. Further prospective studies on a larger cohort are needed to develop adequate treatment guidelines for CDI in hematology settings.
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Affiliation(s)
- C Robin
- Department of Hematology, Henri-Mondor Teaching Hospital, University Paris-Est Créteil (UPEC), Assistance publique-Hôpitaux de Paris (AP-HP), 94000 Créteil, France; University Paris-Est Créteil (UPEC), 94000 Créteil, France
| | - R Héquette-Ruz
- Department of Infectious Diseases, CHU de Lille, 59000 Lille, France
| | - B Guery
- Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - E Boyle
- Department of Hematology, CHU de Lille, 59000 Lille, France
| | - C Herbaux
- Department of Hematology, CHU de Lille, 59000 Lille, France
| | - T Galperine
- Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
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47
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Pearce SL, Clarke DF, East PD, Elfekih S, Gordon KHJ, Jermiin LS, McGaughran A, Oakeshott JG, Papanicolaou A, Perera OP, Rane RV, Richards S, Tay WT, Walsh TK, Anderson A, Anderson CJ, Asgari S, Board PG, Bretschneider A, Campbell PM, Chertemps T, Christeller JT, Coppin CW, Downes SJ, Duan G, Farnsworth CA, Good RT, Han LB, Han YC, Hatje K, Horne I, Huang YP, Hughes DST, Jacquin-Joly E, James W, Jhangiani S, Kollmar M, Kuwar SS, Li S, Liu NY, Maibeche MT, Miller JR, Montagne N, Perry T, Qu J, Song SV, Sutton GG, Vogel H, Walenz BP, Xu W, Zhang HJ, Zou Z, Batterham P, Edwards OR, Feyereisen R, Gibbs RA, Heckel DG, McGrath A, Robin C, Scherer SE, Worley KC, Wu YD. Erratum to: Genomic innovations, transcriptional plasticity and gene loss underlying the evolution and divergence of two highly polyphagous and invasive Helicoverpa pest species. BMC Biol 2017; 15:69. [PMID: 28810920 PMCID: PMC5557573 DOI: 10.1186/s12915-017-0413-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 08/07/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- S L Pearce
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - D F Clarke
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - P D East
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - S Elfekih
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - K H J Gordon
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.
| | - L S Jermiin
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - A McGaughran
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - J G Oakeshott
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.
| | - A Papanicolaou
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,Hawksbury Institute for the Environment, Western Sydney University, Penrith, NSW, Australia
| | - O P Perera
- Southern Insect Management Research Unit, USDA-ARS, Stoneville, MS, USA
| | - R V Rane
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - S Richards
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.
| | - W T Tay
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - T K Walsh
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - A Anderson
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - C J Anderson
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,Biological and Environmental Sciences, University of Stirling, Stirling, UK
| | - S Asgari
- School of Biological Sciences, University of Queensland, Brisbane St Lucia, QLD, Australia
| | - P G Board
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | | | - P M Campbell
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - T Chertemps
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France.,National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | | | - C W Coppin
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | | | - G Duan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - C A Farnsworth
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - R T Good
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - L B Han
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Y C Han
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu, China
| | - K Hatje
- Max Planck Institute for Biophysical Chemistry, Gottingen, Germany
| | - I Horne
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - Y P Huang
- Institute of Plant Physiology and Ecology, Shanghai Institutes of Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - D S T Hughes
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - E Jacquin-Joly
- National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | - W James
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - S Jhangiani
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - M Kollmar
- Max Planck Institute for Biophysical Chemistry, Gottingen, Germany
| | - S S Kuwar
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - S Li
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - N-Y Liu
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, Southwest Forestry University, Kunming, 650224, China
| | - M T Maibeche
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France.,National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | - J R Miller
- J. Craig Venter Institute, Rockville, MD, USA
| | - N Montagne
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France
| | - T Perry
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - J Qu
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - S V Song
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - G G Sutton
- J. Craig Venter Institute, Rockville, MD, USA
| | - H Vogel
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - B P Walenz
- J. Craig Venter Institute, Rockville, MD, USA
| | - W Xu
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - H-J Zhang
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.,Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing, 400016, China
| | - Z Zou
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - P Batterham
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | | | - R Feyereisen
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej, Denmark
| | - R A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - D G Heckel
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - A McGrath
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - C Robin
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - S E Scherer
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - K C Worley
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Y D Wu
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu, China
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48
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Pearce SL, Clarke DF, East PD, Elfekih S, Gordon KHJ, Jermiin LS, McGaughran A, Oakeshott JG, Papanicolaou A, Perera OP, Rane RV, Richards S, Tay WT, Walsh TK, Anderson A, Anderson CJ, Asgari S, Board PG, Bretschneider A, Campbell PM, Chertemps T, Christeller JT, Coppin CW, Downes SJ, Duan G, Farnsworth CA, Good RT, Han LB, Han YC, Hatje K, Horne I, Huang YP, Hughes DST, Jacquin-Joly E, James W, Jhangiani S, Kollmar M, Kuwar SS, Li S, Liu NY, Maibeche MT, Miller JR, Montagne N, Perry T, Qu J, Song SV, Sutton GG, Vogel H, Walenz BP, Xu W, Zhang HJ, Zou Z, Batterham P, Edwards OR, Feyereisen R, Gibbs RA, Heckel DG, McGrath A, Robin C, Scherer SE, Worley KC, Wu YD. Genomic innovations, transcriptional plasticity and gene loss underlying the evolution and divergence of two highly polyphagous and invasive Helicoverpa pest species. BMC Biol 2017; 15:63. [PMID: 28756777 PMCID: PMC5535293 DOI: 10.1186/s12915-017-0402-6] [Citation(s) in RCA: 178] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/04/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Helicoverpa armigera and Helicoverpa zea are major caterpillar pests of Old and New World agriculture, respectively. Both, particularly H. armigera, are extremely polyphagous, and H. armigera has developed resistance to many insecticides. Here we use comparative genomics, transcriptomics and resequencing to elucidate the genetic basis for their properties as pests. RESULTS We find that, prior to their divergence about 1.5 Mya, the H. armigera/H. zea lineage had accumulated up to more than 100 more members of specific detoxification and digestion gene families and more than 100 extra gustatory receptor genes, compared to other lepidopterans with narrower host ranges. The two genomes remain very similar in gene content and order, but H. armigera is more polymorphic overall, and H. zea has lost several detoxification genes, as well as about 50 gustatory receptor genes. It also lacks certain genes and alleles conferring insecticide resistance found in H. armigera. Non-synonymous sites in the expanded gene families above are rapidly diverging, both between paralogues and between orthologues in the two species. Whole genome transcriptomic analyses of H. armigera larvae show widely divergent responses to different host plants, including responses among many of the duplicated detoxification and digestion genes. CONCLUSIONS The extreme polyphagy of the two heliothines is associated with extensive amplification and neofunctionalisation of genes involved in host finding and use, coupled with versatile transcriptional responses on different hosts. H. armigera's invasion of the Americas in recent years means that hybridisation could generate populations that are both locally adapted and insecticide resistant.
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Affiliation(s)
- S L Pearce
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - D F Clarke
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - P D East
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - S Elfekih
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - K H J Gordon
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.
| | - L S Jermiin
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - A McGaughran
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - J G Oakeshott
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia.
| | - A Papanicolaou
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- Hawksbury Institute for the Environment, Western Sydney University, Penrith, NSW, Australia
| | - O P Perera
- Southern Insect Management Research Unit, USDA-ARS, Stoneville, MS, USA
| | - R V Rane
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - S Richards
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.
| | - W T Tay
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - T K Walsh
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - A Anderson
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - C J Anderson
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- Biological and Environmental Sciences, University of Stirling, Stirling, UK
| | - S Asgari
- School of Biological Sciences, University of Queensland, Brisbane St Lucia, QLD, Australia
| | - P G Board
- John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia
| | | | - P M Campbell
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - T Chertemps
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France
- National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | | | - C W Coppin
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | | | - G Duan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - C A Farnsworth
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - R T Good
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - L B Han
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - Y C Han
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu, China
| | - K Hatje
- Max Planck Institute for Biophysical Chemistry, Gottingen, Germany
| | - I Horne
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - Y P Huang
- Institute of Plant Physiology and Ecology, Shanghai Institutes of Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - D S T Hughes
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - E Jacquin-Joly
- National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | - W James
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - S Jhangiani
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - M Kollmar
- Max Planck Institute for Biophysical Chemistry, Gottingen, Germany
| | - S S Kuwar
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - S Li
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - N-Y Liu
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- Key Laboratory of Forest Disaster Warning and Control of Yunnan Province, Southwest Forestry University, Kunming, 650224, China
| | - M T Maibeche
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France
- National Institute for Agricultural Research (INRA), Institute of Ecology and Environmental Sciences of Paris, Versailles, France
| | - J R Miller
- J. Craig Venter Institute, Rockville, MD, USA
| | - N Montagne
- Sorbonnes Universités, UPMC Université Paris 06, Institute of Ecology and Environmental Sciences of Paris, Paris, France
| | - T Perry
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - J Qu
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - S V Song
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - G G Sutton
- J. Craig Venter Institute, Rockville, MD, USA
| | - H Vogel
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - B P Walenz
- J. Craig Venter Institute, Rockville, MD, USA
| | - W Xu
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - H-J Zhang
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, Chongqing Medical University, Chongqing, 400016, China
| | - Z Zou
- State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China
| | - P Batterham
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | | | - R Feyereisen
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej, Denmark
| | - R A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - D G Heckel
- Max Planck Institute of Chemical Ecology, Jena, Germany
| | - A McGrath
- CSIRO Black Mountain, GPO Box 1700, Canberra, ACT, 2600, Australia
| | - C Robin
- School of Biological Sciences, University of Melbourne, Parkville, Vic, Australia
| | - S E Scherer
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - K C Worley
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Y D Wu
- College of Plant Protection, Nanjing Agricultural University, Nanjing, Jiangsu, China
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49
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Scott M, Zegers RGT, Almus R, Austin SM, Bazin D, Brown BA, Campbell C, Gade A, Bowry M, Galès S, Garg U, Harakeh MN, Kwan E, Langer C, Loelius C, Lipschutz S, Litvinova E, Lunderberg E, Morse C, Noji S, Perdikakis G, Redpath T, Robin C, Sakai H, Sasamoto Y, Sasano M, Sullivan C, Tostevin JA, Uesaka T, Weisshaar D. Observation of the Isovector Giant Monopole Resonance via the ^{28}Si(^{10}Be,^{10}B^{*}[1.74 MeV]) Reaction at 100 AMeV. Phys Rev Lett 2017; 118:172501. [PMID: 28498679 DOI: 10.1103/physrevlett.118.172501] [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] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Indexed: 06/07/2023]
Abstract
The (^{10}Be,^{10}B^{*}[1.74 MeV]) charge-exchange reaction at 100 AMeV is presented as a new probe for isolating the isovector (ΔT=1) nonspin-transfer (ΔS=0) response of nuclei, with ^{28}Si being the first nucleus studied. By using a secondary ^{10}Be beam produced by fast fragmentation of ^{18}O nuclei at the NSCL Coupled Cyclotron Facility, applying the dispersion-matching technique with the S800 magnetic spectrometer to determine the excitation energy in ^{28}Al, and performing high-resolution γ-ray tracking with the Gamma-Ray Energy Tracking In-beam Nuclear Array (GRETINA) to identify the 1022-keV γ ray associated with the decay from the 1.74-MeV T=1 isobaric analog state in ^{10}B, a ΔS=0 excitation-energy spectrum in ^{28}Al was extracted. Monopole and dipole contributions were determined through a multipole-decomposition analysis, and the isovector giant dipole resonance and isovector giant monopole resonance (IVGMR) were identified. The results show that this probe is a powerful tool for studying the elusive IVGMR, which is of interest for performing stringent tests of modern density functional theories at high excitation energies and for constraining the bulk properties of nuclei and nuclear matter. The extracted distributions were compared with theoretical calculations based on the normal-modes formalism and the proton-neutron relativistic time-blocking approximation. Calculated cross sections based on these strengths underestimate the data by about a factor of 2, which likely indicates deficiencies in the reaction calculations based on the distorted wave Born approximation.
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Affiliation(s)
- M Scott
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R G T Zegers
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - R Almus
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - Sam M Austin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - B A Brown
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Campbell
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Bowry
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Galès
- IPN Orsay, CNRS-IN2P3, Université Paris-Sud, Université Paris-Saclay, 91406 Orsay Cedex, France
- Horia Hulubei National Institute of Physics and Nuclear Engineering, P.O. Box MG6, Bucharest, Romania
| | - U Garg
- Department of Physics, University of Notre Dame, Notre Dame, Indiana 46556, USA
| | - M N Harakeh
- Kernfysisch Versneller Instituut-Center for Advanced Radiation Technology, University of Groningen, Groningen, 9747 AA, Netherlands
| | - E Kwan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Langer
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Loelius
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Lipschutz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - E Litvinova
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008-5252, USA
| | - E Lunderberg
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - C Morse
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - S Noji
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
| | - G Perdikakis
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - T Redpath
- Department of Physics, Central Michigan University, Mount Pleasant, Michigan 48859, USA
| | - C Robin
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, Western Michigan University, Kalamazoo, Michigan 49008-5252, USA
| | - H Sakai
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - Y Sasamoto
- RIKEN, Nishina Center, Wako, 351-0198, Japan
- Center for Nuclear Study, University of Tokyo, RIKEN Campus, Wako, Saitama 351-0198, Japan
| | - M Sasano
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - C Sullivan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - J A Tostevin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics, University of Surrey, Guilford, Surrey GU2 7XH, United Kingdom
| | - T Uesaka
- RIKEN, Nishina Center, Wako, 351-0198, Japan
| | - D Weisshaar
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
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50
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Robin C, Alanio A, Gits-Muselli M, la Martire G, Schlemmer F, Botterel F, Angebault C, Leclerc M, Beckerich F, Redjoul R, Pautas C, Toma A, Maury S, Bretagne S, Cordonnier C. Molecular Demonstration of a Pneumocystis Outbreak in Stem Cell Transplant Patients: Evidence for Transmission in the Daycare Center. Front Microbiol 2017; 8:700. [PMID: 28484441 PMCID: PMC5401873 DOI: 10.3389/fmicb.2017.00700] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 04/05/2017] [Indexed: 12/24/2022] Open
Abstract
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in hematology. Although occasionally reported, the role of interhuman transmission of P. jirovecii in PCP, compared to that of reactivation, remains an unresolved question; the recommendation to isolate PCP patients in the hematology ward are not well evidence-based. Following an unexpected increase in the number of febrile pneumonia patients with P. jirovecii DNA detected in respiratory samples in our hematology ward, we explored 12 consecutive patients from November 2015 to May 2016. Genotyping of P jirovecii was performed using microsatellite markers. The frequency of simultaneous occupancy of these 12 patients in the same unit on the same day from 4 months prior to the first diagnosis was recorded. In three patients, the P. jirovecii genotype could not be determined because DNA was insufficient. One rare single genotype (Gt2) was found in four of the other nine, all allogeneic stem cell transplant recipients. The transmission map showed that these 4 patients had multiple opportunities to meet on the same day (median, 6.5; range, 4–10) at the daycare center. It was much less among the eight non-Gt2 patients (median, 1; range, 0–9; P = 0.048). This study, based on modern molecular technics, strongly suggests that interhuman transmission of P. jirovecii between allogeneic stem cell transplant recipients is possible. P. jirovecii DNA detected in respiratory specimens supports that isolation and respiratory precautions be recommended in such cases in the hematology ward.
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Affiliation(s)
- Christine Robin
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Alexandre Alanio
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France.,Molecular Mycology Unit, National Reference Center of Invasive Mycosis and Antifungals, Centre National de la Recherche Scientifique, Institut Pasteur, URA3012Paris, France
| | - Maud Gits-Muselli
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France
| | - Giulia la Martire
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Frédéric Schlemmer
- Paris-Est Créteil UniversityCréteil, France.,Unit of Pneumology, Intensive Care Department, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching Hospital, DHU A-TVBCréteil, France
| | - Françoise Botterel
- Paris-Est Créteil UniversityCréteil, France.,Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Cécile Angebault
- Paris-Est Créteil UniversityCréteil, France.,Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Mathieu Leclerc
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Florence Beckerich
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Rabah Redjoul
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Cécile Pautas
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Andrea Toma
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France
| | - Sébastien Maury
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
| | - Stéphane Bretagne
- Parasitology-Mycology Laboratory, Assistance Publique-Hôpitaux de Paris, Lariboisière Saint-Louis Fernand Widal HospitalParis, France.,Paris-Diderot, Sorbonne Paris Cité UniversityParis, France.,Molecular Mycology Unit, National Reference Center of Invasive Mycosis and Antifungals, Centre National de la Recherche Scientifique, Institut Pasteur, URA3012Paris, France
| | - Catherine Cordonnier
- Department of Hematology, Assistance Publique-Hôpitaux de Paris, Henri Mondor Teaching HospitalCréteil, France.,Paris-Est Créteil UniversityCréteil, France
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